Monday, June 6, 2011

What the iCloud Means to Population Health and Disease Management

Behold the cloud!
Intrigued by the spouse's enthusiastic embrace of her iPad, the Disease Management Care Blog has started paying better attention to the Apple company.  So when "iCloud" hit today's news cycle, the amateur informatician DMCB decided to take a closer look.

"Cloud" computing can be defined as the use of computer resources that are on a computer network (such as the World Wide Web) instead of those that are on the hard drive of that computer you are currently using.  So, instead of using "Word," or storing images or tunes on your "C" drive, the "cloud" enables you to use any network-enabled device to access a word processing program or store images on servers located anywhere on the globe.  So, for example, when the DMCB wants to edit a PowerPoint presentation while on the road next week in San Antonio using a friend's laptop, that will not only be possible, but it will also be able to sync it's calendar, upload a new blog post and make some tasty blueberry waffles.

Among health care services, readers may think this is simply an expansion of the on-line medical records phenomenon courtesy of companies such as Microsoft' "HealthVault."  The DMCB agrees but wonders if this cloud thingy takes things one step further:

Much more information is much more available real time.   Colleague Vince Kuraitis likes to refer to a rapidly evolving information technology "ecosystem."  The term may finally start to fit.  This goes beyond the notion of active patient engagement in reviewing, uploading and shepherding their personal health information (PHI).  To the DMCB, the "cloud" concept seems much bigger, with PHI consisting of interlocking evolving "clusters" of data from the patient, traditional providers, health insurers and     - good news - care management companies. 

The converse will also be true: information "monopolies" will wane.  Thanks to the favorable economics of and savings from storing petabytes of clinical data on the cloud (such as medical imaging), traditional health care providers will find it harder to deny access to their patients' data by patients and families as well as cooperating and competing health care providers. Persons with a need to know will find it easier to find that CAT scan from two years ago.  Whether traditional providers will gum things up with high data "viscosity" and overlawyered notions of patient privacy remains to be seen.

It won't be easy: Data integrity and privacy will face new challenges (for example) requiring significant system redundancy, distribution, back ups and yet-to-be-developed engineering and security systems.  The caution here is that we still have a way to go; between here and there will lie data breaches, network outages and critics - like the DMCB - who will wonder when patients will finally get to benefit from all of this.

A central role for care management programs?  In addition to the immediate need for a tailored Google-like search engine (that includes passwords) that can "pull" needed information on a particular patient from the "cloud," the DMCB wonders if care and disease management organizations are best positioned to help some patients access, use and organize multiple clouds of data.  These companies are heavily invested in IT, span the continuum of care across multiple providers and are closely aligned with patients anyway.  More on this in a future post.

The bottom line for disease management: this is good news for care management service organizations, who will be better able to both access and contribute to their patients' information.

Image from Wikipedia

No comments: