“What if, in the midst of a crisis in which workflows, policies, procedures, and operations must be altered, the Centers for Disease Control and Prevention (CDC) could distribute an app to emergency departments as easily as a software developer submits an app to the Apple App Store?”
– Kenneth D. Mandl, MD, MPH, talking so much sense about the Ebola crisis that it gives me hope for the future.
Get yourself some: “Ebola in the United States: EHRs as a Public Health Tool at the Point of Care” (JAMA, Oct. 20, 2014)
Update: more hope, this time from Larry Brilliant in the Wall Street Journal: “Ebola: What Should We Do Now?”
A few key quotes (health geek emphasis added):
“The global public health community has grown much better at detection, leveraging digital tools, such as systems in which individuals report their own symptoms, to find outbreaks more quickly.”
“Patients should be able to draw a drop of blood themselves, like a self-administered glucose test for diabetics, reducing risk of a health-care worker becoming infected. I believe we’ll have this soon.”
“Now, with mobile technologies, cloud computing and participatory epidemiology, we can make [case tracking] a much more efficient process. Specifically, we need a modern, digital contact tracking system.”
Read the whole article. It made me want to get to work even faster today, spreading the word about the promise of what health geeks can bring to the world.
The immediate thinking would be to “provide innovative information technology” in order to address the problems of the world. In this context, however, two (provocative) questions could be asked:
– Since Ebola thrives in countries where there is a genuine lack in information (and not just information technologies), we could wonder if true solutions can be found from abroad. Africa is a place whose future probably depends from its ability to leapfrog (à la mobile banking) and not from imported solutions.
See http://blogs.hbr.org/2012/02/africas-leapfrogging-opportuni/
– Health IT is doomed in developed countries. Dysfunctional standards à la HL7 and Snomed have made it awfully complex to deliver simple services and actually banned innovation. It will need a real paradigm shift (in my view, a patient centered reference frame) before “smart agents” could be dynamically plugged to health systems. So far, health IT is the problem, not the solution!
See “Hospital e-records systems like Presbyterian’s cited in failures across U.S.”
Yes! Thank you so much for bringing in these points.
On the “health IT is doomed” theme:
The article you cite is indeed another indictment of Epic (adding to a long list). But I personally am not willing to give up on health IT.
The SMART Platforms initiative that Dr. Mandl founded (and for which I serve as an advisor) advocates for a “sidecar” solution. That is, instead of trying to rebuild an engine while it’s running, build a sidecar that can solve a specific problem alongside the main system. That’s the idea motivating his suggestion for a CDC app, I believe.
Here is another post where we discussed this issue of a health IT system that is starting to set like concrete, much to everyone’s dismay:
Recognizing the value of data
Ebola presents the perfect opportunity for the nation, if not the world to come together and develop a truly integrated healthcare delivery system that enables us to leverage and deploy medical assets from different markets and implement processes that enable us to control epidemics, treat disease, prevent illness, and promote wellness. Yes – I have been accused of being “Polly Anna” and an “eternal optimist”.