HealthKit Gets the Incentives Wrong

The article is referring to automated electronic access to your medical data (lab test results, diagnosis lists, procedure histories, etc). If you were able to get automated, electronic access to all of you medical information, it would be a very big deal.

Until very recently, medical data was only available from your doctors in the form of copies of paper records, and it's a hassle to pester all your doctors until they give you your records. Even once you got it, the data wasn't digital.

Because of Meaningful Use requirements coming online this year, patients now have to be given electronic access to their data (Meaningful Use requirements determine how doctors have to show that they use Electronic Medical Records in order to receive subsidy money/not get penalized). Electronic access takes the form of online 'portals' where patients can see their data. And although this is a big step forward, the information isn't given to patients in a form that is very useful--the data isn't easily exportable (for yourself or to send to other doctors), and if you've seen doctors in multiple systems your data isn't aggregated.

I'm also one of the PicnicHealth founders, and we're taking advantage of these portals in order to give patients automated access to their data.

(Slight rant):

HL7-all-the-things as a solution to interoperability (hey, v3 is this new fancy thing called XML!) The incentives are often backwards for hospitals to want true interoperability - this is with HIEs have been known to fail - "Why should I give my competitors all of these leads - I mean, patient data?". Add on top of that HIPAA (and state-by-state) requirements, and you impose significant overhead to sharing data even if an organization wanted to.

Health IT is a difficult problem not (primarily) because of technical challenges but because of human challenges (arbitrary updates because of regulatory requirements, requirements in software to mirror what was done on paper years ago, etc.) None of the low-hanging fruit will really change with HIT until we make incentives line up with what's best for patients (which will probably mean changing a lot more with the healthcare industry as a whole).