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adding labs

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Interoperability

Imagine this:

You arrive at the emergency room for chest pain late at night. Your wife shows the doctor an old EKG on her smartphone. The doctor would like a printout, so she uses her app to create a secure weblink, which he opens in a web browser on his computer.  On the new EKG the doctor sees “questionable” S-T changes but since they were already present on the old EKG, he is reassured.

Congratulations: you just spared yourself an unnecessary hospital admission and cardiac catheterization. This is called interoperability. Every time you go to a doctor or check into a hospital, your clinicians can see your entire medical file, including items you’ve scanned, such as EKGs and health records from other institutions. You grant access to whoever you want because it’s your data. Your doctor can write in your timeline, and followers are immediately notified.

People are already doing this… sort of. When I explain illnesses and treatments, I see patients scribbling on the back of envelopes, or writing it down in a text message. That’s side-by-side with their grocery lists, taxi receipts, and some random notes like “shgskw” or “poopie” if they have kids. This is not interoperable data. There’s no way to share this information with a team, especially doctors who are notoriously impatient and arrogant.  Omni Timeline is a solution to the interoperability problem. By using an app that’s designed for healthcare, you can have a team of followers with ongoing access. It’s a new way for families to help each other in times of illness.

As a palliative care physician, I care for the extremely ill. We are missing these opportunities every day. I’ve visited patients on home hospice care without any information except a single diagnosis, with families tired of telling the same story over and over again. I’ve seen patients put on life support against their wishes because an advance directive wasn’t available. We commonly order blood tests, CT scans, and MRIs that would be unnecessary if we could get the old chart. I’ve waited on hold for doctors and hung up countless times. My friends in every other industry can’t believe we still use pagers and fax machines. I told them that I could design a better electronic health record than the software that’s peddled to hospitals and clinics, and they told me to stop talking and just go make it. So I did, but for patients, not doctors.

Ideally, patients wouldn’t have to do any of this. Instead, all of the hospitals and clinics would connect their electronic health records onto the same interoperable system. In the example above, the ER doctor would be able to get your old EKG from the prior hospital without your help.  But electronic health record software is too fragmented, and patient privacy laws make it ten times harder by adding legal and regulatory challenges. Worse, hospitals and clinics don’t really want to share your data, and it’s not possible to force them to adopt a system that hasn’t even been designed yet. So if you’re holding your breath and expecting this to happen, exhale now. You can achieve your own interoperability much faster with Omni Timeline.

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Simple

When I talk to people about the importance of keeping track of their health information, most people agree: they need to do it and they want to. But it's very difficult when there are technical terms that you can't remember and things are happening unexpectedly, Like hospitalizations or pain. And there's also never been a simple way to keep track of this stuff. Until now.

Omni Health Timeline is an iPhone app that lets you update and access your health information immediately. You write down updates from your doctor and scan all the paperwork with your camera. Tagging the entries makes it easy to search quickly.  All the information is in a single list, so it is like a story of your health. But it's more than just a medical record. The people you trust can follow your timeline. That means that as soon as you write something down they'll be updated immediately. And when the patient is too sick to do it themselves, followers can update the timeline too. We think that patients have a better chance of staying healthy when their families are participating.

It might seem strange that a subject as complicated as healthcare could be captured in such a simple app. But we believe that an app has to be simple to be effective, and our users want to focus on the health information so the app needs to get out of the way.

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Version 2.1 has arrived.

Greetings! We’re excited to let you know about Omni Timeline version 2.1. This version includes some important under-the-hood fixes, including faster image processing, as well as some bug fixes. 

Fun fact: it’s widely believed that the term “bugs” originated when pioneer programmer Grace Hopper found an actual bug in a computer. Anyway...

One important bug fix relates to billing. As you may know, it’s free to use Omni Timeline to store, search, and share your health information, and 99 cents a month to have followers (up to 99 of them). We provide you with a three month free trial, and if you haven’t upgraded the app yet, you may be presented with a payment screen unexpectedly. Version 2.1 fixes this problem. We will ask for a credit card to activate the free trial, but we won’t charge the card for three months, and you can cancel without any payment. (Go to Omni Timeline settings and tap the patient’s name to cancel the subscription). 

If you’re wondering about this whole “followers” thing, it’s the best way for families to keep each other updated on the health of a loved one. Omni Timeline is designed to do this better than a generic notes app because it’s designed by a physician specifically for health care. 

As always, if your iPhone is set to automatically download new versions of apps, you don’t need to do anything. If not, tap here to get the update to Omni Health Timeline.  Please contact us at support@omnitimeline.com for any questions.

