June 21, 2011 8:45 AM

Along with millions of others, earlier this week, I watched a very frail looking Steve Jobs address attendees at the Apple Worldwide Developers Conference in San Francisco. In addition to demonstrating new operating systems for the Mac and the iPhone/iPad, Apple announced the new iCloud service.

When demonstrating iCloud, Steve Jobs said, “Keeping devices in synch is driving all of us crazy.” He was referring to music, photos, documents, and other digital media that individuals might store. What is interesting to note is that the process of synchronization is completely automatic, and information on one device is automatically updated on all devices synchronized with other devices using iCloud. Changes on any device are pushed to all other devices.

Jobs makes an interesting observation. We take it for granted these days that our telephones are able to take photographs, play music, browse the web, read documents, and a multitude of other functions. Gone are the days when a phone was a phone and you needed a separate camera to take photos or video. Now, one device does everything.

Think of the iCloud service in terms of medical information. As a clinician, what drives me crazy is reconciliation of medical data. I send a patient to see a specialist, and they stop one or more meds and start two new medications. I receive a consult letter and have to manually go into the EMR and update the medications to ensure that the medication list is accurate and up to date. What a painful process. Would it not be great if the medication changes were pushed into a secure “cloud” and automatically updated the medications list in my EMR? I realize this is simplistic and we have to deal with multiple providers and multiple devices, not all of which can speak to one another. However it is a great concept to aspire to.

Perhaps medication changes from multiple providers are not a good example, but it would certainly make sense if I had an app on my phone that allowed me to E-prescribe medications directly to a pharmacy and my own prescriptions automatically updated the patient’s medication profile in my EMR. At least these two software applications should work together.

What do you think? Could an iCloud type service work in healthcare? What would you want to have automatically synchronized with your EMR?

Originally posted on Canadian EMR

Blogger Profile: Alan Brookstone
CanadianEMR is an authoritative and widely recognized national resource for physicians, medical office staff, healthcare planners, government organizations, and vendors of EMR systems.

Posted by Sue Ansell at June 21, 2011 8:45 AM

Categories: eHealth

Comments

Dennis Giokas email -

Alan, I am totally on side with you. Multiple systems, providers and devices need to speak to each other. As you indicate, it is important to reconcile medications and to make that information accessible. I imagine as a clinician you would want other key data reconciled and available to you such as laboratory results. As you say, that is the “great concept we need to aspire to”. What you described are systems with requisite functionality and interoperability of a Drug Information System (DIS) interoperating with an EMR.

The most unique aspect of “cloud” is that it is a novel hosting strategy that has shown it can optimize the use of computing resources and thus reduce the capital expense to host systems, and ongoing operations and maintenance expenses. However, you still need systems in the cloud to provide essential business and clinical services, and interoperability services to enable the capabilities you describe.

Interestingly, the functionality and interoperability you describe is totally consistent with the interoperable electronic health record (iEHR) approach that Infoway has been investing in. The functionality you seek is in the DIS of the iEHR. What is different? How it is hosted – in the cloud or in more traditional data centres. From the iEHR your EMR can get the current medication list in real time and make it viewable to you as a clinician. From your EMR you can also invoke advanced services in the iEHR such as drug utilization review on that medication list. Optionally, your EMR can download and process that medication list locally. That same medication list in the iEHR can be viewed and processed via an app on your smart phone or tablet device. See my post related to this topic ( http://infowayconnects.infoway-inforoute.ca/blog/vendors/101-the-long-term-view-of-interoperable-ehrs-think-innovation/#axzz1Q2h6HWTi )

Today the provinces and territories are hosting the iEHR capability in their own data centres. In the future they could use cloud-based strategies in what is known as a privat

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