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Consumer Challenge: Creating a Longitudinal Record

by John Moore | June 28, 2010

A very good eZine on all things mobile health, is mobihealthnews.  Brian and his partner Joe have done an excellent job of following many of the developing trends in this sector and occasionally, will have a guest author a column.  On Friday, one of  the co-founders of the iPhone app, iTriage, Peter Hudson, wrote a column on Personal Health Records (PHRs) and mHealth. (FYI, iTriage is arguably, one of the more successful consumer-facing healthcare iPhone apps – they are actually making a living at it, more than we can say for most iPhone app developers). The article caught our attention instantly with this lead-off paragraph:

Personal health records (PHRs) represent a great opportunity for healthcare consumers to take control of their healthcare data and help deliver many meaningful solutions for managing their health. The problem with the current landscape of solutions is that data is not flowing quickly from healthcare systems into central repositories. When this data is available, it is not being delivered to the healthcare consumer in a meaningful way: It’s not easy-to-use, mobile, easily shared, or present with them when they need it.

While Chilmark applauds iTriage and Peter for continuing to extend the functionality of their platform to now address consumers’ mobile access to their PHR, in this case Google Health (Note: iTriage is also working to have similar connectivity to HealthVault), Peter has not addressed the real issue here, how do we, as a society, create the systems necessary that will allow a consumer to easily aggregate their health data to create a truly longitudinal record that they can securely tap via their iTriage app, or some other mechanism, regardless of location, when needed.

And therein lies the rub – those systems do not exist. We are dealing with point-to-point access, point-to-point data retrieval, a complicated, convoluted process that frankly most consumers will not bother with.

Ever the optimist, Chilmark firmly believes there may be a solution tucked within the billions that will be spent to digitize the healthcare sector: The Health Information Exchange (HIE).

In the second of this two part post, Chilmark will look more closely at the HIE market, vendors therein and their efforts, or lack thereof to provide consumer engagement tools that may ultimately allow consumers to create a longitudinal record of their health or the health of a loved one.  Stay tuned.

8 responses to “Consumer Challenge: Creating a Longitudinal Record”

  1. Sean Nolan says:

    John, I am increasingly enthused about the potential for NHIN Direct to really change this dynamic. If we can get universal (or at least regional) email-style addressibility, we’ve removed a huge barrier to participation.

    Sure, lots of the data will start out unstructured — but once things start flowing at all, the market will fix that up quickly.

    I’m actually more optimistic now than I have been for some time … get ready for your @healthvault.com address!


  2. John-
    I must agree that I remain skeptical of the PHR concept. Sometimes I feel like I sound like a broken record, but having been close to implementation efforts for a multitude of healthcare data ‘systems’, they feel less like systems and more like applications. Different vendors sell different pieces. One vendor promises to link them altogether, but really cannot. Data quality issues lurk in the lack of ‘systemness’, and doctors constantly second-guess each other if they don’t like what they see on their end of a terminal. Data just don’t provide an entire picture, and why should the data that I as a patient happen to capture on my iPhone be trusted by my doctor? How can it be verified? Who is liable if it’s wrong?
    Before I believe in the concept of PHRs, I would like to see a truly functioning comprehensive EHR, complete with referring physician data, lab, radiology, pharmacy, progress notes, accurate patient demographics, vitals, allergies and updated insurance information, at the least. I would like to see one doctor share it with another, without going through legal hoops to transfer it electronically. I would like to walk into an ER across town and have my medical history available if I am unconscious. Maybe then I’ll start to believe that my iPhone will provide meaningful information for my physician.

  3. […] Article John Moore, Chilmark Research, 28 June 2010 SHARETHIS.addEntry({ title: "Consumer Challenge: Creating a Longitudinal Record", url: "http://articles.icmcc.org/2010/06/29/consumer-challenge-creating-a-longitudinal-record/" }); […]

  4. Marcia Noyes says:


    You bring up a very good question and one with which many people in the healthcare industry struggle. How do you create a health record system that allows consumers to easily aggregate their health data from multiple data points over their lifetime, and make that accessible on an app?

    One of the first steps will be to gain consumer trust that their health records will be secure. Second, we must help healthcare consumers understand who will ultimately have access to those records. I’m not sure that we can move forward with combining EHRs with PHRs to provide that information, unless we’ve taken those first two steps.

    What iTriage can do in the meantime is to frame the decision-making process for a consumer about his or her medical condition or disease, and then give the consumer useable information that can be accessed via a mobile device. We are a technology about action, and we think PHR data is most valuable if it is used in that frame of reference.

    Providing awareness of all the possible healthcare options, along with pricing information on iTriage, which will only become more robust over time, is critical to putting information into consumer hands so that they do take more control over their health. By doing so, we hope they will become engaged enough to track that information about their health in a personal health record.

    Marcia Noyes
    Director of Marketing/PR
    Healthagen, LLC

  5. Brian Phelps says:

    PHR is a treatment looking for a disease.

  6. Good points! Take a look at Nuvon, Inc. http://www.nuvon.com

    Their offering supports device connectivity both internal and external communications. Interesting!


  7. […] 30, 2010 by John In Monday’s post, Chilmark reflected upon a piece that Peter Hudson, co-founder of Healthagen, the developers of […]

  8. […] proven to … Read More RECOMMENDED BOOKS REVIEWS AND OPINIONS Consumer Challenge: Creating a Longitudinal Record « Chilmark Research  Brian and his partner Joe have done an excellent job of following many of the developing trends […]

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