Tuesday, June 07, 2005

IT and Imagination

The snail’s pace as which Information Technology (IT) is being implemented in health care can be traced in large part to a lack of imagination.

My brother-in-law Jim recently contracted a case of Polymyalgia Rheumatica, which is medicalese for pain in the muscles. The etiology is unknown. It eventually goes away by itself and until it does the pain can be controlled with cortisone.

Although by no means rare, the disease is uncommon enough, and the symptoms general enough (e.g., “my shoulder hurts”) to make the diagnosis less than obvious.

Jim’s HMO Primary Care Physician (PCP) referred him first to a neurologist who referred him to an orthopedist. Neither resulted in a diagnosis.

The next referral was to a rheumatologist. Although Jim is more than usually facile at Internet searches, his efforts to diagnose himself via Internet had up to then been unsuccessful. But when he heard the word Rheumatology he narrowed his search and bingo!!, hit it right off.

So back to the PCP he went, diagnosis in hand together with the treatment. The PCP accepted the diagnosis and provided the needed prescription.

As one can imagine, Jim was more than a little apprehensive before this last visit about how the PCP would react to being handed the diagnosis and recommended treatment by the patient. Happily, things went well and the condition was in short order brought under control

That shouldn’t have been enough. The HMO should have given Jim a certificate of appreciation and put his picture in its monthly subscriber newsletter. Think of what an HMO could save if more patients were able to diagnose themselves!

The airlines now have us making our own reservations and charge us extra if we need help. Will the day come when patients will have to pay a special fee if they need a doctor’s help in reaching a diagnosis?

In the meantime, should the HMO provide a skilled Internet searcher to help patients reach a diagnosis before seeing the doctor?

Don’t laugh. This is the kind of thing that IT makes possible and the sort of thinking that ought to be going on in the leadership circles of health care.

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