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more health care organizations should be interested in adopting the Internet: because it can advance their strategic interests. The third section deals with organizational barriers that hinder Internet use. The discussion there addresses internal and external factors, such as policy and technical barriers, that influence and constrain the form and extent of Internet use, as well as the range of uncertainties that inhibit decision making regarding the Internet. The last section addresses the importance of organizational leadership.

The chapter focuses primarily on Internet adoption by care provider organizations. To be sure, Internet technologies will need to be adopted by a number of different players in the health care arena, including consumers, physicians, and administrators. But because they are likely to bear many of the implementation costs and will have to address issues of acceptance by consumers and care providers, health care organizations are a suitable focus for this analysis.1 The discussion recognizes that health care organizations come in many forms—community-based health facilities, managed care organizations (MCOs) and health maintenance organizations (HMOs), integrated delivery networks (IDNs), and nonacute facilities—each of which may adopt the Internet for different applications, whether management and administration, communications among health care professionals, consumer education, or patient management. The specific factors that facilitate or impede Internet applications will differ from one organization to the other, but the discussion that follows is broadly applicable because it identifies common challenges faced by a variety of health care organizations as they attempt to implement a range of applications serving different types of end users.

Lessons from Other Industries

Internet technologies offer a range of potentially useful applications to organizations in many different industries. Simple Internet applications such as electronic mail (e-mail) can facilitate communication within distributed multinational corporations. Related networked applications can simplify flows of information among elements of a single organization and among multiple organizations. Real-time teleconferencing technologies can support meetings involving individuals located in different cities. Direct capture of sales information can enable retailers to streamline the delivery of inventory and forecast purchasing patterns. New automation systems can allow for distributed management of supply chains, support of human resource functions, and exchange of contact and other sales information. Although the deployment of these systems is still in an early stage, Internet technologies appear to have enhanced organizational performance by lowering costs, increasing efficiency, dif-soft



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