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Connecting Smart Mobile Devices to the EHR

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My colleague, John Lynn, posted a hilarious CES marketing video advertising a new product it calls the iOximeter.  The iOximeter, which operates on both the iOS and Android platforms, is an independent device which attaches to smart phones, turning the phone into a pulse oximeter.

I strongly suspect that an i-glucose meter, i-scale and i-blood pressure cuff designed for the mass consumer market are starting to make major headway.

Not to be Scrooge at the Christmas party — I think such devices are a very positive development — but I’m left wondering what the purpose of getting the data onto the phone really is.  After all, unless the data gets to a physician conveniently, and ideally comes to live in their EMR, just how much good does it do?

On the consumer side, it does little but add bells and whistles to products consumers are increasingly used to using anyway, given that the price point for these devices is low enough that they’re sold in consumer pharmacies.

On the provider side meanwhile, you’re left with data that, while it might be arranged in pretty charts, doesn’t integrate itself easily into clinicians’ work flow.  And with EMRs already dumping huge volumes of data into their laps, some physicians are actively resisting integrating such data into the records.

No, the existing arrangement simply doesn’t do anything for clinicians, it seems.  Yes, consumers who are into the whole Quantified Self movement might find collecting such data to be satisfying, but the truth is that at this point many doctors just don’t want a ton of consumer-driven data added to the mix.

To make such phone-based devices useful to clinicians, someone will probably have to create a form of middleware, more or less, which accepts, parses, and organizes the data coming in from mobile health app/device combos like these.  When such a middleware layer goes into wide use, then you’ll see hospitals and doctors actively promote the use of these apps and devices.  Until then, devices like the iOximeter aren’t exactly toys, but they’re not going to change healthcare either.

January 9, 2014 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Healthcare Pricing, Wiki Style EMR Editing, and Quantified Self Data – @nickdawson Edition

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It’s time again for my roundup of interesting EMR, EHR, and Healthcare IT tweets. Today’s tweets all come from Nick Dawson. I don’t know Nick really well, but see him online quite a bit. Plus, I did a Google Plus hangout with him after TEDMED. He’s a very interesting guy and these tweets illustrate some of his thinking.


I’ve been hearing more and more of these cases and many of them are not even international. I’m not sure if the shift is because of the growth in high deductible plans, but there’s definitely a shift happening as far as awareness of what healthcare really costs. I hope we see a sea change in this regard.

Also, don’t underestimate the medical tourism part of this. I think there are going to be regions of this country and around the world that are going to battle for medical procedures. Eventually we’ll know that certain regions of the country are known for certain medical specialties just the same way we know Texas has oil and Nebraska has corn.


Just the thought of this will make many doctors stomach’s churn, but I like the concept. It would definitely need to be refined so there was a well defined chain of who edited what and when. Not to mention some sort of method for knowing when something was modified and by who. A novel concept, but not one I think we’ll find anytime soon.


I love to read stuff like this. I wonder if Nick pays for the action that happens. This is what really has doctors scared. Nick saved a visit, but the doctor missed out on the revenue that visit would have generated. It’s also why we need to start reimbursing doctors for online visits.

August 4, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

NBA Implements Cerner EHR – NFL Implements eCW

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Over the past couple weeks, a number of major athletic organizations have announced that they’re standardizing their healthcare documentation using EHR software. The NBA is using Cerner’s EHR and the NFL is using eCW’s EHR.

At first blush these announcements remind me of Walmart selling eCW at Sam’s Club and Costco selling Allscripts EHR. Everyone wondered why Costco and Sam’s Club were selling EHR. The obvious answer was that it was a great PR move by eCW and Allscripts. Although, I did hear about one doctor that hijacked an EHR selection process thanks to a Costco mailing. I think that’s the exception.

While big popular sports organizations like the NBA and eCW might be great PR for a company, it is really interesting to consider the unique healthcare needs of a sports league. The first thing that came to my mind was actually whether the teams would want to have their athletes’ health data on one platform. Often, the health of their players is part of their strategic advantage. Certainly there are a lot more rules about disclosure of injuries, but teams still play the injury card before games, in trades, and when signing new players. I imagine the staff doctors for the teams have to be careful how and what they document in the EHR if it’s going to be available to other teams. And we thought privacy was an issue in general EHR use. It’s much more complicated when you have millions of dollars riding on a player.

From a big data perspective, I’m interested to see if either of these leagues will be able to leverage the EHR data they collect in order to deal with the long term health issues of players. This is particularly true in the physically brutal NFL. I’m sure readers are familiar with the long term concussion questions and research that’s happening with the NFL. Not to mention the ongoing battle against the use of steroids and other performance enhancing drugs. Can a unified EHR help to provide a basis for research and understanding of the health consequences of playing in the NFL?

When I start to think about all the medical devices that are coming out, they’re really interesting in an NFL context as well. Imagine all the health data from various devices being sucked into the league’s EHR. When I talked with FitLinxx at the mHealth Summit, they said that the Boston Red Sox used their activity tracking device the year they won the World Series (Seems like Boston might want to consider using it again). From what they described, The Pebble (their activity tracking device) was a great way for the trainer to keep track of compliance with the fitness regiment they suggested. Should this data be in the league’s EHR? I can see health reasons to do so, but it does go back to the question of teams’ competitive advantages.

