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Bosworth: PHRs need to do more than just store data

You may have heard news of Google essentially putting its Google Health PHR platform in cold storage. Whether it’s true or not, the “untethered” PHR—one not connected to a health system’s EHR—has been a non-starter for years. I’ve been particularly critical of the undeserved attention Google Health and Microsoft HealthVault have received, when many smaller companies have been working on PHRs for much longer.

The original head of the Google Health project, Adam Bosworth, left the company in 2007 under suspicious circumstances—did he quit or was fired?—prior to the way overhyped 2008 introduction of this vaporware. Bosworth has gone on to start a new company, Keas, that produces a PHR that incorporates care plans. Keas got some undeserved hype itself, in the form of an October 2009 story in the New York Times that, from what I understand, was suggested by a Times editor who also was advising Keas. (That editor is no longer with the Times.)

Keas itself hasn’t gained much traction, either. I reported in September 2010 that Keas abandoned its original plans to sell direct to consumers in favor of partnering with insurance companies and large employers. That was the last I had heard about Keas until last week, when TechCrunch TV posted the following short interview with Bosworth, entitled, “Adam Bosworth On Why Google Health Failed”:

Bosworth said that Google simply didn’t offer anything the public really wanted. “They basically offered a place to store data,” he said. “Our data shows people don’t really want a place to store data per se. They want to do something fun and engaging. If it’s not fun, if it’s not social, why would they do it?” Yes, that makes sense.

Bosworth said that people need encouragement and even peer pressure to practice healthy behaviors. Bosworth said he lost 22 pounds in 18 weeks by walking 4 miles each way to and from his downtown San Francisco office four times a week, and he credited the encouragement he got from checking in on Keas.

That’s a great sign, but I wonder how many other stories like his there are out there? My guess is, not many. I’m thinking online communities of like-minded people or those facing similar health issues have been far more successful. Last night’s post is a prime example.

Feel free to prove me wrong.

June 6, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Park defends plain-text format of ‘Blue Button’

Todd Park

Well, I guess everything else pales in comparison to the news late Sunday night that Osama bin Laden has been killed and that his body is in U.S. custody, but I had been meaning to bring you something from another part of the government. So now, nearly three hours after I sat down to start writing, here goes.

Remember back in February how I reported that the Blue Button Initiative that HHS, the VA and the Department of Defense had been touting was much ado about nothing because the add-on outputs data in plain, unstructured text that’s essentially useless when imported into an EHR? Well, government officials continue to defend it.

At the Microsoft Connected Health Conference last Wednesday in Chicago, HHS CTO Todd Park extolled the virtues of Blue Button, saying that it was a conscious decision on the part of the people behind the idea—particularly ex-Google and Microsoft star Adam Bosworth and author/Internet scholar Clay Shirky—to export patient information in untagged text format as a quick means of “liberating” data from proprietary systems. It then is up to the patient and his/her providers to decide what do do with the exported record.

“We decided that the burden shouldn’t have to be on the vendor to parse the data,” Park told me offstage.

Well, what do you think of that? Should Blue Button follow some established protocol that organizes data in discrete format like the Continuity of Care Record, Continuity of Care Document or Clinical Document Architecture, or is raw, unorganized text good enough?

UPDATE, 10:50 pm CDT: I found the rest of my notes and see that Park said 270,000 unique users have downloaded data through Blue Button, an average of three times each, even though the government hasn’t done much in the way of marketing. “Simplicity is the key,” he said.


May 1, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Quick TEPR report

PALM SPRINGS, Calif.—I’m tired and ragged from finishing up something that could have a huge bearing on my future while also covering TEPR+. I now understand that the “plus” is because the conference has expanded its scope from “Towards an Electronic Patient Record” to include mobile health and interoperability. To this end, the Medical Records Institute formed a new 501(c)(3) called the mHealth Initiative, which is totally unrelated to the eHealth Initiative.

The mHealth Initiative is headed by MRI vice president Claudia Tessier, former executive director of a previous MRI project called the Mobile Health Care Alliance (MoHCA). The new organization, which will pick up the activities of the MRI’s Center for Cell Phone Applications in Healthcare (C-PAHC), has a workshop planned for March 31 and its first annual conference set for Dec. 9-10. Both events will take place in Boston. Additional workshops will be scheduled for June and September.

Other than the added focus on mobile health, there really is nothing “plus” about this, the 25th edition of TEPR. The organizers tell me that about 750 people have registered, down from 1,200 at last year’s meeting in Fort Lauderdale, Fla., and from a peak of just under 3,000 five years ago. I can’t say that I saw 750 people here, though. I would be surprised if there were more than a couple of hundred people present at the opening session this morning, and the exhibit hall contains just four rows of booths.

Obviously the economy has had a huge bearing on attendance at all kinds of events in recent months, but the decision to meet in a sunny desert resort town may have backfired. After the HIMSS moved its conference to April from February to avoid the brutal Chicago winter weather, the MRI grabbed the open time slot for TEPR instead of waiting until May. But MRI president Peter Waegemann tells me he heard from many people whose bosses vetoed the idea of sending them to Palm Springs at a time when so many others were losing their jobs. Perhaps if TEPR were back in Dallas or Baltimore this year?

I’ll have more later on some actual content from the meeting, including a fascinating proposal from Keas founder Adam Bosworth, late of Google and Microsoft. And, no, I don’t know what Keas actually does. Bosworth plans to announce something in the next month or two.

February 2, 2009 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.