Innovation, Evolution and the Telephone

Point-to-point transmission was all that was available. There were competing standards for everything from device design to content delivery. Early adopters paid hefty up-front costs to get connected. Communication was by no means guaranteed. The market was fragmented.

Does this sound familiar? That was the state of telephone service in 1891. By 1901, however, 2 million people had telephones in their homes, and there were more than 2,000 local commercial and municipal networks. Connections were still iffy, but with more than $500 million in public and private funds invested, nationwide telephone service was on its way.

Micky Tripathi, PhD, president and CEO of the Massachusetts eHealth Collaborative, presented these statistics at a recent National Health Information Technology conference panel. “At the beginning, things are expensive, there are many companies …  I would argue that’s where we are in healthcare IT,” Tripathi said.    

Although Tripathi wasn’t talking about electronic health information exchange systems specifically, there are some parallels between of HIEs today and telephones at the turn of the last century. The future is uncertain, replete with a fragmented market, a plethora of standards, colliding interests and uncertain sustainability. However, the ability to electronically access and exchange health information could have the same dramatic benefits as a nation wired for sound and communication. We have a long way to go before HIEs are as ubiquitous as telephones, but the facilities featured in this month’s cover story have taken the first steps, and those can be the hardest ones.   

In this issue, we look at health IT’s shifting role in other grey areas of meaningful use and remote data access. In the following pages, you’ll find out about issues around radiology images in the EMR, a potential requirement for meaningful use that isn’t yet a requirement, but could become one down the road. We also examine smartphones as medical devices, and their implications for patient data transmission and display.

With both image-enabled EMRs and iPhones, early implementers saw the potential benefits, got to work and eventually showed their colleagues new and better ways to work. (Some 33 percent of physicians now use mobile devices or smartphones to input and review data, according to preliminary data from our Top Trends Survey that you’ll see in full in the next issue.) If you think sustainable HIEs exchanging standardized information and EMRs that contain images are impossibly expensive or just not buildable, think about the early challenges of telephony the next time you take a call.

Around the web

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”

FDA Commissioner Robert Califf, MD, said the clinical community needs to combat health misinformation at a grassroots level. He warned that patients are immersed in a "sea of misinformation without a compass."

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