Challenges in North American medical communities met by computer and information technology

Düsseldorf 07 December 1998 During the last decade of the millennium, handfuls of daunting issues have arisen within the North American health care sector. There is a growing need for cost-saving yet qualitative patient care due to threatening spending restraints. The U.S. government is fully occupied with the revision of medicare programmes. In addition, physicians show an ever increasing dependency on alternative health practitioners. At the same time, they are facing a substantial patient growth in the future, caused by the aging baby-boomers' generation. On top of this, hospitals and health care institutions are completely being reorganized to enter the 21st century. Should it come as a surprise then if health professionals desperately seek for assistance in the world of innovative computer and information technologies?

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During the last decade of the millennium, handfuls of daunting issues have arisen within the North American health care sector. There is a growing need for cost-saving yet qualitative patient care due to threatening spending restraints. The U.S. government is fully occupied with the revision of medicare programmes. In addition, physicians show an ever increasing dependency on alternative health practitioners. At the same time, they are facing a substantial patient growth in the future, caused by the aging baby-boomers' generation. On top of this, hospitals and health care institutions are completely being reorganized to enter the 21st century. Should it come as a surprise then if health professionals desperately seek for assistance in the world of innovative computer and information technologies?

Although more and more doctors turn to the promising assets of the high-tech revolution, the medical profession still has a long way to go as far as the Internet-enabled applications are concerned. Indeed, a restricted number of physicians already heavily relies on leading-edge technology and synthetic pharmaceuticals for improved diagnosis and therapy. Only about ten percent however regularly consults the Internet for medical information. This figure is bound to boost in the coming five years since an ever growing amount of health care magazine editors decide to go on-line. Currently, the Internet is not yet fast enough to manage the enormous traffic but by 2002, this problem will be solved via the introduction of standard satellite use.

Imagine a physician on holiday, who will be able to monitor a patient's vital signs at a distance of a thousand miles, send e-mail and participate in a tele-conferencing session, simply by using a battery-operated laptop computer. In a few years, this situation will become reality. Providing remote care via telemedicine already is common use in many isolated, rural areas of Canada where physical patient visits are hardly possible due to a lack of doctors. The arrival on the market of instruments, allowing to remotely examine the ears, eyes and throats of people or perform tele-auscultation of a patient's heart, has strongly promoted the concept of telemedicine.

Spectacular breakthroughs have been realized in new 3D imaging software. The cutting-edge applications outperform the traditional use of hand-drawn sketches in the mapping of burn surfaces. Brain tumours can be accurately sized and accessible pathways easily determined, if 3D imaging is applied in conjunction with computed tomography (CT) and magnetic resonance (MRI) scanning. Next to this equipment, portable cardiac monitoring systems are emerging, which form a very practical substitution to the heavy units that remain fixed in one location. The most recent development constitutes a portable device to be worn on the body for the transmission of vital signs to the hospital computer while the patient is taking a walk or performing an exercise.

The information systems in clinical laboratories equally will undergo large changes. The new era will see the birth of the interfaceable lab information system (LIS), which will combine data, automation and robotics technology in order to improve biosafety and reduce costs. The medical community is also faced with the very acute problem of the millennium bug which has to be tackled before the end of the year. All electronic equipment identifying the years by their last two digits needs upgrading or replacement. Another hot issue constitutes the abuse of personal medical data. Currently, the U.S. Congress is preparing legislative measures for health care institutions, researchers and government agencies to safely interchange medical records with full respect for the patient's privacy.

The health professionals not only are faced with electronic problems but also with the identification of terminal exotic diseases, such as malaria, dengue, yellow fever and encephalitis, which have been introduced in North America by insects from overseas. A new phenomenon in this regard constitutes the growing interest of conventional medicine for the integration of alternative therapies, such as massage, acupuncture and chiropractic sessions. How to reconcile this kind of medical practices with digital radiology equipped with image relay for the incorporation into data processing networks or with the new futuristic operating theatre remains an enormous challenge. The data for this article has been provided by the MEDICA 98 pressroom services.


Leslie Versweyveld

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