Healthcare software provider Meditech to support iOS 15 secure sharing

Comments

• Reply 1 of 8

  rob53 Posts: 3,251member

  June 9, 2021 11:52PM

  I would love to see a standard format for all the volumes of healthcare information I have to continually submit to each new doctor I see. It's basically the same thing and I've started to try and have a list of all the normal things they ask for. I should be able to have this on my phone/computer so every doctor gets exactly the same information. The one name I don't see is Epic and without them it doesn't work. Found a website listing the largest EHRs and Epic, Cerner and Allscripts were dominating. Epic and Cerner, in 2019, had over 50% of hospital EHRs. I also want all my imaging available on my iPhone, not just the reports. It's next to impossible to get previous doctors and hospitals to actually take the time to forward a patient's total history to their next doctors when they relocate.
  
  Of course the EHR global market is worth over 30 billion USD so anyone messing with them will have a fight on their hands. I honestly hope Apple can get the Meditech led group of EHRs to actually work together so we, the consumer and payer of medical bills and insurance premiums, can provide accurate and consistent information to medical professionals. This won't be easy because it could mean a reduction in data-entry operators and loss of billing income but that's an excuse not a justifiable reason for not participating. 
  
  ref: https://www.ehrinpractice.com/largest-ehr-vendors.html
• Reply 2 of 8

  FileMakerFeller Posts: 1,546member

  June 10, 2021 5:06AM

  There are a number of different formats for data interchange in the health space. Apple has settled on one of the newer ones, FHIR, which is not (yet) as comprehensive as the older HL7 spec (although it depends which version of HL7 you're using). There's a HUGE number of systems exchanging data based on these older formats and it's an uphill battle to convince providers to convert unless they're using a system where multiple formats are supported and they only have to change a single setting.
  
  In Australia there's a push to have all medical records stored centrally; naturally there has been significant pushback from the citizenry with concerns over privacy and security. But the government has a point: the industry has had thirty-plus years to come up with a standard method for storing and sharing health information, and it hasn't happened so government has stepped in.
  
  From a personal point of view having everything on a device I own (with secured backups automatically pushed to a service like iCloud) would be great if my health providers could be granted selective access, but locking in to a single device/data provider is not a good idea for a large population. It may be that Apple's approach becomes a de facto standard that then gets enshrined by an industry standards consortium and other device/OS providers come on board, but there's a lot of detail to be worked out before that happens. It would not surprise me if it's twenty years before we reach some sort of stable ecosystem in this space. Some of the recalcitrance is understandable (money spent on systems is money not spent on treating patients, and we're talking about an industry where people dying is an everyday occurrence so stability and accuracy are paramount) but some of it is just butt-covering and politics.
  
  It's good to see Apple's efforts here, but it's only early days.

  
• Reply 3 of 8

  KillBillOG Posts: 32member

  June 10, 2021 1:39PM

  The balkanization of medical records is not in the best interests of patients. Data informed medical decisions require full data over time not just your last visit, as the ability of both patient and clinician to see and examine changes will help people understand the implications of lifestyle choices as well as efficacy of treatment(s). The ability of clinicians to embrace this comes from their training so I would hope that Apple embraces teaching hospitals in their efforts to understand how people can better understand their health. Health data should not be "mined" for consumer profiling and marketing but sadly most people think of HIPPA as a privacy rule, which it isn't. Privacy is one component, the accountability and portability of the data is crucial. Sadly, our legislators think off health data in "insurance" terms, so we are forced to contaminate medical data with the market place to the point where for all intensive purposes we are receiving medical and healthcare at what feels more like insurance office.
• Reply 4 of 8

  GeorgeBMac Posts: 11,421member

  June 10, 2021 2:49PM

  rob53 said:

  I would love to see a standard format for all the volumes of healthcare information I have to continually submit to each new doctor I see. It's basically the same thing and I've started to try and have a list of all the normal things they ask for. I should be able to have this on my phone/computer so every doctor gets exactly the same information. The one name I don't see is Epic and without them it doesn't work. Found a website listing the largest EHRs and Epic, Cerner and Allscripts were dominating. Epic and Cerner, in 2019, had over 50% of hospital EHRs. I also want all my imaging available on my iPhone, not just the reports. It's next to impossible to get previous doctors and hospitals to actually take the time to forward a patient's total history to their next doctors when they relocate.
  
