Practically since the day physicians put away their barber’s tools there has been a growing knowledge gap between doctor and patient.
The unspoken effect of health IT is to narrow that gap. (Dokkiri Doctor was an anime series in the early 1980s. Image from Wikipedia.)
Much of this started on the consumer Internet, with disease networking and Health 2.0. When a doctor says “you have cancer,” you can now research the condition, connect with others who have the same diagnosis, and be an active participant in your own care.
The initial point of Personal Health Record (PHR) systems like Google Health and Microsoft Healthvault was to make a personal connection to your own health data, for the well and not just the sick. Chronic conditions like hypertension and diabetes start long before they appear, the theory went. Managing wellness prevents sickness.
The same idea is behind genetic testing sites like 23andme. Your genes control your future, goes the idea. Know them, get the data, and take control.
With all that as background, the HITECH stimulus, the drive to create Electronic Health Records (EHR) on all of us, is mainly an attempt to square the circle. EHR data can populate a PHR, and can include everything all doctors know about you.
The challenge that results from all this, as Uwe Reinhardt writes in The New York Times, is to call the doctor-patient relationship into question for the first time in centuries. Doctors are human. They disagree on diagnoses and treatment. The knowledge separating you from that debate is being handed to you.
I have been getting a taste of that, in applying my work at ZDNet Healthcare to my own health. Most recently, a cancer scare against a medicine I was taking caused me to have my doctor change things up. (It would even save money.) I’ve been laid-up for the last week because, it turned out, there were other side-effects I had not counted on.
Lesson learned.
Point is, all this knowledge, and this ability to experiment on yourself, is now available to you, too. You can know your test results. You can Google them. You can connect with others who have similar conditions. You can push your doctor around a little bit, or try to.
The question Reinhardt asks is whether this improves the efficiency of the health care market. It has not, as yet, resulted in much price transparency. It has not leveled the playing field between consumers and any provider, for either care or coverage.
My point, today, is these are early days. Technology has not yet begun to fight on the patient’s side of the health care economy equation. You have the power, through existing tools, to become a fussier health care consumer.
Use them.
