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Does technology enabled health care need a reality check?

By: Ephraim Schwartz, InfoWorld (US online)(11-29-2006)

Many people believe that individuals must take personal responsibility for their own treatment and ultimately their own physical well-being, but is technology helping bring this about.

It is this belief that is slowly becoming embedded in our health care IT systems. And as health care goes high tech, IT expertise will be needed more than ever to manage all the new systems.

An umbrella technology already in use at major medical practices with 20 or more doctors -- according to Michael Lake, principal at Circle Square, a consultancy for strategy and business consulting in health care -- is the EMR (Electronic Medical Record).

Think of the EMR as a health history repository for all of a person's medical records, all in one place and accessible by any system at any medical office, hospital, outpatient facility, or EMR service.

Closely related to an EMR is an even newer concept called a PHR, Personal Health Record. A PHR might be stored on a USB key fob. Get knocked off your motorcycle as I did recently, and the EMR tech in the ambulance might plug the USB device into a notebook and bring up my entire medical history, including my past motorcycle mishaps!

Because an EMR has all the medical data in one place, it can, for example, chart the history of lab tests across time and if it detects a disturbing trend it can send an alert not only to the doctor but also to the patient. If I get an e-mail that my cholesterol is trending up I can take action immediately rather than waiting six weeks until my next doctors appointment. It might even link me to a site that offers low cholesterol diets.

Michael Ross, a physician and a vice president at PAR3 Communications says "there is a recognition that interceding at the end of a train wreck is too late."

But for the immediate future, the EMR reduces "chart pulls" which in a large practice can take an inordinate amount of time, Lake tells me. It also automates doctor's transcription notes and reduces errors that can be caused by a doctor missing something in a voluminous paper record.

Oh yes, Lake adds, you will probably need some kind of IT department to keep and maintain a system like this.

PAR3 is also partnered with a high tech company that puts a radio chip into a prescription bottle cap.

When your dose is due the cap changes color. When you open the bottle and take your meds it changes back. The cap is wirelessly connected to a night light that monitors the caps and that light connects to a dongle and a modem which gets the information out to the Web and to your doctor or a family member depending on the business rules are established.

Electronic prescribing is yet another less flashy technology that is also changing health care. SureScripts runs the largest network between pharmacy and doctor, not unlike an ATM machine, to fill out prescriptions electronically. Tied into an EMR or a PHR system it can evaluate drug interactions, and even suggest alternatives if a non-generic is not covered by the health care insurer.

Once again these technologies require IT expertise to do such things as verify that the pharmacy received the prescription and to prevent fraud and identity theft. So to all of the new computer science graduates I have just one word for you, health care.

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