An app that makes patients more accountable

by Charles Wright on July 18, 2012

I couldn’t help but think, as I  read health economist Jane Sarasohn-Kahn’s article in Health Populi connecting the accessibility of personal health records and patient engagement, that it points to an obvious and immensely attractive future … one where we can access our personal health records – and for that matter our family’s EHRs – via a smartphone app.

Having written earlier about a survey from the financial software house Intuit  which indicated that eight in 10 Americans want access to their medical history via a secure online tool, Sarasohn-Kahn poins out that the most popular feature of Kaiser Permanente’s MyHealthManager is access to lab tests, which are involved in 60 to 70 per cent of a patient’s diagnosis and treatment.

“In the emerging accountable care era,” she writes, “patients need to share in decision-making with their doctors. That means patients need to know their numbers: what they mean, and how changing them can impact their future quality and length of life… where personal behaviour change has the potential to do this.

“Ultimately, the PHR should go beyond delivering data — which in itself, is necessary, but not sufficient, for providing the kind of feedback loops that inspire and sustain behavior change. I’ve seen many PHRs that might offer a clinical definition of a test result, such as LDL or bilirubin. But a scant few offer the kind of feedback loop that is the opportunity for a mobile app to offer: that is, to personalise what changing the number can do to one’s own quality of life. This would mean delivering high impact, engaging video and visuals that talk about lab numbers’ impacts on … sex, money, workplace stress, and other aspects of 3-D daily living.”

And that’s where Quest Diagnostics appears to have gained a potential advantage over its rivals with its mobile phone app, Gazelle.

As its promotional material puts it: “Skip the phone calls and waiting for the mail. Gazelle delivers your results right to your phone. Depending on the state where you live, Gazelle can access your results directly from the lab or your physicians who use the Quest Diagnostics system. Your lab report will include a brief explanation of the normal and abnormal values for each lab test to help you understand your results.”

There’s quite a bit of intelligence in this app. It allows users to monitor their weight and body mass wirelessly with the Withings WiFi Body Scale, which automatically posts data to a computer and has its own app.

Gazelle also stores the user’s medication information and sets up reminders to make it easier to remember to take them.

And look at the way demands are changing. An NHS Local survey in the UK last month indicated that just over half of its patients would prefer to Skype their doctor. The survey, which showed more than 40 per cent of people have difficulties booking an appointment, revealed that although less than one per cent of people have used video calling to “see” their doctor, 52 per cent would do so if they could. Only 14 per cent said they didn’t think there were any benefits in doing so. The mHealth Insight blog makes some very good points about the Skype-based virtual consulting suite.

I wonder if any of our pathology labs see the opportunity that these developments suggest? And it seems to me that the PCEHR could be an essential gateway to this sort of future.


David Doherty July 18, 2012 at 6:27 pm

“sex, money, workplace stress”

Personally I think a lab diagnostics company would be going a bit out of it’s depth on these but it would be great to be proven wrong.

“points to an obvious and immensely attractive future … one where we can access our personal health records – and for that matter our family’s EHRs – via a smartphone app”

Welcome to the Future! Check out from Microsoft.

Mobile Web optimised (so no need to download anything just use it in your secure web browser on any device), patient controlled and permission based, free to patients, can import data from other sources (eg. Google Health), can receive data from M2M medical devices, etc

Jane Sarasohn-Kahn July 18, 2012 at 8:36 pm

Charles and Peter, thanks for your thoughtful comments on my blog. David, I hear your point about a lab company going “out of its depth.” I think what Quest is doing is helping the ecosystem move toward greater data liquidity and playing its part in the emerging health ecosystem that must put the patient/person at the center – instead of providers and institutions being at the core. Charles, thanks for taking the argument for patient-centeredness further…JSK

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