01 Mar The XHR: Neither "E" nor "P" but to the power of X!
Earlier this month Matthew Holt over at The Health Care Blog posted an interview with John Halamka, MD (CIO at Beth Israel Deaconess Medical Center). John is a well known and highly respected pioneer in the EHR space and recently sold the intellectual property of the homegrown EHR he had spearheaded at the hospital to one of my favorite companies AthenaHealth. I found the arrangement pretty interesting, but know the AthenaHealth guys to be super smart and super driven to fundamentally transform the practice of medicine through information tech so I look forward to seeing what they can do.
I found a key piece of their interview pretty compelling. Matthew was reviewing the history of “tethered” PHR’s and the challenge of integrating patient data (now in his case his own children’s) into a common record, and John made an interesting and personal comment / observation:
Matthew Holt: You put out in 1999 one of the very first PHR tethered web-based access virtual medical records for the patients? And we’re now in 2015, I’m still giving talks about how impossible it is to get my kid’s data out of the various practices and systems that he has gone around in his short life. And you hear much, much worse stories from people who have really serious illnesses. Where do you think we are?
John Halamka: Let me give you a couple of answers to that. As you know, my wife was diagnosed with Stage 3A breast cancer in December of 2011. And she managed 35 rounds of chemotherapy, radiation, and surgery because she had access to 100% of her records. Because as you’ve seen from OpenNotes and such things we’ve done, the patient and the doctor actually see the exact the same record. There is no idea of an EHR to PHR. It’s a shared medical record. She told me she could not have made it through her breast cancer treatment without that seamless access to 100% of the data. Her care preferences and care plans were jointly developed and mutually visible. So I think you’re seeing huge patient demand for this sort of thing. And there are some enablers . . . I really like the idea of Apple Health Kit which is a middleware application to take data from all of the devices in your home and share them as you wish with apps that might include a care manager or your doctor.
At Crossover Health, we could not agree more. We have code named our own “patient engagement” technology the “X”HR because it is neither an EHR nor a PHR. In fact, we just got rid of those tired concepts by making it a shared record. Our physicians and our patients can see and use the same information and data. It’s powerful for the patient to be able to have access to their own information but even more powerful when they begin their visit with their trusted advisor by looking at that same information. Not just eyeballing it together, but really discussing it, reviewing it, making plans based on it; and, then following up on this information in subsequent interactions (which may or may not be in person). This concept, and the metaphor of a truly collaborative record is a powerful paradigm shift.