American Medical Association: 3 reasons why you need to completely redesign your EHR

Screen Shot 2018-08-01 at 20.48.10

“3 reasons your Snapchat habit won’t help you master the EHR” by Brendan Murphy, Staff Writer at the AMA Wire.

“Whether you call them millennials or digital natives, there’s no denying that a generation of Americans, one that grew up along with their devices, is perceived to be more tech savvy than any that preceded it”

The born mobile generation is probably the most useful description as they were born in the Nokia Decade (even though most people still don’t yet realise a quirky Finish brand got to define the decade).

“Because of that technology and an unending roster of apps—from Snapchat to Stitcher and everything in between—today’s physicians in training seem to be more proficient in communicating and obtaining information. How does that translate to medical school or residency? When it comes to EHR training, one expert believes, it doesn’t”

I gave a lecture at the largest Medical School in Ireland on this topic recently. It’s fascinating because out of date educators and professional bodies with their out dated customs (banning mobile phones in exams as though there will ever be a day you work as a General Practitioner when you don’t have a mobile that’s at least as powerful as a iPhone X in your pocket, trying to train Doctors to work in an environment where they don’t use a mobile, etc) are being made to look really decrepit to the BornMobile who find it unbelieveable that a Doctor would even be allowed to work without a connected smartphone loaded with high quality content.

“AMA Wire® spoke with Blaine Y. Takesue, MD, a research scientist at the Regenstrief Institute and assistant professor of clinical medicine at Indiana University School of Medicine. Dr. Takesue offered three reasons digital natives may still be in foreign territory when it comes to learning the ins and outs of EHRs.

EHR data doesn’t effectively translate to devices

While smart devices have in many ways replaced clunky computers in a number of arenas, that is less the case in the EHR realm. The smaller screen is a hindrance when it comes to reading and entering data, Dr. Takesue said.“If you’re used to a mobile solution to problems, that’s a much different paradigm than sitting at a computer,” Dr. Takesue said. “It has a lot to do with real estate. EHRs haven’t translated well to a phone. You need to see a lot of data. There’s not enough real estate on a phone to do that without moving through multiple screens.””

I wonder what Dr Takesue thinks of popular smartphone apps like Skyscanner or AliBaba. Perhaps he doesn’t realise that there are people in the aviation/retail industry who were similarly challenged to see the opportunity to press a few buttons on a mobile phone to arrange their travel/shop. Perhaps he doesn’t know that it was unimaginable to millions of retails that their work could be done by customers interacting with the screen of their mobile phone? If you’re struggling to imagine the future a good exercise is trying to imagine the unthinkable things that mHealth makes possible…

Nick Mason 20 years ago it was unthinkable

It’s not a case of “EHRs haven’t translated well to a phone” it’s a case of we need to apply MobileFirst design to Health Records.

The people in the foreign country are not the Born Mobile generation it’s the medics and healthcare industry leadership who are wedded to thinking an Electronic Health Record is and must remain an unwieldy, dangerous bureaucratic billing engine that is inaccessible and incomprehensible to both Clinicians and Patients.

“Systems predate the smartphone

The EHR systems with which large health care organization’s work were created decades ago, and because of that, they don’t feature the same user functionality as newer devices.

“The problem is that many of the most widely used EHRs were not created from 2000 on—they were created last century,” Dr. Takesue said. “What we use in medicine and what we train our students on is legacy technology. There may be a solution that translates really well to mobile, which will allow questions to be answered quickly, but it’s not in wide use.””

It’s futile to hope that there is a bandaid that can offer a mere translation of EHR’s so that they work on mobile and all is well with the world. Starbucks and Walgreens didn’t find success by translating their online services they did it by rethinking what they.were doing and applying Mobile First design principles.

“EHRs aren’t intuitive

Your smartphone, search engine or voice-activated device seems at times to know what you’re going to say before you do. Products that function this way—when the server anticipates potential communications—use a form of artificial intelligence to push out answers and solutions. EHR systems work the opposite way.

“We call it a content pull,” Dr. Takesue said. “As a user, you have to go and pull content you want to see when you want to see it.

For device users, “it hurts expectations,” he added. EHRs “don’t provide the information to the user at the time that they need that information.”

