Tuesday, October 21, 2014
Saturday, October 18, 2014
Comment from another Blogger on the situation with Ebola
And the Ebola Czar's first order of practice, Declare a war on Ebola Thanks Mr. President, I feel much safer knowing there is a Drug Ebola Czar with no medical, scientific or disease (Ebola) control background watching out for us.
Monday, September 30, 2013
Tuesday, July 05, 2011
Why we need Electronic Health Records (EHR’s) (Newt Gingrich)
EHR Implementation
We need EHRs to save lives.
We need EHRs to prevent needless suffering.
We need EHRs to make our healthcare system affordable.
We need EHRs to help solve the growing physician and nurse shortage
by freeing up medical talent from time consuming administrative tasks.
We need EHRs to return medicine to a system that attracts the best and the brightest young people to the profession.
We need EHRs to create a virtual public health and biosurveillance system. We need EHRs to help accelerate research and discovery.
We need EHRs to help support the establishment of a new system of medical justice.
We need EHRs to make it easier for individuals to learn about and become engaged in their healthcare.
The medical profession needs interoperable EHRs.
You need an EHR to practice the best medicine possible.
You need an EHR to decrease your operational and administrative costs and increase your take-home pay.
You need an EHR to help in the prevention of costly and harmful
medical mistakes.
You need an EHR to help reduce your risk of and defend against
medical malpractice lawsuits.
You need an EHR to optimize your resources and the talent of your team. You need an EHR to compete in the growing transparent consumer¬
driven market system where patients are being incentivized to choose doctors based on quality of care and/ or use of information systems.
You need an EHR to easily demonstrate positive outcomes that qualify you for the increasing number of pay-for-performance program bonuses.
You need an EHR to easily share vital medical information with your patients that will help them to take more responsibility for their care.
You need an EHR to allow you to spend more time doing what you
went into medicine to do─help patients.
We need EHRs to save lives.
We need EHRs to prevent needless suffering.
We need EHRs to make our healthcare system affordable.
We need EHRs to help solve the growing physician and nurse shortage
by freeing up medical talent from time consuming administrative tasks.
We need EHRs to return medicine to a system that attracts the best and the brightest young people to the profession.
We need EHRs to create a virtual public health and biosurveillance system. We need EHRs to help accelerate research and discovery.
We need EHRs to help support the establishment of a new system of medical justice.
We need EHRs to make it easier for individuals to learn about and become engaged in their healthcare.
The medical profession needs interoperable EHRs.
You need an EHR to practice the best medicine possible.
You need an EHR to decrease your operational and administrative costs and increase your take-home pay.
You need an EHR to help in the prevention of costly and harmful
medical mistakes.
You need an EHR to help reduce your risk of and defend against
medical malpractice lawsuits.
You need an EHR to optimize your resources and the talent of your team. You need an EHR to compete in the growing transparent consumer¬
driven market system where patients are being incentivized to choose doctors based on quality of care and/ or use of information systems.
You need an EHR to easily demonstrate positive outcomes that qualify you for the increasing number of pay-for-performance program bonuses.
You need an EHR to easily share vital medical information with your patients that will help them to take more responsibility for their care.
You need an EHR to allow you to spend more time doing what you
went into medicine to do─help patients.
Thursday, June 30, 2011
Sunday, March 06, 2011
Wednesday, September 01, 2010
EHR market projected to double by 2012
August 30, 2010 | Bernie Monegain, Editor
MOUNTAIN VIEW, CA – The U.S. ambulatory EHR market, which was at $1.3 billion in 2009, is forecast to reach $2.6 billion in 2012, according to new analysis from research firm Frost & Sullivan.
The rate of electronic health record adoption among U.S. physicians expects to increase over the next two to five years due to a combination of changes caused by healthcare reform and financial subsidies from the HITECH program, the report notes.
"Today, many public and private stakeholders are committed to harnessing the power of information technology to improve the quality and efficiency of our healthcare system," states Frost & Sullivan Senior Industry Analyst Nancy Fabozzi. "We are finally seeing providers make the transition from siloed paper charts to interoperable electronic health records."
Growing complexities in managing the reimbursement process with both government and commercial payers that reward quality over quantity in the care provided will increase the use of EHRs and related solutions for physicians and other clinicians, Fabozzi says.
She predicts HITECH will indirectly stimulate the market by enticing additional stakeholders like commercial payers, professional medical societies, healthcare manufacturers, and various nonprofit organizations to help physicians and other providers successfully adopt information technology in their practices.
Revenues are expected to fluctuate considerably over the next five to seven years, resulting in significant year-over-year shifts. This fluctuation happens as the market matures and increased competition comes into play, causing a decrease in pricing, she says.
Strategic partnering with a variety of stakeholders is important for survival in this market as consolidation on both the vendor and provider side increases. Innovative, provider-focused, and patient-centric technology companies that understand how to manage this industry's unique combination of risks and rewards will achieve business progression.
"Branding and outreach must extend beyond physicians to include non-physician healthcare providers, as well as healthcare consumers," notes Fabozzi. "Both should be directly engaged as advocates for the use of health information technology. Patients need to understand the role EHRs play in driving quality improvements and care coordination among all of their (physician and non-physician) providers."
http://www.linkedin.com/news?viewArticle=&articleID=182956206&gid=40096&type=member&item=28555335&articleURL=http%3A%2F%2Fwww.healthcareitnews.com%2Fnews%2Fehr-market-projected-double-2012&urlhash=GzjO&goback=.gde_40096_member_28555335
MOUNTAIN VIEW, CA – The U.S. ambulatory EHR market, which was at $1.3 billion in 2009, is forecast to reach $2.6 billion in 2012, according to new analysis from research firm Frost & Sullivan.
The rate of electronic health record adoption among U.S. physicians expects to increase over the next two to five years due to a combination of changes caused by healthcare reform and financial subsidies from the HITECH program, the report notes.
"Today, many public and private stakeholders are committed to harnessing the power of information technology to improve the quality and efficiency of our healthcare system," states Frost & Sullivan Senior Industry Analyst Nancy Fabozzi. "We are finally seeing providers make the transition from siloed paper charts to interoperable electronic health records."
Growing complexities in managing the reimbursement process with both government and commercial payers that reward quality over quantity in the care provided will increase the use of EHRs and related solutions for physicians and other clinicians, Fabozzi says.
She predicts HITECH will indirectly stimulate the market by enticing additional stakeholders like commercial payers, professional medical societies, healthcare manufacturers, and various nonprofit organizations to help physicians and other providers successfully adopt information technology in their practices.
Revenues are expected to fluctuate considerably over the next five to seven years, resulting in significant year-over-year shifts. This fluctuation happens as the market matures and increased competition comes into play, causing a decrease in pricing, she says.
Strategic partnering with a variety of stakeholders is important for survival in this market as consolidation on both the vendor and provider side increases. Innovative, provider-focused, and patient-centric technology companies that understand how to manage this industry's unique combination of risks and rewards will achieve business progression.
"Branding and outreach must extend beyond physicians to include non-physician healthcare providers, as well as healthcare consumers," notes Fabozzi. "Both should be directly engaged as advocates for the use of health information technology. Patients need to understand the role EHRs play in driving quality improvements and care coordination among all of their (physician and non-physician) providers."
http://www.linkedin.com/news?viewArticle=&articleID=182956206&gid=40096&type=member&item=28555335&articleURL=http%3A%2F%2Fwww.healthcareitnews.com%2Fnews%2Fehr-market-projected-double-2012&urlhash=GzjO&goback=.gde_40096_member_28555335
Friday, August 27, 2010
Health IT Training Grant @ Cypress College
The Health Information Technology for Economic and Clinical Health (HITECH) Act signed by President Obama in February 2009 seeks to improve American health care delivery and patient care through an unprecedented investment in health information technology. The provisions of the HITECH Act are specifically designed to work together to provide the necessary assistance and technical support to providers, enable coordination and alignment within and among states, establish connectivity to the public health community in case of emergencies, and assure the workforce is properly trained and equipped to be meaningful users of EHRs. Combined these programs build the foundation for every American to benefit from an electronic health record, as part of a modernized, interconnected, and vastly improved system of care delivery.
The Health IT Workforce Development Program focuses on key resources required to rapidly expand the availability of health IT professionals to support broad adoption and meaningful use of health IT in the healthcare community. Those who take advantage of professional training in health IT will find opportunities for interesting, challenging, and important work. Not only do these opportunities represent new jobs, they represent promising careers in a growing sector of our economy.
