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This is the sixth story in a nine-part series on the emerging wave of new-generation technology that monitors our health and wellness.
Why would Bill Tatham, a systems engineer, start a health-care company? Fifteen years ago, this Canadian entrepreneur sold his banking management software firm for about $1-billion. But then his world changed when Janna, his wife, developed breast cancer.
He remembers the fear and anxiety that she experienced while dealing with her life-threatening illness. And navigating the health-care system was an unwanted burden. "We had binders full of paper charting her progress," Tatham recalls. "Sharing timely information between our family doctor, chemotherapist, surgeon and radiation oncologist, that was very frustrating."
After his wife recovered, he resolved to help other families manage their medical information. After all, managing sensitive data and building client relationships are what his original company, Janna Systems, had specialized in for global investment banks.
"I just knew there had to be a better way," Tatham remembers. "My technology could build a real-time therapeutic alliance between doctors and their patients."
That was the genesis of Toronto-based NexJ Connected Wellness, a secure Web-based health platform, which houses an interactive patient medical record.
Eric Topol, one of the world's leading physicians and author of The Patient Will See You Now, believes patients benefit from such live medical records. "Patients should own, view and act on their own medical data – it's their information," Topol says. "Patient records should not sit locked away in physicians' offices."
And now there is an ever-expanding list of companies that offer doctors and patients such portals, including XCite Health of Atlanta, Intehealth.com of Malvern, Pa., HealthSpot of Dublin, Ohio, and Bridge Patient Portal of San Diego.
In general, doctors can call up the information on their office computers while patients can access their records on apps for their smartphone and other devices.
Ryan Nelson, director of business development at Bridge Patient Portal, says his company offers customizable patient care plans and e-reminders for medications and appointments. The data can be seen on any device, including smartphones.
So what else do Web portals such as NexJ's offer?
The first component is education. In today's rushed health care, research shows that patients remember less than 20 per cent of what physicians say – even less if the diagnosis is traumatic, such as the "C" word. So NexJ developed "point-of-care" instruction, a tablet-based app that teaches patients about their condition. The physician shows a patient infographic slides, annotates them and can even record the encounter. When the patient leaves the doctor's office, this is uploaded to the patient's own cloud-based dashboard, the Connected Wellness Platform.
Patients can then review their entire encounter and see the results of related tests and X-rays, which have been automatically uploaded. Their physician also acts as a site curator, adding condition-specific videos, care plans, instructions and teaching materials.
John Reeves, NexJ's director of health outcomes, says, "We designed this so patients could see their own health status, have quality information and not get lost by randomly searching Dr. Google."
Once consent is given, the personalized wellness plan can even be opened up to certified health coaches.
What's more, such platforms capture information beyond the usual laboratory tests and medical imaging. Even retail digital fitness trackers such as the Jawbone Up, Fitbit and Withings can be configured to upload metrics such as calories burned, steps taken and sleep quality. "Right now, 140 different devices can add data to the personal dashboard," Reeves notes.
This also adds a new level of surveillance, which may take some getting used to. In between patient appointments, which may be weeks or months apart, doctors can check up on weight control, exercise levels and home measurements of sugar and blood pressure. Physicians can even decide to send reminders, feedback and encouragement.
While doctors might be too busy to do this in today's practice model, there are ways to automate contacts – even set up electronic filters and alerts.
"We see this as a game-changer," Reeves says. "With this constant flow of communication, patients are activated. We are moving from episodic to continuous care. Patients become participants in their own health care, which is key to managing chronic conditions and achieving health and wellness goals."
This also presents some unique practice-wide population management and research opportunities for physicians. Want to know how many patients have uncontrolled blood pressure? How many had episodes of low sugar? Who missed their appointment this week? All this information can easily be searched – and physicians can then take corrective steps.
Prostate Cancer Canada is already using the NexJ system across the country to help men survive longer. It seems that such digitally-enabled and enriched medical records will be an ever-expanding part of health care. "We set out to build a trusted partnership between providers and patients, where multiple channels of communication come together to empower us all," Tatham says.
Shafiq Qaadri is a Toronto family physician, lecturer and MPP for Etobicoke-North. He has acted as a content adviser for NexJ but it did not review or endorse this article before publication.