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

Case Study Zone

Who is eMed?

Information on Demand: Consumer-Controlled Medical Records

Part 2

Medicine (a 200-year-old guild) and the health care industry (a 20-year-old business) have evolved to the stage of the Porifera. The Internet is going to assist them to evolve through the sponge stage to that of a chordate, with a brain and spinal column. A chordate has nerves to bring information in and out of the brain, and its specialized cells allow it to react in ways that the uniform-celled Porifera cannot. The human chordate, for example, can see, walk, talk, and hear. It is in touch with its environment (receiving information from it) and can effect its environment (sending information to it).

The Internet, by empowering consumers, is a powerful tool creating change in the environment. Those organizations and systems that evolve in response to change will have a differential viability, and that is evolution. Those of us in medicine know that we have been conducting educated guesses in many areas of medical practice for a long time. Medicine is the last great ad-hocracy. Now the consumer knows it, too. There has been a profound percolation of knowledge to the public. The medical profession is being pushed into the information age (into the Porifera stage).

The stakeholders in this process are physicians, patients, insurers, payors, employers, and government. Some of the faces now being seen in these groups are not particularly happy, but some of these constituents also hope that the Internet revolution will help them with their problems. Medicine (the profession) and health care (the industry) are in the information business. They always have been and always will be. They collect information, analyze it, share it with each other, and share it with patients. They have done it using quill and parchment, scrolls, and dead trees, but it was still the information business. One cannot care for people -- diagnose, treat, educate, and prevent -- unless one is in the information business.

For this reason, the Internet and other technologies that are emerging now are natural tools for physicians. At present, a 200-year-old technology suitable for quill and parchment is used for most medical records. An individual’s medical record typically resides on little bits of paper in different manila files in several locations. At best, the medical record is available perhaps 25% of the time when it is needed. It is not integrated or electronic, and it is not possible to analyze it in order to determine what works best.

Going to medical school and serving a residency still means the equivalent of being locked in a room for 7-8 years with thousands of physicians, with no two who do things in the same way.