Best, 

Gaurav Mathur MD

Director, Omni Health Timeline

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#specialist

In Omni Timeline, the hashtag isn’t used for trending topics like #sugarhigh or #UTI. Instead, it’s used to direct attention toward a specialty. For example, if you’re describing an ankle fracture, you might write #ortho. This makes the app very useful for clinical followers. An obstetrician can just tap #obgyn and instantly see relevant information.  Remember that not everything fits into one of these categories, and that’s ok. Here’s a complete list:

#cv - cardiovascular - heart, blood vessels Cardiologist, vascular surgery

#derm - skin: wounds, rashes Dermatologist

#dental - teeth, gums, mouth Dentist, oral surgeon

#eye - eyes and vision Ophthalmologist, optometrist

#ent Ear, nose, throat

#gi- digestive and biliary tract Gastrointestinal

#gu - urinary tract Urologist

#neuro - brain and nervous system Neurologist and neurosurgeon

#obgyn - female reproductive health Obstetrician, gynecologist, midwife

#onc - cancer and blood disorders Hematology, oncology, radiation oncology

#ortho - bones, muscle, tendons, cartilage, sprains, fractures Orthopedics

#pall - Advance directives, goals of care, DNR Palliative care

#psych Mental and emotional health

#pulm - Lungs and breathing Pulmonologist

#renal - kidneys, fluids, electrolytes Nephrologist

#rad - Xrays, CT scans, ultrasounds, MRIs, etc. Radiologist

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Followers

We all need support in times of illness. It might be chicken soup, or flowers, or just a smile. But now, with Omni Timeline, your loved ones can support you in ways that weren’t possible before by staying instantly updated on your health. It might be a daughter snapping a picture of her elderly mother’s EKG, or a husband scanning his pregnant wife’s ultrasound, or a doctor commenting on a medication dose. This kind of practical, real-time communication is crucial in health care, and can even make the difference between life and death. So if there’s someone you trust with your health, consider adding them as a follower, and they can become part of your team.

How do I add a follower?

In the Omni Timeline app, tap “Followers” on the bottom right and then “+” for the app to generate a secret code for you. Give it to the person that you trust - it could be your spouse, your child, or your doctor. When they enter that code in Omni Timeline (Tap Settings -> Start following a patient), you’ll be able to confirm them as a follower. That means that they’ll have access to view and add to your timeline by choosing it from the patient list.

What does the follower see?

The follower sees only the patient you’ve given access to, and no other timelines in the account. For example, Homer Simpson could allow Ned Flanders to view Bart’s timeline, but Flanders would not have access to any other Simpson. That would require Homer to create a new follower for Lisa, and then Maggie, and then Marge, and… he’s just too tired.  Also, followers never see locked medbits - tap 🔒 on any medbit and it cannot be shared outside the account.

Note that if Ned Flanders and his wife share an account, she would have access to Bart’s timeline as well. Take this into consideration when adding followers; all users of their account will have access to one patient in your account.

How many followers can I have?

You can add up to 99 followers per patient. You can end the follower relationship at any time. 

We hope you like this feature - and please send us feedback on how we can improve it!

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Hello world

The hardest thing about designing a medical health record is making it easy to use. We’ve worked really hard on that, and we still have a lot of work to do, but Omni Health Timeline is more user friendly than ever before. And even though it is simple, it is quite powerful. It’s actually two apps in one: a patient health record, and a healthcare communication tool. You’re keeping your records for yourself and the people who care for you. We hope it helps. 

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Human APIs

An application programming interface, or API, is a method that lets one piece of software access information and “talk” to another program. In the quest for interoperability in electronic health records, APIs will be critical.

At Omni Timeline, we designed Unified Health Record labeling. We identified the most important categories in health care, and used a simple tagging system that lets you find most things you need with a single tap. It’s a Human API.

You can find anything by searching for one or two characters, and it also works in SMS-based electronic health records, which are gaining popularity in the developing world. In addition, we also use the following Human APIs:

~ Approximate date

!  Critical info

# Specialist - direct attention to a specialty, like #ob or #ent

We may add more, but that’s it for now. Of course, “Human API” is just a fancy way of saying that information is easily searchable. That’s true. And if you want to know how to pronounce it, the answer is: whatever makes you... content.

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The Right Way to Share Your Medical Records

Let's say you wanted to send someone a copy of your medical record. How would you do it? 

The old way was to mail, fax, or hand deliver a paper chart. That way still works, but it's outdated, and today most people want a digital solution. Unfortunately, email isn’t secure, so Omni Timeline solves this problem in an entirely new way. Patients create a Share, or a selection of medbits in their timeline, which can be accessed securely via the web. Then, they send the access information to the person with whom they want to share their record. It is secured in the following ways:

The website (URL) is a hashed, unguessable address, like https://omnitimeline.com/s/394j8f48

The app picks a password that is unguessable, like df92j95i

The information is securely encrypted during transmission.

The user makes it available for a limited time, and can also end the share early.

The user can see how many times the share has been accessed. If there are too many hits, and the user is suspicious, he can end the share. 

Locked medbits 🔒 cannot be shared.  

You might ask: why not just email the record? This is the solution most people would be familiar with, and is in some ways the simplest. After all, it’s easy to email a PDF.  But it’s unwise, because the last thing you want is your most precious data sitting in someone else's email account. Even if you are certain you can trust that person forever, email just isn't that secure. A permanent record of your chart will be stored in Google's servers if they use Gmail. Apple, Microsoft, Yahoo, and other large companies provide free email services to millions of customers as well. And there's very little they can do to protect a user's email if the user gives someone their password. That happens when a fraudulent website pretends to be Google or a Google affiliate, and it happens often. 