It should be obvious that EHRs aren’t designed to serve the needs of Patients/Medics/Carers but to assist the objectives of profit generating businesses. This is not the reason to resist innovation but rather the design challenge. Trillions of dollars have been wasted on EHRs so don’t expect those benefiting from the status quo to be championing this or lobbying organisations like the AMA to aid their demise. Thankfully a Mobile brand (Apple – the world’s biggest and most profitable corporation) has a new product that they have set on disrupting the lucrative revenues that EHR companies are hoping to hold onto…

Posted in Uncategorized | Leave a comment

What’s the ‘best’ example of ‘Digital Quackery’ you’ve seen?

Everyone’s getting worried these days about a new breed of quacks: app developers making health claims.

Interesting to note that some of those pointing the finger (eg. the American Medical Association) have already turned around once they arrived at the convenient conclusion that they’re ‘snake oil’ unless they pay us a few quid to certify they’re good.

It’s all given me an idea to compile a list of the best examples of “Digital Quackery”. I’ll kick off the list with a few I’ve seen and please feel encourage to add your favorites in the comments (with the reasons):

> The NHS Trust (University College London) that ordered a £400Million EHR from EPIC that was so incompetent at adopting tech that when they bought every member of staff an iPad the majority ended up in store cupboards.

> The Cove (music making app for young people experiencing bereavement) app that a NHS Hospital (St Mary’s in Paddington) wasted their money building.

> The ‘free’ app the NHS Royal Free got for their dialysis Patients to use (they paid for it by giving Google the comprehensive detailed medical records on 1.6Million unconsenting Patients).

> The video Doctor visit companies that masquerade as inexpensive quick ways to get a prescription but are really in the lucrative business of trading Patient data.

> The NHS’s £12+ Billion National Program for Information Technology (NPFit) that introduced an EHR concept that didn’t give Patients access to information even though we know how ridiculous this situation is.

> The Royal College of General Practitioners who ran a Video Consultation Skills Course  that wasn’t live-streamed or video recorded and was led by a GP who didn’t offer video consults and didn’t have a website.

Doctors in wealthy regions of the world ignoring Infection Control issues when experimenting with mHealth on the poor.

> Inefficient Digital Health ‘innovations’ that will lead to an explosion in costs while providing no benefit over the analogue alternatives.

Posted in Uncategorized | Leave a comment

CNBC: Why TeleMedicine is a Bust

Screen Shot 2018-07-01 at 12.45.12

A fascinating article on “Why telemedicine has been such a bust so far” by Christina Farr.

mHealth Insights

The first thing that should be obvious about why TeleMedicine is a bust can be seen at a glance. The newest mass media (Mobile) has made Telemedicine a bust in the same way that it’s made photography, hailing a cab, shopping in a record store, booking travel, booking a hotel, buying a toy or a house, etc, etc. Healthcare is becoming a Mobile Experience. We’re not dropping the ‘m’ in ‘mHealth’ we’re dropping the ‘Health’

CNBC have it captured well: A MAN IN WHITE COAT WITH A STETHOSCOPE TAPPING AT HIS MOBILE is a perfectly valid and useful depiction of telemedicine today. But watch a Patient using their own ECG machine and having their medical data read by a computer and referred if necessary to a Doctor (who may be casually dressed working from home while her children are at school) and you’ll realise just as video killed the radio star the incredible sensors in the super computers in our pockets have removed the tele (meaning is ‘distant’) and we now have to understand that healthcare is becoming a mobile experience (this is why it’s wiser to use the ‘mHealth’ term I coined 10+ years ago) because the potential for medicine/care is now always with us, continuously carried within arms reach and never turned off.

At the end of watching that video ask yourself do these Patients look like they are ‘distant’ from their medicine/care?

We have elderly Patients using these mHealth devices for years and when you ask them about their experience they’ve never felt closer to their medicine/care. There is no doubt that the convergence of healthcare to mobile (mHealth) has enabled us to evolve from TeleMedicine/Telecare.

