The self-portrayal of the electronic diagnosis makers in the internet seems unambiguous: "On our website you are able to get an assessment of your disease or medical condition 24 hours a day and 7 days a week", informs the site of MEDoctor, available in different languages and not forgetting to point out the colourable value of benefit: "You can save your personal, electronic medical file and get back to it later. You will find indication material which will help you to have a better understanding of your condition".
System failed in the DocCheck practical test – because registration was not possible
On first glance, the self-made diagnostician on the other end of the web line also understands the financial side of the principle: "If your membership is sponsored by your health insurance, your healthcare supplier or your employer, please click "Register here" and follow steps 1, 2 and 3". And if – as regular in many countries – the own health insurance company does not offer such support, the Americans have a plan B at hand: "If you do not have a sponsor, you can get registered for US$ 19.95 (21.95 Euro) per month or for a full year for US$ 99.95 (109.95 Euro). Just click "Register here" and continue the credit card process".
Whoever – like the author of this article – puts his innocent hopes on the blessings of American eMedicine has to first of all overcome considerable technical obstacles. Even the registration in German proves to be a challenge: The entry of user name and password grasps at nothing time and again. Hence, the patient should have a telephone at hand – or go straight to a real physician. The English version fails the test as well which proves: The site is not suitable for everyday life. Because a patient suffering from respiratory distress, cardiac problems or whose face is turning blue, does not want to be bothered with the tricks and pitfalls of the internet diagnosis tools. Exactly that is how MEDoctor wants to declare the advantages of the system in a presentation.
At least the principle of the software reveals itself to the logic of the user: By use of ready standard questions the electronic system makes an anamnesis. At the end of the catalogue of questions stands a "pre-diagnosis" – for legal reasons and due to existing physician's liability law, the operators cannot and will not call the output of the system anything else. On the other hand: MEDoctor offers, together with the pre-diagnosis, the electronic filing of patient data – the electronic patient file seems to buzz somewhere out there in the wide spaces of the internet.
Just a hoax?
Not really, but if a physician is trying to understand the rather bumpy foray of the Americans, he has to take a closer look at the nitty-gritty: Services such as MEDoctor are just a small piece of the jigsaw – the entire picture of tomorrow's networking electronic medicine.
The World Health Organization WHO itself placed the cornerstone for the web offensive in the health sector. Already in May 2005, the professionals passed the so-called eHealth Resolution (WHA 58.28) – basically claiming "eHealth for everybody until 2015".
Indeed, analysts assume that the use of IT will revolutionize medicine. The company consultants Frost & Sullivan for example are expecting a real boom on the Europe market of clinical information systems (KIS). Here the turnover volume of the entire market of IT systems for the medical and the administration sector of hospitals will more than double from 3,131 billion US-Dollars in 2003 to 6,343 billion US-Dollars in 2010. The clinical segment should grow by 12.3 percent per year until 2010. "The reasons for this field offering the largest chances for growth are based on the increasing efforts in healthcare to increase quality, improve clinical processes and achieve urgently necessary reductions of costs with the aid of systems supporting medical decisions."
Some of the clinical systems attracting the highest interest are in fact image archiving- and communication systems (PACS), radiology information systems (RIS), electronic medical records (EMR) and computerized physician order entry systems (CPOE). "Within the general development aiming for an integrated healthcare, clinical systems such as the electronic medical record will play an important role for the improvement of continuity of patient care", expects Siddarth Saha, branch analyst at Frost & Sullivan in an according study.
An additional aspect – the growing understanding that treatment mistakes and inefficient proceedings are causing immense costs in medical supply – could, according to Frost & Sullivan, contribute to the market growth as well. Already today the safety of the patient and the security of the data is becoming a large issue – which increases the request for such IT systems helping to avoid mistakes and inefficient proceedings. Today's political setting of course is carrying the e-Health boom of the future. In Great Britain for example, the National Programme for Information Technology (NPfIT) of the National Health Service (NHS) applies. And the e-Health Initiative promoted by the EU-commission are considered to be an important motor for the global trend in the everyday life of hospitals.
Whether those services offered by MEDoctor have a chance, remains to be seen. At least the statistics speak for pre-diagnostics in a self-service format: According to Californian studies, 64 percent of the US emergency hospital cases could be avoided, if the patients learned to evaluate and check the urgency. Only condition for such a breakthrough: Services such as MEDoctor have to be technically available for everybody any time via WWW and to its full extent.