Wednesday, March 22, 2006

The Education & Healthcare Systems: Complimentary Means To An End

Approaching the Point of Diminishing Returns

The Patient-Physician relationship as the fundamental basis for healthcare delivery is approaching the limits of its capacity. The Physician as the gatekeeper and source of health information and services has functioned admirably in this role throughout the course of history. As the volume of information continues to rise and the demand for that information and associated services also rises the ability of any individual Physician to meet that demand decreases. The point of diminishing returns is quickly drawing near. There are short-term solutions, but ultimately a new, expanded platform for delivering healthcare will be required.

Managing Information

The short-term solution is to augment the capabilities of the Physician to manage the vast amount of information within our Healthcare System. Health Information Technology (HIT) is expected to facilitate this process at multiple levels. It can occur at the national level with the National Health Information Network (NHIN) or regional level with Regional Health Information Organizations (RHIO). Locally hospitals can do this with the development of Electronic Health Records (EHR) and Physicians can also participate with PDA's and software products such as Epocrates. While these measures will be helpful to assist in the management of information and coordination of care, other measures will be needed to improve the delivery of services and decrease the cost of care.

Managing Quality & Cost

Quality care initiatives are already being implemented that will standardize "best practices", utilize HIT, develop process and transform healthcare cultures in an effort to improve outcomes. New market approaches to improve the delivery of healthcare through concierge services, and Intensivist extenders or to reduce costs for evaluating and treating minor health problems over the phone, through the internet or while shopping at a local store. Despite all this we still need a long-term solution. The greatest number of healthcare problems and the greatest cost to our Healthcare System is the direct and indirect result of chronic disease and preventable injury and illness. This is where the lever of the new healthcare delivery platform should exert its greatest force.

Health Information As A Core Part Of The Educational System

Health information education needs to become as essential as reading, writing and arithmetic. It is ridiculous to think that a seven minute encounter with a Physician once or twice a year is enough time to impart the collected wisdom and knowledge of our Healthcare System, nor is it enough time for the average person to grasp that information and incorporate it into their life. Health information education needs to begin as early in life as possible. It's a whole lot easier to treat someone who has spent a lifetime developing healthy habits than it is to try and reverse fifty years of hard living. We've come a long way in public healthcare policy from promoting personal hygiene to improvements in public sanitation. I think the next step is to take our vast knowledge of health information and introduce it as a core educational goal.

The Education System As Part Of The Healthcare Delivery Platform

Health information education can be developed alongside our existing educational system. The two main benefits would be to provide an infusion of resources into our current educational system and to develop a culture of healthy lifestyle in our society that will reduce the effects and cost of chronic disease in the future. The education will need three main components. The first is the teaching of a fundamental core of health information. This occurs throughout the K-12 grades. The type of information taught depends on the educational level of the student. The second part is an information management core. Part of this will include health information but it will also be necessary for students to learn how to access, evaluate and apply all kinds of information to their life including health information. The third part is a controversy core. There will, no doubt, be controversy on what type of information is taught as well as how to manage it. While we may not agree on what is delivered in the first two parts we should agree that acknowledging and debating these controversies should be a part of the educational process. Whether we like it or not, debate can be healthy, and controversy is a part of the massive information stream with which we contend. Future generations should be prepared for both of these as much as managing the massive amount of new health information they can expect as they learn to manage their health. Education today is a more cost-effective solution for the health problems of the future.

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