Handouts for Health IT Information Workshops:
1.Click on Information Workshop Schedule to find the dates and times the workshops are scheduled.
2.Summary of HITECH Act
3.Health IT Workforce Training Roles by Member College
4.Health IT Workforce Roles and Competencies and Appendix C. Health IT Workforce Roles Components
5.Health IT Program Information Workshop PowerPoint
http://www.cypresscollege.edu/academics/academicPrograms/HealthScience/HealthInformationTechnology/HITT.aspx
The Health IT Workforce Development Program focuses on key resources required to rapidly expand the availability of health IT professionals to support broad adoption and meaningful use of health IT in the healthcare community. Those who take advantage of professional training in health IT will find opportunities for interesting, challenging, and important work. Not only do these opportunities represent new jobs, they represent promising careers in a growing sector of our economy.
Handouts for Health IT Information Workshops:
1.Click on Information Workshop Schedule to find the dates and times the workshops are scheduled.
2.Summary of HITECH Act
3.Health IT Workforce Training Roles by Member College
4.Health IT Workforce Roles and Competencies and Appendix C. Health IT Workforce Roles Components
5.Health IT Program Information Workshop PowerPoint
http://www.cypresscollege.edu/academics/academicPrograms/HealthScience/HealthInformationTechnology/HITT.aspx
Tuesday, August 24, 2010
Monday, July 12, 2010
Monday, April 26, 2010
Survey: Breaches, ID Theft Increase
Survey: Breaches, ID Theft Increase
The issues of security and privacy will continue to be challenging and elusive in the health care arena. The goals are legitimate, the ways and means of achieving compliance are constricted and problematic.
The issues of security and privacy will continue to be challenging and elusive in the health care arena. The goals are legitimate, the ways and means of achieving compliance are constricted and problematic.
Thursday, March 25, 2010
Real Health Care delievered in a Virtual Environment on Second Life
Recently, through a class “The Internet and the Future of Patient Care” I am taking online at UC Davis on Informatics, I was introduced to the virtual reality site Second Life (http://www.SecondLife.com) The site was developed by a company called Linden Labs and has been up and running on the Internet since 2003. To interact on the site users must set up an account, which is free and become a “Resident.” Users must also download some client software necessary to interact inside the site, known as the “grid.” As part of the setup, users must chose an Avitar (an Avitar is computer image used to represent the user in the action on the screen) to represent themselves. Residents can explore, walk, run, fly, or transport themselves to the places in Second Life. Along the way Avitars meet other residents Avitars, socialize, and participate in activates as an individual and or also engage in group activities, and even buy, create and trade virtual property.
Part of the user interface includes menu and keystroke accessed software tools for building geometric objects that can be endowed with a myriad of attributes. There is also a scripting language that can be used to manipulate various aspects of the environment.
One of the most interesting aspects of this site is that it can be regarded, treated and used as a game for entertainment or simple amusement, but it can and is also being used as an amazing and powerful “tool” for accomplishing a wide array of real life tasks, with physical reality value.
The purpose of using the site for my UC Davis Informatics class is to demonstrate and teach about how the site is being used to provide diagnostic, treatment and informational services for people, in fact patients, needing various health care services in an alternative way. While a virtual reality experience cannot replace face to face clinical care for treating patients who require physical intervention to address their injury or disease, and obviously medication cannot be dispensed virtually, the virtual clinic or virtual health care provider can perform many valuable functions. Presently, Doctor, Physician’s Assistant, Nurse Practitioners, etc Avitars can interactively, in real time interact with patients. They can answer questions, provide detailed basic information and direct patients to information sites on the Internet - an amazing feature in Second Life is the ability for Avitars to interact real time with the real World Wide Web, through virtual browsers, in real time.
So, while this virtual clinical environment can be used to great advantage presently, in the near future through additional, yet to be developed interfaces, the capabilities of the virtual environments will be extended even further. Through real data interfaces to telemedical instruments Avitars will be able to take actual vital readings from a real patient being represented virtually in the online environment. This is another approach to telemedicine that will facilitate an added dimension of patient interaction and care delivery that has some advantages over the present conventional view of telemedicine. For instance, the patient may be more willing to disclose intimate information about a condition such as STD’s that the patient might be less inclined to disclose in a face to face encounter with a health care provider.
