Saturday, March 03, 2007

On-line checkups

Good story in today's Globe about a thoughtful telemedicine experiment between Partners HealthCare System and EMC Corporation. They will test the proposition that more accurate reporting on blood pressure via electronic means from home will lead to better long-term results than the usual reporting by patients to physicians.

As I understand it, most telemedicine to date has occurred in remote locations, where people have trouble driving to their doctor or a clinic -- or to enable a consult from a specialist to a hospital without that specialty.

But there have also been programs of the sort being tried by PHS and EMC. Here is one from Colorado dated 2003. Here is a more recent one from New York.

This is all part of the "earth flattening" cited below. It will require adjustments by insurance companies to avoid the current perverse incentive of the health care system, in which doctors usually only get paid when a patient physically visits them. If this kind of system results in better results, more convenience, and the advantages of asynchronous communications, the insurance companies that figure out how to reward it will gain a competitive advantage.

2 comments:

Jaz said...

Along those lines, a study released this week asked people to rate the most important primary care service they'd like technology to enable for them.

91% chose clinical information over general information and administrative tasks - favouring lab results online and the ability to E-mail the doc instead of visiting over scheduling and general health information. For those 91%, only 26% said their doc already had something similar up and running.

I've heard of a few plans figuring out a way to reimburse E-mail visits, but I'm amazed at the general lack of uptake. Seems like a godsend for the patient and a potential cash cow for the practice. Whatever happened to supply meeting demand?

jessica lipnack said...

So this is from the wayback machine and a quick web check isn't giving me the links that must be there but...

In the early '70s, there was a group of crazy visionaries hanging around Boston interested in the potential of "cable television." The most "far-out" were saying the kinds of things about its potential that the web has finally delivered thirty-some years later. We all knew one another as the "network" was about 11 people wide--or 111 people, not many.

Among them was a distinguished guy somehow associated with MIT by the name of Dick Oldham. Dick had a vision for delivering health care in a new way and was instrumental in establishing what was believed to be the first telemedicine link in the world from Logan Airport to Mass General. If memory serves, what was then called "Channel 2," soon to be the famous WGBH, provided the tech. If someone became ill at Logan, they could be taken to a studio at the airport while a doc at MGH sat in a studio there. This was an early precursor of high-speed data transmission of test results and the application of medical group-intelligence as described in this Boston Globe article of 2007.

Perhaps someone reading here remembers what happened with this experiment--and what became of Dick, a forward-thinking, brilliant guy.