iTriage is an app that runs on the iPhone and provides some of the following functionalities (see: Physicians Using an iPhone Application to Triage Their Patients):
- Information on thousands of symptoms, diseases and medical procedures
- A nationwide directory of hospitals, urgent care, retail clinics, pharmacies and physicians
- Help negotiating medical bills through an iTriage partnership with ...claims adjudication organizations
- Emergency Room wait times for hospitals in select parts of the country
Apparently one of the founders of the company is now moving in the direction of of integration and support by the device for Google Health, a PHR, according to John Moore who blogs over at Chilmark Research (see: Consumer Challenge: Creating a Longitudinal Record). Below is an excerpt from the note:
While Chilmark applauds iTriage and Peter [Hudson] for continuing to extend the functionality of their platform to now address consumers’ mobile access to their PHR, in this case Google Health, .... Peter has not addressed the real issue here, how do we, as a society, create the systems necessary that will allow a consumer to easily aggregate their health data to create a truly longitudinal record that they can securely tap via their iTriage app, or some other mechanism, regardless of location, when needed. And therein lies the rub – those systems do not exist. We are dealing with point-to-point access, point-to-point data retrieval, a complicated, convoluted process that frankly most consumers will not bother with. Ever the optimist, Chilmark firmly believes there may be a solution tucked within the billions that will be spent to digitize the healthcare sector: The Health Information Exchange (HIE).
John highlights in the note a critical aspect of EMRs that is often neglected -- the difficult pursuit of the longitudinal record. Simply put, the longitudinal record consists of the aggregated medical records of an individual across time or, put another way, a life-long record of a patient's care. Up to this point, most EMRs lump the records for a single episode of care such as an inpatient stay. If a patient has multiple inpatient episodes within a single health system, that institution's EMR can usually aggregate records across them.
The challenge is that we Americans tend to frequently move to different cities and receive care from a broad set of healthcare providers and systems. Each of them probably uses a different brand of EMR. As John points out above, most of our hospital information systems are designed to move data "point-to-point" and we lack a central clearing house for healthcare data across multiple providers. The HIE may serve this purpose in the future.
I made reference to the idea of a "an electronic clearinghouse" for clinical data on a much smaller scale in a previous note about comparative effectiveness research (CER) (see: The Inclusion of Molecular Diagnostic Testing in Comparative Effectiveness Studies). The key points are listed below.
For the sake of efficiency, let me distill from this article the key recommendations made by AMP [Association for Molecular Pathology] retarding all comparative effectiveness research (CER) going forward:
- Development of a model process for CER regarding clinical laboratory tests
- Creation of an electronic clearinghouse for information on CER projects
- Development and adoption of standards for the collection and storage of data from genetic testing laboratories