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Cleveland Clinic’s Ed Marx Talks Health IT Disruption, Innovation and a “Patient-First Approach”

January 17, 2018
by Heather Landi
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Along with being a notable experienced health IT leader, Edward Marx, CIO of the Cleveland Clinic, also is a seasoned mountain climber, and his expertise in both areas makes him more than qualified to share his insights on reaching the highest heights of health IT disruption and innovation.

Marx, who took over the CIO role at Cleveland Clinic Sept. 1 after the health system announced his hiring in July, is slated to be a keynote speaker at Healthcare Informatics’ Cleveland Health IT Summit at the Hilton Cleveland Downtown on March 27 to 28. In his keynote presentation, Marx will apply his mountain climbing experiences to driving innovation in healthcare, and what it takes for CIOs to summit the innovation mountain.

Prior to stepping into the CIO role at Cleveland Clinic, Marx held executive positions at the Advisory Board Company and he spent eight years as CIO at Texas Health Resources, following five years in that role at University Hospitals in Cleveland. What’s more, Marx is active with professional organizations, advisory boards and higher education throughout the health IT industry. He is a Fellow of the College of Healthcare Information Management Executives (CHIME) and Healthcare Information and Management Systems Society (HIMSS). He has won numerous awards, including HIMSS/CHIME 2013 CIO of the Year.

Recently, Healthcare Informatics’ Associate Editor Heather Landi spoke with Marx about his priorities leading IT initiatives at Cleveland Clinic, the acceleration of health IT innovation and what he is excited to see develop in the healthcare technology space in 2018. Below are excerpts from that interview.

You started in your new role as CIO at Cleveland Clinic about four months ago. What are your priorities right now?

The number one priority is the exact same priority as the Cleveland Clinic itself, and that is, to ensure that we continue to promote and cultivate a patient-first environment; everything we do is really centered around that focus of putting patients first. The strategies that our organization has are the exact same ones that IT has. One area of focus for 2018 is digitalization, and that’s really about how do we take our practices today and leverage technology to automate them, and that could manifest itself in many different ways depending on the area. It could be exploiting artificial intelligence, machine learning and the digital hospital. We do all of those things already, but it’s about taking them to the next level. The focus is about how do we become more efficient and effective, and maximize the tools that are available to us today to continue to deliver the highest quality patient care possible. At our organization, IT is not a separate strategy than the organization, and it’s important that IT is an enabler of the organization’s objectives and not just something we do because it’s a cool thing to do or it’s the next shiny, bright object that’s out there. We never lead with it, because we always collaborate; collaborating with technology and with what we’re trying to do on the clinical side in order to do the very best by our patients.

There are some foundational things that we work on just like any other strong IT organization. One is leveraging best practices for IT. While we have a good IT organization, we want to continue to improve and grow, and one way we do this is by leveraging best practices, just as the same as clinical side, where we try to increase the quality of care, we look at best practices around the world and then we adopt them within our culture. We’re doing the same with IT. We’re working hard on that. Another key thing for us in terms of focusing on the fundamentals is transforming ourselves into an agile organization. Many of the leading companies today, technology companies specifically, are agile companies and they have adopted agile practices. That’s something that we’re doing, and not just in project management and not just in software management, as many companies do, but we’re adopting an agile format, much like successful tech companies, in everything we do.

A third thing we’re doing is that we’re really enhancing our governance and project management capabilities, so we want to continue to grow and make sure that we’re very effective in our utilization of scarce resources. We all have a limited amount of resources, and so we want to become very adept and very good at how we align those with the organization’s priorities and we do that through strong IT governance and project management. Once we do have those resources secured, and we launch particular initiatives to enable our business, we want to make sure that it’s in done in the very best possible way. In all those areas, we’re working to become the best of class to enable our organization’s mission and vision.

What are the biggest challenges that healthcare CIOs are facing?