  Of course the EHR global market is worth over 30 billion USD so anyone messing with them will have a fight on their hands. I honestly hope Apple can get the Meditech led group of EHRs to actually work together so we, the consumer and payer of medical bills and insurance premiums, can provide accurate and consistent information to medical professionals. This won't be easy because it could mean a reduction in data-entry operators and loss of billing income but that's an excuse not a justifiable reason for not participating. 
  
  ref: https://www.ehrinpractice.com/largest-ehr-vendors.html

  
  

  I don't worry about the data I give them.  I do worry about the data they put out about me.

  
  

  As you point out the EHR industry is worth Billions.   That is largely because it operates on the Google principle of collecting data about you and selling it to their customers.   While that is bad enough, you have very limited capability to identify and correct bad information they are spreading about you.  
  

  
  

  I saw that in action awhile back when I went to see a new physician.   She walked into the exam room with a list of my medications and diagnosis -- many of which were incorrect.

  
  

  I think a good analogy of the EHR industry are the credit reporting agencies:   they collect information about you and sell it to their user base.   If the information is wrong, then that's your problem to discover and correct -- if you can.

  
  
• Reply 5 of 8

  GeorgeBMac Posts: 11,421member

  June 10, 2021 3:00PM

  FileMakerFeller said:

  There are a number of different formats for data interchange in the health space. Apple has settled on one of the newer ones, FHIR, which is not (yet) as comprehensive as the older HL7 spec (although it depends which version of HL7 you're using). There's a HUGE number of systems exchanging data based on these older formats and it's an uphill battle to convince providers to convert unless they're using a system where multiple formats are supported and they only have to change a single setting.
  
  In Australia there's a push to have all medical records stored centrally; naturally there has been significant pushback from the citizenry with concerns over privacy and security. But the government has a point: the industry has had thirty-plus years to come up with a standard method for storing and sharing health information, and it hasn't happened so government has stepped in.
  
  From a personal point of view having everything on a device I own (with secured backups automatically pushed to a service like iCloud) would be great if my health providers could be granted selective access, but locking in to a single device/data provider is not a good idea for a large population. It may be that Apple's approach becomes a de facto standard that then gets enshrined by an industry standards consortium and other device/OS providers come on board, but there's a lot of detail to be worked out before that happens. It would not surprise me if it's twenty years before we reach some sort of stable ecosystem in this space. Some of the recalcitrance is understandable (money spent on systems is money not spent on treating patients, and we're talking about an industry where people dying is an everyday occurrence so stability and accuracy are paramount) but some of it is just butt-covering and politics.
  
  It's good to see Apple's efforts here, but it's only early days.

  
  

  The government has another point (or two):

  First:    I would trust my government far more than I would trust a private, for-profit company to collect, store and sell my personal information.

  
  

  Second:   With the pandemic, we have seen the critical importance of public health agencies being able to monitor diseases, treatments and their effects.  In addition, centralized collection of health information could vastly improve medical research.   Apple is taking advantage of that with their heart study -- where they can query (with the person's permission) their health information from Medicare.   That solves one of the big problems in epidemiologic studies where data is limited to what they can collect directly from the person.
  

  
  
• Reply 6 of 8

  GeorgeBMac Posts: 11,421member

  June 10, 2021 3:11PM

  KillBillOG said:

  The balkanization of medical records is not in the best interests of patients. Data informed medical decisions require full data over time not just your last visit, as the ability of both patient and clinician to see and examine changes will help people understand the implications of lifestyle choices as well as efficacy of treatment(s). The ability of clinicians to embrace this comes from their training so I would hope that Apple embraces teaching hospitals in their efforts to understand how people can better understand their health. Health data should not be "mined" for consumer profiling and marketing but sadly most people think of HIPPA as a privacy rule, which it isn't. Privacy is one component, the accountability and portability of the data is crucial. Sadly, our legislators think off health data in "insurance" terms, so we are forced to contaminate medical data with the market place to the point where for all intensive purposes we are receiving medical and healthcare at what feels more like insurance office.

  
  

  The purpose of a for-profit health care system is NOT healthcare.  That's just a means to the end:  Profit.

  
  

  One of my physicians left a major hospital system for private practice in West Virginia because he couldn't stand being pushed by his organization to generate revenue for that organization.   Later, when i became a home health nurse, on my very first day I attended a mandatory staff meeting where a blond bombshell pulled up in her Lincoln Navigator to instruct us on what she had learned in the LasVegas conference she had attended:   How to exaggerate the presence and severity of bed sores in order to increase revenue the company generated from Medicare.   Medicare even has a name for the practice since it is so prevalent:   "Gaming the system".

