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eHI Conference Day 2: Integrating Patient-Generated Data

January 17, 2012
by David Raths
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Healthcare leaders discuss incorporating patient data while avoiding organizational IT silos

Jan. 12, the second day of the eHealth Initiative annual meeting in Washington, D.C., began on a light note when Micky Tripathi PhD, president and CEO of the Massachusetts eHealth Collaborative, hesitated before coming up with heart disease, diabetes and cancer as the three top chronic diseases the meeting is addressing. “I feel like Rick Perry up here,” he said. “Now I can sympathize with him.”

Those comments got big laughs from the audience.

One key question brought up at the conference—and one that is at the forefront of meaningful use Stage 3 development plans—is how patient-generated data can be integrated with health systems’ data infrastructure. Some patient advocacy groups are creating community-based portals that allow patients and providers to avoid the problem of organizational health IT silos.

Nancy Brown, CEO of the American Heart Association, described a portal program it created called Heart360, which gives patients and doctors a way to manage cardiovascular health and communicate data such as home blood pressure readings, glucose levels and physical activity. It provides a secure location for patients to track and manage their heart health. They can record health data with online trackers, access educational information, and share results with providers. Brown said one implementation of Heart360 is a North Carolina community-based initiative called “Check It, Change It” being run by Durham Health Innovations, a collaboration between Durham County and Duke Medicine, to help residents lower and manage their high blood pressure. A similar study of home blood pressure monitoring by Kaiser Permanente in Colorado last year found that participants were 50 percent more likely to lower their blood pressure than a control group, Brown said.

In a wide-ranging presentation, Vicki Seyfert-Margolis, PhD, senior advisor for science innovation and policy for the U.S. Food and Drug Administration, updated the group about how FDA is expanding its IT infrastructure to support more sophisticated analyses of data. “We are establishing science enclaves to aggregate clinical study data and to analyze large, complex data sets,” she said. As an example, she said, by studying data from hundreds of clinical trials, FDA found that antidepressants could increase the risk of suicide in people under 25. That finding resulted in FDA placing warnings on the labeling and medication guides for these drugs.

Seyfert-Margolis said FDA is still working on guidance for regulation of a subset of mobile medical apps — those that have sensors that attach to patients or that serve as an adjunct viewer for an already-regulated system.

She gave a “no-comment” on the possibility that patient safety concerns might push the FDA to regulate electronic health record software. Stay tuned on that front.

One conundrum mentioned by panel speakers and audience members alike is that although Internet-based wellness tools may be valuable, the older, rural and underserved populations that providers need to reach most don’t access the Internet or mobile technology devices as much as the general population. Some said the real audience for these electronic outreach efforts could in some cases be younger caregivers of older patients or patient navigators working in hospitals and clinics. If there was a consensus at the meeting, it seemed to be that care coordination tools and patient wellness apps, including social media, are still in their infancy. But with hundreds of new health-related apps being published each month, the field is clearly drawing innovators and entrepreneurs.

On a separate note...

Each year eHI honors individuals and organizations that demonstrate leadership and excellence in e-health. This year, Southeast Texas Medical Associates LLP (SETMA) in Beaumont, Texas, which won a Healthcare Informatics Innovator Award in 2011, won the eHI award for its preventive health initiative called Lose Weigh, Exercise and Stop Smoking (LESS). SETMA is mid-size multi-specialty group with 32 physicians and more than 250 employees.

James L. Holly, M.D., SETMA’s CEO and managing partner, accepted the award. He briefly described the LESS disease management tools including diabetes risk assessment, a diabetes screening assessment and a hypertension prevention program. He also talked about the importance of performance tracking and public reporting of physician performance to driving constant improvement in the quality of patient care.