November 11, 2005
You Can't Always Get What You Want…
One of the many hurdles for using electronic health information effectively and efficiently is how to find what you want. Or even how to find what you need.
I keep talking about all we need is access to our personal health information whenever and wherever we want it. We don't need an Electronic Health Record (EHR) in the traditional sense of it being like the current analogue variety.
It's not really that simple. One of the apparent driving assumptions behind the EHR movement is that there is a set of information that is always valuable to know about an individual. There may be, but it is usually not all that is needed. And in the case of managing chronic illness it may be easier to define a set of data that are needed repetitively, but is it always what you need to know to solve the next problem?
The truth is most of the data points generated about the health status of individuals are never needed again. EVER!! That is, most points are never really needed to address the next problem. For example, it is not necessary to know that you fell off a horse when you were twelve and broke your arm in order to treat your Type 2 diabetes.
So, even if all of your health data could be assembled into a digital EHR, most of it would be useless. And, even if you could access all of your personal health information, how would you find what you need this time? Or right now for the problem today?
Even in the management of chronic illness, physicians can fairly easily assemble enough data to make decent judgments about what to do in the absence of previous information. It is not efficient. And it does create needless uncertainty and thus risk, but nonetheless, it is generally effective. So are pen and paper.
This may in part explain why it is so difficult to show value from adoption of EHR.
As I like to define it, healthcare is a technology based, information dependent, personal service. Like most folks, I love the technology part. It holds promise for solving some knotty problems we now face
The November 2, 2005 TechnologyReview.com from MIT has an interesting industry update from alarm:clock.
Called “Finding Signals in the Noise” by Jon Burke, they review some software startups that may help us all find the information we need and want from the massive amount of information that is out there.
Here is the interesting group of startup companies seeking to solve this problem for us. They could have great applications in the area of either EHR or access to the information we need whenever and wherever we want it.
“Few would dispute that we live in an age of information overload. In the last few years alone, blogs have increased the torrent of information each day to unmanageable levels.
This would explain, then, why a corresponding torrent of startups has surfaced recently to help us filter, manage, and control this flood of information. Some rely on insightful algorithms that understand popularity to filter the news, while others rely on the preferences of readers.”
“For example, Digg is a San Francisco startup that ranks news items by letting people choose which stories they like. It just landed $2.8 million in venture capital from Omidyar Network, former Netscape founder Marc Andreessen, and Greylock Partners. We also understand that a comparable site -- Memeorandum -- may close a round of financing shortly.”
“The concept of making users prioritize or create hierarchies for news is not new -- Slashdot has been doing it since 1997. But the latest generation of sites like Digg and Memeorandum are showing that user-prioritized news is, indeed, a powerful and easy way to drive traffic -- in some cases to a site created by a single employee with a lone server.”
“These services could expand their destination sites to other topics, get the same breadth of coverage that Topix.net , an early entrant in the news filtering space, offers, and then perhaps partner or get bought by the kind of big publisher (Knight-Ridder, Tribune, Gannett) that bought Topix.”
“Among other entrants is Inform.com , a recently-launched New York-based firm that automatically categorizes news by breaking down items by key elements. Other related offerings come from Findory , a Seattle-based venture started by a former Amazon employee, which bills itself as a personalized news site that learns and makes recommendations based upon the articles you read.”
“While most of these services claim they'll simplify your life by imposing some kind of order on your news consumption experience, we still wonder about their ultimate utility. It wasn't that long ago that simple RSS readers such as Bloglines , which allow you to subscribe to your favorite headline feeds, were hailed as the ideal method for organizing and consuming content. Call us old-fashioned, but we think RSS readers works pretty well.”
Well, you get the idea. There is a burgeoning industry out there all vying to be the next Google by helping us find what we need in terms of information when we want it and ranked by importance to us. Just think of putting this technology into an EHR or a system of access of medical data bases!!! Now we're really getting somewhere.
Robert B. Teague is a pulmonologist and business consultant who is based in Houston, Texas. E-mail him.
Read other blogs in this series.
