The followingcame out a few days ago. It provides a solid rationale for the pursuit ofsensible e-Health initiatives.
Thursday, September 1, 2011
The Rise of Electronic Medicine
Medicine today is a sea of paper and fax machines, privacybarriers, and unconnected data. The public is ready for a better system.
LastNovember 9 at 2 a.m., I received a phone call from a hospital in SouthernCalifornia. "Your mother needs an emergency operation," said thevoice on the line. "Your father had chest pain while at her bedside andboth are in ICUs. We have no idea what medications they take, what allergiesthey have, or what problems they have been treated for. Can you help?"
Thisis medicine today. A sea of paper and fax machines, information silos, privacybarriers, and unconnected data. And yet, we know the public is ready for abetter system. According to a 2010 Harris Poll, four in five Americans believeany doctor treating them should have instant access to their medical recordonline.
Today,we are moving quickly in this direction. In 2009, President Obama signed theHITECH act, creating a $27 billion stimulus package to accelerate health-careinformation technology in the United States. The law pays doctors to adoptelectronic records, and penalizes those who don't. Fueling the change are datastandards that make it easier to share health information, maturing software,rapid innovation linked to mobile computing, and policies to protect patientprivacy. As a consequence of this perfect storm of incentives anddisincentives, the next five years will see an unprecedented acceleration ofelectronic medicine in the U.S.
Othercountries are moving along a similar path. Some wealthy nations with socializedmedicine are far ahead; in the Netherlands, 98 percent of primary care doctorsalready use electronic records. But most nations—including Japan and China—arejust beginning to bring IT to bear on health care in a systematic way.
Willwe solve the problem of runaway health costs? The health reimbursement systemin 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 that15 percent of lab and radiology tests are redundant or unnecessary. Evidently,one man's redundancy is another man's country club membership.
Animportant aim of health-care reform is to change our broken incentive structureby instead paying doctors a yearly fee to keep patients healthy. For doctors tosurvive this reimbursement change, they will need to keep electronic healthrecords, share data, apply telemedicine to monitor sick people at their homes,engage patients continuously, and integrate the latest treatment knowledge intotheir workflow. That's electronic medicine.
Thetransformation of the health-care industry to embrace the levels of automationtypical of travel and financial services will not be easy. Health care hasunique payment models, referral patterns, workforce expertise requirements,customer needs, and privacy regulations. For these reasons, the centerpiece ofthe HITECH Act is the concept of "Meaningful Use"—paying doctors andhospitals only after they have installed electronic records andshown that they are using them wisely as measured by specific goals. Startingthis year, your doctor will need to keep a computerized list of yourmedications, problems, and allergies. By 2013, your doctor will need to be ableto share these data among all your caregivers (with your permission). And by2015, the hope is that the combination of electronic health records, datasharing, and novel technologies will enable your primary-care doctor torecommend best treatments based on the experience of tens of thousands ofsimilar patients.
Here'smy prediction for the major developments in the next five years:
· Electronic Health Records in theCloud
· Modular Software UnleashesInnovation
· A Network of Networks
· Engaged, Connected, E-Patients
· Genomes Lead to InformationPrescriptions
JohnD. Halamka, M.D., M.S., is a professor of medicine at Harvard Medical School,chief information officer of Beth Israel Deaconess Medical Center, chairman ofthe New England Healthcare Exchange Network, and co-chair of the national HITStandards Committee.
CopyrightTechnology Review 2011.
The fulltext under each of the bullets is found here:
It will beinteresting to see how prescient these are - but I suspect most will becomerealities over the next decade. We are already seeing the first two pointsstarting to be seriously considered.
It wouldbe really good if we had a ‘meaningful use’ style of approach - with theassociated incentives to really ramp up e-Health involvement in Australia - andof course we need to automate the providers first before working on theconsumers!
David.
