Trends that transform electronic health record systems to healthcare delivery platforms
The healthcare industry has spent the past several years building, implementing or fixing electronic health record systems (EHRs) with the primary objective of storing patient records digitally. Viewing EHR systems as static, storage bins belies the potential they have to fundamentally change how healthcare is accessed and delivered.
Let’s examine a few trends that can change medicine.
1. Explosion of medical data
According to IBM, we generate 2.5 quintillion bytes of data daily and have created 90% of world’s data in the last two years. The vast majority of this data constitutes medical information created by devices, health records, wearable computers, imaging systems, lab results, radiology reports, insurance claims and so on. But this is just the macro perspective. In the future, we will also have an explosion of micro data such as genomic data and data from other biomarkers that provide signals of future diseases. Medicine is becoming a data sciencelending itself to be understood through the aid of algorithms.
2. Digitization of a field makes colocation redundant
An ATM makes a bank redundant. Kindle let’s you buy books from anywhere. 3D printing transforms manufacturing just as iPods have changed the music industry. It’s only a matter of time when medical data travels seamlessly over the Internet to make colocation of a patient and doctor redundant.
3. Moving towards the Internet of Medical Things
Nest, a learning thermostat is a great demonstration of what is possible when a device is Internet-enabled – you can control it over your phone, customize it to your needs and save costs along the way. Just as Nest, there are several medical devices that can send data over the Internet. GE’s Vscan ‘shows’ the heart andScanadu’s Scout captures physiological data and sends it to a smartphone via Bluetooth. In due course, every medical device will have its own IP address – allowing it to be accessed and controlled from anywhere. Furthermore, there are several smartphone contraptions as demonstrated by Smartphone Physical that could make remote healthcare delivery possible.
4. Drones for Drugs
Amazon PrimeAir expects to routinely deliver goods using drones by 2015, by which time the FAA is expected to formulate its rules for unmanned aerial vehicles. Matternet wants to do that to deliver food and medications to remote areas – they recently experimented in Haiti and Dominican Republic to deliver 2.2 pounds of goods over 12.4 miles. It isn’t far fetched to imagine that our prescriptions will be fulfilled by a drone.
5. Doctors rely on data more than ever
Twenty years ago, if you complained of mild chest pain your doctor would have possibly given you an aspirin and asked you to return the next day if the pain persisted. Not anymore. Today the same doctor is likely to order an electrocardiogram, CT scan, x-rays of the abdomen and stomach, blood tests and then give you an aspirin after. Without delving into the reasons for this behavioral change, let’s simply be aware that doctors are more open to suggestions through data.
6. Video communication has become common
Last month, Microsoft demonstrated a real-time translated conversation via Skype between an employee speaking in English in Seattle and another speaking in German. It was a breakthrough, giving an idea of the future of global communication that would break language barriers. American Well, Teladoc and similar companies are early examples of medical care based on video. At my company, we are experimenting with remote healthcare delivery from Michigan to Sri Lanka using video and EHR data.
7. Patients are sharing more and more
Using services as patientslikeme and Crohnology, patients are providing great insights about medications, care plans, diet for specific disease conditions. In the future, medical knowledge may greatly rely on crowd-sourcing of disease information. We will discover newer ways to tackle today’s medical problems.
Connecting the dots
If we consider EHRs as nodes that interconnect patients, doctors, devices, labs and so on instead of as storage systems, we can visualize a dynamic flow of medical information. But data by itself is chaotic – we need insight to make it useful and pertinent. When we utilize analytical tools such asIBM Watson that can cull out wisdom from information, the EHR is transformed into an intelligent system.
Let’s connect these dots for a heart patient. Using the patient’s historical data, family data and micro data (e.g. through DNA tests) and data from devices that the patient wears, the EHR alerts the doctor before she falls sick. For example, by analyzing longitudinal data from BP, heart rate, activity and sleep, it suggests and enables a video-call for the patient and doctor. The doctor then examines a realtime ultrasound of the heart over the EHR and prescribes suitable medications. Latest evidence based guidelines assist the process of care. The EHR then triggers a drone to deliver drugs from the pharmacy to the patient. The data from the entire episode is continuously fed back into the network for future episodes of care.
Taking a leaf from another high risk industry such as flying, we never realize that a pilot mostly does not fly the plane. The plane flies on its own – the pilot is merely navigating it with the aid of an expert system that analyzes millions of data points at the same time. If medicine borrows and accepts similar ideas, we have the potential to transform the EHR to scale and deliver healthcare to millions of patients.