Who owns the data within the Electronic Medical Records?
Is it your general physician, who may have entered the data; or your hospital, who host the data; or the EMR firm, who provided the infrastructure; or payers who paid for the whole technology apparatus (true in many insurer led systems); or governments in whose legislation the healthcare apparatus operate; or the patient him/herself? The answer as you can imagine is not simple and there is no clearly articulated policy to set the ownership of data.
Electronic Medical Records are proliferating quick and fast. Multiple markets in Europe (mainly Nordics) are on to replacement mode and many hospitals in the United States will soon realise the ‘true’ total cost of ownership of medical records, as the dollars from federal stimulus (in turn mandated by the Affordable Care & HITECH act) weans off. Replacing EMR providers will invariably entail transfer of data from the old system to the new system. CIOs and their teams will attest that data migration can be an arduous process expensive process and when done repeatedly will invariably lead to loss of data in each single cycle. An added complication is the difference in EMRs and the data captured. For ex: Your old EMR provider may not capture details of childhood immunisation or family history of hypertension
So What to do ?
First, leverage the ‘App’ movement. This means separating the backend and the frontend. Let your EHR provider compete on the front end (read: ease to use, beautiful functionality, rich interface etc), not on the backend. The backend data storage format should be a provider agnostic format (meaning the data can be synched with any EHR provider adhering to health standards). HANDIhealth & Marand in Europe; FeedHenry in the US are some of the firms doing work in similar domain.
Second, using open source EHRs is another option. This is gaining speed in Europe. For ex: IMS Maxims open sourced its EHR a few years back, HP also recently positioned an open source EHR. Open Source already powers most of the internet & is in general is gaining fast mindshare in big data & analytics technology world (Cloudera, Hadoop etc). New Business models are emerging too, which are a step further from the well-known services supported model.
As we start collecting wearable & genomic data into the EHR, the number of companies interfacing with the EHR data will keep increasing. Apple, which is known for its closely linked products to the Apple ecosystem, also unveiled Researckkit, which is an Open source software development framework for researchers.
Unsurprisingly, the future of healthcare will have significant ‘Open’ component.
What do you think ?
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