I found an interesting article on Fast Company talking about the Facebook for Patients. Of course, I’m a sucker for anything that says Facebook and patients, so I had to check it out.

Turns out the article talks about a new Medical Social Network from IBM. Officially it’s being called the IBM Patient Empowerment System. From the description, it’s an interesting mix of PHR functions where you record your health information, patient to patient interaction like PatientsLikeMe, patient to doctor interaction, and even FDA alerts and drug checking.

Of course, I wanted to try this IBM patient empowerment system out myself, but the article didn’t have a link to it. So, I headed to Google and found no website, but the first result was this video about the IBM PHR along with some press releases:

Pretty hard to judge a system if you can’t use it. Plus, it’s hard to interact with other patients if patients can’t find the portal.

I suspect that the reason I can’t find the portal is that it seems like they’re doing a beta test of the website with Gacheon University Gil Hospital in Korea. It doesn’t seem like they’ve opened up the system to everyone yet. It will be interesting to see if they continue to do a partner based approach for rolling out the IBM PHR or if they choose to open it up to anyone and everyone that wants to join.

I’d say the most controversial part of what they’re doing is probably the FDA alerts and drug checking. This tweet by Neil Versel, blogger at Meaningful Health IT news, describes why these types of alerts and information is going to require a change:

Attitude adjustment needed, stat! RT @amednews: Only 8% of doctors say online research done by patients is helpful http://bit.ly/g5Yrzq

March 12, 2011 8:15 am via ÜberSocialReplyRetweetFavorite

@nversel

Neil Versel

The challenge to doctors is whether IBM does it or someone else, the empowered patient is already happening. IBM’s Facebook for Patients is just one piece in the puzzle.

Tonight, I checked out the always-interesting #HITsm TweetChat, which attracted a nice group of informed HIT experts. (It takes place from 8PM to 9PM Central Time on Mondays — I highly recommend you attend sometime.)

While the conversation wandered, as professional chats always do, one theme that came up a few times was the importance of PHRs in the overall healthcare data picture. I watched with interest, since I’m a real PHR skeptic and wondered if anyone had a  breakthrough idea on the subject.

One poster — if I understood him correctly — noted that while he didn’t trust Google or Microsoft PHRs, he’d manage his own health data gladly if it was stored on a very secure, easy-to-populate tool like financial site Mint.com.  I thought this was a tremendously good idea.

For those who haven’t used it, Mint.com allows consumers to suck data from bank and credit card accounts, loans and more into a single interface, making it easy to check on and edit the data with a few clicks.  Not only that, it allows you to create analytical charts, monitor for problems and set goals.  Just imagine how useful those functions could be for personal health maintenance.

Having used Mint.com happily for my personal finances, I yearn for the day when health data is equally accessible and manageable.  It’s easy to imagine — though admittedly, a tall order technically — interesting consumers in building out PHRs if they had access to a simple interface and secure connections to all needed data.

Unfortunately, I don’t know of any PHR that’s quite this sophisticated. Is it time for Intuit (Mint’s owner) to go into the PHR business?

I recently was contacted by a guy named Matt from Poland who had built a simple web application that tracked Blood Pressure called Blood Pressure Chart. If you want to really see what he’s created in action, you can see his own Blood Pressure records, chart and statistics.

I really like the simple implementation of such a niche item such as Blood Pressure. It seems like niche applications for things like Blood Pressure or even blood sugar levels for diabetes could be very useful. I think that many people are just overwhelmed by the idea of using a full PHR software system, but they would be likely to use a simple application like this to track a specific health problem they’re trying to track.

Some work and thought still needs to go into how the doctor and patient will access and document a website like this, but it’s interesting to see the application of technology into such a tight niche problem area. Maybe the focus of an all encompassing PHR product is the wrong direction and instead the focus should be tighter niche products that don’t overwhelm the patient.

I was really interested to read John Moore’s post about the irrelevancy of Google Health leading to its demise. It’s a great post that’s worth a read for anyone interested in the PHR space and in particular Google’s participation in healthcare. I’m a little reticent to bet against Google, but the lack of commitment on Google’s part to healthcare says something. I mean, Google has quite a bit going on with cell phones (Android), web browsers (Chrome), and operating systems (Chrome) just to name a few. You can see why Google Health isn’t high on their priority list. Oh yes, and of course they still have to maintain their dominance in search and all the other products they have (gmail, google docs, calendar, etc etc etc).

With that said, some of the most interesting things were found in the comments of Chilmark’s post. Here’s a couple excerpts:

My college health class used car upkeep as a metaphor for how we take care of our health. With my car, I know I should pay more attention to everything: it’d probably run better if I looked at it more, kept up with the latest from my manufacturer (hey, actually read my owner’s manual).
But honestly? I’m just as happy to pay a mechanic to keep track of what I need, when I need it. The money I pay is as much to escape the tedium of keeping up with all that knowledge as it is for the service itself. I’m willing to bet a lot of people feel that way about health: they probably believe they should be involved, but when push comes to shove they’d rather just pay someone else to worry about it.

This rings far too true. We care, but not enough to really care (at least until we really need to care).

I belive what we are seing here is the end of the B2C direction for PHR. John Moore was the 1st to say that PHR is for B2B model. Google designed it’s solution for B2C (login to data through Google). this was wrong. if you see real addade value apps in the market they are offred as B2B under Microsoft HealthVault.

PHR = B2B Very important lesson learned.

