Data that’s followed a consumer from doctors’ offices, hospitals and pharmacies may someday be compiled into an electronic health record that’s accessible any time. But key steps need to be taken before this can happen. Photograph: Hero Images/Getty Images/Hero Images

A patient’s healthcare experience will one day have the on-demand convenience of hailing an Uber car. That is, if innovators like Dr Jay Parkinson get their way.



Parkinson, the co-founder and CEO of the online medical practice Sherpaa, imagines most routine healthcare needs will someday be taken care of with a few taps on a smartphone app. That includes diagnosing common symptoms, communicating with doctors and scheduling procedures. The tedious and time-consuming process of driving to an office, filling out forms and waiting to be examined will be mostly eliminated. Many clinicians will make themselves available via text or video chat.

For this to happen, the trail of data that has followed consumers disjointedly from physicians’ offices to hospitals to pharmacies must be aggregated into a unified file that’s accessible at any time, experts say. These electronic health records (EHRs) will likely live on the servers of major computing giants that specialize in protecting sensitive data.

It’s a high-tech, data-driven paradigm. And key steps need to be taken before it can happen.

Data dream

Parkinson is already working on it. Sherpaa allows users to communicate with doctors by text, phone call or email message. Patients open the app and describe their symptoms. A doctor can, remotely, pinpoint the problem, email a prescription to a pharmacy or provide a referral.

The service had been available only through employers, but recently added a direct-to-consumer option. Sherpaa is planning to expand because increasing numbers of health practitioners want care to happen just like this – a patient experience that’s increasingly digital and user-friendly. Consumers may eventually have a master profile, a la a Facebook account or a credit report, comprised of aggregated data and activity. And different providers will use that data to improve care.

“People change jobs, cities and insurance companies. To have you tethered to some primary doctor in middle-of-nowhere California who has all your records doesn’t make sense,” Parkinson says. “You need to have a relationship with a primary care service that pretty much exists in the cloud, that’s accessible anywhere, at any time.”

Dr Bob Wachter, chair of the department of medicine at the University of California, San Francisco, says this type of innovation will improve treatments. “If I’m seeing you in the emergency room, I really need easy access to your past medical problems and procedures, and you’re going to get better care as an individual if I don’t have to search and cobble it together, which is the way it is today,” he explains. “And doing it truly at scale is just not doable right now because all the records don’t live in one place.”



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Numbers game

Recent progress in scaling digital health includes the unveiling of Melody, the chatbot that the Chinese search engine Baidu introduced in October. Users input symptoms that the bot compares against a library of data, and a diagnosis is presented to a doctor who can take things from there.

Dr Leslie Saxon, the founder and executive director of the University of Southern California’s (USC’s) Center for Body Computing, says that about 80% of tomorrow’s healthcare will be in the form of what she calls “digital delivery diagnostic platforms”. The remaining 20% will be in the form of the traditional brick-and-mortar experience.

Bots aside, the analysis of large amounts of data will also allow human doctors to quickly compare cases of people who have had similar conditions and symptoms.

“My vision is, somebody reaches out to us with, say, abdominal pain. So everybody with abdominal pain gets the same 28 questions,” says Parkinson. “And it would be cool to show doctors all the patients who answered like this – for example, 98% of them have gas, not appendicitis. That’s a pretty cool use of data.”

The possibilities seem endless. “At a population level, if we’re trying to find out what’s the best treatment for patients with diabetes, the ability to do clinical research that lets us see a billion diabetics and adjust things that might explain a difference in outcomes [is] an enormously important thing to be able to do,” Wachter says.

Change on the way?

Building technology solutions like Sherpaa and Melody isn’t the healthcare industry’s toughest challenge. Rather, the issue is pushing widespread change in a notoriously fragmented and slow-moving field.

“There’s some research that says once a best practice has been accepted and validated by the physician community, it takes at least 10 to 15 years to percolate into everyday practice throughout the community,” says Parkinson. “Healthcare is glacial.”

“If you think about healthcare as a system and the experience of the user as a patient, you realize our experience is very choppy and expensive and annoying,” adds HealthTap founder and CEO Ron Gutman. “So what I think is very important is to create a notion of interoperability.”

Gutman cites Amazon as an example. The company took the disparate pieces of a retail experience and brought everything to a single point, using data to continuously improve. The key, Gutman says, is to bring that same virtuous cycle to healthcare.

And of course, there are the security concerns. A US Government Accountability Office report showed that in 2015, 113m electronic health records suffered some form of breach. Wachter says challenges for hospitals and doctors’ offices will result in data being held in a few massive storehouses. “That’s what I’m hearing from the IT [information technology] security folks – that in the future, all data is going into a very small number of big, central repositories that do this for a living,” he says.

Wachter thinks things will never be 100% safe, so there’s an inherent tradeoff of convenience and better outcomes weighed against privacy and security problems. Yet “the endgame here seems pretty obvious”, he says. “At some point, all will be connected for a given patient. Their ability to monitor things at home won’t be that hard. It’ll be seamlessly connected to their doctor’s office, to the hospital, to the pharmacy. But I’m guessing it’ll be 10 years or more before that’s all fully a done deal.”

This content is paid for by Optum