“Telemedicine, or apps that let you consult with a doctor via video, was supposed to be the next big thing in health care But lack of awareness, questions about cost and reimbursement, and the human desire to talk to another person when sick have hampered the sector. Tech giants like Apple may ride to the rescue… Billions of investment dollars have been poured into apps and websites that offer this virtual consultations with physicians, ranging from Doctor on Demand to American Well. The theory behind them is that millennials would opt for a digital alternative to an in-person physician’s visit, if the option were available. And patients in remote, rural areas who are miles away from the nearest doctor would have few alternatives…   …But telemedicine is still far from mainstream. Even a study sponsored by a telemedicine provider from late 2017 still found that 82 percent of U.S. consumers do not use it”

I think this is an easy to have predicted outcome of telemedicine meeting with the needs of the USA’s Insurer led SickCare model. VC money has unsuprisingly been haemorrhaging from failing ventures because a subsidised video consult isn’t a substitute for a Doctor visit.

People may be gullible when it comes to sharing their data in exchange for online services (just look at the level of personal health info sharing that Patients provide to advertising networks like Facebook or Google) but most of the more experienced older people (who have healthcare needs or care for children or elderly Parents with them) realise there is value in sharing info with a Doctor who isn’t in the business of trading their personal health data.

Yes you can obviously bluff some naive people with the offer of cheap or free chats with a Doctor advice call but communities dominate brands and Patients/Carers are increasingly becoming aware that it’s not smart to subsidise/exchange your incredibly personal and revealing information with unnamed corporations for the advice of a Doctor.

“Why the lack of adoption? Several factors are to blame. The biggest, and most important, is that many U.S. consumers are still not aware they have the option to chat with their doctor over the phone or via video”

Surely this is just because while Clinicians like Prof John Bachman at the Mayo Clinic pioneered in the publishing the evidence for advancing relationships by moving beyond the office-visit-only relationship the USA’s Health Insurer led market has done everything to undermine the Family Doctor relationship/business so the idea of Family Doctors innovating to offer this effectively (like they now do in the NHS) is just unviable because there’s none of them.

“The awareness piece is a big problem,” admits Ian Tong, a physician and the chief medical officer at Doctor On Demand, an app that offers smartphone consultations for $75. Tong believes that part of the problem is the branding of the term “telemedicine,” which isn’t particularly descriptive, so he’s opting to use the term “video visits” instead when he talks to patients about it”

I think this is a mistake and is not realising the additional value that can be offered now that +100 million Americans can connect via video calls on devices that they always carry with them.

We all need to appreciate that mHealth makes expensive, inconvenient & impossible health care experiences inexpensive, ubiquitous & super convenient because when you are asking ‘what are the benefits of a documented consult with a Doctor over a Video Call?‘ the born mobile generation are struggling to think of reasons why you wouldn’t want to video consult with a Doctor…

mHealth isn’t about replacing office visits with video calls it’s about realising “Go and Get Help” no longer makes sense…

“Another setback: Patients heard of telemedicine apps often fear the expense, especially if it’s unclear whether they can use their health insurance. And in some cases, the apps are offering cash prices that are out of reach. $75 might be a stretch for some”

I think this reinforces the commitment to radical transformation of the USA’s healthcare system that Apple Inc senior management are all committing to eg. Apple’s CEO Tim Cook has made it clear that Apple has the unique privilege of not having to care about reimbursement and that they estimate that the upside of this is that they will create a company that will make their current business small (it’s currently the world’s largest and most profitable corporation!).

“Another common theme is that the doctors who are willing to work with app makers are inexperienced, or low-quality. Companies like Doctor on Demand will say they go out of their way to vet — and pay for — the best clinicians. But there is some merit to this concern, especially with the lower-quality services”

I think the opposite is becoming clear: Patients who see you uncomfortable using the mobile tech that everyone else is familiar with may lose confidence in how current you are with your medical knowledge.

“In 2016, researchers posing as patients turned to 16 different telemedicine apps to diagnose skin issues. The results? Some of the online doctors misdiagnosed conditions like syphilis, others prescribed unnecessary meds, and two of the sites used doctors who aren’t licensed to practice in the state the patient was located. The authors concluded that these apps repeatedly missed diagnoses by failing to ask simple, relevant questions”

This was some great work by Dr Jack Resneck and it made some great recommendations:

Screen Shot 2018-07-01 at 14.14.05

but I think the websites tested were quite scammy eg. they published “a variety of disclaimers that they do “not provide health care services,” and do “not create a physician-patient relationship,” but we found that they did make diagnoses and offer specific treatment recommendations (without sending prescriptions to pharmacies)“.

