Health Care in the 21Health Care in the 21stst CenturyCentury

By:Marcus Hall

Table of ContentsTable of Contents

• IntroductionIntroduction• Digital Doctors OfficeDigital Doctors Office• E-Prescribing E-Prescribing • Health-Care over the Health-Care over the

InternetInternet• Health and New ICT Health and New ICT • ProsPros• ConsCons• ConclusionConclusion• ReferencesReferences

IntroductionIntroductionFor my research project I choose to

research the controversial problems between health care and certain new technologies. I attempted to solve this issue in an interdisciplinary manner. My learning objective here was to examine this issue from two or more distinct disciplines and identify the conflicts between them. Here is my research topic:

With technology moving at a rapid pace, Doctor's offices are considering seeing patients via the internet as opposed to having them come into the doctor's office in order to save time and money. Is this something that will take off or something that will not succeed?

One of my goals in doing this research project was to try and provide an interdisciplinary conclusion or solution to this controversial issue.

Digital Doctor’s OfficeDigital Doctor’s Office

• Some doctors think 20% of their routine office visits could be handled safely and less expensively over the Internet.

• Doctors' big fear is that the online discussions with patients will eat up time, with little or no extra payment for the service.

• 98,000 members of Health Cooperative of Seattle have signed up with the MyGroupHealth Web site, which lets them log on: – privately and securely– any time of the day or night to make

appointments for doctor visits– get lab results – order drug refills online.

Patients also get online access to their records.

Offices Cont’dOffices Cont’d• This year, 39% of doctors said they’d communicated with

patients online, up from just 16% five years earlier, according to health-information firm Manhattan Research, a unit of Decision Resources Inc. (Mathews)

• Companies that now cover digital visits are:– Aetna Inc. – Cigna Corp.– Blue Cross Blue Shield– WellPoint Inc. – Humana Inc.

• Ailments most frequently treated online include:– sinus problems cold and flu symptoms– urinary infections coughs

Other common conditions are back pain and sleep issues.

Offices cont’dOffices cont’d

Some state medical boards have rules that limit the use of digitalvisits. Digital formats for patients offered by companies include:

● interactive questionnaires that automatically generate follow-up queries based on the symptoms they initially describe.

● secure email, with patients typing up a free-form message, often sent through a special Web site.

● live online visits, using Web video, live chat or a phone conversation connected through a secure computer system.

E-PrescribingE-Prescribing

● It is quite possible, if illegal, to obtain prescriptions on the Internet.

● In most states it is illegal to prescribe drugs for a patient based on an online evaluation.

● The medical establishment has been reluctant to embrace online medicine.

● The inclusion of electronic prescribing in the Medicare Modernization Act (MMA) of 2003 gave momentum to the movement.

● Economic protection for doctors.● Electronically send prescriptions to pharmacies -- Generate reminder e-mails for check-ups -- Use anonymous patient data for research on

new treatments

Health-Care Over the Health-Care Over the InternetInternet

The Broadband Divide and Health on The Broadband Divide and Health on the Internetthe Internet

● Broadband ●direct service lines (DSL) ●cable modems

● Despite the potential of the Internet, the opportunities afforded by it may not be available to all Americans.

● digital divide marked by gaps in access to computers and the Internet based on:●ethnicity●Education●household income.

● Studies have indicate that inequities in access to the Internet are diminishing.

● There has been recent research suggesting the emergence of gaps based on the quality or speed of one’s Internet connection.

Health-Care over the Health-Care over the InternetInternet

Broadband cont’dBroadband cont’d ●Digital divide is multifaceted ●The other types of divides:●motivation to use new communication technologies, ●the digital skills to be successful●structural differences in usage behavior.

●Less likely to adopt broadband: ●Those who are older ●have less education●less household income●live in rural areas

●The greater communication potential of broadband is associated with increased health-related Internet use.

Health-Care over the Health-Care over the InternetInternet

How Internet Use and Trust How Internet Use and Trust InteractInteract

● Newer health information sources compete for public attention

● Traditional health information channels lower authority and trust in health professionals as a single health information provider in a society

● Trust between patients and health professionals in the health care system is quite important.

● Individuals make up for their lack of knowledge by relying upon cognitive shortcuts or heuristics.

Health-Care Over the InternetHealth-Care Over the Internet

Trust Cont’dTrust Cont’d● If people use interactive features of the

Internet (e.g., emails) to contact health professionals, their total time for conversation with health professionals is likely to increase.

● Internet facilitates the breakdown of health professionals’ monopolies over their own knowledge base.

● The Internet does not necessarily lead to the lessened dependence on health professionals.

Health-Care over the Health-Care over the InternetInternet

Differential Effects of Internet UseDifferential Effects of Internet Use● By using the Internet to play the role of health information

provider , to a certain extent it displaces health professionals in the category of health information provider.

● The frequency of physician visits for treatment of ailments will remain unchanged.

● The relationship between new media and old media

Health and New ICTHealth and New ICT

Information and communication technologies (ICT): is an umbrella term that covers all advanced technologies in manipulating and communicating information.

