Category Archives: Healthcare

Consumer Controlled Cloud Based Medical Records

Introduction

The future has arrived. It is time for cloud based integrated healthcare records and time for the individual consumer to maintain control of their own data. Although challenging and seemingly utopian, such systems could provide uniform privacy and security controls to protect information in a single repository rather than many discreet instances of data stored throughout various healthcare systems.

Patient Medical Records and the Cloud
Public cloud Services provide many benefits and have seen increased use by businesses in recent years. Public cloud services created and managed by third party technology providers offer essential services such as ubiquitous access to data, on demand storage and archiving capabilities, and high availability at a scale and cost that would be difficult for individual organizations to maintain.
However, healthcare has been slow to embrace public cloud services due to concerns over security, privacy and litigation risk. Even as hospitals and other medical operations as well as their clients (the patients themselves) begin to embrace the potential of Electronic Medical Records (EMR), anxiety over the potential negative consequences of the mishandling of patient data, and perceived loss of centralized control have prevented Healthcare providers from taking advantage of Public Cloud Services.
Private clouds, hybrid clouds and community clouds are all good options for using cloud services where privacy is a concern, but each solution must be compliant with regulations such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and The Health Information Technology for Economic and Clinical Health (HITECH) Act.

One Repository for Electronic Medical Records
While the privacy and security of individual’s health records is of primary concern, individual repositories of patient information, fragmented across the Industry, makes the challenge of ensuring appropriate controls more difficult and perhaps ultimately less secure, than a “single” cloud based repository could provide.
The creation of health information exchanges (HIEs) has been underway for some time by various vendors and service providers (Donahue, 2010) with the objective of sharing information between entities. HIEs however, do not address or provide a single source, nor are they designed to. Along with HIEs, Community Health Management Information Systems (CHMISs), Community Health Information Networks (CHINs), and Regional Health Information Organization’s (RHIO) are all examples of programs or models that have tried to address the problem of access to patient data. However, none of these has been a complete success (Vest & Gamm, 2010). All of these solutions leave open the opportunity for inconsistent data across various exchanges, as well as a larger surface area to protect, control, audit and remediate issues over.
A cloud based repository, managed by the government might provide the homogeneity needed to ensure consistent care, security and privacy, while reducing costs and freeing up IT resources at healthcare organizations to focus on implementing and maintaining EMRs that would use the “Public Utility” cloud based data as the source of truth for patient medical records (Vest & Gamm, 2010).

Control of the Medical Record
Whether the patient’s medical record exists in various healthcare systems individual data stores, HIEs or even in a national repository maintained by the Federal Government the critical issue of who “owns” or controls access to the medical record remains a consistent issue. The next major step in electronic health records should be a system that gives the individual access to their own information, along with the ability to approve or reject requests for access to their records. In addition to controlling the access to the information, the ability for the individual to read their own medical records may even encourage them to participate more actively in their own care (Rabin, 2012).

The creation of a national cloud based repository for electronic medical records could potentially provide many benefits for both consumers and providers of healthcare services. There are also significant challenges in creating such a system. Healthcare organizations, along with technology companies should work with Federal and State Governments to design and implement such a system. A national cloud based repository would improve patient care by reducing errors or gaps that may exist in separate healthcare systems records, reduce costs for healthcare organizations by removing the need to maintain their own repositories and to better ensure privacy and security of the information by securing one common system, rather than many disparate ones.

 

 

References
Donahue, S. (2010). Can Cloud Computing Help Fix Health Care. Retrieved from Cloudbook: http://www.cloudbook.net/resources/stories/can-cloud-computing-help-fix-health-care
Vest, J., & Gamm, L. (2010). Health information exchange: persistent challenges and new strategies. Journal of the American Medical Informatics Association , 288-294.
RABIN, R. C. (2012, January 9). Project Puts Records in the Patients’ Hands. Retrieved from New York Times: http://www.nytimes.com/2012/01/10/health/policy/project-puts-records-in-the-patients-hands.html?_r=1

Mobile Technology is a Home Health Care Game Changer.

Mobile Technology, such as cell phones, “smart” phones, and internet connected tablets, have fundamentally changed the way that the average American accesses the internet, purchases products and services, and submits electronic payments. In addition to everyday consumer use, some industries, such as Healthcare are beginning to take advantage of these new powerful, mobile, edge of the network devices.

Home health care in the United States is a growing service that provides in home health services, as well as Hospice and end of life care. In 2007 there were over 14,500 home health agencies in the United States (1). These agencies employ health care workers who typically visit their clients or patients in the patient’s home, or in a care facility. The health care worker is responsible for performing duties that range from simple tasks such as changing bed linens, to more clinical tasks such as taking and recording vital signs, and medication management. The traditional means to document the care of the client or patient has been to carry blank paper forms that the caregiver fills out either at the time of the visit, or in some cases at the end of the day. The use of paper based forms is the not the most cost effective method of documentation. In addition, timely updates to the paper based information are difficult, and manual data entry to transfer the information from the paper into the agencies electronic health records system is laborious and error prone.

Enter mobile technology. Health care technology companies have begun offering software that operates on mobile internet connected devices such as cell phones and smart phones, that replaces the manual paper entry process. (2) A typical home health care mobile system will send the care giver their schedule electronically to the mobile device. The schedule can contain information about where the patient or client is located, what time the care giver needs to arrive, how long the visit should be and most importantly, exactly what the care giver is supposed to do. The mobile software can deliver a patient specific care plan, at the point the care, electronically via the mobile device. When the caregiver has finished the visit, the information is electronically sent to the agencies in-house software system that manages the patient care, and frequently the billing and payroll functions of the agency.

There are added benefits to using mobile devices beyond documentation itself. Most mobile devices use their onboard GPS capabilities as well as other network location based services, to report back to the agency where the care giver is for safety, and to validate and record that the caregiver was geographically within the same area as the patient at the time of care.

While this article briefly touches on some of the uses of mobile technology in home health care, the home health care field represent only one way in which mobile technology is changing forever, the way everyday business, and personal information and transactions are conducted today. With 322 Million Wireless subscribers in the US as of June 2011 (3), the mobile device is by far one of the biggest technology changes in the life of the average US citizen in the last decade.

References
1. Center for Disease Control, National Health Statistics Reports Number 30 November 9, 2010 http://www.cdc.gov/nchs/data/nhsr/nhsr030.pdf
2. CellTrak Technologies Inc. FACT SHEET http://celltrak.com/downloads/Fact%20Sheet.pdf
3. CTIA Wireless Quick Facts. http://www.ctia.org/media/industry_info/index.cfm/AID/10323