expensive for a population that may cross the border daily between San Diego
and Tijuana. 5 But by using video capabilities and text messaging on cell
phones, clinicians were able to follow an initial group of patients and achieve
a high rate of medication adherence and patient satisfaction. 6 More
importantly, this seemingly simple intervention is potentially scalable and
adaptable both to other conditions and regions. 7
This anecdote illustrates just one example of the promise of accessible and
exchangeable health data: for years, proponents argued that the open
exchange of health data would help consumers make better health decisions,
patients engage in their care, practitioners avoid costly mistakes and
duplicate tests, and the government evaluate services for actual value. 8
But to many critics, much of the promise of health information is still
unfulfilled. As one critic noted, out of the “hundreds of apps out there
promising to keep you on a healthy diet, have you exercise regularly, and
make sure you are a happy person every day of the year,” most will have little
utility or efficacy in improving health. 9
Further, there is a great need to share data to improve the delivery of care
and to reduce medical errors. Over a decade after the Institute of Medicine
published Crossing the Quality Chasm, 10 health systems still are not
communicating with full interoperability, or the ability to “talk” to each other
and share data. 11 Increased operability would allow providers to share data
monitor participants carefully to ensure compliance with an anti-tuberculosis drug regimen).
5. Dov Michaeli, A Small Example of the Real Power of Mobile Health, THE DOCTOR
WEIGHS IN (Dec. 5, 2012), https://thedoctorweighsin.com/a-small-example-of-the-real-power-of-mobile-health/.
6. Richard Garfein, RD/TB Institute Lecture on Video Directly Observed Therapy
(VDOT) for Monitoring Tuberculosis Treatment Adherence (Aug. 12, 2015),
12-15_draft.pdf?docID=35881; see also Michaeli, supra note 5 (using a smartphone camera
to communicate with nurse regarding medication adherence resulted in a 99% adherence rate).
7. Kain, supra note 3; see also WORLD HEALTH ORG., MAXIMIZING MOBILE 1, 51 (2012)
(“Currently, applications focusing on individuals are mainly geared to developed countries,
where purchasing power and education are higher.”) [hereinafter WORLD HEALTH ORG.].
8. Health Information Exchange: What is HIE?, OFF. NAT’L COORDINATOR FOR HEALTH
INFO. TECH., https://www.healthit.gov/providers-professionals/health-information-exchange/
what-hie (last visited Sept. 12, 2016) [hereinafter Health Information Exchange].
9. Michaeli, supra note 5.
10. QUALITY CHASM, supra note 1, at 176.
11. OFF. NAT’L COORDINATOR FOR HEALTH INFO. TECH., U.S. DEP’T HEALTH & HUMAN
SERVS., REPORT TO CONGRESS: REPORT ON HEALTH INFORMATION BLOCKING 1, 4 (April 2015),
information.html (“Current economic and market conditions create business incentives for
some persons and entities to exercise control over electronic health information in ways that
unreasonably limit its availably and use.”); see also Patrick Caldwell, We’ve Spent Billions to
Fix Our Medical Records, and They’re Still a Mess. Here’s Why, MOTHER JONES (Oct. 21,
ehr-interoperability (discussing vendor issues and the government’s inability to police them).