Friday, March 18, 2005

Telemedicine in Decline?

Telemedicine in Decline? What does that even mean? Decline from what? Did we ever really have it?

Nonetheless, the National Health Service of the UK is to be commended for truth-telling. In a study authored by Carl May of Newcastle upon Tyne for the prestigious Economic and Social Research Council, we are told that

"Telemedicine'" is disappearing, in stark contrast to the apparent
success of telephone services on which clinical staff decide the urgency of
patients' injuries or illnesses, and advice lines such as NHS Direct.
While we may ask whether telemedicine--the putative benefits of real-time, technology-enhanced health-care-at-a-distance that were hugely touted in the mid- to late-1990s--was ever anything more than chimerical, we may still laud this ESRC group for its exercise in truth-telling.

We may also be tempted to extrapolate. Are other technologies--even, shudder, the Electronic Health Record (EHR) itself--susceptible to this same sort of phenomenon? If so, the corrective came, in part, from the recent JAMA piece on the EHR's limitations. That it had some validity and hit a nerve was evident from the instant, vociferous backlash from the vendors, via HIMSS--all of whom think this is, finally, their Big Day.

Which, in some way, undoubtedly, it will be: 2005-2006 may be the Year of the EHR, which now seems inevitable despite many problems with EHR implementation. And this makes us wonder why telemedicine is looking like the Betamax to the EHR's VHS--all the while even more wondrous high-tech gizmos are being assayed over in Iraq despite many troops' lack of basic low-tech armor.

(But see Don Detmer's well reasoned riposte from the loftier reaches of AMIA, on the subject of the EHR.)

What shall we call this phenomenon? Some might call it the Triumph of the Technocentric over the Infocentric and the Human-centric models of information use. Others might just call it the Triumph of Greed.

Despite which, Don Detmer's and other's pleas are probably valid: don't throw out the baby with the bath water. At least for the EHR. But maybe it would be ok if we had a little more body armor and a little less telemedicine.

1 comment:

M. Simon said...

Uh, armor has been in excellent supply for over a year now.

The field expedient stuff is what every American Army has done since Dec 7, 1941. Adapt to field conditionswith the resources available.

You understand the logistics train in a hospital. What makes you think it isany different for a military in the field?

Requirements do not match initial estimates. Adjustments must be made. It is not a scandal. It is SOP. In fact the military plans for change.

It plans for its plans not matching reality.