Download - Intro: Indivo X 2012 Users' Conference
Indivo X Users Meeting
2012Kenneth D. Mandl, MD, MPHBoston Children’s Hospital Informatics Program
(www.chip.org)Harvard Medical School Center for Biomedical Informatics
The Personal Health Platform How it diffused Why Google Health died on the vine The cure for personal health platforms
Portals: A static view into the EHR
PCHRs: Apps platform, and a patient copy of the data
New England Journal of Medicine
NEJM
Ecosystem
SubscribeThe Verbs of PCHR
New Approaches to Data Liquidity
ShareThe Verbs of PCHR
81.4%
34.1%
VA Survey
79% of Veterans are willing to share personal health information with those outside their health system 62% with a spouse or partner 23% with a child 15% with another family member 25% with a non-VA health care provider
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Add an AppThe Verbs of PCHR
“We cannot overstate how important PHRs are to the efficient functioning of a low-cost, high quality health-care system . . . . We think that the INDIVO system, or something like it is a good place to start.”
--Clayton Christensen Harvard Business School
Keeping EHRs Error-Free: the Value of Patient Engagement
http://commonhealth.wbur.org/2011/07/killed-google-health
• Trust issues
• No app developers
• No data
The App Store for Health
ONC Funded Research Project under the “SHARP” program
Clinical use case
Med-tastic is a well-funded NewCo which has developed an elegant medication list application that has physician and consumer facing functionality. Patients can annotate medication lists for accuracy.
To work, Med-tastic needs Prescribing history Dispensed medication history Allergies Problem list diagnoses
Healthcare IT: Why Can’t
Innovators widely share what they create?
Systems innovate faster to support fundamental health care improvement and cost reform?
Providers readily request features and applications?
?
We imagine EMRs as an iPhone-like platform where Medtastic
could create and widely distribute an app across many
disparate EMRs and PHRs
EHR as an “iPhone-like” Platform
There is a common application programming interface that enables Software developers to build SUSTITUTABLE
applications Push innovation to the edges Nimbly evolve functionality Avoid vendor lock Shrink switching costs Enable disruption
An
Inspired Design
from Dave McCandless
(cc license)
1 Design + 1 Developer + 1 Week
1 Developerin1 Week
1 SMART App in 3 SMART Systems
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SMARTBP Centiles AppRunning on Cerner
Medication adherence
JAMIA 2011
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Brief Tangent
I2b2 NIH Funded Pulled into use at 61 Academic Medical Centers ETL Involved in QueryHealth
“Side Car Strategy”
The data need to come out for analyticsOnce they are out . . .
i2b2
Portal-PCHR Hybrid
SMART Platform Apps Have access to EHR data in a vendor agnostic
fashion (from an Epic system, a Cerner system, or an complementary system with data warehoused from the EHR)
So, one can readily create a patient facing portal, which is an apps platform
Portal-PCHR Hybrid
SMART APPSEHREHR
SMART APPSIndiv
oIndiv
oConnector AppConnector App
Clinician-
Facing Apps
Clinician-
Facing Apps
Patient-
Facing Apps
Patient-
Facing Apps
The best of both worlds: •A local portal, with lots of data from the EHR•A personal health platform with patient control, sharing, and apps
www.indivohealth.orgwww.i2b2.org
www.smartplatforms.org