Email Age Guideposts          

Introduction

Scenario guideposts are defined as indicators, factors, trends, or events that when they occur demonstrate the reality of the scenario. Where possible guideposts are measurable to indicate the degree and direction of movement. When the converse of a guidepost occurs it signals the plausibility of a different scenario.

Guideposts are critical in scenario implementation as they are the basis for monitoring the changing environmental conditions that define the reality of the plausible scenarios. As guideposts are dynamic due to the rapidly changing environment they must be monitored continuously and modified accordingly.

Technology Guideposts

Generic

• Bandwidth increases and becomes less expensive

• Expanding availability of two-way, high quality, live interactive video communication

• Industry movement of mainframe applications onto web based platforms

• Increased strategic partnerships that offer interactive, web-based continuing education.

• Identification of genetic determinants underlying common diseases

• Measurable outcomes determine that effective learning is taking place via the Internet.

• High band width interactive communication of voice, data and video

• Evolution of wireless technology

• Limited technologies facilitate trial execution and consumer information capture (i.e. Palm Diary)

• Artificial intelligence technology that is available and reliable

• Increasing use of bio-informatics/genomics in research and clinical medicine

• Growth of regional, state, and national Information Technology infrastructure and Internet access in rural areas

• Increase in number of employees who work at home or other non-traditional locations and flexible work schedules 

Clinical Services

• Expansion of Telehealth technology
• Virtual electronic patient records that transparently, but with adequate security, integrate disparate databases are developed and used
• Increased use of telemedicine for consultations

• International acceptance of Telehealth - number of countries accepting telemedicine

• The Electronic Medical Record (EMR) becomes the norm (i.e., in hospitals, multi-specialty clinics)

• Increasing availability of web-based EMR products

• Consumers are monitored and interviewed primarily through home monitoring devices and Internet technologies

Education

• Number of courses offered exclusively on-line by health science schools (including medical schools).

• Number of health science schools giving credit for completion of online courses from other sources/schools

• Students cite the web site as an important element in convincing them to apply for and attend UTMB

Research

• Data mining of human genome database
• High band width interactive communication of voice, data and video
• Evolution of wireless technology
• Drug discovery, especially gene and protein-based
• Internet submission of grant applications
• Expedited review of applications
• Internet publication of scientific reports increases
• Demise of the “printed” scientific journal
• Computer models that will reduce wet laboratory testing requirements

• Increased participation in use of technology based research data bases

• Use of genome to predict therapeutic responses

Consumerism Guideposts 

Generic

• Consumer advocacy groups increase societal pressure for improved medical outcomes

• Consumers seek out research programs that are designed to treat their specific disease or health condition

• Single payer system (voucher) developed

• National media attention on information technology malfeasance

Clinical Services

• Consumers are monitored and interviewed primarily through home monitoring devices and internet technologies
• Increase in public availability, and awareness of provider’s medical outcomes and reputation
• Increased use of web-based patient education by providers
• Increased number of visits to health care organization websites
• Increased use of alternative and complementary therapies

• Increased consumer utilization of e-Medicine information sites

• Public acceptance of e-Medicine practice

• Rankings of telehealth program quality are published by independent groups (governmental or consumer)

• Increasing use of high quality telemedicine programs by patients

• Use of email and web for patient-physician communication increases

Education

• All health science schools commonly offer some courses exclusively on-line
• All health science schools commonly give credit for successful completion of online courses from other sources/schools
• Accrediting agencies accept and/or endorse the practice of awarding credit for courses offered exclusively online
• Increased strategic partnerships that offer interactive, web-based continuing education
• Ability to dissolve political and stereotypical boundaries to be able to focus on team-based learning
• All health science schools commonly offer courses, both on- and off-line in alternative and complementary therapies

• Rankings of distance education program quality are published by independent groups (governmental or consumer)

• Increasing use of high quality distance education programs by students and practitioners

• Increased alumni loyalty towards the institution as the source of their life-long learning

• School and program accreditation criteria will reflect wellness, prevention of illness, and end of life care

• Increased participation by non traditional students

• Acceptance of older and traditional “schools of thought” as solid curricula, i.e. holistic medicine, end-of-life care

• Increased participation of workforce in life-long learning activities to keep pace with changing healthcare job market

Research

• Pharmaceutical companies increasingly seek collaborations with a limited number of academic health center’s (AMC) with reputations for expertise in new technology research projects  

Economic Guideposts

Generic

• Expanding development of partnerships with businesses and health care organizations

• MGMA and AAMC data reflect increase in expenditures for information technology

• Insurance companies/managed care organizations appoint e-CMO’s

• Centralized research operation results in strategic relationship with a variety of drug companies

• AMC’s are competing for drug company partnerships and ability to coordinate large, multi-facility studies

• The percent of AMC sub-contracts as an indicator of interactions with other institutions

• Increase number of AMC and community partnerships (funded grants)

Clinical Services

• Insurance companies compensate for email/internet consults

• Revenue generated by telehealth programs nationwide increases

• HCFA and MCO establish documentation and billing guidelines for telehealth practitioners

Education

• The demand and utilization of online educational programs by students, alumni, and other target groups is sufficient to justify continuing investment in the development of these programs
• All health science schools commonly coordinate courses, both on- and off line, across schools to avoid duplication and increase collaboration

• Revenue generated by distance education programs nationwide increases

• Student recruitment for cyber-education is competitive and provides sufficient return on investment (ROI)

• Institutions commit to and support continuing education delivered electronically

• The demand and utilization of online educational programs by students, alumni, and other target groups is sufficient to justify continuing investment in the development of these programs

Research

• Increase in corporate and private sector funding

• Funding for data mining of human genome database increases

• Increase in the number of business starts from technology transfer

• The proportion of clinical trials being performed by commercial clinical research organizations verses AMCs

• Government funding of non-proprietary research

Legislative/Regulatory Guideposts

Generic

• New legislation in response to concerns associated with the use of information technology

• Federal government appropriates increased funds for development of information systems

• Increase in legislation/regulation regarding the Internet medium

• Federal and state governments recognize need for the development of an infrastructure for all technology and appropriates increased funding

Clinical Services

• National or reciprocal medical licensure
• Legislation sets up single payer system (voucher)

• Changes in government regulations for privacy and security based on consumer demand and requests

• Legislation allows interstate and/or international telehealth services to begin and expand

• Increase in HCFA regulations regarding practice patterns

Education

• Accrediting agencies accept and/or endorse the practice of awarding credit for courses offered exclusively online and from other sources/schools
• States remove residency restrictions for distance education
• Accrediting agencies accept and/or endorse competency-based (as opposed to or in addition to time based) academic advancement

Research

• Legislative restrictions on aspects of research and use of consumer information