Empowering the Patient - Health Informatics in the Cloud - page 71

Both the American Heart Association (AHA) and the American Diabetes
Association (ADA) have used the HealthVault API as part of tools they have cre-
ated for patient management of diseases within their respective domains. AHA's
Heart360 [ 16 ] allows patients to track and manage their heart related health data,
access additional information and resources on how to be heart healthy, and share
their results with their provider. A separate app for providers allows them to see how
their patients with a heart condition are doing. Again, the HealthVault system man-
ages consent to assure that patients are always in full control of access to their data.
The Telcare® Blood Glucose Meter is another interesting example of the PHR as
a health app platform. It uploads results directly to HealthVault without the need for
a Smartphone. The patient, their caregivers and their health providers can all access
the data with the patient controlling who is in their “network” and can view their
information. [ 17 ]
There are other important providers of PHRs. The Dossia Consortium, a not-for-
profit association of major employers, was formed in 2006 and provides an open-
source, secure, PHR platform supporting apps for consumer, patients and providers.
[ 18 ] An interesting example in public health was developed with the New York City
Department of Health and Mental Hygiene (DOHMH) and consists of two compo-
nents: 1) a dashboard (external to the PHR) that provides volunteer workers with
graphical population and individual level tracking and reporting, intervention, com-
munication and contextual education materials; and 2) a Dossia PHR app that tracks
a hypertension initiative. Other PHR apps provide health risk assessment, medica-
tion management and other capabilities along an integrated health record that
includes data from medical devices (wireless blood pressure cuff and scale).
MediKeeper was founded in 2003 and launched its PHR in 2004. Today it also
supports PHR apps and provides other software for risk assessment as well as a
patient portal. [ 19 ]
Patient Apps
In January, 2007 Apple® introduced the iPhone® and the idea that virtually anyone
could create relatively simple programs (“apps”) and efficiently sell them through
an online store without having to deal with the details of software distribution and
online e-commerce. Today the iPhone and Google's Android™ are the two most
popular Smartphones and there are over 500,000 apps in each of their stores. A site
that tracks mobile technology publishes a “Consumer Health Apps for Apple's
iPhone” report that it says lists over 13,000 apps. [ 20 ]
As would be expected, the patient health apps vary enormously in sophistication,
functionality and the degree to which they are directly involved in patient care.
A search of the Apple app store for “blood pressure” finds 86 apps. Most allow
patients to manually enter their readings so they can graph and track them and even
send them by email to their physicians. Patients are not covered by HIPAA so they