Physician, wire thyself

Michael Rogers Columnist • Profile • E-mail

The American health care system has many problems, but one of them is at once obvious and generally ignored: most doctors and hospitals still work in the buggy-whip era of information technology, dependent on pen, paper and manila folders.

At the turn of this century, when the average industry was investing $8,000 per employee on computer technology, health care was spending $1,000. By now, if you belong to a frequent shopper club, your grocery store almost certainly has far more computerized data about you than does your doctor.

Why is this important?  Partly because it wastes enormous amounts of money: the National Coordinator for Health Information Technology estimates that simply by using electronic health records we could save between 7.5 percent and 30 percent of the $1.6 trillion dollars now spent annually on healthcare. But beyond that, a fully computerized medical system will allow some remarkable new features and services for patients. And that doesn’t mean waiting for new breakthroughs — it can be done with the same information technology that almost every other business in the country has already adopted.

Think of the transformation that banking has undergone: global ATM networks, online banking, debit cards, paperless checking.  If applied to health care, those same technologies could produce some astonishing results.

• You’ll go to your physician’s Web site to make an appointment. The site will include a secure messaging system to access test results and send pre- or post-visit questions; cyber-savvy offices will probably have a nurse who fields the questions and passes the more complex ones on to a physician.   
• You’ll be able to access your own medical records online to add updates on your health or issues to follow up on your next visit.  If you’re visiting a new doctor, you’ll be able to send on your entire medical record beforehand, including not only other doctors’ notes, but test results and images such as X-ray and MRI.  You might even carry your records with you on a plastic card, or — for emergencies — in a tiny chip implanted under your skin. 
• The diagnostic devices in your doctor’s office, from the fever thermometer and stethoscope to a mini-MRI or X-ray device, could wirelessly transmit the results directly into your health records. 
• You could have diagnostic devices at home — blood pressure, blood sugar, heart rate, urinalysis and others — that automatically send results to your doctor’s office. 
• Rural physicians will be able to “call in” specialists from major teaching hospitals to “see” patients via video conferencing.  The consultant can have the patient’s full history right in front of them, along with real-time test results.
• In hospitals, RFID chips — the tiny radio chips that will replace barcodes in retail stores — can take on multiple roles. Each patient would have an RFID chip in their bracelet that would communicate with the tablet-style PC that nurses and doctors uses to update records. Each drug out of the hospital pharmacy would have an RFID chip as well and if it didn’t match with the patient’s chip a warning would sound. 
• Medicine could use the data-mining technologies that retailers like Wal-Mart already employ to improve service and efficiency. When patient records are in digital form, it will be far easier to determine if antibiotic A is superior to antibiotic B in treating a given ailment. It will also widen the sort of disease tracking that the Centers for Disease Control and Prevention now does on a national basis. A doctor in Milwaukee can immediately see what the doctors on the other side of town have encountered in recent weeks, providing an instant picture of health trends in the local area.
• Doctors will order prescriptions and tests on handheld devices or desktop computers that will connect straight to pharmacies and labs with no potential misreadings.  (Physicians’ bad handwriting has long been a source of humor, but there’s nothing funny about sloppy data entry when lives are at stake.  Electronic entry should improve the process significantly.)

MORE FROM PRACTICAL FUTURIST

Practical Futurist Section Front

Will the Internet transform storytelling? What evolutionary psychology says about social networking At this radio network, the audience is the star Is the Internet dumbing us down? Who will fix my wired (and wireless) home? Will road warriors choose electrons over airplanes? Who will be the TV Guide of the Internet? Why is U.S. always last for new phones? Weighing the risks of biotechnology What will make the laptop obsolete? Practical Futurist Section Front   Add Practical Futurist headlines to your news reader: