The Status of Electronic Health Care Upgraded to Probable


The marriage of medicine and telecommunications seems to be one made in heaven. That's ironic, since the goal is to keep people out of that venue for as long as possible.


Insiders make a differentiation between remote treatment and electronic health records. The two disciplines are very closely linked, of course. While there are many services and a lot of deployed infrastructure, the overall field never has exploded. Inherent drawbacks included bandwidth limitations, security concerns, differences in the laws in cases in which the electronic communications cross state lines, how electronic records will be reconciled with Health Insurance Portability and Accountability Act (HIPAA) requirements, health professionals' resistance and-for those willing to participate-the difficulty of being reimbursed.


It is safe to say, however, that the promise of telemedicine is so obvious that it was clear far earlier than other telecom-related businesses. The ability for a farmer in rural Kansas to have his radiological imaging looked at by an expert in St. Louis or New York City was clear decades ago. Thus, the gestation period for the networks and tools to do this type of thing seemed to take longer to mature simply because the wait started earlier.


Today, however, the tools are fully ready. Just this year, at least three significant announcements have been made-two within the past month-and the Obama Administration has made electronic health care records a goal of the stimulus package the president signed into law in February.


This week, Dell and Perot Systems said they will provide services, desktop equipment, storage gear, servers and medical information systems to a variety of medical facilities. The alliance, announced at the Healthcare Information and Management Systems Society conference in Chicago, will provide either on-site or hosted services. A packaged medical record and clinical practice-management system for small facilities will be available from Dell through Walmart's Sam's Club.


Another recently announced partnership-this one between General Electric and Intel-focuses on the investment of more than $250 million during the next half-decade in systems to remotely track the elderly and chronically ill. Paul Otellini, Intel's chief executive officer, is quoted in Forbes as saying that chronic care is responsible for about 80 percent of spending on health care overall. The story says the market is expected to grow from $3 billion this year to $7.7 billion in 2012, though it gives no source for the figures. The alliance features the sale of Health Guide, Intel's personal health system, by GE Healthcare. The companies will develop systems aimed at medication compliance, sleep apnea, fall prevention, diabetes monitoring and cardiovascular disease, the story says.

In early February, IBM, Google and Continua Health Alliance unveiled software enabling data from a personal medical device to stream results into a Google Health Account or other public health record. The information would cover patient monitoring, screening and routine evaluations. The information can be shared with physicians and other health care professionals and interested parties, such as grown children monitoring their parents' health.

These announcements are symptomatic, so to speak, of a rising acceptance of electronic health care. The writer of this piece a Pharmafocus differentiates electronic treatment from electronic health records, which has achieved wider acceptance to date. The piece mentions some of the inherent drawbacks to telehealth and alludes to the big companies that have made announcements this year. The writer says that the discipline has gotten good exposure in consumer-based media and does a good job of describing its advantages. Acceptance is growing, but the piece cautions that "it will not be a widespread for a few more years."

USA Today has a very informative story about electronic medical records. It's a hot topic because the economic stimulus bill contains $18.5 billion for initiatives, which is enough to get anyone's attention. The writer does a good job of laying out the issues and seems to be subtly backing the concept. A reporter and his or her editor has a lot of power in framing a story. One way of pushing a particular point of view is by making the opposing view seem, well, lame. Consider this presentation of the rationale of those opposing increased emphasis on electronic records:

Naysayers suggest health information technology (IT), the overall move to computerization, is full of false promise. Digital records can lead to better care and fewer medical mistakes, they say, but the costly transformation could waste money if the doctors and hospitals buy systems that can't be connected to share information.

Thus, the writer says that those opposed to pushing electronic medical records acknowledge it will work unless, of course, those implementing the project mess it up. Either there is no real opposition to these initiatives, opponents are grasping at straws or the writer is for some reason not really presenting the full case against the idea. It is fair to note, however, that she does mention financial concerns toward the end of the piece.

Expect to hear a lot of about all flavors of electronic health during the coming months. In addition to making sense, there is a feel-good element to these initiatives. In a sure sign that the area is hot, a new iPhone application, the Allscripts Remote from Allscripts-Misys, has hit the App Store this week. It is, of course, not the first medical application for the hot smartphone.