Group Health's online offerings include online medical records, secure e-mail between patients and providers and parental access to online medical records for their children.

The medical record includes an after-visit summary, which has been emphasized by Group Health leadership for two years and continues to be part of the drive to improve services and put the patient first, Moran said,

Group Health is a consumer-governed nonprofit healthcare system that provides health plan coverage to 580,000 residents in Washington and north Idaho as well as clinical care at 25 outpatient centers and one hospital. It has contracts with 39 other hospitals.

In 2000, its MyGroupHealth looked like standard static "brochure ware," as Moran called it.

Year by year, the program has become more interactive, providing not just e-mail services between doctor and patient but also prescription renewals, lab results, requests for doctors' appointments and reviews of benefits.

Group Health had to bring along its 900 physicians, some of whom were resistant to change - including one who e-mailed to say, "I'm never going to practice this way."

In designing MyGroupHealth, Moran said, Group Health put the patient first. "Others put physicians first," she said.