I can’t see how Dr Resneck hasn’t been obliged to report the Doctors involved to their credentialing authorities before/at same time as publishing a public paper about how they are working dangerously and without licensure.

“Finally, even in the digital age, a lot of people simply want to see their doctor in person. They’re not Luddites. But sick, vulnerable people often need in-person reassurance from another human being in the room. A smartphone app simply won’t cut it”

I think this is classic view of someone who thinks video calls are about just trying to do what’s normally being done with an office visit. Just as Spotify didn’t try to recreate the record shop on our mobiles, Uber didn’t try and recreate the taxi rank, AirBnB didn’t try to recreate the work of the Hotel Reservations department, it’s invaluable that we all try to reimagine the opportunities we have to offer new supportive services to Patients who are always connected and are increasingly having a copy of their medical records and a means to easily and securely share them (this is the rocket fuel that drives demand for video consultations with independent impartial Doctors).

I think it’s important to realise the #1 reason Doctors don’t want to remotely video consult with their Patients is because it encourages Patients to do something most Doctors have little/no training helping Patients with.

“Will this ever change? Roy Schoenberg, the CEO of American Well, believes that doctors, insurers and employers will increasingly inform their patients about the option to use telemedicine, which will help consumers get over many of their fears. If they’ve already got a relationship with that doctor, a virtual consult might seem like an easier alternative to getting across town to a doctor’s office and sitting in a waiting room”

I think this is a very good measure of how wedded the USA healthcare system is to serving health insurers. Amercian Well has taken $210million in venture funding over 6 rounds yet still hasn’t realised the big opportunity is in offering services direct to Patients. Imagine the CEO’s at Uber/AirBnB/Spotify thought that the Taxis/Hotels/MusicLabels would inform their customers about the option to use their mobiles to get their product via their mobile phones!

“But getting doctors to jump on board is easier said than done, and takes time. Many are afraid of liability, as it’s possible to miss something during a remote visit. And for years, it wasn’t clear whether they would get paid as much as an in-person visit. Reimbursement questions are still getting resolved across different states, but most of the commercial and government plans are on board with the idea of telemedicine — at least in specific circumstances.Another marketing boost for telemedicine could come from the big tech companies. American Well got its a plug from Apple, which announced it would work with the company for its heart-health study, so that participants could get easy access to a doctor’s office if they needed it.”

This is a huge problem and the most effective thing we’ve seen to help with it is the provision of accredited mHealth training for Healthcare Professionals that we helped produce.

“Finally, many consumers who use high-quality telemedicine apps are spreading the word. “Consumers are realizing that it can all be done via an app, whether it’s getting a prescription, an exam or ordering labs,” said Doctor On Demand’s Tong. “There’s no need to sit in that waiting room anymore.””

I agree with this and think it’s even more positive. People using other (non-healthcare) apps are coming to expect healthcare services to work as seamlessly. We all know a rising tide raises all boats so has your organisation gone Mobile First yet?


*** UPDATE Monday 2 July 2018 ***

Tomorrow at 11am GMT I’ll be discussing this post in a FaceBookLive video discussion with Dr John Bennett MD (and guests) from

Follow InternetMedicine on Facebook/Twitter to get updates. Click back here after the discussion and  refresh the page and you’ll be able to replay the video recording of the discussion.

*** UPDATE Tuesday 3 July 2018 ***

Click here to watch the video over in the InternetMedicine ‘mHealth Studio’:

Links to videos suggested in the discussion:

At the Doctors2.0 Paris Conference David Doherty shares Mobile Video Consulting best practice.

Here is the link to the video of Apple Health Record being demoed by Dr Ricky Bloomfield at HIMSS.

