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EHR app causes buzz at mobile health care summit

A soon-to-be released medical application for smart phones was the talk of a Canadian mobile healthcare summit Thursday, not so much for what it will do but for the innovative way it's being developed.

"Awesome," and "very impressive" were the words used by two Canadian CIOs to describe the project of San Diego's Palomar Pomerado Health, which has dedicated a mere three people -- one of whom is a programmer -- to solve one of the biggest problems for health professionals: how to take advantage of new wireless devices by connecting to hospital electric health records.

"If we can do it you can do it," Dr. Benjamin Kanter, Palomar Pomerado chief medical information officer, told attendees at the Toronto conference.

Few EHR software used by Canadian and American hospitals and clinics have mobile versions. Most vendors are still working on them, but they likely won't interconnect. In the meantime, a number of North American hospitals are offering doctors and nurses read-only access to patient data for tablets and smart phones through Citrix, which for Kanter isn't ideal.

Determined to find a better way, Kanter's team set an ambitious goal: to build a smart phone viewer that works with the device's operating system to connect to as many EHRs as possible using a single interface.

It would not merely retrieve data but also display it graphically, or, in a waveform. Ideally, it would show a live feed of a patient's vital signs, X-rays and patient records from any institution or doctor's office that has their records.

Initially, the app will connect through a VPN for security.

The first version, for Android handsets, should be piloted in March.

Funding has come from a foundation associated with Palomar. Kanter said the hospital hopes to commercialize the app in some way.

Briefly, it uses a Java-based server architecture to reformat data pulled from EHRs and send it to the user interface. But that isn't enough -- the app has to be licensed to access the records. One key to the project advancing so far is that Palomar struck a partnership with one of the biggest software vendors, Cerner Corp., so the app can access its database at the hospital.

To be successful, Kanter acknowledged in an interview, Palomar would have to strike similar deals with the EHRs used in institutions and doctors' offices in whatever area its deployed in. That's because the goal is not merely to give physicians access to patient data from his hospital, but also to any institution a physician is eligible to connect to.

Although he didn't give details of the software development, he insisted the Palomar approach is relatively straightforward and inexpensive. Work on the app was started just over a year ago.

And Palomar is doing it with just one of the hospital's programmers, he emphasized. "You've really got to know who resources are in your organization that may be innovators," he said. "The innovators may come from nursing, from your therapists, from your Web team, from your physicians. And if you don't give them an opportunity, you won't know what you might be able to do internally."

In an interview, conference co-chair Peter Gilbert, director of IT at Grand River Hospital, which serves the Waterloo Region in southwester Ontario, called the presentation "awesome ... I think we could do the same thing here."

"We need to look seriously at how a publicly-funded hospital in the States has been able to advance their technology like this," he added, "when we seem to stumble on things like policy and rules."

Dan Coghlan, vice-president of finance and CIO of Providence Care Centre, which operates three non-acute care hospitals in Kingston, Ont., called Kanter's presentation "very impressive."

"I leaned over to my IS director next to me and said 'Why can't we do that?' ... We've got smart people up here to do it. The question is whether or not we have a relationship with our vendor to have that trust."


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