Patient record – for the patient, the consultant, the hospital?

Does the patient want to manage the data?

Any time a patient enters a hospital – be that outpatient or inpatient – a detailed patient record is created and updated throughout the stay.  And in these days of GDPR (General Data Protection Regulation – to be effective 25 May 2018) there is now a great deal of focus on who owns the data.  Pretty clear, fundamentally, that a patient record records data pertinent to a patient and should, therefore, logically be owned by the patient.  But the patient does not have a way to record the data – and generally it falls on the hospital to do so – notwithstanding that some of the data may be recorded and stored separately by the consultant attending to the patient.

And GDPR brings many welcome improvements and protections for the patient with respect to the data, the patient’s access to the data and other people’s use of the data.

Microsoft and Google – false starts

In his book ‘The Digital Doctor’ Robert Wachter devotes one chapter to ‘Personal Health Records and Patient Portals’.  He recounts the efforts of two of the Technology giants in looking to break into healthcare: Google Health and Microsoft’s HealthVault.  And both seem to have given up the ghost.  Probably because when people went to use the platforms the value did not match the effort to accumulate and maintain the data.

And what I had not realised: most of the Health Information Exchanges formed during the Obama Healthcare drive have also failed: not as much effort and interest in aggregating and integrating the various health records as we had all expected.  Or perhaps it just proved too hard to do.

So Wachter believes that for now most of the patient health record will be focused with the Electronic Health Record (‘EHR’) providers (e.g. Epic, Cerner, Meditech, etc.).  nad the better EHR providers will, with their customers, provide good portals for the patients to access their data.

And this is not to say that the facebooks, googles, microsofts and amazons will not return once more to provide consumers with another, smarter solution.  But for now looks like the action will be controlled by the EHR vendors.

In some respects I think this is a reflection of the lack of standards and relatively late deployment of EHR (which is the equivalent of ERP in industry). We are now left with lots of data which is not easily integrated or aggregated – certainly not at consumer level. It will probably take a major shift: where consumers have electronic data available to providers and will only deal with providers who are able to process (and update) the patient data. There are some signs that this may be driven by the health insurers – as they look to dictate more and more to the providers. For now through looks like there are major opportunities in the next few years for the Epics, Cerners, Meditech etc – to build out very strong positions, probably to be taken out by the Apples, Googles, Facebooks and/or Amazons when they see fit.



UK – gathering momentum for electronic health records

Good to see that US push on electronic health records has not gone unnoticed elsewhere.

UK Health Secretary, Jeremy Hunt, seems to be push adoption of electronic records and alluding to the nonsense which is the current situation.  Will be interesting to see whether UK government seeks to push some real pounds sterling behind the initiative.

There have been a lot of scare stories about confidentiality of personal data – privacy of personal health records.  The key point is that the records belong to the patient.  Must be possible for patients to get better service by having up to date, comprehensive, electronic patient records which they can choose to share with any healthcare provider.

Some interesting debate taking place in the US now that we are in the ‘meaningful use’ phase of adoption – where providers need to demonstrate that the solutions are being used between providers and between providers and patients in a meaningful way.

We should not underestimate the potential complexity of moving this forward – and some of the likely blockers to change.  But this should be about improving quality of patient care and making it more efficient for everyone.  Should enable providers to provide an improved service.


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Patient doctor collaboration

Interesting post on project healthdesign: The Doctor’s Role in a Health 2.0 World.

Describing the patient as the ceo for his own body ie he takes responsibility, while the doctro is described as the consultant – advising the patient, seems like a good model, which reinforces the idea that the patient needs to manage his own lifesytyle, etc.

The other interesting obeservation relates to the general ‘information overload’ being experienced by all of us in all walks of life.  It is quite possible that a patient may know a great deal more about his specific condition than the doctor providing the advice.  However the doctor hopefully brings a broader picture and understanding.  Seems no reason why the patient and doctro should not collaborate in advaincing the situation.  Of course this does tend to turn the more traditional doctor/ patient model on its head.