12 June 2013
Patients Can Dream
I can dream, and they are not simple dreams. Medical care has become too complex and doctors are having less and less time to spend with patients. My ideal medical experience would be to have secure access from my home computer to my medical records on a server in the doctor's office. There I would be able to check my medical history for accuracy and possible errors. I would be able to add by date, health symptoms that I was feeling and maybe a scale for pain caused, or for queasiness not resulting in vomiting. The doctor would be able to review my entries on an as needed basis and send me an email to call or I could call the doctor if needed for an appointment or a televideo conference. When needed I could ask for a blood draw to check out a group of symptoms and the doctor would be able to approve or disapprove.
I would still have available regular appointments or on an as needed basis. When I would be at the doctor's office for an appointment, his assistant would pull up my records and check what may have happened to medications, symptoms since my last appointment and if, or if not, what could be the need for the appointment. Any additional, if any, information would be entered. When the doctor entered the exam room, he could check the screen for anything out of the usual and the results of any lab tests and be able to ask a few questions and if needed make a diagnosis and give me a prescription, if necessary, or discuss measures I could take to alleviate the problem.
Then if there was something that he could not diagnose or a test did not give an indication of a solution, he would be able to take the symptoms and any developed patterns to a connection to servers round the country and query for information and possible outcomes. If none were returned, then he could possibly know that there is no immediate problem. If there were a few similar instances, he could read what had transpired and decide if he wanted more detail. He could then query by the case (without personal information) and if there were enough similarity, he would have a phone number to contact and establish a dialog with the doctor involved to discuss the information. If there were other cases, then the doctor could talk individually with the other doctors or have a video conference with those that were similar to what he was seeing.
Then from what he learned he could do the tests indicated or if none was indicated, could still decide that more symptoms or pattern was needed. Then he would discuss with me what he had learned, instruct me of symptoms to watch for, what to do if they developed, or if a pattern developed and when to call. If any of these developed and he was confident enough he could then prescribe a medication, call me in for another test, or advise me to report to the hospital for observation, a treatment, or surgery.
This would be cost effective for me and my insurance, and time effective for him. Many tests could be avoided that would not have been productive in reaching a conclusion or diagnosis and would possibly clouded the true problem.
Some day, in hopefully the not too distant future, this will be possible. There may be patient monitoring applications available to monitor many symptoms and track certain information that may minimize office visits and allow treatments that are more accurate.
My main concern will be Medicare and insurance companies getting in the way and preventing this happening. Healthcare rationing and profit greed must be managed to make efficient use of the new technology. If these two items are allowed to run rampant, then technology may be of little value and often limited before they can be proven of value. With the current wave of limiting expenditure of resources, healthcare rationing may become a unwelcome necessity, but the current excessive profit motives of medical insurance companies can still be sidelined and kept out of most equations.
In my dream, I can see a great future for telemedicine and other technologies related to telemedicine. I can even see contract medicine gaining importance, allowing doctors to serve patients more effectively. This would be especially true in the rural areas and less doctor dense areas.
There are many other concerns that I have not touched upon, like the growing monopoly of hospitals. They too will become manageable and the loss of life now attributable to errors happening in these institutions will become manageable. Some day, and hopefully not too distant in the future. As telemedicine becomes more profitable and efficient, hospitals will need to become more efficient or risk going out of business.