Nexu - Personal Medical Record
Nexu is a personal electronic medical record (EMR) designed to promote patient self-advocacy through increased access to educational materials, greater personal health organization, and promoting personalization in treatment through collaboration.
University of Cincinnati, 2012
"...to understand a complex problem, you have to reach a thorough understanding of each of its root causes and how they interact... but finding a practical solution requires a different strategy. It is more of a matter of finding the simplest single ‘lever’ capable of producing the biggest positive result."
- Paul Polak, Out of Poverty
In order to define the project direction, I developed an exploratory research plan. Knowing that I wanted to develop a tool that gave patients power in decision making, I needed to understand what that meant in practice.
I began with interviews of patients, caregivers, and medical providers. From these conversations I understood the power patients often lacked was an ability to self-advocate.
I conducted an extensive literature review of published clinical trials, where patient advocacy and self advocacy played a key role in determining patient outcomes.
The Simplest Single Lever
The provider-patient relationship typically takes one of two forms. In the first, the physician acts as an arbiter of health who determines a specific course of action, recommending the patient to follow along, leaving all alternatives out of the conversation.
In the second, the physician acts as an informer, outlining the treatment options available to the patient, with the expectation the patient will be able to decide which option they prefer.
The end of my exploratory research culminated in a report, The Simplest Single Lever, a reference to the Paul Polak quote above. My "simplest single lever" was giving patients the ability to self advocate. It had been shown to be one of the greatest indicators of a patient's positive outcomes, and more importantly, it was an indicator that a digital tool could potentially effect.
Three markers that determine a patient's ability to self-advocate
Increased Disease Education
Increased Mindful Non-Adherence
Increased Assertiveness with Providers
Patient self advocacy changes the one sided approach to healthcare so patients can take ownership of their personal role in healthcare within the context of the care teams.
The tool must:
Be patient owned and controlled
alleviate barriers to collaboration
Facilitate disease education & research
Track a patient's values & health goals
Focused on brainstorming incentives to get people involved in their own healthcare.
Discussed barriers to knowledge, gamification, rewards, and a provider's control.
Having a tangible object was important for patients to feel that they had a sense of control. Much like the clipboard at the end of a hospital bed is the physician's record, the physical object of Nexu became the patient's.
A personal electronic medical record to increase patient self-advocacy.
Pulls data from electronic medical records (EMR), collecting care team information and a complete medical history all in one place.
organizes data in an interactive family tree to enable tracking genetic background
An essential monitoring tool to determine if treatment plans are meeting established goals.
In compliance with the Meaningful Use mandate, Nexu collects patient goals and translates those goals to actionable health plans.
Stores emergency contacts and shares that information with any clinic in the country.
Encourages patients to think about end of life care and provides place to store those documents.
my Med School
Helping to organize the research you’ve done on any disease into libraries where you can access and share that information easily as well as get it verified by independent physicians.
Keeps track of past and future health “to do’s” as well as providing tools for in office tracking like talk to text recording of diagnoses and journaling during health events or procedures.