Thursday, November 19, 2009

Health gets personal in the cloud

Cross-posted from O'Reilly Radar

Healthcare is one of the biggest industries in the world. The United States spends over 17% of its GDP on healthcare and the issue of the industry's future is being hotly debated in Congress. Whatever happens to other elements of health reform, health information technology will play a key role in moving us towards the goal of bending the cost curve and improving quality and clinical outcomes. A Personal Health Record (PHR) is one way that patients can have some control of their own health data, while providing an interoperable platform for sharing relevant clinical data between providers. Healthcare is changing rapidly and there are some important trends worth watching.

Healthcare in the near future will be quite different than it is today. Web enabled technology is already changing the way medicine is practiced. As the digital nation comes of age we will see new opportunities, and new challenges, bringing healthcare in America into the 21st century. Health consumers will come to expect they will have control over their own health data. Having secure, interoperable access to clinical data will allow patients to partner with their care providers in new ways incorporating Web 2.0 principles.

For example, Google announced at the Health 2.0 conference that they have entered into a partnership to provide telehealth services through their Google Health platform using MDLiveCare. With the integration of MDLiveCare technology, Google can provide a service that offers patients access to doctors from remote locations, via webcam or telephone, into its personal health record offering. This will be particularly valuable for those who are caring for their loved ones from far away. My family is scattered around the country and caring for our mother with advanced stage Alzheimer's was quite a challenge that would have benefited from this type of service.
Here is a screenshot of Google Health:

"Patients remember less than 25% of what they're told when they consult with a doctor,” said Bob Smoley, CEO, MDLiveCare, in the statement. "By directly synchronizing the information that's shared…we're able to provide patients with a convenient solution to review their physician or therapist encounters."

"We strongly believe that the patient has the right to control their own health data," said Product Manager of Google Health Roni Zeiger, MD a practicing Internist who also works in urgent care. "You can now request an online consultation with a physician. At the end of the visit the doctor documents the encounter and it is immediately sent to your Google Health account and you will have a complete record of the doctor's notes."

Also, Microsoft has introduced My Health Info as part of HealthVault. My Health Info is an interactive and customizable dashboard that allows people to view all their health information: Blood pressure, blood glucose, BMI, immunizations, allergies, lab results, medications, steps walked, health articles and more, in a single, organized, and convenient location. It connects with HealthVault so information updated in one product is automatically updated in the other. This service offers tools and widgets to upload, organize and monitor health information stored in their personal HealthVault accounts. The service also allows people to research medical concerns, read the latest health news, gain guidance from medical experts, learn about nutrition, and monitor conditions such as high blood pressure or diabetes.

This is the main screen for My Health Info:
"As consumers are increasingly being asked to manage more of their health and wellness, they are looking for solutions that help them navigate an overwhelming amount of information, enabling them to take control of their personal health data," said David Cerino, General Manager of Consumer Health in Microsoft Health Solutions Group. Marguerite Yeo, Director of Product Marketing for Microsoft HealthVault told me about Online Care deployed by Hawaii Medical Service Association (HMSA) an independent licensee of the Blue Cross and Blue Shield Association. Online Care, enhanced by Microsoft Healthvault, allows patients to see physicians immediately, through live consultations via Web or phone. By providing access to doctors anytime in the patient‘s home, health plans like HMSA have the opportunity to shift healthcare to less expensive care settings when appropriate.

Another company that is doing some interesting work in this area is Practice Fusion. Practice Fusion is a free, Web-based electronic health record service for physicians. They recently announced the launch of Patient Fusion, their new PHR, at Dreamforce 2009 in San Francisco,'s user and developer conference.

"The healthcare and life sciences community is a rapidly growing sector," said Clarence So, Senior Vice President of Strategy, "The platform allows companies like Practice Fusion to quickly innovate around a common objective for improving health." Through Patient Fusion, doctors grant patients instant access to their medical records, medications and immunization history. Updates to the patient's records are available in real-time in the cloud. Patients will also be able to schedule appointments, request prescription refills, email their physicians, and, most importantly, share their data with other providers at any time.

Here is a shot of the main Health Manager screen:
Thumbnail image for myhealth_screenGrab.png

They also announced ChartShare, a feature which allows users to have real-time access to patient records in a familiar and interactive format. All authorized users can access records simultaneously. This enables care providers to share clinical data and allows real time collaboration and consultation.

"Practice Fusion continues to innovate in the healthcare market by offering a free Web-based PHR that is an extension of the practitioners' EHR. We're unlocking the physician EHR to give patients access and control over their own health data," said Ryan Howard, the CEO of Practice Fusion. He also told me, "The January release of Patient Fusion will allow the same ability that physicians now have using ChartShare for portability of data on the patient side."

Whether it is by using a platform like Microsoft HealthVault or Google Health, or a SaaS model EMR/PHR like Practice Fusion, the options for patients and providers to coordinate care using Web 2.0 technology is making great strides. We will increasingly see platforms that provide virtual visits with care providers, and greater use of the web for tasks like making appointments, medication and therapy reminders, and making payments. I look forward to the day when I can login for a consultation with my doctor as easily as I Skype with my friends around the world. The future of healthcare is here, and it is beginning to be distributed.
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