Applying Moore's Law to Health IT

[Lisa_Malloy]

By Alice Borrelli, Director, Global Healthcare Policy, Intel Corp

Congratulations to the Bipartisan Policy Center (BCP) for hosting a constructive summit on Health IT to release the report: Accelerating Electronic Information Sharing to Improve Quality and Reduce Costs in Health Care.

The report laid out progress that the Office of National Coordinator (ONC) is making through Meaningful Use Stage 2 with solid recommendations to advance interoperability.  To reach the goals of electronic information sharing which support improvements in the quality and cost effectiveness of care, the BCP calls for a national strategy and long term plan for standards and interoperability, as well as improving the accuracy of patient matching.   

The report suggests that public and private sector efforts demonstrate the attributes of a voluntary consensus standards body as outlined in the “National Technology and Transfer Act.”   Given the success of the Open Data Center Alliance to develop associated reference architectures and voluntary standards for cloud computing, we would suggest that this process could be a model for building a consensus to drive data exchange and deliver what physicians and patients need.  And to be explored through a future blog, perhaps a common data model that all vendors could implement could be developed through an industry/government alliance.

During the BPC event, Dr. Mark Blatt, MD and Intel’s Global Medical Director, offered collaborative workflow as a means to remove waste, delay and cycle time through the exchange of data.  As one example, Dr. Blatt highlighted how the marketplace could collapse the delivery of patient care, especially consults from hours to minutes, when using real time data exchange through videoconferencing and data sharing on devices such as a tablet.  In fact, we need to think about applying Moore’s Law to healthcare where we double the access to patients while cutting the costs in half – maybe not in the 24 months that technology moves, but at a much more accelerated pace than today’s practices.  And, at the same time ensuring that this patient information is securely transferred to the clinicians and patients needing the data. 

Meaningful Use Stage 2 Final Rules, which go into effect in October 2013 for hospitals and January 2014 for eligible professionals, will change the dynamics of Electronic Health Record (EHR) data exchange toward a more robust system with industry standards required for certification:  HL7, LOINC, SNOMED-CT and IHE profiles.  Additionally, certification requires EHR technology to be able to receive, display and transmit, using standards for more than 20 different types of data needed for clinical decision-making.  A summary of care record for 50% of care transitions (exchange) must include data elements for problem, medication and allergy lists which overlap physicians’ preferences.

As healthcare moves from a volume to value based system, the business case for data exchange that facilitates care coordination is being made nationally through ACO’s, Independence at Home practices and bundled payments.  With the current direction from ONC, coupled with recommendations from BPC, Health IT will provide the underlying framework to ensure the success of these programs.

Key findings from the Doctors Helping Doctors survey of over 500 clinicians showed that:

• More than 70 percent cite the lack of interoperability and an information infrastructure—along with the associated costs—as major barriers to electronic information sharing.


• Only 22 percent of clinicians surveyed perceive the lack of a business case to exchange information to be a major barrier.


• When asked about their information needs for transitions of care, a majority of clinicians agree that medication lists, relevant laboratory test results and relevant imaging test results are essential to clinical decision-making.  


• They prefer that only the information they view as “essential” be  “pushed” to them, with the ability to access the rest of the information through a “query.”