Offer Online Services Research Articles

Datapoints: Internet-Based Behavioral Health Services in Health Plans

307 F percent of individuals with Internet access use it to obtain health information (1). Despite the increasing salience of the Internet, little systematic information exists on the prevalence of health plan–sponsored online resources for behavioral health. Data presented are from a nationally representative survey of commercial health plans sampled from 60 nationally representative market areas. A total of 368 of 441 eligible plans (83%) responded to a survey on alcohol, drug abuse, and mental health services in 2003. Medical directors indicated whether each of their three largest products offered Internet-based resources via e-mail, Web sites, or Internet-based videoconferencing. Data are weighted to reflect national estimates. We examined differences by three product types (health maintenance organization [HMO], preferred provider organization [PPO], and point-of-service plan [POS]) and three behavioral health contracting arrangements (specialty managed behavioral health care organization, comprehensive contracting with a single vendor for general medical and behavioral health, and internal behavioral health services provided by plan employees or a network administered by the plan). Analyses were conducted at the product level. Most products offered online provider directories and educational information (Figure 1). Two-thirds offered behavioral health self-assessment tools, and almost one-half provided online referral. About one-third provided personalized responses to problems. Only 2% offered online counseling. Products with specialty contracting were the most likely to offer online services. Products with comprehensive contracting rarely offered most online services. HMO and POS products were more likely to offer online services than PPOs (data not shown). For example, about a third of HMOs and half of POS products offered personalized responses online, compared with less than 10% of PPOs. For-profit plans were more likely to offer online patient self-assessment, referral, and personal response to questions. Products in the Northeast were more likely than those in other regions to have online directories, selfassessment, educational information, and online referral (data not shown.) The survey found that health plans Internet-Based Behavioral Health Services in Health Plans

REVIEW: E-book about E-learning Online Education and Learning Management Systems-Global E-learning in a Scandinavian Perspective

Prior to year 2000 Scandinavian universities offered selected online courses attracting a few pioneering students. Today, even primary schools offer online services to students, teachers and parents. Online education is becoming mainstream education in Scandinavia.

Innovating in Digital Government in the American States*

Objective.The purpose of this research is to examine why some states have embraced digital government more extensively than others.Methods.Multivariate regression analysis is used to empirically test explanations for state innovation in e‐government. The primary dependent variable is the percent of state‐level government websites offering online services to citizens.Results.Republican‐controlled legislatures are more likely to embrace e‐government, implying that efficiency concerns may drive reliance on digital government. Innovators in e‐government were states with fewer households with Internet access and less use of the initiative process, indicating that citizen demand was not a factor. More extensive use of e‐government is also associated with legislative professionalization and professional networks—factors that may be useful for explaining the diffusion of other administrative reforms, and technical issues lacking political salience.Conclusions.These data suggest e‐government implementation is driven by legislative professionalism and, to a lesser extent, state professional networks, rather than citizen demand. These indicators fitLowi's (1972)conception of “constituent policy” as a top‐down process, confined to administrative or legislative circles, compared to distributive, regulatory, and redistributive policy. We hypothesize that other administrative reforms, particularly those lacking political salience, may exhibit similar relationships with legislative professionalization and professional networks.

Patients, physicians, and the Internet.

The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more health information online and will take more responsibility for their care. The doctor/patient relationship will be altered: Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but most physicians are unprepared, and many are resistant.

Relative impact of print and database products on database producer expenses and income—Trends for database producer organizations based on a thirteen year financial analysis

A 13-year analysis of the finances of a major database producer organization, which is also a publisher of abstracting and indexing (A&I) products, indicates trends regarding the impact that both printed products and database products † † Throughout this paper the term “database products” is used to refer to those products that are marketed in the form of a database. In fact all products are generated from a master database and in that sense are products of a database—print products (sometimes referred to as paper or hard copy products) and database products (sometimes referred to as tape products or C-R products) are both products of a master database. have on the financial status of the organization. The question of “migration” (from printed to online database products) and the fact that expenses have increased more than income are discussed as they relate to the survival or growth of database organizations. Since the database has gone online, there have been significant increases in the database revenue (online royalties), connect hours, and numbers of online users; at the same time, there have been decreases in the number of database leases and licences, the number of print product subscriptions, and the excess of income over expenses. In constant dollars, the cost of producing an abstract has decreased, the subscription charge for printed products has increased only slightly, the lease and license fees have decreased, royalty charges have increased, and hourly connect fees have remained steady (even though the size of the online file has increased greatly). The problem is that of maintaining a balanced financial status in light of increased income from one class of products, decreased income from another class of products, and increased cost of operation. Income, expenses, excess of income over expenses, and prices have been plotted in both real and constant dollars. The product a user gets for his money, including database quality and growth, are discussed in relation to cost. Possible approaches to ensure economic viability are considered in terms of expenses, efficiency of operation, marketing, products, services, and pricing. The most promising approaches lie in the areas of pricing and development of new products and services. The possibility of developing a consortium of database producers for offering online services is proposed. There appears to be no alternative to increasing the prices for online users. Data provided relates to one database producing organization, but the trends are considered to be representative of numerous A&I databases.