Physician executives explore "New Science" frontier: Bridging the communications gap between medical staff and administration. (Next!).

Add another item to the job description of every physician executive -- chief technology officer (CTO).

On the high frontier of scientific advances, physician executives are at the intersection between the imperatives of technology and the demands of management.

Medically trained executives can be advocates for scientific research and technology investment. In the competition for capital and budget priorities, physician executives are the communications bridge between the medical staff and administration.

With their clinical training, physician executives are in a unique position to translate new scientific discoveries into practical terms that non-clinical managers and lay board members can understand.

The practice of selecting physician executives to lead academic medical centers is a long-standing tradition. Now, physician executives are taking the helm in many integrated health systems and regional medical centers.

Shift away from managed care

The emphasis on technology follows a mega-shift in the health care environment.

The basis for competition in the 21st century moves from managed care contracting to technology competition in centers of excellence.

In the next five to 10 years, there will be a steady stream of technology infusing health care organizations:

* Genetic discoveries will lead to new diagnostics and pharmaceuticals.

* Computer-aided drug discovery will double the number of new medications in the pipeline.

* Advances in materials science will yield genetically-engineered tissues, heart valves, even complex organs such as livers.

* Hybrid imaging devices will combine CT, PET, MRI and holography with images in 2D, 3D, 4D and real-time.

* Customized therapeutics will be designed to match the genetic makeup of individual patients, including pharmaceuticals and genetic therapy.

* High-speed, high-definition images will be created for teleme dicine.

* Medical applications of artificial intelligence will be designed for diagnosis, treatment planning and continuous monitoring of chronically ill.

* Wireless, hand-held digital electronic medical records will be capable of voice recognition.

* Telepresence surgery will take place with minimally-invasive, remotely guided instruments capable of precision beyond any human.

* Nano-technology, will create very small devices for diagnosis and treatment.

No need to wait for the future.

Many of these devices and advances are already here, like the "camera in a pill," hybrid CT-PET scanner and telepresence surgery.

The stream of new pharmaceuticals is already widening. More than 300 genetically based drugs and diagnostics are in clinical trials today, with some 180 trials just on cancer.

Biotechnology companies are energetically mining the Human Genome Project's databases, narrowing the search for new biologics that pinpoint targets on the genome.

Internet-informed patients are clamoring to be treated by experimental drugs and to become enrolled in clinical trials.

Pharmaceutical manufacturers are carrying the message to patients through mass media and direct-toconsumer marketing.

Patient support groups on the World Wide Web are posting new research findings before they appear in scientific journals.

National media provide saturation coverage of scientific discoveries and experimental treatments, with special access to the latest findings in clinical journals as they are published.

3 forces at work

The future of health care will be driven by three fundamental forces:

1. Demographics

2. Consumerism 

3. Technology

Physician executives will play a key role in managing the conflicts between consumers who want access to new technology, physician advocates who are extending the envelope of their professional disciplines and fiscally responsible trustees who insist on analyzing the cost benefit of technology investment.

Physician executives need to manage technology acquisition in a process that is open, rational and sensitive to multiple perspectives:

* Technology scanning: Ask clinicians -- physicians, nurses, pharmacists and other health professionals -- to lead a broad-ranging search to identify new technology in each of their disciplines that may become available in the next two to five years, and beyond.

* Technology assessment: Select a limited number of leading-edge technologies for more detailed assessment of the potential impact on the practice of medicine and the delivery of nursing and other health services within the organization.

* Financial feasibility: Identify a short list of high-priority technology developments for analysis of financial feasibility, as these new devices, drugs and treatments reach the market.

* Research synergy: Support the conduct of basic or applied research, consistent with the role, mission and resources of the organization. Foster research and evaluation among the medical staff and encourage participation in collaborative research projects and "beta site" developmental efforts.

* Technology partnerships: Seek partnerships with companies that are developing new technology or significantly advancing the state-of-the-art. Technology partnerships can take many forms, including consultation, clinical trials, beta testing and capital investment.

The role of chief technology officer is widely recognized in companies whose stock-in-trade is technological innovation. This is a natural for academic medical centers, large integrated health systems and regional medical centers that wish to position themselves as market leaders and early adopters of technology.

Physician executives are the natural candidates for the CTO position, with their combination of clinical training, technical expertise and management skills. The respect given to physician executives by boards and nonclinical managers is another reason to position physician executives as the "keepers of the flame" who can translate scientific advances into terms that managers and board members can understand.

This century will be remembered as the "century of biology." Physician executives can show the way.

Russell C. Coile, Jr., MBA, is a nationally-recognized futurist specializing in the health field. He is national strategy advisor for Superior Consultants, Inc., a Southfield, Mich.-based consulting firm specializing in digital business solutions. He is the author of 10 books on the future of health care, including Paperless Hospitals, just released for 2002 by Health Administration Press. As the editor of Russ Coile's Health Trends, a monthly newsletter now in its 14th year, his trends predictions for the past 10 years have been 90% accurate.

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Physician executives are well positioned to take on a new leadership role: chief technology officer. Discover how you can combine your medical/scientific knowledge and business know-how to help usher in a new age of technological innovation.