Panel: Commercial Onramps to Consumer Health Information. Margaret Cary, M.D., M.B.A., M.P.H., Regional Director, U.S. Department of Health and Human Services, Moderator

Moderator:
Margaret Cary, M.D., M.B.A., M.P.H., Regional Director, (HHS)

Speaker 1:
IBM - Health Village
Jeffrey D. Miller, Brand Executive, Health Networking Solutions,
Worldwide Healthcare Solutions, IBM

Speaker 2:
America's HouseCall Network (AHCN)
Timothy J. Bahr, President, Healthcare Division, Orbis Broadcast
Group

Speakers 3
America Online
Ellen Taylor, Manager, Business Development, America Online

Speaker 4
Time Warner Cable's Full Service Network
Susan Bruce, Director, Interactive Education and Health Programming,
Time Warner Cable's Full Service Network

=========================================

Dr. Margaret Cary is the Director of Region 8 for the Department of
Health and Human Services and is the first physician ever appointed
to that position.  She's made a special impact on healthcare relative
to native Americans and also to technology issues.  For example, she
was the leader of a national summit on technology and service to the
citizen.

She received her M.B. degree from  Baylor College of Medicine, her
M.P.H. from UCLA, and her M.B.A. from the University of Colorado at
Denver.

Please welcome Dr. Margaret Cary.

[applause]

It is great to see all of you here.  I see a lot of folks that I
know, as well as a lot of new people.  It's good to see the
conference growing.

In case some of you haven't been reading the paper, we in the
Federal government are in the midst of a national debate on what our
role is in the country.  In the last three years the Federal
workforce has been cut by over 200,000 people.  On many issues we
are behind the private sector, but we're learning.

Last night we heard from Tom Ferguson that everything that we're
doing is last on the food chain of what the patients want.  We're
great at getting lots of information but we're not too good at
getting it out -- and that's where the private sector comes in.

For a long time the other principle content providers were voluntary
organizations like the Heart Association and the Cancer Society.
They are also effective in getting information to specific
populations.  The emergence of major communications information
service providers offers opportunities and challenges for all of us.
We all share the goal of getting out information and as we figure
out how to get to more patients effectively, there will be more
opportunities for us to work together.

We also have a responsibility to high risk patients and populations
that may not be covered by the market approach.  The market tends to
make care of the middle population the priority.  The rich have
their own systems, and the poor need help.  In the big book titled
"The History of the World," there are cycles: the rich get richer,
the poor get poorer; then there is a revolution and they switch
places.  So what I'm saying is that, depending on where you are, it
might be a good idea to get information to the poor who don't have
market access.

In the Federal government, we have a role to partner with private
organizations in order to ensure sound content and equitable access.
We have access to lots and lots of information which should be made
available.

As the moderator for this session, I will introduce each panelist
separately.

Jeff Miller is the Brand Executive for health networking solutions
with IBM.  He works on the deployment of network technology to help
consumers reengineer their business and delivery systems.  He's
worked with IBM for 13 years and most recently has worked to bring
IBM's Health Village offering to the marketplace.  Health Village is
IBM's newly developed consumer-oriented network-centered (whew! that
was hard to say -- thanks for writing such good copy) system that
uses Internet technology as an initial delivery vehicle.

Jeff received his Bachelor's Degree in Economics and Computer
Science from Northwestern University and his M.B.A. from Duke
University.

Please welcome Jeff Miller.


* Jeffrey D. Miller *

Thank you Maggie.  I have to first say that as hard as that was to
say, one of the things that is harder is delivering on those
promises.

I'd like to share some thoughts about how we're going about
delivering the Health Village.  To start, I'll give some background
on Health Village.

The Health Village is, in essence, a project where we focus on
delivering a host of villages -- not just a single village -- into
the consumer health environment through private Internet offerings
or public Internet offerings in partnership.  We want to create
villages that are customized to different segments of the
population.  Our goal is not only to build one information center
where people can access information on health care, but to develop a
two-way network between consumers and providers -- to facilitate a
bilateral exchange of information rather than a one-way system that
simply gives information.  We believe that building the Health
Village is similar to building any network.  When I started working
in this area a little over a year ago, I talked to friends at the
IBM research center.  I talked to them about what it was we knew
relative to consumer delivery.  They built me a little foil to show
what are some of the obstacles when building a network system for
the consumer population.  Whenever you're designing something for
the marketplace and the consumer, there are a number of obstacles
that you face.  These obstacles can be grouped into three sections:

1 - Economic -- cost of equipment, cost of services, etc.  How you
get access to an entire population if the cost of a PC is $2,000 and
the cost of a server $20 a month.

