I believe there is an incredible opportunity for us all, as they say in the classics ‘necessity is the mother of invention’. It seems the perfect storm is brewing; aging population, rise of chronic disease, rising costs and budget pressure. The question is how do we set a course through this storm, to ensure the destination is much better than where we have come from? (Poetic even if I say so!)
A couple of words caught my eye in the PCEHR review, ‘meaningful use’. The concept is to achieve a state where the health records are used to improve the health of the community, drive diagnosis accuracy up as well as improving the research and development of new drugs and more effective treatments. This is all about the data! Getting it to a point of completeness and accuracy so it can be used meaningfully!
This may sound familiar as its part of Obama’s plan to change healthcare in the USA. To achieve ‘meaningful use’ and they have defined a 7 stage process to guide their industry along. Similar to the Royal review’s recommendations, Obama has put in place a series of investments as well as ‘consequences’ for not achieving these milestones. When you consider the ‘private’ or corporatized nature of the USA healthcare system, you would assume that it is against their business model to help their ‘customers’ go next-door. So surely there are less vested interests here inhibiting us from creating a national health record system?
Perhaps the idea has not been fully ‘sold’ to the public and the implementation not optimal. Speak to any GP and they will bemoan the integration and the additional workload… which the review recommendations address. So once these issues are sorted out, we begin down a path where the accumulation of data drives every facet of the industry forward and towards a better, faster and cheaper healthcare system!
Marc Andreessen founder of Netscape, a web browser that competed with Microsoft in the early days of the internet is attributed to saying that “Software is eating the world.” He was referring to the dramatic shifts that happened to the music and video industries as they became digital. I think he was wrong, ‘Data is eating the world.’ It’s the use of data to understand that can transform everything we do! The trick here is to not look at digitisation as just a substitute for the old, but as a new way to do things. (For example a CD was more convenient, however on-line music has changed the industry.)
In healthcare there has been a lot of ‘substitution’ but not a great deal of leveraging the potential of eHealth. For example having an electronic patient record is more convenient, however being able to aggregate a large number of histories and understand how treatments are affected by lifestyles which affect long-term health outcomes, has the potential to produce new protocols which deliver better outcomes which will lower costs.
Thinking about the ‘use’ of data once its digital, will lead us to a situation where we are thinking beyond the horseless carriage and to driving efficiency, lowering costs and opening up new ways to revolutionise the way people are kept well.