The New York Times

194348 Resource 182418 191501 183236 1199899385870 1200002137784 Controlled Google Closing in on Lifespan Health Planning

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. 9 application/xml false Health Care Reform Lifespan Planning Record LPR The New York Times "Google is Pursuing Plans to Put a PC in Every Pocket." This Times article explores Google's cell phone strategy. http://query.nytimes.com/gst/fullpage.html?res=9A07E2DF173FF935A35752C1A9619C8B63&sec=&spon=&pagewanted=1 Health Politics "Health Records of the Future." This program from the Health Politics archives discusses the details of a Lifespan Planning approach. http://www.healthpolitics.org/program_transcript.asp?p=your_health_future Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 5.1; (R1 1.5); .NET CLR 2.0.50727; .NET CLR 3.0.04506.30) 127.0.0.1 127.0.0.1 plarson 24.13.80.118 false true false false true 179654 false false true false false false true 194387 Resource 179654 173239 183236 1199921341497 1200065044190 Controlled a new EMR alternative

Mymedicalrecords.com

I read with great interest your post about electronic patient records. I’d like to introduce you to MyMedicalRecords.com, which has by far the most sophisticated, user-friendly, web-based, secure approach compared with any of the other companies in the field. And it is recognized as such by some within the healthcare industry: we have tens of millions of patients at least passively in the system through our partners and revenues are expected to shoot from $550,000 last year to $27 million in 08. Yet almost nothing has been written about <stockticker />MMR</stockticker /> (I’m a freelance journalist brought in to help them get some media exposure—I had written one article about <stockticker />MMR</stockticker /> a couple of years ago and didn’t really understand how revolutionary it was at the time).Sincerely,Scott S. SmithDirector of Public RelationsMyMedicalRecords.com<street /><a href="mailto:ssmith@mmrmail.com">ssmith@mmrmail.com</a>   10 application/xml false Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 5.1; (R1 1.5); .NET CLR 2.0.50727; .NET CLR 3.0.04506.30) 127.0.0.1 127.0.0.1 plarson 24.13.80.118 false true false false true 194608 Resource 179654 173239 183236 1200174382565 1200242754332 Controlled A PHR With Value Built In

MyMedLab

The issue with the slow adoption of PHRs is that consumers quickly realize what they have purchased is really just an empty box, a bank account with no money in it.   They begin to understand that a place to store their data is not as important as the access to that data to begin with.  Most PHRs leave it to the consumer to gather their private information from less than cooperative providers.<u1:p /><o:p /> A real Health 2.0 solution involves more than just a pretty box; it must contain valuable data regardless of what the consumer contributes.  It self-populates important data, then allow the consumer to expand it if they choose.<o:p /> I am the founder and CEO of the 21st Century medical lab, MyMedLab.  Our mission has been to remove the barriers that consumers find when attempting to get more involved in their health.  We have seen first hand the frustration consumers encounter from a health care system that “protects” them from their own information.<u1:p /><o:p /> In November, we released the latest version of our online portal providing consumers direct access to the same diagnostic lab tests once only available to doctors.  A simple consumer friendly process allows them to choose from a list of the 100 Most Common Tests as well as 20 Wellness Profiles based specifically on their age, sex and family history.  <u1:p /><o:p /> Once they have chosen the appropriate test and purchased it online, they visit one of 2000 participating collection sites across the country at their convenience, without an appointment to have their samples drawn.<u1:p /> <u1:p /><o:p /> Results, when complete, are reviewed by a physician in their home state and automatically uploaded into their own MyMedLab Personal Health Record (PHR).   From inside their private PHR, they can access detailed information about their results through the embedded links to the National Library of Medicine.   <u1:p /><o:p /> For first time users, their initial results create the “baseline data” and allow them to track changes in their health over time.  Our testing becomes a valuable tool for not only those looking to find potential health problems early, but as a way for those with chronic disease like Diabetes and Heart Disease to get directly involved in their care.<u1:p /> <u1:p /><o:p /> The MyMedLab PHR allows consumers to easily share this information, if they chose, with their family doctor by printing them out before they next appointment or faxing their results directly from inside their PHR.  <o:p /> David Clymer, CEO<u1:p /> MyMedLab<u1:p /><o:p /> 10 application/xml false Mozilla/5.0 (Windows; U; Windows NT 6.0; en-US; rv:1.8.1.11) Gecko/20071127 Firefox/2.0.0.11 127.0.0.1 127.0.0.1 204.13.183.235 false true false false true 194704 Resource 179654 173239 183236 1200346908723 1200353049221 Controlled Nice summary

Two spams for a single post--surely you're on to something, Mike. Seriously, I would love to have my patients' parents come to me with their complete record with them in one convenient place. This would be particularly useful for imaging things like previous x-rays, CT scans, and EEG tracings. 10 application/xml false Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.0.3705; .NET CLR 1.1.4322; .NET CLR 2.0.50727) 127.0.0.1 127.0.0.1 24.196.50.2 false true false false true 195010 Resource 179654 173239 183236 1200599799653 1200670846652 Controlled Why Centralize?

Thanks Mike for a great review - as always. I have recently moved to the US and was struck by the way physicians seem loathe to share information with their patients. The concept that the info might belong to the patient (who paid for it after all) does not seem to strike home. With regards to personal health information it would seem logical to me that all of a patient's health infrmation could be stored on a single card or chip and kept with the patient inthe same manner as a drivers licence. No matter where that person is or who s/he consults, that information in its entirety is available to the healthcare provider. This could be backed up on their home PC.It alleviates the need for large expensive databases and reduces the chances of fraud. 10 application/xml false Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322; InfoPath.1) 127.0.0.1 127.0.0.1 148.168.127.10 false true false false true 182418 blog blogsite/HealthCommentary/web