2 - Social obstacles  -- How do people get to the information?
Because of differences between us, we access and process information
differently.  No two people go about getting information in the same
way.  So, as you begin to build a health network, you also have to
address these cultural and societal differences.

3 - Technology -- Because of the ever-present, ever-changing nature
of technology, the whole idea of building online services and
networks is changed.  We'll see many changes over the next five
years, so you have to decide whether you want to wait until the next
change or if you want to go ahead and start doing something.  If you
wait, you could be waiting forever.

How do we begin answering the questions of our consumers?  Well,
there are four main questions that you have to answer when you're
building a network.  I have them displayed on the slide projection:

1 - Access  --  Who do you want to build the consumer health network
for?  Who's going to access it?  Are you building a universal
network or are you building a network for a specific community?
Then you have to ask yourself: How are they going to get to the
information?  And once you start to look at these access questions,
you come to the second question.

2 - Presence  --  If I'm building a health network, what presence do
I want to get off of it?  And there are two components -- context
and content.

     a) Context - What is the purpose of the network?  Am I looking
at more of a universal network?  You have to determine the context
in which the network will be operating.

     b) Content - Are you going to provide interactive, dynamic
information or static information?  Are you going to put out
information that in 90 days is 'old news'?  How do you deal with
credibility?  How do we deal with the contradictory nature of the
information we provide?

3 -  Integration  --  How do you integrate your information into the
existing system?  How does the consumer communicate with the health
system more effectively?  How do I get the information from my
doctor that he won't be at the appointment on time?  You need to be
able to integrate into existing systems.  We don't have the
wherewithal to rewrite the clinical systems, the private business
systems and such.

4 -  Enablement  --  Once you've begun to figure out answers to the
questions of "who" and "how," and you've figured out what your niche
will be, then you know which planet you are on in the solar system.
Then comes the question of:  How do I begin to enable an entirely
different system to be used?  How can I take the health network and
change the fundamental way that I deliver information?  This is the
real challenge for us.

Now all of this is nice and well, but it all comes back to one
person and that's the consumer.  My mother used to keep a little
saying stapled to her desk:  "No one can bequeath you good health.
Nor can the government guarantee it for you.  But like happiness, it
can only be found by yourself for yourself."

As we focus on building health networks, we have to keep the
consumer in mind since they're using the tool we hope to deliver.


* Moderator Margaret Cary *

Under Tim Bahr's leadership, the Orbis Broadcast Group has become
the leading industrial distributor and producer of TV news health
programming.

He was one of the principle architects of the Journal of the
American Medical Report.  Orbis produces over 200 medical news
reports each year.  His company launched and programmed American
Medical TV.

Today Tim is discussing America's HouseCall Network (AHCN), which
combines the expertise of the company in producing medical programs
with the technology of the Internet.  HouseCall allows the
individual to use new technology to engage and interact with
consumers and professionals.


* Timothy J. Bahr *

Thank you Maggie.  I'm going to preview for you a rather complex
system today, very simple but very complex.

America's HouseCall Network will premiere in about a month.
Actually it's going to launch next week in New York City.  When we
first started two years ago, there was published in the Journal of
Public Policy -- and this was something we decided we wanted to
tackle -- a challenge to organize information, make it easily
accessible and make people aware of it.  We wanted to make it
accessible to the widest possible population as quickly and
efficiently as we could.  HouseCall is a fully integrated health
care system using traditional ways in which people are used to
receiving medical information.

We designed America's HouseCall Network to be a open system.  It is
open to anybody, anywhere who can access the Internet or a
telephone.  The system will be available on the World Wide Web, it
will be promoted and will carry messages on TV, and it will offer
operator-assisted linkage to the online world.  Audio text will be
available to people who are trying to access information over
telephones.  It will be advertised on American Airlines; they will
have a regularly scheduled program and passengers will be given
information on how to interact with the system they saw while
traveling.

We're also studying interactive TV.  We're trying to make the system
ready to use interactive TV when it's available.

In order to address the issue of integration we wanted to provide a
system that worked well with the existing frameworks through which
people get their information.

On the consumer side, we offer 24-hours-a-day/7-days-a-week medical
information.  We want to create a community and let people with
similar disorders communicate with one another.  We will invite them
to participate in physician-moderated chat groups as well.

