Monday, August 29, 2011

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 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.

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