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Ohio Department of Aging Boomerang: It all comes back to you!

Boomerang: It all comes back to you!

My Future - March 2013

Narrowing the gap - putting medical technology in the hands of patients
Patient-centered tech is bringing care home and improving outcomes

The staff of Boomerang would like to thank guest author, Randy Wexler, MD MPH

The pace of the technology revolution in health care has been dramatic when viewed from the diagnostic (magnetic resonance imaging-MRI) or interventional (surgeries done through a laparoscope) standpoint. In fact, these are the types of things most people ponder when they think of technology and health care. The one thing that all such technology has in common is that they occur in physician offices or in the hospital. That is about to change.

Greater numbers of physicians are migrating away from paper charts and to electronic health records. Such a change will have a significant impact on how patients communicate and access health care in the future. Most of these systems have "web portals" that allow patients access to a host of functions, including the ability to view their medication lists and lab and test results, as well as the convenience of scheduling appointments and renewing prescriptions without picking up the phone. Patients also can ask for advice on simple concerns such as whether they need a pneumonia shot, or what to do about a cold.

These systems are encrypted, protect a patient's personal health information and automatically record all interactions within a patient's personal medical record. Many patients will find it easier and quicker to use web portal functions than to spend time on hold or wait for a call back. This will allow patients to access health care at a time and place that is convenient for them.

Patients also will experience changes in how care is delivered. Telemedicine, in which the patient is "seen" by his physician by logging into a computer, has evolved at a very fast pace. Technology today allows a physician to listen to a patient's heart, examine his throat or check his blood pressure from miles away. Such technology is ideal for those who have difficulty traveling from their homes, or who live in remote areas that would require an hour or longer drive to be treated for a medical problem.

Technology also will allow for a more proactive approach to certain chronic diseases. For example, patients with heart failure often develop extra fluid on their lungs, which then necessitates a trip to the emergency department for care. Researchers are working to perfect devices that can be implanted into a patient to detect changes in a patient's physiology days before she develops symptoms. This will allow physicians to make treatment recommendations long before the patient becomes symptomatic, which can significantly reduce the need for emergency department visits.

Finally, smartphone apps will allow patients to track and communicate their medical status to physicians. As this aspect of such technology evolves, it will be important to assure that Health Insurance Portability and Accountability Act privacy protections are built in, but it is only a matter of time.

Although the adoption of technology that can be used by patients in the outpatient setting has lagged behind the technology used in the hospital or office setting, the gap is narrowing. It is in all patients' best interest to understand what technology is available to them and how it can be used to improve not only their health, but also their access to care.

Dr. Wexler is the associate professor of Family Medicine at The Ohio State University Wexner Medical Center.


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