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Advantages And Disadvantages Of Internet Health Care

Advantages and Disadvantages of Internet Health Care
The internet has become a major contributor to everyday living, from shopping to renting
movies to researching personal health issues. Today, there are thousands of internet
websites that can be used to access health information. Anything from researching and
ordering prescription medications, to learning about illnesses, or even chatting online
with trained physicians can be found via the internet. Although there are many benefits of
internet health care, there are also many problems that can arise from using this
information. So, should health care services be available on the internet? That question
will be answered by discussing the advantages and the disadvantages of internet health
care.
Advantages of Internet Health Care
Over the past couple hundred years, the way that health care is delivered has changed
dramatically due to the building of hospitals, advancements in surgery, and the rise of the
internet. In the past 10 years there has been a major shift in the Health Care industry due
to the rise of internet health care services. Before the internet, if health problems were to
arise in an individual, he/she was generally taken care of in the doctor’s office or by
home remedies. If any questions were to arise about the health of yourself or others, the
expertise of a doctor or nurse was generally needed. However, due to the rise of the
internet, health issues and questions about anything from medications to illnesses can
easily be obtained in a matter of seconds. Also, being able to communicate with doctors
or order prescriptions online has proved to be a huge advantage. In the next few
paragraphs, the advantages of internet health care services and its impact on the health
care industry will be discussed.
Researching Medications Online
The internet has been a huge advantage to the health care industry for many reasons, one
being the use of the internet to research medications. There are thousands of sites on the
internet that contain information on any thing from medications and their uses to finding
out about diseases and their causes. One such website is RXList.com, where hundreds of
medications can be researched. Everything about a drug is listed from what illnesses the
drug treats down to its structural formula. Studies show that 71.5% of people who used
internet health care sites to do research felt more knowledgeable about their illness and
the medications they were taking. (8th HON Survey, Health on the Net Foundation, May-
June 2002, pg. 3)
Researching Illnesses
Other websites such as WebMD.com can be used as a very resourceful web page to
search illnesses. Any question one may have about an illness or disease can be answered.
This access to information is very good for people who do not understand their illness
and its side effects. For instance, when a doctor informs the patient about their illness,
many patients do not understand the doctor’s terminology. With WebMD.com, the
patient is able to do further research about their illness in words and phrases they can
understand. Studies show that 52% of patients who discussed the results of internet
searches with their health care providers found the consultation more constructive. (8th
HON Survey, Health on the Net Foundation, May-June 2002, pg. 4) They were actually
able to communicate with the doctor as well as the doctor being able to communicate
with them. So, the internet can be used to do research on illnesses and medications, but
what about using the internet to communicate with doctors and order prescriptions?
Communicating with Doctors Online
The internet is becoming an important alternative for patients and health care providers to
share information with one another. The patient is now able to email or chat with the
doctor about any questions they may have, as well as the doctor being able to inform the
patient of any new medications or alternative medicine that will help the healing process.
The figure below shows how the internet plays a major role in the delivery of health
care:

Opportunities for the Internet in Healthcare

Clearly, one of the benefits of the internet is its ability to provide real-time
communications with doctors without having to transport patients to and from the
doctor’s office. This also helps with expenses associated with office visits. Of course,
the quality of the services rendered over the internet is a big concern for patients and
doctors at this point in time. One of the key concerns is the possibility of websites giving
out false information on questions asked about the health of a person. This is why only
official, or approved, websites should be used to retrieve health information.
Ordering Prescriptions Online
Another advantage is the use of the internet to order prescriptions or refills on
prescriptions. For instance, if you keep in contact with your doctor via emails, it is a time
saver for the doctor to prescribe medications without the patient having to come into the
office. Also, being able to get on official pharmacies web-sites that patients use to order
refills is a time saver. However, there are websites that illegally sell medications or
counterfeit medications to places around the world. There have been many investigations
focused on private practices in different countries that are making millions selling
medications online without a prescription. That issue will be discussed further in the
paper. Again, although there are advantages for online pharmacies, there are some
websites that problems could arise from. Only official, or approved, websites should be
used to get prescriptions filled. There are many groups now that are trying to take that
step and are pushing hard for healthcare providers to exercise a great deal of caution
when they utilize the internet to render services. There are groups that have set a code of
ethics for internet healthcare providers to follow. Some of these groups are as follows:
the Internet Healthcare Coalition (IHC), which introduced an eHealth Code of Ethics,
American Medical Association, the Health on the Net Foundation (HON), and Health
Internet Ethics (Hi-Ethics). Other groups, such as the American Accreditation HealthCare
Commission (URAC), offer validation programs and seals of approval that let consumers
know specific web sites that follow ethical guidelines. The ethics movement prefers a
self-regulatory approach to building trust and protecting privacy rather than increased
government regulation, which is looming on the horizon as lawmakers focus on internet
privacy abuses. These websites are an advantage to patients wanting to find doctors,
review their profiles, evaluate their abilities, and schedule appointments. Being able to
find the right doctor with credibility makes the patient feel more comfortable and secure.
Internet health care services are a huge advantage for patients and doctors alike. Being
able to look up an illness or medication and learn everything about it not only comforts
the patient and helps them understand what’s wrong with them, it is also good for the
doctor to research and learn more to help treat his patients better. Internet health care
services have also had an impact on health care in general and the way it is carried out. In
my opinion, internet health care services are very beneficial to society. Official health
care sites would not only help the people who need it, the sites would continue to cause
an upward spiral in the health care industry.

Disadvantages of Internet Health Care

Usage by the Elderly
Although health care on the internet may be beneficial in many ways, it also has some
serious drawbacks. A challenge of internet health care is the use of the internet by the
elderly. Medicare participants over the age of 65 are a target group for using health care
on the internet. On the surface, this does not seem to be a problem. But it is. This group
does not use the internet. They generally do not own computers, and definitely do not
utilize the internet. According to a study by the Kaiser Family Foundation,
“today’s elderly are resisting new technology.”(Joseph, Stone, 2005, p. 75)
Nadine Joseph and Brad Stone diagnose the elderly as having “internet phobia”
(2005, 74). This problem is an issue because many aspects of Medicare are easily utilized
using Medicare’s on line website, Medicare.gov.
The internet is used by the government as a means of informing participants of choices
available to them. One of the new options available to Medicare participants is a drug
discount card. Using Medicare’s website is the easiest way to sort through all of the
different cards to find the one that best suits each participant as an individual. According
to the Kaiser Family Foundation, an organization that researched demographics
specifically in the use of the internet, Medicare participants are not using this resource.
The Foundation states that a new way should be implemented. (Joseph, Stone, 2005, p.
74)
The Kaiser Foundation found that less than 31% of citizens over the age of 65 had
attempted to log-on, and only 2% of citizen’s over 65 had accessed Medicare’s
website (Joseph, Stone, 2005, p. 74). Because a large majority of citizens over 65 have to
use Medicare, and many elderly are not getting online, putting Medicare online is not
beneficial. So the easiest way to get the most benefit is by using the website, yet,
participants aren’t doing so. Putting Medicare on the internet is essentially hurting the
elderly. They are not able to enjoy the benefits of the resource, therefore Medicare’s
advantages should be made available through some other means that is more accessible to
the elderly.