For the providers we intend to deliver interactive continuing
medical education.  We've been in this business for about 12 years
now using other media such as television.  Professionals will be
able to take online courses, etc. and receive credit online for
their studies.

There will be practice management and consumer information
available.  And for hospitals we will provide a national referral
network built in to the system.

For managed care, we focus on disease and demand management.  The
idea is to provide the information through respected third parties
and organizations so that managed care organizations can make it
available to patients and physicians.  We are providing a cost
effective means for organizations to distribute information to a
very large population.

How we will create awareness?  Everything that Orbis does will now
carry the address on the back -- HouseCall.Com -- and will say: "For
more information on the material you have seen in this program, you
can get it at HouseCall.Com."

Through all this, we want to create a credible source for medical
information.

The American Association of Physicians are our key partner.
Together we are designing a lot of programs.  We're in the process
of producing 48 titles that will be given out through the doctors'
offices -- top-line living-with information -- and those programs
will teach people how to go online for additional information,
receive email updates, enter chat rooms, participate in regularly
scheduled physician moderated chat rooms, etc.

The National Health Council represents 108 of the volunteer
organizations in the country.  They are another key strategic
partner, and HouseCall will provide access to all their members.

Finally, to wrap up, the nation's leading authority on prescriptions
and OTC drugs will be on HouseCall.  A number of hospitals and acute
care centers, and leading producers of digital information will join
as well.  Media alliances will be announced.  All of this will be
announced next week at the Waldorf in New York, and we invite anyone
who's interested to attend.


* Moderator Margaret Cary *

Ellen Taylor is the business development manager of America Online's
health channel.  She focuses on building content, programs and
communication on major health issues affecting AOL members.  I used
AOL the other day, and it was very cool.  I normally use the
government LAN system which is more bare-bones.

Prior to working at AOL, she was with the National Cancer Institute
as patient education specialist.  Her responsibility at NCI included
evaluation and development of patient resources.  Ellen also worked
for AT&T in their health promotion program, where she implemented
the first program targeted at family involvement in worksite health
promotion programs.  She also has authored two textbook chapters on
this subject.


* Ellen Taylor *

Thank you for the complement.  The online medium is the newest we
have for reaching the public and professionals with health
information.  As with anything, there are challenges we face in
using this medium well.

I'd like to start with an overview of AOL and our approach to health
information.  Content is important, but what keeps members coming
back is community.  As an example -- and Dr. Ferguson covered this
well last night -- this comes from a message that was posted on one
of our boards about bone marrow transplants.  This woman had had a
transplant 4 months prior, she was not feeling well, and was worried
that this was not normal.  "I'm still so fatigued and tired of
fighting the seemingly endless effects.  For the first time in the 4
years I've been fighting cancer I'm starting to feel I will never
have a normal life again.  If there is anyone out there who did get
well, please write.  I am at the point where only someone who has
been through this can understand how I feel."

Annie was looking for people with a similar experience.  Perhaps she
was in a small city, so she posted a message on an online community,
and she received a lot of responses.

One person said, "My husband had a BMT two years ago, and we had no
idea how weak he was going to be when he got home.  I wish you luck,
and know there are lots of people who have been in your shoes."

Someone else, "You are not alone!!!  Let me tell you where I am.  I
could not climb stairs for eons.  Please write if you have
questions."

"I agree with the others.  4 months is not very long.  I am at 6
months out.  I was very discouraged, but realize that your energy
will come back.  Until then, have faith.  E-mail if you want to
talk."

I would encourage all of you who are not familiar with the medium to
go into the message boards and see the powerful impact that this
medium can have.  That's what will drive the medium in the upcoming
months and years.

We at AOL refer to everything as channels.  That's a place where
information and communication is aggregated.  Let me give you an
overview about what the channel at AOL consists of.  We have 50
health forums, and these forums consist of content, message boards,
chats, and communication with experts.  The boards are one of most
active areas of the service -- we have over 2000 of them on topics
from ADD to BMT to infertility.  We schedule member-facilitated
chats, led by people with experience in arthritis to cancer
survivorship to gambling anonymous.

We have events with physicians, talking about diabetes, blindness,
or pain control.  Special programming is a big component.  The Great
American Smoke Out is an example, or allergies in the spring, or
overeating right around the holidays.  This is a 24 hour a day, 7
day a week medium.  We also have medical databases and full Internet
access.  Any databases on the Internet, we can point to and people
can search through AOL.

