Cutting Edge Issues

eHealth:
Towards A New World of Communications in Medicine

Case Study: Overlake Hospital Medical Center

Information on Demand: Consumer-Controlled Medical Records

Finding Leaders for Internet Health Care

Building the Security-Capable Enterprise

Planning Business Strategies with Internet Support

Internet Use as a Survival Strategy

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Who is eMed?

Information on Demand: Consumer-Controlled Medical Records

When they tire of waiting for the EMR, consumers will adopt the personal medical record.

By Alan R. Zwerner, MD, JD

Medicine, I believe, is very physician-centered. That is both a good thing and a bad thing. Why are physicians available to see patients on weekdays from 9 AM to noon and 1 PM to 4 PM? If care were patient centered, they would be available to see patients until 9 AM. Then, they would go home; they would be available during the lunch hour, and again in the evening and on weekends. If physicians were truly patient-centered in terms of service (which they certainly are where clinical things are concerned), there would be no waiting room. A number of other circumstances would be different, as well. The Internet, being a very powerful technology, will allow newly-empowered patients to change medicine as it is into medicine as they wish it to be.

EVOLTION IN MEDICAL CARE

Consumers plus technology constitute a force that is moving medicine from Porifera to chordate. As Darwin pointed out, evolution occurs because the environment changes, whether slowly or rapidly, and whether by huge or small amounts. In response to that change in the environment, organisms survive (or do not) at some differential rate. The ones that survive are the ones that can adapt. The first animal was unicellular, like an amoeba or paramecium; it evolved into a more complex animal called a Porifera, or sponge.

The sponge has billions of cells, all of which are the same. They live together. There are no nerves, so there is no information coming in or going out of the organism. There are no eyes, no ears, no brain, and no spinal column. Instead, there are, in effect, many amoebae living together. Why? The advantage is that it takes a bigger fish to eat them if they are together. That is worth thinking about when Internet companies merge, when health plans merge, when medical groups grow together, when insurance companies buy each other, and elsewhere throughout life. An organism may be no more sophisticated than an amoeba, but if it bands together with others so that it takes a bigger fish to eat the group, the individual organism gains a period of time during which it will not be swallowed by the small fish. If it does not evolve to become more efficient, it may not survive.