So be safe out there. Share your medical records the right way, and treat them with care. 

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In health care, patients are the real content creators.

When you go to the doctor, they ask you questions about your health. Your responses form part of the information that enters the chart, and thus achieves credibility because a doctor wrote it down. But it's only as accurate as you are, and if you tell the doctor you've had five asthma attacks a week, that's what he'll write down. But what if it was really ten this week, and two in the last month? Your doctor has no way of verifying what you say. Or, you might describe  symptoms that the doctor doesn't write down because he doesn't find them relevant, or interprets in a different way than you meant, or that he forgets by the time he gets to the computer to type in what you said. The point is: the part of the medical record that the patient describes (the medical history) is less accurate than the patient's own experience.

So: there is the actual experience, the patient's memory of the experience, the medical history that the physician elicits, and what he actually writes down. As you might imagine, there are lots of ways for information to go bad. Medical information is surprisingly unstructured. Whether it's a three ring binder of assorted papers, or an electronic record with clinician notes, medical records are very messy. They are full of conflicting and repetitious information, sometimes to the point of absurdity: "Rectal examination revealed a normal size thyroid."

Omni Timeline empowers patients to solve this problem in a very direct way: by writing things down as they happen. When you write down "fever 101.2", you won't accidentally misremember 102.1 when you recount it to the clinician. When you scan a picture of a rash, there's no need to try and describe it later - you have the actual photo.  When you scan the doctor's consultation note, there is no ambiguity later on about their recommendations. 

So, when it comes to health care, there's no point arguing over whether patients will be able to create content, because there is a ton of information that only the patient knows, which they will forget unless they write it down. We must empower patients to do this. It is the first step in inverting the medical record. We foresee a day when instead of asking your doctor for a copy of your medical record, they will be asking you.

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Simple enough for a patient, simple enough for a doctor.

Most people think that doctors, clinics, and hospitals have specialized ways of documenting care, and thus few people have tried to create a medical record that patients could use. The thought was always that if a health record app is simple enough for patients to use, then it must not be powerful enough for doctors, and would therefore be of limited value. 

I disagree completely. It is difficult to create an app that is simple enough for patients but powerful enough for doctors, but it's not impossible. In fact, we have spent a great deal of effort in making the app simple enough for doctors. That may sound strange, but medical training is in how to diagnose and treat patients, not how to use specialized software. Many of my patients could manage an Excel spreadsheet better than I could. We should expect doctors to be medically savvy, not computer savvy

But even doctors who aren't geeks get frustrated when software doesn't do things that we know are possible. For example I can search entire gigabytes of email in less than a second, but I have yet to use an electronic health record that can offer me similar functionality. Years of feature creep and technical debt create a number of different and unrelated parts of a database that are simply too complicated to search.

By putting all the patient health information in one list, Omni Timeline becomes much more powerful because it is simple. And that makes it easy for patients - and doctors - to use.

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Software engineers: we're looking for you!

If you have skills in Python, Django, SQL, and Web development, get in touch!  Omni Health Timeline is a patient medical record that's simple, elegant, and powerful, so that even regular people can use it, (including my parents!) It is unusual because we’re not creating new expensive technologies, and yet it’s a service that every person needs (although not everyone knows it yet), and thus has a large potential for growth. You’ll be working with me and a front-end iOS developer. As a physician, I am extremely clear on the design and function of the app, from the visual interface and user experience to the most critical elements like security and privacy. It works like this: simply write down health information in entries (“medbits”) of 99 characters or less, and scan images (progress notes, wounds, EKGs, etc) that save as attachments in this health timeline. Because this is patient controlled information, it is not subject to HIPAA and therefore prior experience with HIPAA development is not required. However, patient privacy and security are foundational to the service. We are looking for skilled and passionate engineers who can help us improve our back end technology. This will include improvements like search, PDF support, and optical character recognition. But the most exciting feature is one that will allow users to share health information with other users that they trust. I value diversity and I am hoping for a diverse response to this. What I like best about Omni Timeline is that it will empower everyday people like us to maintain our own health records, so that our copies of progress notes from the local dentist to the biggest hospital are all filed together, in our own control. I want to create a future where we own our own health records, and not some corporation.  I hope that you can help.

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Instructions

Our instructions have moved! http://www.healthtimeline.org/instructions.html

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Omni Health Timeline - Store, search, and scan all your health information. Free for iPhone/iPad. Simple.

www.omnitimeline.com

[omnitimeline]

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Omni Health Timeline - Store, search, and scan all your health information. Free for iPhone/iPad. Simple

www.omnitimeline.com

[omnitimeline]

One account for your family.

Remember, you can create multiple patient timelines in a single account. We recommend including your children and dependent family members in a single account (one username/password), so that you can switch between family members seamlessly. 

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Cloud.

As you use Omni Timeline, you may notice that your record is only available when you are online. We know this is inconvenient, and we are working on methods to store and sync information on mobile devices securely.