Digital access to better, more affordable healthcare: What’s on the horizon?

21 February 2012 | Dr. Bill Crounse, Senior Director, Worldwide Health, Microsoft

​During the past several weeks, we’ve been digging into the topic of redefining access to healthcare, including the problem, why it is so difficult to solve, and where we are seeing progress. This week, we are closing the series with a discussion of technology advancements that show promise in making a difference.

First, we’d like to talk about some promising technology that may help us reduce—perhaps even eliminate—the technology barrier that still exists for many.
 
Super Wi-Fi: The move from analog to digital television since 2006 has freed up the low-frequency wireless spectrum that can travel farther and penetrate buildings better than the higher frequency spectrum that current wireless technologies use. Once dismissed as “white space,” the spectrum offers a more reliable and accessible connection to the Internet, without the difficulty and expense of installing fiber optic lines and other new infrastructure.
 
As this spectrum becomes available to cable, satellite, and Internet providers and as consumer devices that utilize it begin to appear over the next few years, we expect to see high demand ―from rural communities, urbanites in concrete buildings with poor reception, and more ―that will likely cause supply to rise quickly, with the net effect of lowering Internet costs.
 
Always-on mobile devices: Internet-enabled mobile devices, such as smartphones and tablet computers, continue to proliferate. By all accounts, smartphone use is continuing to grow at a rapid rate, and increasing demand is improving affordability for these ever more powerful devices. The Pew Internet & American Life Project [i] found that 35 percent of American adults own a smartphone and that the young, African-American and/or Hispanic demographic groups—all groups that the digital divide has hit hard—show a higher than average use of smartphones. Bandwidth is becoming an issue in some areas, but white space may help with that over the next several years.
 
Accessibility: As the white space spectrum becomes usable and as portable device use becomes more prevalent, we are likely to see affordable, always-on connectivity in the hands of many more people in the United States. That opens the door to sharing information rapidly with more people through online communication and collaboration tools, such as Windows Live, Microsoft Office Web Apps, Skype, and Microsoft Lync. The wide variety of online communication options and accessibility features, like speech and gesture recognition, which are being built into more and more technology, increases the means available to communicate for the differently abled, as well.
 
With technology advancement paving the way, we have some ideas for addressing the key issues we’ve discussed over the last several weeks.
 
The physician shortage
 
There’s no question that more physicians will be needed in the coming years, but we can also make a difference in the efficiency of physicians today to help them better manage and provide high quality care to their current patients. Solutions like those developed by MedOne Hospital Physicians, with Microsoft Lync at the core, can help to improve caregiver communications during patient stays and to streamline access to patient information. We expect to see continued advances in real-time provider communication and increasingly streamlined medical records making the work of physicians more efficient in coming years.
 
Patient-centered care can also reduce the strain on physicians who manage care for patients with chronic conditions. London’s UCL Institute of Child Health is using a patient-relationship management system incorporating Microsoft Dynamics CRM and Microsoft HealthVault to put more chronic care responsibility and information into the hands of young diabetic patients and their parents, and it’s seeing good results. Because patients are young, they are gaining knowledge that may improve the way they manage their conditions throughout their lives. But a catch-22 remains—as forward-thinking medical providers use technology to help patients better manage their care, the need for in-person appointments is reduced, and yet those appointments continue to be the basis for healthcare compensation. We hope to see the business models evolve to recognize that medical contributions to patient care do not always take place in a clinical setting.
 
Advances in telemedicine, a technology that’s been around for a while, are both improving access to patients in remote locations and allowing medical professionals, such as nurse practitioners, to practice in remote locations under electronic, visual oversight from a physician or other medical practitioner. Wound Technology Network does just that, providing wound care in home or remote clinics using smartphone technology to transmit visual images and patient data back to a satellite control center staffed by wound care specialists.
 
New, portable products from Polycom, combined with Microsoft unified communications, are not only supporting telemedicine, they also have potential to expand training opportunities beyond medical school walls. While it’s likely that some components of medical training will always need to take place under the in-person supervision of a professional doctor/educator, other components can lend themselves to electronic formats, potentially expanding opportunities for students. Even today, some resident supervision and consultation takes place electronically.
 
Patient literacy and engagement
 
These same technologies hold promise for increasing patient awareness of and participation in their care and rehabilitation. Smartphone and PC technology can be used today to monitor test results in the home, providing immediate feedback to both the patient and the care provider when tests show reason for concern.
 
Mason General Hospital, a small Washington community, built an online portal where patients can clarify and reinforce information discussed during appointments, learn about their role in their care, and contribute to their own care. Even older patients who find technology initially threatening engage in the portal after attending workshops in its use. Programs like this one and London’s UCL Institute of Child Health’s diabetes monitoring program for youth are one way doctors and medical facilities are helping to grow patient knowledge about and engagement with disease management and healthy lifestyles.
 
Smart phones, availability of low cost devices, and connectivity will go a long way toward helping with information and monitoring. But one more rapidly expanding technology—gaming—might be the “killer app” for patient engagement. Once the domain of youth, gaming consoles like Kinect are becoming more common not only in homes, but in medical and care/rehabilitation facilities. In the latter, patients engage in exercise disguised as fun physical games, like bowling or dancing, as well as more targeted, therapist-led activities. Elsewhere, rehab programs have incorporated physical games designed to address specific rehab goals, and the potential to use active gaming as an even richer, patient-centered part of rehab and health maintenance is huge. Kinect provides electronic feedback on movement that can be used to provide immediate feedback to a patient, and it’s easy to envision wellness-focused exercise programs delivered through these devices for people of all ages and levels of health. Even nutrition and medication management might one day be integrated through reminders and analysis of daily activities contributed by the patient. With Kinect now available for PCs, it will be possible to make solutions like this available to even more health consumers.
 
Technology that, only a few years ago, seemed futuristic and visionary seems less out of reach every day. Although we are far from solving some of the problems we’ve discussed in this series, we see a lot of possibility on the horizon. We plan to continue this important conversation and hope you’ll join us on Twitter with the hashtag #digitaldivide, on Facebook, and on the web.
 
Dr. Bill Crounse
Senior Director, Worldwide Health, Microsoft

Microsoft in Health Blog

About the Author

Dr. Bill Crounse | Senior Director, Worldwide Health, Microsoft

Dr. Bill Crounse is Senior Director, Worldwide Health for the Microsoft Corporation. He is responsible for providing worldwide thought leadership, vision, and strategy for Microsoft technologies and solutions in the healthcare provider industry. Read more