Doctor-Patient Relationship
Another reason healthcare on the internet is not good has to do with its effect on doctor-
patient relationships. To demonstrate, here is a hypothetical situation: Cindy uses the
internet to research symptoms she is experiencing. Cindy is able to find an illness that is
supposedly the cause of her symptoms using various websites available to her on the
internet. Cindy then continues to research the prescription drugs that should be used to
cure this illness. After this research is complete, Cindy visits a physician. Many things
could now happen. One situation, Cindy could refuse examination, and instead, insist the
physician prescribe drugs “A,” “B,” and “C,” for the illness,
“XYZ,” she found on the internet during her research. Not to say Cindy is incorrect
about the diagnosis and the drugs needed to treat that illness, but how can a physician
know. He or she must perform the tests necessary to be sure the correct ailment is
diagnosed. This could put a rift in the relationship of this doctor patient for many
different reasons. Cindy could choose to see a different physician, completely eliminating
the existing relationship, or when Cindy refused examination, the physician could
develop a negative feeling toward Cindy.
Another scenario would be the same situation of Cindy researching the internet and
visiting a physician, except Cindy allows the physician to carry on the exams and tests
necessary. After this occurs the physician begins to tell Cindy a completely different
ailment has caused her symptoms than the one she concluded from her own research.
Again, many problems could arise from this situation, as well, mainly the trust Cindy has
in her physician’s knowledge, not to mention the extra difficulty the physician now
faces trying to convince Cindy that what she found online is incorrect. What ever the
reason be, if Cindy begins to question the credibility of her physician, she is likely to
resort to treating herself.
A study done by the Health on the Internet Foundation shows that over half of the health
professionals (67%) agreed that there is a “risk of patient self treatment” (Analysis
of 9th HON Survey, 2005, p.2). The survey also found that 60.4% of health professionals
were concerned about the internet encouraging “patients to challenge a physician’s
medical authority” (Analysis of 9th HON Survey, 2005, p.2).
At least in the above hypothetical situation, Cindy visited a physician. Some would
choose to not do so. Instead these people could choose to deal with the sickness in their
own way. This will result in self-diagnosis, the above mentioned self-treatment, and will
likely lead to misdiagnosis. Such occurrences will only decrease the health of the
population, morbidity rate, and will most certainly begin to effect the death rate, or
mortality rate. Self-diagnosis is likely to happen, and this is not something to be ignored.
The difficulty experienced by the physician in Cindy’s case is another problem
related to internet health care. The physician is forced to prove that he or she is correct,
and the research that Cindy had performed is incorrect. How does Cindy know the
information her doctor provides to her is accurate? Cindy should know this because her
physician is educated, experienced, licensed, and certified. How can she know the
information she found online is correct? She can’t. This hits home with the main
problem of online information, especially health related information, when a person’s
life could be in danger. There is no way of knowing the credibility of the information
unless it is somehow regulated.

Too Much Information

As with most of the information on the internet, much of the information regarding health
care is disorganized. There is more information out there than most people need. This
problem causes people to go on what can be described as a “fishing expedition,” in
which consumers go blindly looking for information, not knowing if the information they
get back is going to be what they are actually looking for. According to 0Shelia
McKechnie in her article Health on the internet: A mixed blessing, “the internet is a
victim of its own success: it is one thing having a rich and readily available resource but
it is quite another if the resource is highly disorganized and unreliable” (McKechnie,
1999, p2). In 2000, Dyer KA and Thompson CD produced a CD called Cyber psychology
and Behavior, called “Internet Use for Web-Education on the Overlooked Areas of
Grief and Loss.” Here Dyer explains that because there is so much anonymous
information on the internet, there is no way to get unbiased information. The data must be
carefully sorted through to determine what should be adopted as reliable or what should
be permanently discarded.

Lack of accuracy
Another problem with internet health care is its lack of accuracy. There is no way of
knowing whether the information you are looking at is credible. This problem has been
recently addressed by the Health Improvement Institute in an effort to try to come up
with a solution. The Health Improvement Institute is a key research source used by the
Agency for Healthcare Research and Quality branch of the U.S. Department of Health
and Human Services. One person best described this growing problem by stating,
“The plethora of health information and the slickness of its presentation make it
difficult for consumers to tell high-quality, authoritative information from high-
technology frauds and self-promoting cure-alls” (Quality of Health Information on the
Internet, 1997, p2). In a workshop conducted by the group for the entire healthcare
industry, the accreditation of internet producers was described as “an enormous and
costly task requiring a large staff with expertise in varying fields to monitor thousands of
health-related sites” (Quality of Health Information on the Internet, 1997, p2). Not
only is there too much information to even know where to begin regulating it, but it
would be a very costly task to take on by the government. Some of the other problems
that result from lack of accreditation include the health risks associated with
misinformation. The task of monitoring these health care sites to make sure they are
accredited and that they keep up their accreditation would be very hard to manage.
However, there were quite a few solutions that this workshop came to agree upon, such
as requirements of a system to tell fact from fraud, empowering consumers to evaluate
health-related internet sites, and industry standards and accreditation of internet
producers.