Further, implementation of future features for things like, medical training; mental health treatment, disease diagnosis, public health issue management and etc are as boundless as our imaginations. There is real value being derived already through these virtual worlds, but the possibilities for the future are truly exciting. If you haven’t experienced a virtual world before now, all I can say is you are missing out on an amazing experience.
Part of the user interface includes menu and keystroke accessed software tools for building geometric objects that can be endowed with a myriad of attributes. There is also a scripting language that can be used to manipulate various aspects of the environment.
One of the most interesting aspects of this site is that it can be regarded, treated and used as a game for entertainment or simple amusement, but it can and is also being used as an amazing and powerful “tool” for accomplishing a wide array of real life tasks, with physical reality value.
The purpose of using the site for my UC Davis Informatics class is to demonstrate and teach about how the site is being used to provide diagnostic, treatment and informational services for people, in fact patients, needing various health care services in an alternative way. While a virtual reality experience cannot replace face to face clinical care for treating patients who require physical intervention to address their injury or disease, and obviously medication cannot be dispensed virtually, the virtual clinic or virtual health care provider can perform many valuable functions. Presently, Doctor, Physician’s Assistant, Nurse Practitioners, etc Avitars can interactively, in real time interact with patients. They can answer questions, provide detailed basic information and direct patients to information sites on the Internet - an amazing feature in Second Life is the ability for Avitars to interact real time with the real World Wide Web, through virtual browsers, in real time.
So, while this virtual clinical environment can be used to great advantage presently, in the near future through additional, yet to be developed interfaces, the capabilities of the virtual environments will be extended even further. Through real data interfaces to telemedical instruments Avitars will be able to take actual vital readings from a real patient being represented virtually in the online environment. This is another approach to telemedicine that will facilitate an added dimension of patient interaction and care delivery that has some advantages over the present conventional view of telemedicine. For instance, the patient may be more willing to disclose intimate information about a condition such as STD’s that the patient might be less inclined to disclose in a face to face encounter with a health care provider.
Further, implementation of future features for things like, medical training; mental health treatment, disease diagnosis, public health issue management and etc are as boundless as our imaginations. There is real value being derived already through these virtual worlds, but the possibilities for the future are truly exciting. If you haven’t experienced a virtual world before now, all I can say is you are missing out on an amazing experience.
Monday, March 22, 2010
Understanding the Health Care Bill Overhaul
If enacted, the reconciliation bill combined with the Senate-passed bill would, from 2010-2019: -Spend $938 billion on expanding insurance coverage, including $464 billion in subsidies to help uninsured people buy coverage. -Expand Medicaid coverage to 16 million additional people. -Require many employers to offer coverage for their workers. -Collect $69 billion in penalties from uninsured individuals and employers for non-coverage. -Provide coverage through an insurance exchange to 24 million people. -Reduce the number of uninsured by 32 million people, but leave 23 million (including illegal immigrants) not covered. -Cut Medicare spending by $455 billion from currently-projected levels. -Not affect next month’s scheduled 21 percent cut in payment rates to doctors who treat Medicare patients. -Produce a net reduction in federal deficits of $143 billion.
Sunday, March 21, 2010
The Future of Health Care on the Internet and the Use of Personal Health Information Portals
Introduction
One of the most interesting and promising uses of the Internet in the health care arena is the prospect of broad adoption and use of one of the many available sources of applications/portals/websites for storing, managing, sharing and using personal health information, i.e. Personal Health Records or PHR. Internet juggernauts Google and Microsoft in addition to several others have launched feature rich Internet portals that allow individuals to collect manage and use their personal health information by and health care professionals. These sites go way beyond a static record file and are so much more than just repositories for historical medical data. The goal of these applications is to provide a comprehensive set of tools and features to improve users’ quality of life in addition keeping an information trail of medical history. And in the case of Microsoft and Google in particular, these sites, for now, are free or inexpensive to personal users.
Four Selected Providers
Microsoft’s Health Vault (free)
HealthVault is an Internet application website offered by Microsoft for storing and maintaining and sharing health and fitness information. The site was launched in October 2007 and is located on- line at http://www.healthvault.com. The site is intended to not only provide access and value to the individuals maintaining the records but also to health care service provider professionals at the information owners discretion and direction.
