In his recent snapshot of the future of health care, What Health Care Will Look Like in 2030. Maybe, published in a recent issue of The Wall Street Journal, Commonwealth Fund president Dr. David Blumenthal lays out a future vision of tech-enabled service delivery using a few examples. In one, a mobile device helps you monitor and arrange services for an elderly loved one. In another, you injure yourself and can manage your own health using an online portal.
I like the health care future that Dr. Blumenthal describes – and in my personal health care, have tried to incorporate these new tech tools as much as possible. But he warns that whether this delivery system moves from the unusual to the common is dependent on two factors – security and interoperability. On the security side, he says:
If people can’t trust the privacy and security of cloud-based health records, they won’t feel comfortable using them. But health-care information systems are currently no more secure than those of retailers, banks or any other organizations connected to the Internet. Current privacy and security regulations in the health-care field were conceived and implemented before the web existed, and don’t offer adequate protections for the 21st century.
But, I think that the security issue may be a bit off. For most people, if their electronic health care information was as secure as their on-line banking information, they would be satisfied. But there is a perception that this is not the case. These negative perceptions about the data security competencies of health care organizations is a big issue for consumer adoption of new tech tools. And, headlines like this one – 29 Million US Health Records Exposed By Data Breaches Between 2010 And 2013 – give consumers pause.
The second problem is interoperability – “assuring that all these electronic devices – electronic health records, personal sensors, and personal mobile devices – can talk to each other.” I wrote yesterday about sharing addiction treatment data – Solution Needed: Incorporating Addiction Treatment Data Into The Integrated Care Model – which is a small piece of the interoperability puzzle. And then there are large systems issues related to interoperability, including the focus of one of our keynotes at last year’s OPEN MINDS Technology and Informatics Institute (see Stop Integrating Data & Start Liberating Data). And, we’ve reported on the challenges to interoperability posed by lack of cooperation and high fees by some technology companies (see Are EHR Vendors Holding Patient Data Hostage? and Medical Records Held Hostage – From Consumers) and possible solutions with new API technologies (see APIs & Why You Should Know What They Are and Can APIs Solve Our ‘EHR Problem’?).
But the real rub about lack of interoperability and the sharing of data, is at the consumer level. For all the talk about consumer focus, health care systems do not provide consumers with a convenient experience (see Preparing For The Amazon Effect). The face of this fractured consumer interface was aptly described by my friend and colleague Jody Powers in her perspectives in a recent briefing – Learning From The Consumer Experience With Personal Health Data.
We have a lot of stakeholders in the field – executives of provider organizations and tech firms to name a few – who are invested in making the future health care system the tech-enabled system described by Dr. Blumenthal. But it is going to take some “big picture” thinking (and industry-wide action) about the security of consumer health data, and data exchange convenience for consumers, for this to happen. I think the advice of English cultural commentator Warren Ellis is most apt:
“To be a futurist, in pursuit of improving reality, is not to have your face continually turned upstream, waiting for the future to come. To improve reality is to clearly see where you are, and then wonder how to make that better.”