By chance, have you recently ordered any prescription drugs or paid your insurance premiums online?  Or scheduled a doctor’s visit through a “virtual receptionist?"  Or perhaps participated in an interactive chat for consumers who share similar medical concerns?

If so, you are among the millions of Americans who are increasingly taking advantage of point-and-click access to the wide range of healthcare information and services that dot the cyberspace landscape.  On the other hand, if you aren’t currently connecting with companies that define the e-health market, chances are you will—sooner than you might imagine. Thomas Manney, director of Information Technology at River Oaks Imaging in Houston, offers this assessment:  “The economic benefits of the Internet linked with healthcare will drive the acceptance of new innovations among healthcare professionals, along with the multiple clinical benefits that involve integrating tools to enhance patient care.” Clearly, Internet technology has impacted all facets of the healthcare industry and everyone who plays a part in either providing or receiving medical care.

The Market for E-Health Consumers

Let’s first define the concept of “e-health.”  Over the last several years, Internet technology has revolutionized all aspects of business-to-business and business-to-consumer sales, service and marketing strategies.  The result is the explosion of Internet-based business activity referred to as e-commerce.  A world unto itself, e-commerce has dramatically impacted every industry and segment of society, including healthcare.

Specifically, e-health refers to the sector of e-commerce that has opened up new avenues for healthcare consumer communication and education, pharmaceutical products and medical services delivery and monitoring, and business partnering among companies that are the driving force behind this economic phenomenon.  In simple terms, e-health represents the practical application of e-commerce to healthcare companies who do business primarily, or exclusively, via the Internet.  The impact of e-health on the general population is explained in a June 2000, online report entitled “E-Health Consumers of Tomorrow Will Be Driven by Commerce, Connectivity, and Management Resources.” (www.aispubcom/EhealthBusiness/061500.html.).

According to the report, “The number of consumers looking for healthcare content via the Web is expected to jump from 23.6 million, as of second quarter 1999, to more than 79 million by 2005.  And, the number of consumers connecting with payors and providers online is expected to jump from just 2.7 million to as high as 64.5 million for the same period.” Clearly, as more consumers become comfortable in utilizing Internet-based healthcare services, the proliferation of businesses that provide these services will increase significantly.

The Dominant E-Health Companies

The e-health industry is not monolithic.  The hundreds or thousands of companies that comprise this sector of e-commerce run the gamut from thriving, home-based businesses that supply online medical billing for small, mom-and-pop physician practices—to large corporations that offer an end-to-end, seamless “suite” of Web-based services and resources that can be customized to fit the needs of a sole practitioner or a large healthcare organization.

For purposes of this discussion, let’s focus on the e-health companies that have carved a significant niche for themselves in terms of volume of business, impact on the industry, and leadership in setting standards for Web-based healthcare commerce.  Several categories of companies deserve mention. Consumer health portals:  Companies under this heading are among the most popular and best publicized within the industry.  The major Internet search engines have a strong consumer health thrust.  For instance, the health section of www.altavista.com includes timely medical news, pharmaceutical updates, and a wide range of content on topics such as fitness, nutrition, weight loss, men’s health, women’s health, and medical insurance, etc.

Clicking on to www.healthonline.com connects viewers with a portal that bills itself as “the first nationally syndicated digital healthcare and medical network.”  Among its features are articles that address seasonal health issues (sunburn, allergies, tick bites), health education for teens and young adults, and content geared toward specific “health e-communities”—such as pregnancy, hypertension, substance abuse, sexually transmitted disease, and so on. Consumers who have a more academic interest in health matters can benefit from the information made available at www.medplus.nlm.nih.gov.  Although this site is powered by a government entity (the National Institutes of Health), it makes a solid contribution to Web-based healthcare education, which is a significant component of the e-health industry.  In particular, this site offers educational resources such as a medical encyclopedia and dictionaries, links to medical libraries, and a service for locating doctors, dentists and psychologists nationwide, along with detailed information such as alternative therapies for AIDS patients. 

