I’ve recently begun crystallizing some thoughts about the future of eHealth in the United States: There seems to be an encouraging climate emerging. First, More insurers are willing to reimburse doctors for online care. Second, there are continued calls for federal employees to adopt telecommuting as a practice.

There are some important policy hurdleSs however. First, my sense is that many members of the U.S. IT workforce who were “right-sized” after the Internet bubble and left the IT sector cannot now realistically be expected to return to help with the eHealth build-out. In order for them to contribute, the American healthcare IT sector needs to provide incentives – less with promises of stock options and more with actual, upfront offers of educational loan repayment. While there is federal school loan repayment help for healthcare workers (the National Health Service Corps Loan Repayment Program) and healthcare researchers (the National Institutes of Health Loan Repayment Program), there is no similar help for those who will lay the “groundwork” for telehealth.

Second, it is no secret that the U.S. IT sector demonstrates “bicoastal geographism” even as tech salaries are not keeping pace with real estate costs in those regions. At the same time, U.S. IT firms and their healthcare customers won’t adopt telecommuting for IT staff at all, or from the American heartland (ironically, there seems to be little hesitation in taking some of these functions completely offshore). The building of a managerial class that can and will manage a distributed work force seems necessary to a successful eHealth build-out.

I propose that any cohesive national rural telehealth IT support policy should take these factors into consideration.

Patients should work with physicians on privacy

Whether a patient’s medical records are currently in paper format on a physician’s desk or stored electronically, it is important that everyone involved become an active participant in ensuring the security, privacy and accuracy of that medical information. Patients should talk to their health care provider about how their medical records are stored and accessed. Questions about how prescribed information is communicated to the local pharmacy should be asked. Remaining vigilant and knowledgeable about all aspects of health care, including data storage, can significantly reduce the health care costs resulting from inefficiency, medical errors, inappropriate care, and incomplete information.
Medical technology is increasing every day and health care quality is consistently on the rise, but with private practice physicians seeing 15-20 patients a day and hospitals seeing even more, it is vital that physicians and patients play an active role in the management of record keeping. The privacy and security of medical information should be everyone’s concern, patients and health care providers alike. The Illinois Foundation for Quality Health Care encourages patients and physicians to develop a dialogue about how medical information is stored and transported and work together to create wider use of EHR technology that will benefit all parties involved in the health care process.