Guest Blogger: Richard has over 15 years of experience as product manager and public policy analyst. He is currently researching the use of technology to improve health care access. You find more of Richard’s writing on his blog.

No doubt, electronic medical record (EMR) buyers would love to wave their hands and clear the fog that envelops the EMR software purchase process.  Buyers’ uncertainty and distrust combine to create angst and skepticism that their purchase will be the correct one.

One tool to navigate this process: Like a doctor taking a medical and family history, the history and heritage of an EMR vendor can tell you much about the direction and competency of offerings.

Vendors for large customers (hospitals over 250 beds and physician groups over 100) have a historical software competency much like a DNA thread of a virus, with many of the distinct markers carried down to descendents. In the case of software, it is the concept of how the software is built that is carried through each revision and new product.

Prior to EMRs, software was created to register and bill patients and to reconcile financial transactions and records. That is their core competency and strength. To leap to EMR is a complete anathema to the financial paradigm. While orderly in the financial side, the EMR side is counterintuitive to them and their software shows that monolithic belief that once a design has been settled, little else can be done to customize it for future use.

Like their larger brethren, smaller EMR vendors who specialize in the primary care medical market have difficulty in accommodating subspecialties.  That’s because primary care tends to be more uniform in their approach than subspecialists who are much more fragmented than primary care. That fragmentation creates numerous requests for special features that may not be economically feasible for a small EMR vendor.

In summary, the heritage of an EMR vendor won’t ensure that you will be satisfied with your purchase. It will, however, make you aware of the bias and alert to how that may translate to functionality and support.  Vendors can change, but it’s difficult to break that “DNA lineage” unless there is an abrupt break from the past. The next time a sales representative hails you for a sales presentation, look a bit closer at the history and values of the vendor. It might just save you money.

Anyone that works in Healthcare IT knows who John Halamka is and so of course I was interested in his post of his top 10 impressions after HIMSS. It’s an interesting list and I think he does a pretty good job of looking at things from a very high level. Here they are as posted on his blog:

1. Meaningful Use is everywhere. Vendors are promising EHRs, modules, appliances, and services to help clinicians achieve it. I had dinner on Monday night in a small Indian vegetarian restaurant. Sitting next to me were 3 engineers from Bangalore who were arguing about the details of Meaningful Use in between bites of vegetable curry. I could not escape Meaningful Use anywhere!

2. Certification is everywhere. It’s particularly ironic that many vendors claimed their systems were certified, even though the certification NPRM was just released today, making compliance with the new certification process in time for HIMSS impossible.

3. Cloud computing, Software as a Service and ASP models are popular tactics to accelerate EHR rollouts. There are still lingering concerns about how to ensure privacy in a cloud environment.

4. Several firms such as Intersystems, Axolotol, and Medicity are offering HIE platforms that include many of the standards noted in the IFR. The marketplace for HIE products is just emerging and it’s hard to predict who will become the market leader.

5. The Continuity of Care Document is gaining traction. I found many vendors supporting CCD exports from their EHRs. A company called M*Modal , has developed natural language processing technology that captures dictated content in its original context (ontology-driven
rules) as a CDA document.

6. Consultants abound. It’s clear that Regional Extension Centers and Health Information Exchanges will require expertise and staffing from professional firms. They all had large booths at HIMSS.

7. 30,000 people attended, including 10,000 I did not recognize (just kidding). It’s clear to me that many IT professionals, even those with limited healthcare domain expertise, attended HIMSS to better understand how they could participate in the euphoria of HITECH stimulus dollars.

8. Self service kiosks for patient identification and self-registration are now mainstream. Just as we print our airline boarding passes, we can now use credit cards or biometrics to check into ambulatory care appointments and automatically settle all co-pay balances.

9. Image exchange in the cloud is being offered by several vendors. As I mentioned in Monday’s blog, Symantec announced an appliance for small clinician offices that cloud enables all imaging modalities using a facebook-like social networking invitation to share/view images.

10. PHRs and patient engagement are becoming more mainstream. Google and Microsoft continue to innovate in the non-tethered PHR marketplace.

Here’s the story from the American Medical News:

The Mayo Clinic announced the launch of a new personal health record system that will be available to anyone, including those who are not Mayo patients. Those involved with the project say the system, powered by Microsoft HealthVault, could also carry benefits for non-Mayo physicians.

Is it just me, or is my headline (which is theirs also) really misleading? When I saw the headline I was really interested to see the type of PHR that Mayo Clinic had created. Instead, all they’re doing is adopting Microsoft HealthVault. That’s a big win for Microsoft HealthVault, but that’s been publicly available for a while. I’m not sure why Mayo Clinic joining HealthVault makes it any more available to those outside of Mayo.

The more interesting part of the article is when they talk about Mayo Clinic moving forward despite Beth Israel Deaconess Medical Center in Boston stopping claims data from being sent to Google Health:

The launch of Mayo’s system came days after Beth Israel Deaconess Medical Center in Boston announced it would stop sending claims data to patients’ Google Health accounts due to the possibility that the data contain errors. The move reignited the debate over whether PHRs can contain too much data that is not useful to physicians, or dangerous for them to rely on.

Mayo’s system will allow the import of claims data through Health Vault, but Mayo’s physicians will likely not use it, the organization said. Other patients and their physicians can choose whether the information is relevant enough to be kept.

I’d still like to see better support for PHR in various EMR and EHR products. However, until there’s a good standard I don’t expect that to happen anytime soon.