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Sep 25 2014   11:39AM GMT

How wearable devices are building an EHR ecosystem



Posted by: adelvecchio
Apple Health, EHR, EHR integration, EHR systems, Google Glass, Google Health, wearable devices

zach watsonGuest post by Zach Watson, content manager, TechnologyAdvice

Gathering reliable physiological data from patients has been one of the main targets of healthcare innovators for some time now. Now that EHRs are used by a majority of office-based physician practices, the foundation for such a data infrastructure is in place.

Two obstacles have historically blocked the implementation of patient-generated health data: lack of automation in processes and lack of patient adoption.

To acquire the necessary physiological data, providers need patients to adopt wearable health hardware on a widespread scale. In theory, wearable technology will record valuable health data such as blood pressure, heart rate, and glucose levels and deliver it into a patient’s record inside the EHR through a direct HIPAA-compliant protocol.

Until recently, wearable devices like Nike’s FuelBand and the Fitbit remained niche products used by fitness fanatics or early adopters — and not by the chronically ill population that providers need to collect data on. Additionally, these wearables weren’t able to directly integrate with electronic medical software systems. This meant a third-party application such as Microsoft’s Healthvault was needed in order to store and transfer the information.

If a process isn’t intuitive, users aren’t going to adopt it. This is true with wearable devices on the consumer side, and patient-generated data on the provider side. Just like a great deal of healthcare IT, the capabilities existed, but not in a scalable or connected fashion.

Major developments from Apple and Google, introduced in the last year or so, may finally make wearable devices the bridge to EHRs for which providers have been longing. Changes to payment models and a shift to quality-based reimbursement mean that device integration with EHRs is quickly becoming integral to truly preventive treatment plans.

Google Glass makes waves in the OR and exam room

Google tried and failed to create a bridge between patients and providers with Google Health. The release of Google Glass has quickly catapulted them back into the healthcare arena. While many fitness devices are strictly consumer-facing, Google Glass is gaining the most traction with providers; they that are using it everywhere from the exam room to the operating room.

Outside of the operating room, Google Glass allows physicians to record an unprecedented amount of information during a patient exam. Glass’ software connects to databases via Bluetooth, so physicians can utilize the hardware to capture photos and record videos that can be streamed directly into the patient’s record.

Further, by recording simple procedures like changing dressing on a wound, physical therapy, or proper dosing for medications, providers can easily create rich educational content that can be shared through a patient portal. Several EHR providers, such as iPatientCare, Inc. and drchrono, have already developed, or are developing, apps that integrate with Google Glass.

Google Glass is also playing a larger role in the operating room as physicians use the hardware to apply information from a patient’s health record during surgical procedures. Homero Rivas, M.D., Stanford University’s director of innovative surgery, recently used a Glass app called MedicAR to overlay the anatomy of a human model with stills from magnetic resonance imaging (MRI) to increase his precision during the operation. If the MRIs are stored in the EHR, this makes another compelling case for the integration of wearable devices.

Google has even developed contact lenses that can measure a patient’s glucose levels through the moisture in their eyes. These lenses could be especially useful for diabetic patients that have a history of poorly managing their condition. If a patient’s blood glucose level becomes dangerous, providers would receive an alert through their EHR to contact and advise the patient.

Glass has more immediate potential for providers, but the contact lenses do foreshadow what wearable devices could look like in the not-too-distant-future.

Apple Health unifies disparate data sources

While Google Glass is finding a home in the operating room, Apple’s new Health app is being positioned as a unifying health data platform for patients. Health and its companion development platform HealthKit provide patients with a hub to integrate data from all their health applications, eliminating data fragmentation.

In terms of development, a number of major healthcare players seem to be buzzing about the possibilities of Health and Healthkit. The Cleveland Clinic is reportedly testing the Health beta and giving Apple feedback, while Kaiser Permanente is said to be quietly piloting several apps developed on the HealthKit platform. Apple is also in talks with EHR market leaders, including Allscripts Healthcare Solutions, Inc. Apple’s already announced a partnership to integrate directly with Epic’s MyChart personal health record.

Of course, integrating with every EHR would be a lofty undertaking, but if Apple partners with some key players, Health could become a foundational communication element between wearable devices and EHRs. Peter McClennen, president of population health management at Allscripts is clearly on board with wearable device integration.

“That technology wave, if you look at other industries, is very clear. Every watch, every phone, everything is connected. It’s about keeping people healthy in a more productive model of health delivery,” McClennen said in a Q&A with EHRintelligence.com.

But what about Apple’s hardware? The tech giant already has deals with Nike, and other prominent devices are likely to follow, though the hope is that the iPhone’s large user base will quickly come to view their phone as a hub for everything health-related.

Other, smaller organizations are innovating around EHR integration as well. Bay Area-based startup Augmedix is reportedly working on a Glass app for transcription purposes. No doubt others will follow on both Apple and Google platforms.

Integrating wearable devices with EHR software will create more than just a bridge between devices. It could bring the EHR, and therefore the healthcare provider, into an ecosystem of technology in which the patient is a central figure and active participant. Now that some technology behemoths are in the EHR integration game, the potential for healthcare seems huge.

About the author: Zach Watson is content manager at TechnologyAdvice. He covers healthcare IT, business intelligence software, and emerging technologies. Connect with him on Google+.

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