Monday, July 6, 2009

Online healthcare is a game changer

Dr Stanley Borg, in the Journal of the American Medical Association, recently wrote that "whatever your views on the flaws and failures of the US health care system, you have to admit that things are changing. Make no mistake: online care is a game changer."

I agree, but what did he mean by that?

Could he be talking about how technology is going to radically improve the way we deliver and receive our healthcare? Does he see new technologies as being around the corner, and about to envelop us and help us improve our health? What does he really mean by "online care"? Is it enough for us to communicate with our doctor on the Internet, or should we be becoming involved in online groups and counseling fellow patients? Should we have all of our medical records stored online, and be able to access them ourselves to make sure that they are correct. Should we be wearing electronic monitors of our heart, our breathing, our temperature, all of which constantly transmit our vital signs in real time to the database of our choosing? Or should we be undertaking robotic surgery using automated machines controlled by a surgeon hundreds of miles away?

Does this sound scary, or is it a form of "techno-utopia" that we should all be seeking? I can easily answer that one at least. Techno-utopia, as defined by Wikipedia, is “a hypothetical ideal society, in which laws, government, and social conditions are solely operating for the benefit and well-being of all its citizens, set in the near- or far-future, when advanced science and technology will allow these ideal living standards to exist; for example, post scarcity, changes in human nature and the human condition, the absence of suffering and even the end of death.” We are certainly not close to this.

In place of the static perfection of a utopia, others have envisioned online health as occuring in an "extropia," an evolving open society allowing individuals and voluntary groupings to form the institutions and social forms they prefer. Perhaps the web 2.0 is the beginning of this extropia?
We have to be careful not to be “techno-Utopians” - excessively, uncritically accepting of technologies. People like this don’t tend to use new technologies as effectively as they could because they view the technologies as ends in themselves, not as tools. It is commonly held that using new technologies uncritically implies bad habits of the mind. Taking television as an example, one could argue that this technology has led us to concentrate on superficial, rapid acquisition of knowledge rather than on deep thinking and careful consideration. Look at all the “news bites” prepared for TV – and how if you are trained in media skills, you are almost always taught to literally speak in short “bites” that are easily reportable but often meaningless.

Healthcare on the Internet, in partnership with your doctor, does promise huge benefits not only for us all, patients, clinicians and society in general, and is, to quote Dr Borg, a "game changer". But in embracing technology, the human factor must not be forgotten. It is not the cleverness of the technology that is important but how we use it to derive most benefit for us, for our children, and for society. We have to learn to improve, to control, and to effectively use the tools and techniques now available to deliver online healthcare to improve our health and, in doing this, to enrich the quality of our lives.

If we look at the future direction that online healthcare is moving in, and which is being supported by the Obama Administration, the following themes are evident:

§ Our future isn’t what it used to be, as we move to the era of virtual hospitals and global clinicians
§ Our health system is gradually changing and becoming electronic and distributed, with less dependency on buildings, and more on communication networks from the patients home to the operating theater
§ Research is opening up whole new ways of delivering healthcare, using all our senses, and in a much more personalized manner
§ Patients are demanding better and more accessible healthcare, and will obtain it from all around the world in future
§ The doctor-patient relationship is changing, and will become increasingly open and driven by empowered patients living in an information rich environment – where the Internet is increasingly influential and important in clinical consultations.

Online care is a game changer, and we should all embrace it and learn to use it to our best advantage.

Peter Yellowlees MD has recently published "Your Health in the Information Age - how you and your doctor can use the Internet to work together." The book is available at Amazon, iUniverse, and most online bookstores.

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