References 43THE TWENTY-FIRST CENTURY
Unquestionably, the psychological practice environment of
the twenty-first century will be dramatically different than it
is today. The specifics of change are, of course, unpre-
dictable. However, at least one major trend is clear. Our
nation’s health care system is just beginning to appreciate the
applicability of technology, particularly computer and
telecommunications technology, to the delivery of clinical
services. The Institute of Medicine (IOM), which has served
as a highly respected health policy “think tank” for adminis-
trations and the Congress since its inception in 1970, reports
that
Health care delivery has been relatively untouched by the revo-
lution in information technology that has been transforming
nearly every other aspect of society. The majority of patient and
clinician encounters take place for purposes of exchanging clin-
ical information.... Yet it is estimated that only a small fraction
of physicians offer e-mail interaction, a simple and convenient
tool for efficient communication, to their patients. (Institute of
Medicine, 2001, p. 15)The number of Americans who use the Internet to retrieve
health-related information is estimated to be about 70 mil-
lion. Currently, over half of American homes possess com-
puters, and while information presently doubles every
5 years, it will soon double every 17 days, with traffic on the
Web already doubling every 100 days (Jerome et al., 2000).
And, at the same time, the IOM further reports that the lag
between the discovery of more efficacious forms of treatment
and their incorporation into routine patient care is unnec-
essarily long, in the range of about 15 to 20 years. Even then,
adherence of clinical practice to the evidence is highly
uneven.
The era of the “educated consumer” is upon us. How con-
sumer expectations and the unprecedented explosion in
communications technology will affect the delivery of psy-
chological care is yet to be determined. Highly complex issues
such as reimbursement for virtual therapy environments,
automated diagnostic testing protocols, ensuring psychologi-
cally based enriched living and long-term care environments
for senior citizens and the chronically ill, not to mention
financial support for clinical graduate students, will all be
debated in the public policy (e.g., political) arena. Professional
psychology must become active participants in this critical—
and ongoing—dialogue, in order to ensure the future of pro-
fessional psychology, research in applied psychology, basic
psychological research, and the public welfare in terms of
health care and social services.
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