COMMUNICATION, COLLABORATION and TECHNOLOGY
Dare, Frances, Safavi, Kaveh, Americas Quarterly
The marriage of information and communication technology and health services is helping to solve the problems that physicians and patients face every day.
Across Latin America, obstacles to health care access are similar. Beds are full, waiting rooms overflow, and treatment delays are common. Creating equitable access to health services requires addressing the ubiquitous challenges of escalating demand, rising citizen expectations and unrelenting pressure to do more with less.
One solution is to find better ways of incorporating information and communication technology (ICT) into health services. That has been the approach of Cisco's Internet Business Solutions Group (IBSG). In almost a decade of working with Latin American health care leaders, Cisco IBSG consultants have developed innovative health care approaches and modeled the potential economic impact of programs supported by ICT.
In one example, IBSG consultants worked with the Chilean Ministry of Health to design a health program for patients with chronic conditions. The proposed three-phase program began with call-center-based health coaching by clinicians, followed by community-based telehealth kiosks for early diagnosis and, finally, devices for at-home patients for remote monitoring of health status. Five-year savings from the program were estimated to be $150 million.
Much of the recent innovation has been the result of direct input from providers themselves. They have helped to identify where improvement is needed and highlighted promising solutions to the gaps in quality and access. For instance, Cisco IBSG focus groups with Mexican pediatricians and obstetricians in 2003 highlighted the need for easy-to-use reference information. One point of consensus among the physicians was that their top need is "quick answers to clinical questions." As one physician explained, "The most appropriate thing would be to have an online system accessible to all regions in the country, providing good training to general practitioners through specialist physicians available online, 24 hours a day."
The "Map of Medicine" is a solution that responds to this concern, providing clinicians with evidencebased, visual decision paths for specific conditions or symptoms. When faced with an unfamiliar case, clinicians can quickly reference diagnostic questions and treatment options. A similar Spanish-language reference customized for clinical practices in Latin America would have wide application. To implement it, leading health institutions need to endorse or revise the procedures for followup on common symptoms and then make these solutions available from computers and mobile devices.
Real-time collaboration between primary care and specialist physicians is another way of boosting productivity. Medical specialists are often concentrated in urban settings. Providing widespread access to their expertise is therefore a persistent challenge. Patients must often travel long distances at great expense with significant time away from work to receive specialty care. Today, specialist-primary care physician interactions are possible through a range of video-conferencing technologies. In Buenos Aires, infectious disease specialists have begun hosting case reviews with physicians in rural Patagonia. …