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Posts from the ‘Personal Health Record’ Category

Smartphone as a Personal Genome Assistant

A few months ago, I wrote about a press release:

Using the Google Phone’s built-in bar code reader, Dr. Pellionisz demonstrated how personal genome computing can detect genome-friendly and genome-supportive products from foods to cosmetics to building materials and beyond.

You upload data from personal health record system such as Microsoft Healthvault or Google Health; genomic data from 23andMe or Navigenics to your smartphone and then by using the bar code reader, you can find products that are probably good for you based on your genomic and health profiles. Though the system has several limitations (e.g. how useful genomic data is right now regarding medical decisions), it sounds quite interesting.

Here is the process on video:

Personal Health Records: What Are They Good For?

Chilmark Research published a slideshow focusing on the definition and the problems of personal health records (PHRs).

Electronic health records raise doubt: Of course, they do

An excerpt from a recent article on Boston.com:

When Dave deBronkart, a tech-savvy kidney cancer survivor, tried to transfer his medical records from Beth Israel Deaconess Medical Center to Google Health, a new free service that lets patients keep all their health records in one place and easily share them with new doctors, he was stunned at what he found.

Google said his cancer had spread to either his brain or spine – a frightening diagnosis deBronkart had never gotten from his doctors – and listed an array of other conditions that he never had, as far as he knew, like chronic lung disease and aortic aneurysm. A warning announced his blood pressure medication required “immediate attention.”

Expecting Google Health to change healthcare is something like expecting Wikipedia to substitute all encyclopaedias in the world…

Doctors using Electronic Medical Record: Video

I do clinical rotation now before graduating in August so I can see how healthcare works at least in Hungary from inside. I see how much administrative work a doctor must do day by day. And even if the switch might be painful, we need to use electronic medical records.

Anyway I think e-patients will use personal health records sooner than doctors start using EMRs.

(Via WSJ Health)

MyFamilyHealth: Genetics and Personal Health Records

I’ve just come across MyFamilyHealth, an interesting genetic/PHR service:

MyFamilyHealth is a web-based service provided by Genseq Ltd., a privately-held personal genomics and health analytics company offering you the opportunity to learn about your genes and health. Through MyFamilyHealth services you can discover the disease risk and health conditions that run in your family. The company was founded in April 2007 by two successful entrepreneurs Jean-Yves Sireau and Jim Mellon.

myfamilyhealth

Patients:

  • create a family tree
  • record the family’s health history
  • review their health risks

Physicians:

  • their patients share family health history
  • identify and stratify risks based on the latest scientific guidelines
  • make more informed choices about diagnosis and treatment

But they are open to health organizations as well.

Medsphere: The Future of Healthcare is Open?

There is a real hype about electronic health records nowadays and Medsphere seems to be an interesting example. Dr. Edmund Billings, Chief Medical Officer for Medsphere and a pioneer in the development of electronic medical records, kindly answered my questions.

Please introduce briefly your service to us. What does Medsphere focus on?

Medsphere offers electronic health record (EHR) through OpenVista, a commercialized open source version of the U.S. Department of Veteran’s Affairs VistA solution.  Most hospital administrators and physicians say the high cost of purchasing traditional systems and equipment is a significant barrier that prevents hospitals from adopting EHR.  Medsphere has incorporated open source technology to revolutionize EHR, making it much more affordable and with less implementation time.  John Halamka, CIO at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston and a Computerworld columnist, recently profiled Medsphere favorably in his blog.

Why open-source?

Medsphere understands that EHR’s are essential to transforming healthcare, but we also appreciate the drawbacks – high cost, long implementation time.  The use of open source helps mitigate both of these main drawbacks – by allowing all groups involved to talk to one another, the old roadblocks are gone and integration is seamless.

There are plenty of EMR systems on the market (EPIC, Cerner, Meditech, Mckesson, Siemens, etc.). Why is Medsphere different or  unique?

The VA system was never designed with a software vendor business model in mind.  It was made to be usable and readily deployable,  much simpler in general.  Over 20 years, it has been deployed in 170 VA facilities and has been used by most residents during their VA rotations.  Its proven and now, its in open source.

Secondly, aside from the introduction of open source into the field of EHRs, Medsphere differs from others on the market in the way that it addresses payment. Rather than a prohibitive up-front cost, they use a subscription-based pricing model that allows for much easier entry into the market.  The subscription covers quality certification, support and all upgrades.

Finally because it is released in open source, it eliminates “vendor lock”  where the customer is locked to their vendor for anything and forever and “vendor fatigue” where everything you ask for costs the customer more.

Do you think patients are ready for this e-health based service?