*** UPDATE Wednesday 4 July 2018 ***

Some interesting feedback via Twitter chat with Irish GP Valerie Morris MD who has now for some unknown reason deleted her tweets which is a great shame as I was going to enjoy hearing Dr Morris explain how a ‘fully computerised’ GP doesn’t yet have a website nor offer Patients any access to Healthcare Records:

@mHealthInsight: I think the vast majority of Doctors outright dismiss the value of video consults yet so many prefer video consultations when they themselves need the advice of a Doctor

imageScreen Shot 2018-07-04 at 08.21.01

@DrVBMK: David, don’t kid yourself. Telemedicine won’t replace the traditional Dr-Px consultation which includes EXAMINATION. Vocationally trained GPs know the risks involved if you don’t examine a patient. And guess what, Medical indemnity is higher for those engage in telemedicine.

@mHealthInsight: I think the issue is so many presume telemedicine must be about diagnosis & prescribing. You can also provide care, management, followup etc

@mHealthInsight: Would be great if you could join me and @InternetMeds for a discussion on this topic at noon today

@DrVBMK: Quick comment: Busy surgery all day – 2 emergencies this morning – child & adult – managed here then sent the ED. And I’m only halfway through my morning list. of patients. Lunchtime is for home visit to see palliative patient. How on earth do you provide care using telemedicine

@mHealthInsight: I think you’ve presumed that I think the benefits of telemedicine is an excuse for under resourcing GP services.

@mHealthInsight: I think you’ve presumed that I think the benefits of telemedicine is an excuse for under resourcing GP services.

@DrVBMK: It’s your words, not mine. You haven’t answered my question In earlier tweet.

@mHealthInsight: Video of the discussion with Dr John Bennett is now posted on @InternetMeds (skip the first 30 mins)

@mHealthInsight: in answer to “How on earth do you provide care using telemedicine”? you use your time efficiently, let Patients/Carers help you with documentation etc. It’s quite complicated (otherwise everyone would already be doing it) but you can learn from fellow GPs

@DrVBMK: Are you a GP? Your tweets don’t reflect that you are one nor does it reflect real life General Practice.

@mHealthInsight: would you like a job?

@DrVBMK: Medical indemnity for full time Irish GPs is no less than €20,000 per annum (more if you provide telemedicine, OOH, minor surgery etc). Will you pay that upfront???

@mHealthInsight: How big is your HSE list as if 500+ it’s well worth us meeting up as I’m sure I could save you a small fortune

@mHealthInsight: Probably best to email me as documented video consults with Patients that aren’t enticed with offers of prescription drugs is very low risk

@DrVBMK: 98% of GP practices are fully computerised. The only time I use a pen is to sign my name. I am from the old School of Medicine. A computer will never be the interface between me and my patient. I respectfully decline your offer. I love my job.

@mHealthInsight: Do you really think there is a single “fully computerised” GP practice in the whole of Ireland?

Posted in Uncategorized | Leave a comment

Apple FaceTime can now support group calls

Screen Shot 2018-06-04 at 20.27.16

At the Apple World Wide Developer Conference (WWDC) today Apple announced that the latest iOS12 software update for the iPhone, iPad and Mac (expected to be live later this year) will support FaceTime group video calls with the ability to coordinate video calls with up to 32 participants supported by messaging features during the calls. FaceTime call participants can be added at beginning or mid-conversation and can select to join via video or audio only.

Imagine how powerful this will make FaceTime calls for Healthcare uses? Imagine how much more efficiently 911/999 Emergency FaceTime Calls would be? Imagine how amazing it would be for GPs to be able to dial up other Carers, Family Members and Specialists when they need assistance during a Consultation? Imagine how much more effectively Video Consulting services are going to be able to perform?


What uses and new services can you think of for this new mobile video calling service?


Posted in Uncategorized | Leave a comment

Join us at the Global Clinical Trials Connect 2018, 25-26 April, London

Global Clinical Trials Connect

On Thursday the 26th April 2018 we’ll be presenting on Mobile First Clinical Trial Design at the Global Clinical Trials Connect 2018 Conference in London.


“The Global Clinical Trials Connect 2018 conference focuses on introducing pioneer technology, developing better patient engagement and collaborating strategies in clinical trials. With the right commitment and attention to detail, contract research organizations (CROs) and pharmaceutical companies can drive collaboration with greater efficiency.

