intro: indivo x 2012 users' conference
DESCRIPTION
Introduction to the 2012 Indivo X Users' Conference, including a history of Indivo and Personal Health Records, a discussion of the reasons for Google Health's demise, and how Indivo's open architecture might provide a solution.By Kenneth Mandl, MD MPH, Faculty, Boston Children's Hospital Informatics Program.TRANSCRIPT
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Indivo X Users Meeting
2012Kenneth D. Mandl, MD, MPHBoston Children’s Hospital Informatics Program
(www.chip.org)Harvard Medical School Center for Biomedical Informatics
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The Personal Health Platform How it diffused Why Google Health died on the vine The cure for personal health platforms
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Portals: A static view into the EHR
PCHRs: Apps platform, and a patient copy of the data
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New England Journal of Medicine
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NEJM
Ecosystem
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SubscribeThe Verbs of PCHR
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New Approaches to Data Liquidity
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ShareThe Verbs of PCHR
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81.4%
34.1%
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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
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“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
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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
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The App Store for Health
ONC Funded Research Project under the “SHARP” program
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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
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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?
?
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We imagine EMRs as an iPhone-like platform where Medtastic
could create and widely distribute an app across many
disparate EMRs and PHRs
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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
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An
Inspired Design
from Dave McCandless
(cc license)
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1 Design + 1 Developer + 1 Week
1 Developerin1 Week
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1 SMART App in 3 SMART Systems
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SMARTBP Centiles AppRunning on Cerner
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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
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“Side Car Strategy”
The data need to come out for analyticsOnce they are out . . .
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i2b2
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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
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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
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www.indivohealth.orgwww.i2b2.org
www.smartplatforms.org