If Federal Communications Commission Chairman Julius Genachowski gets his way, we will have a national broadband plan with 100 megabit Internet connection to 100 million U.S. homes by 2020. And that could make remote medicine a reality.
The FCC's National Broadband plan contains a 25-page chapter on health care, and calls upon the Department of Health and Human Services to make so-called e-care projects a "top priority." One suggestion is the creation of a Health Care Broadband Infrastructure Fund to make sure all health care facilities -- including rural ones -- have adequate connectivity.
At the very least, clinics, hospitals and even doctor's offices should be encouraged to put health records into a secure database that can be accessed by patients and their authorized care givers, wherever they happen to be located.
The health care portion of the broadband plan sites an example of "Beverly," a 49-year-old stroke victim from a town 75 miles outside of Boston. After she arrived at her local hospital, staff set up a video link to Massachusetts General Hospital, where a stroke specialist observed her and conducted a neurological exam while receiving vital signs and lab data.
Based in part on her nods in response to yes and no questions, the specialist determined the stroke was caused by a clot. He prescribed tPA in the nick of time, and when she arrived at Mass General by ambulance, her symptoms were completely gone.
In addition to saving lives, video consultation and other "telehealth" techniques can save money by giving facilities remote access to world-class specialists without having to have them on their payroll. The broadband plan said avoiding costs from moving patients from correctional facilities and nursing homes to emergency departments and physician offices could result in $1.2 billion in annual savings."
Simply by switching all providers to electronic health systems with on-screen reminders to prompt physicians to prescribe influenza and pneumonia vaccinations could save up to 39,000 lives annually, according to a study cited in the FCC's report.
National adaption of electronic health records (EHRs) could save more lives by alerting physicians and patients of dangerous drug allergies and drug interactions when the doctor is punching in the prescription. According to one study, this alone could result in a net savings of as much as $371 billion for hospitals and $142 billion for physicians over the next 15 years.
Just as with other aspects of broadband penetration, the United States has some catching up to do. According to the FCC, this country "ranks in the bottom half (out of 11 countries) on every metric used to measure adoption, including use of electronic medical records (10th), electronic prescribing (10th), electronic clinical note entry (10th), electronic ordering of laboratory tests (8th), electronic alerts/prompts about potential drug dose/interaction problems (8th) and electronic access to patient test results (7th).
There are also some exciting possibilities in mobile health delivery via laptops, smartphones and other portable devices. Not only do portable devices enable physicians to access lab results, images and drug data from wherever they happen to be, they also can allow patients to monitor vital signs such as glucose levels, blood pressure and other data, and to transmit that data to physicians, caregivers or clinics.
Lifescan, a Johnson & Johnson company, offers an iPhone application that connects to a glucose monitor to transmit data to a patient's caregiver or physician.
And there's a $1.99 "AcneApp" for the iPhone that claims it can treat acne by projecting light from the phone's screen to your face. "Rest the iPhone against your skin's acne-prone areas for 2 minutes," says the advertisement "to improve skin health without prescription drugs." I don't know if it works, but the App will soon be the subject of a clinical trial by Baylor College of Medicine.
So next time you go to the doctor and ask about a drug to cure whatever ails you, perhaps instead of writing a prescription, he or she will simply say, "There's an App for That."
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