What Is The Future Of Collaborative Medicine?

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Author(s): 
David Edward Marcinko, MBA, CMP, and Professor Hope Rachel Hetico, RN, MHA, CPQH, CMP

With an increasing amount of medical information on the Internet, patients are becoming more used to participating in their own healthcare. These authors examine how the evolution of Internet technology has changed the way patients interact with their healthcare providers and how podiatry practices can take advantage of the Web.

In 1995, the primary use of the Internet was e-mail for the masses. Later, doctors linked to hospitals and insurance companies for clinical information and insurance benefits coverage. Today, physicians are finding deeper avenues for the Internet that range from improved efficiencies (electronic medical records, digital transcription services) to continuing medical education and consultations with colleagues.

   Ever since the introduction of the term “Web 2.0”″ in 2004, there has been much definitional obscurity about its true impact in medicine. Although no one has defined it clearly, we think the health-on-the-Internet evolution falls into three categories.

   Health 1.0. This is today’s dying healthcare system in which doctors communicate information to their patients. It is a basic business-to-consumer business model in which the Internet is one big encyclopedia of aggregate knowledge. Some doctors maintain Web sites and others do not. Nevertheless, Health 1.0 has a command and control hierarchy where doctors are on top of the pyramid and patients are on the bottom.

   Health 2.0. According to healthcare journalist Matthew Holt of http://www.thehealthcareblog.com, Healthcare 2.0 may be defined as: “information exchange plus technology.”

   Holt says Health 2.0 “employs user-generated content, social networks and decision support tools to address the problems of inaccessible, fragmentary or unusable healthcare information. Healthcare 2.0 connects users to new kinds of information, fundamentally changing the consumer experience (e.g., buying insurance or deciding on/managing treatment), clinical decision-making (e.g., risk identification or use of best practices) and business processes (e.g., supply chain management or business analytics).”1

   Therefore, if Health 1.0 is a static book, Health 2.0 is a dynamic discussion. For example, the power of the Internet is illustrated in the phenomenon of “crowd sourcing.” In this context, the term means to harvest the reach of social networking (wisdom of crowds) to solve a problem. For example, www.PodiatryPrep.com is an example of how podiatrists connect for global board certification assistance.

   Health 2.0-plus. The Dictionary of Health Insurance and Managed Care defines this emerging hybrid as a bridge uniting the philosophy of contemporary Health 2.0 with futuristic Health 3.0 technologies.2 Cisco System’s HealthPresence, developed in 2010, is one example. Using the network as a platform, HealthPresence combines video, audio and information to create an environment similar to what patients experience when they visit their own doctor.

   Health 3.0. Soon patients will not only be seeking information but actionable intelligence. Patients will communicate almost as with another patient or doctor. The Internet offers some amazing opportunities. Imagine using your iPhone to send pictures and streaming videos of conditions for a second opinion.

How Market Tensions Challenge The Traditional Delivery Of Healthcare

John Luo, MD, of the Semel Institute for Neuroscience and Human Behavior at UCLA, lists three competitive trends that are challenging traditional Health 1.0 delivery and that are producing much fear and anxiety among medical practitioners.3

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