The future of medicine in this country is not clear. We are not really sure if in 10 years we will have a system where health care is a marketable good (like it is currently) or a system that considers health care to be a right and something that is guaranteed to everyone. Electronic Health care strengths, and challenges, will be instrumental in whichever system our country adopts.
Given the current number of doctors, number of medical schools, and number of specialists, if our country adopts a more socialist* approach we don't have the resources (by keeping everything the same). Already our hospitals and emergency rooms are awash with the uninsured, taxing our emergency systems, and costing billions of dollars to hospitals and tax payers. We need more doctors if we approach the problem from a supply standpoint. However, like with power conservation, many scholars in the field feel that some of the strain on the system can be alleviated through preventative medicine, better use of records, and standardizing treatment procedures. All of which can be immensely helped by e-health care.
However, as a few people mentioned in their comments, and as I was planning on talking about anyway, many patients have concerns about the transformation, many which are centered around privacy.
We like the idea that our trusted doctor has the only copy of our information safely locked in his office, we have heard the stories of identity theft, hackers, spyware, and other means of electronic crimes. We worry that our information could be obtained and used towards us in a negative manner, perhaps by corporations in marketing, employers, insurance companies, or just criminals.
Who gets control? Healthcare 2.0?
Part of what needs to happen, and what is happening is actually very related to what we have been reading and watching videos about for class. The power of the people! Innovative e-healthcare systems, like Microsofts Health Vault, give control to the individuals on who see's there information, and what information is shared. If you are interested it is kind of a cool website to poke around and see what the future my hold.
One of the main competitors to Microsofts product is, you guessed it, Google Health! Google Health is an interactive website that allows you to compile your health information from your providers, and from yourself, and allows you to send this information to who you choose, it also helps to organize the heath information that is available on the web and to point it users to sources of important information. As far as privacy is concerned the user is completely in charge of who sees the information and google uses no advertisment (yet how they will make money eventually is still a big question, currently it is still a beta program).
In a trial program conducted in Cleveland the patients seemed eager and willing to participate and quickly the 1600 spots were taken up as the New York Times stated the "patients apparently did not shun the Google health records because of qualms that their personal health information might not be secure if held by a large technology company." (http://www.nytimes.com/2008/05/20/technology/20google.html?_r=1)
I think that privacy issues are very important, but I also think that it has some stigma attached to it. We are not concerned that our financial information is completely stored online, or that we can obtain credit reports and other information, but certaintly when it was a new concept many people were very concerned with how it would be used and how it would be kept private. As these new sites begin to increase their use I think people will get used to the idea and some of the stigma will be lost and people will trust companies, such as google, to keep their information private ( hopefully the government would TIGHTLY regulate this to ensure full compliance), but I really believe that as with everything technology related, the success and failure is completely dependant on the input of the users and the power that is given to the people. Its our information, we control how its used!
*I write socialist as a descriptor, not as a judgment as I personally am a proponent of health care as a right, and a socialist medical system provides this health care as such.
Saturday, June 27, 2009
Friday, June 26, 2009
The First Step is Digitilization
We have all seen them, shelves and shelves of colorful records, shoved together behind the receptionists desk at our family physicians office. On our appointment day our records are diligently searched for and placed in the doctor's office, where he or she can peruse their previous notes on our treatments, conditions, or concerns. This system seems to work, but in other settings it proves problematic. Perhaps a person is in a traumatic car accident and is rushed to the hospital, but the attending physicians have no idea what the patients medical history is, they have no idea if that slight irregularity in the persons heart rhythm is genetic and normal for the person or if it is the first sign of a growing problem. The emergency doctors don't know what medications the patient is on, and must make decisions based on incomplete information. Transfer of medical records is time consuming, costly, and in-efficient. Can this system be improved to be used in the 21st century?
The study of health informatics says yes. Even though many doctors and hospitals have long used computerized records for payroll and billing, many have not computerized their health records. One of the first steps in the health informatics revolution is the complete digitilization of health records or the creation of Electronic Health Records (EHR's). This itself has proved to be controversial, as many groups have tried, and failed, to get doctors and nurses, as well as healthcare facilities to embrace technologies. Though many in the industry feel that finally technology has reached the point that it can be feasibly used to meet the demands of the medical profession.
Before examining the impact on the United States, its important to realize the global nature of the e-healthcare situation. E-healthcare works. There is a laundry list of countries, such as Denmark, India, and Thailand, that have instituted electronic infrastructure into their healthcare systems. Denmark has system that pretty much all of its citizens are enrolled in that tracks (electronically) what medications a person is on, when it was prescribed, and by what physician. Remarkebly modern medical facilities in India and Thailand streamline the healthcare process by providing digital records to its doctors, helping to create a high quality, low cost healthcare option.
A recent study suggested that E-heathcare systems are used in less than 1/5th of healthcare facilities in the United States. The technologically most advanced, and innovative country in the history of the world has only 20% of its healthcare facilities running 21st century programs? This is a huge problem. A theoretical study, published by the RAND corporation, suggests that if 90% of the US healthcare facilities began using e-health care, costs would drop by 77 billion dollars per year, or about 6% of the total cost of health care in the United States.
Graph obtained from http://www.economist.com/surveys/displaystory.cfm?story_id=13438006
Doctors have often been some of the largest opponents of such a systematic shift. This can be attributed to stuberness, insufficient compensation for learning time for new systems, and unfamiliarity with the new systems. I believe that one of the first steps in modernizing our healthcare systme is the full cooperation of doctors, and something I think will be easier as our generation becomes doctors. As people that grew up with web 2.0 become the leaders in health care, it should face less and less opposition, especially when the recent stimulus packeage is providing a lot of money for this to happen. Ultimately digitizilation of records will reduce costs, save lives, and provide a higher level of care. It needs to happen, and it will very very soon.
