Two months after activating all four sites of a study into portable, patient-controlled medical records, a Mt. Sinai researcher is seeing evidence that his model could help drive down imaging costs through an innovative, open-source model.
David S. Mendelson, lead investigator in the RSNA ImageShare project says that his NIBIB study, which has enrolled 600-plus patients, has found that not only are patients “enthusiastic” about taking control of their health records, but that they are able to become more active participants in their care.
“I get comments routinely that it’s about time something like this was available,” he says. “The ones who sign up are internet savvy, but I’ve got 60- and 70-year-olds who embrace this. For people who have a health condition that requires a lot of imaging, the endpoint is convenience; they need their images to be seen at these outside places.”
In an examination of the viability of portable imaging records, Mendelson’s group is on the verge of releasing an upgrade to its open-source software, which should accompany its expansion into community as well as academic practices.
Under the terms of the investigation, a pair of companies—Microsoft's HealthVault, lifeIMAGE, and InSiteOne, which is now owned by Dell —provide the patient with an account over which the patient has total control. Those records communicate with an edge server built by Mendelson’s team at one of the academic development sites, which allows for patients to access their accounts remotely via web-based login.
“The important notion here was patient control,” Mendelson says. “If they need to share, they show it on the fly or credential a provider via email links controlled for a month or six months at a time.”
In planning for global build-out, the software used in the study is based upon IHEXDS-5, the same set of open-source standards upon which the state of New York is building a health information exchange.
“We wanted to build a solution that could converge with that infrastructure, so we built our solution around that,” Mendelson says. “Different people may want different kinds of solutions, but building on open standards drives down costs.”
Although he doesn’t currently have a payor model, Mendelson is exploring potential price points. He says that in the face of sites charging $50 for a CD of patient scans, “$8, $10 might be reasonable to keep stuff online for a month or two.”
“We have an application for more funding to be able to explore more economic models,” he says.