Lack of accreditation
Also connected with the problem of accuracy is a potential problem due to a lack of
accreditation. This creates a risk to the patient by not ensuring the privacy of online
health care. When someone looks up something health care related, as well as anything
else on the internet, they leave a trail that can easily be accessed by anyone with a
computer and a little time. This presents a problem because an insurance company can
also check what websites someone has looked at, and it could jeopardize an insurance
policy if the provider thinks that you may have a preexisting condition. In 1996, the
Health Insurance Portability and Accountability Act (HIPPA) were enacted to prohibit
things like this from happening. HIPPA protects a patient’s confidentiality of medical
records through the electronic submission of data, which includes information that is
transmitted via the internet.

Disadvantages of Online Pharmacies

There are many advantages and disadvantages to online pharmacies. One of the biggest
advantages is the ease of access for many of the patients. This allows people who might
be unable to travel to the pharmacy get their medicine delivered to their houses. The
reason that online pharmacies have gained an increase in use is because of the lower cost.
Most of the internet sites are Canadian or pose as Canadian sites. The reason for this is
because Canadians pay about 50% less for their prescriptions. (Doehrman, 2005, p. 1)
And for many of the elderly who squeak by each week on their social security checks can
use a few extra bucks.

Problems with providing prescription drugs on the Internet

A major concern of the online pharmacy industry is that some sites pose as Canadian
sites when they are not. An article by Ricardo Alonso-Zaldivar states, “About one in
five online pharmacies offering discount prescription drugs from Canada appears to be
actually located in that country.â€ﾝ (Alonso-Zaldivar, 2005, p. A.18) This raises concerns
as to the safety of these medications, because the consumer does not know where the
medication is coming from or the validity of the effectiveness of the drugs. The ease of
access to these sites also can be a disadvantage to some consumers. It can be a
disadvantage because online pharmacies have become a place where illegal drug
trafficking takes place. “Substance Abuse and Mental Health Services Agency
(SAMSHA) estimates 9 million people now abuse prescription drugs, meaning they use
them for non-medical, and often recreational, purposes.” (Marks, 2003, p. 1) Also
SAMSHA says that about one third of those who consume these drugs are minors, which
prescription drugs are involved in about a quarter of the overdose deaths in the United
States. (Marks, 2003, p. 1) This is mainly from people taking these drugs and selling
them to other individuals without them providing a prescription for these drugs. Michelle
Singletary said, “In a recent report by the General Accounting Office, the federal
agency found many instances where Internet pharmacies -- most operating in foreign
countries -- exhibited shaky business practices, including not requiring people to have a
prescription to make purchases.” (Singletary, 2004, p. E.18) These sites also do not
provide directions for these drugs or provide possible side effects that could affect them. I
think this is a major flaw in this industry because someone who has no knowledge of the
drug they are taking could do major harm to themselves or those around them should they
go out in public.
The online drug industry also has a problem with people using counterfeit drugs. This can
lead many consumers to waste their money on drugs that are ineffective. Also this can
pose many health dangers for those consumers who use the counterfeit drugs. Some of
these include not getting the medicine that they need in order to get better. As well as
providing those with drugs that could do harm to the ones who consume them.
Using the Internet in order to obtain a prescription is not a bad idea. But I think that there
should be more regulations on this industry. They also need to increase their supervision
of these sites. The benefits could easily out weigh the consequences if the government
controlled the industry a little more.

Should Health Services be Available Online?

In conclusion, internet health services have many advantages as well as many
disadvantages. Some of the advantages being the use of the internet to research health
issues, research medications, and chat with doctors online. Some of the disadvantages
include lack of accuracy, lack of internet skills by elderly people, and false online
pharmacies. Although there are many disadvantages, internet health care is and will
continue to be a huge advantage to the world. Eventually, all of the approved websites
will be labeled as official, and the false websites will be eliminated.