Digital Health Data vs. An Analog Memory

from the the-possibilities-are-endless dept

What started as a quiet evening one recent Saturday ended with a multi-hour visit to my local emergency room.

It was a relatively "vanilla" visit for a suburban ER — I walked away with multiple stitches and a bruised ego. But I received one service I probably didn't need, reminding me we still have a long way to go before the great potential of digitized medical data is realized.

I received a tetanus shot that I'm almost certain was unnecessary. However, all the evidence against getting the shot lay only in my memory. While there are likely several records of my last tetanus shot in multiple, siloed databases, not a single one was within my reach when I needed it most.

Of all people, given my career and the passion I have for the tech sector, I should have been ready for this. In an era when health and medical data are increasingly digitized, my information shortfall that night was easily and entirely avoidable.

"When was your last tetanus shot?" the ER doctor asked me. As I fumbled to recall with exactness the particular date, time and place, he jumped in, "Sounds like it was tonight." Moments later, the nurse strolled in and administered the shot.

I'm almost certain I got a tetanus shot before I went to Nigeria in 2014...or was it when I went to Ethiopia in 2013? Despite my inability to recall the date with precision — surely, it's been in the past 10 years, hasn't it – that information is available somewhere.

My insurance company knows. The clinic or doctor's office where I received the shot surely digitized the details. But that Saturday evening, we weren't able to access any of this digitized information. I'm looking forward to the day, fast-approaching, when that changes.

We're in the midst of a revolution in personal health, thanks in large part to consumers' enthusiasm for wearable fitness activity trackers. Sales of health and fitness trackers continue to rise with an ever-expanding suite of wearables. Health and fitness apps and devices let us capture, collect, manage and better understand our own medical data in unprecedented ways. And when we can control our own health records, we are better informed when we go to the doctor's office or the pharmacy or, in my case, the emergency room.

Technology also enables us to share diagnoses and test results, seek second opinions and shop for less-expensive care. The more information patients have, the more invested we are in our own care — and the better we can serve as a "safety net" for our doctors' potential oversights or lack of information.

Consider the extraordinary case of the woman who served as her family's caregiver when her father was admitted to the hospital unexpectedly. Doctors wanted to give him a blood-thinner drug that their outdated records indicated he was taking. The woman pulled up her father's medical records using an app, BlueButton, which showed that he had been off the blood thinner for two years, so none was administered. Shortly after being discharged from the hospital, the man cut himself badly in a fall. Had he been on that blood thinner, that fall might have resulted in much more serious injuries.

Digital data allows us to take an active role in our health—not just by delivering us the right information, but by allowing us to see where our lifestyle choices influence our health. For example, by tracking the number of steps I take in a day, my sleep and other measures of activity, I can see how going to bed thirty minutes later than normal impacts my activity level on the following day.

And data will fundamentally change doctor-patient relationship, too. Today's doctor assessment largely relies on the same approach that has been used for hundreds of years – the doctor asks the patient questions in an attempt to pinpoint the problem by intersecting the answers with her or his own knowledge and experience.

Of course, this type of discovery is fraught with imperfections – our brains are analog and we forget the particulars of our health history. But good digital data never lies. As more of our health data is captured, stored and shared, doctors will become more efficient, our health care system will get better and we will be healthier.

In the ER down the street, with me sitting on a sterilized bed in a sterilized room on an otherwise quiet Saturday night, a doctor, a nurse and a patient could have changed analog behavior — if only we had had access to digitized information.

Shawn DuBravac is chief economist of the Consumer Electronics Association and the author of "Digital Destiny: How the New Age of Data Will Transform the Way We Live, Work, and Communicate." Follow him on Twitter @shawndubravac.

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  1. identicon
    Anonymous Coward, 25 Sep 2015 @ 1:27pm

    Two major challenges to solving this issue.

    1) HIPAA.
    HIPAA is great for a privacy standpoint, but it also makes sharing medical information very difficult. Because Hospitals, doctors, other caregivers have to follow all the necessary precautions to get consent for access to medical records of a patient that may be stored in another Hospital or health care system. This isn't insurmountable, but it is a challenge that can be hard to automate.

    2) Different EMR systems.
    There are at least half a dozon different "major" EMRs, as well as plenty of smaller solutions. Each one stores and manipulates data differently. So, it's really hard to pass data between them. So they made a standard for communication of records. well one kind. Then another for a different kind. and another. and another. And each one adds more complexity to deal with in the underlying EMR. Sure, by standards their interoperable. but the Requesting, authorization, and actual transfer is a largely manual process. Mainly because the systems can send and request data, but human intervention to select/fulfill the requests. (It's really hard to query and access a third party system AND follow all of the HIPAA compliance checks)

    So the idea that all this information is somewhere in different walled-off silos is pretty accurate. But this is the way it essentially has to be in order to be compliant with patient privacy. The tech for sharing records is fairly readily available, contrary to what many might claim. The real bottle neck is the law and keeping in compliance. Not intentionally, just the result of laws that were constructed around paper records being faxed, without consideration for the advent of information being able to be sent in a more automated fashion. Meaning, most of the authorizations have to happen manually.
    Specifically: Every time you want records outside the given organization, the patient has to sign the request for release and more or less specify what can be released. This stipulation alone precludes most of the automatic procurement of records and building of a complete medical history.

    The challenge of a global record is not in the technology, but in a dated regulatory framework that has failed to keep up with modern advances.
    But... that's pretty much par for the course.

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