21st Century House Calls

Coffee Brown, University of New Mexico, Talk Radio News

In a statement echoed by several subsequent speakers at the “The Wireless Future of Health IT” panel discussion, Craig Barrett, Ph.D, Chairman, Intel Corp., said, “Most of the focus on Health Information Technology (HIT) has been on the Electronic Medical Record (EMR), but it can be much more than that.”

The President’s budget includes $36 Billion over ten years, “but how will it be spent?” Barrett asked.

He said that HIT can expand access to medical care, allow for more home monitoring, and allow greater computing power.

Access can be expanded by “e-visits,” which allow the physician and patient to visit over the web. It can allow a local physician to consult with a regional expert, or an expert on some exotic disease, or permit consultation with a specialist who cannot immediately come in person.

Home monitoring can allow medicine to be more pro-active, and thus prevent much more expensive hospitalizations. Devices like blood pressure cuffs, glucose meters, and blood oxygen monitors, among many others, can communicate with medical computers, generating automated patient advice, a provider call-back, or other responses. The equipment needed to make this available would typically cost less than a single hospital admission.

Computing power is increased in a number of ways. As HIT becomes more integrated databases can be shared. Off-site computing could, for example, allow a more powerful remote computer to process cat scan images, or a more specialized program to help analyze an EKG.

Hit can coordinate ambulances with road closures, emergency department diverts, and other resource changes.

These were among many examples Barrett and other experts used to show that the point of HIT is not a bigger, better, faster form of a paper medical record, but a whole new approach to medicine.

“However,” Barrett said, “These things all require policy changes.” Right now, Medicare and Medicaid tend not to cover any of the computer adjuncts, or wellness care in general. Patients would like to remain at home as much as possible. “Over 90 percent of diabetic care is already self-care,” he said.

Truly integrated electronic healthcare, from the ubiquitous cell-phone to international expertise, to automated prompts and triggered responses, to coaching for best self-care and adherence to complex regimens, could keep more patients better cared for in the comfort of their own homes, he finished.