People regularly turn to the Internet for games and gossip, news and entertainment, essential information and high weirdness. And now, apparently, for their health as well.

A number of successful online medical interventions have been reported in recent months, helping folks quit smoking, lower their blood pressure and deal with any number of ailments. New York City cardiologist Dr. Nieca Goldberg figures it's a great trend, as long as people are going to reliable and trusted sources for help. "I think it is the wave of the future and, theoretically, it seems like a great idea," said Goldberg, a spokeswoman for the American Heart Association, a clinical associate professor of medicine and medical director of the Women's Heart Program at New York University Langone Medical Center and author of Dr. Nieca Goldberg's Complete Guide to Women's Health. "There could be multiple interactions with patients that are brief and effective."

Online interventions have spanned a variety of medical issues. One program, for instance, used Internet and telephone interactions with heart attack survivors and cardiac patients to help improve their heart health. A study found that participants' blood pressure and cholesterol levels fell, more of them quit smoking and they were one-third less likely to die than cardiac patients who did not receive the attention. Several programs have popped up to help smokers quit. An analysis of 22 clinical trials found that Internet- and computer-based smoking cessation programs gave smokers nearly twice the chance of successfully quitting than if they had tried to quit without help. Those successes have led the University of Illinois at Chicago to spearhead a $2.9 million federal effort to encourage young adults to use proven online smoking cessation programs.

Alcoholics also can find online support. A Dutch study found that one in five excessive drinkers who used an online self-help Web site to help them with their problem reported that they had lowered their alcohol intake to levels less likely to cause health problems.

And chronic conditions such as psoriasis also have been shown to be helped by online interventions. One study in Boston found that half of the users of online psoriasis support groups believed that the quality of their lives had improved, and two in five reported improvement in the severity of their psoriasis.

In some instances, the Internet also provides "nudges" to help push people into healthy habits. One worksite e-mail health program developed by Kaiser Permanente, for instance, provided participants with weekly e-mails and mid-week reminders that set personalized health goals for them based on an earlier survey they had filled out. They were encouraged to eat more fruits and vegetables, lower their intake of fats and sugars, and exercise more. A study of the program found significant health improvements among people who received the e-mails. They were, in fact, eating better and exercising more. Even those with advanced fitness goals can receive online assistance. The magazine Runner's World currently offers online training programs featuring personal advice from world-class runner Bart Yasso. Dr. Robert Mallin, an associate professor at the Medical University of South Carolina, said such online programs could appeal to people who don't like going to doctors, therapists or support groups for help with their problems. "There's certainly an advantage to having face-to-face, eyeball-to-eyeball contact, but I think also people who would never step into a doctor's office or a room with a support group will explore those things online," said Mallin, a spokesman for the American Academy of Family Physicians.

Online support groups, for example, allow people to gather information and communicate with others who have a similar problem while retaining their anonymity. "You don't have to participate," Mallin said. "People don't even have to know you're there." However, both Goldberg and Mallin voiced concerns, too. Goldberg wants to see large-scale studies of the effectiveness of these online programs before they are pursued to such an extent that they supplant regular modes of health care. "When there's a concern about cost containment, we have to make sure the cost containment occurs within the context of quality care," she said. "This is a great idea, but I don't think we're 100 percent there yet." Mallin worries about people getting bad information from Web sites. "The biggest worry everyone has about health information on the Web is how accurate it is," he said. "I always ask my patients to run something by me they've read on the Internet or on one of those chat sites."

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The Deloitte Consumer Spending Index rose to 2.94% in August from an upwardly revised gain of 2.39% a month ago, reaching its highest point since before the start of the recession. "The year over year pace of decline in real consumer spending appears to have stabilized," said Carl Steidtmann, chief economist with Deloitte Research, a subsidiary of Deloitte Services LP, and author of the monthly Index. "Personal income tax rates are at the lowest levels of the past 50 years and unemployment claims are down from their peak, while home prices are beginning to show signs of stabilizing after plunging for the last three years. The recent strength in auto and home sales indicate that an uptick in real spending is materializing for a select few sectors. However, U.S. consumers continue to ride the wave of frugality when it comes to their more discretionary purchases."

A&P announced on Tuesday that its Live Better! Wellness program now provides online pharmacy services. "We are proud to introduce this innovative new benefit, which will make filling prescriptions more convenient than ever before. It is just another way we are helping our customers maintain their health by offering improved access to prescription drugs," stated Carol DiNicolantonio, senior director of pharmacy for A&P. Prescriptions are processed, filled and distributed from this "home delivery only" pharmacy located in Old Tappan, N.J.

