Access to records–Let’s build on what we have

I attended a launch event for the BCS guide to keeping your Health record Safe and Secure on Monday 25th Feb – a great guide on what to consider when accessing your records, anything from password to sharing your record. Dr Charles Gutteridge (responsible for Summary Care Record) and Tim Kelsey – NHS CB were the two keynote speakers. A good discussion, and few things stood out from what Tim said a) Let’s not focus on the roadblocks on why we can’t empower patients. A key failing in the national programme, we were so focussed on issues which in reality did not make a difference to patients. b) We have no choice but to go on this journey, we may not have a national service if we don’t. Well, that’s motivation enough, and I fully agree on the point around ‘us’ obsessing on issues which in reality makes no difference to patients, I unfortunately see this far too often.

Microsoft was represented in a small way Smile We had a together with SiteKit few banners/stands at the event as seen in below picture (it’s all about location, right?). A dry-run for the main launch of eRedbook at the NHS Innovation Expo on the 13-14th March.

BCS Event 2013 Feb

However, the main revelation for me has been Summary Care Record (SCR). As I have been meeting Charles past few months, I have learnt what SCR really is and it has positively surprised me. Not only do they (we?) have 22m+ records, it’s being used in pharmacies and out-of-hours settings making a real difference on delivering better health outcomes. My personal view is that SCR has unfortunately been tied very closely to the failures of NPfIT and the SCR ‘brand’ is suffering from it.

The SCR team (a great bunch of people) have worked and overcome many of the issues I/we are discussing right now, and believe we need to leverage the experience and investment made in SCR better (maybe even rebrand it).

Exciting times ahead!

It’s all coming together

My last blog was dedicated to the eRedbook, and the importance of this initiative deserves I believe another entry. Two main reasons, a great app for driving bottom up change and as mentioned before, if we want to transform delivery of health, the changes have to come from both top down, and bottom up. eRedbook is just right in my opinion, engaged audience, creates an electronic record from birth and activates family and friends (the whole idea of Obama’s social pulpit strategy).

The second reason is my own sense of satisfaction, eRedbook concept when discussed back in May 2010 was met with plenty of enthusiasm but also with scepticism, but I believed in it and we went ahead. There have been painful times, no doubt about, that but believing in the impact this can have was enough motivation to keep pushing. And here we are, still long way to go, but its out there and being used.

There is some additional information on the RCPCH web site, including a presentation that is freely available for download.

The first 45 days of this new year have mostly been spent on some big ideas with key industry partners, I believe the time is right in many ways to start coming up with propositions to generate more momentum. The partners we are talking to are just the right ones to make that happen in collaboration and our ambitions aligns very much with what the NHS Commissioning Board is trying to do. More to come, but enough to say that the train is about to leave the station, jump on!.

A red book anyone?

Well, I wished for one and got it just before Christmas! A project we effectively started (thought of) in May 2010, just before HealthVault was launched and have since then spent a lot of time on it. The suggestion came through a colleague of mine, and via a PCT he used to work with back then. The idea was ‘simple’ but yet so powerful and potential for being disruptive – to digitise the Personal Child Health Record (PCHR), also called the Redbook in many places.

Whilst the initial collaboration with the PCT didn’t work out, we believed in the idea and continued working on it. We teamed up with a partner (SiteKit) interested in taking this further with us and the work started. Whilst the idea is ‘simple’ it was far from simple execution to make this happen, an extensive collaboration with RCPCH, Department of Health and other industry suppliers was essential to produce this first version. The initial version will be part of Year Zero (DALLAS programme) – you can read more about it in the EHI article with comments from RCPCH.

To outline the opportunities coming out of this would require more than a blog, and every organisation we talk to find a slightly different way to derive more value from this digital health record – beside it being the electronic version of the current book. It doesn’t get much more exciting than this, and 2013 I hope will be the year we drive electronic personal health record on large scale using eRedbook.

For organisations interested in discussing further, please contact us on hvukbd@microsoft.com or visit http://www.eredbook.org.uk for more information.

Health Choices on Windows 8

Sean’s recent blog about Windows 8 and health reminded me of a piece of great work I almost forgot to mention. We launched Health Choices almost 6 months ago, a mobile experience of HealthVault and NHS Choices content and scorecard data. These apps have had good reviews (most of the ‘not so good’ reviews are to do with Scotland and Wales, which are not covered by NHS Choices and nothing to do with the app itself) and we had an opportunity to work with the DPE team inside Microsoft to develop a Windows 8 version of the app.

Well, it was launched some time ago, in fact around the time of Windows 8 launch! You can find it here. Please note you need Windows 8 RT or Pro to run this, and please note it does not cover Scotland or Wales. One more thing – only available in the UK.

My congratulations to 3Chillies for building the Windows 8 app and the mobile apps – fantastic work. I’ve worked with the guys from 3Chillies for over 7 years and they never disappoint me – keep up the good work!

Lastly, have a look at other Windows 8 apps for the Public Sector.

