As we sit around contemplating data models, nomenclatures, privacy impact assessments, and technical architectures for an interoperable electronic health record (EHR), the real world is racing ahead of us. Consider this.... One day we may wake up and find that many of our patients have their own online Google health record. Dr's are using their iPhones to access not only the Google health record, but diagnostic images. Maybe that latest ultrasound will be available on YouTube.
This is not as far-fetched as it sounds. Many of us leading the charge in health informatics are old fogies, locked into the technological concepts of the 1970's, 80's and 90's. We still think websites are pretty cool, while our kids (most of whom are now adults) are texting one another with a coded language that certainly doesn't look like Snowmed or ICD-10.
This involves not only new technology, but new ideas, new ways of relating to one another and new values. Perhaps the biggest risk to what we are all now calling the EHR is that our work will be eclipsed by a marketplace and a generation that doesn't have the patience for our bureaucratic approaches to EHR development. I would liken our state to the recording industry. We're working with 8-track tapes that give us quadraphonic sound while our kids are downloading iTunes.
Blogger Vince Kuraitis has written an analysis titled Connecting the Dots...Google Health Promises to Create and Dominate Next Generation PHRs. Also check out this post linked from the Clinical Cases and Images Blog for an example of what you can see on You-Tube.
Is the Google initiative a bad thing? No, not at all. Its certainly a little scary to those of us who really worry about things like patient safety and privacy. However, if we are to achieve our goals for eHealth (for example the Canada Health Infoway goal of providing EHRs to 50% of the Canadian population by 2010), maybe the Google approach is the way to go... and perhaps we won't have a choice. It may happen in spite of us.