It appears that the post mortem on Google Health is already being performed – six months before the patient is dead! But pointing a finger at the US Healthcare system misses one of the key issues, surprising for such a marketing-savvy company. What exactly was in it for the patient? Isaac Kohane, who directs the informatics program at Children’s Hospital in Boston, and co-directs Harvard Medical School’s Center for Biomedical Informatics gets its right when he commented, “Expecting patients to actually do data entry is not a scalable and workable solution.”
The Rise of the Patient Community
When someone gets diagnosed with a disease what’s the first thing they do? They certainly don’t fret about meaningful use or interoperability, or even lament the fragmented Health Services in the USA. Their disease is personal, but not unique.
They will be one of the millions seeking out sites like www.patientslikeme.com or one of the countless disease-specific communities springing up all over the internet. They don’t want to be physicians. They want to know what their outcome is likely to be, and who shares their situation.
This desire for a sense of community at a time of uncertainty is a natural human emotion, and that drives behaviour. It can also improve outcome. Quotes on the patientslikeme home page such as “I don’t think all the money in the world could replace what I’ve learned here,” speak volumes for its power. Filling out EMR details to enable information flow will not provide the benefit they are after, so it’s not being done.
Rich, secure data will educate decisions and drive better outcomes
Now imagine if physicians had the scientific equivalent of patientslikeme to guide their decision-making. Imagine them having the ability to identify their patient as a member of an anonymised community (cohort), defined by a combination of clinical history, omics profile and increasing dimensions of diagnostic data – all fleshed out with up to the minute research information.
Most importantly, physician colleagues who have treated those other patients could have easily entered outcomes for patients in that cohort. They benefit from interoperability but do not NEED it. This can work even in small aggregates of clinics and hospitals – easily within the reach of even a fragmented, but highly populated, Health system.
What’s in it for the patient if clinicians share their experience of treating defined patient cohorts? Better outcomes, more consistent decision-making and best practice.
What’s in it for the physicians? Better outcomes.
What’s in it for Science? The creation of a unique knowledge base, secured and anonymised to protect the individual.
This is what we are doing with our commercialised Personalised Medicine solutions. It puts ‘real-world’ data, at the right time and with the right analytical capabilities, into the hands of researchers and clinicians. This allows them to make more informed decisions and enables ‘virtual’ collaboration between physicians.
Innovation is about Changing Clinical Practice through data
I recently heard Professor Steve Smith, CEO of Imperial Healthcare Trust comment that: “Innovation in Healthcare is only achieved if an idea actually changes clinical practice”. Asking patients to move their own data around so that others can view it has been shown not to meet that measure.
Allowing clinicians to see and share outcomes, which contributes to anonymised cohorts, provides all the symbiotic characteristics of a community. This will genuinely change clinical practice for the betterment of patients and a more effective healthcare system – however ‘Balkanised’ it may be.