

HealthKit Gets the Incentives Wrong - nogaleviner
https://blog.picnichealth.com/apples-healthkit-gets-the-incentives-wrong/

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joesmo
Why would it have been a big deal if healthcare providers did decide to share
health data back? It seems to me all this data is available from one's current
and previous doctors. What type of information is the article referring to?

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troyastorino
The article is referring to automated electronic access to your medical data
(lab test results, diagnosis lists, procedure histories, etc). If you were
able to get automated, electronic access to all of you medical information, it
would be a very big deal.

Until very recently, medical data was only available from your doctors in the
form of copies of paper records, and it's a hassle to pester all your doctors
until they give you your records. Even once you got it, the data wasn't
digital.

Because of Meaningful Use requirements coming online this year, patients now
have to be given electronic access to their data (Meaningful Use requirements
determine how doctors have to show that they use Electronic Medical Records in
order to receive subsidy money/not get penalized). Electronic access takes the
form of online 'portals' where patients can see their data. And although this
is a big step forward, the information isn't given to patients in a form that
is very useful--the data isn't easily exportable (for yourself or to send to
other doctors), and if you've seen doctors in multiple systems your data isn't
aggregated.

I'm also one of the PicnicHealth founders, and we're taking advantage of these
portals in order to give patients automated access to their data.

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nogaleviner
Hey, Noga here. What do other people know about EMR/clinical data integration?

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perturbation
(Slight rant):

HL7-all-the-things as a solution to interoperability (hey, v3 is this new
fancy thing called XML!) The incentives are often backwards for hospitals to
want true interoperability - this is with HIEs have been known to fail - "Why
should I give my competitors all of these leads - I mean, patient data?". Add
on top of that HIPAA (and state-by-state) requirements, and you impose
significant overhead to sharing data even if an organization wanted to.

Health IT is a difficult problem not (primarily) because of technical
challenges but because of human challenges (arbitrary updates because of
regulatory requirements, requirements in software to mirror what was done on
paper years ago, etc.) None of the low-hanging fruit will really change with
HIT until we make incentives line up with what's best for patients (which will
probably mean changing a lot more with the healthcare industry as a whole).

