Ephemeral Communications

8-28-2013 9-37-01 AM

SnapChat is ridiculous. It’s raising $80M at an $800M valuation. How are self-deleting pictures and videos worth nearly a billion dollars?

SnapChat discovered a nascent human behavior: people share more stuff when they know it can’t come back to haunt them. I thought SnapChat was only for sexting until I started using it. One hundred percent of the SnapChats I receive are of my friends being idiots throughout the day. They’re funny and silly, but usually a bit embarrassing. I never received half a dozen silly selfies via traditional texting. But with SnapChat, I receive silly selfies all day long because my friends know I’ll get a kick out of it for 10 seconds and then forget.

Healthcare could learn a thing or two from SnapChat. The healthcare system discourages providers from communicating (in order to care for patients) so that there’s someone to blame if things go wrong. The hallway consult is dead. Providers should communicate whenever and however they need to in order to get the job done.

Doctors shouldn’t be allowed to abjure data from the EHR. The EHR should have a complete audit record. But providers should be allowed to communicate without fear of legal repercussions, when and where appropriate.

More broadly speaking, this is a question of communication channels and intended audiences. Some communications were intended to be strictly provider-to-provider and were never intended to be provider-to-patient, provider-to-lawyer, or provider-to-insurance. In an ideal world, the EHR would be strictly provider-to-provider. That would allow providers to communicate on their own terms.

Each of these non-provider entities expects that everything in the EHR should be written for their needs: patients want patient-friendly data and notes, lawyers want to see as much documentation as possible (no matter how irrelevant or the cost it places on other providers that have to wade through it), and insurance companies want as much documentation as possible so they can find a reason to reject claims.

Providers can’t create multiple versions of the EHR in which each version written for the non-provider parties that want to read and access that data. That would simply be too time consuming and laborious. Patient portals have begun to tackle this issue, with links from diagnoses and lab results to websites that provide a medical explanation in a patient-centric fashion. But patient portals still have a long way to go.

Other initiatives, such as OpenNotes, have been received positively by providers and patients, though I can’t help but wonder what information providers have started leaving out of notes knowing that patients will read their comments directly.

A handful of companies, such as Avado, are trying to tackle this issue head on for patients. Some specialties are better suited to this than others. For example, Avado has been particularly successful with expectant mothers  who are excited to learn and engage with their providers. On the other hand, patient participation in ophthalmology is poor since many patients are older or can’t see well.

Perhaps with enough data, someone can create a Google Translate for the various parties that want to access EHR data. Please email me if you have any insight on this.


Kyle Samani is a healthcare technology entrepreneur who is passionate about healthcare and technology startups.

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