Intro: Indivo X 2012 Users' Conference

Indivo X Users Meeting

2012Kenneth D. Mandl, MD, MPHBoston Children’s Hospital Informatics Program

(www.chip.org)Harvard Medical School Center for Biomedical Informatics

The Personal Health Platform How it diffused Why Google Health died on the vine The cure for personal health platforms

Portals: A static view into the EHR

PCHRs: Apps platform, and a patient copy of the data

New England Journal of Medicine

NEJM

Ecosystem

SubscribeThe Verbs of PCHR

New Approaches to Data Liquidity

ShareThe Verbs of PCHR

81.4%

34.1%

VA Survey

79% of Veterans are willing to share personal health information with those outside their health system 62% with a spouse or partner 23% with a child 15% with another family member 25% with a non-VA health care provider

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Add an AppThe Verbs of PCHR

“We cannot overstate how important PHRs are to the efficient functioning of a low-cost, high quality health-care system . . . . We think that the INDIVO system, or something like it is a good place to start.”

--Clayton Christensen Harvard Business School

Keeping EHRs Error-Free: the Value of Patient Engagement

http://commonhealth.wbur.org/2011/07/killed-google-health

• Trust issues

• No app developers

• No data

The App Store for Health

ONC Funded Research Project under the “SHARP” program

Clinical use case

Med-tastic is a well-funded NewCo which has developed an elegant medication list application that has physician and consumer facing functionality. Patients can annotate medication lists for accuracy.

To work, Med-tastic needs Prescribing history Dispensed medication history Allergies Problem list diagnoses

Healthcare IT: Why Can’t

Innovators widely share what they create?

Systems innovate faster to support fundamental health care improvement and cost reform?

Providers readily request features and applications?

?

We imagine EMRs as an iPhone-like platform where Medtastic

could create and widely distribute an app across many

disparate EMRs and PHRs

EHR as an “iPhone-like” Platform

There is a common application programming interface that enables Software developers to build SUSTITUTABLE

applications Push innovation to the edges Nimbly evolve functionality Avoid vendor lock Shrink switching costs Enable disruption

An

Inspired Design

from Dave McCandless

(cc license)

1 Design + 1 Developer + 1 Week

1 Developerin1 Week

1 SMART App in 3 SMART Systems

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SMARTBP Centiles AppRunning on Cerner

Medication adherence

JAMIA 2011

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Brief Tangent

I2b2 NIH Funded Pulled into use at 61 Academic Medical Centers ETL Involved in QueryHealth

“Side Car Strategy”

The data need to come out for analyticsOnce they are out . . .

i2b2

Portal-PCHR Hybrid

SMART Platform Apps Have access to EHR data in a vendor agnostic

fashion (from an Epic system, a Cerner system, or an complementary system with data warehoused from the EHR)

So, one can readily create a patient facing portal, which is an apps platform

Portal-PCHR Hybrid

SMART APPSEHREHR

SMART APPSIndiv

oIndiv

oConnector AppConnector App

Clinician-

Facing Apps

Clinician-

Facing Apps

Patient-

Facing Apps

Patient-

Facing Apps

The best of both worlds: •A local portal, with lots of data from the EHR•A personal health platform with patient control, sharing, and apps

www.indivohealth.orgwww.i2b2.org

www.smartplatforms.org