Link For Life Whitepaper

February, 11 1

You are a Stranger

in a Strange Place

& You’re sick, very sick…

Link-‐for-‐Life™—a Global Public Health Solutions for we the people.

An Overview of Global Public Health Issues & Solutions

January 2011 Page 2

Issues Affronting Global Public Health

“Healthonomics” and the Tipping Point

Global health care is expensive, so much so, we see prosperous nations on the cusp of healthcare bankruptcy. Today of the 195 official independent countries of the world, the top 50 nations are spending over $5 trillion on their public health and human services. These same nations are also declining their quality of health in all the metrics-‐that-‐matter in public health care and wellbeing.

Country leaders know that a healthy nation is a prosperous nation. The contrasting is readily seen within impoverished nations. Wealth is the blood of nations but health pumps the blood. The dynamic tension between the health of people and the prosperity of people is fueling the tipping point. We call this the Healthonomics of a nation. In most 1st world nations, public health is a central topic of government’s concerns, actions and reactions. This becomes very apparent at the mere mention of a spreading pandemic.

Global health care is under great and rapidly escalating stress that affects everyone both directly and indirectly. Today we see disease and disorders evolving into new strains, reactive therapeutic treatments failing, losing effectiveness or simply not available but to a select few. We have learned that disease and disorders have no boarders and can spread rapidly—worldwide. Increasing public global travel of course compounds this.

We look to the 2,500-‐year history of health care practiced as an art. The practitioners of the art-‐of-‐medicine are losing community standing, economic incentives, and they are faced with growing complexity in the practice of their art. At the same time greater and greater specialization and sub-‐specialization is expected of the profession. This has intensified with the arts-‐of-‐medicine moving to the sciences-‐of-‐health.

Also fueling the tipping point is the seemly slow evolution from the arts-‐of-‐medicine moving to the sciences-‐of-‐health. Most medical scientists and academicians agree that the year 2000 was the apex of this tipping point. Since 1985 we have seen information technologies increasing focus on the cellular and molecular understanding of life. In 1986 we saw the ebb of a biological scientific research initiative motivated by a new strain Ebola appearing in quarantined research primates in Virginia1. This unique event oddly motivated the United States and Britain to sponsor the mapping of the human genome. This much-‐publicized multinational scientific project quietly spawned many other IT data centric analyses of aligned research and computational aided interest in the cellular, molecular biological life sciences.

Life sciences and medical research scientists began computationally doubling data every six months on a global computational scale by the year 2000. This rapid growth of data had never occurred in a single sector prior to this period. The world’s supercomputer centers performed more and more computational biological and biochemical analysis than ever before. This phenomenon continues today, with present estimates doubling life sciences data every three months.

1 Why Map DNA http://gallery.me.com/howardasher#100039


January 2011 Page 3

The new era of the sciences-‐of-‐health

The sciences of health have begun teaching us the disease process at the cellular and recently at the molecular levels. We are beginning to learn what is the genetic predisposition of disease and health disorders. We are learning that each disease expresses a unique protein signature. These protein signatures and other biomarkers can usually be expressed in our biofluids; saliva, urine, blood, etc., eventually negating the need for tissue biopsy or other invasive methods. We are beginning to see disease progress or regress at the molecular levels. We are learning that people with specific biomarkers react better to a systemic therapeutic than those without the certain biomarker. We above all are beginning to re-‐learn that no two people are alike and that one pill does not suit all.

Most importantly, we are beginning to learn medicine and health is very personal and personalized medicine will make an enormous difference in human health and wellbeing.

Solutions Affording Global Public Health

Let’s get Personal

In order for we the people to enjoy the arriving benefits of personalized medicine we absolutely need to have full ownership and possession of our personal health records, history and eventually our very personal and private genotype, phenotype and genetic predisposition. We need this complete information 24/7 anywhere and anytime we need health care. We need this personal health record (PHR) to always be up-‐to-‐date, accurate, and complete. We need our PHR!

We also need our PHR to belong to us we the people, and not owned by any institution or health network. We need to be free to move from one health care system to another without ever being concerned we could lose access to our health information, history or any part of our health record.

We need to know our PHR will be non-‐disruptive to any health care institution or health network. Just like we can do with our bank ATM debit card, use it anywhere in the world and know we will not be disruptive to any institution. We also need to trust our PHR information will only be available on a need-‐to-‐know basis. Again just like our bank ATM transaction. We know our financial information is safe. We trust that the grocery clerk only gets approval when we ask for $20.00 cash back from our ATM debit card transaction. We know the grocery clerk has no knowledge or access privilege to our entire bank record. The point here: this is not a new concept. If the global banking system can do this successfully for the last 20+ years, so should our global health system.


