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Sarah White's insight:
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When you believe without knowing you believe that you are damaged at your core, you also believe that you need to hide that damage for anyone to love you. You walk around ashamed of being yourself. You try hard to make up for the way you look, walk, feel. Decisions are agonizing because if you, the person who makes the decision, is damaged, then how can you trust what you decide? You doubt your own impulses so you become masterful at looking outside yourself for comfort. You become an expert at finding experts and programs, at striving and trying hard and then harder to change yourself, but this process only reaffirms what you already believe about yourself -- that your needs and choices cannot be trusted, and left to your own devices you are out of control
1. The integration must take into account each user’s day-to-day life and workflow, including patients, providers, IT staff, and additional caregivers. Some users will need access to a greater depth of information, while for others design and usability will be paramount.
2. The design should be interoperable and support the integration of multiple MITs into a single EHR. In particular, developers should make sure to eliminate redundancies between the systems, where app users and EHR users might enter the same data into different fields.
3. Multiple environments have to be secure, but their security can’t keep them from interacting with each other. Stakeholders WellDoc interviewed reported problems with competing firewalls in implementing the integration.
4. Both halves of the integration, but especially the patient-facing app, should work natively on as many mobile devices as possible. Patients are most likely to use a system that allows them to continue using their device.
5. The mobile health offering is subject to a limitation already standard for EHR apps: it must be able to run even when network connectivity is sparse or intermittent, as is sometimes the case in large hospital complexes.
6. It’s crucial to have a support team in place familiar with the technology to help acquaint users with it.
7. Make sure the two systems adhere to common standards. Not only data interchange standards like HL7, but also making sure that measurements in both systems use the same units. If lab-collected blood glucose data in the EHR and patient-collected blood glucose data have the same unit, but one is potentially more accurate, the integrated system should easily identify and distinguish the two.
8. The team working on an integration should be ready for a more complex process than anticipated. A clear vision, good communication, and a steering committee are important for anyone attempting to integrate a mobile heath offering and an EHR.
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