The study of health informatics says yes. Even though many doctors and hospitals have long used computerized records for payroll and billing, many have not computerized their health records. One of the first steps in the health informatics revolution is the complete digitilization of health records or the creation of Electronic Health Records (EHR's). This itself has proved to be controversial, as many groups have tried, and failed, to get doctors and nurses, as well as healthcare facilities to embrace technologies. Though many in the industry feel that finally technology has reached the point that it can be feasibly used to meet the demands of the medical profession.
Before examining the impact on the United States, its important to realize the global nature of the e-healthcare situation. E-healthcare works. There is a laundry list of countries, such as Denmark, India, and Thailand, that have instituted electronic infrastructure into their healthcare systems. Denmark has system that pretty much all of its citizens are enrolled in that tracks (electronically) what medications a person is on, when it was prescribed, and by what physician. Remarkebly modern medical facilities in India and Thailand streamline the healthcare process by providing digital records to its doctors, helping to create a high quality, low cost healthcare option.
A recent study suggested that E-heathcare systems are used in less than 1/5th of healthcare facilities in the United States. The technologically most advanced, and innovative country in the history of the world has only 20% of its healthcare facilities running 21st century programs? This is a huge problem. A theoretical study, published by the RAND corporation, suggests that if 90% of the US healthcare facilities began using e-health care, costs would drop by 77 billion dollars per year, or about 6% of the total cost of health care in the United States.
Graph obtained from http://www.economist.com/surveys/displaystory.cfm?story_id=13438006Doctors have often been some of the largest opponents of such a systematic shift. This can be attributed to stuberness, insufficient compensation for learning time for new systems, and unfamiliarity with the new systems. I believe that one of the first steps in modernizing our healthcare systme is the full cooperation of doctors, and something I think will be easier as our generation becomes doctors. As people that grew up with web 2.0 become the leaders in health care, it should face less and less opposition, especially when the recent stimulus packeage is providing a lot of money for this to happen. Ultimately digitizilation of records will reduce costs, save lives, and provide a higher level of care. It needs to happen, and it will very very soon.
The Evolution of Medicine--An Introduction
The medical profession is one of the oldest and most visible professions. Doctors and healers have been a part of society for thousands of years. However, it is interesting to note that it is unclear whether or not doctors and healers had any impact on the actual health of their patients, in fact some scholars assert that doctors, with their lack of knowledge of pathogens and proper sterilization techniques in fact were more likely to harm their patients. The modern medical profession can be traced to the discovery of antibiotics such as penicillin in the early 20th century. Until then the odds of survival where equal or better by not seeing a doctor!
Medicine has often lagged a bit behind the times. In the 18th and 19th century as other industries underwent enormous development propelling the world into the industrial revolution, the medical profession largely remained somewhat constant. Similarly in the 20th century, as most industries computerized at a staggering rate, the medical profession remained a mostly pen and paper operation. This is not to say that physicians and the medical profession were not being innovative at the time, rather from the discovery of antibiotics, to the discovery of the human genome by Watson and Crick, to amazing new surgical techniques, to new sterilization technologies, vaccines, emergency medicine, new diagnostic tests, the medical profession was (and is) in a period of great discovery, one that is using modern technology to accomplish its goal of improving the health of people worldwide. This revolution in medicine created the modern medical knowledge base and the amazing and life changing procedures that we take for granted today.
Another revolution is coming, one that will change the way medicine is delivered to patients worldwide. A revolution in how doctors and health care professionals organize and collaborate with each other, and how health care is perceived. Our new president has made a health care reform a priority, a priority that is much needed as the United States spends more per capita GDP on health care than any other nation, but does not receive the highest level of care. This blog will attempt to explain, discuss, and react to the implications of the digitization of medicine, and the changes that medicine will undergo as a result. Our society will be forced to re-evaluate its priorities and way of thinking about health care in the coming years as the ancient profession of medicine will enter into the 21st century and be forever changed.
Medicine has often lagged a bit behind the times. In the 18th and 19th century as other industries underwent enormous development propelling the world into the industrial revolution, the medical profession largely remained somewhat constant. Similarly in the 20th century, as most industries computerized at a staggering rate, the medical profession remained a mostly pen and paper operation. This is not to say that physicians and the medical profession were not being innovative at the time, rather from the discovery of antibiotics, to the discovery of the human genome by Watson and Crick, to amazing new surgical techniques, to new sterilization technologies, vaccines, emergency medicine, new diagnostic tests, the medical profession was (and is) in a period of great discovery, one that is using modern technology to accomplish its goal of improving the health of people worldwide. This revolution in medicine created the modern medical knowledge base and the amazing and life changing procedures that we take for granted today.
Another revolution is coming, one that will change the way medicine is delivered to patients worldwide. A revolution in how doctors and health care professionals organize and collaborate with each other, and how health care is perceived. Our new president has made a health care reform a priority, a priority that is much needed as the United States spends more per capita GDP on health care than any other nation, but does not receive the highest level of care. This blog will attempt to explain, discuss, and react to the implications of the digitization of medicine, and the changes that medicine will undergo as a result. Our society will be forced to re-evaluate its priorities and way of thinking about health care in the coming years as the ancient profession of medicine will enter into the 21st century and be forever changed.
Wednesday, June 24, 2009
Topic
I intend to study the social implications of Health Informatics. This is the intersection of health records, computer science, and treatment methods, and is a very important and relevant topic for the times ahead.
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