Information Technology Reference
In-Depth Information
clean piece of paper. The barriers to entry are fairly low in the provider EHR market
and, indeed, we are seeing many new companies enter it. It's even lower in new
markets such as registries and quality reporting. Reinventing hospital information
systems would require a tremendous effort requiring a well funded startup company
with a sound and probably phased strategy for market entry. If it is going to happen -
this is pure speculation - it may well be from new companies created abroad with
India and/or China being the most likely sources. I certainly hope the next genera-
tion of health enterprise systems is developed here, but it may not be.
App Platforms
Several PHR and even some HIE technology vendors have recognized the potential
value that could be created if they make the data they store or have access to avail-
able through a standard set of conventions (usually called an API) to app develop-
ers. The Harvard SMART platform [
1
] extends this idea to an EHR developed
specifically for this purpose. I see no reason why this idea cannot be implemented
by commercial EHR vendors. It is also possible to envision that some standard set
of APIs might be developed such that one app can work with most, if not all, com-
pliant EHRs. The pressure to do this would likely have to come from the healthcare
industry or the government. It is tempting to wonder if this might also happen, in
time, in the large legacy health enterprise information systems.
What's requited is that all involved recognize the potential to view their products
as a “database” that could connect to interested users of that data more powerfully
and facilely through an “app platform”. It is very tempting to draw a parallel to the
app platforms and marketplaces that are already
de rigueur
in the Smartphone space
but these new health platforms would have significantly greater complexity given
the amount of data that could be made available, its complexity and the strict
demands for privacy, security and trust. However, data is being liberated in other
domains, why not healthcare?
The Future of Home Telehealth
This is an old concept but, for the most part, the underlying technologies have not
changed much. Some progress has been made. Scales, blood pressure and other mea-
surement devices now have Bluetooth
®
which now works well enough that the need
for managing wires has been largely eliminated so devices can be placed more con-
veniently for the patient. The scale, for example, can be placed in its traditional bath-
room location. Touch technology is far better and less expensive because touch panels
are now so widely used in cars, new tablet computers and other devices. However, for
the most part, today's in-home telehealth products are surprisingly similar, both func-
tionally and technologically, to what was offered a decade or more ago.
