I have been reading a article on linkedin about Google and Microsoft's jousting for the Health IT dollar. It is suggesting that ChromeOS may be the key for Google. First 99% of all EHRs, PMS and Health Financial Systems run on Microsoft. Many of these are desktop applications that use Citrix to emulate an enterprise system. ChromeOS and Google Health is all about Cloud computing. It is a bit of a step to see Google in any health business in the near future besides PHR (Personal Health Record) and they have quite a bit of catch-up to do to equal the features of MS Health Vault. But, with enough money and time you can do anything.
Many Healthcare facility HIT departments are run by desktop IT personnel and the Cloud architecture is quite a leap. In saying that, people can be trained and things do change but very slowly and at a cost. I know of one hospital in Central Oregon that is looking at implementing their third EMR because the wrong people were making the wrong decisions.
Cloud technology is not new, It has been in every major industry for a long time. It could save the healthcare industry hundreds of millions of dollars. By hosting a system you reduce your personnel overhead, maintenace, and capital equipment cost. You gain "Ecomomies of Scale" by utilizing shared resources. With a true cloud architected system, you reduce the cost of your client machines, i.e., netbooks or mobile devices instead of tablets and laptops. This is where ChromeOS comes into play and provides a considerable cost saving for the client. The Operating System is free just like Android for the Smartphones, which reduces your cost considerably. Ask your IT department for a report on MS licening for your facility if you do not believe me. Another feature is increased security. With no storage on the clients machine (netbooks, smartphones) you know longer have to worry about laptops being lost or stolen.
The potential for HIT saving with cloud technology is just starting to be realized. Think about this example. You pay for your EMR via subscription which run via Cloud, the patient data is stored in a HealthBank where the customer owns and pays for the storage, and you can access the data from anywhere because it is all in the Cloud.
Jeff
Monday, July 13, 2009
Thursday, July 9, 2009
PHR Comparisons, there is one for everybody
PHR Comparisons, there is one for everybody
There is much confusion about Personal Health Record (PHR) in the market these days. I became aware of this by an analyst review of our mobile PHR (mPHR). He compared our mobile PHR with a Web App /cloud/browser based PHR. He then proceeded to give our mPHR a undeserved low rating. This is understandable if you do not know the difference in a Smartphone app mPHR and a Web App also known by the new name Cloud applications. There are numerous Cloud PHRs on the market today with different capabilities, strengths, weaknesses and cost. From a high level, it can sometimes be difficult to tell the difference between applications and their platforms. When making a selection of any tool you need to know what are the requirements and how you want to use it.
The PHRs today are divided into three groups; Mobile SmartPhone (mPHR), Cloud Apps, and other devices such as USB and smartcards i.e., credit card with memory chips. Each type of PHR serves a different purpose and provides a useful and needed service. I will speak to the strengths and weaknesses of each of them.
Web Apps/Cloud PHR:
These are browser/server based systems that need to be connected to the Internet to operate. There is no store and forward capability and if you are not connected to the Internet you have no access to your data. They provide convenience for entering and reading data and some have a simple client interface so that at least some of your critical data may be viewed on a Smartphone Web browser if an Internet connection is available. The client smartphone option is usually offered for an additional cost. Internet browsers on smartphones tend to be slow and have limited area access. Mobile PHRs normally provide fewer features than Cloud based systems, but this too will be changing as bandwidth availability grows larger and smartphones acquire more memory capabilities.
Smartphone and mPHR:
Smartphone are cellphones that are more of a computer than standard cellphones, e.g., iPhone, Android, Blackberry... Today, mPHR's run on these smartphones. As I mentioned before Smartphones of today do not offer as much computing power, memory, or bandwidth as Cloud/WebApp systems. Inprovements in memory and computing power in smartphones is improving rapidly. Remember your first computer? Smartphone's differentiating feature is that they are totally portable and can go literally anywhere you go. Which means that your health data is always with you when you need it. There are many areas all over the world that do not have Internet service and you will likely find dead zones within ten miles of your home. http://www.deadcellzones.com/ If you need access to your medical record in one of these areas you will need a mPHR or USB device that is not tethered to the Internet, i.e., Your health data is on your phone and with you. At a minimum important health information such as Medications and Allergies should be carried with you at all times. In most cases, when you need your health information the most, you do not have it with you and you are not sitting in front of your computer at home.
A mPHR that connects to a browser based Cloud PHR is a good option, you can manage your health at home and carry your most important data with you on your mPHR. Note that most mPHR's do not contain as much information as Cloud PHRs because of memory constraints. Some mPHR's, like motionPHR a product of Communication Software, Inc. also offer an ICE (In Case of Emergency). ICE is a feature that provides first responders, such as EMTs, with much needed data about your health and contacts. With the exception of the data you decide to provide with the ICE feature, a mPHR that is password protected will be of no help to first responders.
One of the drawbacks of a mPHR can be security. Most of the mPHR's on the market today have little or no security or they just have simple password protection which does not protect your data on the phone. When selecting a mPHR make sure that the data is encrypted and password protected.
