IT May Energize a Global Revolution in Health

The health care industry is about to undergo a global revolution driven by a force it can no longer resist: information technology. While hospitals and other care providers have long been quick to adopt breakthrough technology in medical devices, procedures and treatments, far less attention has focused on innovations in networking and communications.

But that is about to change. IT security will eventually meet the expectations of the health care industry, just as has happened in other sectors, such as banking. And when it does, powerful IT networks crisscrossing the globe will change the way much of health care is delivered:

• Outsourcing and off-shoring medical and nonmedical services will increase, providing more efficient health care at the most cost-effective rates.
• Systems integrations will allow more medical records to be transferred swiftly and securely.
• Efforts to monitor the safety of medicines will gain global access to data.
• Professionals and patients will find authoritative and up-to-date information on every specialty online.

In the future, there will be three, often-overlapping modes of delivering health care services: those performed in person by humans, those performed by people at a remote location and those performed by computers without direct human involvement.

Off-shore outsourcing in combination with a 24-hour work cycle will be appropriate when certain conditions are met - mainly, if the information involved in the task can be digitized, and if workers at different sites can do their jobs independently from one another.

These changes won't come quickly. There will be plenty of obstacles as institutions and networks reach across borders and encounter different laws as well as technical standards. Licensing, accreditation and accounting issues will arise. But such issues are likely to be resolved eventually.

The most noticeable changes will be the offshore outsourcing of diagnostic services - particularly imaging, such as X-rays and mammograms - and consultations by specialists.

Doctors in the U.S. and other countries have long practiced variations of telemedicine to provide care to patients in hard-to-reach and underserved locations. In the future, telemedicine will be practiced more as a way of distributing work loads and lowering costs. Teleradiology in particular, in which X-rays are taken at one location and then transmitted to doctors at another site, appears ripe for expansion.

Forces driving the growth of teleradiology include a significant shortage of radiologists, aging populations and more use of imaging in trauma situations, which in turn has fueled a need for 24-hour radiological services in emergency rooms.

Globally integrated health-information systems are evolving, along with standardized formats for patient records - making the charts easier to translate.

A detailed medical history can be crucial if a person becomes ill or has an accident far from home. Integrated information systems and records that translate easily would help in natural disasters and other mass-casualty situations.

Computer programs and Internet technology will play big roles in overcoming obstacles such as languages and units of measure, and conflicts between encryption and other software. But experts in IT and medicine will be indispensable at every stage, whether for building the tools for integration or assisting in specific records transfers.

U.S. hospitals and doctors already rely increasingly on workers abroad to transcribe audio recordings into written notes. Typically, the audio recording is sent in the evening, US time, to transcriptionists in India, for whom it is morning. A written version of the recording is then available to the doctor over the Web before the next day shift begins in the US.

As people become more mobile, an international database on drug safety will be created. Various programs do this kind of work in their home countries, including MedWatch, an initiative of the Food and Drug Administration that investigates and reports on adverse drug reactions and other safety issues involving medical products.

MedWatch relies on a wide network of domestic sources, including pharmacy companies, insurers and professional associations in the medical, dentistry and nursing fields.

But no agency routinely collects and shares information between countries. This is a growing concern in the US as people travel more and buy prescription drugs from pharmacies in other countries to save money.

Source: Wall Street Journal, Amar Gupta, 11/23/08