Google found that certain aggregated search queries tend to be very common during flu season annually.

Supermarkets and drug store scanners could offer information opportunities.

New health ‘‘transformation’’ could synergize knowledge, innovation and actions for better health.

Alerts on mobile phones of disease outbreaks. Internet news, or blogs and other new communication

vehicles.

ProsPros• Cost• Time• Electronic records help doctors take better care of patients and

patients take better care of themselves. • The Internet is a valuable tool for acquiring health information,

care, and services.• Patients can:

– Request appointments online – View medical history including immunizations and medications – Learn lab test results online – Ask questions via secure e-mail • Doctors can: — Share patient chart instantly with other providers and

referring doctors – — Get emergency access to patient's health information — Increase safety by reducing handwriting/transcription errors — Get automated computer alerts about potential medication

allergies — Generate reminder e-mails for check-ups — Use anonymous patient data for research on new treatments

(Landro 2004).

ConsCons● Doctors might seek to boost their revenue by making

excessive use of online communications, or classifying quick emailed messages as reimbursable visits.

● In the current environment health care is not organized or structured to satisfy patient needs and enable or support the work of practitioners.

● The average American's health-care experience is fraught with high cost, poor service and uncertain quality.

● Issues to be resolved such as how much control patients should have over their own medical records

● Technical standards and uniform formats.● Potential privacy violations● Digital divide● A big impediment is that in most states it is illegal to prescribe

drugs for a patient based on an online evaluation.● Demographics

ConclusionConclusionThe issue of health-care in America has been a very controversial

topic this year. For my research project I wanted to do something that was relevant to today's societal issues. So I choose to research this subject in interdisciplinary manner but more specifically look at the relationship between health-care and new technology. With technology moving at a rapid pace, doctor's offices are considering seeing patients via the internet as opposed to having them come into the doctor's office in order to save time and money. Is this something that will take off or something that will not succeed?

This issue can be studied across many different disciplines such as science, medical, communications, marketing, etc. Through my research I’ve found that patients want access to safe, reliable medical care on the Internet, just like banking, shopping or booking a flight. There are major concerns in the public about who is ultimately responsible for an individual’s health and well-being. Most patients are unaware of their own health data and to some degree don’t even feel it’s their responsibility to know what procedures they’ve had, what medications they’re on, etc.

There are many studies out there that show those who are younger, more educated, and live in an urban areas are more likely to use the Internet for health-related information seeking and communication than those with a dial-up connection. (cont’d)

Cont’dCont’dThe free market no doubt holds many elegant solutions,

cures and preventive regimens, and free-market health care would lead to superlatives beyond our imagination. For the free market to exist in this sector of our economy there has to be dramatic change in our political environment. The opportunity for change in the US has not been greater and the risks and benefits have not been timelier (Ratzan). With the speed of technological innovations in e-health growing and opportunities advancing globally one can see the potential for online doctor visitations and healthcare increasing over the next few years.

ReferencesReferencesBrewer, Benjamin. "The Doctor's Office: Internet Visits with Doctors Can Beat Office Appointments."

Wall Street Journal. (Eastern edition). New York, N.Y. 19 Aug 2008 Web.20 APR 2010 Goldstein , Jacob. "Can Technology Cure Health Care?." Wall Street Journal Online (2010): n. pag.

Web. 20 Apr 2010.Landro, Laura. "The Informed Patient: Push Grows for Online Health Data." Wall Street Journal.

(Eastern edition). New York, N.Y. 11 Mar 2004 Web.20 APR 2010 Latour, Kathleen M. “Health Information Management: Concepts, Principles, and Practices. AHIMA

( 2006) Chicago, Illinois.Lee, Chul-joo.“Does the Internet Displace Health Professionals?” Journal of Health Communication,

13:450-464. 2008. Web. 20 APR 2010.Lee, Chul-joo and Hornik, Robert C. (2009) “Physician Trust Moderates the Internet Use and

Physician Visit Relationship.”Journal of Health Communications, 14:1, 70-76 Web.20 APR 2010Mathews, Anna Wilde. “The Doctor Will Text You Now.” Wall Street Journal. (Online Edition). 09 Jul

2009 Web. 20 APR 2010Rains, Stephen A. “Health at High Speed: Broadband Internet Access, Health Communication, and

the Digital Divide.” Communication Research. 14 Apr 2008 Web. 20 APR 2010Ratzan, Scott. “21st Century Opportunities in Health: E-health and Technology.” Journal of Health

Communication, 14:1, 1-2 01 Jan 2009. Web. 20 APR 2010Rogers, Michelle, Lisl Zach, and Prudence Dalrymple. "Understanding How Vulnerable Populations

Use Common." http://www.ideals.illinois.edu. N.p., n.d. Web. 20 Apr 2010.<http://www.ideals.illinois.edu/bitstream/handle/2142/14997/RogersiconferenceposterFINAL.doc.pdf?sequence=4>.

Olmen, Josefien van. "Primary Health Care in the 21st century: primary care providers and people's empowerment." Tropical Medicine & International Health 15.4 (2010): 386 - 390. Web. 20 Apr 2010.