Pervasive computing: Rx for higher health care costs?

Computerworld - WASHINGTON -- A federal agency sees pervasive computing -- the ability to give end users access to numerous interconnected devices -- as potential first aid for cutting rapidly escalating health care costs.
The National Institute of Standards and Technology (NIST), an agency that works to speed technological development in the marketplace by developing standards and conformance testing, has been examining this still evolving technology for several years.
But at its third annual pervasive computing conference, held here today, NIST officials focused their attention on the health care industry, where costs are running ahead of inflation. NIST officials believe that IT can do a lot to improve the industry's efficiency.
"Although the health care industry is one of the major industries in the United States, it has been one of the slowest to embrace information technologies," said NIST Director Arden Bement, who said he sees health care as a particularly fertile area for technology deployment.
Indeed, Bement and conference attendees said health care facilities rely heavily on paper to manage care but would benefit greatly from broad use of electronic records, personal digital assistants (PDA), wireless networking and mobile management middleware.
Health care companies have been moving toward the technologies that form part of the foundation of pervasive computing. But before pervasive computing can be realized, a wide array of technical issues, including security and usability, will have to be addressed, said Bement and conference attendees.
Pervasive computing -- a broad term covering a large number of devices and platforms -- stresses ubiquity of access. As envisioned, it would allow end users to interact seamlessly with desktop, handheld and embedded systems.
In health care, pervasive computing could make it possible to create a single electronic patient record that physicians could access, regardless of what device they used, said Dixie Baker, vice president for technology at Science Applications International Corp., a systems integration firm in Redondo Beach, Calif.
But the "lack of standards is huge" in the medical field, and interoperability problems between clinical standards and payment systems are just one of the challenges facing this industry, said Baker.
The role of the NIST is to determine where standards could be useful in moving pervasive computing along.
For instance, health care workers will likely use PDAs as they move around from patient to patient, but XML isn't available on all PDAs. Either the manufacturers aren't aware of the standard, or the standard has to be "fine-tuned" for portable devices, said Mark Skall, chief of the software diagnostics and conformance testing division ofthe NIST. PDAs have to be standards-compliant for IT to be effective in the health care field, he said.
Other technical challenges include finding ways to make an application aware of the performance it can get from a wireless network as it moves from one network to another, said Mike Wehrs, director of technology and standards, Mobility Planning Group. One question he posed: How do I change the behavior of the application by looking at the network capability?
Bement cited a Robert Wood Johnson Foundation study on health care that said approximately 30% of health care costs are administrative-related and pointed to a movement toward IT in health care as one way to contain costs.

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