Ken Willett

Healthcare IT, integration, and making patient care better

What We Need Is iCloud for Healthcare

The Apple iCloud system, and similar online backup systems for non-Apple systems (e.g., Carbonite and Dropbox) have added a new dimension to data backup. Yes, part of their role is to keep your data safe in case something bad happens to your computer. But they also provide a simple, intuitive way to make your data available where ever you need it. It seems that this is a capability that could be of significant use to healthcare providers with regard to their EHR data.

I’m not talking about an HIE system. HIEs attempt to address a much more complex set of problems: sharing data across organization boundaries, reconciling data about the same patient from different sources, reporting biosurveillance and immunization data to government entities, etc. What an ambulatory provider needs is much simpler: a way to get to data about his or her own patients, reliably and under a variety of circumstances.

Web-hosted EHRs can do some of this. Data is available from home or office; some of these EHRs have mobile device support; and the EHR vendor (presumably) backs up the data to insure against loss. However, the vast majority of EHR users don’t have this ability, and can only access their EHR in the office.

Healthcare practices have a range of disasters they need to protect against. Besides the usual failed hard drive, office fire or natural disaster, there is a new one: failure of an EHR vendor. There are now some 600 ATCB-certified EHRs on the market; within a few years the majority of those will no longer be in business. That means that many providers will be switching EHRs during that time, and trying to salvage their patient data to be loaded into their new EHR.

If data were stored in a cloud-based system in a neutral format, such as XML, it could readily be provided to a different EHR or to an HIE. It would also be possible to provide outcomes reporting beyond what is provided by an EHR vendor on their own internal data. Such a system would stimulate its own ecosystem of tools and applications, without requiring an EHR vendor partnership for each one.

There are risks, or course. Updates to this storage system would need to be reliable and automatic, as they are with iCloud, to assure that information was up-to-date. HIPAA requirements would need to be met to assure privacy and availability. Internet outages would still be an issue for access to this data. But overall, data availability would be much better than it is today.

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