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Events

Articles

Apr 07: Electronic Medical Record – An illusion?

rural providers

We live in the world of Big Data. Everything we do, is recorded. Even when we think we are not connected to the internet. Companies spend millions trying to gauge whether you are more likely to buy a Birkin or a Coach. The age of big data is here, albeit about 15 years later than promised. And Facebook, Twitter and Instagram know more about your likes and dislikes than your husband does.

In such a world where technology has defeated personal privacy, one would wonder, or perhaps somewhere secretly hope, that there is a black box somewhere collecting everything there is to know about your health. A Utopian world where should you fall sick, and need assistance, there is enough that everyone knows about you so that no matter where you are, who you are with,  you can get treated. So that if you were, God forbid, ever in a serious accident, lost your consciousness, the paramedics would just need to put in your name in a secure cloud, discover your history of sickle celled anemia, and prescribe treatment accounting for that information. No time lost. Smooth, synchronous, accurate, organized, actionable information.

Yet, no such master repository of information exists anywhere in the world.

One is forced to wonder – why is that the case? What are the specifics of the global healthcare industry that have not allowed us to capture everyone’s blood groups and chronic illnesses, yet have allowed us to capture through the likes of Facebook the television shows we like watching? I have heard several arguments in my career, none of which I find convincing.

One argument is – it would be expensive to build a system that captures information about everyone. That couldn’t be more far removed from the truth. The US Government just enacted a trillion-dollar legislation mandating universal health care coverage, and spends 18% of its GDP on healthcare. Most technologists estimate that startups like Facebook would cost a million dollars to build (http://thenextweb.com/dd/2013/12/02/much-cost-build-worlds-hottest-startups/). A trillion-dollar budget could build a million Facebooks. A million Facebooks. We can reject this argument outright.

The second argument is – who would maintain it? Again, it would cost too much. Well, every time you’d visit your doctor’s office, they’d simply add whatever diagnosis and prescription they provided to your record. They already spend a couple of minutes doing that for you manually. Surely, doing it electronically doesn’t take away from their ability to treat other patients by requiring more of their time (unless you build a really poor version of Facebook. Sort of like healthcare.gov).

The third argument is – its not the building, or the maintaining that’s troubling. Its too much information about us being on the web. I get that there are privacy concerns around an individual’s health history. But there are also privacy concerns around having Google know that I last bought a dress on Rue La La, and that they ought to advertise other dresses, bags or shoes to me the next time I open my Gmail account.  Heck, they’d probably already know if I were pregnant, had a smoking addiction, or suffered from amnesia based on the topics I was searching for using a uniquely identifiable IP address associated with my computer. Google knows about my health history, because I use Google to search for things concerning my health. Even if one were to assume there were legitimate privacy concerns, I think complying with HIPAA should address those sufficiently.

The fourth argument is – no one is thinking about it. You should start it. I might. But in the meanwhile, the organizations building dedicated electronic medical records for providers and payers could just as easily build a system for profit that becomes a platform that the world adopts. The purpose of this system is to consolidate the fragmented health care world.

So what is really going on?

Through this blog, I will explore the specific challenges that exist in the electronic medical records industry, the opportunities and risks, specifically in the context of the Indian market.

Why India? Well, other than the fact that I’m from there, from the perspective of any enthusiast of medical records’, India should be the epicenter of all this innovation. Millions of Indians don’t have access to basic food and water, yet have access to mobile devices connecting to the internet. It represents both the developed world and the developing world – it has obesity and undernourishment and micronutrients deficiencies all in the same country. It has diabetes and water-borne malaria.

India provides a platform for huge impact to be created, affecting billions of lives. That is the opportunity that India presents to an enthusiast of electronic medical records.

Lets explore this space through the medium of this blog. And lets find a way to solve the greatest challenges of the world. Source

HIMSS Special Part 1: HIT Visionary Zach Fox
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