The fundamental Flaw with the #EMR is it’s just Medical and with the #PHR is it’s just Personal

Ted Eytan has always been an Inspiration to me. His definition of Health 2.0 is still at the core of what drives HealthCa.mp today. I am privileged to know Ted personally and I always find his blogs to be a source of more inspiration. If you are interested in health care do yourself a favor and check out his blog.

I was reading Ted’s recent blog: 

This statement made me really think:

“I think it???s probably conventional wisdom that a person???s health is influenced by their individual actions as well as their environment and social milleu. Medical care, though, has not operated this way.”

That is my emphasis and not Ted’s.  

In recent months I have seen continued discussion about what to call the electronic records that are being deployed for use with our health. I have seen them described as:

  • Participatory Health Record – Roni Zeiger of Google
  • Portable Health Record
  • Electronic Medical Record
  • Personal Health Record
  • Medical Claim Record
  • Member Health Record
  • Electronic Care Record
  • Electronic Claim Record

I am sure you have come across other ways to describe these records. If you have come across an interesting description please let us all know by leaving a comment to this post.

The delivery of health data on mobile devices is once again opening up the question of what we call these records. 

I am increasingly referring to them as “Life Records.” I believe that we don’t know what information will be relevant to our health until after the fact. When you consider this almost any data could be relevant. For example, if you were to check in to an Emergency Room with bad stomach pains may be your check-ins from Foursquare, or the photos you had taken of food you ate might be relevant to diagnose a case of food poisoning. We are already seeing hints of this with innovative developments such as Asthmapolis which is linking GPS data with Asthma inhalers. 

This brings me to connecting Ted’s astute observation with the title of this blog post. 

We are not solitary beings. We are social animals. We interact with others. We influence and are influenced by others. We adopt and adapt behaviors based upon our environment and the people we interact with. If we are truly wanting to transform health care we need to recognize the social interaction and environmental factors that impact each and everyone of us. When we take the transformative step of recognizing this fact we realize how the EMR (Electronic Medical Record) AND the PHR (Personal Health Record) are BOTH missing the point.  The Personal 

If we want to promote health and wellness and a better quality of life then we need to inject the social dimension in to the heart of both the EMR and the PHR. I am not talking about placing a token social veneer on these applications. I am talking about embedding social at the heart of these applications. That doesn’t mean everything is suddenly public. We have learned, through the various iterations of Facebook privacy rules and the implementation of Google Plus and the Circles feature that we can enable social interaction while maintaining levels of privacy that we, or people we trust, can control.

We have to learn to use computers for what they are good at. Let’s capture all the data we want and use computers to filter and analyze. We have learned how to use computers and friends to capture, share and rate content. 

If we really want to transform health and enable a better quality of life we need to recognize the social and environmental dimension in the lives of each and everyone of us. Consequently the EMR and the PHR need to evolve to embrace this new world. 

An EMR that has just Medical information is blinkered as is a PHR that includes just our Personal Health information. We have to add the social and environment data to both.

Should Health Care Move to the Cloud – Absolutely (but carefully)! #EHR #HIT

There is a great article on Power Your Practice: “Should Health Care Move To The Cloud?

The answer should be Yes – But we need to do it carefully, making sure we retain control of our data and that it is housed securely in a robust and available environment.

If we want an effective Health Care System we need a system that is centered around the patient and not the hospital or physician, as it is today. When you focus on the patient you realize that they are not a static entity. Even when in Hospital they are often being moved around between different departments for different tests or procedures. Typically when a patient is receiving medical care they are not at home base. They are at a pharmacy, a doctor’s office or a hospital. The device they have to hand is their phone and not their laptop or desktop machine – if they even have a computer at home.

Just as Steve Jobs envisioned iCloud to connect devices and make our data available where we are – whether on the web, our phone, a tablet or a laptop or desktop. The data is synchronized via the cloud. When we commission a new device the data we want is available and seamlessly synchronized with the cloud.  

Google Health may be dead but the real power of the platform was not the user interface – the user interface basically sucked. 

No, the real power of Google Health was as a data conduit. Indeed I changed pharmacies because CVS offered me the ability to automatically receive my prescription information in Google Health. 

Yes, The fact that I could connect my Fitbit, my pharmacy, other health records and other wellness sites to Google Health was the real power of the platform. Now that role is basically left to Microsoft HealthVault unless one of the new breed of Personal Health Record platforms, such as NoMoreClipboard.com or one of the many listed at myPHR.com steps up but really HealthVault is the only game in town for connected health.. 

