Intended for healthcare professionals


What next for electronic communication and health care?

BMJ 2004; 328 doi: (Published 13 May 2004) Cite this as: BMJ 2004;328:1143
  1. Alejandro R Jadad, director,
  2. Tony Delamothe, web editor
  1. Centre for Global eHealth Innovation, University Health Network, Toronto General Hospital, Toronto, ON, Canada M5G 2C4
  2., BMJ, London WC1H 9JR

    New tools that require new thinking

    The past decade has brought a range of electronic communication tools that promised to improve health care. As editors of this theme issue, we invited submissions describing how these innovations had lived up to their promise.1 These are our reflections on what we did and did not receive.

    What we learnt from the submissions

    The editorial announcing our theme issue resulted in the submission of nearly 100 articles—more than has been submitted for any other theme issue. The snapshot they provide shows that new media and communication tools are already transforming the way in which we communicate, learn, and think. The expansion of the internet, the launch of personal electronic assistants, and the penetration of wireless networks are making new relationships between doctors and the public possible. At the same time, they are exposing the weaknesses of our conventional approaches to clinical care, education, and evaluation of new interventions.

    We believe that we are just scratching the surface of the possibilities created by electronic communications. We can no more foresee the shape or extent of their effects on the health system than our ancestors could have foreseen the blossoming of science that followed the invention of the printing press.2

    Impact on health: where art thou?

    Our original editorial solicited articles that shed light on how new electronic applications could improve people's health—yet many of the submissions reported process measures far removed from health outcomes. For example, several papers described clinical decision software but gave no information on whether its use actually improved patient care in practice. We discovered how new electronic tools are being used to perform old tricks (for example, data entry on to handheld computers rather than into paper records), but not adequate answers to the question, “So what?”

    Many of the submitted papers reported plausible clinical interventions but were rejected …

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