Managed Care - February 2009 - (Page 31) ior so that those who will create these complex algorithms and other means of pattern recognition and predictive modeling will not only ultimately know how to put such a wondrous computation together, but, perhaps more importantly, will know what questions to ask in the first place. It will eventually be this ability to pick out that one important piece of information from the morass of data that will be the key to allowing the use of that information to determine how someone is doing and whether they are in need of further intervention; what may help them do better than they already are doing; or what may prevent them from getting worse over time. We already have some of the capabilities of collecting some of these data but we do not even know how often some of the data ought to be collected, let alone what particular pattern(s) may provide that early identification of a problem that could not only prevent a hospitalization or ER visit but maybe even the complication or the disease itself. Physicians are never going to have the time to spend going through volumes and volumes of data, so it is likely going to be up to the computers themselves to not only collect the data, but to integrate, correlate, and analyze it to find the things that the DM nurse or the physician needs to know about and act upon. These series of devices/computers will talk to one another and learn from one another through what has been called by the Institute of Electrical and Electronics Engineers (IEEE) “proactive computing,”1,2 where computers will be able to “sense, calculate, and act on behalf of a person with or without human interaction, as best fits the circumstances.” As the commoditization of these powerful sensors and processors continues, proactive computing will evolve “where computers anticipate the needs of people around them,”1,2 allowing the propagation and interaction with networks of sensors that infuse the patient’s milieu, including home and work and anywhere they may go. In an article entitled “Remote Medical Monitoring” in the April 2008 issue of IEEE’s Computer magazine, the authors predict that “telemedicine (the delivery of primary care in situ, wherever the patient may be, via information and communications technologies, or ICT) will be revolutionized by the decreasing cost and increasing power of the ICT that are becoming ubiquitous in our lives.” They also point out, correctly, that the potential implications of that on public health are staggering.5 The DM company and call center of the future will be one of the hubs where this information is collected, collated, analyzed, stored, and then acted upon by the routing of that information to the place that will allow the best and the most appropriate interaction. In that world of the future, that routing may be to the patient’s physician; to the patients themselves; to a caregiver; to a DM nurse or health educator; or, perhaps increasingly, back to the patient’s series of computers and sensors themselves to modify their interaction with the patient and help that patient achieve optimal health. We may or may not end up with the autodiagnostic full-body scanners seen in many science fiction movies or the handheld tricorder (medical handheld multi-scanner) that Dr. McCoy from the original Star Trek series pioneered. But what we do end up with will likely eventually provide much the same level of information. MC Notes 1. A terabyte, a measure of computer storage capacity, is 2 to the 40th power, or approximately a thousand billion bytes (that is, a thousand gigabytes). Source: WhatIs.com. In most computer systems, a byte is a unit of data that is eight binary digits long. A byte is the unit most computers use to represent a character such as a letter, number, or typographic symbol (such as “g,” “5” or “?”). A byte can also hold a string of bits that need to be used in some larger unit for application purposes (for example, the stream of bits that constitute a visual image for a program that displays images or the string of bits that constitutes the machine code of a computer program). Source: SearchStorage.com. 2. Remote Control for Health Care by Barnaby J. Feder; Published Sept. 10, 2006; The New York Times (business section). 3. DARPA is part of the U.S. Department of Defense. The wearable system called the “smart T-shirt” has already been used successfully to monitor the vital signs of climbers on an expedition to Mount Everest. 4. “Emerging Trends in Medical Device Technology: Home is Where the Heart Monitor Is,” Carol Lewis; FDA Consumer magazine, May-June 2001. 5. “Remote Medical Monitoring”; Jurik, A.D.; Weaver, A.C.; IEEE Computer magazine; Volume 41, Issue 4, April 2008 Page(s): 96-99. Copyright ©2009 by Atlantic Information Services Inc. Reprinted with permission from Atlantic Information Services Inc., 1100 17th Street, NW, #300, Washington, D.C. 20036, 202-775-9008, www.AISHealth.com For more information on The Next Generation of Disease Management: 2009 and Beyond visit www.aishealth.com/Products/bdm.html FEBRUARY 2009 / MANAGED CARE 31 http://www.WhatIs.com http://www.SearchStorage.com http://www.AISHealth.com http://www.aishealth.com/Products/bdm.html
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