The British have a long history of bravely venturing off into the unknown, and with cloud computing as their new frontier, they are forging ahead yet again. A hospital in the UK is testing a pilot program that has the capacity to host all electronic health records for patients on a cloud platform, placing control over medical information into the hands of its patients. With the new system, patients will be able to manage their own records and open up access to whomever they choose. While this is a huge thumbs-up for cloud technology, the news is somewhat dampened by the early June report that hackers obtained the passwords of admin accounts at the UK’s national healthcare system, raising concerns about how secure all this medical information will be when it’s all online.
But push on they must, with the panache of the British explorer Sir Ernest Shackleton, who once glibly said while crossing the Antarctic and facing many dangers, “Difficulties are just things to overcome, after all.”
The cloud platform being tested, known as Extility, has been a joint venture between the Scottish-software developer, Flexiant, and the Edinburgh Napier University along with the Collaboration for Leadership in Applied Health Research and Care, a partnership aimed at improving patient outcomes and applying health research. Flexiant has designed the scalable platform so that users can access information on numerous web and mobile devices in real time and as information becomes available. Additionally, the software is intended to play nice with other trusted web-based services, such as Facebook and Paypal.
After 18 months of collaborative development, the Chelsea and Westminster Hospital in London is launching the two-year program with a demonstration run of simulated patient data to test large-scale deployment. The program will also determine the feasibility of utilizing the same set of healthcare data across a broad range of services. In other words, the success of the program will depend on accessibility and cradle-to-the-grave usability. Another feature being tested is clinical diagnostics, which would use data to provide early warnings and risk assessment scores to patients and healthcare professionals for the goal of preventative medicine.
But one of the biggest aims of running the pilot is to build the public’s trust in healthcare managed via the cloud. And that’s a tall order when 2011 has seen its fair share of security breaches on the web. The success of the platform depends on the ability of Flexiant to keep data secure, which it intends to do through a multiple authentication system and new identity checking methods.
While the tech community can cheer at this move, it is a shame that implementation of electronic medical records is taking so long. For years it has been obvious that a transition to electronic records is warranted, seeing that paper-based medical records are one of the most antiquated systems in society today. Just visit a new doctor to be reminded of the amount of paperwork you have to fill out…again. You’ll spend precious time searching your brain for the name of the medical condition that your aunt had back when she was a child. The office also has to request copies of your old medical records so they have a complete background. If your doctor recommends you see a specialist, that office gets physical copies of your healthcare information as well. All of this paperwork, file keeping, record transmission, and archiving has to be done manually by staff of hospitals, doctors offices, pharmacies, and other healthcare services. That doesn’t even get into the insurance companies, government agencies, and law enforcement that need access to this information, to varying degrees.
So what’s the delay? In light of the ease with which we can share files, photos, music, and video online through social networks, the current state of medical records, which are significantly more important, is frankly an embarrassment. A number of companies are providing services to digitize old medical files, create new systems for record keeping and set up medical office networks and databases to share that information internally and connect to external sites. One company, CliniComp, recently completed an electronic medical record system of all 59 U.S. military hospitals, but sadly, the software doesn’t currently connect to the military’s clinical information system.
This underscores a point: digitizing medical records is only half the problem — the other is easily utilizing them.
Cloud computing appears to be the solution that everyone has been looking for amidst all the concerns over digital records from doctors and patients alike. The cloud offers decentralized access to data using multiple Internet-ready devices, instead of end users depending upon specific software or a medical group’s IT support keeping the software in working order. Furthermore, it places the burden of responsibility for that information on users rather than staff members. Both cloud platforms and intranet systems can be hacked into, but the cloud is likely to be much safer when managed by a professional company whose primary goal is managing the cloud than a small company’s ability to keep a hospital or medical group’s systems up to date and completely secure while perpetually training staff members on proper protocol.
With all the great features that cloud-based medical records could provide, the biggest concern for the future is the unauthorized release of patient data. A New York Times article from 2009 indicates that it may not be hackers or disgruntled employees who are the biggest threat to someone releasing your medical records with your name on them, but the practice by companies of selling de-identified patient records for analysis and data mining by other companies. The article describes how the little footprints we leave behind on the web, in forums and personal profiles, for instance, can be correlated to de-identified data in order to re-identify a person’s name that the record belongs to. Clearly, once data are put out on the web, they’ll be there forever.
In the end, the hospital in the UK should be applauded for boldly moving forward into the proverbial Heart of Darkness that is electronic medical records. It will be exciting to see how the public warms to ‘cloud’ medicine and just maybe, a hospital in the U.S. might get the courage up to walk in their footprints. Or they could just start using Practice Fusion.