   | | Public Health |  | | Story of the Week | January 09, 2008 | | Mobile phones for planning and adherence | By Mike Magee, MD
You may have noticed a front-page headline recently in The New York Times: “Google is Pursuing Plans to Put a PC in Every Pocket.” According to the Times, “what Apple began with its iPhone, Google is hoping to accelerate with an ambitious plan to transform the software at the heart of cell phones… The personal computer is climbing off its desktop perch and hopping into the pockets of millions of people.” Experts predict that a burst of new tools for software programmers will accelerate this exciting transition of computing power from the desktop to the pocket.
As so often is the case these days, this story brings with it an obvious health care angle. Consider for a moment your personal medical record. Not too long ago, America’s leaders in medical informatics in government and academia were content to debate the merits and challenges of moving from a paper-based medical records system in hospitals to an electronic system. That was a worthy goal. But as leaders diligently began this conversion, the environment began to shift under foot.
In fact, by 2005 it had become quite clear to many leaders in the field that “the record” properly resided with the patient from whom health data emerged – not the hospital -- and that the data that flowed through the medical community was only a part of the overall picture. Thus, the concept of a “personal health record” began gradually subsuming the vision of an electronic medical record.
Today, the “personal health record” is on the verge of being subsumed again – this time by a new, more comprehensive concept called the Lifespan Planning Record, or LPR. The Lifespan Planning Record includes much more detailed information intended to help an individual manage his or her overall health – ranging from economic, social, educational, and spiritual goals and milestones to medical and scientific objectives.
The Lifespan Planning Record offers an exciting vision of how radically different our health care future could be. Born today, the newborn child’s LPR would already be inhabited with a great deal of data – ranging from some reasonable compilation of the records of parents, grandparents and siblings to future diagnostic and preventive therapeutic measures, based on familial information. Print, video and graphic information from other accessible intelligence databases would be seamlessly interwoven.
As time passes, this “living record” would flexibly grow and adjust to assist informed decision making, preventive behavior and full and complete human development.
But what does this have to do with Google and cell phones?
The answer is that the LPR can only be realized through significant advances in our technology infrastructure. And Google’s most recent action begins to address several hurdles that stand in the way of the LPR. One is the problem of bandwidth and transporting information – a curve Google is clearly ahead of. Second, people -- especially those with a high burden of chronic disease and those challenged by socioeconomic factors -- often don’t own computers or have trouble using them. But cell phones are everywhere. Third, the development of new applications is a must – to help people manage complex medical knowledge and to store vast amounts of data. And Google has already started down this road.
Obviously, many issues will need to be sorted out – not the least of which are confidentiality, patient privacy, and control over records. But Google’s announcement opens the door to this potential reality just a bit more, shedding new light on our health care future. For much more detail on the LPR concept, please watch this week’s video (embedded with this blog post) or read the full transcript, below. What’s your take on the idea of a Lifespan Planning Record? Please post a comment. | | |
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