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!
David.
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