OrrThe world is fast becoming wired — and wireless. Technology and productivity tools have changed business, providing workers with mobility and connectivity. Bottom line — you don’t have to be at the office (home or corporate) in order to work.

Healthcare — the part that diagnoses and treats patient disorders — finally is showing signs of leveraging technology for improving mobility and connectivity within the practice of traditional medicine.

Hurry up and wait
“Estimated Waiting Time from this point is …” Delays and waiting represent a disease of epic proportions in the U.S., and likely every healthcare system worldwide. You wait everywhere along the chain while data is entered, re-entered, checked, re-checked, paper and computer databases are updated, ad nauseum. Technologies to reduce waiting and delays include smartcards, computerized patient records and connected networks. Smartcards seem a simple addition to my wallet to speed up the continuum of healthcare processes and transactions. If Costco, Sam’s and every grocery store in the U.S. can afford this technology, physicians and HMOs can, too. Do you have one yet? I’m still waiting for mine. My radar says it’s coming — soon.

We’ll have to get back to you
“The doctor is busy right now… .” I’ve never been directly connected to a doctor when I called his office. The problem is management and planning. There typically is no doctor, nurse or para-professional whose job is to manage these calls from patients. Doctors tend to focus on patients in the office, with outside phone calls squeezed around the in-house patients. Setting up an intensive email/phone service staffed by a nurse/physician combination linked to the patient database should handle all of these medical interactions with swift and comforting instructions. Call it Dr. E, and she’s always in or on-line, 24×7. The missing link — computerized patient records (CPRs). SNOMED is a new term we’ll all learn shortly (standardized nomenclature in medicine), and its widespread adoption should accelerate the deployment of CPRs. Then, you shouldn’t feel guilty calling for help at 5 a.m. with a question or concern.

You need to see a specialist
Physicians have become rapidly educated regarding the referral patterns of their practice by the database mining programs from the managed care networks. They have staked out clearer positions for referrals and refusals, with the backing and support of diagnostic protocols and evidence-based medicine. Statistical analysis and expert systems have delivered structural improvements to the diagnostic process, and these systems continue to improve. The net result is that you likely can proceed to a specialist, when necessary. Disease management programs, under development and early use during the past five years, will see exponential growth in the next few years for patients falling within disease categories that consume ongoing medical services.

I’m waiting for the results to come back
This famous phrase is disappearing faster than the dinosaurs, primarily due to the Internet and computerized systems optimized for specialist services and physicians. In fact, specialists probably offer the most efficient medical practices in the country, due to the repetition of common procedures and inter-connection required with referring physician offices. The net result is that reports from specialists increasingly are communicated via the Internet — either to a desktop or portable computer. Radiologists performing initial reviews from home or remote sites outside the hospital are improving services for everyone. The live deployment of voice recognition systems (for report transcription) coupled with the surge in bandwidth (for images) indicates that these links will continue to speed up.

Whoops, or hmmmmmm
Either of these two words are enough to make me jump off the table. Computer-aided diagnosis and computer-assisted tools are reducing the use of these words inside surgical and physician offices. Excellent examples of products incorporating new computer-controlled aids include depth of anesthesia monitoring, computer-assisted minimally invasive cardiac surgery, computer-assisted diagnosis of mammograms, computer-assisted replacement of hips, laser eye surgery and many others in clinical trials.

You can look it up
Patient treatments and historical records increasingly are logged into computer databases for quick recall and comparative analysis. Recent studies indicate that physician demand for reviewing prior radiology images increases exponentially when the images are rapidly available online. The traditional file room system (delays, lost films, slow service) artificially suppressed demand. Now we see physicians actively using this information to the benefit of patient diagnosis and treatment. The technology driver is economical data storage, both online and offline.

None of these individual technologies are killer apps — that award is being held for the cell-phone with an integrated web-cam connected to an on-call doctor. Meanwhile, all of these tools bring incremental improvements to the real-world demands of medical care.

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to [email protected].