Do you have an iPhone? Great, me too. Now, on the count of three, we’ll both drop our iPhones into a pail of water.
Ready? One, two… Wait, what’s the hesitation? I don’t see you taking the plunge with me.
And this underscores one of the big problems with our inevitable future with electronic health records (EHRs): our mobile devices just aren’t up to the task. In fact, if you stop and think about it, we’re really expecting an awful lot from these little technological marvels.
In addition to this shortcoming with hardware, there are potential problems with the EHR networks and the challenges of sharing secure data. Even if this is all addressed with regularly updated software, we still have to think about our creaky, inconsistent energy infrastructure.
I’m actually quite excited about EHRs, since they represent a leap forward in the way patients are diagnosed and treated. That’s why I hope there are serious efforts to address a few key challenges associated with the rapid uptake of EHRs.
Tough Mobile Devices
The dare to drop your iPhone into water seems silly, but it highlights the inherent weakness of the device. Despite having a (relatively) tough exterior, the iPhone and most Android devices are not exactly waterproof.
We, as humans, are fairly water-resistant. It’s a nice design perk that allows us to swim, dash through the rain, and spill coffee on ourselves. (None of this is recommended with your iPhone.)
In many cases, we’re pretty tough on our bodies. From sports to everyday life, our bodies are pretty resilient. We get banged up, patched up, and do it all over again. Through much of this full-contact life, we’re carrying delicate computers, often wrapped in some kind of third-party case. It’s like Bubble Wrap around a china doll: bulky, unattractive, and definitely not part of the original design.
Our smartphones will become more powerful and more integrated into our health lives. From heart monitors to blood glucose tests, smartphones are becoming essential health devices.
Manufacturers will need to consider ways of making more durable devices, not just pretty things that run great in the lab. Someone’s life may literally depend on it.
Few manufacturers make tough smartphones, but hopefully more are on the way. We already have tough wristwatches, tough cameras, and some very tough cars. If we’re going to tote our health information on these devices, we’re going to need a device that actually works if you get injured around water.
That leads to the next issue to consider:
Proprietary EHR Format
Does anyone know what EHR my local hospital uses? If so, let me know—I’d like to install the right app on my smartphone.
Actually there are two regional hospitals. I sure hope that they use the exact same system, although I doubt it. Does that mean I need to download two apps and enter vital health information twice?
If you are injured and need access to your health records, you can quickly scroll through your apps and find what you need. But in a different scenario, you may be unable to work your password-protected device. What happens? How do medical professionals get to essential health information?
In an emergency, EMTs might check for a medical alert bracelet or necklace, but beyond that they’re going to be looking for your wallet. Yes, that low-tech leather thing in your pocket, which contains your driver’s license and health insurance card.
To my knowledge, there’s no universal health dock for emergency rooms and EMTs. They can’t just take your iPhone and access your personal health apps. Your mobile EHR is only useful if it is accessible.
Right now, we’re in a fragmented marketplace where there are lots of major solutions vying for the dominant position. Until we have an accepted standard that everyone adopts, we’re going to be living in a world where your wallet contains the most high-tech information about your health.
Which leads us to the third issue to consider…
Fragile Computing Cloud
People love to read scary fiction. Zombies and vampires stories are more popular than ever.
Know what’s really scary? Try reading the book One Second After by William R. Forstchen. It’s a book that paints a terrifyingly realistic world after an electromagnetic pulse.
In the book, the US is hit by a terrorist attack that leaves us without electricity. We are more reliant on electricity than we realize, and the story details our decline into chaos and anarchy.
In the past, doctors could work with handwritten patient records if the electricity failed. But as we all know, many of those records are moving into the cloud.
While many experts debate the security of the cloud, few are talking about the very basic challenge of electricity. With no power, there’s no way to download patient records. And with no physical backup, doctors may find themselves with precious little information about the patients they need to treat. Even if a hospital has generators as backup, that still doesn’t solve the problem of Internet access if the rest of the grid is incapacitated.
Doctors and pharmacists use electronic devices for dosing, contraindications, and diagnosis. Knocking out the power grid or disabling one of these clouds could have a devastating effect on the way a doctor treats a patient.
The Good News
There is good news in all of this. Smart entrepreneurs undoubtedly see these opportunities as well.
Over the past few years, we’ve seen a massive growth in tough cameras. If these cameras continue to be popular, manufacturers may see a market for more durable smartphones. They are missing some profit opportunities, which are being addressed by aftermarket cases.
And with EHRs becoming part of modern medicine, we’ll begin to see some synergy between professional and patient apps. As an industry, we’ve done a pretty good job with application programming interfaces (APIs) that allow for secure connections. It would make sense to bridge the gap between personal health records on a smartphone and hospital computer systems. Information about your health conditions, allergies, and current treatments could help save your life.
The big challenge may be something that happens at a government level. The average citizen has no influence over the security and backup of our electricity grid. We also have no real input about how much of our information will be migrated digitally to the cloud. These are questions that are answered by government and utility companies. This can be good or bad news, depending on how you frame the challenge.
Looking forward, there are good reasons to be excited about mobile health. Our devices are becoming more powerful, the software is smarter, and the EHRs are poised to make a positive impact on healthcare.
Just don’t drop your smartphone in water and everything will be fine.