HEALTH CARE NEWS AND VIEWS

More has been discussed and written about the health care system in the U.S. in the past 20 years than during all of the recorded history of this country. It seems as though, despite all the theorizing and rhetoric, there is a spiral to devolve into a nonsystem with every "reform" that the medical-pharmacuetical industrial complex, third party payers and the government institutes in the name of improved outcomes in care, health and the bottom line. These reforms achieve none of these objectives in the long run and frequently not even in the honeymoon period shortly after being instituted. Managed care as it turns out, really had and continues to have little to do with care and everything to do with managing cost. This becomes an oxymoron when one considers that many of the most influential parties in the mix are for profit entities.

But there are bright spots in the picture. Many of them are shining from the outside in. Some especially brilliant paradigm shifts are integrating from within traditional venues. This is a time of rapid change and with it comes great opportunity. This section is dedicated to bringing to you some news of these occurrences and suggestions of resources to explore for reliable information on related topics. Here, also, are some of my personal views and advice on navigating through some of the turbulent areas in the search for the right health care for your needs.

Health Care Information on the Internet:

The Good, the Bad, and the Others
Health care news is abundant on the world wide web. Much of the information posted can be of questionable value because it exists as a free speech forum. As such, there is no gold standard for web based information. This becomes a subject of significance considering the numbers of people looking for information on the net to assist in making complex health related decisions.

A Harris Poll done in 2002 concluded that 110 million people used the internet for health information at some time during that year. This is more than double the number in a poll taken in 1998. The U.S. population seeks e-health advise at a rate of 32% or nearly 1 in 3 persons. The estimated rate of use of the internet for health information by U.K. subjects is 1-2%. The numbers are growing yearly worldwide.

How can consumers know that the information they are reading is credible? Several criteria can be applied to health information in all formats.

Accuracy and Currency: When was the information last updated? Is it relevant? Are resources and references sited and the author or original source clearly listed?

Is it clear when the information is based on evidence or opinion?

Relevancy: Is the information written for a single specific audience such as consumers of health care or providers, i.e. doctors, nurses, etc. or a mixed audience? If it is intended for a mixed audience, are there explanations of a majority of the more technical medical language that may be used? Is it fairly easy to understand?

Comprehensiveness: Is the information complete? Besides basic information are issues such as coping, prevention and lifestyle issues discussed? Are other references, books or websites, mentioned as resources for more information?

Purpose: Is the purpose of the site clearly stated?

Ownership of the site: Is it easy to identify who is responsible for the information? Is there a link to contact that person or entity with questions, comments or feedback?

Ease of use of the site: Is it easy to navigate and read?

Personal Information: Does the site require a registration to access basic information? Educational sites should not need this for basic information. Registration with or without a fee for specialized information or products should be clearly stated and easy to avoid if not desired.

E-health Site Credentialing: Instructions and helpful hints to evaluate health information sites can be found by contacting URAC, which is the e-health information accrediting arm of the American Accreditation Healthcare Commission, Inc. They have a stringent list of 53 criteria and an annual fee of $500.00 to maintain their seal of approval. They provide this for strictly consumer oriented sites. To learn more about them go to webapps.urac.org.

The Michigan Electronic Library has one of the most highly rated sites for links to published full texts articles from reputable sources. The name of their site is mel.org. On their site go to Health Information Resources. Within that section there is a document on evaluating health information on the internet.