PHRs: Are We Giving Them Spoons Instead of Shovels?

Why low-tech hurts....

In the June 16th print issue of The Economist, there's a good piece on the behavior of crowds and politics, describing why 'The electorate is irrational (p.42).'

The piece includes a story about an economist who goes to China and sees hundreds of workers using shovels to build a dam. The economist asks why the workers aren't using a mechanical digger.

"That would put people out of work," says the foreman. The economist replies "If it's jobs you want, take away their shovels and give them spoons."

Are we giving our nurses and docs spoons (outdated paper-record keeping systems), and withholding the shovels (electronic or web integrated medical/health records and systems)?

The question we're all trying to answer: In terms of productivity at our respective organizations, how much would better 'tools' in the form of EHR systems reduce the workload and pad the effects upon our healthcare system of baby boomers as well as looming nursing and doc shortages?

Yesterday Vince Kuraitis, author of e-Care Management (another must-subscribe H/HC blog), put up a great post.

Vince provided his spin on Google Health & the tech giant's potential plans to dominate the personal health record (PHR)/electronic health record (EHR) market.

Put aside 20 minutes for this must-read post (including the Comments section).

Imagine the spin-off opportunities that may be created by an integrated and multipartite EMR/PHR system, with various compenents controlled by "users" or patients (portable or web-based PHRs) and managed EHR systems integrated across hospitals and docs offices.

These records would then be coordinated and accessible through either web-based applications and/or servers within the docs offices and hospitals (see my comment on Vince's post for further explanation of what such a system might look like).

In this scenario everyone wins, because the products that are developed are oriented around how different market segments will use them, but the health information inputs, whether 'commercial' or 'consumer,' can still 'talk' to each other.

End-use is the penultimate goal - and not everyone wants to use a PHR/EMR for the same purpose. Marketing would be audience appropriate, designed to appeal to reducing inefficiencies on the hospital/physician side, and in obtaining/maintaining 'control' and access over personal health and wellness information for consumers.

Think of the telecom/mobile phone market. Many providers have sprung up to provide ways for people to talk and email on portable devices. Other firms were founded to provide commercial services and plans.

The point is that in telecommunications, we can all pick the providers and plans that have the most relevance to our needs/wants. Shouldn't we be able to do the same in the EMR/PHR market? And yet whether you use a Blackberry, Verizon services, a Cingular phone, or a landline, we can all 'talk' to one another regardless of what vendor we're using. Of course, I'm vastly simplifying the process for the sake of this exploratory analogy.

If PHRs are both web-accessible (personal health URLs as Vince posits) and remotely portable (ie thumb drives), companies that provide 'skins' similar to those available for Ipods are just one possibility of future entrepreneurial activity.

Picture animal-shaped skins, complete with colored lanyards, for patients at Children's hospitals, for example.

Is there potential for a new Apple offering here? For an Apple/Google PHR partnership? Google provides the PHR web-based access and Apple provides the peripherals, designed with the company's flair for innovative aesthetics?