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Modernizing the Medical Record

As medical data goes digital, patients gain power.

In April, a San Francisco–area startup called BaseHealth announced health-management software that integrates diet, exercise, genetic tests, and medical records, then calculates a patient’s risk for more than 40 diseases—including type 2 diabetes, lung cancer, and Alzheimer’s disease—and suggests ways to lower the risk of developing them.

Along with Apple’s recent announcement of its Health app, which compiles data from other apps that track activity and medical data into a single dashboard, and a similar initiative from Samsung, BaseHealth’s software is part of a push for a new kind of electronic health records that integrate both personal and medical information.

BaseHealth founder and CEO Hossein Fakhrai-Rad calls the current approach to medicine fragmented. “You don’t have a 360-degree complete view of health,” he says. Looking at just one piece of the puzzle hampers preventative health care, he adds. Type 2 diabetes, for example, which runs in Fakhrai-Rad’s family and was the subject of his doctoral research, remains, for all its complexity, a preventable disease. Doctors often look at diet but ignore other risk factors like genetics, he says.

“[Genetic data] is one more piece of patient care data that helps motivate and excite patients,” says Katherine Sutherland, a physician in Silicon Valley who recently began offering BaseHealth’s application to some patients. “No matter what any results show, you are going to recommended improving diet, exercise, and lifestyle, but you’ve got a lot more force to show them why it’s going to work,” she says.

BaseHealth’s program integrates lifestyle information, genetic data, and medical records data, all under the guidance of a doctor. Other offerings from companies like Apple promise to integrate medical information with lifestyle data, but those products don’t require the involvement of a doctor, whereas patients using BaseHealth can’t even get their full results until a doctor grants them access after an in-person consultation. “We are including physicians because we believe they are a key factor in the health ecosystem,” says Fakhrai-Rad. That involvement distinguishes BaseHealth from other personal genetics companies like 23andMe, which was censured by the FDA in November 2013 for marketing health reports directly to consumers.

Before a patient can use BaseHealth, a doctor must upload information, such as prescription history and physiological measures like blood pressure, that would commonly be found in an electronic medical record. The patient can then upload lifestyle and family history data. The doctor can add a patient’s genetic analyses by ordering genotyping or whole-genome sequencing from one of BaseHealth’s lab partners. All that information is then crunched together to provide an overall risk assessment for various diseases and recommendations for changes to the patient’s diet or exercise routine, based on peer-reviewed journal articles. Doctors can tweak the recommendations according to their own familiarity with the patient. “Physicians can override to say don’t do this, do that,” says Fakhrai-Rad.

Increasing patients’ access to their medical records could help them and their doctors make health decisions together, says Helen Burstin, chief scientific officer at the health-care-focused National Quality Forum.

It could also help people make decisions based on their own judgment, rather than relying completely on a physician’s advice. “When patients are armed with better information about the potential risks and benefits, they may make a decision that may be different than what a clinician would have decided for them,” says Burstin.

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