The channel is built through the best of what's out there, working
with partners or taking the best of what's on the Internet.  We also
develop original programming developed in house.  The important
thing we can do is package what's out there -- I told NCI they had
great content, and the benefit we bring to the table is to put this
content in an area and build community and programming around it.
That content alone won't bring people back.

There are a number of opportunities for consumers and health
professionals.  Consumers get wider access to information.  AOL is
all about community with others with similar concerns, and access to
expertise, talking to physicians about them.

The opportunities for health professionals is a mass audience -- you
can reach anyone with Internet access, in your city, state, the
United States, or the world.  You can also reach a niche, so if
someone has a rare disease with only a few 100's of cases, people
will find out about a newsgroup and find each other, such as with
male breast cancer.  Community is built around chronic illnesses and
people with rare diseases -- it's so compelling for them to find
someone going through what they're going through.

The opportunity that we have is to create interest and involvement
at a substantive level.  We put up content targeted at both
consumers and professionals.  Databases, chat, access to expertise,
all can be given to the audience.

Challenges: there's a lot of information out there -- 10,000 health
related web sites.  Don't ever search the Web just for the word
"health."  There's too much information. How can consumers evaluate
what's out there?  Unless there's a name attached to the
information, like the NCI.

Challenges for health professionals: we're live 24 hours a day,
seven days a week.  You always have to be up and running and
programmed.  It's has to be there for the consumers.  Focus on
approach with the importance of context and content -- broad or
narrow, static or dynamic, and which partners?  Tim has the distinct
advantage of being linked to the medical network, but for others,
how do people find you?  And how do you get people to come back?
That's what programming is all about.


*  Susan Bruce *

Thank you.  I would like to share how Time Warner is bringing
information and services in health care to consumers through
interactive television. Orlando is the home of the most advanced
interactive television in the world.  We have 4,000 homes online and
will be bringing schools on later this year.  All of the content is
digital and stored on computers.  It's accessible 24 hours a day
with a simple remote control.

It's hard to talk about this -- you have to see it.  I'll show a
brief video that discusses the current services and programs we
have.  Many of these are models for our health area.

[video begins]

Time Warner's vision of the cable of the future is here today with
the Full Service Network.  With a home terminal and remote, viewers
enter a parallel universe where they can order movies, go shopping,
play video games, and access information on demand.  Interactive
television channels coexist with broadcast and cable.  Traveling
between the two is as easy as pushing a button.  A home printer
provides instructions, maps, recipes, and other information.

"What we're really doing is transferring control from providers of
information and entertainment to the consumer, so the consumer has
control and choice.  This is the revolution behind the technology."
-- CEO of Time Warner

That revolution is the result of combining cable with fiber,
computers and data switching.  At Orlando, the Full Service Network
has upgraded cable with fiber optics, video compression and
switching.  These signals travel to a node and then on to coaxial
cable to homes.  Navigator helps viewers move through the network on
existing TV's and a new remote control.  With Navigator, an arrow
pad travels from one service to the next.

Omnio guides viewers and amplifies the ways to use the system.
Omnio represents nine primary systems.  Movies offers a library of
popular films.  Previews are available for every one.  Viewers can
fast forward, pause, rewind, and skip forward.  If viewers need to
stop, their movie will be held in memory where they left off.

In shopping, viewers enter the Dream Shop to the world's best
stores.  To enter a shop, just put the logo into the shopping bag.
Video clips describe the product, and customers can browse or buy.
Purchases arrive within days.

For games, viewers can play Klondike, or Gin or Pods.  Up to 16
players can compete in a single game.  Parents can control the types
of games children play.

Viewers get the news they want.  News includes CNN, ABC, and NBC
news, local news, weather, and national business and entertainment
articles from Time.

Smart Living provides a wide range of educational and health
services, combined with entertainment to make learning fun.
Educational services include a variety of interactive edutainment.
Health includes community health resources, plus health and fitness
programs.  Programs can use their controls to personalize their
choices, compiling hotlists for each member where they will be
visiting frequently.  Customers protect their information with pin
codes, and parent locks are available.

The Full Service Network is developing new and better services.
This includes telephone services and high-speed PC services.  With
convergence, the FSN customer can access and retrieve information
through cable modems, 100-times faster than over regular telephone
lines.  Expansion of FSN is unlimited.  Its boundaries stretch as
far as the future.

For Time-Warner Cable, the Full Service Network revolution has just
begun.

