Change Can’t Happen with Technology Alone
Guest commentary by Michael L. Cowan, MD, chief medical officer at BearingPoint and former surgeon general of the U.S. Navy
It's official. The economic recovery package has been signed and $19 billion is marked for health information technology. But, before we can fix anything or facilitate technology adoption, we need to understand the major shifts and changes that are occurring in health care today.
Since President Bush's call to action in 2004, the government has made some progress with electronic health records and regional health information exchanges. These are good first steps, but advances in technology and changing values in our society mean our industry must become more agile to accomplish the radical transformation the industry needs to undergo. The rapid increase in consumer uses of Web 2.0 for health care information and community-building has changed the nature of the doctor-patient relationship and the way health care is consumed today. At the same time, the increasing amounts, depths and accessibility of medical knowledge have necessitated a change in thinking about the way medicine is taught and will be delivered in the future.
From a consumer perspective, the Internet has democratized health care. Access to vast quantities of vetted, actionable and reliable health care information has shifted the "power of knowledge" from the doctor to the patient. In earlier generations, only doctors had the latest medical information or experience managing disease. Now, people are constantly "plugged-in" and can easily search online for health care information. They also can access social networks of people with similar ailments with whom they can share their collective wisdom. This has irrevocably changed the nature of a doctor's relationship with patients. As part of health care reform, the new Secretary of Health and Human Services will need to think about how we can change the structure and policies of health care to acknowledge this and monetize the automated, online or virtual service models that consumers are demanding.
Furthermore, unlike past generations, today's patients have become more empowered and active in managing their own wellness. Web-focused, techno-savvy health care consumers are more willing to store personal or private information online in the hope of speeding progress for cures. Many now create and manage their own personal health records online. Hopefully, the new Secretary will work with President Obama to help cultivate this consumer grassroots movement to personal health records with the right incentives, standards and economic policies.
From a medical perspective, the recent completion of the Human Genome project will enable a new frontier in personalized medicine. The study of genomics has progressed to the point where experts can not only identify more than 20,000 individual genes in a human's DNA, but also how they relate to drug treatment. This advanced medical knowledge, combined with improved information access, will enable preventative and diagnostic care to match unique personal genetic characteristics. The impact of this is that future drugs will be tailored to an individual's genetic composition and history, making them more effective in treating diseases in each individual. However, before we achieve this goal, personalized health care will require many factors -- both diagnostically and therapeutically -- to be managed in a completely different way from the past.
With these trends in mind, I hope the new administration understands people are increasingly thinking of health care as a consumer service. Today's patients comparison shop and have become "prosumers." They not only choose their own care, but also produce vital information in the process. As a result of this health care consumerism and the rise of the Web, doctors will act more and more like consultants as the main mode of doctor/patient communication transitions to the Internet instead of a visit to the doctor's office. Thus, virtual management of patient conditions will become increasingly common. I hope the administration keeps these trends in mind and works toward enabling a future in which personalized healthcare and mass customization of treatments becomes a reality.
I am hopeful the administration will approach health care reform with an open mind, listening to alternative views, embracing current realities and facilitating positive change. If so, we will all benefit from a new frontier in health care in 2009 and beyond.