The Live Better! Pharmacy provides such services as prescriptions filled by pharmacists, access to pharmacists seven days a week, easy prescription transfers and prescriptions delivered to the patient's door.

From supermarkets to big box chains – the savvy pharmacies are adapting to the increasing web awareness for their customers. New services on their websites offering patients medicinal depletion guidance with integrative medicine and nutritional counseling are keeping the smart Independents thriving. Pharmacists OnLine®can get you out of the boring 4-5 page ‘static or supplier site’ and keep you competitive.

The National Association of Chain Drug Stores Retail Advisory Board hosted a webinar Tuesday afternoon featuring speaker Thom Blischok, consulting and innovation president for Information Resources Inc., discussing the changing paradigm of today’s cash-crunched shopper by way of its NACDS ECON09 program.

The bottom line — today’s shopper is predominantly buying less and will continue to buy less for the foreseeable future. So the strategy is to position your company against that new shopping paradigm, Blischok suggested. In his closing remarks, Blischok outlined five strategies for both retailer and supplier:

• Simplify the shopping experience (78% of shoppers want this, Blischok said). As today’s consumer is bombarded with messaging and discounting, the retailer/supplier who makes the shopping trip easy ought to come out a winner.



• Redefine end-to-end shopper communication. Online media, including such social media sites as Twitter or Facebook, not only continues to gain in popularity, but serves as a growing source for information for today’s consumer. “Social media plays a major role in influenced-based marketing,” Blischok said.



• Recognize and capitalize on changing rituals now. Rituals such as more and more consumers making up a shopping list at their kitchen table (with the laptop very likely opened to Facebook and other web sites right next to them). Retailers or suppliers may want to seek out ways to get on that shopping list in the first place instead of attempting to convert an impulse purchase at the store.



• Focus on familiar products. Primarily because trial outside of trusted name-brands is somewhat inhibited right now, Blischok suggested.; And Prepare for a new conservative shopper long-term. Because the dollar-saving shopping behaviors consumers are learning today are not likely to fade even after the economy begins its recovery. The conservative shopper buys less and more carefully, Blischok said.

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The Internet has been a contributing force to the effectiveness of the patient-safety movement, advocates say. In the past decade, there has been a grass-roots swelling of patients and families demanding a stronger role in healthcare reform and quality improvements. That is not a coincidence: 10 years ago, the Institute of Medicine released its landmark To Err is Human report and, hospitals suddenly found a spotlight shining on their practices. Although medical errors were happening before 1999, there was a lot more awareness of them after the report, said Helen Haskell, who became a safety advocate as a result of medical complications that led to her son's death

Haskell, along with advocates Dale Ann Micalizzi, Susan Sheridan and many others, have taken their efforts to the Internet to connect with families who have endured similar experiences in hospitals and who want to try to change the system. In the beginning, everyone was fragmented, Haskell said. But now "we're all in touch, we all know each other."

Social-networking sites and Web pages have allowed safety advocates to establish connections that otherwise would be difficult to create, she said. In addition, safety advocates have developed Web sites for their causes. The group that Sheridan co-founded, Parents of Infants and Children with Kernicterus, has a button on its Web site that allows people to file complaints directly with the Joint Commission. Micalizzi's Facebook page contains links to several resources, including to other groups with Facebook pages, external blogs and organizations.

Patient-safety advocates are a fundamental part of system improvement, said Mark Novotny, a physician who is interim CEO of 99-bed Southwestern Vermont Medical Center, Bennington, which asked for Micalizzi's help after hearing her speak at an Institute for Healthcare Improvement forum. "A lot of healthcare is designed around those of us providing the care," he said. "How can you possibly understand what patients want if they're not in the room?" Medical errors and patient harm have led to providers and families taking sides in battles, when advocates say what the process needs is an injection of compassion and communication. Because, ultimately, the goal for both providers and patients is the same: successful outcomes and healthy people.

In a way, the healthcare system itself has created these advocates. And yet, without their influence, changes might not happen, said Paul Schyve, a physician and senior vice president at the Joint Commission. Increasingly, the advocates' perspectives on how errors are managed are being listened to, Schyve said. Providers are realizing that patients and their families have a role in their care, and their stories are being told to help inspire improvements. There is "clearly a much better appreciation" for that role, he said. But "that appreciation is not universal," he said. Patients are taking charge of their health needs – using the web as a main resource for information. The ‘Baby Boomers’ are the largest addition, to date, for wellness research on the web.

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