The way most doctors and health care professionals do their
jobs has hardly changed over the past thirty to forty
years. Contrast this with the enormous changes in,
transport, manufacturing and telecommunications.
The combination of technological change, the demands of
business and the rise of consumerism are causing radical
changes in the way healthcare is practiced around the
world. President Obama, with his promotion of information
technology, broadband networks and electronic health
records, is poised to accelerate these changes in health
practices. They will be the 21st century's equivalent of
the public health initiatives of sanitation and nutrition
which revolutionized healthcare in the twentieth century.
Integration of online technologies will see doctors and
patients working together using shared electronic health
records with patients having much more say in their
treatments. The development of widely available broadband
networks and video mail will eventually bring
electronically delivered healthcare into everyone's home.
Three processes are underlying these dramatic changes
across the health industry:
1. Evolution: The evolutionary processes are the new tools,
the hardware and software of the computer industries; and
changed business processes in healthcare. We need to
substantially redesign many of the traditional processes
used to practice medicine so that we can take advantage of
the new available multimedia technologies. Technology, and
in particular, Internet technology, is transforming the
medical landscape. As a practicing physician, I no longer
write any notes on paper - all my clinical work is
electronically recorded. House staff attend rounds armed
with a vast array of reference information stored in
hand-held personal digital assistants. The iPod is their
reception platform for lectures presented as podcasts and
vodcasts.
2. Revolution: The revolutionary changes are easier access
to information and knowledge on the Internet, leading to
fundamental transformations in the area of healthcare
delivery. Patients are increasingly expert in their own
diseases and have more collaborative relationships with
their doctors. The provision of clinical care is changing
rapidly as information technologies become increasingly
used and accepted, with a move away from episodic care to
concentrating on continuity of care, especially for
patients with chronic disease who will create the greatest
disease burden in the future. Care is gradually moving
away from a focus on the service provider to that of the
informed individualized patient and from an individual
provider approach to treatment to a team approach.
Increasingly, less focus is placed on treating the illness
and more is placed on wellness promotion and illness
prevention. This is the model of "Information Age
Healthcare."
3. Devolution; The devolutionary changes will see
organizations becoming more localized and less
hierarchical. The world of healthcare will be flatter than
it is now. Over the next fifty or so years large hospitals
as we know them will reduce in number, leaving fewer
centers of expertise staffed by super-specialist doctors
and other health professionals. Healthcare will become a
more distributed enterprise. We will be able to
increasingly concentrate our scarce health resources on
wellness promotion, instead of just the treatment of
illness. There will be more resources available, for
instance, to undertake the mass immunization campaigns that
we need around the world.
Our health system has to meet the challenges contained in
the crucially important report from the Committee on
Quality Healthcare in America published by the Institute of
Medicine. This influential report noted that "information
technology must play a central role in the redesign of the
healthcare system." It is wonderful to see President Obama
driving the current widely acknowledged broken US Health
system in this direction and I believe that it is essential
that he is strongly supported in this endeavor.
----------------------------------------------------
This article is based on excerpts from the recently
published book "Your Health in the Information Age - how
you and your doctor can use the Internet to work together"
by Peter Yellowlees MD. Available at
http://www.InformationAgeHealth.com and most online
bookstores.
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