[end video]

I had to shorten this tape for today; we also have sports,
interactive local event guides with movies and dining, a Pizza Hut
build-your-own pizza, banking, music, and many others.  As you saw,
Smart Living is the educational and health venue; what AOL calls
channels, we call venues.  We'll be launching Smart Living this
summer, and we'll have health videos on demand.

We're really excited by the development of Health TV, which is
launching in early 1997.  The purpose is not to just offer
information, but also to give tools for changing behavior.  One of
the main components is a personal health profile:  users will
complete a questionnaire, which is then analyzed by the program, and
it will serve as a record of the history and situation.  The program
will provide information on health risks and recommend videos and
materials that might be of interest based on their health profile.
We are also developing a whole library of materials with health
videos:  the user will be able to browse and bookmark services which
they constantly go back to.  We'll have community calendars with
seminars, bloodmobiles, and 5k runs in the area.  We plan on
developing Health TV to increase interactivity and group activities.
We envision a neighborhood going on a weight loss program to lose
200 pounds.  You can enter your own progress, check on others, and
organize group dinners.

We also will offer shopping, and pharmaceutical guides, emergency
references, and continue to tie content with local services.

The third stage of Health TV will be linking it with HMOs in a
clinical environment.  Time Warner is also participating in a very
ambitious project in conjunction with a consortium of companies
spearheaded by the Koop Foundation, and this is to kickstart in the
private sector, developing health care networks and to pull
different environments together so you will be able to link and
access a consumer health profile and multimedia education to a
variety of locations: home, school -- you'll be able to pull up a
child's health records -- the government when appropriate, and of
course the clinic.  The goal is to create these health objects that
can be accessed and transmitted across different platforms.

Tom Ferguson mentioned that there are many ways to skin a cat, and I
believe that interactive television will make a significant
contribution to other media and methods to help consumers and health
care professionals implement health care strategies.  One of the
ways we'll be doing this is with the cable modem trial, where we'll
be cross-promoting both high speed access to services and
interactive television.  You'll be able to watch a video on diabetes
and then find out what is going on in the latest research.

I apologize, this is a short period of time to talk about a lot of
different initiatives and hopefully we'll have some time to talk
more in the next couple of days.


* Question and Answer Session *

Cary: I'm reminded of a series of teledemocracy forums we've had
around Denver.  How do we get access to folks who don't have the
equipment?  I know that your company, Tim, has access in libraries.
Could you tell us more about that?

Bahr: We've got an association to create access through computers.
Also there will be a local phone dialup to get audiotext playback.

Cary: Jeff, you and I talked about access to Indian people.  How do
we do this with inner-city folks and with people on reservations?

Miller: There are two things you have to focus on.  First is, there
are a variety of technologies, such as kiosks.  The other aspect is
partnerships with organizations who take responsibility for caring
for these folks, whether those are governmental or nonprofit.

Q: I'm here to represent the National Association of Physician
Broadcasters.  I'm excited by what I'm seeing in the arena of
Internet and television.  I encourage producers to call on
professional physician broadcasters and commentators.

Cary: I'm a member too, and I'm glad to see we're here.

Q: I'm interested in learning about the financial models,
particularly Health Villages and the American House Call network.
What models are you using to market to consumers?

Miller: Our model is a complex economic model.  Since we don't
deliver universal service but work with the sponsoring organization,
we share risk with that sponsor.  They pick up the per user/ per
month fees.  On top of that we have some value-added services which
the consumer pays for directly -- per click transactions.  We do not
use advertising per se, we've got some research that shows consumers
prefer non-advertising sites.

Bahr: Like Jeff, we are not using an advertising model.  We do have
a sponsorship model that allows organizations to provide sponsorship
grants.  There will be links from relevant content where people can
leave content and go to sponsor areas.  There are some areas where
the consumer will pay directly for information, but the initial
content is all free to the consumer.

Q: My question speaks to what Dr. Cary has alluded to, speaking of
the lower third of the economic and educational level of this
country, making sure that those people have access.  What
specifically are your organizations doing to help promote access for
that tier of people, and are you looking at partnering with
community networks to deliver that information?

Bruce: 98% of the U.S. has TV sets.  Time Warner is providing the
set-top box for the interactive television trial, and over the next
couple of years we'll be learning about interactive television.  We
have several lower income neighborhoods in our pilot.  We're trying
out pricing models, but many services will be free to the consumer,
such as the library application and a large portion of the health
and educational environment.

