EMR “The Movie” — Coming Soon (Maybe)
by Fred Fortin
In a previous post on the “everyware” revolution in health care, I argued, that we’ve come to think of the Electronic Medical Record (EMR) as an electronic snapshot of someone’s medical history and current health status, taken more or less regularly (more likely, irregularly), awaiting to be pulled for direct eyeball examination by the relevant medical expert (subject, of course, to the physics of the medical space/time continuum, otherwise known as the ‘office visit’.)
But what if the EMR was more of a movie instead. a continuous flow of real time information collected directly from the source — your body – by arrays of remote, ambient or wearable sensors, with the data ported to an intelligent, networked, expert system geared to flagging critical indicators, thresholds, locations and whatever else, for that matter, that needs monitoring. Out-of-the-norm readings would be protocoled to ‘push’ alerts out to the clinician (and to the empowered patient as well) who would use filtering and editing software tools to find the disease ‘narrative’ that lay hidden in the mountain of electronic data waiting at the ready. All this would happen behind the scenes, building up to the climatic moment when the clinical hands-on examination would take center stage (and only if a virtual one would not do).
One key player in this revolution, for example, is your friendly ubiquitous cell phone. In Calling Dr. Cellphone, Tom Blackwell of Canada’s National Post writes about a study published this month in the American Journal of Hypertension that coupled a wireless blood-pressure cuff and a cellphone to send alerts to patients and doctors when their blood pressure got too high or too low. He says that this study
“is just the latest example of a growing push to employ cellphones in health care, harnessing electronic devices that almost everyone carries to monitor chronic diseases, let patients confer with doctors from afar and encourage stricter adherence to medication, diet and exercise. There are cellphones that keep track of diabetics’ blood sugar, help diagnose dangerous heart rhythm fluctuations and monitor the reliability of pacemakers.”
Blackwell also mentions the development of a “Doctorphone” that will allow patients to video conference with physicians possibly avoiding those unnecessary office visits or trips to the emergency room.
In this regard, one can imagine the engaging capabilities of Apple’s iPhone being drafted into service. There are already efforts underway to make EMRs directly accessible to the iPhone (see earlier post).
Another upcoming impressive player in this EMR movie are technologies such as LifeBed, which offers 24-hour continuous patient heart and respiratory rate monitoring using a passive sensor array technology that installs on any standard mattress as a coverlet enabling “Intelligent Medical Vigilance”. The system extracts information invisibly with no direct patient contact – “without patient compliance issues” — getting accurate measurements even through clothing, gowns, or sheets. It also alerts caregivers of unauthorized bed exit and, of course, has the capability to trend and store patient data.
There are many more examples of the electronic actors that will star in the EMR movie. Now don’t hold your breath, it probably will not become a huge summer blockbuster. In fact, there may be many retakes and remakes before the plot is fully realized and audience actually materializes. But one thing we do know is that the advertising is in full swing, and the movie trailers ought to be terrific.