by Dr. Scott Erdley, Senior Editor
Erdley, S. (June, 2012). Kol.umn.fu.tur.e – iOS? W8? Android? Lion? Linux? Chrome? Cloud? Internet? Web? Different? Same? Really matter? And whither cometh healthcare? Future Thoughts Now Column. Online Journal of Nursing Informatics (OJNI), 16 (2). Available at http://ojni.org/issues/?p=1685
Again, the crossroad seems like where I live for some odd reason. Or is it every other step? Oh well, today’s diatribe finds me exploring (possibly even lamenting) the eventual outcome of multiple different operating systems and or overall transparency of the direction this melding is headed. While capitalism is still the rule, ergo individual OS’s for the masses, if you look closely everything is starting, starting I say, to ‘talk’ to each other. It almost seems as if there’s a shift back to the dummy terminal concept of yesteryear (kinda’). Ultimately, though, the bottom line in the big picture is the almighty dollar / euro / yen (you get the drift), which still rules the roost. Nonetheless it is becoming apparent, at least to this person, a shift of sorts towards the notion of data / information as equivalent to money. IOW, who has the most d/i has the most $’s.
Apple is shifting their strategy towards ubiquity in terms of hardware and software. Their hardware increasingly relies on applications and data in the ‘cloud’ (hosted somewhere other than the actual computing device). Microsoft is joining the fray behind Google / Android. What’s really happening is each entity is quietly (maybe?) becoming collectors, data / information collectors. Witness the relatively noisy debacle of privacy policies of certain browsers secretly collecting / monitoring users. The ability to sell and or predict is related to the amount of data / information about the persons (and persons they are, for sure) targeted by the vendor / company. The more known, and specifically the greater the detail of that ‘known’, the easier it is to target individuals. Pretty basic strategy when you get down to it.
The twist is, though, how health institutions and or organizations adopt this sort of data accrual. In the US the federal government has been accumulating data / information for quite a few years. Large and small health organizations also are accruing (or should I say ‘collecting’) similar information. What is done with it is a very serious concern. What is really of greater import, though, is the communication of this ‘stuff’ by said organizations.
Implementation of EHR (or whatever is the term de jour at this point in time) is just the beginning of the connectivity concern. Not only implementation but also the collection of health data, why, and for what purpose? The penultimate reason is improvement of care. The more base reasons include marketing and profit. To truly be appreciated digital records, regardless of rationale, require accessibility from anywhere anytime by all users. A corollary to this is ‘security’ at all times regardless of accessibility requirements. Which, in turn, leads me back to the beginning – accessibility regardless of OS / platform, securely, in a timely fashion as warranted by the provider and or patient. Can meaningful use truly be patient care? Or is it another phrase for profit margin.
So, let’s return to the beginning. Ubiquity is at hand. Soon what is used to communicate will no longer be of concern; we will be connected. Not sure if resistance is futile but the thought is there. We will use tools to communicate (some with keyboards attached, some via speech, others via thought) with each other, among each other, to each other. I just want to know– will I be able to reach the off switch? Can I still say ‘no’? Can I be treated without losing my identity? I can hear it now – “Your data is incomplete. Please return to the front kiosk and complete the form before meeting your provider. Failure to comply will result in rejection. Thank you.”
As always, feel free to post your thoughts as well as questions about technology and ‘the future’ here at OJNI and or email me (firstname.lastname@example.org). I look forward to reading your ideas and perspectives.