Most people probably saw the story a few days ago in The Wall Street Journal, which was then picked up by nightly news and other outlets, about pharmacists using the Internet to improve hypertension control. Physicians and researchers, concerned about the high rate of uncontrolled hypertension among patients who are taking medication, decided to try a new method.
Kaiser Permanente Colorado tested a home-based monitoring system; they used blood pressure cuffs connected to computers (and the Internet) via USB to help patients monitor themselves at home. Pharmacists could then securely look at the patient's progress and recommend dosage changes to their doctors without requiring a patient visit in-clinic. The results were promising.
This isn't the first time the Web has been used to facilitate easier access to medical help. Despite futuristic visions of the potential for Web-enabled medicine, however, the current trends are toward the gathering of basic medical data, including a limited amount of Web-enabled information from medical monitoring.
Probably the earliest and most well-known online medical site is the popular WebMD. The information portal is the most-visited medical Website online. The Web has no shortage of natural and homeopathic medical sites, either.
Of course, the old-fashioned face-to-face visit with your doctor is probably never going to go away, but it can be augmented and personalized through more interaction via technology's enabling communication.
Google (Nasdaq: GOOG), for example, has online software called Google Health that allows users to organize their health information online for use with their doctors, healthcare facilities, and pharmacies. Google and has teamed with IBM Corp. (NYSE: IBM) to broaden the scope of Google Health with support for integrated applications and even monitoring devices. Google Health integrates with your Google login and is focused on privacy. But so far, the service is not widely used by members of the medical profession.
Microsoft Corp. (Nasdaq: MSFT) has software called HealthVault, an online data vault into which personal health data from various compatible devices can be stored. The software gives output that both the user and their physician can use to track progress and is more commonly used than Google Health, but still in its infancy as well. Common devices that can be plugged into (or wirelessly transmit to) HealthVault include blood pressure cuffs, scales, heart-rate and heartbeat duration monitors, and even blood-sugar monitors.
David Cerino, general manager of Microsoft's Health Solutions Group, says that his company is targeting a "fundamental gap" in the healthcare process. That gap is the "lack of information flow between the hospital, the patient and the patient's care team outside the hospital."
What we're seeing with Google Health and HealthVault is likely just the first generation of these Web-enabled medical tools. As doctors become more connected to their patients with home-monitoring systems like this, and as medical facilities more readily embrace electronic records, the tools will become more common.
Speaking to the Healthcare Information and Management Systems Society conference in early March, chairman Dr. Barry Chaiken articulated the need for electronic medical records and interaction: "We must create electronic systems so appealing that they make physicians want to leave their paper medical records behind," Dr. Chaiken said. "We must create clinical decision support systems that make it routine for physicians to check their internal knowledge with data and evidence. We must offer workflow solutions that improve the efficiency of using health IT. We must make physicians want, yes, demand, the enormous power that IT brings to the practice of medicine."
Chaiken wants to go to a "higher level of medical practice, one where both physicians and nurses can concentrate on examining, interacting, and motivating patients while technology handles the burdens of collecting, storing, and accessing data."
This vision of interconnected patients, doctors, nurses, and hospitals is currently mostly science fiction, but as technology (and our acceptance of it) improves, so will this vision as a reality.
— Craig Agranoff is an entrepreneur and national social media consultant as well as a published specialist in online reputation management and monitoring.
This earlier thread had died and made a pretty strong comeback... if you'd like to hear some of the reasons a lot of people aren't much in favor of the fast push to adopt and deeply EMR/EHR read through these comments... pretty insightful stuff.
That said, the whole Google health issue is also quite interesting- you may find this blawg post of value. If they truly are reassigning their design/support team, it may be the beginning of a death knell....
The whole concept of putting this type of information in the control of either M$oft or G00gle is not to my liking on a number of levels.
As far as reliability of the M$ offering, I draw your attention to these snips, from Items 11 and 19 of their terms of use (notice they DON'T call it 'service')
We may change the Service or delete features at any time and for any reason. We may cancel or suspend your Service at any time. Our cancellation or suspension may be without cause and/or without notice. Upon Service cancellation, your right to use the Service stops right away.
Customer support is not offered for the Service, unless the materials we publish in connection with a particular Service specify that it includes customer support.
If you create, transmit, or display health or other information while using Google Health, you may provide only information that you own or have the right to use. When you provide your information through Google Health, you give Google a license to use and distribute it in connection with Google Health and other Google services.
Google may place limits on, modify, suspend or terminate Google Health generally, and may suspend or terminate your use of Google Health if you fail to comply with this agreement. This suspension or termination may delete your information, files, and other previously available content.
These alone would keep me from signing in. Give up the right to use and distribute it? Seriously?? And neither of these parties feel they are considered "covered entities" and therefore they are not required to comply with HIPAA regulations on privacy, because you elected to allow your information to be put there yourself!!
Unfortunately, the ownership and privacy of personal medical data will probably hinder the development of any widespread EHR system. Tons of companies would love to datamine medical records, but patients should be justifiably concerned about which companies will be allowed to do so. (If Facebook's data sharing policies are a nightmare, just imagine the problems when the information is actually important and perhaps life-threatening...)
1) while Congress has mandated EHR, there are lots of versions out there
2) some are not compatible as layers of data may not synch up properly. Case in point (and surely unintentional) your comment is all one word. If electricians or plubmers had the same problems, we'd end up with pink and purple wires and a lot of duct tape.
Craig - Thanks for this. I'm all for improved communications on all levels. However, I was left (after the article and your post) to wonder "why is the pharmacist the connection to the physician?" I mean, don't you think the doctor should be on the "A" list.
I believe it's a windfall for everyone as Chris says -- but I doubt it will allow doctors to play another 9 holes. Those days seem long gone, sorry to say Chris. Most physician's I know barely have time, even with advances and time savers. Most are out on Sunday ;-)
Some of the most simplest technology could help doctors run a clinic more efficiently and thus see more patients. I was particularly impressed by an iPhone app called MedWaittime, that keeps you updated on whether your appointment is running late or on time. So instead of sitting in a waiting room for two hours, you can get on with your life and show up at the right time. This application only costs $50 a month for the clinic and has to be worth the cost in terms of resulting efficiencies. Simple technologies can make all the difference if only Healthcare providers would wake up. For more on this app, see this article http://tinyurl.com/22uxga8
As a network engineer, I am familiar with Cisco's Telepresence. I was fortunate to take the two week installation class. That's why a local health organization tapped me to help setup a semi-truck medical facility. It was comparable to what I consider a normal clinic. The only difference is that information from tests was sent to a central office via a sat link where it was analyzed. Then the doctor and patient would converse real-time using Telepresence.
It seems like a great way to get sophisticated tests to areas that are lacking doctors.
Craig, I think anytime a patient can avoid waiting for hours in their Physician's office or on line at their pharmacy, it is a windfall.
As these beta technologies move into 1st, 2nd and 3rd generation applications, more and more medical uses can be monitored. This is both a win for patients and doctors.
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Expert Integrated Systems: Changing the Experience & Economics of IT In this e-book, we take an in-depth look at these expert integrated systems -- what they are, how they work, and how they have the potential to help CIOs achieve dramatic savings while restoring IT's role as business innovator. READ THIS eBOOK
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