I think some of the bigger challenges are security, of course, such as how do you ensure that you have all the appropriate safeguards in place, and how do you continue to mature in that area at the same pace as those who seek to do damage? So, security is a big focus for us.

Going back to what we were talking about before as far as strategy, how do we leverage technology to enable the business in a way that’s effective and efficient? All of us have scarce resources, so it’s about how do we operate as agile as possible given the environment that we’re in, with the changes in healthcare, the landscape today? We need to do a lot of things differently. It goes back to the saying, ‘What got us here, won’t get us there.’ We need to figure out new ways to operate. That’s always a challenge, so that’s why we’re focused on some of those foundations that I mentioned earlier to meet that particular challenge. I think between the new ways of operating and security, those are the two biggest challenges that we’re facing.

What are you most looking forward to in 2018, in terms of innovation and progress in the health IT world?

I think we’re going to see rapid adoption and acceleration of technology-enabled enhancements. We’ve talked about a lot of these for several years, but I think we finally have the right mix of different things happening that are going to enable this sort of rapid acceleration. Those things are the advancement of technology, number one, but now also the empowerment of everyone, sometimes I call it consumerism, but everyone understands the capability now of technology. And, third, in an organization like the Cleveland Clinic, with the amount of innovation that already takes place and the culture of innovation, when you mix the maturity of technology, the ubiquity of technology, as everybody understands it and are digital natives now, and the innovative culture that we have, we are going to see this rapid cycle of deployment, acceleration and transformation of what we’re doing with technology.

An example of an initiative that we have already started on with AI is with what we’re doing with Microsoft using Microsoft HoloLens. We continue to exploit that technology and the capabilities there. [editor’s note: Cleveland Clinic and Case Western Reserve University have partnered with Microsoft to use HoloLens, a fully self-contained holographic computer, to leverage virtual reality to train medical students on anatomy. Students put on a HoloLens headset and are guided through a lesson on a virtual human subject, a human body in 3D. A video of the project can be found here.] And then, finally, all of that, AI in particular, leads us to precision medicine, and we’re already seeing early results.

I think we’re going to see that rapid acceleration and deployment of new technologies in 2018; we’ve finally hit the tipping point. That’s what I’m really excited about, because, at the end of the day, it’s about that patient-first objective and enabling us to take better care of our patients and increase the quality of care.

On the subject of patient engagement, what role does technology play in the Cleveland Clinic’s ongoing patient engagement strategies?

We have an office of patient experience and I think we were the first in the country to have a patient experience officer, and that officer is a peer of mine; that’s how important that role is. We do a lot of things to engage with patients and ensure the patient has a great experience and much of that is technology-enabled. We have a new system that we are rolling out to engage patients at the bedside, and this includes the ability to leverage a large screen so that patients can control their entertainment and also receive clinical care information and education materials and it gives them the ability to interact with caregivers through their medical record. This system gives patients the ability to eventually control environmentals in their room, to order meals, to basically have this strong interactive relationship.

We also focus on engaging our patients whenever they may be around the world. We have spent a lot of time and effort to make sure that through our smartphone applications, that there’s always a connection with the Cleveland Clinic for patients and for prospective patients; that they are engaged with their medical record, that they can interact with their providers, that they can see providers through their app, schedule appointments through their app, have quick access to providers, do some of their visits virtually, so there’s a whole host of things that we’ve done on the mobile side that really engages the patients.


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At the Seattle HIT Summit, UW Medicine’s Grosser Asks Leaders to Rethink Patient Engagement

October 22, 2018
by Mark Hagland
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UW Medicine CIO Joy Grosser shared her perspectives on patient engagement and the patient experience

Are patient care leaders failing to make a conceptual distinction that might really make a difference? That question was pondered by Joy Grosser, CIO at UW Medicine, the four-hospital University of Washington health system, in her opening keynote address on Monday morning at the Health IT Summit in Seattle, being held at the Grant Hyatt Hotel in downtown Seattle, and sponsored by Healthcare Informatics.

