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It is an enigma that the introduction of technology has led to improvements in productivity in practically every area of endeavor except the field of medicine. This paper asserts that properly applied technology, based on a systems engineering approach, can help reduce the cost while maintaining the quality of health care delivery. Achieving this goal will require more cooperation and coordination at the Federal level to insure that a focused systems approach is used in applying and developing technology that will lead to cost reduction. It is further asserted that much of the technology that could help reduce costs resides in the DoD and the DOE and has not historically been of prime interest to the NIH. Several dual use applications are presented that show how defense related technology can benefit the field of medicine.
A new approach to a national initiative to applying technology to reduce health care costs is proposed. The steps in such an approach are first to develop a health care systems architecture and identify the key cost drivers. Then, to define technology roadmaps so that critical technical issues can be addressed on a priority basis using a focused systems approach to the problem. Implementation of this national initiative will require multi-agency funding and coordination, perhaps through OSTP or NSTC. This means that agencies must work together as never before, and that technology is made available and funded by whatever agency or source is capable of supplying the technology. Finally, a framework, called GUILDS (Government, Universities, Industry, Laboratory Development), is proposed to facilitate the formation of teams comprising medical research institutions, industry, national laboratories, and government agencies to develop the technology required. A National Biomedical Engineering Virtual Collaborative Environment is proposed to be established immediately to serve as a focal point for coordinating the GUILDS involved in this initiative.
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