Taylor: AOL has been focused on providing access within schools.
I'd be interested in talking with anybody about the community
network program, so catch up with me.

Bahr: We're also interested in working with community networks.
We'll be using TV to deliver information directly to people.  There
will also be interactive television symposiums at hospitals across
the U.S.  People may not be able to go home and go online, but they
will get valuable information at the time of the broadcast.

Miller:  We are also involved with community programs.  We have a
corporate initiative on education and getting technology to the
classroom, but we're also working with different organizations on
getting the technologies to places where they can be used, such as
kiosk-based activities.

Cary: The Denver public library has branches where people can get
access.  I'm talking with HMOs for them to help get the information
out.

Q: I was listening to Bruce's presentation, and I was concerned
about people inputting their health information.  How do issues of
privacy come into that, or do people just relinquish these rights?

Bruce: That's what we'll be exploring.  The users has the choice of
not saving the information, they can run the program and delete the
information, or they can make the information confidential.  We're
using a Department of Defense encryption, so all Time-Warner
employees can do is delete information from people who've left the
service.  As people start working and setting up health records from
the home and making those records available to some people, this
will come under a great deal of scrutiny.  We're taking on that
challenge.

Q: I'm in the prevention field of alcohol, tobacco, and other drugs.
I'm old-fashioned in that "it takes village to raise a child."  What
happens when people are no longer knocking on each others' doors
because it's all going through a flip of channel?

Taylor: What we're about is communities.  This is an enhancement,
not a replacement of everything we've been taught.  You've got to
use the medium for what it does best.  You can have experts come
online and have parents and children sitting in on the discussion
together.  We had Columbia Health Care sponsoring children talking
to physicians, which went over very well.

Response: It's just that you're thinking in those ways, and it's
helpful.  There are a lot of web pages sponsored by the federal
government, and services like AOL can get the 60,000 people, and we
can get 5,000 maybe.  Are these companies willing to work with
federal agencies whose auditoriums don't hold your size audiences?

Cary: You can tell the Federal Web pages, because we're running a
contest to see whose can get to be the oldest before we change it.
I know at HHS we're working on a lot of Internet issues, like
getting information up in a timely matter.  That's what this
conference is about is to hook these things up together.

Miller: Shannah Koss actively works with state and federal government
to see how we can integrate this information into our service.
We're willing to work with you on this.

Taylor: Our approach is to package the best of what's out there.  If
it comes from a reputable, credible source, that's great.

Cary: The wake-up call is Dr. Ferguson's research that what we're
doing -- the shovelware -- is really low down on what people want.
Generally it's the person-to-person contact.

Q: I'm Naomi Broering, president-elect of the Medical Library
Association.  I'm pleased that libraries have come up so much today.
The library is really the community network.  Many of the medical
libraries are feeling major budget crunches, but our mission is to
serve the public good.  So what I would like to do is offer an
opportunity for some of you to work with the MLA to find mechanisms
to reduce the cost of getting access, or to make grants available to
these libraries that do provide this service to the underserved.  I
would love the opportunity to talk to you.  We have depended on the
National Library of Medicine, but it's time to extend.

Cary: I was at that NLM meeting, and I was talking with them about
what they're doing.  A woman from Texas was telling me she loved her
job, there was a biopsy where no one knew how much to cut, and she
was able to get the information in an appropriate time.  That was an
amazing use of these libraries. Libraries do save lives.

Q: I direct the Public Health Training and Information Network in
North Carolina.  Do any of you have R&D on how many hits are for
that subpopulation -- the rural, the inner-city poor?

Taylor:  You can't track Internet access.  We can track demographics
of our members, and the percentage under $25,000 is less than 10%.

Bahr: I'm not aware of anyone who's tracking demographics to that
level.  The senior age segment is one of the strongest growing
segments, but it's very hard to track individual hits.

Bruce: With interactive television, we can track every click, and we
will provide statistics on demographics without ever releasing
individual information.

Q: There are organizations that are trying to reach out to these
groups, and I'm wondering in your community services parts are you
focusing on ways to reach out to these groups?

A: Yes.

Q: In the preliminary conference brochure, American HouseCall
Network was affiliated with Microsoft.  What is Microsoft doing in
this area?

Bahr: When this launched, MSN was going to be its own content
network.  When MSN moved to be an Internet provider, we moved to
just be a web site, we're not residing in MSN.  As far as what
Microsoft is up to, that's what I know.

Miller: Microsoft has a strategic interest in health care, and we
all know they're working in this area as well.