Treatment of diabetes, like most areas of medicine, has changed considerably over the years as a result of technological advances. From the discovery, purification, and mass production of insulin to the development of less painful ways to deliver it, the lives of people with diabetes have been improved — and sometimes greatly extended — by both diabetes-focused research and broader improvements in medical care.
Although it can be difficult to predict the impact of an emerging technology, there are several exciting developments on the horizon that may soon significantly change how people with diabetes receive medical care or manage the condition on their own. At least one relatively new innovation, the continuous glucose monitor, is already changing the daily routine for some.
This article examines several innovations that are likely to change — or are already changing — the way medical care is delivered and the way medical information is communicated. Not all assessments of medical technology are completely upbeat, however. Especially when it comes to electronic health records, many experts are either frustrated at the pace of progress or skeptical of how the technology will be used.
Electronic health records
Dr. Richard Hellman, who is past-president of the American Association of Clinical Endocrinologists and has an endocrinology practice in North Kansas City, Missouri, laments that although someone can get money from an ATM or use a credit card anywhere in the world, medical information often cannot be easily accessed when it is needed. “The tragedy is that information doesn’t move around to the benefit of the patient,” he says. “There is much too much information that can’t be transmitted.”
The problem is not a technological one. Electronic health records already exist in many forms. Medical practices and hospitals often keep records of patient visits on a computer system; these records may include lab test results, imaging studies, weight and blood pressure measurements, comments by doctors and nurses, and anything else that can be captured digitally. However, these records often cannot be easily shared with other practices or hospitals because of the closed nature of the computerized record systems. While it may be possible to send information by e-mail or to print it out and then send it by fax or regular mail, an enormous amount of time could be saved by an integrated system in which everyone’s records are immediately accessible to health-care providers who need to see them. Such a system would be particularly useful in emergency situations, and if implemented correctly, the records would not be subject to accidental destruction in cases of disaster such as floods and fires.
But while the technology exists to develop an integrated system, security concerns and competition have so far stymied its realization. “It needs to be secure so someone can’t hack into [electronic files], take the information, and sell it,” says Dr. Hellman. To overcome the other roadblock, competition, the tech industry would need to “agree on common protocols: some agreement that there are certain standards that have to be used.” There would also need to be agreement on financing the new system: who would pay for the software, equipment, training, and data entry as paper records are computerized and computerized records are converted to the new system.
But Dr. Hellman asserts that these should not be actual barriers, citing the financial industry, which has been sharing information for years without significant security or compatibility issues. Just as a bank card from Indiana can withdraw cash from an ATM in Europe within seconds, with an integrated record system, a hospital emergency room anywhere in the world would be able to look up someone’s health problems or drug allergies as soon as he is admitted. And, for that matter, a natural disaster such as Hurricane Katrina would not be able to destroy the medical records of thousands, which is what happened in 2005.