Google recently announced that it will pull the plug on its personal health record service, Google Health. The fall of a personal health record platform should not come as a great surprise, as many similar services have failed over the past two decades. Most of them have relied on tedious data entry and have offered little in return. They haven’t tracked actionable information such as medication adherence or health-related behaviors and they haven’t allowed the information to be easily shared with medical providers. Google's service suffered from the same problems, but the fact that they weren't able to power through these issues should get us to think twice. Maybe the problem is not in the implementation… Maybe we need to go back to the drawing board…
Google's failure to achieve adoption stems from the fact that it is impossible for anyone to build meaningful tools at scale on top of today's fragmented health IT backbone. The next step should be clear. We need to forget about separate Electronic Medical Records and Personal Health Records and start thinking about “Collaborative Health Records.” Core health data such as medical problems, medications, allergies, and medical procedures should be automatically populated by clinical information systems. Individuals should be able to easily track chronic disease management and health-related behaviors using applications on their cell phones, tablets, computers, and television. Of course, much of this data should be automatically populated by devices such as glucometers and blood pressure cuffs. The “Collaborative Health Record” will then facilitate fruitful communication between individuals and their clinical health coaches because they will have a common ground.
Here in New Media Medicine, we are opposed to making claims if we are not actively building a solution. In fact, our CollaboRhythm platform is built on the notion of a “Collaborative Health Record”. It uses the Indivo X Personally Controlled Health Record as its back-end, but it also uses the same record for clinical documentation and for communication between individual and health coach. So the personal health record is still an important part of the solution, but only if it is used to its full potential.
As another example, Spry was a project built by David Byrne, Elliot Cohen, Alexandra Dumitriu, Selene Mota, and Michalis Tolkas during Health and Wellness 2011. Users don’t sit at a computer and enter lists of medications or medical problems. They wear Wockets (specialized accelerometers) that track the magnitude of their tremor, and they use a cell-phone application that helps them to track their medication adherence and to correlate adherence with tremor control. Of course, all of this data is available in real-time with the individual’s clinical coach, since the application is built on a “Collaborative Health Record.”
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