You can't go anywhere these days without hearing snippets of the healthcare debate - what should and shouldn't be a part of any government plan, the promise and the challenges of universal healthcare (which would extend access to the 50 million people currently uninsured in the U.S.), the potential ins and outs of legislation currently on the drawing board, etc. The options can be dizzying and there is much confusion around what is even up for debate The Daily Show for a little comic relief).
In the face of all this uncertainty, one thing that is certain is technology (Health IT) is going to play a large role in the transformation and advancement of the every day health and wellness of individuals around the world. Just think of all the information that is already accessible to help individuals learn about and manage their health (ever go to WebMD or your health provider's Web site?) Then think about all the information that can be digitized and linked to create relationships and uncover trends or connections that can lead to improved diagnoses and treatments. (There's a fun story on mapping our genomes from the <a href="http://www.nytimes.com/2009/01/11/magazine/11Genome-t.html?pagewanted=8&_r=1">New York Times</a> that can get the brain turning.) The possibilities truly open up when all of this information is at the fingertips of every doctor, from wherever they are, and can be quickly applied to improve the treatment of patients everywhere.
Healthcare organizations are starting to recognize the potential and integrate the network and the healthcare applications it enables into their patient care and future plans. I think U.S. provider <a href="http://xnet.kp.org/future">Kaiser Permanente</a> articulates their vision and the role technology plays in that vision well: "We need data, connectivity, accessibility, and absolute confidentiality. We need real time data to support patient care. We need systems that provide medical science as well as medical records. We need systems that link patients to doctors, doctors to doctors, doctors to nurses and care team members, laboratories to databases, imaging centers to databases. We also need monitoring equipment to computer oversight systems that provide a new safety net and support structure for care. Patients should be able to do e-scheduling, e-visits, e-referrals, e-tests results, and electronic secure messaging with their caregivers.
The system should be so electronic that the administrative overhead linked to paper sorting, filing, generating, and processing should be instantaneous and extremely accurate. Paper medical records should be the rare exception rather than the rule. Imaging results should go directly from the scanners to the physicians with no film or files to be lost in transit. Patients in their own homes should be able to link up in telemedicine consults with their doctors and nurses--avoiding major transportation headaches and providing instant responses to in-home crises and potential problems. Homes should have scales linked to caregivers for congestive heart failure crisis and motion monitors for patients with hip or stoke issues. Safe reliable in-home care should be the expectation of most patients."
It's a vision that I am sure we would all like to see come to fruition sooner rather than later. If for no other reason than Health IT can help automate the healthcare system to improve information accuracy and reduce mistakes. It is estimated that <a href="http://www.internetnews.com/government/article.php/3796636/Senate+Mulls+Stimulus+Funds+for+Health+IT.htm">98,000preventable deaths</a> occur at U.S. hospitals each year, a number which could be reduced if patient information could be accurately correlated with medication and treatment plan information. The United Kingdom's <a href="http://www.nhs.org">National Health Service</a> has quantified the number of the health service's errors derived from poor information at 27% (leading to close to 1200 deaths a year in England and Wales).
As with any diagnosis and treatment plan, however, it's not perfect and there are complications to be aware of before adopting all of this technology. First and foremost, the information must remain secure (which requires healthcare organizations becoming proficient in the complexities of network and data security and the proper <a href="http://www.informationweek.com/news/healthcare/clinical-systems/showArticle.jhtml?articleID=219100499&cid=nl_IWK_health_html">storage</a> of all this information). Then there is the issue of confidentiality: Where are the lines drawn between a patient's rights and a patient's right to know? What is the most effective use of these tools (particularly around <a href="http://www.informationweek.com/news/healthcare/patient/showArticle.jhtml?articleID=219200127&cid=nl_IWK_health_html">social media</a> and Web 2.0 services and applications). Who even <a href="http://radar.oreilly.com/2009/06/manifesto-health-data-rights.html">owns</a> all of this information.
There are a lot of questions that need to be answered; hopefully they will be during the larger healthcare debates that are taking place right now. While all the details may still be fuzzy on what the future of healthcare looks like, it is clear that the network and the Health IT services and applications it enables will be critical in the creation of a more sustainable healthcare system.