Recap from #Health2STAT plus #TheWalkingGalleryII and HealthCa.mp/SFBay #HCSFBay on 9.23.11

Yesterday I attended the Washington DC Health 2.0 STAT event, A lively event comprising a series of rapid fire 5 minute presentations.

I live blogged the sessions which also went out on Twitter under my @ekivemark handle.

You can follow future events on Meetup. DC Health 2.0 STAT Meetup. The sister event is Health Informatics Pulse (#HIPDC) and the next event in that series is on October 6th. I am scheduled to present at that event. Find out more here.

Here is a recap of my Live Blogs from last night at #Health2STAT.

#Health2STAT kicks off

1)    Use of Mobile, Social, and Open Government Technologies To Advance FDA???s New Regulation of Tobacco Products
Sanjay J. Koyani is a Senior Communications Advisor in the U.S. Food and Drug Administration???s (FDA) Center for Tobacco Products (CTP)

#Health2STAT speaker 2 – Research to Reality: A Virtual Community of Practice Michael Sanchez

2)    Research to Reality:  A Virtual Community of Practice

Michael Sanchez is a Public Health Advisor with the Division of Cancer Control and Population Sciences at NCI.

3)    Clinical Quality Linked Data on health.data.gov

George Thomas is an Enterprise Architect in the Office of the Chief Information Officer at the US Department of Health and Human Services.

Health2STAT – Customer Satisfaction index.

4)    What They Really Think and Say About Mobile

Drew Bennett is Senior Director, Product at ForeSee Results and is responsible for all product strategy and deployment.

#Health2STAT @Emspringer up to talk about warriors and promoting help seeking behavior

5)    Real Warriors Campaign: Affecting health-seeking behavior with a Mobile Site

Emily Springer is a Consultant at Booz Allen Hamilton currently supporting the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) as a social media strategist for the Real Warriors Campaign.

#Health2STAT @reginaholliday talking about “street art meets Health 2.0”

6)    Street Art Meets Health 2.0

Regina Holliday is a patient rights advocate and artist based in Washington, D.C. She is developing a series of paintings that depict the need for clarity and transparency in medical records. 

Regina is organizing #TheWalkingGalleryII as part of San Francisco Health Innovation Week. HealthCamp will be there. HealthCampSFBay
takes place on Friday September 23rd (tickets are available now!) at Kaiser Permanente’s Sidney R Garfield Innovation Center in San Leandro, CA. 

#Health2STAT @reginaholliday talking about "street art meets Health 2.0"

6)    Street Art Meets Health 2.0

Regina Holliday is a patient rights advocate and artist based in Washington, D.C. She is developing a series of paintings that depict the need for clarity and transparency in medical records. 

What can you do to get you message out: Write it on a wall.

Still love the Ted Eytan Definition of Health 2.0 – The inspiration behind HealthCamp.

Empowered patients are part of the checks and balances in an effective health system.

Come to HealthCampSFBay on 9.23.11 and get involved in the WAlking Gallery II and Health 2.0 (September 25-27th)

#Health2STAT @Emspringer up to talk about warriors and promoting help seeking behavior

5)    Real Warriors Campaign: Affecting health-seeking behavior with a Mobile Site

Emily Springer is a Consultant at Booz Allen Hamilton currently supporting the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) as a social media strategist for the Real Warriors Campaign.

What is the Real Warriors Campaign:

Social marketing campaign to encourage warriors and families to access psychological help

RealWarriors.net – The focal point of the campaign

Research told them to go with mobile. m.realwarriors.net

Make information more accessible.

Functionality:
– 24×7 access to live chat
– Video profiles of people who have sought help and continue to have successful careers.
– Articles on topics such as stress
– Shopping Cart to view download and articles videos etc.

Integration:

Branding
Imagery
Social Media links
Access to Full site

Integrated Strategy:
Mobile Site web page
blog post etc.

Since launch of campaign 21% of access to the main site came from mobile devices.

#Health2STAT – Customer Satisfaction index.

4)    What They Really Think and Say About Mobile

Drew Bennett is Senior Director, Product at ForeSee Results and is responsible for all product strategy and deployment.

Talking about measuring what customers think about mobile.

4 Mobile Themes:

1. Functionality
2. Mobile Is/Isn’t the Web
3.Technology Issues
4.Adulation

Functionality:

People have a very specific task to accomplish.

The emergence of the tablet has moved mobile to more of a browsing experience.

Mobile IS/Isn’t the Web:

– Some people want everything from the web site.

“The right content is king”

Technology Issues:
– People don’t expect technology problems.

Adulation:
– People are thrilled to participate via mobile. 
– They are willing to give feedback

How do you measure:
– Phone and Tablet are different

Context:
– Mobile is a critical growing channel