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Guest Editorial, Medical Informatics 2040

In a book titled Medical Informatics 20/20, published in 2007 by Jones & Bartlett, the authors talk about key management strategies and selected health information technologies that health care executives should focus on over the coming decade. The management strategies include collaboration, open systems and innovation. The key health information technologies include electronic health record (EHR), personal health record (PHR) and health information exchange (HIE) systems.

The authors project that in the U.S., by 2020:


  • 80 percent of health care provider organizations will have implemented EHR systems.


  • 80 percent of the general population will have started using PHR systems.


  • 80 percent of EHR and PHR systems will be linked via HIE systems.

    Achieving those objectives will lay the foundation for dramatically improving health care. Radical re-engineering and transformation of health care will start to come about when the following emerging health information technologies are eventually implemented:


  • genomic information systems and bio-repositories;


  • nanotechnology and implantable health IT systems;


  • medical robotic systems; and


  • wearable health IT systems.

    By 2020, these emerging solutions will be used by less than 20 percent of health care providers and patients in this country. However, the time has come to start focusing our attention on these cutting-edge technologies and how they will be employed to further transform health care.


    Future scenario — 2040

    By 2040, it is conceivable that every U.S. citizen will be required to have an entry in a national biorepository and genomic information system.

    Genomic information systems will be integrated with EHR and PHR systems and will allow for early identification and treatment of individual disease/health care issues. Hard data yielded from these systems will allow providers to better treat their patients, while researchers target specific diseases/conditions. Medical schools and provider organizations will be able to train and employ the right mix of specialists to treat their patient population.

    By 2040, most citizens will have made the choice to have an implantable nanotechnology device that will be tailored to meet a number of their personal health care requirements. For example, interactive implantable medical devices could be used to more accurately identify patients who are unable to communicate. The device could be programmed to contain key clinical information about a patient in an emergency care situation. The device could be programmed to be used as a tracking device for Alzheimer patients. Based on one's genomic information, the implantable device could be programmed to monitor specific conditions, and to dispense medication as needed while simultaneously alerting one's health care provider. The implantable medical device could wirelessly communicate or interact with the more robust, "smart" EHR or PHR systems of the future.

    By 2040, other emerging technologies such as medical robotics and wearable health IT systems will be widely deployed.


    Strategic outlook

    It is time for health IT executives to begin the process of shifting the emphasis of their strategic thinking to the 2040 timeframe. We must couple innovative, cutting-edge technologies (e.g., genomics, implantables, nanotechnology, robotics) with EHR, PHR and HIE systems so that radical changes really start to happen.

    Leading health care provider organizations should consider collaborating with other organizations on pilot projects utilizing these innovative, cutting-edge health IT solutions. HIE


    Mr. Groen spent more than 30 years as a hospital CIO and other senior health IT positions. He is currently an adjunct faculty member of the Computer & Information Science Department at Shepherd University in West Virginia.


    References available upon request to the editor. E-mail requests to
    Source:  Vol. 12 •Issue 1 • Page 10, Guest Editorial, Medical Informatics 2040, Radical re-engineering will transform health care in the 21st century., 

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