differences have failed, but Dickinson wants the United States to try again. Any progress that can be made in harmonizing the world’s patent systems will accelerate innovation everywhere.


Both government and private insurance companies will play a vital role here. Because almost all health care is paid for either by government or employee health insurance, these institutions essentially are the market. What they’re not willing to pay for, no one is likely to develop. David Lawrence, CEO of Kaiser Permanente, explains that there are two key concerns. He says that there is enormous consumer interest in home diagnostic technology, but the problem now is that almost none of the information collected with home devices makes it into the patient’s medical record. This information could be extremely valuable, but unless we develop a way to make it easily available to physicians when they need it, consumers will soon realize that the devices cannot deliver what they promise. He also sees enormous potential for quality-of-life technology such as a device that would make it easier for people with cerebral palsy to communicate or the revolutionary new wheelchair developed by Dean Kamen that can travel over uneven surfaces and even go up and down stairs. If these devices can be purchased with government or insurance dollars, the demand for innovation will be strong. Reimbursement policies will also be important for new biomaterials and for nanotechnology.

The newly created Health Technology Center in San Francisco commissioned a survey of physicians to elicit their views on the use of information technology in their practice. Although 96 percent of respondents agreed that Internet-enabled technologies will make the practice of medicine easier and improve quality of care no later than 2003, only 34 percent use Internet-enabled sources for information about prescription medications, and only 7 percent have adopted automated systems for prescribing medications. (The Institute of Medicine report To Err IsHuman: Building a Safer Health System recommended adoption of such systems.)

The respondents said that the greatest barriers to use of Internet-enabled services are “a lack of uniform standards for health information and the inability of current health information applications to communicate among themselves.” The vast majority believe that the federal Health Care Finance Administration and the private insurance companies must take the lead in removing these barriers by requiring physicians to use the Internet for claims processing. This would force the health-care system to develop uniform standards and protocols for communicating information.

The need for standards for communicating information was reinforced by a workshop convened by the National Science Foundation and the Food and Drug Administration, “Home Care Technologies for the 21st Century.” The workshop

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