Another popular Web site for general healthcare consumers is www.intellihealth.com. Along with content focused on women's and men’s health, the site also includes a drug resource center and timely information on health safety, vitamins and nutrition, etc.  A unique feature is a service enabling viewers to receive personalized health assessments via e-mail.  Several consumer health portals address the medical needs of minority communities, especially Hispanics and Latinos.  In particular, www.salud.com offers information on disease management (arthritis, cardiovascular problems, high cholesterol, etc.), sexual health, nutrition, and personal wellness.  The site includes a medical dictionary with easy-to-understand terminology.  Viewers who click on www.graciasdoctor.com  will immediately recognize the site’s international thrust in providing healthcare information geared toward Hispanic/Latino communities.  Information on family health, mental health and nutrition is among the diverse content posted on the site.  Similarly, www.drtango.com presents a wide array of consumer health information for viewers of all ages. One of its unique features is its link with Adam.com, a portal that offers interactive, 3-D modules and “broadcast-quality digital” transmission suited to consumer/patient education.

A number of prominent Web sites address health issues geared toward African-American audiences.  For example, www.blackhealthnet.com offers a wide array of consumer health information under the classifications of general health, women's health, alternative medicine, and fitness. The site also includes a medical Q&A page, along with incisive articles written by noted clinicians on topics such as cardiovascular disease in African Americans, the role of radiation therapy in treating prostate cancer, and prenatal care. In addition, according to the site's editor, Dr. Brian Stone, future content will explore issues such as racial disparity in healthcare delivery, and a re-examination of the controversial "Tuskegee experiment."

Another prominent site is The Black Health Internet Pages, www.bhip.net.  The content focuses on children's health, dental health, diet and nutrition, exercise and fitness, men's health, mental health, sexuality, and women's health.  An "Ask the Expert" feature discusses timely topics such as a parent's guide to body piercing and tattoos, pregnancy and health concerns, and ways to improve personal nutrition. Along with offering a physician specialty locator, the site also links with sites devoted to Black parenting and the "African-American Program" sponsored by the American Diabetes Association.

African Americans, who are drawn to more holistic health advice, are encouraged to visit www.africanamericanhealth.com. The site focuses on the inter-related components of personal health: spiritual, mental, emotional, "energetic" and physical.  Article content is devoted to topics such as acupuncture as part of alternative medicine, cleansing the body through detoxification, keeping hair and skin healthy, and protecting your eyes.  Considerable emphasis is placed on eating properly to promote health and wellness, including a guide to restaurant eating.  "Housecalls," a Q&A feature, and "Healthchat" round out the site's offerings to health-conscious consumers.

Physician services portals:  A myriad of Web-based companies vie for the attention and revenue of physician groups that seek ways to streamline their medical practices while enhancing patient care.  One of the industry leaders is Healtheon/WebMD.  Physicians who subscribe to www.webmd.com have at their disposal a comprehensive suite of services.  These include continuing medical education, healthcare news articles, electronic lab tests results, online insurance eligibility verification, a “virtual receptionist,” pharmaceutical drug databases, physician-peer chats, and a service that enables practitioners to customize their own Web sites. A leading competitor is www.medscape.com.  This site is geared to a professional audience that includes doctors, nurses, medical students, and medical office managers. Physician-related services include online continuing medical education, headline medical news, trend-setting clinical insights, treatment updates, and multi-specialty practice guidelines. 

“Back-end” services portals:  A discussion concerning e-health would be incomplete without mentioning the companies that drive the technology behind the burgeoning growth of Internet-based healthcare corporations.  These include:  Intel Corp., IDX Systems Corp. Security Solutions, MedicaLogic, and McKesson HBOC, Inc. 

Without describing the technological innovations these companies are making, we suggest that readers take an online tour of these firms to acquaint themselves with their vision and corporate mission. Another prominent company in this category is WinCare, headquartered in Medford, Oregon.  The company provides Windows-based products for the healthcare industry, particularly the long-term health sector.  As more Americans live longer and require more extensive personal healthcare, companies that provide technological solutions to facilities that serve aging patients will continue to carve out an indispensable niche in the e-health market.

“Technology, particularly computer technology in long-term care, has increased jobs significantly,” mentions William Inge, CEO of WinCare.  “Revenues in LTC exceed a billion dollars a year, with the market being driven by Web-based applications that improve accountability and quality indicators for long-term health providers.”

