There have been some interesting developments in health portals in the past few weeks. Over in theUSA, Microsoft launched HealthVault: a free site – paid for by advertising – that allows users to store personal health information and inputs from medical devices, and choose who to share the data with.
By getting HealthVault to market, Microsoft apparently stole a march Google, which is supposed to be developing a similar product. Back in theUK, meanwhile, NHS Connecting for Health has unveiled an enhanced' version of the HealthSpace website so patients can see their summary care records in 'early adopter' sites.
These developments are interesting because Microsoft and Google are pretty good at reading consumer trends and they obviously think there is a market for sites that allow people to both store information and interact with healthcare and health advice providers.
Not that the trends are hard to read. Over the past few years, there has been a proliferation of sites that allow people to collect 'health' information and join communities built around it; self-help groups, diet clubs and running magazines have all got in on the act.
Indeed, the Department of Health has spotted the potential. HealthSpace started out as a glorified version of the page at the back of the Telephone Directory that was provided for you to jot down your GP’s and other useful numbers.
But it is now routinely mentioned in policy papers as a point of interaction for patients and a way of reaching individuals with diet, exercise and other tips.
Nevertheless, HealthVault and HealthSpace are different. The former is not being marketed as a personal health record, but as a 'platform' that organisations can use to reach people who can pick and choose from the services on offer.
The latter is still very much more about letting patients do things that the NHS has graciously decided they should be able to do – such as look at summary care records that it has created.
On the other hand, NHS CFH’s patient involvement lead Marlene Winfield talks about HealthSpace as a site on which patients will be able to record their own data and preferences. It represents, she says, the start of a new 'dialogue' between users and the NHS.
Will the NHS listen? It certainly should. In his latest report on the NHS, Derek Wanless complained about the paucity of information that was available to judge whether the billions poured into health service have been well spent.
He wanted much more information – critically, outcome information – to be collected. Good IT is obviously critical, here; and it’s no longer necessary to assume that huge, national systems must be created to get it.
The NHS procurement community is hoping that common coding and standards will not only improve purchasing and supply, but allow commissioners and trusts to track drugs and products from order to use, allowing the true cost of outcomes to be calculated in the process.
In the meantime, though, the NHS actually has more information than it thinks – it’s just that a lot of it is 'soft' information that does very little with.
A Healthcare Commission report recently criticised the NHS, yet again, for ignoring complaints; which ought to be a good source of information about certain aspects of healthcare, if collected and dealt with systematically.
Patient portals aren’t necessary to do this, but they certainly help. Patient opinion is already allowing patients to record both plaudits and gripes about their treatment – and the results are fascinating. Even with relatively few entries, a few wards come up again and again as dirty, noisy or uncaring.
And, of course, the comments are public. Brighter hospitals are starting to respond. Others will have to follow (as choice takes hold, which hospital would you pick – one that responded to an entry about full bedpans being left in public bathrooms or one that didn’t bother?)
It ought to be possible to go further. If HealthSpace is supposed to be about patient generated data, how about creating a blogging facility? Not just to pick up dirty wards, but to address the Wanless issue and to allow people to reflect on the outcome of their treatment and whether they’d go through it again.
Even in theUS, healthcare professionals were initially sceptical about the value of letting patients see their records, never mind contribute to them. Now, as IT makes interactivity routine in many areas of life, attitudes are changing.
The NHS can’t isolate itself from these trends. The good news is that if they can be harnessed, there is plenty of useful information to be culled from them.