Google Health (free)
Google Health, http://health.google.com, provides an on-line web portal that allows one to organize in one place, all their health information. There are tools and features that assist in assembling medical records from doctors, hospital and pharmacies. Additionally there are tools to allow sharing of information with family members, physicians or other caregivers.
Dossia (Available to qualifying members only)
Dossia is a Web-based application for storing and managing personal health records (PHR). Unlike Google Health and Health Vault, Dossia, is not available to the public at large. Dossia is the product offering of an independent, non-profit organization known as the Dossia Founders Group.
Users have to be qualified. Presently, Dossia use is only offered only to employees, dependents and retirees of AT&T, Applied Materials, BP America, Inc., Intel Corporation, Pitney Bowes, Cardinal Health, Sanofi-Aventis and Wal-Mart, the Dossia group's founding companies.
Users have the ability to aggregate medical data, claims information from insurance companies and also pharmacy records. Dossia records are stored in a private, encrypted electronic health record hosted in a modified open-source database called “Indivo” that can be accessed over the Internet using a secure connection.
MyHealthArchive Ultimate (modest subscription fee)
MyHealthArchive is a subscription based web portal PHR application. For $9.98 per month, subscribers get access to what the developers call a “revolutionary tool which gives patients the power to collect their own health information and then access it using a secured website, anytime, anywhere in the world.” The application facilitates managing health and wellness for the customer.
Features
The applications currently available have an impressive array of features and benefits already and we can only expect that over time the applications will improve in terms of usability and functionality.In terms of current features below is a partial listing:
· Comprehensive medical record aggregation
· User configurable presentation of the user interface
· Secure access
· Control over with whom data will be shared
· Accessibility over the Internet
· Guided wizards and or comprehensive user help information
· Print, email or fax all or parts of records
· Tools to help plan visits to physicians or other care providers
· Wellness information, preventative advice and health information libraries
· Personal health goal planning, calendars and progress tracking
· Interfaces with biometric tools such as glucose testers, heart rate monitors and other fitness products
· Tools for managing medication regimens
Interoperability
One of the most poignant and problematic issues in health care today is the interoperability of the myriad of diverse systems in use by all of the stakeholders in the heath care arena that optimally will share data. Because there is and likely will continue to be a broad array of health care applications for managing health record information, the data formats, document taxonomies, networking protocols and data interchange formats will continue to be complex and significant issues. The notion of “one source of truth” for a patient’s medical information and history is likely a distant if ever achievable goal. Much data will be shared undoubtedly. The risk of problems as a result of data being passed from one system to another is significant and much effort will continue to be expended to insure the accuracy of the data will be required for the foreseeable future.
Societal Benefits
In addition to the significant, obvious and exciting benefits to be gleaned at a personal level from the broad adoption and deployment of Personal Health Information (PHI) systems, there are also potentially spectacular things that can also be accomplished in the area of public health management if scrubbed (meaning concealing or protecting the privacy rights and concerns of the individuals) PHI data can be aggregated for study, analysis, data mining and other use by public health management professionals and medical researchers. The potential benefits and advances that can be made as a result of this type of a data source being made available cannot be underestimated – it will be game changing in terms of the strides that can be made in managing health concerns at a societal level.
Barriers to Broad Adpotion
While the potential benefits to individuals and to society as a whole are legion, there remain many barriers and obstacles to achieving broad adoption of PHR/PHI systems. Some of those include:
· Lack of time
o Collecting and managing the amount of data that will constitute the complete comprehensive health record for an individual or a family will be a formidable task. Time is the enemy in modern life. The demands on our time are already limiting in terms of what we can accomplish in our lives – one more – enormous task will overwhelm most. Likely, the majority of people will attempt to collect and manage only the information that they deem most important for the present level of concern about health issues.
· Fear of security and privacy issues
o Many people, with good reason, will be suspicions of any on-line, public network, aggregation of PHI information especially when the service is provided at no direct charge to the individual. This will cause many to not participate voluntarily.
· Complexity
o This may be partially a generational issue. Many people will not find the on-line applications user friendly, intuitive or understandable.
· Data input errors
o Problems with data and or functionality with the system(s) may lead some users to not use or to stop using the systems. Especially in the case where a data or system error leads to a significant personal problem.
· Terminology
o Medical terminology and medical descriptions can be incomprehensible or too challenging for some people. A user friendly, “lingua franca” may not be achievable. If people don’t find the information ineligible or meaningful their rate of adoption and perception of value will be much lower.
