On Product Development and More...

I visited the doctor the other day. Since it had been more than 10 years since my last visit (he was a dermatologist; which means that part of me has been relatively healthy), I had to fill out the standard questionnaires that I fill out each time I visit a new doctor. Each time I do this, I recollect how inefficient the medical industry is. And how ready we are for a truly universal Electronic Health Record (EHR) System.

As I have written in past blog posts, my former company, Abrevity, sold Information Management solutions. As head of Product Management, I met with potential partners who were interested in using our technology to create some fairly interesting “verticalized” solutions. The most interesting involved leveraging information management constructs to implement an EHR System.

Due to this partnership, I immersed myself into the world of electronic health records. This world was not entirely foreign to me. As I had worked at I-many for several years – which sold enterprise software solutions into the Life Sciences market. As such, I am quite knowledgeable about the world of prescription medicine.

To date, the penetration of EHR Systems is unacceptably low. According to an article in Fast Company (entitled “Why Electronic Health Records Are Worth the Hype -- and the Price”), only 17% of doctors use a basic EMR system.

Why is that? Well, according to an article in Medical News Today (entitled “Electronic Health Records Still Rare In US Hospitals”), the barriers to adoption are significant. They include:
- Inadequate capital for purchase
- Concerns about maintenance costs
- Resistance from physicians
- Unclear return on investment
- Lack of staff with adequate IT expertise

I think this analysis explains the problem. We are evaluating EHR Systems from the wrong vantage point.

An individual’s electronic health record should not be owned by a single physician (or a single hospital). Rather, to do this correctly, an individual’s health record must be owned by the patient. After all, the patient is the customer in this process. As such, I refer to ultimate solution as a patient-centric EHR System. Where the community of physicians and care providers who service a patient can better work together to provide higher quality and hopefully more affordable health care.

Within a patient-centric EHR System, it is the physician’s responsibility to ensure that their patient’s records are maintained and kept up-to-date. Within a patient-centric EHR System, it is the physician’s responsibility to evaluate a patient’s records to ensure that he/she is not recommending a therapy or prescription or operation that contradicts what another physician is advising or prescribing. As owners of the record, it is the patient who should decide who has access to their records. In fact, the patient should be able to annotate their own records – to record their progress or symptoms so that they can be reviewed, when necessary, by the physician.

The patient-centric EHR System I am advocating is a specialized Community of Practice– where the common goal is to provide that patient with superior, consistent health care. This essentially is an EMH System built upon Web 2.0 concepts. I see this as the future of a Universal EHR Systems.

Who is going to pay for this? Well, I believe Senator John D. Rockefeller (who is proposing the Health Information Technology Public Utility Act of 2009) is on the right track. The patient-centric EHR System will ultimately be funded by federal grants. Unfortunately, private industry is ill-equipped to solve problems of this magnitude.