Healthcare 2020: Technology in the New Millennium.

Patients will become partners in their healthcare using doctors as consultants rather than managers.

When you pump your own gas at the filling station are you working for the gas station or yourself? When you take a pregnancy test at home are you a savvy self-helper or part of the HMO's

-- Kevin Kelly, "New Rules for the New Economy"

The most pervasive change in the new millennium will be the way technology empowers patients to take control of their healthcare. Internet-informed patients will become partners in the promotion of their health, using physicians and other providers as consultants rather than managers. Information technology will allow patients to access the health system on a "7x24" basis, at their convenience.

Language is often the precursor to change. The word coined for this kind of patient involvement has been called prosumption. In his 1996 book, "Digital Economy," Don Tapscott describes the increasing role of the consumer in functions formerly performed by the producer. For example, "prosumers" might receive custom newspapers over the Internet, with only the stories and subjects that are of interest to them. When the consumer defines, then receives this type of newspaper, he or she has assumed the role of publisher (producer) and consumer. The same might be said for home pregnancy tests (doctor and patient), and pumping your own gasoline (mechanic and driver).

So, over the next 20 years, the adoption and embracing of technology in healthcare will increase at an accelerating pace. The process of healthcare will become substantially digitized and electronically enabled. Managed care will switch from a gatekeeper concept to one of highly automated care management.

Dream Come True

The wired world of healthcare in 2020 isn't just a dream. Recent breakthroughs in remote surgery, gene manipulation, cloning, and molecularization of microchips have opened a world of possibilities. Questions of morality, government intervention, and the cost-benefit tradeoff between health and illness are the issues facing the nation in the new millennium of healthcare.

There is a concern that technology will accelerate the emergence of a two-tier health system. Uniquely personalized high-tech treatments such as gene therapy may not be covered by health insurance. These services will be available at a cost. Some patients will have the discretionary resources to pay these costs, but others will not.