The NHS’s deals on clinical applications are just a prelude to a much wider adoption these technologies according to US analysts, Forrester Research. In a list of the top 10 healthcare predictions for 2004, Forrester forecasts that 2004 will mark the shift of IT attention from back office to the clinical examination room in a movement driven by Medicare, health plan and employer demands for error reduction, quality improvement and cost containment. “Two huge deals in 2003 – Epic Systems at Kaiser Permanente and IDX at the UK’s National Health Service [with BT in the London Local Service Provider bid] – are just the prelude,” enthuse the Forrester analysts. "In 2004, look for more billion dollar projects and a flurry of activity among the next wave adopters – the two thirds of [US] physicians that work in group practices of eight or fewer." Other predictions are focused mainly on pharmaceuticals and consumer relationships with healthcare providers. In a depressed pharmaceutical industry, the analysts predict that IT will be spared in downsizing exercises because it offers predictable savings and must-have improvements. They forecast continuing changes in pharmaceutical marketing with reps switching from laptops and PDAs to tablet PCs. They also predict an extension of e-detailing – electronic briefing on new products – that will see nurse practitioner and physician assistants receiving information in this way. On the consumer front, a sharp rise in online prescription ordering is forecast, driven ironically by intensive media coverage in the US recently about rogue and overseas online pharmacies. The analysts also say consumers will be enabled to use health websites more easily by the introduction of natural language searching. Forrester also revisited its 2003 predictions to see how many had materialised. They record varying degrees of accuracy for their predictions in all areas of healthcare and pharma, but one was spot-on: the view that hospitals and home health agencies would extend human capital with IT. Examples of this trend are endless, they claim. They cite an ambitious Health Buddy programme launched by the Veterans Health Administration which, by the end of 2004, is forecast to reach 25,000 chronically ill patients living at home. There are also examples of nurses using robots to conduct virtual examinations and links such as the one between Medtronic pacemakers and IBM phones which provide remote monitoring. Forrester says: "[Such]Devices and partnerships will become more common as ageing baby boomers continue to strain resources and defend their independence." The analysts also say they correctly predicted that there would be no outcry about privacy – a trend that will reassure NHS staff tasked with the making information governance work. Some feared the Health Insurance Portability and Accountability Act (HIPAA), which came into force in April, would cause widespread fears over the privacy of personal information. "Although all healthcare consumers received a mailing or disclaimer from their MD, dentist or pharmacist, not even two thirds registered having done so," say the analysts. They warn however, that while consumers will forgive human errors in handling personal information, anyone who intentionally abuses information can expect their business to nosedive. Other predictions that materialised wholly or partially included increased uptake of clinical decision support tools and greater consumer scrutiny of doctors’ performance.
