Future e-health trends

Forecasts for major developments in e-health over the next five years: cloud, modular, genetic, and network.

John D. Sahara Mucha (John D. Halamka), MD, MPH, professor of medicine at Harvard Medical School and BIDMC's chief information officer, Chairman of the New England Healthcare switched network (New England Healthcare Exchange Network), and Co-chair of the National HIT Standards Committee. Here are his predictions for the major developments in e-health over the next five years:

Electronic health record in the cloud

Doctors are good at diagnosing and treating diseases. They are not good at hosting servers, managing databases, and implementing government-issued data protection rules, and they are not willing to pay for expensive hardware and software. I believe that the only way to quickly achieve an electronic health record is the cloud.

Cloud computing stores data and programs on a central server, not in a doctor's office. It requires new security engineering solutions to protect against malware, service denials, and complex hacking attacks that can jeopardize private medical information . But it can solve other problems, such as enabling complex software to be scaled up and maintained in the clinician's office without any technical involvement.

In the short term, regulatory requirements will lead to the rise of “private clouds” provided by large hospitals and software vendors, but given the enormous commercial potential of providing electronic record hosting services to more than 500,000 US physicians, commercial cloud offerings Commercial cloud providers are likely to develop secure hosting plans. When I was the Chief Information Officer at the Beth Israel Deaconess Medical Center (BIDMC) in Boston, I estimated that moving infrastructure and applications to our private cloud would have reduced the cost of implementing an electronic health record. Half.

Modular software liberates creativity

Less expensive cloud-based software, combined with tablets, will bring a wave of software innovation. Until recently, medical information technology innovation relied heavily on the development of several very large vendors who sold hospitals with a $100 million price tag. In the future, electronic health records will become more modular, like online app stores that let consumers download games or programs for their phones. Imagine a cool new app that provides a dashboard for people with diabetes to display their daily blood glucose readings and sounds an alarm when they manage their disease. Today's doctors must wait for the only supplier in their medical center to develop such an application. In the near future, modular software will enable doctors and patients to tap the creativity of thousands of entrepreneurs.

Consumer computing hardware will also accelerate the new innovation ecosystem and bring it to the patient's bedside. More than 1,000 clinicians in our hospital have used their own funds to purchase tablets such as the iPad and the Samsung Galaxy Tab. Although developed for the average consumer, tablets have proven to be an ideal computing device for doctors: they are less than a pound, have 12 hours of battery life (or a shift), and can fall from five feet. It is not subject to great damage and can be wiped with a disinfectant.

Network network

Many people believe that doctors constantly share data to coordinate treatments, conduct research, or track outbreaks of disease. The reality is that there are only a few hospitals and cities in the United States that can safely exchange health records, and there are fewer economic conditions to do so. However, in the next few years, new standards for secure data e-mail between vendors will be integrated into e-health records. The use of fax machines will gradually decrease, and patients will expect that every time they see a new doctor or visit a new hospital, their health record will follow them.

Is there a huge database to hold all our health records? Will there be a single network connection to insurance companies, doctors and patients? This is unlikely due to privacy concerns. Instead, we believe that regional data exchange will develop between cities, states and regions. Just as there are many email service providers and many Internet service providers on the Internet, there are many private and public Health Information Service Providers that can exchange data with each other. This will establish a national health information network consisting of subnet alliances.

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