The global pharmaceutical industry has seen a downturn in recent years because of the challenges and cost associated with pharmaceutical development, procrastination in drug development, etc. Clinical trials field is also faced with such challenges. Cases of failures, cost and delay are high. It is high time that we look into innovative strategies, new technologies, effective and quality collaborations to address these issues, which can cater to the needs of the patient and the industry. Due to complex clinical trials and bygone data standardization methods, we need algorithms and lucrative strategies that will enhance the clinical trials outcomes. There are vast data collected across clinical trial process, the standardization of these data will turn into an opportunity for companies to trap the information and raise clinical trial design, patient recruitment, monitoring insights and augment decision-making”

Key Topics:

Partnership & Collaboration – Sponsors, CROs, Sites and External Vendors
Outsourcing strategies and models
Patient centric clinical trials
Real World Clinical Trial Strategies
Electronic Clinical Outcome Assessment and Electronic Patient Reported Outcome
Clinical Technology and Driving Innovation
M-Health, Wearable and Consumer Technology
Artificial Intelligence Technology in Clinical trials
Patient Recruitment and Site selection
Keeping the Patients Informed After the Trial – Post-Clinical Trial closed communities
How to future proof your clinical operations
Data Quality & Technology
Big-Data and IoT in Clinical Trials
Clinical Data Strategy & Analytics
Implementing Risk Based Monitoring
Streamlining R&D and lower costs in clinical trials
Adaptive Trial Model
Clinical Trial Auditing
ResearchKit & Mobile First Clinical Trial Design

Speakers include:

Sam Adamson, Business Development Manager, Australia, NZ & USA, GreenLight Clinical outsourcing & Clinical Trials.

Aji Barot, Business Development Director, HealthUnlocked

Kate Chapman, Director, Clinical Technology Consultants (Former Associate Director, Interactive Response Technology Services, Shire Pharmaceuticals)

Lucy Clossick Thomson, Director Clinical Operations Strategy, AstraZeneca

Sarah Cooper, Business Development Manager, NIHR Clinical Research Network

Emma D’Arcy-Sutcliffe, Director, Patient Engagement and Innovation, NexGen Healthcare Communications

David Doherty, cofounder, 3G Doctor

Rita Fitzpatrick, General Manager, ESMS Global

Kylie Gyertson, Head of CCTU, UCLH

Oleksandr Karpenko MD MBA, Managing Director, Olexacon

Disa Lee Choun, Director Head, Data Acquisition, UCB

Nancy Meyerson-Hess, Associate Partner, admedicum Business for Patients (Chair)

Gjon Mirdita, Head of Site Management, Key Markets, R&D Solutions, NEMEA & CESE, IQVIA

Sheuli Porkess, Deputy Chief Scientific Officer, ABPI

Nawab Qizilbash, Clinical Epidemiologist & Head, OXON Epidemiology

Michael Ramcharan, Managing Director, Reumat Consulting

Belle Roels, Head of Clinical Operations UK and Ireland, GSK

Tom Ruane, Global Head of Patient Recruitment, Parexel

Victor Sastre, Senior MSL, Coordinator of the MSL Working Group AMIFE

Nico Schönig, Senior Data Analyst Global Clinical Operations, Boehringer Ingelheim

Vasil Todorov, Clinical Program Leader, GSK

Mike Tremblay, Founder & CSO, Volv global

Max Woolley, R&D Manager, Pre-Clinical Lead, Drug Delivery, Device Design & Development, Renishaw

Get in touch via the comments if you’ll be in London and would like to meet up. Refresh this page on Friday April 27th 2018 for my slides and a video of the talk. In the meantime you might like to watch a presentation I gave a couple of years ago on the topic of “What would happen if we took a Mobile First approach when designing Clinical Trials”:


Video coming soon…

Posted in Uncategorized | Leave a comment

NHS Digital is doing sterling work to undermine trust in the NHS

Screen Shot 2018-04-16 at 15.11.00

“The Home Office is displaying a blatant disregard for the trusted and vital GP-patient relationship, and its casual approach to confidential patient data risks alienating highly vulnerable patients…  …It is treating GP patient data like the Yellow Pages, and we are calling on NHS Digital to take urgent measures to suspend the agreement that is allowing them to do so…   …The scale of the examples we’re hearing about are becoming increasingly alarming – and if all are true, paint a terrible picture”

