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E-Patient Update: Time To Share EMR Data With Apps

Posted on November 18, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Like most Americans, I’ve used many a health-related app, in categories including vitals tracking, weight control, sleep management, medication management and exercise tracking. While I’ve continued to use a few, I’ve dropped most after a few uses because they didn’t contribute anything to my life.

Now, those of you who are reading this might assume that I lost interest in the apps because they were poorly designed. I admit that this was true in some cases. But in others, I’ve ceased to use the apps because the data they collect and display hasn’t been terribly useful, as most of it lives in a vacuum. Sure, I might be able to create line graph of my heart rate or pulse ox level, but that’s mildly interesting at best. (I doubt physicians would find it terribly interesting either.)

That being said, I believe there is a way healthcare organizations can make the app experience more useful. I’d argue that hospitals and clinics, as well as other organizations caring for patients, need to connect with major app developers and synch their data with those platforms. If done right, the addition of outside data would enrich the patient experience dramatically, and hopefully, provide more targeted feedback that would help shape their health behaviors.

How it would work

How would this work? Here’s an example from my own life, as an e-patient who digitally manages a handful of chronic, sometimes-complex conditions.

I have tested a handful of medication management apps, whose interfaces were quite different but whose goals seem to be quite similar — the primary one being to track the date and time each medicine on my regimen was taken. In each case, I could access my med compliance history rather easily, but had no information on what results my level of compliance might have accomplished.

However, if I could have overlaid those compliance results with changes in my med regimen, changes in my vital signs and changes in my lab values, I have a better picture of how all of my health efforts fit together. Such a picture would be far more likely to prompt changes in my health behavior than uncontextualized data points based on my self-report alone.

I should mention that I know of at least one medication management app developer (the inspiration for this essay) which hopes to accomplish just this result already, and is hard at work enriching its platform to make such integration possible. In other words, developers may not need much convincing to come on board.

The benefits of added data

“Yes,” I hear you saying, “but why should I share my proprietary data?” The answer is fairly simple; in the world of value-based reimbursement, you need patients to get and stay well, and helping them better manage their health fits this goal.

Admittedly, achieving this level of synchronization between apps and provider data won’t be simple. However, my guess is that it would be easier for app developers to import, say, pharmacy or EMR data than the other way around. After all, app platforms aren’t at the center of nearly as many overlapping data systems as a health organization or even a clinic. While they might not be starting from zero, they have less bridges to build.

And once providers have synchronized key data with app developers, they might be able to forge long-term partnerships in which each side learned from the exchange. After all, I’d submit that few app developers would turn up the chance to make their data more valuable — at least if they have bigger goals than displaying a few dots on a smartphone screen.

I realize that for many providers, doing this might be a tall order, as they can’t lose their focus on cultivating their own data. But as a patient, I’d welcome working with any provider that wanted to give this a try. I think it would be a real win-win.

Android’s Advantage Over iPhone in Mobile Health Applications

Posted on February 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The reports are all over the web comparing the Android market share to iPhone’s market share (see one example here). These numbers are important for anyone in the mobile health space that’s considering their strategy for developing a mobile health application. The same goes for EHR vendors that are working on their mobile EHR strategy.

The reality as I see the mobile phone market share numbers is that Android is taking the lead when it comes to market share. No doubt, iPhone still has an incredibly compelling offering and many loyal fans. This is particularly true in healthcare where a doctor having an iPhone is in many ways a bit of a cool “status” symbol for the doctor. However, in the long term I think that even healthcare will see a similar market share shift to the Android over the iPhone as well.

Why am I so bullish on the Android in healthcare despite healthcare’s current love affair with the iPhone?

The core reason that I think the Android phones (and much of this could apply to tablets as well) will do very well as mobile health applications is because of how much customization is possible with Android devices. In fact, pretty much anything is possible on an Android phone because of the open source nature of the software. I expect many mobile health applications will need and want to exploit the flexibility and openness of Android over the iPhone.

One concern I do have about this idea is that Android does pose its own challenges for developers. In the case of the iPhone, you basically only have to code your application to work across a small handful of iOS versions and handsets. In fact, Apple has smartly made sure that many things remained the same across every iPhone. This makes developers lives much easier. In the case of Android, you have hundreds of possible handset combinations you have to consider when developing your application. This can be really hard to test and can often lead to a bad user experience for some Android devices.

In some ways, the current Android environment reminds me of the challenges we use to face (and still do today in some ways) in creating a webpage that worked across all the various web browsers. A lot of effort went into making sure your website worked everywhere. However, over time the standards have developed and this is much less of an issue today than it was when the internet first started. I believe the same will be true for Android.

The reality is that Android and iPhones are both here to stay for the foreseeable future. Most mobile health applications are going to have to be able to support both platforms. Some might say that we should just be glad that it’s only two platforms we have to worry about. We had a lot more than two to think about back during the internet browser wars.

We Know What’s Right, but It’s Hard

Posted on August 24, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In perusing various blogs, I came across Matthew Gibson, MD’s blog and this really compelling article titled, “It’s So Easy, and Yet…” Here’s one especially poignant section:

What I see day in and day out is complications of simple, easy to manage problems like diabetes, high blood pressure, asthma, etc. These are things that we KNOW how to treat. We know how to prevent complications. And yet, I just had a man last week who required half of his foot to be amputated as a complication of untreated diabetes. I had a woman this week who came in seeing snakes on people’s clothing, because her blood pressure was so high it was affecting her mind. Last month, I saw a man who had large amounts of yeast growing in his mouth and groin because his blood sugar (and thus urinary sugar) was so high.

This morning, I’m caring for a truly pleasant gentleman with COPD (bad chronic lung disease usually caused by smoking). He hasn’t smoked in the last 15 years, but he smoked quite heavily before that. Even though he’s been doing things all right as far as his lungs are concerned for the last 15 years, he has to live with the consequences of his actions prior to that. For the last several days, I’ve seen him decompensate and gasp for air, feeling like he’s drowning, because he can’t get the air to move through his lungs like he should. How did this kind old man get to this point?

At the core of his comments is the idea of how do we motivate ourselves to do something we know we should be doing. This is a really hard question to answer and something we probably will never solve completely. However, I think there’s plenty of room to improve even if we never become perfect at it.

Over on Smart Phone Healthcare we’ve spent a lot of time reviewing various mobile health applications. I’d say that the large majority of mHealth applications are about trying to help solve this problem. Plus, I think the mobile device connected with good data about ourselves is one method that will help us be healthier.

Related to this idea, is what I’ve called treating healthy patients. This is a concept that won’t leave me since I think it will be a fundamental part of the future of healthcare. I believe we’re on the brink of a series of devices and technology that will help us monitor our bodies in such a way that we can identify sickness within us before we feel sick. This information won’t make everyone change their behaviors, but it will help many.

We’re in the very early stages of monitoring our bodies and connecting all that data with action. However, it’s exciting to see that now many of these things are possible thanks to powerful computing and a new generation of devices.