The sleek, four-armed "da Vinci" robot has been called a breakthrough technology for procedures like prostate surgery. That's just the kind of impressive-sounding innovation that critics of the healthcare reform act say will be stifled by the new law, with its emphasis on cost control and the comparative effectiveness of new pills and devices. The Affordable Care Act will not reward this kind of innovation. The act will stimulate a panoply of true medical innovations. These may not be flashy; they might not even be visible to patients. But they will improve healthcare and lower costs.
Within two years, Pennsylvania should have in place a first-generation, Internet-based communications network that allows for the exchange of patient health data among doctors, hospitals, pharmacies, insurers and, eventually, the federal government. Pennsylvania has been staked to about $17 million in federal stimulus money to help build its statewide HIE system, and in February 2012, Republican Gov. Tom Corbett made appointments to the new Pennsylvania eHealth Collaborative Advisory Committee. In the intervening months, stakeholder groups have been meeting with consultants and contractors to iron out the finer details of the exchange networks.
Thanks to the big stick provided by the Affordable Care Act in the US, some healthcare organizations are pushing more aggressive use of network bandwidth and cloud technology. But ask any random sampling of physicians, technologists, and health industry observers. They'll tell you technology isn't restraining the next big paradigm shift in healthcare. The bandwidth is willing. "It's less about the technology holding the industry back, and more about the reimbursement model for healthcare," says Kenneth Kleinberg, senior director of research and insights at The Advisory Board Company, a global healthcare research, technology, and consulting firm.
Each year, tens of thousands of Americans are implanted with tiny battery-controlled devices that regulate the beating of their hearts. But some patients, like Hugo Campos of San Francisco, fear they're being kept out of the loop. Those devices transmit streams of medical data directly to doctors. That's because even though Campos' ICD can wirelessly transmit data twice a day about his heart and the ICD itself, that information goes only to his doctor. Campos has to make an appointment and ask for a printout. And that, he says, just doesn't seem fair. This has become his crusade, and that of a growing movement of people who call themselves "e-patients."
A recent report from Chilmark Research for instance, shows that while the HIE market grew more than 40% in the past year, most of that growth came in privately sponsored, enterprise health information exchanges, rather than in public health information exchanges that seek to connect providers across regions and states. The main reasons for the rapid health information exchange growth, according to Chilmark, are the Meaningful Use criteria that will require interoperability between systems as patients are moved from one care setting to another, and the impending changes in reimbursement methods that will necessitate greater care coordination.
Late this week, the FCC approved some changes to the current allotment of the wireless spectrum, paving the way for Sprint to expand its current 3G network and launch an LTE service. The FCC also approved a second set of spectrum-use rules, regulating the 2360-2400 MHz band for use in hospitals as a "Medical Body Area Network," or MBAN. The MBAN will allow doctors to hook their patients up to the physiological sensors like EEGs, heart monitors or neo-natal sensors and have those lightweight and often disposable sensors transmit information back to the monitoring equipment without wires.