Patients are not only ready for PHRs, they want them. They realize that there has to be a better way than the old paper and pen method.  They shake their heads when their records are not available or when they are asked over and over again the same questions about their medications, allergies.  We live in an incredibly plugged-in society that does not want to wait for the old paper and pen method to catch up. Even our presidential candidates are jumping on the bandwagon.  The key to broad adoption is that the health information should be a direct by-product of care entered by the patient and the practitioners during the process of care,  not a redundant or strictly patient driven.  Lastly, cellphones and mobile devices are a key form factor particularly in chronic disease e-health management.  Patients can be interacted with in real-time to assess their care and status.

What are your plans for the next months?

Our near-term plan is to further engage and support our customers and community in their open source projects.  We have recently released our source code under the AGPL open source license and are moving to open up more API’s.  We want to provide more opportunities for customers to meet their own needs and to support collaboration across the community.

Ahead of Google Health and HealthVault: PointOne

Google Health and Microsoft HealthVault seem to be the leading forces in the market of electronic health records. Now I would like to show you something that can shape the future of healthcare. Robert S. Pothier, the President and CEO of PointOne Systems, answered some of my questions about the RedBox system.

  • Please tell us what RedBox is about.

RedBox is the core technology of PointOne. It is a software that takes in patient information from a variety of sources, analyzes the information based on established medical best practices, research findings and our own algorithms, and then provides reports that can focus on overall health assessments, risks and next steps.

  • What do I need to do to use it?

Although RedBox has been in development since 1998 and PointOne has been marketing its capability since 2001, the tool has not been available at a consumer level until this year. PointOne is now working on interfaces that will allow consumers direct access. At the end of July PointOne will launch a website called ClearSense that will allow consumers to get reports directly and use their Personal Health Records as a source of information for the reports. The new website will be Beta tested with a select group for a short time and then available to the public for free initially.

  • Why do you think it is beneficial to have online health records?

Consumers need to be in control of their own healthcare and having immediate access to our own health records is key to that. If we expect individuals to manage their own health, they need the data to do so. It is ridiculous that I can’t see everything that’s been done to me, my wife or my children from a health perspective in one place. How can I monitor my blood pressure or cholesterol if I don’t have access to that data over time? The doctor has it in his records, along with my immunizations and other things. Why don’t I have it? We talk about it being “private” and “confidential” but right now it’s only “private” and “confidential” to the doctor. For me it’s just a hassle to get access to it.

  • Where does the health data come from that is used in RedBox?

Initially the data will come directly from the consumer (answers to a questionnaire) or from a PHR (likely not a lot of these at first). Eventually, however, we’d like to see RedBox access data from anywhere health data resides, whether it’s a fitness club, blood donation center or even home monitoring devices.

  • In some of the reports you published, there are action items that can improve my health (e.g. get an annual physical exam or schedule a hypertension evaluation). Are these suggestions made by physicians or this is an automatic feature of the software?

This is an automatic feature of the software. The reports we provide are not dispositive, meaning we don’t say “you have diabetes” or “you have breast cancer”. That’s for a doctor to decide. However, our reports are designed to be educational. In addition to learning something about yourself, it also lists what you should be doing to monitor your health or providing information about tests you should consider. For example, many women do not know that the BRCA1/2 tests are even available. If you had a family history of breast or cervical cancer on one of our reports, the action item would mention the test as something to consider. It’s pushing the right information to the right people.

  • What do you expect from the next months? How many users do you think will register?

We do not expect that this is a technology that will explode onto the scene. The use of this technology will be a gradual development as PHRs develop, as people become use to the idea that these reports are possible, as health data becomes more consolidated and cleaner. We use the following analogy to describe the process:

(True Story: http://www.niagarakite.com/history.html) – In 1847 in the United States Charles Ellet was trying to build a suspension bridge over the Niagara Falls gorge. The gorge was 800 feet across and 225 feet deep and the river was very swift. In order to get the suspension cables across the gorge they needed a way across that didn’t involve hiking down, taking the boat across and going back up the other side. So, Mr. Ellet sponsored a kite flying contest to get one thread across the gorge. In 1948 a 15 year old boy got his kite across and won the contest. Mr. Ellet used that single thread to tie ever-increasing gauges of string, rope, wire and ultimately the steel wire cables that supported the bridge.

PointOne has the same approach. We are trying to build the bridge of health data analytics being accessible to everyone. Initially, however, we realize we will need to cast some small threads across and pull ever increasing applications across before we will be able to accomplish our goal in full.

The future of healthcare IT is the analytics. Right now everyone’s focused on the collection, management, movement and protection of health data. That’s an IT exercise. The eventual holy grail of healthcare IT will be the analysis of that data to provide information to the ultimate consumer.

Check out more about it at PointOne.

Google Health: The First Steps

We’ve been all waiting for this for a long time now. Google Health is officially up and running. It aims to play the main role in the electronic/personal health record story. What is it about?

Google Health allows you to store and manage all of your health information in one central place. And it’s completely free. All you need to get started is a Google username and password.

