Are you sleepless in Seattle with EHR systems

Are you like the hero in the 1993 movie “Sleepless in Seattle”, calling radio shows and interacting on social media trying to find an EHR system for your medical practice that actually helps you care for patients?

Danny Lieberman, founder of Pathcare, talks about how to help doctors and patients with simple, easy-to-use commodity digital tools that can be provided on the Internet as a service.

The definition of sales is fulfilling someones need.

EHR systems are no different.

Current Electronic Health Record (EHR) systems address the business IT needs of government agencies, hospitals, organizations and medical practices, not the healthcare needs of patients and certainly not the needs of physicians for easier decision making and stress reduction.

What options does a busy doctor have to improve his effectiveness in light of an increasingly complex environment?

• More regulation and government involvement (especially in the US)
• Increasingly sophisticated drugs and medical devices
• Private practioners need innovative marketing to stand out above the noise
• Too much technology
• Too much information

There are search engines, there is buying an EHR system and praying for the best. There are many many extremely innovative online services and mobile appss for healthcare. There are patient communities and doctor communities. There are doctors experimenting with Facebook and Twitter.

The one thing we don’t have but really need is a simple, cheap and effective digital tool for sharing data between doctor and his patients.

Providing a force multiplier for the doctor during the in-office visit

We will explain in this article, how private social networks for patients and doctors amplify physicians’ capabilities, ease decision making and enable them to care for more patients in less time.

What is a private social network for patients and doctors?

A private social network for patients and doctors is a digital tool whose primary mission is improving patient health and reducing physician stress. It allows patient-mediated input of data before or during visits to the office, making the clinical data collected more up-to-date, complete and correct. It makes the decision making process easier and reduces stress.

A private social network for patients and doctors is designed from the ground up to be private. A doctor/healthcare provider relates to and connects with a care circle (or “cluster”) of patients and caregivers. There is no overlap between doctor networks and no overlap between patients. Patients have full access control over their data. Data shared on the private social network for patients and doctors cannot be shared by design with public social media like Facebook.

Private social networks for patients and doctors enables a patient to provide their doctor with data, on a timeline, within the clinical guidelines and without having to wait for a visit to the office.

A well designed private social network for patients and doctors helps build a level of intimacy and rapport that can deepen the diagnostic and treatment process.

Benefits for doctors and patients

Private social networks for patients and doctors enables a patient to provide their doctor with data, on a timeline and within the clinical guidelines without having to wait for a visit to the office. This ability is a powerful feature that yields two immediate benefits:

1. Helps a physician make a quicker and more accurate diagnosis
   • Helps a physician achieve more consistent and repeatable diagnostic and treatment planning.
   • Helps improve execution of the treatment plan with better follow up on progress.
   • Provides tangible benefit for the doctor, saving precious time in patient interviews.
2. Helps patients improve their health
   • Helps patients better understand their condition and treatment plan.
   • Helps improve execution of the treatment plan and management of their disease or issue.
   • Provides intangible advantage for the patient: Knowing that someone is listening and that treatment can be adjusted using the latest data on their condition.

Accessibility

Private social networks for patients and doctors runs on tablet devices and browsers over the Web using controlled private networking to share data between physicians and patients in a patient-issue context.

Applicability

Private social networks for patients and doctors is applicable to any medical practice from pediatrics and family medicine to multi-disciplinary specialties such as neurology and nephrology.

Private social networks for patients and doctors may be of particular value for patients with disorders that require intensive involvement of family members and ongoing data collection, for example: Parkinson’s disease, Multiple System Atrophy, Alzheimer or Attention Disorders in young children.

A model for an ideal private social network for patients and doctors.

Ideally a Private social networks for patients and doctors system has two central parts:

1. Clinical issue worksheets (A combination of evidence-based clinical guidelines and patient data)
2. Private controlled networking sharing data between doctor and patients

Clinical Issue worksheets

Issue worksheets are used by the doctor to manage diagnosis and treatment directly with patients.

A worksheet starts out as a template unrelated to a patient and without patient data and is then instantiated and managed for a specific patient.

A worksheet includes the following groups of information:

• The corresponding ICD-10¹codes for describing aspects of symptom/disease
  • Diagnosis
  • Researched and tested treatment instructions
  • Contraindications
  • Further investigation and diagnosis
  • Differential diagnosis
  • The relevant clinical guidelines
• Advisory data
  • Instructions from a doctor to patient
  • Feedback from patient to doctor on a continuous timeline

Controlled networking

The Private social network for patients and doctors provides a secure and effective way for a physician to interact with her patients without requiring them to come to the office or hospital clinic or initiate phone calls etc. It also allows patient-mediated input of data before or during visits to the office, making the clinical data collected more up-to-date, complete and correct. Unlike social networking applications such as Facebook that have a chaotic, grid topology and no particular context, the Private social networks for patients and doctors network has a controlled 1 to N (doctor to patients) topology and patient-issue context. The Private social networks for patients and doctors controlled network provides granular access control for sharing of data between doctor and her patients.

Typically a private social network for doctors and patients would have 4 levels of access control:

1. Private (only the doctor can see the data)
2. Shared with selected patient(s)
3. Shared with a group of patients, for example, men over 50 with a family history of colon cancer.
4. Shared with the entire network of clinical practice (for example, an advisory issue worksheet that specifies a certain schedule of exercises or other forms of self-care and includes options to let the patient report difficulties or measures of success back to the physician.)

Using powerful and familiar social software, private social networks for patients and doctors enable tagging and free text searching of all content shared between a doctor and his patients.

What about security and privacy?

A private social network for patients and doctors is an application that uses commodity devices and strong cryptography for data protection.

Private social networks for patients and doctors run on tablets and on the Web, using distributed data and private, controlled networking instead of big central databases and centralized message hubs.

The approach taken by Private social networks for patients and doctors has 3 key advantages from a security and privacy perspective:

1. It improves data security. The data distribution between patients and doctors reduces the attack surface for Private social networks for patients and doctors relative to application servers with big central databases and message queuing systems that are vulnerable to cascade attacks.² No single device possesses a copy of the entire patient data set.
2. It improves patient privacy. Private social networks for patients and doctors provide health-care providers with a better solution for patient privacy since the borders are clear and patient and doctor have full access control over issue worksheets and data.
3. It improves flexibility and speed of development of new capabilities. Private social networks for patients and doctors use an open plugin-based software architecture, where loosely-coupled plugins can provide new functionality using a small number of open, light-weight data model standards and application programming interfaces.

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