Getting Excited About the Technology Wave in Health Care

Posted on | January 4, 2007 | Comments Off on Getting Excited About the Technology Wave in Health Care

For many caregivers of my generation, technology has been viewed with double suspicion. First has been our concern that it would separate us from the people we serve, undermining touch and trust. Second has been the worry that technology in the wrong hands could drive policy in the wrong direction — limiting choice, access, coverage, privacy and relationships between the people and the people caring for the people.

But now a year short of 60, I see, even in my own peers, and certainly in the two younger generations of new clinicians rising in the ranks, a greater sense of security about technology, a belief that it can be harnessed for good, but to do so, physicians, nurses, and other caregivers must be in front of this movement and define it.

This requires not simply an understanding of the interface between science and technology, but also a broad and impassioned view of what we would like to build out as a better health care system and an understanding of how best to leverage technology as a connector, informer and enabler to get us there effectively and efficiently.

Some of the steps that are pointing us toward a better way to approach health have become increasingly obvious to all and have been the subject of many Health Politics programs. These include:

–Re-centering the health care system around multigenerational prevention and healthy homes

–Moving from electronic medical records (EMRs) to personal health records (PHRs) and from personal health records to lifespan planning records (LPRs)

–Empowering health consumers and supporting their active engagement and full participation in health care teams

–Expanding coverage to all and critically examining the wisdom of an employer-based, non-transportable health insurance system.

–Moving diagnosis of chronic disease from age 60 to age 20 and adherence to treatment plans from under 25% to over 75%

In all of the above, technologic advances in information, engineering and science are in the process of being harnessed, and if done well could assist the U.S. in applying its vast national spend in health care in a more effective, equitable and just manner. But, to do so, caring professionals of my generation must allow themselves to become excited about the possibilities and involved in reshaping the system itself.

What if, for example, you were able to place sensors in the orthotic shoes of diabetics, and if they and their clinicians could be alerted when pressure levels reached a point where the possibility of developing a skin breakdown was imminent. How many of the 90,000 diabetic amputations in the U.S. population’s 21 million diabetics could be prevented? Imagine the savings in suffering and dollars, and the increases in productivity. Well, companies are working on that, patents have been filed, and new products will launch this year and next.

And what if we had a simple multi-gene test that could identify the 20% of lung cancer patients who truly would benefit from chemotherapy? That would revolutionize our staging system for this disease. Well, as we saw in today’s New England Journal of Medicine, National Taiwan University’s Hsuan-Ya Chen and his colleagues, have devised such a test.

And what if GE, or Siemens, or Intel, or Microsoft really went after re-engineering the home, so that it wasn’t simply "where the heart is" but also becomes "where the health is;" and what if they simultaneously recognized that the LPR is the killer application that will finally tip America’s health care system from intervention to prevention?

That would be exciting, right?