But for those with short memories, the Internet has been a year away from revolutionizing health care for over a decade. Yes, a decade. It’s almost as bad as waiting for the year that mobile advertising takes off, but I think we’re actually getting closer to that year.
That’s not to say that I don’t think we’ll get there. I think we will, but I don’t think it will come immediately or easily. There are a number of issues left to resolve before we get closer to technology fully enabling health care, remote patient monitoring and mobile health.
I do not want to oversimplify what is really a complex issue, but I do see some major stumbling blocks to full-scale adoption in the near term.
Technology — Let’s call it technology standards for device interoperability. It’s not there yet. It’s coming, but it’s not there yet.
Products — In order to have health care you need an end-to-end solution for multiple disease states. Take chronic disease as having the highest burden on “the system” and you need to have a suite of products available to have a solution.
Privacy — If you’re 50 years old or older you probably have second thoughts about storing all of your medical records on Google let alone let someone access them.
Reimbursement — Unless a doctor gets paid to do it, I can assure you that he/she is not going to spend his time on it-until forced to.
Fragmentation — There are still far too many one-off, one-way and proprietary solutions available. Just Google “EMR” and tell me what you come back with. Enough said. There has to be financial incentive for a company to move to a common standard and until a solution is proved you will see lurkers but no real movement. That puts an end-to-end solution years away.
Adoption — consumers have to embrace and demand it. Doctors need to get paid for it.
The Last Mile — This is a term that was originally used to describe getting connectivity such as telecommunications or cable to the end-user. Same is true here for the doctor who needs to implement it or the patient who needs to use it. It’s hard for a multitude of reasons. As I search for the metaphor in this I see health care delivery as a marathon. This is the marathons of all marathons and that the last mile is absolutely the toughest. I’d say we’re at around mile four.
As I evaluate the state of the industry today on 2013 and look back on the words I wrote in 2009 I can say that I see progress. However, for some of the key questions, I don't think we're moving quickly enough at all. Across all of the stumbling blocks, we're frankly, stumbling.
Unfortunately, I don't have as many solutions as I do questions but I like to look back occasionally at where we have been in order to understand where we need to go. And where we need to go is to still address the above critical questions but we're in mile eleven now and need to avoid hitting the wall.
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