I have had a vision (non-religious) of the future. I will preface it with
a short vignette.
I was visiting New Hampshire (USA) some 200 miles (322 kilometers) from my
home, when my wife developed a severe sore throat. For various reasons, we
decided to treat this as though it were a strep throat and institute
penicillin therapy. I went to a pharmacy, said I was a doctor, and asked
them to give me a prescription for penicillin. They were not satisfied
with my statement that I was a doctor (the green hair? the lip ring? the
SR-71 tatoo?), and asked me for identification. I didn't have anything on
me that said I was an M.D. so they asked me what my practice zip code
was. I gave it to them and voila ("there it is"): I was in *their*
computer. Let's see if I made myself clear: I WAS IN THEIR
COMPUTER. Well, that really helped, and things moved along quite
smoothly. My wife's viral illness received the usual treatment and we were
on our way.
Within five years, much if not all historical information will be gathered
from patients by computer. There is already an abundance of data that says
that patients are much more comfortable answering medical questions
presented by a computer than a human.
But computers have difficulty gathering drug histories. I've mentioned
this before.
So what's the answer? It will probably vary by country, but in the U.S. it
will work like this. There's really no other way.
The key is: what question do you ask the patient? Well, what you do is
present them with a pull-down of all the pharmacies within a 10 mile radius
of their home address and ask them which of these pharmacies they have used
for prescription drugs in the past five years. If necessary, you expand
the list to 20 miles or ten years or both.
With the pharmacy name(s) in hand, you query the pharmacies directly and
get the patient's prescription drug history. Do you get
over-the-counters? No. Will it be 100% accurate? No. Is it about a mile
better than any other method? Yes.
Will it be put in place in a trade secret or an open source
fashion? Questions, questions....
