A New Prescription for Personal Health
dan tynan on Sep 02 2008 at 5:34 pm | Filed under: Da Web, Google, Identity Theft, Microsoft, Web 2.0
Services like Google Health and Microsoft HealthVault are the best thing to hit medicine since the oral thermometer
I hate clipboards. Not all clipboards, mind you, just the ones I’m invariably handed every time I go to a new doctor’s office. If I have to fill out one more paper form listing my name, address, and the details of that time I broke my arm during senior ditch day in high school, resulting in two impressive looking scars on my left forearm (and being grounded for two weeks), I may scream.
Virtually everything else I do is digital, but the medical professionals in my life cling to paper and pen like leeches to a patient diagnosed with the vapors. Fortunately, however, that may soon change, now that heavyweights like Microsoft and Google have entered the personal health records business.
At Microsoft HealthVault and Google Health you can create an account online, fill out a medical profile listing all your physical attributes and ailments, or import medical records from existing health care services. Any care provider with access to these services can grab your records – no clipboards required.
The problem? Right now there are only a handful of pharmacies, labs, and health clinics that let you import or export records digitally. Odds are your doctor isn’t one of them – yet, anyway. But that may be changing, too.
[ more after the jump ]
In June, Kaiser Permanente announced a partnership with Microsoft HealthVault that in time could provide service to its nearly nine million HMO subscribers, and it’s not the only one pushing digital health records. Blue Cross of Northeastern Pennsylvania is rolling out MyHealth Mobile, a new service provided by Diversinet that lets its subscribers control access to their medical information using cell phones. It works like this: Health data is stored in a secure electronic vault, and subscribers use software on their phones to log into their vault and choose the information they need and where to send it. Records can be faxed to pharmacies, emailed to insurance companies, or text messaged to specialists.
Digital health records must overcome two big hurdles before they become mainstream. The first is doctors and other medical professionals who are typically loathe to adopt new ways of doing things. For them, the cutting edge is still a scalpel, not a computer.
The second is the fear that putting the information online in one tidy package will make it easier to steal thousands of records at a time. Given all the news about data spills and identity theft, it’s a reasonable question. It really boils down to whether you can you trust the record keepers to keep your information private and protect it sufficiently against the dark side.
“Manual record keeping has a lot of risks too,” notes Barbara Cox, senior principal for Noblis, a nonprofit science and technology strategy firm. “Paper charts are easily lost or misplaced, trucks transferring paper records to off-site storage flip over, and the documents are lost. Electronic records provide much more security and control. And doctors have the information available to make diagnoses faster, easier, and safer.”
While services like Google and Microsoft aren’t governed by same federal privacy rules as doctors or insurers, they are required to meet the guidelines of their own privacy policies, which are typically much stricter, says Kirk Nahra, a partner with the law firm Wiley Rein in Washington DC and an expert on health privacy.
Cox says consumers will need to choose personal health record providers at least as carefully as they choose their health care providers, to ensure they take adequate care with records and aren’t just out to sell or exploit them. She also urges patients to push their physicians to break out of their old analog habits and explore the brave new digital world.
For me, digital health records can’t come soon enough. In fact, they’re just what the doctor ordered.
(This story originally appeared in the September 2008 issue of US Airways magazine, along with a photo/illustration of yours truly that’s too hideous to even contemplate. No, I am not that fat. Really.)
Dan – I think you are wrong on this one. In fact KP already has better medical records and digital patient management than ANYONE. IN fact, it wouldn’t surprise me if Microsoft is after connecting to that somehow than the other way around.
But it is STILL the wrong way to do it. There is a simple way to tell. Most of the industrialized world has better healthcare than we do – especially the insurance/payment/tracking/records part. And guess what – they aren’t using these new ’solutions’
Why aren’t we just doing like they do?
Hi Dan – it’s amazing to me just how misunderstood this entire area is, and I think that lack of understanding is part of what keeps healthcare IT (HIT) in the rather stagnant state that it’s in. Besides being an MD/MBA, I’ve also published a couple papers on the Health Information Exchange space (HIE) – basically that means mobilizing patient data across providers and making it readily available at the point of care, and I’ve consulted with a few large groups concerning HIE efforts.
The bottom line is that the real economics behind all of this still doesn’t exist. Believe it or not, there is little to no evidence showing that HIT and/or HIE actually saves money from a clinical perspective. Electronic Health Records may, indeed, save money at a clinic or hospital level, but the type of more macro savings has yet to really be seen. When it comes time for adopting HIE solutions providers, payors, patients, companies and the government have all balked at footing the bill.
That’s more on what I consider the “professional” side of things. In the consumer space it’s somewhat even more perverse. Patients know that they should be tracking their disease/illness/medications, etc, but adoption of information technologies that make this process incredibly simple for patients has remained at very low levels. When it comes down to it, consumer-patient behavior is such that they just don’t use these tools reliably.
Sure it would be nice to never have to use those clipboards again, or not have to retell your story in the emergency room six thousand times, but few HIT solutions are going to eliminate those processes, at least in the next 10-15 years at least. Why? Liability and provider behavior. First, the liability aspect is enormous for physicians (who really operate and think like one-man businesses) – if you don’t fill out those papers and don’t sign away on the dotted line, the bottom line is that their butts are on the line. In the era of HIPAA and lawsuits over hot coffee spills no physician in his right mind would veer totally away from paper. Secondly in the emergency room, retelling your story to the triage nurse, ER nurse and the physician is all part of the diagnostic process. 80-90% of diagnoses are made just through the patient’s history (of their current illness). Physicians aren’t just going to veer away from this behavior – because that would both open them to liability and also go against their training.
So, when it gets down to it, these issues are only the surface of what’s going on and they represent a large, large inertia that needs to get moving if we are to ever adopt these technologies. Happy to chat more sometime on the subject.
BTW – KP’s electronic medical record system is $3.5 billion (yes, billion) over budget and still is not fully and properly operational. Owen’s right about MSFT going after KP’s info, but plain wrong about KP’s EMR status. And if you think that other industrialized countries have better HIT than we do, I encourage you to look in to the UK’s National Health Service nationalized patient records. They have a much simpler system and have struggled for over 5 years, despite a national mandate. It’s a caution to heed as we build our systems.
Based on the aforementioned comments, I am troubled to see if a system like this can be viable in the US when it’s obvious that our “brother” nations are experiencing detrimental ticks in their systems. I would like to see something like this happening in the future, but the country needs to fix it on a grass-roots level first. If it’s possible to have a local system in place, then eventually they could be connected together in a secure, private network that will inevitably be more beneficial to the citizens who may want access to their medical information w/o it being jacked from other presences in the vicinity (wireless connected, that is).
Any Update on Myhealth Mobile? I noticed AllOne Mobile announced a partnership with Healthvault and also with the US Army.