| It is clear that most stakeholders in the health industry | | | | exacerbate these problems. |
| now support President Obama's view that it is | | | | I have just spent been on call over the last weekend |
| essential that we have substantial healthcare reform, | | | | working in a major Academic Medical Center |
| and soon. The arguments around the issue are not | | | | Emergency Department managing acutely psychotic |
| whether this should happen, but how and when it will | | | | patients transferred there as a place of last resort |
| occur. An excellent white paper has just been written | | | | because the only local locked inpatient psychiatric |
| on how national telemedicine initiatives are essential to | | | | facility was closed to admissions because it was full |
| that reform. The whole paper, primarily authored by | | | | as a result of major financially driven cuts to local |
| Rashid Bashshur PhD and Gary Shannon PhD, is | | | | outpatient mental health services. This is the sort of |
| available for free download at | | | | concrete evidence that the American healthcare |
| In brief the paper makes the case that the need for | | | | system is broken, inefficient, disorganized and |
| reform stems from long-standing problems in our | | | | inequitable. |
| health system, and demonstrates that the central role | | | | Why is this relevant? Simply because we must |
| of telemedicine derives from an ever-expanding body | | | | improve our system of care, make it more integrated, |
| of research-and experience that attests to its merit in | | | | and start using electronic healthcare more intelligently |
| addressing these problems. | | | | and more frequently. Electronic health records |
| The paper notes that "despite the fact that the United | | | | represent a means to improving the health care |
| States spends more on health care than any other | | | | system but are only a partial solution to the problems |
| country, both in absolute numbers and on a per capita | | | | we face. The practice of telemedicine, where patients |
| basis, the health status of Americans ranks relatively | | | | are treated by videoconferencing or email in real or |
| low when compared with that of people in other | | | | asynchronous time, incorporating electronic medical |
| developed nations. Moreover, the general discrepancy | | | | records, is a much better way of working, and allows |
| between expenditures and health status indicators in | | | | many of the geographical and cultural inequities we |
| the U.S. masks significant differentials among | | | | face in health care access to be overcome. The white |
| segments of the population, based on socio-economic, | | | | paper argues effectively and strongly for those |
| geographic, cultural, ethnic and other factors." | | | | involved in planning healthcare reform to take a broad |
| The consequence of these factors is that we continue | | | | view of the use of health information technology, and |
| to suffer from inequities in access to health care, | | | | to think beyond electronic health records to a time |
| inefficiencies in the delivery of care, escalating costs | | | | where we will be using telemedicine incorporating |
| and the prevalence of adverse life styles that | | | | electronic health records. |