I am stunned at how many folks have already installed our brand new HealthVault app for Windows Phone. Forget any questions I may have had about the momentum of the mobile platforms; this is where the world is going.
The app is meant to be a handy general purpose tool --- optimized for use whenever you need to quickly save or look up health information: recording an immunization, sharing key information with a school nurse, consulting with a provider on measurements like blood pressure, weight or glucose --- that kind of thing. A couple screenshots to show off the sweet-looking UX:
One of our program managers is a new dad and has been field-testing the app for some time. He was raving about it in email, and I asked if I could share some of his feedback:
I pulled out my phone, loaded the app, and entered her height, weight, 3 vaccines, and ear infection condition in no more than 1 or 2 minutes. I didn’t time it – but it was super quick. This was over 3G as well. The vocab search for immunizations was AWESOME, and I had no problem entering her 3 vaccines. To be honest, if it wasn’t for this application, this information probably wouldn’t have made it into her record for a LONG time. As working parents, the last thing we want to do when we get home is sit at a desk and enter data .... The sheer convenience of being able to do this when it’s relevant and so quickly was a great enabler.
On a side note: The reason I really want to keep our own records now is due to a mistake at her last visit. I took her without my wife and they asked if she needed a flu shot. I didn’t know – so I asked for them to check her records, and if she didn’t have one to give her one. They did. I later told my wife, and she freaked out. Turns out [my daughter] had just had a flu vaccine. She called the office and they forgot to add that to her record. Turns out nothing bad will happen getting the flu vaccine twice, but we’d still rather it not happen. Had we had this app and [kept] things up to date – I could have just pulled out my phone and checked myself. This reminded my not just of the usefulness of our mobile story, but also the importance of maintain[ing] your own records in HealthVault.
SO COOL! This app will be a great complement to all of the other great specialized apps that are coming online. Just a few on WP7 --- check out Livescape for keeping track of nutrition, exercise and more, SkinScan for tracking moles, and Weight4Me for watching your weight.
And OK, I just have to add this in too. This afternoon the team took some time off and held a gingerbread -building competition (thanks to Linda and Kris for setting it up!). We had a whole set of hilarious and questionable entries, ranging from the “Gingerbread Guillotine” (I have video) to the “Ops Tub Time Machine” as created by our operations team. But most timely was “HealthVault Mobile”, showing how an unfortunate accident victim can receive better treatment when armed with our new app. I’ll just leave you with the picture and say --- I love my team.
The anecdote about a missing update in the kid's record leading to a second flu shot is not actually such a clear-cut demonstration of the importance of PHR. As the dad said, getting two jabs wasn't a problem. For treatments where it would be a problem, one might assume that the clincian would take correspondingly greater care, and do more checking rather than rely passively on the record (which is why the idea oft touted by politicians that EHR will supplant taking medical histories is wrong).
By the same token, in cases where patient history is really critical, will self-entered records be trusted?
I'm a great supporter of e-health, and I work in the field, but I worry that the business case is not as clear cut as vendors would have us believe. We need more evidence!
Thanks for the comment, Steve --- but having family members with complex conditions myself, I think it's crystal clear that you're wrong here. There have been a bunch of times where we've known better than the doc. And you bet, when we tell them they are wrong about what happened to US ... they listen.
Beyond the specific example, it's tough to argue that having a better handle on your personal health isn't a positive thing. Being able to track progression of symptoms over time, more easily get second opinions, even just keep a worried family informed ... I welcome the skepticism, but have a tough time really understanding it.
I'd encourage you to try it yourself, whether with HealthVault or another solution. I'd be willing to wager that within a year or so you'll have had a number of situations where access to your own data made a difference.
I love health vault but being in Australia, our health system is catching up. Everyone is overtly concerned about who has access to their information. Sigh great blog.
Thanks Rohan! I'm really hopeful that the Aussie PCEHR project evolves towards a more effective model ... at the same time, we're working to figure out how to accelerate our own international plans. So I hope there will be a great answer for Australia soon! ---S
I do not doubt that a PHR is useful. My argument is that the business case for this technology investment needs to be more rounded and dare I say it evidence based. I believe vendors put too much emphasis on the anecdotes of the worried well, and of politicians who've personally experienced hospitialisation and come out preaching that electronic health records willsave having to take all those annoying histories. Well, they don't.
A rational evaluation of e-health must also examine the downsides. This is where we cannot duck the question of liability when a patient-entered record turns out to be erroneous.
More seriously, as far as I can tell, the business case for new Unique Health Identifiers is often based purely on the number of adverse events that can be attributed to misidentification of patients. But I've yet to see any analysis of the new sorts of morbidity and mortality that will come from errors in transcribing or matching UHIs. If the argument is that e-health will save lives, then logically, e-health bugs must imperil lives.
Believe me, I am a huge supporter of e-health and am very active in the field. I just call for a more sober presentation of the issues.
Thanks Steve. If I boil up your points, it seems like you're saying two things: (1) Yep, seems like there is benefit here. (2) We shouldn't rely on anecdotes alone to believe in that.
I agree. That's why we continue to participate in studies, for example a recent one at Kaiser Colorado that documented a 50% improvement in hypertension control when using a self-monitoring program vs. traditional methods (see my blog here: blogs.msdn.com/.../sweet-50-better-chance-of-healthy-bp-levels-using-healthvault-monitoring.aspx).
Liability is a red herring here, because doctors rely on patient-reported data every day in every visit. With a PHR in the mix, we just all have better and more complete "memories" to work with.
The evidence is pretty clear --- when patients and doctors have better and more complete information, we get better care.