Getting Connected

Yes, I saw Watson win at Jeopardy. I have heard presentations on how Watson was being used to assure that a cancer treatment was personalized to assure best outcomes for the patient. Recently, IBM Software Solutions Group senior vice president announced in a news release that “For the first time IBM will make its IBM Watson technology available as a development platform in the cloud, to enable a worldwide community of software application providers to build a new generation of apps infused with Watson’s cognitive computing intelligence. The move aims to spur innovation and fuel a new ecosystem of entrepreneurial software application providers—ranging from start-ups and emerging, venture capital-backed businesses to established players. Together with IBM, these business partners share a vision for creating a new class of cognitive applications that transform how businesses and consumers make decisions. With this move, IBM is taking a bold step to advance the new era of cognitive computing. Together with our partners we’ll spark a new class of applications that will learn from experience, improve with each interaction and outcome, and assist in solving the most complex questions facing the industry and society.”

Of course, my first reaction upon reading this news release was to question whether this is more hype or ask if have we truly entered a new era. We have heard these types of promises before.

This issue of Directions in Pharmacy focuses on health information technology. Just as Watson has opened up a whole new era of cognitive computing, we focus on the same types of developments that are happening in health care. It provides me with an opportunity to reflect on my personal evolution to become more comfortable with computers.

In many ways, I am really old school. I started working with computers when punch cards were used to program a computer—hard to believe! More than 50 years have passed since that graduate school experience, and the change in computing has seen exponential growth. People of my era were skeptical about how computers would improve our lives, and some may still be.

Recently, I was reflecting on how my approach to handling money has changed dramatically as I have become more secure with using the financial tools available. Many younger people probably wonder why I had any trouble moving from using cash or writing checks to using online payments or automatic monthly payment withdrawals. It was hard for me to quit balancing my checkbook each month and rely on my bank statement, but I have. Paying that bill or making a contribution online was hard at first, but now I do it routinely. However, I still ask for transaction receipts when I use my credit card, so I am not completely liberated.

I share this personal perspective because I think it conveys the thought that what has happened in the financial world could happen in health care when we solve the interoperability issues and achieve system connections across the health care continuum. Just think what we, as pharmacists, will be able to do when we have access to the information we need—and can share our patient outcome goals with other team members. Is such a possibility realistic in the coming years?

This question is raised by many of us who have been hearing for years how health care is changing as information connections occur. Our experience, however, is that for each step forward, we end up taking 2 steps back, often due to unintended consequences.

The articles in this issue would suggest that things are different now and that this time the promises are more realistic and, therefore, probable. One difference is how connected most people are to their smartphones today. As we learn how to harness that connectivity and use it to promote better health care outcomes, we will see improved access with better outcomes and lower cost. I believe these benefits will result in quicker adoption.

Another reason I believe things are different now is that the current system is so broken. An administrator once told me, as we talked about how to make change happen in our hospitals, that real change can occur only in 2 situations: 1) when the system is working so well that people have nothing to lose by the change, or 2) when the system is so broken that no one has anything left that they want to protect. The latter seems to be where the US health care system is today. As the articles in this issue suggest, pharmacy is being well positioned to make change happen, but more importantly, to take advantage of the change to better serve our patients.

Mr. Eckel is a professor emeritus at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He is interim executive director of the North Carolina Association of Pharmacists.