Last night I got a fresh lesson on perspective, for the price of a hockey ticket. Following a father and his son of 6 or 7 in the parking lot, we passed a burly ticket scalper, mechanically calling out, "Anyone need tickets?" The boy looked up at his father and said, "That man doesn't want to go to the game?"

Once understood and familiar, as we learn over and over again, things become invisible to us. With technology, beyond the psychological conditioning, there's even a physical shrinkage. Compare your cell phone to the shoebox-size contraption Michael Douglas lugs around in 1987's "Wall Street."

Computers are another obvious example. Though the computer's role in medicine has a long way to go before it achieves the invisibility that familiarity bestows, that process is under way. Whether it's aiding physicians through computerized reminders or decision support systems, connecting patients and services through telemedicine, or easing storage and access to patient data, computers are inexorably gaining a bigger role in the doctor/patient equation.
A couple of reports in this issue evidence the trend. Tele-ophthalmology, as Drs. Matthew Tennant and Helen Li point out in Retinal Insider is no longer limited to the plains of Alberta or Oklahoma, but is today serving patients in Los Angeles and Washington, D.C.

In Great Neck, N.Y., technophile Ken Rosenthal, MD, is going live with a Web portal that he thinks may save 15 to 20 minutes off each patient visit. Read about his adventure in Technology Update. Though initially he's just precollecting information like patient history and insurance coverage, Dr. Rosenthal may be onto something.

A study published last year shows that: 92 percent of patients would support using a computer before visiting their doctor to prompt the doctor to do health screening tests; 92 percent would support such usage to prompt counseling about health behaviors; and 86 percent would even support such usage to prompt a change in their treatment for health conditions.1

Yes, there are obstacles ahead, serious obstacles and questions at each instance in which computer technology intersects with medical care. Patient privacy, the impact on the quality of care, even mundane issues like reimbursement in telemedicine, they're all still to be resolved. And they won't be any time soon.

Still, it won't be all that long before that little boy is old enough to go to a hockey game on his own. How—even if—he sees the computer when he visits his doctor's office is going to be fascinating to watch.

1. Sciamanna C at al. Patient attitudes toward using computers to improve health services delivery. BMC Health Services Research 2002;2:19.