A couple of recent articles have given me hope, after a really depressing session at my local surgery today for an NHS Health Check. It began when I spotted two adjacent notices in the waiting room, the first encouraging patients to access the surgery’s online facilities, and the second banning the use of mobile devices. It descended further when after producing the form I’d been asked to complete about height, weight, alcohol consumption, family history of disease etc., I was asked every question all over. When I protested, I was told that as most patients don’t fill in the form, or forget it, they ask patients anyway. (Discretion suggested it probably wasn’t the right time to suggest that perhaps that was why people don’t fill in forms…)
However the first article, by Zahid Latif, who heads up healthcare for the Technology Strategy Board, indicates a restlessness with the current use of patient data that appeals to me. He goes on to explain how the projects in the TSB’s dallas programme are making use of collaborative access to data in a number of ways to improve health and social care. My part in this, DHACA, gets a mention too.
The second, an editorial in iMedicalApps, is even more inspiring as it appears to be going down the usual route of complaining about data & work overload and then produces a bright glimpse of the future almost out of nowhere. The cause of the overload concern is the partnership, previously reported by us between a company we have written much about recently, AliveCor, and Practice Fusion that enables patients to download ECG traces into the PHR. Extrapolating this, the editorial posited:
Consider, for example, the average primary care physician who may care for a panel of over 1,000 patients. It is not hard to imagine how things could get out of control. If each patient has a single device that generates a monthly dataset (e.g. a blood pressure spreadsheet), that’s over 30 reports per day.
Having considered various unattractive options, the final paragraph suggests the need for:
…algorithms for interpreting and reacting to information patients’ transmit. There may be a big opportunity here for automated platforms that respond to this data–think an app store within the EHR where clinicians can download tools relevant to their practice. For this to work, we’d need validated, off the shelf tools that are minimally resource intensive.
…which just about sums up everything I have been arguing for recently; interoperable access to good vital signs information, good algorithms to identify alerts from those vital signs early, automated platforms, a store of medical apps, and a good, trustworthy, validation procedure for those apps. Other than a mention of another step towards iDoc, that was just about perfect, and more than made up for my health check; the nurse was after all trying.
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