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Palo Alto Medical Foundation | Enoch Choi, MD | Mobile Doc
What's *really* new on the Web, as opposed to buzzwords and soundbites?:
There are generally applicable technologies, such as syndication formats (RSS/ATOM/iCal): subscribing to content that's applicable to your daily routine: My patients can subscribe to my iCal feed of my clinic schedule and add it to google calendar to see when they can fit in a visit to me. Since I operate a drop-in clinic, they don't have to make an appointment, they just come over.
There are very narrowly developed technologies: electronic medical records remotely accessible by physicians or patients. I use electronic medical record software (EPIC) that I can access from anywhere and order anything as if I was in the clinic physically: nursing orders, labs, xrays, prescription faxing, and ugh-writing chart notes. My patients can access this via a personal health record view of what i've authored (PAMFonline), where they can ask questions, review their visits, make appointments, and request refills.
Which tools best embody the new opportunities from your point of view and why?:
I think there are plenty of good tools, but I think the opportunities are made by the individuals implementing the tools. It's more about the willingness of a service provider like myself, being willing to adopt tools that will make my patient's experience better. It's a balance of trying to improve efficiencies of business processes, while constantly improving the connectedness our patients feel.
Who's doing the best work with the new tools (technically or in terms of social benefit or both)?:
Individuals like myself who are willing to try mobile technologies such as an OQO (pocketable Windows XP computer). I was able to look up patient's prescription records in Katrina medical disaster relief and write prescriptions in places without any infrastructure, with paper records rotting with mold. I came back to my own clinic and realized mobile access to our own EMR loosed me to practice wherever I am, unbound by my physical clinic. I can provide virtual consultations for patients via eVisits, through their personal health record - a secure web portal.
What's the bad news? What are the greatest barriers preventing web-based technology from producing social change?:
Unfortunately, I only see non-profit companies who are well capitalized make the deep financial committment over long periods of time to use new technologies to revolutionize their processes. It's prompted Kaiser to make a 10 year $1B investment in the same tool we're using because they see the same potential.
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