Risks
In addition to the visceral apprehension expressed by some, there are real risks in putting sensitive personal information into a data repository that is accessible from the public network. While all of the providers are cognizant of the risks, have engineered to minimize them and purport to have them in hand and well managed[i], it is well known that risk of human or machine error and or accidental or intentional disclosure cannot be completely eliminated. While HIPPA and other compliance rules may not apply to all of the potential players in this space, there are those potential participants, i.e. health care service providers that have legitimate potential liabilities that have to be assumed, managed or still eliminated. Then there are all of the usual systemic risks that come as a result of using electronic data automation. Besides unauthorized access and inappropriate disclosure, loss of data by error, system failure or break down, corruption of data, and logic errors are all potential risks and problems that come with any electronic data strategy.
Future
The promise and potential value of personal health record systems is great. The real value and the tremendous benefits are yet to be realized and but the enormous potential of a feature rich database application with this level of detail is truly exciting. There is much work to be done as of yet and the real keys to achieving a tipping point in terms of ubiquitous use and adoption is yet to be fully understood and articulated. As is the case with clinical setting electronic record systems, part of the barrier is the labor and time required to create the records. Just as this aspect of EMR and EHR systems needs to be improved it is also true of PHR /PHI systems. Ease of access and data input methodologies are improving continuously and have been enhanced and improved recently by advances made in the mobile computing arena.
[i] Google’s claims “[Google]… stores your information securely and privately, but you always control how it's used. We will never sell your data. You are in control. You choose what you want to share and what you want to keep private. View our privacy policy to learn more.”
One of the most interesting and promising uses of the Internet in the health care arena is the prospect of broad adoption and use of one of the many available sources of applications/portals/websites for storing, managing, sharing and using personal health information, i.e. Personal Health Records or PHR. Internet juggernauts Google and Microsoft in addition to several others have launched feature rich Internet portals that allow individuals to collect manage and use their personal health information by and health care professionals. These sites go way beyond a static record file and are so much more than just repositories for historical medical data. The goal of these applications is to provide a comprehensive set of tools and features to improve users’ quality of life in addition keeping an information trail of medical history. And in the case of Microsoft and Google in particular, these sites, for now, are free or inexpensive to personal users.
Four Selected Providers
Microsoft’s Health Vault (free)
HealthVault is an Internet application website offered by Microsoft for storing and maintaining and sharing health and fitness information. The site was launched in October 2007 and is located on- line at http://www.healthvault.com. The site is intended to not only provide access and value to the individuals maintaining the records but also to health care service provider professionals at the information owners discretion and direction.
Google Health (free)
Google Health, http://health.google.com, provides an on-line web portal that allows one to organize in one place, all their health information. There are tools and features that assist in assembling medical records from doctors, hospital and pharmacies. Additionally there are tools to allow sharing of information with family members, physicians or other caregivers.
Dossia (Available to qualifying members only)
Dossia is a Web-based application for storing and managing personal health records (PHR). Unlike Google Health and Health Vault, Dossia, is not available to the public at large. Dossia is the product offering of an independent, non-profit organization known as the Dossia Founders Group.
Users have to be qualified. Presently, Dossia use is only offered only to employees, dependents and retirees of AT&T, Applied Materials, BP America, Inc., Intel Corporation, Pitney Bowes, Cardinal Health, Sanofi-Aventis and Wal-Mart, the Dossia group's founding companies.
Users have the ability to aggregate medical data, claims information from insurance companies and also pharmacy records. Dossia records are stored in a private, encrypted electronic health record hosted in a modified open-source database called “Indivo” that can be accessed over the Internet using a secure connection.
MyHealthArchive Ultimate (modest subscription fee)
MyHealthArchive is a subscription based web portal PHR application. For $9.98 per month, subscribers get access to what the developers call a “revolutionary tool which gives patients the power to collect their own health information and then access it using a secured website, anytime, anywhere in the world.” The application facilitates managing health and wellness for the customer.
