special focus

42 > www.ehealthonline.org > June 2011

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 in-cluding 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 sur-gery, 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 Path-ways which use the state of the art clinical knowledge management, workflow and business rules engines.• A seamless graphical user inter-

face with inbuilt speech recognition and facial recognition technologies, which would ensure that the clinicians do not have to look at their monitors while try-ing 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;

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 post-ing, interfacing with finance (AR and GL), but now slowly aspects like clinical documentation, order entry, structured reports from EHR like discharge sum-mary, 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 symp-toms’ and probable diagnosis before he visits his/her doctor. Today it is com-mon that an expectant mother and her husband have more questions to ask compared to what a doctor had to an-swer a decade ago. This means the need for more patient education material and access to patient portal and PHR are be-coming a necessity than want.

Welcome to the age of Healthcare In-formation Technology!!!

The FutureWhetheryoucall itGartner’sCPRGenera-tion5ortakealeafoutofMichaelCrichton’sNextoritcouldbeourfavoriteJurassicParkmovie.

The future of EHR and PHRs will be based on Clinical Genomics and Pro-teomics; drug delivery will have Nano-technology as an integral part; Robotic surgeries will be a common phenome-

Atrial Fibrillation or Tachycardia; Acute Myocardial Infarction or Ischemic Car-diac diseases. And, also the engine would be able to provide the interfaces over browsers or any kind of mobile commu-nication devices.• Communication server which

would be able to print reports, fax them, send SMS alerts and even call users or pa-tients based on rules.

EHR and PHRs will be accessible from anywhere and at any time thanks to Cloud Computing 3.0. The prob-ability 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 geri-atric patients and which are connected to our PHRs seamlessly. Our vital signs would be monitored unobtrusively and paramedics would arrive before a seri-ous 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.

The history of Medicine so far can be represented by the below diagram.

500 – 460 BC

Chinese, Greek & Roman Medicine

1847 – 1865 ADGerm Theory, Early Genetics & Eugenics

1998 AD Embryonic Stem Cell

Therapy

3300 – 3000 BC

Ayurvedic & Egyptian Medicine

12thCentury ADEuropean Medicine

(Early Modern)1901 – 1929 AD

Serology & Virology

11h Century AD

European Medicine (Medieval)

1895 – 1899 AD Radiology & Psychia-

try2012 AD

Cloud Based EHR

9th Century AD

Persian & Islamic Medi-cine

1882 AD Bacteriology

2003 ADHuman Genome Project

1000 BC

Babylonian & Hebrew Medicine1676 AD

Microbiology

1928 ADPenicillin

AUTHOR

VaMsi Chandra KasiVajjala , Head,

HealtHcare products and application ser-

vices division, religare tecHnologies