Speaking to an audience of healthcare leaders, Grosser, who joined UW Medicine as CIO just under a year ago, said that one key thing that patient care organization leaders need to ponder is the crucial difference between patient engagement and the patient experience, as an understanding of that distinction can really make a difference in how organizational leaders strategize forward to meet the needs of patients and communities.

Beginning her presentation, entitled “Patient Engagement: Can Digital Health Help Our Patients Become a Member of the Healthcare Team?” Grosser noted that she finds the terms “patient” and “provider” somewhat limiting and problematic, but also that terms like “consumer” can also be problematic, Grosser outlined some of the challenges and opportunities in enhancing both patient engagement and the patient experience







Joy Grosser

“When it comes to patient engagement, how are providers and patients—how are we working together to improve health?” Grosser asked her audience. “We all know that medication adherence is an issue. People do what physicians tell them to do, but how to we create greater engagement, which contributes to improved health outcomes? And how does information technology contribute? Even though my father was a physician, my parents were somewhat of the era in which you did what your doctor told you to do, without asking. Some years later, people began to research medical issues on their own. Now, my children’s generation has a completely different attitude. There is always the question of ‘why’ patients should do something in particular.”

Meanwhile, Grosser said, “I use the broader umbrella term ‘digital health’ to describe how we bring things to our patients.” Indeed, she said, “Oftentimes, ‘patient engagement’ and ‘the patient experience’ are described as interchangeable, but I find they’re very different things. The patient doesn’t have to be engaged to have an experience.” That said, “There is overlap, though. In fact, if you’ve had a bad patient experience, it’s going to be harder to engage as a patient.”

Meanwhile, Grosser told her audience that, while hosting a patient portal is just a beginning when it comes to engaging patients, website development is a necessary start. In fact, Grosser said, in a road trip the past weekend in which she went through several different large communities, she web-searched the websites of several different hospital organizations, and found that, among several of them, one could only scheduled appointments in a couple of or a few medical specialties, and that most appointment scheduling still had to be accomplished via telephone call.

So some of the limitations of patient portals include that, since the development of a patient portal was a requirement of the meaningful use program under the HITECH (Health Information Technology for Economic and Clinical Health) Act, simply having one really is no longer a differentiator in the market; second, portals tend to be not strongly customized versions of EHR (electronic health record) brand templates; and the portals that have been created tend to be difficult to customize as “containers” for a variety of patient-facing tools.

Still, Grosser noted, “There’s that opportunity to be a container of patient information, rather than just one place that the EHR sits. We recognized that there were limitations, as we moved into an app world and wanted to link those apps,” she said, of the hospital industry’s movement forward in this area.

Meanwhile, as a practical matter, telehealth inevitably started small, Grosser said. “It started with physicians saying, ‘OK, put my picture online’” to create an initial presence. “We didn’t move there as an industry, we moved as individuals; so much so that all our EHR vendors have pulled in virtual care elements into their EHR solutions. Our physicians were often slow to respond, though.” In relation to that, she recalled,  I worked in an organization in Southern California in which they began training physicians just out of residency” to specialize in telehealth, and “to learn how to interact from a screen. We actually worked with film industry people to train” those physicians how to interact more effectively through a screen. “There are literally physicians coming out of residency who are working online. People are calling them Uber doctors. They’re working for third-party vendors. We might want those physicians in our healthcare systems as well,” she noted.

More broadly, in terms of creating and expanding on a digital health presence, Grosser said that there really is a market growth opportunity there, but that so often, internal opposition will be a limiting factor. “Oftentimes,” she said, “your physician billing organization will say, ‘We can’t see a person virtually for the first time, because we can’t verify them as a real person. But there’s a real differentiator when teledoc companies said, I don’t care if I’ve seen you in person before or not.” So, she asked, “Are your physicians looking at this as an annoyance, an add-on, or a growth opportunity? I was at a conference about a year ago, and people were touting an online experience, except you got an appointment by calling first. They had linked the medical records, and visits, but not the scheduling for the visits. And are these visits recorded in your medical record as a visit? Or deemed as being an urgent clinic, where the documentation will have to be redone?” Numerous practical challenges remain.

