tiality, security, access). However, the country still has a significant digital divide. For those who are unable to be custodians of their own data, solutions such as health information exchanges will be needed, and somebody else will have to act as that primary coordinator of care. The Office of the National Coordinator for Health IT (ONC) has developed a consumer e-health group that focuses entirely on that issue. ONC talks about three “As”:
Products on the market today enable the monitoring of daily activities inside the home. How can they best be packaged and used? What reimbursement system will support their use? How will people be trained? How can information be gathered to promote particular actions to be taken? There are many challenges with patient-generated data. The first relates to the engagement of the patient and includes issues of culture, literacy, privacy, confidentiality, and security. For example, who is the custodian of an adolescent’s health information? How does it affect the doctor-patient relationship? How will individuals who do not know how to use computers be assisted with the use of these technologies? How will providers keep pace with the amount of information available to patients on the Internet? Will competition develop once patients have access to the same information their providers do?
Second, many have questioned the reliability of patient-generated data. In a face-to-face meeting, providers may use body language to determine truthfulness. However, the reliability of physician data may also be questioned. Some patients have discovered that some of the information in their medical record is not accurate. Having everybody look at the data ensures that the value of the data goes up and the integrity stays as high as possible.
Lastly, there is a need for the intuitive collection of data. If the use of a device requires special training, it probably will not be used. To this point, software will need to be designed better for intuitive usability. If a device is easy to use and is able to ensure that safety measures are put in place, it will deliver a better outcome. Finally, the technology needs to be incorporated meaningfully into the lives of the consumers.