Aenor Sawyer, MD

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Part of the problem in healthcare is that the data is fragmented or it's isolated of in one point of contact for instance your primary care doc, and even their record doesn't speak to the hospital record and vice versa or if you go to a referral centre, they don't have access to any of that information.

It's getting better, we have the technology and now it's being developed purposefully to create the interoperability that we need so that the patient can move through the system wherever they need to and their information's available to whatever provider they are interfacing with that day.

There are electronic medical records at large facilities now and even in the smaller offices now it's been legislated and there are in place, but the problem is even those don't speak well to other medical records system, even if it's the same company, they get deployed and really pretty isolated ways guys whose applicants different than our applicants, etc, and the data isn't freely exchanged so that's where this big exchanges like HIEs were first describe the health information exchanges.

They haven't been well utilized yet, but the idea was that data could be pushed to a neutral area and then utilized. If you look at just the electronic medical record, it doesn't necessarily do everything. It actually doesn't do everything. And we actually say the process of medicine happens outside the EMR.

But the EMR is a nice data repository, but the process of medicine happens between us, between the patient and the provider, between the provider and other providers and the EMR doesn't function well that way. So we've created tools outside of the EMR to do functionality that the EMR doesn't, but they don't necessarily interface with the EMRs because traditionally the EMR companies haven't wanted there to be holes drilled in them so to speak.

There's a lot of complexity and liability with data flowing in and out of the EMR. We're also now trying to import more patient driven or patient reported data into the health record and into our research that we do, and on top of that, not just patient reported but social analytics, data that's collected from marketing or your cell phone use or a variety of areas where data has already been collected on you, and there is a great interest in superimposing that data on the physiologic and clinical data we collect to get more information about what causes disease and I think that the more that happens, the more the plane gets blurred between where something is protected health information and where it's completely up to the patient what they share.

It's very hard for us right now because we used to have very clear definitions and boundaries around it, and so those planes are being penetrated and I think it's getting more and more blurred.