- Advances in internet-connected consumer devices and electronic personal health records mean the systems can now support the flow of potentially powerful clinical data to care organizations, and may finally be poised to facilitate efforts to improve patient outcomes and lower costs, a new viewpoint article in the JAMA asserts.
- Driving the latest effort to enable interoperable personal health records is adoption of a new data standard called Fast Healthcare Interoperability Resources, or FHIR.
- A second viewpoint article in JAMA examines the potential for wearable devices that monitor heart rate and activity, and smartphone technology that integrates information from devices such as blood pressure monitors, to aid in the diagnosis and management of patients with arrhythmias. The opinion also acknowledges limitations of the technologies and warns against "inappropriate reliance on them for diagnostic purposes."
Patients can now collect their own clinically-relevant data with electronic sensors found on virtual assistants, smartphones and smart watches.
Companies such as Samsung, Apple and Fitbit are adding electrocardiographic and fall-detection information to the health-related data on devices that already monitor heart rate, activity, nutrition and sleep patterns. Developers working with Amazon have created software using the virtual assistant Alexa to collect symptom descriptions, track blood glucose measurements and improve patient engagement.
The FHIR standard uses web-based programming protocols to simplify interoperability and connect healthcare organizations to the framework that powers the internet, note the viewpoint authors. The effort aligns with the meaningful use stage 3 requirement that took effect Jan. 1, giving patients the ability to connect third-party applications to electronic medical records through an application programming interface.
The improvements in mobile hardware and sensors, digital communication standards and accessible software suggest that the digital healthcare landscape may now be mature enough to support the broad adoption of personal health records, said the viewpoint authors, Christian Dameff, Brian Clay and Christopher Longhurst from the University of California, San Diego. "Whether these technological advances ultimately improve patient outcomes, lower costs, and improve quality remain the most important unanswered questions," the medical doctors wrote.
In a separate viewpoint article, author James Ip of New York Presbyterian Hospital wrote that wearable devices monitoring patient heart rate and electrocardiographic signals are particularly useful for determining if arrhythmias such as atrial fibrillation, paroxysmal supraventricular tachycardia or ectopic beats are present. However, abnormal findings must be validated with direct electrocardiographic recordings, he asserted.