App maker says standards, connectivity are keys to making PHRs work

By Neil Versel

PocketHealth App by CognovantThe graveyard of personal health records is littered with failures large and small, but some continue to push forward, believing that conditions are finally just about right for consumers to take more control over their health data.

For Cognovant, a Kansas City, Mo., startup that announced this week that it had landed $500,000 in seed funding from angel investors, interoperability is the key to making "untethered" PHRs work – and PHRs may be a major component to interoperability.

"There is a lot of value in patient portals and in tethered PHRs if you get all your care in one place," Cognovant President and CEO Dr. Joseph Ketcherside, a nonpracticing neurosurgeon, tells MobiHealthNews. But not everyone gets their care from a single institution or organization, so their health records tend to be fragmented.

"There's a struggle within the industry to have all that information in one place," notes Ketcherside.

To this end, Cognovant is preparing to launch its first product, the PocketHealth mobile PHR, an app for the Apple iOS and Android platforms. Expect it to hit the market in the next couple of weeks, in three variations. The free PocketHealth Essentials will allow individuals to manage their own health data and connect electronically with providers, following the Continuity of Care Document (CCD) standard.

For an extra fee, PocketHealth PHR adds procedure information and connectivity to lab and radiology data. A third version, PocketHealth Family, helps people manage health data for their whole families.

With many untethered PHRs—those not tied to a particular health system or insurer—patients have to key in a lot of data manually. "People won't take the time to enter data," Ketcherside says. Plus, patient-controlled records don't fit into paper-based workflows, so hospitals and physician practices would not take the time to log into a secure website or plug in a USB drive in order to read information from patients. Nor have doctors been particularly willing to trust patient-entered health data.

Ketcherside and Cognovant co-founder Stan Pestotnik, the company's chief strategy officer who also founded clinical decision support and patient safety surveillance software vendor TheraDoc, have decided to go down a different road.

"From the user interface standpoint, it might look like every other PHR," Ketcherside says. "But the guts of our PHR are comparable to what you would find in the parts of an electronic medical record." In other words, the developers focused on standards.

Stage 1 standards for "meaningful use" of electronic health records require providers to give patients electronic copies of their own records, in CCD format. In future stages of meaningful use, providers likely will have to be able to import CCD data.

"You are seeing the gradual growth of empowered patients," says Ketcherside, who was a product management director at Cerner from 1998 to 2002. He then served as chief medical officer of TheraDoc for nearly four years before moving into clinical informatics leadership at two health systems and later into health IT consulting.

Ketcherside sees standards-based PHRs as addressing the "last mile" of connectivity and interoperability at the patient level. That is not a new concept, but without meaningful use spurring greater adoption of EHRs, there hadn't been much to connect to. "Five years ago, or even three years ago, you would have been like the first guy with a fax machine. What do you do with it?" Ketcherside says.

"I've been struggling [with interoperability] on the enterprise side for 14 years," he says. Now, he believes it finally is time to look at connecting with patients.

"Our real goal in this is to make healthcare safer and smarter," adds Ketcherside.

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