The M4 Mantra - "Making Medicine More Mobile"
Thursday, April 23, 2009
| Peter J. Haigh, FHIMSS
Author - Peter J. Haigh, FHIMSS, Tele-Mobile Healthcare
Healthcare diagnosis and treatment in the USA is very much a “Mahomet must go to the mountain (1)” kind of business; the onus is on the patient to do whatever is takes transport themselves to the provider’s location. Huge progress has been through medical research and equipment invention, yet the model for how these are used has remained almost unchanged for decades Telemedicine, Home Health visits and the long abandoned Doctor’s “House calls” represent only very minor “exceptions to the rule.” Would it save time and money if patient transport was restricted to occasions when an in-person consultation or special medical resources were really needed? Could it be valuable if specialist advice was obtainable by means more effective than a phone call or a page?
Some have been thinking and talking about this for several years, myself included. Now more people are beginning to believe in the possibility, thanks to communications and other technologies developed for other purposes, but which look like they will allow for change in how healthcare is treated in the same way as the rest of the economy and society in general has changed. We bank over the Internet, buy merchandise the same way, and of course we communicate increasingly via phones and other devices which are inherently mobile. When and how will the business we call Healthcare harness this flexibility and convenience? My crystal ball is a little cloudy, (largely because I’m a technologist with knowledge of healthcare, not a medical practitioner with knowledge of technology) but I see signs (and dream dreams) that “the times they are a changing ... (2).”
What do I see? I see TeleStroke (3) and STRokeDOC (4) using the power and flexibility of 3rd generation cellular data networks to connect apparent stroke victims with radiologists and .neurologists who can communicate and study brain images to collaborate on diagnosis and determine things like whether to prescribe TPA within the short timeframe in which it’s effective, even though the medical specialist and patients are all physically remote from each other. I hear about the transmission of vital signs and diagnostic images of patients while they are en route by ambulance to an emergency room (5) so that “the golden hour” (or its equivalent for their condition) is put to best use in starting or preparing for their treatment. I’ve personally contributed to the creation of M3, a multi-year trial enabling clinicians to diagnose and order treatment when they are “wherever they are”, better yet to receive alarms when their urgent attention is needed, using a fully functional PC with all the IT applications available to them that they would have at the ICU bedside. I dream about remote physiological monitoring based on cellular telephony devices (phones, Smartphones, PDAs, etc.) which allow both the patient and the care-giver to be able to move around at will – and this dream is coming true. The huge value proposition is that with cellular devices already owned by a high (and rapidly rising) percentage of the population, the significant cost of today’s monitoring systems can greatly reduced.
How can we take even more advantage of the IT and telecom technologies used in the examples described above? We need medical practitioners and healthcare providers of all kinds to “take of the blinders” and think about how they can take advantage of these technologies to transform the way they work, to make it more timely and efficient by removing the barriers of time and distance from diagnostic and treatment as it is provided today........ Just keep up the M4 mantra.........
(1) Francis Bacon, circa 1601 On Boldness “If the hill will not come to Mahomet, Mahomet will go to
the Hill”, subsequently reworded.
(2) Bob Dylan, Copyright 1963
(3) http://www.universityofcalifornia.edu/news/article/18338
(4) http://telestroke.massgeneral.org/default.aspx
(5) http://www.welchallyn.com/pressroom/releases/2007/2007-04-17.htm