Data is generated by everything from bracelets that track steps to sensors that can tell how many pills a patient has taken in a given time period. But does any of it get integrated into electronic health records (EHRs) in a way that doctors can use?
The short answer is no.
“We have a flood of innovative devices, all of which are made by individual companies that are all trying to figure out how to extract money out of the healthcare system,” says Robert Havasy, MS, senior director of health information systems for the Health Information and Management Systems Society (HIMSS). “When you are trying to capture new revenue, that doesn’t require working nicely with other people.” Each device generates its own form of data, most of which aren’t compatible with EHRs, forcing doctors to download specific apps or visit websites if they need to access the data.
On the other side, the EHR companies haven’t been incentivized for interoperability—including accepting data from devices—so there’s no real push to do so, Havasy says. “When you have an established EHR vendor system not paying attention to connected health and device makers built around capturing and controlling the experience of users, you end up with poor integration.”
There is some movement to have data flow smoothly from one device platform to another. Havasy points to Xcertia—a collaboration among the American Medical Association, American Heart Association, HIMSS and DHX (digital health experience) Group—and the nonprofit Continua Health Alliance, as examples or groups working to help devices share data.
“For things to change, you need more than just a good technical standard,” says Havasy. “It also requires a will to change. Right now, the business incentives are aligned around proprietary networks and not sharing data, and for most companies, their best financial interest is to continue down the path they are on.”
Patients will likely drive this change, Havasy says. As patients become more aware of the capabilities of these devices and the potentially helpful data they can generate, they will likely demand from doctors and vendors data that can seamlessly move throughout the healthcare system, including to EHRs. This will give device makers more incentive to use a common standard and EHR vendors a reason to work with them.
Manufacturers must also help doctors manage the data, focusing on alerts for anomalies rather than producing a torrent of mundane, daily data.“The last thing a doctor wants is 300 blood pressure readings a year for a patient,” says Havasy.
The biggest potential of devices integrated directly to doctors’ EHRs is the “sentinel effect.” “If a patient thinks a doctor is paying attention to their data, they are more likely to make healthy choices,” he says. “They don’t want the doctor to see their bad numbers and disappoint them. If patients think they are being watched, it is a powerful force that can alter behavior.”