I bet device makers would love to compare professional athlete’s use of their devices against all of the other data that’s being collected by regular users. Would make for some pretty compelling charts if I could compare my health indicators against Lebron James or Peyton Manning.

What’s also interesting to consider about a major sports league using an EHR is a connected PHR. In these situations you want your players to be well connected to the doctor and you have a real financial interest in their compliance with doctors orders. PHR in this case could make a lot of sense. Although, I wonder if many prima donna athletes would balk at the idea. Well, at least they can have their agent or assistan log in for them.

I do wonder what special features Cerner and eCW were asked to do for the NFL and NBA. Of course, not much of it would likely be useful for the rest of us.

December 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Personalized Medicine – Processing Millions of Health Data Points

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“When you go to the doctor’s office and they do a blood test, they typically measure no more than 20 things. With the technology out there now, we feel you should be able to measure thousands if not tens of thousands if not ultimately millions of things. That would be a much clearer picture of what’s going on.”

This quote comes from a fascinating article by Jon Cohen called, “Examining his own Body, Stanford Geneticist Stops Diabetes in Its Tracks.” The idea is simple, but extremely powerful. I think it also paints a clear future for healthcare.

Michael Snyder is right that we need to have tens of thousands and ultimate millions of data points to be able to really effectively treat the human body. When I start to think about this, it actually makes me proud that the medical profession can treat a patient as well as it does with such limited information. Yet, it also gives me great optimism that the best advances in healthcare are still ahead of us.

As I’ve mentioned multiple times before, I believe that the body of medical knowledge will become too complex for the human mind to process on its own. In fact, we might already be there today. When you add in thousands and eventually millions of additional data points, then no one could even start to question this idea.

How then will we be able to process all these data points? Despite the human minds amazing characteristics, it will have to be assisted by technology. The human mind won’t likely be taken out of the equation, but computing power will assist the human mind to make much better decisions.

One problem with this idea is that the EHR software of today aren’t designed to handle this type of processing. EHR software is the database of healthcare and some might say that’s even a stretch. Does that mean that we’re going to have to deploy a new wave of software and technology to support this type of smart healthcare data processing?

July 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Memory Based Health Care to Information Based Health Care

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The incomparable Vince Kuraitis sent out a tweet a while back that I think is worth highlighting. It was actually a retweet of @Cerner_Network who seems to be quoting L Kolkman, Mosaica Partners, so I’ll give credit where credit is due. Here’s the core of what the tweet said:

From Memory Based Care to Information Based Care

I also love that the tweet included the hashtag #freethedata.

Vince has been a long proponent of the idea of freeing the data. Although, I think the idea of moving from memory based care to information based care is a much bigger deal than just freeing the data. Sure, freeing the data will be an important part of being able to provide information based care. In fact, it’s really quite necessary to provide proper health care.

The thing about this transition is that whether healthcare data is “free” and interoperable doesn’t really deny the fact that doctors are being inundated with more and more data every day.

Back in May of 2009 I wrote this post titled, “Body of Medical Knowledge Too Complex for the Human Mind.” If this was true in 2009, imagine how much worse it is today.

Even if we don’t take into account the wave of information that is and will be coming from those apps, devices, and quantified self-ers (which I assure you is coming. Even if we don’t consider all the data that doctors will be able to get from various HIE sources (which is also coming). Just within a physician’s own EHR software and the body of medical knowledge that’s being published each and every day, the physician’s memory is at its limit.

This isn’t a knock on doctors by any means. I was stunned when my wife went to her OB/GYN after not seeing her for a few years she was able to recount the most important salient points of my wife’s child birth history. This was all without the chart (which they’d filed away in permanent storage for some reason and didn’t have it available for the appointment).

Yep, many physicians are extraordinary people with extraordinary memories, but we all have our limits. Computers have their limits as well. We’ll never be without doctors and that’s a good thing. However, we’re slowly seeing the move to where a doctor really can’t be the best doctor without some technical assistance dealing with the overload of information. I think that’s a good thing.

April 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Quantified Self Is the Future

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I know I’ve mentioned the quantified self a few times in the past. Basically quantified self is that we’re all going to start finding methods, apps, sensors, etc that will collect data about our bodies. I have never been more certain of this movement than I have been talking to the people at the Connected Health Symposium in Boston. It’s going to take a few years for all of the technologies to develop, but it’s going to happen.

A simple example of this is a startup company I met called Ubiqi Health. They have a migraine tracker that helps people to track their migraines and identify their cause. Plus, this is just their first integration. I think it’s really smart for them to work on migraines first. Lots of people have migraines and very few people have a problem admitting that they have a headache (or migraine). For some reason it’s socially acceptable to say you have a headache, but not so much to say you’re depressed for example.

One thing that’s also become clear is that it’s not just going to be devices that work to “quantify” someone. It’s going to be a great mix of devices, but also is going to have to include the narrative that a person provides. The interesting thing is that from the narrative you can often capture events that might have influenced the “disease” and also can explain the quantitative data.

This is going to be really interesting to watch. I’m still thinking about how all of this data is going to affect the doctors and how they treat patients. Either way, it’s going to transform the way we deal with “health care.”

October 20, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.