Friday, September 16, 2011

A Good Vision for The Future Evolution of E-Health. I Like This Perspective!

The following came out a few days ago. It provides a solid rationale for the pursuit of sensible e-Health initiatives.
Thursday, September 1, 2011

The Rise of Electronic Medicine

Medicine today is a sea of paper and fax machines, privacy barriers, and unconnected data. The public is ready for a better system.
Last November 9 at 2 a.m., I received a phone call from a hospital in Southern California. "Your mother needs an emergency operation," said the voice on the line. "Your father had chest pain while at her bedside and both are in ICUs. We have no idea what medications they take, what allergies they have, or what problems they have been treated for. Can you help?"
This is medicine today. A sea of paper and fax machines, information silos, privacy barriers, and unconnected data. And yet, we know the public is ready for a better system. According to a 2010 Harris Poll, four in five Americans believe any doctor treating them should have instant access to their medical record online.
Today, we are moving quickly in this direction. In 2009, President Obama signed the HITECH act, creating a $27 billion stimulus package to accelerate health-care information technology in the United States. The law pays doctors to adopt electronic records, and penalizes those who don't. Fueling the change are data standards that make it easier to share health information, maturing software, rapid innovation linked to mobile computing, and policies to protect patient privacy. As a consequence of this perfect storm of incentives and disincentives, the next five years will see an unprecedented acceleration of electronic medicine in the U.S.
Other countries are moving along a similar path. Some wealthy nations with socialized medicine are far ahead; in the Netherlands, 98 percent of primary care doctors already use electronic records. But most nations—including Japan and China—are just beginning to bring IT to bear on health care in a systematic way.
Will we solve the problem of runaway health costs? The health reimbursement system in the U.S. pays doctors and hospitals for how many treatments they provide, not how good that treatment is. In Massachusetts, for instance, I estimate that 15 percent of lab and radiology tests are redundant or unnecessary. Evidently, one man's redundancy is another man's country club membership.
An important aim of health-care reform is to change our broken incentive structure by instead paying doctors a yearly fee to keep patients healthy. For doctors to survive this reimbursement change, they will need to keep electronic health records, share data, apply telemedicine to monitor sick people at their homes, engage patients continuously, and integrate the latest treatment knowledge into their workflow. That's electronic medicine.
The transformation of the health-care industry to embrace the levels of automation typical of travel and financial services will not be easy. Health care has unique payment models, referral patterns, workforce expertise requirements, customer needs, and privacy regulations. For these reasons, the centerpiece of the HITECH Act is the concept of "Meaningful Use"—paying doctors and hospitals only after they have installed electronic records and shown that they are using them wisely as measured by specific goals. Starting this year, your doctor will need to keep a computerized list of your medications, problems, and allergies. By 2013, your doctor will need to be able to share these data among all your caregivers (with your permission). And by 2015, the hope is that the combination of electronic health records, data sharing, and novel technologies will enable your primary-care doctor to recommend best treatments based on the experience of tens of thousands of similar patients.
Here's my prediction for the major developments in the next five years:
·         Electronic Health Records in the Cloud
·         Modular Software Unleashes Innovation
·         A Network of Networks
·         Engaged, Connected, E-Patients
·         Genomes Lead to Information Prescriptions
John D. Halamka, M.D., M.S., is a professor of medicine at Harvard Medical School, chief information officer of Beth Israel Deaconess Medical Center, chairman of the New England Healthcare Exchange Network, and co-chair of the national HIT Standards Committee.
Copyright Technology Review 2011.
The full text under each of the bullets is found here:
It will be interesting to see how prescient these are - but I suspect most will become realities over the next decade. We are already seeing the first two points starting to be seriously considered.
It would be really good if we had a ‘meaningful use’ style of approach - with the associated incentives to really ramp up e-Health involvement in Australia - and of course we need to automate the providers first before working on the consumers!

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