Everywhere you turn today you're confronted with the Internet. The Internet is quickly becoming an efficient and effective way to do business -- and health care is no exception.

The eyecare industry has traditionally had a "three O" delivery system -- optometrist, ophthalmologist and optician. Now it's appropriate to add a fourth "O" -- for online.

Consider the explosive membership growth just one of the many eyecare goods and services networks has experienced. E-dr. now has nearly 9,000 registered members, up from about 5,000 at the beginning of this year. About 80% of them are O.D.s, and 20% are M.D.s.

In this month's column, I'll explore e-commerce trends that are starting to affect the medical profession in a positive way. You should be able to apply some of these ideas to extend your patient outreach, reduce costs and improve overall practice efficiency.

Patients want online services

There's no doubt as to where patients stand on e-commerce. Recent Cyber Dialogue research shows:

�         33.4 million online adults would like to access information through their doctor's Web site

�         34.6 million online adults are interested in communicating with their doctor's office by e-mail

�         14.8 million online adults are likely to switch doctors to gain Web site access

�         almost 12 million online adults would change to a doctor who communicates with patients via e-mail.

Americans are now online, and they expect to meet you there.

A recent study asked: "If patients could communicate with their doctors -- or be monitored -- through the Internet, what percentage of in-office visits could be eliminated?" Respondents believed a 20% visit reduction possible.

E-care also holds tremendous potential for providing continuous monitoring of patients who require it. DiabetesWell.com, a doctor-initiated company, enables patients to interact with their doctors from home -- to ask questions, transmit glucose levels and schedule appointments.

Handle routine tasks

Using the Internet can also improve practice efficiency. You can send automatic appointment reminders, provide a map link to your Web page that gives patients directions to your office, refill prescriptions, and order office and medical supplies online.

Electronic claims processing is a big improvement over paper forms. It's cost-effective, efficient and improves your cash flow through faster claims payment.

It's also interesting that the median age of Internet-oriented individuals is 35 and their median annual income is $62,000. Sixty-three percent are male and 37% female. These are ideal demographics if you want to reach potential candidates for refractive surgery.

Where we're headed

Looking ahead, I see five primary uses for e-care in your practice (I've listed some related online companies):

�         a means for electronic capture and in-office storage of medical records (Medicalogic)

�         a way to communicate with vendors, patients, potential patients, payers or others (Healtheon/WebMD, TotalEyeSight.com)

�         a healthcare information re-source (Healthcentral)

�         a source of prescription drugs and essential supplies for your practice and your patients (drugstore.com, PlanetRx, supplyeye.com)

�         real-time capture of clinical information in both acute and ambulatory settings (DataCritical).

The future of e-care is still being invented. Success will go to those who bring together knowledge, talent, capital, vision and the power of the Internet to create productive synergies and profitable growth.

Dr. Gable is chief executive officer of Dynamic Health Connections, Inc., in Lake Forest, Calif., which provides specialized consulting expertise for subspecialty physician groups, managed care organizations and other medical organizations. You can reach him at dhc38@aol.com.