The Supreme Court, Obamacare, and the march toward digital health

imageI’m sure there are many folks in the health industry who will have a sleepless couple of nights. On Thursday, June 28, the Supreme Court of the United States is set to rule on what we’ve all come to know as Obamacare – the most sweeping overhaul of the US healthcare system since the enactment of Medicare. Will the individual mandate stand or will it fall? Will insurance industry reforms on exclusions for preexisting illnesses, coverage of adult children, and the removal of lifetime spending caps remain in force or be dismantled? Will federal support to encourage the implementation of electronic medical records and the digitization of healthcare continue?

imageThere is no doubt that the Supreme Court’s decision will directly impact some of the above. If you operate a hospital, insurance plan, or practice medicine you will no doubt be affected in some way regardless of the ruling. And, each and every one of us who receives healthcare will ultimately be touched by what the Supreme Court hands down irrespective of how it rules on health reform constitutionality or individual rights. Healthcare touches everyone.

One thing is very clear to me. We cannot, must not, take our eyes off the goal to bring healthcare into the digital age. America (and Canada) lag the rest of the industrialized world in the use of electronic medical records. I’ve often written about the puzzled looks I get when traveling through Europe or Asia and I mention that a least half of American doctors still document their work in a paper chart. “How can that be”, my foreign associates will proclaim! “We thought American medicine was the most advanced in the world.” Well, perhaps our diagnostic and therapeutic capabilities are on a par or better than the rest of the world, but our records are not. Furthermore, without digitization and the ability to analyze large volumes of data from millions of patients, we are seriously limited in our ability to apply advanced analytics to improve the quality of care. We cannot improve what we cannot measure. That is why the health industry and our medical records must be digitized.

imageBesides digital records, healthcare can also be markedly improved through the adoption and use of more contemporary communication and collaboration technologies. Instant messaging, secure e-mail, voice over IP, video and web conferencing are commonly used in other industries while healthcare still wrestles with paper, phone and fax. Not only would patients and health professionals be better served by such technology, these solutions would vastly improve productivity and facilitate more timely exchanges of information in clinical workflow. We must also leverage such technologies to bring care out of the hospital and into ambulatory settings including the patient’s own home. And for our senior citizens, we must continue to develop solutions that enable remote patient monitoring and other means to help the elderly better manage chronic conditions and age in place.

Patients and professionals deserve better than what they’ve been getting. We cannot, must not, slow the march toward the electronic transformation of American medicine no matter what happens to Obamacare.

Bill Crounse, MD Senior Director, Worldwide Health Microsoft

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