One area of real opportunity, Grosser said, involves live chat with patients. “I’ve looked through many surveys” of healthcare consumers, to determine what it is that consumers say they want. Fundamentally, she said, patients want three things: access, communication, and knowledge. “But maybe how they want those will evolve, as the IT side evolves as well. They want mobile, including chat. And honestly,” she said, creating “chat is so easy. It’s an incredibly important part of that mobile industry as well.” And, she said, patients want a voice experience—in some cases, via technology like Alexa. That opportunity will be particularly strong on the mental health side of the industry.

In fact, Grosser said, healthcare consumers “want the same experience they get when booking airfares. They want to do that here in Seattle with hospitals and clinics,” to find out which patient care organizations will offer what types of physician visit availability, and eventually, even to compare specific moment-to-moment comparative availability. “And how do they get a Kayak-type experience, where they describe the kind of physician they want, and a mechanism can help them?”

Beyond scheduling ease, Grosser noted, “Patients want communication with their healthcare team. And they want knowledge,” including trusted, customized knowledge. That is where some type of Alexa experience, involving artificial intelligence, could prove quite appealing to patients in the near future.

Meanwhile, engagement could also apply along another dimension, Grosser told her audience. And that would be in the area of wearables and other consumer-facing devices that could appropriately communicate specific types of patient data to clinicians, as needed. For example, she said, “If I’m in orthopedics, I might not want to know how much you walk every day, but I might want to know you walked after your hip or knee replacement, or that you went for your physical therapy. AI [artificial intelligence] can help me filter the information I need as a health system.”

Ultimately, Grosser said, when it comes to innovation, “We are moving towards a mobile health maturity model. We’re looking for patient-generated data, generated in a meaningful way. We have to understand that that kind of information is meaningful.”

Meanwhile, Grosser asked, “How do we get to those empathetic health and healthcare tools? This is where I think the market for engagement will take us a long way. Patients will want to connect with non-threatening people to help them take the next steps. How do we make sure that they’re taking the right steps? That we want them to go off particular medication? How do we classify the right apps for them? Work together with their clinicians on the best apps for them?”

There are vast opportunities to create new forms and channels for the engagement of healthcare consumers, Grosser emphasized. But patient care organization leaders need to be very aware of the emergence of a broad range of disruptors, from technology and retail companies like Microsoft and Amazon, but also from such business combinations as CVS as Aetna, as any of those entities might easily rush in to fill voids that patient care organizations have not yet figured out how to fill.

“I think disruptors are good things to the industry,” Grosser told her audience. “If we look at Amazon-related headlines—at Amazon, they’re looking for data scientists, and have been talking about tackling healthcare for some time. My adult children were born before Amazon was created,” she noted. “I asked my children this weekend what they thought about doctors being on Amazon. They said, oh, that’s a great idea! And ended up being engaged in a great conversation. They don’t look at healthcare as a continuum of care. They look at it as offering options” to consumers. And in that context, she said, it's important to note that “The book industry was a test for where else Amazon wanted to go.” And after several years focused primarily on selling books, the executives at Amazon figured out how to succeed in selling a vast range of consumer goods via the same model. Could Amazon disrupt the retail pharmacy industry? Could the CVS-Aetna merger end up strongly disrupting the patient care delivered in medical clinics? What about the announcement last week on the part of Walgreens, which will be partnering with the 14-hospital, Grand Blanc, Michigan-based McLaren Health Care, to expand pharmacy and healthcare services across that state?