  
  

  She leaned her elbow on the table then held it up to show us the red mark and told us:  "See that red mark?   That red mark meets the criteria so you can classify that as a class 1 bed sore and Medicare will pay us for you to treat it".
  
• Reply 7 of 8

  beowulfschmidt Posts: 2,132member

  June 11, 2021 11:46AM

  GeorgeBMac said:

  
  

  The government has another point (or two):

  First:    I would trust my government far more than I would trust a private, for-profit company to collect, store and sell my personal information.

  
  

  
  For the United States, at least, I think this is a very naive statement.
  
  

  GeorgeBMac said:

  
  

  The purpose of a for-profit health care system is NOT healthcare.  That's just a means to the end:  Profit.

  
  

  One of my physicians left a major hospital system for private practice in West Virginia because he couldn't stand being pushed by his organization to generate revenue for that organization.   Later, when i became a home health nurse, on my very first day I attended a mandatory staff meeting where a blond bombshell pulled up in her Lincoln Navigator to instruct us on what she had learned in the LasVegas conference she had attended:   How to exaggerate the presence and severity of bed sores in order to increase revenue the company generated from Medicare.   Medicare even has a name for the practice since it is so prevalent:   "Gaming the system".

  
  

  She leaned her elbow on the table then held it up to show us the red mark and told us:  "See that red mark?   That red mark meets the criteria so you can classify that as a class 1 bed sore and Medicare will pay us for you to treat it".
  

  And I believe part of the reason it's naive lies within what GeorgeBMac lays forth here.
  
  The health insurance industry in the US is in bed with the US government.  As much as one might argue that Obama's Affordable Care Act benefitted consumers (which is debatable, having watched it play out), it benefitted health insurance providers far, far, far, more than it did consumers.  I've worked in the insurance administration sector for upwards of twenty years, and the number of subscribers to health insurance plans skyrocketed into the stratosphere with the ACA's individual mandate.  Whether the payment for those subscribers came from public or private funds, insurance companies reaped a huge benefit.
  
  I'm sure that sounds very tin foil hat-ish to some, but it's my observation.
• Reply 8 of 8

  GeorgeBMac Posts: 11,421member

  June 11, 2021 8:54PM

  beowulfschmidt said:

  GeorgeBMac said:

  
  

  The government has another point (or two):

  First:    I would trust my government far more than I would trust a private, for-profit company to collect, store and sell my personal information.

  
  

  
  For the United States, at least, I think this is a very naive statement.
  
  

  GeorgeBMac said:

  
  

  The purpose of a for-profit health care system is NOT healthcare.  That's just a means to the end:  Profit.

  
  

  One of my physicians left a major hospital system for private practice in West Virginia because he couldn't stand being pushed by his organization to generate revenue for that organization.   Later, when i became a home health nurse, on my very first day I attended a mandatory staff meeting where a blond bombshell pulled up in her Lincoln Navigator to instruct us on what she had learned in the LasVegas conference she had attended:   How to exaggerate the presence and severity of bed sores in order to increase revenue the company generated from Medicare.   Medicare even has a name for the practice since it is so prevalent:   "Gaming the system".

  
  

  She leaned her elbow on the table then held it up to show us the red mark and told us:  "See that red mark?   That red mark meets the criteria so you can classify that as a class 1 bed sore and Medicare will pay us for you to treat it".
  

  And I believe part of the reason it's naive lies within what GeorgeBMac lays forth here.
  
  The health insurance industry in the US is in bed with the US government.  As much as one might argue that Obama's Affordable Care Act benefitted consumers (which is debatable, having watched it play out), it benefitted health insurance providers far, far, far, more than it did consumers.  I've worked in the insurance administration sector for upwards of twenty years, and the number of subscribers to health insurance plans skyrocketed into the stratosphere with the ACA's individual mandate.  Whether the payment for those subscribers came from public or private funds, insurance companies reaped a huge benefit.
  
  I'm sure that sounds very tin foil hat-ish to some, but it's my observation.

  The post you were responding to was abut the for profit American healthcare system.  I'm not sure why you responded to it talking about the insurance industry.  But, anyway:

  
  

  If you were one of the 50 million Americans blocked from the health care system prior to the ACA you would not be posting such politicized nonsense.

  
  

  Did the insurance industry benefit from the ACA?   Maybe.  Maybe not.  The question is irrelevant.   The ACA was designed to fix the worst failures of the American healthcare system while working within that private system.   It probably could have been done better by scrapping that system and going with Nationalized system, but we decided to keep the private system and fix its biggest failures: The ACA did that.
  

  edited June 2021