Inge offers a career tip for professionals who gravitate toward this industry sector.  “Computer utilization in LTC is in its infancy.  Future computer technology—and related employment opportunities—will be in the area of Artificial Intelligence (AI),” he explains.

Breaking into the Industry

Getting a job with an e-health company requires attainment of certain technical skills and having a clear understanding of the contribution one can make to a fast-paced, forward-thinking company.  This begins with understanding the unique challenges that face Web-based companies.  “The Internet is a wonderful tool for the healthcare industry; however, it’s quite a different medium from traditional ways of doing business,” mentions Lisa Borders (right), senior vice president of Corporate Development for Caredata.com, based in Atlanta.

“Individuals working in healthcare are advised to use all the functionality of the Internet to meet the overarching goal of providing quality, efficient healthcare,” she adds. 

Basically, there are three routes for talented graduates to enter the e-health industry. One pathway is technical:  programming, web design and development.  Another route is through the administrative and finance functions of such a company. The other primary career path is through marketing and promotions. Obviously, appropriate degrees include: computer science or a related technical discipline, accounting and finance, and sales/marketing or communications/public relations.  Even non-technical majors are advised to take as many computer and Internet-related electives as possible.

From a technical standpoint, what is most important for persons working with Web-based companies is to develop both “hard” and “soft” skills which enable them to handle multiple projects and advance the mission of the organization, however that may develop over time. In particular, students should become as knowledgeable as possible of HTML, computer graphics, database development, JavaScript, software related to Web site design, product management, systems administration, and usability and quality assurance matters.

With respect to “soft” skills, students are advised to take advantage of classroom and extracurricular experiences that enable them to sharpen their skills related to written and verbal presentations, project management from conception through implementation, interpersonal negotiation, time management, and the ability to handle multi-tasks simultaneously.  It’s also important to have a basic understanding of how businesses are run and what drives their success in competitive markets. “Individuals interested in converging Internet technology and healthcare are advised to learn the fundamentals of what makes a business profitable,” says Borders. “You don’t need to change how you are learning, but there is always a better way to do business.  The basics do not change, but how you accomplish the delivery of care changes.” 

Corporate Culture

One of the interesting facets of working in e-health is that the corporate culture tends to be more “laid back” than in traditional companies.  Often the dress code is more relaxed, and employees who work on the creative side enjoy more freedom in how they produce the graphics, content, and other technical apparatus that drive the Web sites. With respect to how e-health companies are distinctive, another point must be made.  Job titles don’t necessarily mean a great deal in the world of e-health.  That is not to say that they aren’t important.  There is considerable ego satisfaction associated with fancy titles such as:  Business Development Consultant, Usability Manager, Senior Graphic Designer, Product Implementation Coordinator, Technology Manager, Trade Show Coordinator, Partner Manager, IT Technician, and Strategic Sales Manager. 

The point is that job functions are not confined to a specific job title.  As e-health companies carve their niche in the world of e-commerce, constantly there are new initiatives that demand realignment of human resources--along with both the technical and creative talent--that propels the success of the organization.  In simple terms, “go with the flow.”  Show yourself to be flexible, adaptable and eager to tackle more challenging work assignments regardless of what your current job title is.   

Career Progression

Moving up in the company is not a matter of receiving a fancier job title; rather, it depends on successful project management and timely delivery of information and services to the constituencies that the company serves:  internal and external customers.

For new graduates, the important thing is to get your foot in the door with a leading-edge company.  This does not have to be a mega corporation located in Silicon Valley.

Thomas Manney specifically advises, “To get a broader set of skills, I recommend joining a smaller company.  These companies allow you to work on multiple tasks, a lot of which were not part of the job description.”  Another key to career success is to “stay abreast of the developments in your particular area,” Manney says.  “Information technology and healthcare applications are constantly evolving.  Keep your eyes open to new and exciting changes, be willing to explore new areas, and ask people already involved in the field how their work experience has been.”

Do you have what it takes to succeed in the fast-paced world of e-health?  If so, don’t hesitate to investigate opportunities with the companies that are among those constituting the driving force of the new economy.

Calvin Bruce and Urcel Fields are content writers for MedCAREERS.com and WebMD.com, among other healthcare Web sites.