Meanwhile, employers represent another potential disruptor in this area. And auto manufacturers, who face the reality that one-quarter of the cost of producing a car, is eaten up by employee and family healthcare costs, are contracting directly with organizations like Cleveland Clinic, in order to cost-effectively manage their employees’ and employees’ family members’ costs for high-volume procedures like total joint replacement. Patient care organization leaders also need to look at the venture capital funders in healthcare to see where VC companies are investing their money into the future.

In the end, Grosser told her audience, the potential for patient care organization leaders to move proactively to engage their patients and improve their experiences, is great; but the potential for outside organizations to come into healthcare as disruptors, is also significant.

Patton concluded her presentation by sharing a quote from General George S. Patton: “Never tell people how to do things. Tell them what to do and they will surprise you with their ingenuity.”


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Health2047 Spin-Off Focuses on Prediabetes Coaching

October 9, 2018
by David Raths, Contributing Editor
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First Mile Care seeks to scale up CDC’s proven National Diabetes Prevention Program
First Mile Care CEO Karl Ronn

Health2047 Inc., a Silicon Valley-based innovation company founded by the American Medical Association (AMA), has spun out its second startup, First Mile Care, a preventive chronic care company focused on prediabetes.

Health2047 previously launched Akiri, a San Francisco-based company developing a blockchain-based network-as-a-service platform for the healthcare industry.

There are an estimated 84 million people living with pre-diabetes (higher-than-normal blood sugar level), according to the company. With $2 million in seed funding, First Mile Care is building a platform that will offer people coaching to make lifestyle decisions that can reverse prediabetes and reduce the risk that their condition will develop into type 2 diabetes.

The First Mile Care platform is based on the proven National Diabetes Prevention Program (DPP) method developed by the Centers for Disease Control and Prevention (CDC). The coaching program has been shown to reduce the incidence of type 2 diabetes by 58 percent compared to placebo.

In an interview with Healthcare Informatics, First Mile Care Founder and CEO Karl P. Ronn described First Mile’s approach. “The CDC developed an approved diabetes prevention coaching program that works, but it just hasn’t scaled,” he said. “Approximately 200,000 people have taken the program in the seven years it has been available. That leaves 84 million who haven’t. The question is: can we scale it?”

First Mile has set an ambitious goal of getting half of prediabetic population into a coaching program in the next 10 years. “That scale of intervention would change the chronic disease landscape in the United States, said Ronn, a former Procter & Gamble executive.

To accomplish that goal, Ronn said First Mile will have to make the coaching intervention as convenient as possible. “If I want you to do something weekly for 16 weeks and monthly or bimonthly for six months after that, it better be easy to do or you are going to drop out,” he said. “It has to be within 10 minutes of your home. The reason we are called First Mile Care is that rather than trying to figure out how we are going to get the last mile from our hospital or doctor’s office to your home, we are more interested in that first mile, and we need to be able to make it possible for you to get that coaching in that first mile from your home.”

An easy way to model that is ZIP codes, he said. There are 42,000 U.S. ZIP codes. “It has to be as convenient as regular weekly shopping trips and that means showing up in all those ZIP codes,” he said. “I could need 40,000 to 100,000 coaches to handle 84 million people.”

First Mile is building a technology platform to build a matching system between individuals and coaches much like Uber does between drivers and riders. The platform will also track progress and provide feedback to users and use analytics to discover best coaching practices. “The tech platform tis important in matching people and tracking progress,” Ronn said, “but really I am trying to build a relationship between you and your coach so you can get done what you need to do. I don’t want the technology to get in the way of that; I want it to support it.”

Another reason the timing is right for the company’s launch, he said, is that Medicare has recently started to pay for this type of coaching program and other insurers are starting to follow suit.