Features
The applications currently available have an impressive array of features and benefits already and we can only expect that over time the applications will improve in terms of usability and functionality.In terms of current features below is a partial listing:
· Comprehensive medical record aggregation
· User configurable presentation of the user interface
· Secure access
· Control over with whom data will be shared
· Accessibility over the Internet
· Guided wizards and or comprehensive user help information
· Print, email or fax all or parts of records
· Tools to help plan visits to physicians or other care providers
· Wellness information, preventative advice and health information libraries
· Personal health goal planning, calendars and progress tracking
· Interfaces with biometric tools such as glucose testers, heart rate monitors and other fitness products
· Tools for managing medication regimens
Interoperability
One of the most poignant and problematic issues in health care today is the interoperability of the myriad of diverse systems in use by all of the stakeholders in the heath care arena that optimally will share data. Because there is and likely will continue to be a broad array of health care applications for managing health record information, the data formats, document taxonomies, networking protocols and data interchange formats will continue to be complex and significant issues. The notion of “one source of truth” for a patient’s medical information and history is likely a distant if ever achievable goal. Much data will be shared undoubtedly. The risk of problems as a result of data being passed from one system to another is significant and much effort will continue to be expended to insure the accuracy of the data will be required for the foreseeable future.
Societal Benefits
In addition to the significant, obvious and exciting benefits to be gleaned at a personal level from the broad adoption and deployment of Personal Health Information (PHI) systems, there are also potentially spectacular things that can also be accomplished in the area of public health management if scrubbed (meaning concealing or protecting the privacy rights and concerns of the individuals) PHI data can be aggregated for study, analysis, data mining and other use by public health management professionals and medical researchers. The potential benefits and advances that can be made as a result of this type of a data source being made available cannot be underestimated – it will be game changing in terms of the strides that can be made in managing health concerns at a societal level.
Barriers to Broad Adpotion
While the potential benefits to individuals and to society as a whole are legion, there remain many barriers and obstacles to achieving broad adoption of PHR/PHI systems. Some of those include:
· Lack of time
o Collecting and managing the amount of data that will constitute the complete comprehensive health record for an individual or a family will be a formidable task. Time is the enemy in modern life. The demands on our time are already limiting in terms of what we can accomplish in our lives – one more – enormous task will overwhelm most. Likely, the majority of people will attempt to collect and manage only the information that they deem most important for the present level of concern about health issues.
· Fear of security and privacy issues
o Many people, with good reason, will be suspicions of any on-line, public network, aggregation of PHI information especially when the service is provided at no direct charge to the individual. This will cause many to not participate voluntarily.
· Complexity
o This may be partially a generational issue. Many people will not find the on-line applications user friendly, intuitive or understandable.
· Data input errors
o Problems with data and or functionality with the system(s) may lead some users to not use or to stop using the systems. Especially in the case where a data or system error leads to a significant personal problem.
· Terminology
o Medical terminology and medical descriptions can be incomprehensible or too challenging for some people. A user friendly, “lingua franca” may not be achievable. If people don’t find the information ineligible or meaningful their rate of adoption and perception of value will be much lower.
Risks
In addition to the visceral apprehension expressed by some, there are real risks in putting sensitive personal information into a data repository that is accessible from the public network. While all of the providers are cognizant of the risks, have engineered to minimize them and purport to have them in hand and well managed[i], it is well known that risk of human or machine error and or accidental or intentional disclosure cannot be completely eliminated. While HIPPA and other compliance rules may not apply to all of the potential players in this space, there are those potential participants, i.e. health care service providers that have legitimate potential liabilities that have to be assumed, managed or still eliminated. Then there are all of the usual systemic risks that come as a result of using electronic data automation. Besides unauthorized access and inappropriate disclosure, loss of data by error, system failure or break down, corruption of data, and logic errors are all potential risks and problems that come with any electronic data strategy.
Future
The promise and potential value of personal health record systems is great. The real value and the tremendous benefits are yet to be realized and but the enormous potential of a feature rich database application with this level of detail is truly exciting. There is much work to be done as of yet and the real keys to achieving a tipping point in terms of ubiquitous use and adoption is yet to be fully understood and articulated. As is the case with clinical setting electronic record systems, part of the barrier is the labor and time required to create the records. Just as this aspect of EMR and EHR systems needs to be improved it is also true of PHR /PHI systems. Ease of access and data input methodologies are improving continuously and have been enhanced and improved recently by advances made in the mobile computing arena.
[i] Google’s claims “[Google]… stores your information securely and privately, but you always control how it's used. We will never sell your data. You are in control. You choose what you want to share and what you want to keep private. View our privacy policy to learn more.”
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