USB and SmartCards Devices
These devices are based on a USB connection to a PC. They are produced in all shapes and sizes from key fobs to credit cards with USB connectors. These devices are good alternatives to a mPHR if you do not have a Smartphone. They are cost effective, small and very portable. The major drawback that I have encountered is that doctors offices will not let you plug in a USB device into one of their computers because of the potential risk of a computer virus. My recommendation to medical facilities is to disable their USB ports for this reason. Hopefully trauma centers have computers available that can read their patient electronic devices if the need arises. I do not have any information on first responders ability to read these devices in a emergency situation.
PHR's are fairly new concept in the Medical world and I expect a significant evolution to occur in the next few years due to the current and intense focus. Whether you have a USB device, Cloud PHR, or mPHR, having a PHR is the first step to taking charge of your health. The cost of these systems to you, the consumer, is quite low and the government has considerable interest in making them an integral part of your care. Expectations are that the PHR and your participation will improve health care outcomes and reduce your overall costs. I suggest that you try one, the investment of time and a small amount of money may save your or a family members life.
Jeff Brandt
CTO
MotionPHR a mPHR for the iPhone
MyMobileMedBox for Android
There is much confusion about Personal Health Record (PHR) in the market these days. I became aware of this by an analyst review of our mobile PHR (mPHR). He compared our mobile PHR with a Web App /cloud/browser based PHR. He then proceeded to give our mPHR a undeserved low rating. This is understandable if you do not know the difference in a Smartphone app mPHR and a Web App also known by the new name Cloud applications. There are numerous Cloud PHRs on the market today with different capabilities, strengths, weaknesses and cost. From a high level, it can sometimes be difficult to tell the difference between applications and their platforms. When making a selection of any tool you need to know what are the requirements and how you want to use it.
The PHRs today are divided into three groups; Mobile SmartPhone (mPHR), Cloud Apps, and other devices such as USB and smartcards i.e., credit card with memory chips. Each type of PHR serves a different purpose and provides a useful and needed service. I will speak to the strengths and weaknesses of each of them.
Web Apps/Cloud PHR:
These are browser/server based systems that need to be connected to the Internet to operate. There is no store and forward capability and if you are not connected to the Internet you have no access to your data. They provide convenience for entering and reading data and some have a simple client interface so that at least some of your critical data may be viewed on a Smartphone Web browser if an Internet connection is available. The client smartphone option is usually offered for an additional cost. Internet browsers on smartphones tend to be slow and have limited area access. Mobile PHRs normally provide fewer features than Cloud based systems, but this too will be changing as bandwidth availability grows larger and smartphones acquire more memory capabilities.
Smartphone and mPHR:
Smartphone are cellphones that are more of a computer than standard cellphones, e.g., iPhone, Android, Blackberry... Today, mPHR's run on these smartphones. As I mentioned before Smartphones of today do not offer as much computing power, memory, or bandwidth as Cloud/WebApp systems. Inprovements in memory and computing power in smartphones is improving rapidly. Remember your first computer? Smartphone's differentiating feature is that they are totally portable and can go literally anywhere you go. Which means that your health data is always with you when you need it. There are many areas all over the world that do not have Internet service and you will likely find dead zones within ten miles of your home. http://www.deadcellzones.com/ If you need access to your medical record in one of these areas you will need a mPHR or USB device that is not tethered to the Internet, i.e., Your health data is on your phone and with you. At a minimum important health information such as Medications and Allergies should be carried with you at all times. In most cases, when you need your health information the most, you do not have it with you and you are not sitting in front of your computer at home.
A mPHR that connects to a browser based Cloud PHR is a good option, you can manage your health at home and carry your most important data with you on your mPHR. Note that most mPHR's do not contain as much information as Cloud PHRs because of memory constraints. Some mPHR's, like motionPHR a product of Communication Software, Inc. also offer an ICE (In Case of Emergency). ICE is a feature that provides first responders, such as EMTs, with much needed data about your health and contacts. With the exception of the data you decide to provide with the ICE feature, a mPHR that is password protected will be of no help to first responders.
One of the drawbacks of a mPHR can be security. Most of the mPHR's on the market today have little or no security or they just have simple password protection which does not protect your data on the phone. When selecting a mPHR make sure that the data is encrypted and password protected.
USB and SmartCards Devices
These devices are based on a USB connection to a PC. They are produced in all shapes and sizes from key fobs to credit cards with USB connectors. These devices are good alternatives to a mPHR if you do not have a Smartphone. They are cost effective, small and very portable. The major drawback that I have encountered is that doctors offices will not let you plug in a USB device into one of their computers because of the potential risk of a computer virus. My recommendation to medical facilities is to disable their USB ports for this reason. Hopefully trauma centers have computers available that can read their patient electronic devices if the need arises. I do not have any information on first responders ability to read these devices in a emergency situation.
PHR's are fairly new concept in the Medical world and I expect a significant evolution to occur in the next few years due to the current and intense focus. Whether you have a USB device, Cloud PHR, or mPHR, having a PHR is the first step to taking charge of your health. The cost of these systems to you, the consumer, is quite low and the government has considerable interest in making them an integral part of your care. Expectations are that the PHR and your participation will improve health care outcomes and reduce your overall costs. I suggest that you try one, the investment of time and a small amount of money may save your or a family members life.
Jeff Brandt
CTO
MotionPHR a mPHR for the iPhone
MyMobileMedBox for Android
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