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The Email Age Scenario
Imagine
a world in which the functions of academic medical centers are
provided in a “virtual” environment.
The age of technology has become so pervasive that all
aspects of daily life, including health care, are significantly
impacted.
The three traditional roles of health science centers,
namely teaching, research, and patient care have adapted
state-of-the-art technology to their needs.
The consumer of their services has demanded major changes
in traditional (read that old fashioned) methods of service.
Consumers
have challenged and successfully eliminated roadblocks to their
demands, including government regulation.
A single payer program with patient choice as a key feature
has been developed.
Employees are given a voucher for a fixed amount to be used
for healthcare and can get that care anywhere they choose. An
active lobbying effort has mandated responsiveness.
Legislation has been enacted to support patients’ needs.
Research-oriented
and opinionated students, granting agencies, patients, and
employers have demanded high quality, value laden services in a
low-overhead, cost-effective manner.
The availability of ubiquitous complete access, 24 hours a
day, 7 days a week, with privacy and security safeguards and high
speed communication systems, pervades all aspects of our lives,
from “virtual” commerce on a global scale to “virtual”
health care.
This has fostered a new form of competition providing a
large variety of choices to the consumer.
The sophisticated patient, armed with information obtained
from the World Wide Web, will “shop” for the best care at the
best price.
Opportunities
to market services are no longer bound by geography.
Worldwide customers are available to providers.
But competitive factors demand constant attention in order
to avoid loss of market share.
Strong interaction and close communication between consumer
and provider are necessary for success.
Heavy technical demands require a technically skilled
workforce.
“High tech” orientation towards customers is essential.
Niche markets need to be continuously identified and
developed.
Flexibility in service lines is essential, and the ability
to modify approaches to customers in order to fulfill their needs
and desires is constantly required.
Partnerships
and consortia development have resulted in multi-disciplinary,
proprietary-oriented research without boundaries, driven by
societal interest rather than government regulations.
Technical transfer of basic research to commercial markets
is commonplace.
The
same principles apply to teaching, which has taken the form of
“borderless” classrooms with “just-in-time” classes,
designer courses and “virtual” degree programs.
“Virtual” degree programs have become equal in rights
and privileges, as well as quality, to traditional programs.
Since
the majority of patient care and teaching activities is
“virtual,” generally at consumers’ homes and at their
convenience, health services must accommodate them.
Twenty-four-hour comprehensive health care coverage,
independent of location, will be routine.
The patient’s care provider will be available regardless
of whether the patient is at home, work or traveling. Primary care
providers will need training and experience in areas such as
occupational medicine, workman’s compensation, public health,
travel medicine and knowledge of other cultures’ medical
practices and pharmaceuticals. Advances in robotics will allow for
distance procedures and even distance surgery.
This is particularly different from current health care
delivery, so the traditional provider must adapt.
Home visits to supplement telemedicine, rather than
requiring patients to come to centralized facilities, will be
expected.
The health science center campus will change in its mission
to include the necessary infrastructure to support the advanced
technology. Only procedure-oriented services will take place in
these facilities.
Creative and innovative “virtual” methods of providing
care must be continuously refined so that low cost, quality care
is maintained.
The
new paradigm of healthcare is defined by the following:
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Telemedicine
care is widely available and accepted by patients and
providers alike
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Provider
assisted telemedicine includes physician assistants and nurse
practitioners
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Home
visits complement "virtual" consultations
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Expert providers are available regardless of home site
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Visits
to providers are significantly reduced
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Loss
of direct interaction is more than offset by convenience and
ease of access
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The
mobility afforded by telemedicine technology for both patient
and provider produces new work environments
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Privacy
and security of patient information is assured
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Technology
has provided user-friendly equipment, peripherals are easy to
use and easily monitored
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New
relationships between healthcare providers and first
responders who may not be medically trained
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High
quality, accurate educational material is available
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Full
range of patient services are available including:
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