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I think this idea has a lot of potential, but it leaves me to wonder if it misses the section of the population who likely needs it most: those who lack or cannot afford internet access. How do we reach these folks with such innovative tools?

Self-service doesn’t miss the non-online population entirely, and those with at least onlne access at a friend’s home, senior centers, etc. can use websites, and where their employers okay it, and why shouldn’t they, at work. Automated outbound online coaching is already being sent by post, where participants have no online address, and can be transmitted via IPods, wireless phones, handhelds, etc., though there will always be some who lack even a postal address. The drawback is that postal communications do add costs, both for the paper involved and the postage, for example, so make it more expensive to reach the most “communications challenged”, but they are by no means cut off. It will probably reduce the frequency of their receipt of messages, and if they have to use phones and mail to ask questions/get answers, delay and add more costs to responses, but online access is certainly available to the vast majority of people, one way or another. Many DM programs have included loaning participants computers and ‘Net’ access and training them in Internet use, but this adds greatly to costs, so is reserved for only the highest risk/reward participants. Since every added participant can gain personal value and yield value to sponsors, at least increasing the numbers does a lot of good.

Cyber technique helps for clinic and hospital physicians, also buyers in developed area can earn benefits. But in east Asia and developing countries, GP goes into community, families periodicly would be practical, although no evaluation could be found about the results and effect.

Consumer driven health care is here to stay. As mentioned previously, the internet is only one way that consumers will get information. Self-Service kiosks are taking off like a rocket and healthcare kiosks will fuel the growth.

10-12 years ago people did not walk into a doctor and say, I have this pain in my back and this is what I think it is, and WebMD said this is the drug I need” But today that is what people do.

An educated population will make healthcare more efficient.

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