So what is next for First Mile? “Our seed funding will enable us to prove we can do what we said we could do in terms of develop this coaching process in the wild,” Ronn said, “and create the on-demand system. In the process of doing it, we want it to be effortless and delightful for the coach and for the person. We are in a learning model to prove we can do it. Within 18 months, we will be scaling it up. “



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Top Ten Tech Trends 2018: A Patient-Generated Health Data Future is Becoming a Reality

September 5, 2018
by Rajiv Leventhal, Managing Editor
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Providers are becoming more open to integrating patient-generated health data into clinical processes, but core challenges still remain

Editor’s Note: Throughout the next week, in our annual Top Ten Tech Trends package, we will share with you, our readers, stories on how we gauge the U.S. healthcare system’s forward evolution into the future.

Last fall, the Boston-based Partners HealthCare system launched a project with the aim to provide its clinicians and researchers with access to patient-generated health data (PGHD) from more than 420 consumer and clinical health devices. Working with Durham, N.C.-based vendor Validic, Partners Connected Health announced its plan to integrate PGHD into care plans and the electronic health record (EHR) throughout the Partners HealthCare network this year.

Of course, Partners HealthCare is far from the only organization working on PGHD projects across the U.S., but the initiative, along with many others, proves that patient care systems are turning more toward collecting and integrating key data from consumers that is accumulated outside of a facility’s four walls. Indeed, during the second quarter of 2018, wearables were one of the top-funded categories for digital health VC funding, according to a Mercom Capital Group report.

That said, plenty of fundamental challenges remain, even as the motivation to integrate PGHD into clinical processes increases. For one, patients must be willing to use the devices and be engaged in collecting their own data. In the Partners HealthCare/Validic project, the devices used were either ones that patients already owned and were comfortable with, or were purchased from Amazon or someplace similar. In previous PGHD initiatives, Partners HealthCare tried to get most patients to use a single device, but the results were less than ideal, recalls Kelly Santomas, R.N., senior director, Partners Connected Health, an arm of Partners HealthCare.

For this initiative, Santomas’ team particularly wanted to collect data on patients’ blood pressure and glucose levels, activity and weight. She notes that the data is being integrated into providers’ EHRs, and that incorporation has not been difficult. The challenge with this project, so far, she says, has been fighting the perception that the patient data is not valid.

For instance, Santomas offers, if a patient is taking his or her blood pressure at home, and then that recordation is sent to the EHR, some providers might see that number as invalid. “But that’s a misconception,” she asserts. “It’s interesting, because we send patients home right now, tell them to buy a blood pressure cuff, write down their levels, and email it to us. So how do we know that is valid? You are assuming patients will do the right thing and give the right information, and working within [providers’] perceptions [on that] is the biggest challenge,” she contends.

Kelly Santomas, R.N.

Brian Modena, a clinical researcher at the Scripps Translational Science Institute who has researched the effectiveness of mobile health data gathered outside the doctor’s office, also believes that integrating this information into EHRs “is easily doable.” But Modena doesn’t see this being done industry-wide and he says that’s because “healthcare is always so slow to adapt, and people are used to the old way.” The “old way,” he says, involves a nurse taking a patient’s blood pressure and handing that off to the doctor, who then gives the patient advice. “The question becomes, are doctors going to look at PGHD? And if so, how often will they use it? What type of format should you put it into so doctors can easily process it?”

To this end, Santomas believes that physicians genuinely do want to incorporate patient-generated data, but it needs to be presented in a way that makes sense and is actionable to them. “They don’t have the time to sift through [non-valuable] information. So we need to make sure we are providing the data in a format that makes sense, is actionable, and benefits the patient in the long run,” she says.

UPMC Innovating Toward a Patient-Centered Future

In 2017, the University of Pittsburgh Medical Center (UPMC) said it would be investing in Xealth, a digital health startup that offers a digital prescribing platform, allowing clinicians to prescribe patients digital educational content, disease management apps and monitoring devices.

Rasu Shrestha, M.D., chief innovation officer and executive vice president at UPMC Enterprises—the health system’s innovation hub that funds promising health tech ventures—says that one of the primary reasons for the investment was to solve what he believes is a major barrier in advancing forward with patient-generated health data: an EHR divide that exists between providers and patients.

