By Marc Perlman
Information is the future of healthcare, and the industry is developing an almost unquenchable thirst for it. The good news is that healthcare organizations are amassing data at an unprecedented pace. Rapid adoption of electronic health records (EHRs) in the wake of the HITECH Act is helping to fuel this growth. Some statistics calculate adoption among US physicians at a rate as high as 72 percent.1 US healthcare is also on the cusp of major advances in remote monitoring capabilities—specifically mobile health (mHealth)—which stands to take data directly from the device or patient to the data center, driving volumes exponentially. US healthcare professionals can finally start changing healthcare with effective use of real information in the care process that will positively affect patient safety and outcomes.
We are beginning to see and quantify the impact of digital health information. A 2012 study conducted by Weill Cornell Medical College researchers and published in the Journal of General Internal Medicine found that the 56 percent of physicians who used commercially available EHRs provided significantly better quality of care than physicians using paper records for four measures: diabetic blood glucose testing, breast cancer screening, sexually transmitted disease screening and colorectal cancer screening.2 The U.S. Department of Health and Human Services reinforced this message on March 6, 2013, when it announced efforts to accelerate health information exchange. Acting administrator for the Centers for Medicare and Medicaid Services (CMS) Marilyn Tavenner stated, “We are already seeing benefits, such as a reduction in hospital readmissions due to these reforms. Health IT and the secure exchange of information across providers are crucial to reforming the system, and must be a routine part of care delivery.”
Even with these promising results, the industry is still at the very early stages of the healthcare transformation journey. On the road to personalized medicine and improved population health, next milestones must include the ability to better assess performance and outcomes, clinical effectiveness, and comparative effectiveness. As important is the widespread secondary use of the vast amount of data being captured across the healthcare ecosystem, such as EHRs, claims/billing systems, research databases, and clinical and laboratory systems. When mined, shared, and analyzed, this valuable data can drive patient care improvements, predict public health trends, and reduce healthcare costs. The good news is that technology is no longer the barrier.
To make this leap, however, the aggregation of data alone is insufficient. Instead, we require liquid data—data that can flow to where it is needed in a form that can be easily accessed, is semantically interoperable, and can be acted upon immediately.
We have faced some hefty roadblocks in our quest for liquid data, including competition among those providing and consuming healthcare information that has led to data lock-in. In addition, the largely transactional systems in place today were not designed with broader initiatives in mind. Instead, they primarily support individual silos across the healthcare and health sciences ecosystem, which has precluded the integrated view that is essential for collaboration and secondary use of health data.
To get to the liquid information levels required within healthcare organizations to affect change, systems need to strongly consider four foundational tenets when evaluating health information solutions:
- Open Standards
- Commercial Off-The-Shelf (COTS)-based
Interoperative health information exchange is the key enabling technology in the quest for liquid data. Health information exchange solutions aggregate and normalize data from core transactional systems and, more importantly, enable healthcare providers and researchers to act on that data both within and beyond the walls of the healthcare facility. To advance the critical secondary use of health data, a health information exchange solution must also support:
- De-identified patient information
- Secure document exchange
- Clinical document indexing
- A standard message format
- An auditable document trail
In addition, in today’s multi-vendor environments, integration standards and repeatable processes are critical to providing adequate data management capabilities. A platform-based, COTS approach helps to ensure more rapid technology implementation as well as a less expensive path forward as best practices improve.
With the four foundational tenets noted above guiding the approach to health information exchange, healthcare organizations can begin to more easily share their liquid data with public health registries focused on advancing population and epidemiological research, extending the volume and usefulness of available information. From there, advanced analytics—with retrospective as well as predictive capabilities—can drive productive use of secondary health data on a wide scale.
Building the right infrastructure to support data collection, integration, and transformation is essential to achieving liquid data that holds the key to unlocking new insight and accelerating our journey to highly effective and efficient personalized care. Once US healthcare professionals have achieved an integrated health platform, the possibilities for achieving predictive, preventive, personalized, and participatory care—and the many benefits it affords—will begin to unfold.
- “Physician Adoption of Electronic Health Record Technology to meet Meaningful Use Objectives: 2009-2012.” The Office of the National Coordinator for Health Information Technology. December 2012. http://www.healthit.gov/sites/default/files/onc-data-brief-7-december-2012.pdf.
- “Electronic Health Records Shown to Improve the Quality of Patient Care.” Science Daily. October 9, 2012. http://www.sciencedaily.com/releases/2012/10/121009111202.htm.
"Quenching Healthcare's Thirst for Liquid Data"
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