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special focus

The history of Medicine so far can be represented by the below diagram. 3300 – 3000 BC

1000 BC

500 – 460 BC

9th Century AD

11h Century AD

Ayurvedic & Egyptian Medicine

Babylonian & Hebrew Medicine

Chinese, Greek & Roman Medicine

Persian & Islamic Medicine

European Medicine (Medieval)

12thCentury AD

1676 AD

1847 – 1865 AD

1882 AD

1895 – 1899 AD

European Medicine (Early Modern)

Microbiology

Germ Theory, Early Genetics & Eugenics

Bacteriology

Radiology & Psychiatry

1901 – 1929 AD

1928 AD

Serology & Virology

Penicillin

1998 AD Embryonic Stem Cell Therapy

2003 AD Human Genome Project

2012 AD Cloud Based EHR

ly catching up. Due to the above reasons and more, EHR/EMR is truly a must buy on every CIO/CXO’s shopping list. And in India, unlike its Western (USA, Western Europe, Australia) and APAC counterparts; focus was more on revenue related aspects like billing, charge posting, interfacing with finance (AR and GL), but now slowly aspects like clinical documentation, order entry, structured reports from EHR like discharge summary, case notes and more are becoming common requirements. Similar to the Western countries, the need is stemming from the acute pressure from payers and patients alike. After all, a typical educated patient searches Google or Bing on the symptoms’ and probable diagnosis before he visits his/her doctor. Today it is common that an expectant mother and her husband have more questions to ask compared to what a doctor had to answer a decade ago. This means the need for more patient education material and access to patient portal and PHR are becoming a necessity than want. Welcome to the age of Healthcare Information Technology!!!

The Future Whether you call it Gartner’s CPR Generation 5 or take a leaf out of Michael Crichton’s Next or it could be our favorite Jurassic Park movie. The future of EHR and PHRs will be based on Clinical Genomics and Proteomics; drug delivery will have Nanotechnology as an integral part; Robotic surgeries will be a common phenome-

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non; petabytes of data will be crunched in a matter of minutes if not seconds. This is OUR FUTURE! The future EHRs will be based upon the following core components: • A clinical inference engine which can compute all kinds of interactions including drug to drug, drug to food, drug to lab, drug to diagnosis, drug dosage alerts, drug to gene, drug to allergy, and more. • Inbuilt vocabulary server which can understand whether you call CABG, coronary bypass, coronary bypass surgery, coronary artery bypass graft or open heart surgery. The systems will have the ability to understand patterns and match them without human intervention. • Online interfaces to Insurance company systems to ensure that the meds or other orders are covered and this will be handled almost instantaneously. • Crunching engine – which will have the capability to process Petabytes of data to provide the right Evidence based medicine and well defined Pathways which use the state of the art clinical knowledge management, workflow and business rules engines. • A seamless graphical user interface with inbuilt speech recognition and facial recognition technologies, which would ensure that the clinicians do not have to look at their monitors while trying to communicate or while diagnosing their patients. • Repurpose engine, which would be able to provide true contextual search, for example: if a Cardiologist searches for ’CAR’, the top results would be to do with Cardiology such as Digoxin or Warfarin;

> www.ehealthonline.org > June 2011

Atrial Fibrillation or Tachycardia; Acute Myocardial Infarction or Ischemic Cardiac diseases. And, also the engine would be able to provide the interfaces over browsers or any kind of mobile communication devices. • Communication server which would be able to print reports, fax them, send SMS alerts and even call users or patients based on rules. EHR and PHRs will be accessible from anywhere and at any time thanks to Cloud Computing 3.0. The probability of giving the wrong medications or an anaphylactic reaction occurring due to a drug-allergy reaction would be miniscule. Most of our mobile devices would have auto medication dispensing units built into them especially for geriatric patients and which are connected to our PHRs seamlessly. Our vital signs would be monitored unobtrusively and paramedics would arrive before a serious medical mishap occurs. The world of ‘Minority Report’ is probably not too far away. True social computing in combination with tele-presence will make the future of telemedicine much more than what it is today. And it goes without saying that, all the information would be provided through EHRs and PHRs.

AUTHOR

Vamsi Chandra Kasivajjala , Head, Healthcare Products and Application Services division, Religare Technologies

eHEALTH-June-2011-[42]-Special Focus  

special focus The Future Ayurvedic & Egyptian Medicine 12 th Century AD European Medicine (Early Modern) 1901 – 1929 AD Serology & V...

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