Untethered Healthcare

Given all the discussion about the difficulty and expense of converting a practice or hospital to electronic health records, it is refreshing to hear from someone at the front lines of digital health who says, in effect, “just do it.” Dr. John Mattison, CMIO for Kaiser Permanente,  speaks from experience, having gone through the conversion process five or six times in different settings. Dr Mattison spoke at the Telecom Council of Silicon Valley’s Mobile Health Forum last week. Under his leadership, Kaiser Permanente was able to convert all their fifteen thousand physicians to EHRs within three years. “EHR conversion is about leadership and change management.  I hear about a lot of first timers scanning paper into electronic records. The problem with that is that scanned images are not searchable. You just need to abstract the older records where necessary and only scan very selectively,” said Mattison. Kaiser Permanente’s kp.org  EHR which is based on Epic now has three million users.

Dr. Mattison also talked about the key role smartphones will play in healthcare. “Smartphones are the wellness delivery channel of the future. This is going to explode; it is big and it is soon,” he said, indicating also that the mobility of the consumer will drive the development of new solutions. He highlighted some gaps in current smartphone technology that will need to be filled in order to facilitate healthcare workflows: status aware protocols for SMS when someone is away from the phone and mobile standards for role-based access, for starters. Dr. Mattison also discussed the role of social media in mobile, participative healthcare and the need for a “sustainable, lifelong model of privacy” where health information is easily quarantined from other social media interactions.

If the smartphone is going to be the wellness delivery channel of the future, I would add that today’s phones as application development platforms still have a ways to go to fully enable this. In developing mobile clinical applications you quickly run into the problems like fast, secure roaming across disparate networks. Maintaining application state and secure user context when roaming from the hospital WiFi network onto a commercial cellular network –  when the physician leaves the hospital to go to lunch while reviewing patient data — can be problematic on a number of the main smartphone platforms. Currently Windows Mobile is the only platform with a full-on mobile VPN, though that is likely to change. Support for workflow applications, where a user is really interacting with multiple applications in a seamless way, is still limited for third party developers. As the dominant player in enterprise applications, RIM seems to understand this better than most.

Your thoughts on other barriers or enablers to widespread use of smartphones as a healthcare platform?