Originally Published MPMN September 2001

EDITOR'S PAGE

E-Health Solutions: Why Hospitals Are Part of the Problem

Ricky Richardson is mad as hell, and he's not going to take it anymore. His wrath isn't directed at the mass media, however, but at the healthcare system.

Chairman of the UK Telemedicine Association and a practicing pediatrician, Richardson traces the origin of our current pyramidal healthcare structure back to the Egyptians. "The medical profession has ruthlessly exploited patients for 6000 years," he fumes. The citizenry has suffered under the dictatorship of "bigoted, avaricious, refractory, conceited, and inherently conservative" healthcare professionals long enough, says Richardson. "It is time that patients fought back."

"My medical friends love me, of course," he wryly adds.

I spoke with Richardson while doing research for an article on e-health and telemedicine. An outspoken crusader for e-health efficiencies, Richardson blames the technology's slow uptake partly on flawed economic comparisons.

Past studies have compared the cost of treating patients by electronic means versus treating them in the traditional manner, notes Richardson. "Of course, the telemedicine group is going to be more expensive because of the technology investment. But if you start dismantling the bricks-and-mortar hospitals and radically reforming healthcare delivery, then you will start to see a very attractive macroeconomic picture," says Richardson. "Even the gray-suited mandarins at the treasury look up at this point."

In Richardson's view, the deployment of e-health solutions and a redefinition of the role of the hospital should be placed on parallel tracks. Home monitoring equipment and devices that can transmit and receive medical data and be reconfigured from remote locations can reduce or even eliminate hospital admissions. The savings can be substantial, according to Richardson and other e-health advocates. "Once you remove the hotel component from the hospital, you erase 60% of the cost," claims Richardson.

Given the reluctance of the healthcare establishment and its enablers within the government and reimbursement organizations to embrace change on this scale, Richardson places his hope in people power. He envisions an evolutionary process similar to how ATMs changed the relationship between banks and customers.

As ATMs migrated from the bank wall to various public places, bank branches became redundant. Many were shut down, because banks were able to deliver services to customers at more convenient locations. The same pattern will apply to capital-intensive hospitals and to the healthcare exchange in general, contends Richardson. The current system requires the patient to travel, often some distance, to take up a few moments of the specialist's precious time, Richardson told attendees at a recent telemedicine conference. "In any other consumer industry, the service is delivered to the customer. I think the present system is abhorrent," he says. It is also obsolete, according to Richardson. "The point of interface is moving out of the hospital and into the retail and home environment," he stresses.

Of course, we have heard this before. Telemedicine was supposed to change the face of healthcare during the previous decade. While substantial strides were made, deployment of the technology has been spotty at best. For most people, e-health is still a curiosity more suited to Epcot Center in Florida than the real world. Debating its merits as an alternative to the current healthcare structure and not simply a costly add-on may be the e-ticket to success.

Norbert Sparrow

Copyright ©2001 Medical Product Manufacturing News