Clarity Health Journal: Food Diary app

Consumer Health Application

You are in a stretcher being taken to the Hospital Emergency Room.  A business trip or vacation  has been interrupted, you are away from home, no one you know or knows you is around. You’re unable to communicate with the paramedics even if they could understand you; you’re just trying to  keep breathing. Where is your health information: your medication records; your most recent doctors visit; lab results? Even your emergency contact, blood type and known drug allergies?

Will digital medical records save your life?

Now imagine you have an a consumer health application, a simple health card is in your wallet. It contains your emergency contact, blood type, allergies, health insurance and a web site to access your full health information. You could also have an  Emergency report with you that you printed before going on your trip. All this information could save your life.

All your family health info

The majority of us leave our health information in the hand of professionals, our doctor, the clinic or hospital. Most times this is enough; our family doctor can fax or send details to a specialists, the hospital or clinic will sent lab results or clinic notes to our family doctor. All your health information is safe and secure in the hands of the medical professionals you deal with regularly. But when an unexpected event occurs, this safe and secure health information is not available to the paramedics or doctors tiring to save your life.

Your health information at your finger tips

Maintaining your personal health information gives you and your family control. Keeping a family health record will give you a secure, safe and comprehensive set of health information that can be used to keep you healthy.  And when you need it it could provide a voice that is missing during an emergency situation.

Consumer oriented healthcare

Healthcare reform is a political hotbed in the US. Even in Canada, Europe and other parts of the world health care is a political and financial concern. As our population ages and health care needs rise we need to maintain costs to reduce the overall impact on our future health. Everyone agrees that to preserve even our current levels of health care spending we must make changes for greater sustainability.

Recall how stores, banks and other services industries operated 15-20 years ago. There were no online registrations or self-help kiosk. Today some stores give consumers choices, the ability to self-server or to get personalized services from an associate.

Global eHealth access

When traveling we don’t normally take all of our health information with us. You may have some recent details on your prescriptions, but not much more. A friend told me that when he travels he usually runs for exercise, on his shoes he has a tag that contains his doctor’s name and phone number as well as the doctor’s cell phone. If my friend were to drop unconscious someone could contact his doctor and get help immediately…hopefully. While this medical emergency contact information is a start it doesn’t suffice for most people with serious health conditions.

It makes perfect sense for a healthy person to carry emergency contact information. Perhaps, it would be worthwhile to have more immediate info accessible to the emergency response person wherever you may be. Yet a simple slip of paper with information on it is not enough. How does someone know you have such a document in your pocket? Some solutions such as medic-alert have been used for individuals. A simple call to a toll-free number provides access to medical information using a call center services. Is there a better way?

Personal Healthcard can be used to access info during emergency

One solution to this issue is USB key technology. Why not use a USB Key? How many USB Keys do you own and how many have you misplaced or lost? Compare that with your credit card. You carry one or more of them in you wallet, purse or pocket. Even when lost you can easily get them replaced or reissued. Devices like a USB need a computer, credit cards just need card readers or scanners. And even without the computer or internet a smartcard can have information on it and in it that can still provide information when needed.

Many have compared eHealth with eCommerce and ATM banking. We can take a page from this domain and use the smartcard. This is used for credit and debit cards. A personal healthcard based on smartcard technology can store encrypted data about the individual and also have access to family members’ health details if needed. The card would have a photo for identification and a number and name to identify the person quickly. Yes, it would be required that the emergency response would have to have a card-reader to access the stored data on the card. The technology can even have information printed on the card, along with a Name, Health card number there can be an emergency phone number to a central agency.

The card can also have a 2-d barcode that can be scanned to reveal more details that may be needed by EMS and that the user would want to keep private form someone visually inspecting the card. Scanning the 2-D barcode could also direct the user to a website. With added security questions and login the site can provide access to a full health record. Add RFID and a biometric such as a fingerprint, retinal scan or DNA and you have a very secure mobile device for health information. This would eliminate individual hospital cards and allow global access to health details wherever you are.

Clarity Health Journal 2-D barcode

Such a solution could be used by anyone. The scanner and card-reader technology is readily available and easily deployed by EMS and hospital ER departments. It would reduce the stress related to remembering passwords and also make it easier in case of emergencies.

Keep your Health, while you got it.

In another time my age would be considered old. Not to say that I am young, I think I’m middle-aged. My mother-in-law and father-in-law are in their 80′s and they are still very active. My mother-in-law takes week long bike trips that cover 75 km a day, my father-in-law still works as a human resources consultant. They are both physcial and mental well and contributing socially. What once was old is now middle-age and seniors are as active now as ever. The boomer generation is living longer and contributing more than ever.

When it comes to old-age we all hope to get there, the alternative is unattractive. And we want to retain both our physcial and mental health. We expect it, just as we expected to go to university, start a professional career, buy a house, raise a family and see them start their own education and begin their careers as well. And as we get older the last thing we want is to suffer ill health and become a burden to our family and society. But as I said we all will eventually get there, it is just a question of when?

Staying healthy is a goal for all of us. Stay young at heart, that is, keep it pumping. Stay mentally active, keep learning new things. It really is that simple.

Personal Health Information

Who’s your keeper?

When you go on vacation you give a key to your home to someone. You may even have a neighbour that keeps an emergency key for you. And you trust them not to go through your stuff; just water the plants and bring in the mail. Who does this for your health information?

