Healthcare Technology Alliance hta.groupsite.com

Nice article Jack. It will definitely be interesting to watch how these efforts by Google, Microsoft and other PHR vendors eventually help patients and consumers.

In addition to areas that you mention in your article, I believe that there is significant value to be achieved if healthcare organizations and care providers find efficient ways to share patient information using these tools. As you mention, there are some major hurdles to overcome before we see wider adoption including privacy concerns and global consent.

Aju:

I wonder if organizations that fall under HIPAA rules (or similar EU policies) will be closed out of the greatest benefits of the new networked health record. I've already seen some rumblings about legislators wanting to restrict PHRs even though it's the patient's own data. I completely agree that there are savings to be had -- and, I'll bet, lives to be saved and families to be made healthier -- with better information sharing.

With our old-school privacy restrictions, it's the ad hoc, person-to-person, consensual and mostly commercial applications that will be easiest to develop. My record at my health club; my girlfriend's STD specs; my grandma's activities of daily living -- all of the applications where no doctor is involved are free and clear. It's when a physician or a hospital or a lab touches the data that draconian privacy regimes kick in.

I'll put my money on free and open commercial and personal connections blossoming years before the restricted, legislated, regulated medical industry. It's just human nature and the power of markets.

--Jack

Jack,

I really like the scenario based style.  I guess what struck me about the overall article is all of the "enablers" mentioned exist in some form today.  Maybe google winds up making the health mash-up platform, but the water cooler argument we always seem to be getting into these days is why would any of us actually put the time and energy into any of this?  I saw an article a couple days ago that looked at the uptake of wellness programs at plans with rich alternative medicine benefits.  The expectation is people who are into alternative treatments would be more interested in overall wellness.  Turns out that isn't true.  People are enrolled in wellness because someone told them they have to enroll.  Is this the same? Will people only touch their PHR because someone tells them they have to do it?

I apologize for hijacking your thread, but I'm curious to hear thoughts on what will be the real drivers of PHR uptake?  One of my personal theories is older or at risk people will populate and keep up a PHR if they know that in an emergency the paramedics and ER docs would have that health info immediately.

David

David:

I just finished the Worst Case Scenarios: http://www.in3.org/articles/gh2018worst.htm

There are a lot of them and they're scary. PHRs are kind of boring by themselves, but there are a couple of smaller apps that may drive acceptance.

--Fitness

I'm always amazed by the amount of money, attention and gear dedicated to exercise, weight loss and fitness. People spend many millions on complementary medicine, vitamins, diet supplements. These are voluntary purchases of better health -- mostly outside of the regular medical context. I'm doing a talk at a wellness and health club conference on digital self-care, and the gizmoa are astounding. Not necessarily scientifically valid, but interesting.

--Hooking up

Young people don't got to doctors because they know they'll live forever. Except if they're getting STD tests or contraceptives in a new relationship. I wonder if the Facebook generation would be happy to have a public sex health status badge.

--Insurance, health savings

As third-party payer schemes disappear, Americans especially are going to have to become more educated consumers. In he Age of FedEx, Priceline and Amazon.com, healthcare is the only thing we buy that we don't know how much it costs or how good it is.

--Eldercare

Many Boomers have been relatively careful with their health, but now they're responsible for their parents' health, as well. Metrics for family care are combined with telemedicine and monitoring systems to manage the Greatest Generation's last years.

PMRs will have to be automatic or they're not worth the hassle. Soon enough there will be a one-time opt-in at the pharmacy, the health club, Starbucks, American Express and other e-commerce sites that will gather the data and post it to Google withou a second thought. Physicians will be the last to get it togetherm but the investments in technology and marketing money that can pay off don'thave that much to do with doctors, I think.

--Jack