Risks and Opportunities Map

Health Related Information

Ancient map makers drew whatthey knew and then noted:Beyond here there be dragons!This map acknowledges that there are, to this day, dragons.

Medical information is rapidly moving from paper records to electronic formats and new sources of information are being added. The electronic formats provide opportunities to capture, store, share and use information in new ways. These new ways create risks and opportunities.

Most of the elements identified and discussed here have been identified and discussed by others. What is new, is a broader view of more elements at the same time and their interdependencies.

It is these interdependencies that pose risks and create opportunities.

Agenda:• A Large and Growing Market• The Historic Simple Map• The Near Term Complex Map• Risks: Litigation• Risks: Data Sharing• Opportunities: Better Needles &

Haystacks• Opportunities: More & Better Data• Opportunities: The Power of Large

Numbers

Health Information: A large and evolving market

• Part of $19 billion for Medicare and Medicaid Health IT funded by the American Recovery and Reinvestment Act of 2009

• Hundreds of independently developed electronic medical records systems being offered in the market place; scope ranges from single practitioner systems to systems for hospital groups

• One vendor claims 30,000 doctors; their system is free and revenue from the health information is part of their business model*

• There are evolving changes in provider/patient interfaces § and new, non-traditional formats for routine delivery of health care

• There are “captive” and independent information systems for participants: Google Health and Microsoft Health Vault dominate

• Telemedicine, a major source of data is now a $3.9 billion category

The Historic Simple Map

Structure: Near-Future Complex Map

Dozens of providers share data (not files) about a participant.Participants have data too.

Major Elements: Near Future Model

Beyond here

there be dragons

HistoricSimple

Near FutureComplex

Increased Complexity

=Increased Risk

LitigationThe threat of litigation will continue but the form will be different:• Fewer errors. • Better

standards for care – what is required?

• Better records about what happened.

• Easier identification of parties

Increased Risk

Data Sharing

A lab report is sent to the doctor with a link back to the lab. If that link is not removed by the doctor it could be passed to a social network thereby creating a risk to records in the lab and along the entire path.

Controls need to be in place to assure that required sensitive date is properly cared for.

Increased Risk

Increased Participation,

Connectivity, &

Database Size

=Increased

Opportunity

Increased Opportunity

Better ways to findneedles of information …

Increased Opportunity

… in more large haystacks of data because of large populations andcentralized databases.

Increased Opportunity

Link to information from non-traditional sources:• iPhone apps• Telemedicine• Urgent care facilities• Intel’s studies on ageing• PatientsLikeMe.com

Increased Opportunity

Access to more history as time passes to providebaseline for research

Increased Opportunity

Track large percentages ofparticipants of new medsand procedures:• Earlier assessment of risk• Identification of variables

Increased Opportunity

Track procedure and drugInteractions across larger populations allowinganalysis of variables

Increased Opportunity

Increased sharing ofInformation among participants, e.g., PatientsLike Me: better informed andbroader choices

Increased Opportunity,

Better data to set standardsof care for management, insurance and litigation

Increased Opportunity

The power of large numbers:Search for 1 patient in 1,000Database of 30,000 doctors250 patients per doctorFind 7,500 candidates

Increased Complexity

Increased RiskIncreased Opportunity

… and dragons

Healthcare Information

• Practice Fusion: Free EMRs http://practicefusion.com/• How Can Healthcare Software be Free? http

://goo.gl/r9BP• PatientsLikeMe : Patients Helping Patients Live Better

Every Day – sharing personal health information: http://www.patientslikeme.com/

• Patients Like Me Partners: With PatientsLikeMe, you get instant access to structured, real-world patient data — reported via clinically validated outcome management tools — as well as large, engaged patient communities. And you get it now, without the red tape.

• http://partners.patientslikeme.com/products/• Take health care off the mainframe A TEDMED

presentation about Intel’s research using the way older people use their telephone to track changes in health. http://goo.gl/vALK

• Online Care: Internet links for doctors and patients http://americanwell.com/products.html

Contacts:• LinkedIn• EMRnet (blog: Exploring the value and complexity

of networked electronic medical records) • hal9007@gmail.com

References