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs

“The BMA has been vocal in its opposition to this data sharing arrangement between NHS Digital, the Home Office and the Department of Health and Social Care, which risks undermining the very foundation of the doctor-patient relationship…    …We therefore welcome this report, which echoes many of our key concerns over the ill-thought out and potentially destructive agreement that NHS Digital is yet to resolve…   …As stated by the committee, most immigration offences clearly do not meet the high public interest threshold for releasing confidential data, which according to NHS England, the GMC and even NHS Digital’s own guidance, should be reserved for cases which involve ‘serious’ crime…  …Doctors were being asked to “effectively act as an enforcer for the Home Office…   …If the bond of trust between doctor and patient is broken, it risks not only the health of that individual, but can also have serious public health implications if people suffering from infectious conditions avoid seeking medical treatment…   …use of the data sets a dangerous precedent that opens up the possibility of patients’ data being passed on not just in immigration cases, but for other non-health-related purposes”

Dr John Chisholm, Chair, Medical Ethics Committee, BMA

“We will consider the Health Select Committee’s report carefully and will take into account any new evidence as it becomes available, but we have been through a rigorous process to assess the release of demographic data to the Home Office…   …This has established that there is a legal basis for the release and has assured us that it is in the public interest to share limited demographic data in very specific circumstances.”

Sarah Wilkinson, chief executive at NHS Digital

mHealth Insights

It’s horrific to see new private only pay clinics springing up in areas of the UK where poverty is the highest and it’s because immigration offenders have realised that the supposedly ‘confidential’ NHS GP and Hospital records relating to them and their families are being used to shop them to the Home Office.

Of course there are a million other more effective ways to trace immigrants (they are mostly young and have mobile phones that are accurately identifiable by location or they are being homed/employed by citizens who have mobiles and all of this monitoring can be easily done by the Home Office) so I think it’s clear the NHS is doing this because it thinks they’ve concluded that there is a short term economic benefit.

It should be clear that it is vastly cheaper to give every immigration offender free NHS care than it is to try and care for them when they get really sick and turn up with a false identity in a hospital. By sharing details (that include Patients’ names, date of birth, address) the NHS is driving growth in criminal gangs who are stealing citizens identities and this is putting Patients (and the Professionals trying to care for them) at much greater risk of making very expensive mistakes (treating a Patient based on completely inaccurate information in their NHS Record).

No individual Doctor is going to speak out, refuse or complain against the Home Office because they will probably just turn their investigation to the ‘non-compliant’ Doctor so please support the British Medical Association and Royal College of GPs call for a suspension of a memorandum between the Home Office and NHS which has given them access to data that is undermining the ethical principles underpinning confidentiality and the determination to act in the best interests of Patients.

Please share and write to your MP and ask them to back calls to abolish the MOA

Screen Shot 2018-04-16 at 14.57.18

Related posts: 

Daily Telegraph: “NHS 111 enquiries will be handled by robots within two years, leaked report suggests”

Google apologises for paying ad revenue to rape apologists & racists but says nothing to the 1.6 Million NHS Patients who didn’t consent to sharing their Hospital records

Posted in Uncategorized | Leave a comment

American Medical Association launches a Healthcare Interoperability & Innovation Challenge with Google

In a rather bizarre turn around just when the US is just waking up to the huge privacy implications of sharing their sensitive medical information with companies like Facebook & Google (who then seemingly think it’s perfectly ok to sell it onto any advertisers who pay them) the American Medical Association has “announced the AMA Health Care Interoperability and Innovation Challenge sponsored by Google to inspire novel examples of mobile health technology—such as wearable devices and applications—that effectively monitor and share medical data between patients and physicians to improve the management of chronic diseases”.

mHealth Insights

“The AMA is working to unleash a new era of patient care through its Integrated Health Model Initiative (IHMI) by pioneering a common data model for organizing and sharing meaningful health data like patient goal, state and functioning, and assembling an unprecedented collaborative effort across health care and technology stakeholders” said AMA President David O. Barbe, M.D., M.H.A.”

