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TR: Would patients benefit from this kind of approach? Will we soon be able to view lots of different test results on our iPhones, for example?
IK: Yes! The platform model will greatly ease the ability for vendors of personal health records to offer connectivity or subscription services on hospital or practice platforms. This will accelerate access to the patient, including on the iPhone.
TR: What kind of third-party applications are you thinking about?
IK: Genetic testing in clinics has been available for more than 20 years, yet studies show that most doctors don't know how to order and interpret such tests. Few EHRs support any genetic testing or interpretation of genetic tests. If you had a platform model, a number of companies, including some of the existing [direct-to-consumer] ones, could build applications to order tests and provide interpretation.
TR: The aim of the stimulus bill, obviously, is to stimulate the economy. Will this approach help?
IK: We see this as being stimulating to the economy, because it allows scores of companies to develop business plans around these applications. The basic platforms could be sold by existing vendors but be designed to load third-party applications. It would create a much larger ecosystem of competing, evolving health-care applications driven to meet the different niches of health-care practice. Urban and rural practices, for example, don't need the same kind of support.
TR: Does the recent stimulus legislation move us in the right direction or the wrong direction?
IK: The legislation is not specific enough to endorse the platform approach or argue against it. The concern is that the money has to be spent awfully fast. If nothing particularly innovative is done soon, it's the shovel-ready applications [which would likely closely resemble existing EHR programs] that will be implemented, and those are monolithic. We would argue that one of the most important things government could do is propose rapid adoption of a platform model that would allow third-party applications.
TR: Recent studies suggest that very few hospitals and physicians' offices are using EHRs. How will that affect implementation efforts over the next two years?
KM: You can look at low adoption rates as a glass half empty or half full. The empty view is that we have not been successful in getting the technology out there. But we are looking at the glass as half full. There are lots of offices out there that are ready for something completely new.
Medicine today is a sea of paper and fax machines, privacy barriers, and unconnected data. The public is ready for a better system.
In the wake of Google Health's collapse, one company hopes to promote personal health tracking through employers.
A new program analyzes iPhone apps and finds the ones that are grabbing your data.
While the model of creating independent modules that can access a platform of core functionality is appealing in that it provides a constant stream of innovation, the regulatory and security requirements around this sort of information may make this a bit more complicated than creating an app that manages a to-do list. Also, I believe that the involvement of government agencies will be an onerous burden on small companies that we would rely on to develop these tools. That said, the existing EHR companies should take note and re-think how they develop their software and how they embrace and enable small 3rd party development organizations.
Throwing money at such a high impact public service would not bring innovation. How about learning some lessons from NHS (UK). Too often private sector exploits the public purse to the detriment of delivering value for money.
iphone is a great connectivity and viewing platform but
EHRs seem to be a database/security issue on the very back end and a brokered middle level based on web technologies and human (medical professional) filtering that enforces industry and government processes. Existing systems are proprietary throughout, but the real solution should be open standards based and vendors should compete on the middle layer; this approach will help to keep costs down and innovation up. I'm sure a few students could model solutions.
Just like we knew we should have contracted Disney to build mass transit systems like at Disneyworld, we should have Apple honcho healthcare records. Everybody can be given an iPod to keep all their medical info in it and all the Doc needs to do is Sync in reverse!
YOU THINK I'M KIDDING?????
This issue of integrated IT systems vs some user-driven amalgamation of the best of the best is as old as IT management itself. Efficient, effective IT systems need consistent data definitions and processes. In business, the lack of satisfaction with IT systems often betrays a lack of agreement on the business processes per se. It is difficult to get assertive, competent professionals to come to agreement with each other on the proper business processes and data meanings. The morass of medical systems, financial systems, reimbursement systems, and quality systems will never get better without new leadership that can stand back and look at the whole problem. New iPhones are not the solution.
Guest (ronnie.williams)
The following link shows some security issues which are currently in an iPhone.
http://www.technologyreview.com/communications/22782/
That means the iphone apps can be cracked and run on any iphone model and firmware version.
this should be an important point while designing an iphone app at such a major scale !
Manufacturing in the United States is in trouble. That's bad news not just for the country's economy but for the future of innovation.
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olechief
1 Comment
EHR
While the concept is very desirable, the execution will leave a lot to be desired. In an era of HIPAA security, how do I assure that my EHR are not shopped around for other purposes? How do we assure ourselves that the whiz-bang apps proposed are secure enough to protect my EHR? I have a very visceral sense that government control and access to my EHR will lead to a loss of choice in my medical treatment and a Canadian style of rationing to my detriment. Color me extremely cautious!
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