Healthcare Technology – Past, Present, Future
Healthcare providers generally look at patient input, test & scan results, and past history before determining diagnosis and prescribing treatment/medicines/lifestyle changes/frequency of checkups, etc. This involves lot of paper documents, physical records, keeping track of visits, medicines, bills, claims, tests, procedures, etc and consequently a need to keep track of a lot historical data. It is time consuming, error prone and costly. And if these records are misplaced then it could require a diagnosis from start.
Conceptually it seems digitizing this process should be an obvious need and a straight forward problem, but solving it is a different matter. Like all complex processes healthcare technology requires a mix of people, process and technology. The number of healthcare scenarios, knowledge and capabilities are just too varied and constantly evolving to structure into a rigid system. And with healthcare there is a very critical need for accuracy, reliability and security considering its impact on people’s lives. These factors must be ensured before thinking about new systems and processes.
It is important to note that in most countries paper/physical records are still the primary medium to store and share health data. This is driven by regulations, current processes, high cost of the systems, lack of trained resources, and to some extent resistance to change. However, these have been complemented by EHR/EMR (Electronic Health Records/Electronic Medical Records, both used interchangeably but EHR is more commonly used now) systems in some countries where either government or market guidelines/standard practices are available to build systems around. WHO’s ICD-10 is the most widely used international standard with countries adapting it to their specific needs.
Electronic health data systems in various forms like EHR/EMR and a multitude of custom software’s and vendors have been in existence for a while now, since the ‘70s in developed countries. These are generally built around a specific country’s healthcare market, primarily due to the variations in rules & regulations and existing level of technology usage. The capability of these software’s can vary from inflexible client-server based to modular cloud/mobile based versions. Some existing EHR/EMR software’s have moved to cloud/mobile based versions, but with existing limitations. The main features they provide are billing, claims, reminders, prescriptions, document management, practice management, and patient engagement. Along with these some vendors provide specialized features for specific diseases, telehealth, population health management, etc. But again they are limited to the hospitals/chains using the software.
These EHR software’s have comprehensive features for the products and services they provide, with good stability and security, but are resource intensive and require long lead times for implementation. This makes it prohibitive for smaller hospitals/practices/chains from using them and indirectly results in a smaller market size for healthcare technology. If the cost, implementation lead time and training needs can be reduced to a level that is acceptable to smaller practices then it can create a wider market acceptance.
If we consider the many devices, medicines, procedures that have been developed by Dr’s, researchers, pharma and healthcare companies then it shows that there is no lack of innovation in the healthcare industry. All of them have helped in treating a lot of health issues, some of which were life-threatening in the past. They have reduced visits to Dr’s/hospitals/test labs, simplified patients’ daily life for some chronic diseases, reduced the cost of procedures and medicines and have made some of these treatments widely available.
Unfortunately, this is still not enough. There are still large parts of the world without access to even basic healthcare, dr’s, hospitals, medicines and procedures due to a combination of lack of resources and trained people, difficulty in reaching rural/isolated areas and access to relevant information. The gap between human capability and technological systems to use relevant data for accurate diagnosis at the right time is still big. This reduces the availability of healthcare providers in both physical & virtual environments and increases the lead time for treatment. Even in developed countries the cost and waiting time for treatment of some basic health issues is very high compared to what is available in other lesser developed countries.
This is where technology can have a bigger impact. Since the 90’s there has been a wave of new technologies that have disrupted the way some industries operate, E-commerce and its impact on global trade being one of the main examples. The overall impact for consumers has been beneficial through increased competitiveness, higher efficiencies and wider choice. But there are some industries which have been slow at adapting to these innovations, healthcare technology being one of them. There are various reasons for it like regulatory and legal issues, technological capability, cost benefit limitations and ease of use. Another reason is the incumbent healthcare and technology providers’ desire to maintain the status quo.
Security, cost, ease of use and access to patient information are among the main reasons given for the current state of healthcare technology. While they are valid reasons, they can no longer be used as an excuse. There are a number of security, communication, mobility, cloud storage/compute technologies available at a fraction of the cost to what was available decades ago. There are countries that have passed or are passing laws (US being one) to make it easier to share patient data via health exchanges, incentives to implement standardized EHR systems and creating marketplaces to make it easier to choose insurance, healthcare providers, etc. In some countries private companies are taking the lead in building such systems due to limited government guidelines / resources.
All this leads us to look at what technologies we have now which address some of the current healthcare issues and also what new technologies/systems that need to be created for the future.
More to follow …