Gary A. Puckrein is President and Chief Executive Officer of the National Minority Quality Forum. In 1998 he founded the Forum’s predecessor program (the National Minority Health Month Foundation) to help communities and policy makers eliminate the disproportionate burden of premature death and preventable illness in special populations through the use of evidence-based, data-driven initiatives. Dr. Puckrein has built the Forum’s capacity to house vital statistics and other information-including demographic, environmental, claims, prescription, laboratory, hospital, and clinic data-in a centralized data warehouse. HDC was thrilled to have him serve as a keynote presenter at our recent event in Chicago, Putting Health Data to Work in Our States and Committees. Below, Dr. Puckrein elaborates on some of the themes he touched upon at our Chicago event.
Analog medicine is characterized by patient charts—file folders shelved in physicians’ offices (typically behind receptionists’ desks) that contain clinicians’ notes on their patients’ medical histories. Because these charts are not machine readable, reviewing them is cumbersome and costly, which has hindered detection of adverse events, limited quality improvement, and discouraged identification of disparities, inefficiencies, and fraud. But all that is changing.
Today we are moving inexorably into the world of digital medicine. Points of care are being required or induced through financial incentives to replace analog patient charts with electronic health records, which are machine readable and transferrable across global networks. They are enabling us to build new systems to improve management.
The age of digital medicine is dawning with a proliferation of home and personal devices that monitor biometrics—such as blood pressure, cholesterol, and blood glucose—and transmit readings to electronic health records that are globally accessible by individuals and their health-care providers. Manufacturers of blood glucose meters are competing to release products that will transmit findings to the cloud. Microsoft and its partners are far enough along in development to announce their research on contact lenses that monitor blood glucose and have the ability to transmit those results to personal health records. Intel Corporation’s new Chief Executive Officer, Brian Krzanich, recently announced Intel’s intention to speed up the rollout of chips for smartphones, tablets, and wearable devices as consumers move away from personal computers; these chips will support medical devices.
There will be many variations as research and manufacturing companies link new knowledge of genetics, biochemistry, and molecular biology to innovative technology to improve the quality of care and meet the needs of consumers. The efficiencies and outcomes from such efforts will encourage the propagation of new tools for earlier and more effective care, more efficient use of medical personnel, and reductions in avoidable inpatient stays and emergency-room visits.
Digital medicine will have its challenges. Patient privacy will be an enormous concern, requiring vigilant management of private- and public-sector data aggregation. Delivering the right information to the right person at the right time will also be a challenge. How we reimburse for innovative technologies will affect the pace of innovation. The practice of medicine will be reshaped by the coding of medical encounters into bits and bytes.
Our personal medical histories are becoming digital recordings that will survive long after we have passed away. Each of us can expect to contribute to the advancement of medicine as future generations of researchers analyze our digitized histories to develop more effective, life-sustaining therapies and devices.