As Shrestha sees it, on one end, clinicians spend a great deal of time in their EHRs, as that’s where they document and how they bill. “Essentially, it’s how they provide care, and these care pathways and decisions they make are all documented and contained in the EHR,” he says. But at the other end, patients don’t live in the EHR. “At best, they maybe live on their phones, and they might use apps that might be connected to mobile devices. But these apps and devices are separate and are different from the EHR, and they don’t communicate well with each other. So you have these two divides, these two worlds, that are coexisting in these two different spheres,” Shrestha says.

Rasu Shrestha, M.D.

What’s more, if patients do download a health data app, it’s likely they won’t use it very frequently, and even if they do, they might also be fitness fanatics and own Fitbits and Apple Watches, meaning there is a lot of data that is remaining in the confines of the patients, apps, and devices, and in no meaningful way is being made back to the physician’s eyeballs, explains Shrestha. “Patients might make mention of this [data] during an annual visit and maybe they even take printouts. But that’s the extent of the interaction we see today,” he adds.

Bridging that divide was a big factor in the work UPMC is doing with Xealth. Shrestha says that the two organizations are co-creating a set of capabilities that will allow for clinicians who live in their EHRs to directly prescribe apps to their patients, much like how they are prescribing medications in the EHR today.

The prescribed apps then appear on patients’ phones, and with patients’ permission, a bi-directional interface can be created between apps and devices—through the patients’ phones, to the EHR. “Data would then be consumed in a matter that the EHR could understand,” Shrestha says.  “All of the readings and the data elements would then be available to the clinical decision support systems within the EHR, or through various means into the database of the EHR itself. That is something that is noble and unique, and this needs to be a standard of care and best practice across the board,” Shrestha asserts.

And UPMC physicians are embracing the validity and quality of the data, too, he adds.  Up until as recently as a year ago, he notes, physicians were resistant to engaging patients and consumers. But what were once disconnected experiences and data that simply was overbearing for clinicians in the little amount of time they had has now become data that is easily consumable and digestible for them, Shrestha says. “I am seeing that change happen in front of my very eyes.”

What Could Apple’s Role Be?

In June, Apple introduced a Health Records API (application programming interface) for developers and researchers with the goal “to create an ecosystem of apps that use health record data to better manage medications, nutrition plans, diagnosed diseases and more.”

The Health Records feature allows patients of hundreds of hospitals and clinics to access medical information from various institutions organized into one view on their iPhone. “For the first time, consumers will be able to share medical records from multiple hospitals with their favorite trusted apps, helping them improve their overall health,” Apple officials stated at the time. And starting this fall, Apple officials say that developers building health apps can individualize experiences based on the user’s unique health history.

Shrestha, for one, says he’s excited about the way Apple is approaching things. “It’s a really good thing that there is now one place on patients’ iPhones where they can collect information that belongs to them from any health institution that they have their data in, and that they can also send data back to the hospital. That’s a big deal for patients,” he says.

But, he adds that it shouldn’t be just about the Apple ecosystem and iPhones, because “There is also a whole ecosystem of patients and consumers on Android devices and others.” So, Shrestha asks, “How do we make sure we enable a much broader view to apps that may reside across other ecosystems and allow for that bi-directional interface to happen?”

In the end, Partners Connected Health’s Santomas believes that it’s realistic to think PGHD can soon be used to improve clinical outcomes. “Ideally, I’d love to see a world where the patient can access the healthcare system virtually, on their phones and computers, and as a provider I can sit there and talk to patients, pull up their record, and pull up their PGHD so I can have a sense of what’s going on while they’re at home,” she says. “All of that works together and gives us a much more holistic view of what’s going on with the patient versus just these small episodes of when I see them only in the office. That’s my vision.”

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