Almost every day there is news of a new device or smartphone application that can be used to collect and transmit health related data. The Internet provides the means to move the data, cloud computing provides the means to store and analyze it, and the devices and apps provide the means to collect and transmit it. Data, data, data! But where is the information doctors and patients need to provide better and less costly health care?

In this blog we are looking at data collection devices and smartphone applications that are prescribed or recommended by a doctor and/or are acquired by a patient with or without consultation with the doctor. This later group includes apps to track a patient’s training for a specific sport such as running or bicycling. As noted in my recent blog, Expanding the Scope of EMRs, this type of data presents new challenges and opportunities.

What do Doctor’s Need?
There is no way a doctor can keep up with all the devices. The last thing they need is a patient who asks, “Doc, what does this data about my last bike ride mean?” A doctor needs information about the device and needs the raw data analyzed and converted to information she can use. She needs to know or be able to quickly learn enough about the device to assess the quality of data. Data, such as a heart rate, with no reference point is meaningless.

The analytic processing should be provided by an EMR to assure required data security and to integrate all of the available meaningful data about a patient’s health including physician examinations. The system should be able to analyze the data and provide decision support for the doctor. It should also initiate appropriate action such as sending a message that says “data indicates need for immediate attention” or making a note in the electronic patient record to remind the doctor to look at the data as part of the patient’s next appointment.

What do Patients Need?
Patients need to be able to do what is in their best interest with a minimum amount of effort to gain the optimum benefit for them and what they care about. As an example, if I am a bicycle rider, today I can use a combination of devices to collect data about my ride, heart rate and caloric burn. I can then upload that information from my smartphone.

Minimum effort would allow me to upload to one system, e.g., my personal health record (PHR) where it would be analyzed and made available to my EHR for use by any of my doctors as noted above. As directed and defined by me, some of the data and analysis, including personal health information, could be forwarded to a social network such as PatientsLikeMe.com. Some of it could be anonymized and forwarded to another social network for further analysis. And, some of it could be forwarded to my cycling group for bragging rights. The analysis could be sent to me with trend lines to measure progress and, if appropriate, caution me about my maximum heart rate on hot summer days.

Who Provides the Technology?
There are several missing pieces today. EMRs are required by federal regulations to provide some analytics for “meaningful use.” Device vendors and interested third parties could provide device-specific tools to analyze the data. That sort of participation is fairly common as part of the Internet. Users want better data and some will work to get it. A device that can advertise that it can be used in conjunction with a list of EMRs gains a competitive advantage.

Device vendors need to provide information about their device and the data to allow the doctor to assess its usefulness in a particular set of circumstances. A trade association or the EHR vendor could monitor the information to separate unsupported claims from demonstrated capabilities. Credibility is critical.

The larger the number of participants and the greater the number of interfaces the more significant data security becomes. In this model, the EMR will have primary responsibility for security.

Doctors will have additional choices to make including what information they want to get. They may want to track a patient with a newly-prescribed device daily and that frequency could be reduced over time. They may want to track key parameters which vary by patient. They may want benchmarking data to assess results for specific patients. The richer the choices, the more valuable the data will be to the doctor. The means to set these parameters should be provided by the EMR system.

The Greater Value
Devices are being used to track diseases and cures. As more devices are used they will become less expensive and the quality of the data and the databases used for analysis will improve. Patients will be given new tools to self –manage their care. They will be motivated to do what needs to be done by knowing the doctor is tracking their progress and friends in their social network are lending encouragement.

Devices purchased by people who simply want to track their health will provide data about healthy people that is generally not available today. Tracking people at very early stages in the onset of a disease rather than waiting until they see a doctor will place a greater emphasis on prevention rather than cure and lead to better health using lower cost solutions.

Better healthcare at lower cost.