Bob on Medical Device Software

There's an article in the October The Atlantic Monthly entitled About Facebook (subscription required) by Michael Hirschorn. His contention is that Facebook is currently the site that "comes closest to fulfilling the promise of social media." As I read though the description of what that means -- the way you qualify friends, the ability to track others and their interaction with others, and the restrictions you can put in place on what others can see about you, the groups you join, etc. -- it made me think of the implementation of EMR systems. The primary components that Facebook has tackled are work flow and interoperability (I've touched a little on this before).

Maybe the Facebook model could point the way to better EMR solutions. As I started to look around I found that others are thinking the same way.

The first question is how are the requirements for an EMR system solved though the functionality provided by a social network?

1. Patient-centric: I think a huge missing piece in today's EMR systems is patient interaction. Most are only concerned with data presentation, record management, and billing functions for the physician. Except for a few limited read-only web portals, the patient does not have the ability to add content or even interact with their own medical record. An important paradigm shift would be that the physician would seek out and gain permission to access the patients private medical account, not the other way around.
2. Patient-Doctor interaction: By not allowing the patient to have interactive control over their health information you are also limiting their ability to interact with their physician(s). Also, if multiple physicians were able to have a common platform for patient consultations it would save time, confusion, and duplication. Patients and their doctors can be thought of as a group of friends that need to interact in a unique way.
3. Multi-media: If teenagers can share music and video, why can't patients and doctors share symptoms and test results just as easily? Also, the improved Web 2.0 interactivity holds a lot of promise for innovations in the presentation of medical data (e.g. Silverlight comes to mind).
4. Security: Nothing is perfect, but I think the Web has already proven itself secure. Think about the number of Web sites where you've left your credit card number, let alone if you're like me you do all of your banking on-line. HIPAA standards can most certainly be met with current Web technology.

As the article points out:

In Facebook's vision of the Web, you, the user, are in control of your persona.

The same should be said for your personal health information.

In addition to providing work flow restrictions, Facebook also allows developers to create custom applications though the use of the Facebook Platform. By doing so, it has created a well-defined sandbox in which to create user defined content. MySpace will also be following suite in this regard.

It's the "walled garden" that opens the door to interoperability. This strategy is considered flawed by some (quoted in the article), but is perfect for EMR purposes. Within the confines of these APIs any medical record content provider would be able to share their data inside the sandbox. The real value is the content of the data, not the mechanism that allows access into the environment.

I know there are many other issues that need to be dealt with when considering EMR functionality. However, when thinking about the popularity and ease-of-use of these social networking sites it's hard not to see them as a possible model for improving health information flow.

This entry was posted on Wednesday, September 12th, 2007 at 8:36 am and is filed under EMR, PHR. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.