Success of digital health depends on all Canadian

Success of digital health depends on all Canadian

After more than a decade of hard work and collaboration, digital health is making treatment safer, more efficient, and, ultimately, better for Canadians.

Consider the following:

Use of electronic medical records (EMR) in community-based practices in Canada has yielded efficiency and patient care benefits valued at $1.3-billion since 2006.

Drug information systems reduce prescription errors and result in fewer adverse drug events with annual estimated benefits of $475-million.

Tele-health saved patients over 47 million kilometres in travel and $70-million in personal travel costs in 2010 alone.

Through investment with our jurisdictional partners, Canada Health Infoway has already established the foundational requirements for securely capturing, storing, sharing, accessing and managing health information. And while every province and territory is at a different stage of development, they are all working on these foundational elements according to their local priorities and needs.

Canadian consumers are comfortable with digital tools and are global leaders in the adoption and use of information technologies such as social media, online shopping and digital banking. Coupled with a growing desire to manage our wellness and to take on more active roles in the management of our chronic diseases, we find ourselves at a pivotal moment in our digital health journey.

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Google Health Canda? Your Health Records and EMR

I always wondered what would happen if Google Health decided to launch in Canada. Would there be an effect on the Canadian Healthcare system? Or would PIPEDA (Personal Information Protection and Electronic Documents Act) get in the way?

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About a year ago Google announced that it would launch a service to allow users to store their own health records on a secure website. There was a lot of discussion about what it would look like but the wait is over. A free public “beta test” version of Google Heath is now operational at google.com/health.

The service allows users to create an online profile that includes information about any medical conditions, test results, procedures, immunizations and medications. You’re also asked to enter in your height, weight, blood type and race. With this information, the service, in theory, could offer you tailored medical information as well as serving as a central hub storing your medical records.

Eventually the goal is for users to be able to import their health information from the secure websites of care providers. To that end, Google already has arrangements with Beth Israel Deaconess Medical Center in Boston and the Cleveland Clinic as well the online pharmacies from Longs Drugs, Walgreens, RXAmerica and Medco. A relationship with Quest Diagnostics allows users of its services to import their lab tests. Google also has a link to the American Heart Association’s heart attack risk assessment site so that you can get your customized risk assessment without having to retype your height, weight, cholesterol and other into the Heart Association’s site.

One nice feature is the drug interaction alert that lets you know about potential conflicts between drugs you take. Of course, you have to remember to enter all your drugs for that to work.

Because none of my providers are among Google’s initial partners, I had to enter all the information myself. Fortunately, it was easy to find because the health clinic I use most of the time has its own online service that stores this information. I’m pretty happy with what my provider offers but it’s an island of information. If, for example, I were to have a blood test done elsewhere, that information would not be on my provider’s site nor is there a way I could even type it in. Google is trying to solve that problem by creating a health record keeping system that is controlled by the user, not the health care provider. This is especially important for those of us who don’t belong to a health maintenance organization (HMO) because we might visit different physicians who are not affiliated with each other.

Clearly privacy is the number one concern when it comes to any online medical information service. Google’s health privacy policy states that “You control who can access your personal health information. By default, you are the only user who can view and edit your information.” You can, however choose to share your information with others. The company also promises not to “sell, rent, or share your information” and will let you delete your account or any information in it at any time.

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Can health care make voice interfaces viable?

One of the big surprises in my career, watching technology develop, has been the failure of voice interfaces. Chalk it up to accents and the complexity of English. Listen to a Southerner or a Scotsman and the problem becomes obvious. Better yet try listening to your kids.

The only way to make it work is to make it work. And thanks to the immense growth in military medicine, you have a platform on which this forcing can happen.

Nuance Communications says its Dragon NaturallySpeaking is now being used by over 6,000 clinicians, because it was mandated by the military as the preferred way to document care with its AHLTA system.Whatever you think of AHLTA or the military, the bottom line is you now have a complete voice-to-text interface for medical diagnosis, with 6,000 users and growing.

AHLTA consultants say the system is saving clinicians time, and enabling the creation of more complete medical records.

Nuance has now begun the process of transferring this experience into civilian medicine, which I hope means that interfaces for McKesson, Cerner and Microsoft are coming soon.Once we have a beachhead for spoken interfaces in medicine, perhaps we can expand it into other areas, and speech will finally take its rightful space as the right way to talk to a computer.

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