Google believes that you own your medical records and should have easy access to them. The way we see it, it’s your information; why shouldn’t you control it?

  • Keep your doctors up-to-date
  • Stop filling out the same paperwork every time you see a new doctor
  • Avoid getting the same lab tests done over and over again because your doctor cannot get copies of your latest results
  • Don’t lose your medical records because of a move, change in jobs or health insurance

Let’s create your health profile and tell us your opinion!

Anyway, when I write an e-mail in Google Mail, I get some relevant ads on the sidebar. I hope I will never get pharma ads or spams from doctors based on my Google Health profile…

Further reading:

Personalized Genetics: Privacy and the Virtual Gene

Here is the regular post about the recent improvements of individualized medicine. This week, T. Ryan Gregory at Genomicron attempted to define the term genome. While The New York Times tried to redefine disease, genes and all.

What if a unauthorized person get access to the 23andme database? He will have a lot of information about many people. Ok, they can use strong encrypting algorithms but we know there is no 100% secure system. Maybe providing a anonymous service as Keyose this problem could be nearly totally prevented.

But this is not the only problem. Not at all!. What if I just take some of the spit of my new partner or my employee and send it to 23andme pretending to by my own spit? Then I could access to the genomic information of a third person without his/her permission. That sounds not really funny!

Google and Microsoft together on medical health records:

And if you’re fed up with these news about the personalized genetic companies, send a virtual gene to your friend in Facebook.

More here.

Medicine 2.0 Carnival: Health 2.0 Apps and Virtual Education

med320.jpgI’m afraid this is the last time I host Medicine 2.0 (#19) before the summer as all the dates are taken by great bloggers. So now I would like to share dozens of interesting and useful links with you about the realm of Medicine 2.0 (education, virtual environment, communication) and Health 2.0 (patient communities, web tools in health care, e.g.). I hope you’ll enjoy

Let’s start with a new review from Joshua Rosenthal, Ph.D. posted at Read Write Web about new Health 2.0 apps. He focused on:

  • Personal health records: Google Health and Healtvault:

healthvault.jpg

glucose-monitor.gif

  • Trends:

Right now everybody has your data but you. Your doctor, your employer and your insurance company have the information and the tools. But that data is lost every time you move, switch doctors, switch jobs or insurance companies. Ironically, the person who has the greatest chance of impacting your health behaviors (you), has virtually no access to information and tools to do so.

So let’s move on with the well-known sections:

Medical education:

Joshua Schwimmer at Efficient MD talked about Google Book Search and Medical Education.

At the Clinical Cases and Images blog, there are some learning tools dedicated to Electrocardiogram (ECG, EKG).

David Rothman shared a presentation about nursing education with us.

The Tomography Blog presented an Online Dictionary of Radiology Words.

Sandra Porter at Discovering Biology in a Digital World launched the the OpenOffice challenge.

On my favourite French medical blog, Internet (Web2.0) et ophtalmologie, there is an extended list about how Medworm can be used for an opthalmologist.

Deirdre Bonnycastle at Medical Education Blog posted a video about 3D medical education.

Commmunities and personal health records:

Rod Brouhard at About.com listed 7 ways to organize personal medical information.

Uri Ginzburg at Medical 2.0 presented Doccheck, a medical community with more than 500,000 users.

The Canadian Medicine blog has a new online book group called Literary Physicians.

Flags and Lollipops posted about the New JoVE blog & commenting on papers.

Jay Parkinson, the web 2.0 doctor, announced hello health at the Health 2.0 conference.

Medical Search and health 2.0:

Hamza Emadeen M. at GooMedic had an interesting question: Can We Play Surgery On XBOX Then Perform It In The OR ?

Scott Shreeve at Crossover health shared his views about the long tail of health care.

At HealthDot, you can wath 5 videos about Doctor 2.0 and Pateint 2.0.

At Digital Pathology Blog, check out the best sites about pathology.

Bob Coffield at Health Care Law Blog tends to use the apps of Google.

What should science blogging be? asks the BPR3 blog.

Deepak Singh at BBGM examined the future of semantic web.

Amy Tenderich at Diabetes Mine analyzed the patient aspect of health 2.0.

And my submission is Dangers of Web 2.0: In Medicine where I analyzed the dangers web 2.0 cause in medicine.

At last, but not least, let me present the Medicine 2.0 Congress that I plan to attend this September in Toronto, Canada. You can read more about the whole concept at the blog of Gunther Eysenbach.

med2-conference.jpg

If you plan to host an edition in the summer, contact me (berci.mesko at gmail.com). If you’d like to know more about the carnival, please visit the official page at medicine20.wordpress.com. If you write a medicine 2.0 related article, don’t forget to submit it here.

The next issue is due to be published on the 6th of April The Patient’s Doctor. See you next time!

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