Editor's Note
High Hopes for High Tech
My dreams of a medical practice where technology enhances the care of patients have remained only partially fulfilled.
I am a closet geek. Beneath my polished, doctorly veneer lies the heart of an inveterate button-pusher, an early tech-adopter of the first rank. Twenty-five years ago, television personality Dick Cavett’s ads for Apple Computers prompted many to ask, What would I ever do with that? I marched out and bought an Apple II+. A few years later, when I had souped up my Apple to its limit, I bought my first “laptop,” which was so big it exacted a major toll on the quadriceps if you really tried to use it in your lap. And I am on at least my fifth generation of cell phones, having started with a car-based clunker that required me to keep a suitcase-sized transmitter under the seat and a curlicue antenna on the roof. I am passionate about gadgets, and I dream about new and better ones daily.
I have carried that passion into my work. I introduced an IBM XT to our office to do word processing in the 1980s. I bought my own IBM 386 and developed a template in Microsoft Word to type my office notes in the 1990s. And I led a committee at our physician-hospital organization to bring computerized medical records to parts of that organization.
Yet my dreams of a medical practice where technology enhances the care of patients have remained only partially fulfilled. Although I marvel daily at technologies such as MRIs, PET scans, and even the partially realized electronic medical record (EMR) at our hospital, I fume when I stumble over dysfunctional, time-consuming processes such as refill authorization that cry out for the application of technology because it would save time and money, and reduce mistakes. We’re still a long way from geek heaven in medicine. Some of our articles this month suggest that we’re taking small steps toward tech nirvana. Nudged by local and national initiatives, the EMR is slowly diffusing across the medical community. Telemedicine is helping in real-time, and nanotechnology and improved MRIs will help in future-time.
Yet some of our articles caution that technology has its downside. Users of the EMR have found hassles and hiccups. And it all costs money that with each day seems more and more scarce. We need technology that will save lives by helping us diagnose quicker and treat smarter, save money by making care more efficient, and, perhaps, save threatened specialties such as primary care by making them more financially viable. But we must not go broke buying gadgets at the expense of not being able to take care of people.
At the recent Nobel Conference at Gustavus Adolphus College, Rice University nanotechnology expert Jennifer West, Ph.D., suggested that technology doesn’t have to break the bank. After dazzling us with an improbable Star Trek collection of devices such as nanoshells, nanotubes, and buckyballs, she described an application that could identify infections in minutes. She had challenged eight teams of post-docs to design a handheld gadget that would do this and cost less than $200. All four teams succeeded.
I still have dreams of seamless integration of medical information between provider and patient, of genetics entering daily medical practice to tailor diagnosis and treatment to the individual, and of medical technology serving but not ruling medical care. We may not be there yet. But slowly, the improbable is becoming the possible. And that makes it an exciting time to be a geek.
Dr. Meyer can be reached at cmeyer1@fairview.org