API galore

We met Unilever some time ago to discuss opportunities around HealthVault and their HeartAge calculator (=a more meaningful way to understand your cardiovascular risk). The opportunities are many to use a tool like HeartAge and HealthVault, but why stop there! Unilever arranged a Hackathon this weekend to get ideas and concept from a wider crowd. We were invited to give an overview of our API together with other suppliers like NHS Choices (which is used in the Health Choices apps). Idea is to leverage all these API’s and build a stronger (different?) propositions with HeartAge. I heard some of the initial and very creative ideas from developers and entrepreneurs, and it is amazing what you can come up with by taking people from different backgrounds/expertise and put them in a room.

The Hackathon is still going on, my usefulness finished quite early as my in-depth knowledge of the HealthVault API is somewhat…uh…limited Smile Instead, I invited one of our partners join us and become a mentor during this Hackathon. Silas from Concentra kindly agreed to join me, and his technical insight impressed me. I shouldn’t have been, Concentra were a big part of the South London and Maudsley NHS project by creating the connector to the EMIS feed, and with that, gained a deep insight into the workings of HealthVault.

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(Silas in action!)

Another area of collaboration with Unilever was to produce a Windows 8 app of HeartAge. The user experience of this app is fantastic and makes the most of the Windows 8 user interface.

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Making self-monitoring easier

We all know that with good input, you are likely to get better output – common sense I believe, and this principle applies to self monitoring as well, be that wellbeing, fitness or ‘illness’ scenario. One input in these scenarios is devices like blood pressure monitor, weight scale, pedometer, blood glucose monitor etc. The input from these devices can provide the clinician with valuable history and a factor to consider when making clinical decisions. There are other maybe more important benefits like empowerment, motivation, incentive etc, but not a topic for today.

So, that all makes sense I hope, in fact most telehealth trials have a significant element of self monitoring using home devices.

HealthVault has a great way of connecting devices to the platform using HealthVault Connection Centre (HVCC). In the UK, HVCC connects approx. 160 devices and supports many use cases (scenarios). The challenge has been the difficulty of getting these devices connected, could be USB, Bluetooth or even IrDA (remember that?). The issue is not specific to HealthVault, but an industry wide challenge.It needs to be easier, pick-up and use scenario is what we need.

With that in mind, we have been working very closely with A&D past 18 months to understand how we can make the experience much easier, which in turn will increase adoption (after all, we are consumers and used to things ‘just work’) and drive down cost of telehealth. A&D has shown great leadership in self monitoring, and have taken a strategic decision to invest in Near Field Communication (NFC) enabled devices. A fantastic move for the industry and I hope other device manufacturer will follow and innovate further.

The A&D NFC enabled devices work with smartphones which have NFC and uploads data directly to HealthVault. Currently the only supported platform is Android (an app needs to be downloaded from Google Play), but with Windows Phone 8 now supporting NFC, we hope the app will be available on Windows Phone 8 very soon. More information on our coverage of the NFC devices can be found here.

Have a look at the videos showing the activity monitor, blood pressure monitor and weight scale in action. You can buy them from White Medical or from other reputable online retailers.

Lastly, I would like to thank the folks at A&D (Geoff, Mike, Frank and David) for their hard work to bring these devices to market. Visionary and make it happen in short timeframe – a combination not easily found!

it’s been a pleasure! (even with my weight printed on their leaflets – it wasn’t a mistake, Frank, was it? Smile)

Let’s walk

The Expert-24 app as mentioned in my last blog was all about giving you a snapshot of your current health and guidance. What follows on after that is the ‘do it’ bit, and that could be the most basic but yet so effective – walking. Many of us don’t walk enough, and making us aware of how many steps we really take per day, and incentivise to take more steps can be the first goal to a healthier lifestyle.

So, with that in mind, with the Expert-24 app offered through Wellbeing Centre at Microsoft, we launched a Step challenge back in May this year. This wasn’t the first Step Challenge run by Wellbeing Centre, but first one on HealthVault. We had intern develop the app, took about 3 weeks (not full time) and highlights once again that it’s not the technology which is difficult, but developing a clear value proposition (for the consumer/patient/employee, and with that requirements) and User Experience where the effort needs to go. One would have thought that technology driven projects are long gone, but you’d be surprised how many still approach it the wrong way…

The challenge was great fun, form a team and walk around GB using a HealthVault enabled pedometer. A 6 week challenge and first to reach destination wins! There was a HealthVault team, but we didn’t win…in fact nowhere near top 10 teams.

So, 3 weeks in, I am looking at the league table, and noticed that the HealthVault team was not doing very well, kind of like Liverpool few weeks ago  – not much going for them. Solution I thought was to cheat Smile. Thinking I am going to be clever and add additional steps into my HealthVault account to make up the difference, but turns out the intern was one step ahead of me. You can request data from HealthVault with certain conditions, like date range and from this specific device. As we were using HealthVault enabled device, the data was uploaded directly through Connection Centre and guarantee the provenance of the data gathered (you can edit, but that is logged in History).

Ok, so wasn’t thinking about cheating (really), but the provenance of data is an important aspect when apps connect and consume data from HealthVault. In a scenario where a healthcare provider gives out a specific device, the app can be built to ensure only data from that device is used.

A small example of the social and game layer in driving behavioural change. The social aspect was very interesting, we had people from different groups coming together for the first time. We are hoping to run this next year, but with another pedometer/activity monitor, a set of recently launched devices I will be talking about in my next blog – very, very exciting stuff.

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