Personally, I have three different electronic health records providers, and that is even without signing up for Google Health (2008-2012 RIP) or Microsoft HealthVault (2007-present). Massachusetts General Hospital alone has three different storage systems, depending on which doctors need to be reached.
They tell me they plan to evolve to a unified service. This sounds both wise and convenient, but I can only imagine the political nightmares for their CIO in choosing the right solution.
In the early stages of any new industry, a wide range of solutions for a given problem is typical. As entrepreneurs offer up solutions or companies hire skilled people to develop those solutions (or APIs to access commercial solutions) in-house, a confusing diversity of offers often confronts customers.
Over time, the marketplace evolves to choose one. Remember previous battles, like VHS vs. Betamax and Blu Ray vs. HD DVD, and in our own space GSM vs. CDMA and TDMA vs. IDEN? The eHealth category is now expanding, alongside its close relatives iHealth and mHealth, with applications and interfaces targeted at hospitals, insurers, clinics and individuals.
We consider this wonderful news for our wholesale industry. The storage and sharing of records, including MRIs, PET scans and (at almost 27MB each) digital mammograms, will continue to fill networks and push hospitals and a multitude of other service centres to be open to large pipes, managed networks, co-location access, vast storage and so on.
In addition to large medical buyers, the plethora of consumer applications which track steps, heart rates, calories, treadmill actions, and on and on will fill our phones and pads and require significant backup to see long-term trends in our personal health. The Apple store has 68 app choices for "personal health records", 1,037 for "disease" and 2,200 for "health". Many of them are fun to use and they all point to a future of data-empowered healthcare consumers. Each of us can produce Big Data about ourselves.
In the US in particular, we can hope the digitisation of healthcare can lower costs. Jason Kane of our Public Broadcasting Service (PBS) reported in 2012 that we spend $0.17 of every dollar of our GDP on healthcare, or $8,233.00 per year per person. This is 2.5 times as much as developed nations in Europe and obviously many multiples of spending levels in less-developed parts of the world.
Even with this, the US has fewer hospital beds per person (2.6 per 1,000 vs. the OECD average of 3.4 per 1,000) and fewer doctors per person (2.4 vs. 3.1 per 1,000). An experienced New York surgeon tells me that we are in for a huge nursing shortage as the baby boomers age. More doctors are using email, telephone sessions and Skype or FaceTime discussions to add data-intensive convenience for patients and themselves, and to help the underserved rural areas of our country.
There will be bumps in the road. Recently, for example, after one of his patients committed suicide with a prescription he had written, a psychiatrist was sanctioned for offering his rural Oklahoma patients Skype-based therapy sessions, without having met them in person for at least a first visit. Nonetheless, all signs point to a digital health future – for access as well as costs.
Hospitals report some success with assembly-line thinking to lower costs, and certainly technology can take over many small tasks that now require trained humans. These systems and efforts will multiply dramatically before Darwinian forces sort out the most effective and user-friendly solutions.
We can hope the sorts of systems and creative entrepreneurial thinking that have taken costs out of other industries – including telecoms – can do their magic on quality of service in poor and rural areas, while also helping to tame healthcare costs. And hopefully, it can also generate some healthy demand for our industry’s products in the process.
