The Internet and Healthcare.

Written for health care executives to keep up to date on ways the Internet is changing health care delivery and how it applies to their organizations, this book is short, readable, and not overly technical. The key premise focuses on the complete restructuring of the health care industry and the new approaches needed to support information exchange at many levels, ranging from local to global. Internet technology is a critical factor in making this occur, but only if it supports organizational goals and is crafted into an appropriate technical architecture. Staying abreast of rapid technological change and knowing how it applies to the health care enterprise comprise the most difficult and challenging tasks in health care management. This book does not focus on technical details, but offers enough detail to suggest how and why the Internet belongs in the business framework of health care organizations. The authors of the book's nine chapters have extensive experience in advising the health care industry about communications and technology. They suggest examples of how the Internet will affect both administrative and clinical tasks; how it impacts communication between and among patients, payors, and providers; and how it can be harnessed into integrated delivery systems. They also identify some key challenges to creating information networks, including security concerns. Every chapter has been updated for this second edition, as indicated by the currency of the references. Two new chapters address physician call centers and use of the Internet from the physician's perspective. This latter chapter is especially relevant. It notes the widespread availability of health information to the public, and correctly asserts that physicians must comprehend the variety of resources available to them and their patients via the Internet. While describing the potential for the physician to access patient care data, payor data, and medical literature over the Internet, the chapter concludes “perhaps the most profound effects of the Internet will be seen in the areas of communication between physicians and patients. Better communication should translate into better care, and better care to better outcomes” (42). This place is the only part of the book that addresses the role of the Internet in enhancing access to medical knowledge. The widespread availability of the National Library of Medicine databases, as well as other commercial and noncommercial health Web sites, is mentioned. The challenge of evaluating the quality of Web sites and the recent emergence of guidelines for that purpose are also noted. Calling attention to the value of librarians in promoting access to quality Web information and teaching both physicians and their patients how to apply quality criteria would have strengthened this discussion. Several chapters deal with planning ways to implement Internet technology in an organization's health care delivery system. The authors offer practical advice: link Internet needs to the business strategy, define expected benefits, ensure adequate underlying infrastructure, and prepare for investments in training. Several models provide additional detail. Missing, however, is any detail about human systems involved in creating and supporting an Internet information strategy. What level and kind of staff are needed? What kind of training and ongoing staff support should be planned? These issues could have been another opportunity to acknowledge the multiple roles medical librarians can play. This book can add to the medical librarian's overall knowledge of ways the Internet affects health care delivery. It is a worthwhile addition to a medical library of any size, as it chronicles where the industry is now and what potential the future holds. Its greatest use would be as an aid to organization-wide information planning.