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New wearable and ingestible wireless diagnostics promise to improve quality of life for physicians and patients … if EHRs would cooperate.
The "always on" smartphone world of today matched with personal digital diagnostic technologies in development by the likes of Microsoft, Apple, Google, and other digital powerhouses promise to revolutionize chronic disease management and empower population health to stratospheric levels.
The development initiatives using data created and transmitted via smartphones using wearable, clothing embedded, ingestible, and other personal sensors are limited more by imagination than technology.
Just one little problem: The ability to convert another tsunami of new patient data into usable and actionable information for physicians using existing EHR technology is more than a decade in the rearview. The existing system platforms are static warehouses, not digital highways.
Further, each EHR's warehouse is an island unto itself because it uses a different layout, nomenclature, and even language designed to make changing to a competitor as difficult as possible by making data migration to a new system an expensive and daunting process. Until Congress stepped in, exorbitant ransoms imposed by some EHR companies to translate the data into the standard language are effectively bad memories.
The Wall of Interoperability
Still, federal law, which prescribes that all EHR data is to be contained in a standard format called a CCDA (Consolidated Clinical Document Architecture, if you must know), to be certified. The law, however, has more loopholes than grandma's knitting.
That makes the new healthcare information highways, population health, and similar programs that convert EHR warehoused data into usable information for physicians and other healthcare providers (among a host of other enabling and time-saving features), the ultimate solution hobbled by that EHR industry manufactured wall to data called "interoperability."
Circumventing EHR companies by automating removal of the CCDAs out of EHR systems has been solved by a very clever few, as has even making them interactive, but it comes at a cost because each version of each EHR has to be done separately.
To achieve a single-keystroke model (inputting data only one time), which is not only desirable but the only way to get people to use it, tons of EHR data has to be machine translated into a common language, delimited, mapped, parsed, validated, and, finally, populated into a common platform so that it can be made into something useful for providers. Every day. That takes lots of time, money, and skill, which can be undone by EHR companies at will every time they issue an upgrade, new version, or even a simple update - and expensively redone.
In return, providers get useful, time-saving tools that can allow them to do much more in much less time, which is the key to a reasonable quality of life for physicians.
That makes effective population health, let alone enhancing it by new wireless, personal smartphone app-enabled diagnostics, equivalent to baking a cake by having to get and process the raw ingredients from farmers and dairies instead of a cake mix from the supermarket.
The obvious solution, of course, is to pull the data directly into the information manufacturers' systems, circumventing the EHR warehouses, which will be hoisted by their own petard in the open ocean without a paddle because information systems cannot be EHR-specific to be effective.
In the end, there is a bright future for developers, physicians, healthcare providers and, especially, patients.
EHR companies? They took a different road. The survivors will join the program, and the time to do so is so very close.