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by Todd Woody

(IDG) -- Nearly a thousand people attended an Intel Internet health care conference here today, but relatively few doctors seemed to be in the house.

Physicians are widely considered to be key to the creation of an online health care system. However, an Intel study on doctors and technology released Tuesday suggests physicians remain largely unwired at work and that existing technology may not always suit the practice of medicine.

"Very few doctors, even in the most high-tech clinics, [are] using the Internet for work," says Eric Dishman, an Intel ethnographer and coauthor of the study. "Even if they had the infrastructure at work to access the Internet, they don't have the time."

Dishman and colleague John Sherry interviewed and observed nearly 100 doctors, administrators and other health care professionals at work in clinics in the Pacific Northwest and Boston areas. The duo work for Intel Architecture Labs, advising engineers on how to create consumer-friendly products.

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The study found physicians at a "frustration flashpoint," overwhelmed by paperwork and the demands of managed care organizations that give them less and less time to spend with their patients. "Doctors cite the distraction of paperwork as one of the key reasons the quality of patient care is suffering," Dishman and Sperry wrote.

"Most physicians are on top of the paperwork for the first two patients they see in the morning and then fall behind," Sherry says. "By 5:30 or 6:00 they stop seeing patients and tackle a stack of paperwork." A video accompanying the study showed a physician's file transfer system – a suitcase she used to lug paperwork home.

The online health care industry has largely focused on getting doctors to use PCs connected to the Net in their practices. But while PCs may work for office administrators, they may not suit many physicians' needs. For instance, a few doctors in the Intel study experimented with entering patient information on laptops they carried into the examining room. But it took as long as four minutes for some of the computers to boot up.

"Four minutes is a long time when the doctor only has seven to 10 minutes to see a patient," Dishman notes.

Then there are more basic issues. "Physicians told us that not being able to type quickly is a big fear," Sherry says.

The online health care industry will need to develop different types of devices and services – such as handheld computers or digital transcription services – that fit the way doctors work and relate to their patients. That means figuring out how to integrate technology with some useful paper-based tools, such as medical charts.

"The chart has a long evolutionary history that [doctors] have adapted to," Sherry says. "With a chart, they can walk down the hall and quickly review a patient's history before they go into the examining room."

The physicians that Dishman and Sherry interviewed said they aren't necessarily averse to technology and would like to see a solution that cuts the inefficiencies and cost of the current paper-choked system. The study found that many doctors go online at home and that the most common use of the Net by doctors is to conduct medical research.

"There is a long way to go in the process of leveraging the power of computing, particularly the Internet, in the improvement of the quality of care," the study concluded. "As new technologies become available, doctors realize that their practices and systems need to change, but they also feel overwhelmed about where to start."

The security of medical information transmitted over the Internet also ranks as a major concern of doctors, the study found. Intel and the American Medical Association hope to alleviate that fear with an initiative to create digital certificates that authenticate doctors' identities online.

Of course, the success of the project announced Tuesday will depend on a critical mass of physicians adopting the Internet in their medical practices.