Medical record technology needs to catch up to ATMs, cell phones

Who could have imagined 30 years ago that an entire world of facts would be available anywhere around the clock? Want to find out what movie is playing at the local theater? No need to call or check the newspaper for that information, just go to your computer, wireless device, or call up the Internet! Want the latest breaking news out of Asia? Need a satellite or weather radar map of your city or one you will be visiting soon? This information is just keystrokes away. Want to stay in touch with your college roommate who moved to Europe (or even try to find him after many years)? No need for costly overseas phone calls or worrying about time-zone variances-just dash off an e-mail or Internet voiceover IP (VOIP) phone call, and await his free reply. With wireless e-mail devices and instant messaging (IM), that reply may come in the blink of an eye-literally. Diagnosed with a scary-sounding condition that you and your family have never heard of? The Internet offers answers and helps you converse with people who have the same problem so you do not have to feel so alone.

Lives changed

Almost 37,000 people running the New York City Marathon (including me) last year were all accurately timed live as they crossed each checkpoint. Anyone can follow these runners from his or her computer anywhere in the world. E-mails/IMs with this information are sent to wireless devices/cell phones, including those of spectators cheering on family and friends. Small global positioning system (GPS) devices can tell us where we are anywhere in the world, and help us locate our cars and children easily.

The daily functioning of health care also has been radically reformed by information technology. Few, if any, medical offices today function without computers that provide scheduling and billing functions, high-speed Internet connectivity to get immediate answers to questions, and messaging software that allows co-workers to share information without having to be in the same location or on the same shifts.

When the telephone was introduced, most physicians never thought they would need one. Many of us remember rotary dial phones and pagers, probably the only communication devices (besides the mailbox) in medical offices when we were kids. How many medical offices today could manage without their phones, voicemail, fax, Internet-connected computers, cell phones, and wireless devices?

Though many aspects of modern medicine could not function without computers, the full power of information technology in health care has yet to be fully explored. The next 30 years will witness a dramatic change in that dynamic: while few technologic leaps may ever compare with the explosion of the Internet, harnessing its power to provide instantly accessible personal medical records to health-care providers is the next frontier.

Expanding accessibility

Many health-care facilities already have electronic medical records that are accessible by its employees, but such accessibility needs to be expanded to include all practitioners at all times. The security and logistical concerns of creating such a national system seem daunting, but imagine the payoffs in the future. As ophthalmologists, having instant access to a new patient's history, including images, tests, surgical and consultant reports, and drug reactions would be invaluable in diagnosis and treatment.

The potential to create research databases with such information can revolutionize clinical trials and other quantitative and qualitative analyses of outcomes and quality-of-care issues, while also providing a goldmine of information to expand medical education.