New technologies in medicine

We are at the threshold of a technological era in medicine. The Government is interested in harnessing technology to alleviate manpower, cost, access and distribution problems existing in the health care system today. There exist, on the one hand, several examples of technology in use today which clearly improve the quality of medical care but which do so at considerable cost. On the other hand the techniques which have the potential for reducing the cost and increasing the availability of health services can only do so when they are deployed in situations where sufficiently large populations can be aggregated to take advantage of the economies of scale that are implicit in these techniques. There is a pressing need to demonstrate that these potentialities for economy and improved access can be realized. This can only be achieved by mounting fairly extensive experiments that will make evident the economies of scale that are inherent in these technologies. This type of demonstration is made feasible by readily available communication capabilities which now exist. The fact that it is now possible for a large number of medical institutions to share a common automated medical service has very clear and immediate implications not only for the reduction of unit costs but also for the dissemination of high quality medical information, advice and services. In addition, the sharing of this service will exert pressures that will move communities of hospitals toward the sharing of other services and toward standardization of their operations. Both within the hospital, and to a greater extent within doctors' offices, the necessity for development of modular, evolutionary, user-oriented reliable systems is becoming increasingly evident. This latter area, the physician's office, where the majority of medical care is in fact delivered in this country today, remains largely untouched by technological aids. Given the persistence to a large extent of the present organizational scheme of primary care delivery, successful entrants into this marketplace will in all likelihood primarily operate within the physician's environment to tap his thinking for purposes of problem definition, and then reconfigure existing technological components into a purely problem solving user-oriented system.