Terry Mullett-Ressell of Sextant, Inc. presented her perspective on e-health through a case study of the Kaiser customer-oriented web site which she founded and helped develop along with a physician from Yale.
Originally called CareTouch, it involved a significant investment of time and resources by Kaiser and, ultimately, by IBM ($10 million). The corporation was set up as a for-profit entity to give it the freedom to operate somewhat independent of Kaiser (at least in theory). The concept was initially to exploit intellectual property within Kaiser (e.g. clinical guidelines and protocols) and provide a consumer-friendly web site to foster healthier lifestyles and improved disease management within and beyond Kaiser. With a relatively captive customer group that had exhibited some loyalty over the years, the thinking was that this was a solid investment for Kaiser in securing even greater loyalty among existing clients, achieve more efficient resource utilization, as well as potentially to attract new customers.
The pilot was offered in California to Kaiser customers. However, in the ensuing months, internal politics became difficult to manage. A subscription approach to revenue never fully materialized, and disputes developed between the Plan and the medical group over ownership, the value of the clinical guidelines, and other matters. These issues were ultimately worked out but dramatically extended the revenue growth time frame.
The site still exists today and, while it has achieved some of its initial goals, its future is not entirely clear. The experience certainly provides an excellent case study of the trials and tribulations of trying to integrate e-commerce into a well-established integrated delivery system. Another example of a similar site is MedUnite involving several other managed care plans, which should be going live shortly.