Personalized health records and genomic tests for patients

Two articles recently highlighted two very different areas of medicine that are quickly colliding and pointing to a new direction for health delivery.

The first, published in the Wall Street Journal, discusses the steady rise of personalized health records through companies like Google, Microsoft, and WebMD. The second, published in USA Today, examines genetic tests and the disconnect between what is available and what physicians understand about genomics.

The WSJ article discusses the idea that individuals over age 50 are increasingly looking for improved ways to monitor their health and make better, more informed choices. Many companies believe that personalized health records (PHRs) are the answer. However, according to the article, less than 5% of the online population uses internet-based PHRs. One reason posited to explain this lack of interest is that the need to use the Internet for health information is simply not deemed necessary. The author of the article briefly discusses some of the pros and cons of the three major PHRs available on the market and explores where they could go in the future.

There is no doubt as to the potential utility of PHRs. Major companies like the three mentioned in this article as well as many others have been trying for years to corner this market and grow it, without success. Despite expanding capabilities of the PHRs, patients are not using them. Not surprisingly, no one seems willing to abandon this model, despite the massive amounts of money being spent with very little return. Though privacy is perhaps one answer, it is no way the only one.

The fact is, though the name PHR connotes something that is personal, this approach is ironically not that personal at all. As we have discussed before through these posts, health delivery has the opportunity now more than ever before to become part of patients’ (and providers’) lives. Bank robber Willie Sutton is famously known to have answered the question of why he robs banks with the quip, “that’s where the money is.” So to with health. Individuals live in the moment, facing health decisions on a daily basis and often multiple times within the day. Without uniting daily activity to a more comprehensive approach to health, PHRs may continue to face intense pressure to engaging patients and ultimately in improving outcomes.

Likewise, genomics remain at the fringe in medicine among providers, despite an increasing knowledge base and applicability of genetic information. The USA Today article references a study we discussed on 360 a few weeks ago regarding patients trusting physicians with their genetic data, and yet very few physicians actually feeling comfortable enough to handle that information. With nearly 2,000 diseases with genetic tests available and over a dozen medications that mention genetic testing, this discrepancy conveys a serious problem.

Examining these two articles together reveals an interesting conundrum. Patients are thus far unwilling to engage on the Internet to monitor their health via personalized health records and yet the movement toward extremely personalized medicine through genomics continues at a rapid clip. In the coming years, we are bound to see these two distinct issues coalesce in an innovative approach to health that will yield tremendous results. Some companies are already starting to examine this area and to devise new methods of furthering health delivery in a personalized fashion that guides and instructs, while remaining cognizant of the relationship between life and health. As this process continues, the interrelationship of technology, health, and genomics will continue to expand.

Douglas Elwood is Chief Strategy Officer, Zibbel, Inc., and blogs at Mobile Health 360.

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