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Information Therapy

The Wall Street Journal introduced me to a new term in yesterday's paper - Information Therapy. Excuse my ignorance iof you're already familiar with this terminology. Healthcare journalist Laura Landro explains that Information Therapy essentially involves using Electronic Medical Records to motivate and help patients take better care of themselves.

If patients have high cholestorol, you typically tell them to change their diet, exercise, and perhaps prescribe Lipitor. But compliance is a major issue. So in the future, you'll prescribe Information Therapy as well - they'll log into their EMR every few months after getting their cholestorol checked, and will have to look at the chart showing that it's climbing or falling. The climbing chart might have an extrapolation that shows that at the current rate of rise, their hearts will be pumping custard in 18 months, motivating them to live healthy or die. Alternatively, the compliant patient might be encouraged to continue to exercise, as they see the extrapolation to eternal youth.

I'm a huge supporter of EMR and I think that when patients have online access to their medical records, they will wonder how they ever took care of their health any other way. But I worry about two things here:

1. Giving it a name like "Information Therapy" conjures images of some new medical specialty, and yet another "billable" item in the healthcare system. People who are perfectly capable of identifying rare Zimbabwean coffee urns on eBay will have "therapy" to look at a bar graph on a computer screen. The reimbursement might be called "digital ocular multi-dimensional Cartesian coordinate perceptual enhancement therapy."

2. There is an implicit assumption here that the only thing that ever stops people from making wise and rational choices is access to the facts - inform the people, and they will make rational choices. No further elaboration needed on this assumption!

So let's move forward to EMR as soon as possible. But let's not create a whole new cost to the healthcare system to ensure and insure what should just be plain personal responsibility.

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