The Future Is Now

Alice Lipowicz, writing for Washington Technology magazine reports today that health information technology and electronic health records underpin many of the provisions in the comprehensive health reform legislation passed by Congress, especially in improving efficiency, transparency and quality of care and reducing fraud. The new law has provisions for improving healthcare quality, as well as transparency, including collection of information about physician ownership in facilities. It has anti-fraud provisions, including expanded data collection and a larger number of data elements to be reported by providers. Most importantly the law states that the secretary of Health and Human Services shall ensure that there is enhanced use of health care data to improve quality, efficiency, transparency, and outcomes. While it is not clear whether improving healthcare disparities is specifically mentioned in the bill, the requirement, that data be used to improve, among other things, outcomes, is promising. It would almost certainly include improvement in healthcare disparities as one type of health outcome to be improved. In the end, the potential impact of technology on healthcare and disparities should not be overlooked nor underestimated. The impact of this legislation will undoubtedly go far beyond mere information sharing between patients, providers and healthcare systems, to enabling clinical research and the development of interventions not currently conceivable. The potential benefits of technological advances on healthcare disparities are likely to been seen in at least 3 areas. First it will help us get a better understanding of the causes and determinants of healthcare disparities. Computer technologies in healthcare could also enable the design of new and more effective clinical and behavioral healthcare interventions. By relying on user centered design strategies in the development of future ehealth technologies, we may be able to turn sociocultural beliefs and behaviors, which may limit clinical efficacy, into tailored design features which facilitate the diffusion and adoption of powerful health tools. Finally computer technologies in healthcare may also enhance current provider interventions enabling a level of provider efficacy not currently possible. These computer based healthcare interventions will not likely be limited by contemporary barriers of geographic proximity to a hospital or clinic, literacy, language or human error. In the future healthcare system, Human to Human (H2H) computer aided connectivity will enable providers and healthcare systems to stay in audio and visual contact as needed with any patient. Human to Thing (H2T) internet based connectivity will enable both providers and patients to know about the health status of individuals or populations and their surroundings at any time, in real time, prior to the need for and after hospitalization while device interconnectivity will mean the development of “intelligent devices” that can make decisions and do things independent of the “human element”. In this future healthcare system clinical interventions will be delivered via a variety of formats including the web, game console, interactive TV, cell phone and PDA’s, not just in person. In addition they will be delivered anywhere and at any time as needed by patients. Perhaps the most exciting thing is that given the passage of healthcare reform, the future is possible…now.