When you are travelling do you have enough information with you about your health? Can you get your health information? What if you are unconscious, perhaps your spouse or travel partner can convey the information needed.

Of course your family doctor has your health information, right? So is your doctor your keeper? Can they provide this info when you are out of town? When you are in the waiting room of a hospital in another city or country, when you can’t speak for yourself, who is your keeper?

Medic Alert has a great message; “we speak for you”. Their service includes more then allergy alerts it includes health information. Other services provided phone support for medical emergencies.

As a Scuba Diver my wife and I belong to Divers Alert Network(DAN), along with travel insurance DAN provides a 24-7-365 phone services in case of medical emergency. But they don’t have my medical record.

Perhaps all you need is a sheet of paper folded up in you pocket, with a list of numbers, perhaps drug prescriptions and contact details. Is this enough?
With my bank card I can go to any ATM almost anywhere in the world and withdraw money. I may not be able to deposit a physical cheque but with ATM access and internet access I can do almost all of my banking anywhere I go.

Clarity Health Journal

Yes the same is possible with my health information. A smartcard with PIN access, that can be read in any computer in a hospital of doctors’ office. And you can use the internet to access what you need. Of course you will still need a neighbour to water you plants and feed the cat.

Manage your diabetes

Che Guevara freedom fighter and doctor

Ernesto “Che” Guevara was a trained physician before becoming a freedom fighter. As a medical student he sought to change the world through the treatment of leprosy patients. By the time Ernesto was in medical school a protocol and treatment of this chronic disease was widely available. His specialty of medical research became one of treatment rather then curing patients.

My experience with doctors is that through their training or because of their personality many present themselves as authority figures. As patients we revere their opinion and sage advice adding to this image. At least this is historically the case.

What is a doctor to do when their advice and knowledge is challenged? When Ernesto couldn’t fulfill his desire to make world-wide impact as a doctor, Ernesto became Che the revolutionary leader and freedom fighter. I have seen some doctors turn their attention to Health IT as a way to make significant changes in healthcare.

People with a calling for social change, especially through medical treatment have specific personalities. Doctors, Nurses and other care providers tend to be “sensing, intuitive and judgemental” personalities based on Myers-Briggs. These are generalized views yet, there is evidence that through training these are the personalities that are successful in the medical profession. People who seek careers in accounting or computer science tend to be much more “introverted, thinking and detailed” types. While medical science does tend to require similar discipline and logical thinking it seems to be much more intuitive than some of the more exacting disciplines that use much more quantitative evidence rather the qualitative techniques. How often have you seen a doctor have “gut reaction” to symptoms reported rather then get out precise measurements to make a diagnoses. Yes, we have much more measured scientific results through lab tests, decision support and evidence based medicine, yet in most cases the doctor just “knows” or at least gives this impression to the patient. If they have doubt it would affect many of their egos to show it.

Based on the differences in personalities it is a struggle to combine the Medical and Computer disciplines in a single individual to work on electronic healthcare. Doctors don’t want to be pigeon holed and required to document each atom of data. They want to stay in touch with the patient and see the computer as coming between them and their client. Electronic systems need to be used to be effective, data needs to be categorized and atomize so that it is easy to index and query. This dichotomy makes these two professionals difficult to combine their skills to create the best of both.

The doctor’s most successful tool is information. Years of training and exposure to medical techniques gives them the confidence to treat patients. In my experience they use few references and not in front of the patient. Many doctors’ rarely say, “I don’t know” or “let me look that up”. Partly this is training but also there is, I believe a desire to show no weakness to the patient, thus not losing their confidence. After all if you, as the client, have any doubt you may question other things that you are being told.

With the ever increasing availability of information we face greater challenges to medical information. Like the priest of old that kept scrolls away from the eyes of the worshipers became demystified once the Guttenberg press allowed laymen to see and read the bible themselves, today the internet gives patient access to medical information previously only seen my the “high priests” of medicine.

Patients at times know as much and sometimes more then their family doctor regarding their specific ailment. In the case of individuals with chronic diseases, who have had the conditions for all their lives, new doctors may be challenged by the patient who has had more and greater first hand experiences with the ailment than they do. All this challenges the medical profession.

Technology is seen as a threat to both nurses and doctors because the balance of power is shifting. Current privacy legislation even points out that all the personal and medical details gathered by doctors and nurses belong to the patient. The introduction of personal health information systems controlled and owned by the patient then further erode the hold of medical professionals on medical issues.

 

The eyes have it

When I began school I didn’t speak English. As a immigrant child my first day in school was terrifying. I literally knew not a word spoken by the teacher or the other students. There was a cousin who was born in Canada and spoke some Italian, but like me it was only the vocabulary learned from our parents. It wasn’t proper Italian; it was “montanare”; literally “mountain speak” a dialect not from a region but from a small town in the region. You can well imagine the difficulty for the first several weeks as others spoke English and French; it was a bilingual school in Northern Ontario, and yet I could barely communicate in either language.

Children learn quickly, and given the situation it was impressive that I passed that first year of school. But, I wasn’t considered an outstanding student and just got by. Still by the second year I was able to communicate in English with the teachers and other students, in a French patois with schoolyard friends and a bit of Portuguese with other immigrate children. Still schoolwork was a struggle.