This is an incredible turn around as the AMA CEO has been pointing fingers at mHealth and making claims it’s little more than modern day snake oil.

“The winning ideas will demonstrate how the applicant uses patient-generated health data in meaningful ways to have maximum impact on improving physician workflow, improving clinical outcomes, and reducing cost in the health care system. The three best ideas that are submitted to the Challenge by June 7, 2018 will be selected to share $50,000 in credits for Google Cloud”

What a bizarre set of zero-actual-cost prizes. Google is highly profitable and is generating over $100,000,000,000 in annual revenues so why are the prizes being given to promising start ups being paid in ‘monopoly’ money?

I have no doubt the AMA shopped this collaboration opportunity around with Apple, Facebook, Microsoft and Amazon and in deciding to work with Google they didn’t agree to be paid for the collaboration with Google Cloud Credits (I doubt most of the executives at the AMA even know what they are).

“assembling an unprecedented collaborative effort across health care and technology stakeholder”

I’m very cynical as it’s very unlikely the AMA hasn’t seen what Apple are doing with Health Records so it just looks like Apple either refused to pay the AMA any money because their focus is on what helps Patients rather than what gets reimbursement (and so they’re going to stubbornly refuse to be positive about their ground breaking work) or this is a last ditch attempt to help steer Patient record control towards Google’s ‘freemium’ ad funded business model on the proviso that the AMA have a seat at the table.

Doesn’t sound promising for the AMA when you consider this along with Google’s track record of taking Medical Records of Patients without consent (aka theft).


CHICAGO – The American Medical Association (AMA) today announced the AMA Health Care Interoperability and Innovation Challenge sponsored by Google to inspire novel examples of mobile health technology—such as wearable devices and applications—that effectively monitor and share medical data between patients and physicians to improve the management of chronic diseases.

“The AMA is working to unleash a new era of patient care through its Integrated Health Model Initiative (IHMI) by pioneering a common data model for organizing and sharing meaningful health data like patient goal, state and functioning, and assembling an unprecedented collaborative effort across health care and technology stakeholders” said AMA President David O. Barbe, M.D., M.H.A. “The Challenge we’re announcing today is an extension of the AMA’s work and will explore possible uses of mobile health technology to provide patients and physicians with a rich stream of medical data that is important for improving care and long-term wellness.”

The Challenge invites the health and technology sectors to present solutions that demonstrate how patient-generated data is captured by mobile health monitoring technology, transferred to a medical practice, and transformed into accessible and actionable information for the patient and physician to improve health outcomes.

Specifically, entrants are asked to present ideas on how to:

  • Import (or transfer) patient-generated health data from a mobile device or a mobile application into one or more phases of clinical care. Examples of phases: Assessment of current condition, risk stratification, goal definition (both patient and physician), treatment plan, intervention(s), recording of observed outcomes, re-assessment.
  • Extract (or transfer) data from one or more phases of the clinical care and send it back into a mobile application or mobile device so patients can view, track and ultimately act upon the information relative to their goals or share it with other physicians.

The winning ideas will demonstrate how the applicant uses patient-generated health data in meaningful ways to have maximum impact on improving physician workflow, improving clinical outcomes, and reducing cost in the health care system. The three best ideas that are submitted to the Challenge by June 7, 2018 will be selected to share $50,000 in credits for Google Cloud.

To learn more about the AMA Health Care Interoperability and Innovation Challenge sponsored by Google, go to:

# # #

Media Contact:
Robert J. Mills
AMA Media & Editorial
Phone: (312) 464-5970

About the American Medical Association
The American Medical Association is the premier national organization providing timely, essential resources to empower physicians, residents and medical students to succeed at every phase of their medical lives. Physicians have entrusted the AMA to advance the art and science of medicine and the betterment of public health on behalf of patients for more than 170 years. For more information, visit


*** UPDATE: 2 July 2018 ***


AMA Challenge Salutes Three Mobile Health Innovations

For immediate release:
Jun 29, 2018
Posted in Uncategorized | Leave a comment
%d bloggers like this: