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Change is the one constant in health information technology. What does the future hold?
Today's health information technology (HIT) is evolving at a startling rate.
Who could have predicted that the commercialization of the Internet 17 years ago would spawn a health technology industry that would alter our entire continuum? Who would have guessed that the government would spend billions on incentives for physicians to adopt electronic health records (EHRs), decision support, and quality reporting at the point of care? Who would have guessed that these electronic data could be aggregated and used to monitor and/or assess population health for the country, region, city and even your patients?
"It's much cheaper to keep people well than it is to treat them when they're sick," he says. "Part of wellness will be monitoring what's specifically important about each patient, like bathroom scales for congestive heart failure patients or glucometers for diabetics that transmit data directly to their EHRs."
Population health management improves dramatically with near-continuous monitoring of the individual patients. Some folks, however, reject constant monitoring for any reason, technologically or otherwise. Nevertheless, Halamka notes the trend.
"We are moving from episodic care to longitudinal care," he says. "So we're going to monitor you and your health on a continuous basis to keep you well as opposed to treating you when you're sick.
"I think we're going to have a much greater degree of connected devices that do more personal monitoring than ever before as part of wellness," he says.
Whether patients will come to accept and even expect this type of monitoring if it means better healthcare for themselves or their loved ones is another question.
"This is the direction we're all heading, which means more telemetry in the home, more personal health records, and more business intelligence analytics to support it all," Halamka says.
"Doctors and their teams will manage patients' healthcare remotely using electronics, and they won't be alone," Weiner says. "They'll have physical and virtual administrative and clinical support teams."
Care providers of the future will monitor patients remotely, he adds. The enabling technology might be physically attached to the patient's body, worn as clothing, be freestanding in the patient's home, or even be built into a house's architecture.
According to Weiner, physicians themselves also will be in regular if not constant contact with the patient's care team as well as their own support staff.
"Every aspect of care in the practice will have an electronic workflow," Weiner says. According to Weiner, these electronic workflows will include:
"That's a classic Patient-Centered Medical Home [PCMH] model," Weiner says. "All of this will happen. When it will happen is a little less clear."
Expecting all of the changes to be on the backs of PCPs, however, is not realistic, Weiner says, particularly if the physicians are practicing in small offices.
"Doctors can't do it alone," he says. "They need support infrastructure to change behavior and provide care outside of the office."