In 1999 an estimated 17.5 million people—nearly half of all adults using the Internet in the United States—visited World Wide Web sites offering health care information. As Internet use becomes more prevalent, it will transform the local, low-return US health care industry. We believe that in this transformation the players holding the best hands are the major medical centers of the United States rather than the Internet pure plays currently dominating the landscape of e-health care.

Why? The recent woes of the e-health care players already show how hard it is to make a go with this model. Only a very few of them will thrive. Nevertheless, by making the performance of second- and third-tier treatment centers visible, procedure by procedure, to anyone with a browser, those few will eventually drive less eminent institutions out of treatment areas in which they are not world-class or require them to become suppliers of routine care to first-tier institutions. As the marketplace increasingly comes to recognize the potential of long-established brands, customer bases, and revenue streams for dominating e-commerce, the major medical centers of the United States will find themselves with an enormous opportunity to become the premier players on the e-health...