January 2011 Page 4

Above all, we need to have one private and personal trusted place to know we will always have our lifelong health information, records, images, prescriptions, lab results, and any and all of our health record available to us. We need to know we can log into a health care facility and our entire health record is accurately available on a need-‐to-‐know basis, to any caregiver, throughout the point-‐of-‐care (PoC). We need to know that any health care we receive throughout any PoC will be automatically placed into our PHR and always be up-‐to-‐date, complete and accurate. We indeed need to know that we no longer need to fill out a form to be seen by a caregiver. We know we may not remember all the important allergies, medical, surgical, immunization and pharmaceutical details the caregiver needs to know to perform fully informed care. Moreover, in many emergency or disaster situations, we the patient may not physically be capable of communicating our medical histories to caregivers. We need our caregivers to be fully informed about us, at PoC, after all our health histories are unique to us and yes it is very personal and private.

The EMR and the Missing Link

Many countries have spent much effort, money, time and political capital to motivate health care institutions to install and deploy electronic medical record (EMR) system to a meaningful use. EMRs after all would reform healthcare! Well no they will not. At least not all by themselves—for that is exactly what EMRs are and should be—all by themselves and institutionally centric. They must be institutionally centric to help the exact institution perform clinical practices, specific to the institution’s clinical workflows, clinical resources, schedules, and best practices. Asking an institutional EMR to be “Patient-‐Centric” is, well—silly. EMR’s are prospectively designed to be institutionally centric and must be to be successful for the unique needs of the clinical or healthcare or hospital or any specific health care institution.

Institutional EMRs must manage many different patients most requiring specific care in alignment with their specific clinical condition. A hospital EMR is taxed with many different patients, each requiring a wide and variable clinical workflow, different schedules, various medical resources, lab tests, diets, etc.

EMRs cannot nor should not try to be all about the patient. If for no other reason, someday the patient will leave the institution. This happens everyday to a US soldier under the ALTA EMR, or a Military Veteran under VistA, or a Kaiser patient under the highly customized Epic EMR system.

When a patient leaves a closed harmonized health network, and requires health care, they become a stranger in a strange place. In fact they may be worse off, for when they are within their closed health network, they rarely fill out a form and do not need to remember all their personal health information and history.


January 2011 Page 5

So what’s the missing link—a very patient-‐centric PHR that can harmonize and non-‐disruptively synchronize with any EMR at any institution, clinic, dentist, pharmacy, anywhere, anytime. Once again, just like the global banking system has done successfully, so should our global health system.

So where is our global health system?

ATM Link-‐for-‐Life™ Global PHR

Automated TeleMedicine, Inc. (ATM) believes an individual’s PHR should be available to the person, anytime, anywhere they require any health care, dentistry, medication or other health services. An individual’s PHR should not be able to become lost or unavailable for any reason. An individual’s PHR should be 100% secure. An individual’s PHR should be private, very private. An individual’s PHR should be accessible securely to any www-‐connected device. The PHR should not require the person to have access to a computer, or any computer skill, nor require any literacy skill. An individual’s PHR should be available to the caregiver on a need-‐to-‐know and only with the personal biometric permission of the individual or their authorized guardian. The PHR should never disrupt the institutional electronic medical record (EMR) system, yet should instantly exchange appropriate information at any and all points-‐of-‐care (PoC), in real time.

The PHR should automatically recognize the caregiver’s credentials and permit access to the relevant health care information germane to each specific caregiver. The PHR should enable accurate linguist translation from the caregiver to the individual. The PHR should automatically align with any EMR system, at any PoC. The PHR should be accessible to health care professional within any health network, worldwide. The PHR system should provide a free professional EMR to any health care professional who needs one for their private, secure and unrestricted use. The individual’s PHR should remain with the person for their entire life regardless what health network they use. The individual’s PHR should become complete, accurate and helpful rapidly over time.

The individual’s PHR too should be very close to free! ATM Link-‐for-‐Life™ is 99¢ per year, per person.


January 2011 Page 6

We the people should never be in need of healthcare and a stranger in a strange place without our complete and accurate health record. We the people should expect our health caregiver to have exactly what they need to perform fully informed care to us at any PoC. This is not a luxury—but a necessity of life.

Contact:

Howard Asher ◊ Howard@ATM-‐Health.com ◊ +1.619.997.5900

Documents

Link For Life Whitepaper