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Aneesh Chopra: 'Sustainable HIE Focuses on Verbs, Not Nouns'

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The ‘Indian George Clooney’ candidly discusses the future of the health IT industry, HIE and the open app market

Yesterday, May 30, HIMSS hosted a Twitter Chat with the former U.S. CTO Aneesh Chopra, who is now senior advisor of health care technology strategy at The Advisory Board. Since Chopra has stepped down from his government post to reportedly run for lieutenant governor in Virginia, he was a bit chattier during this Twitter Chat and bolder with his opinions and said some interesting things about the state of healthcare IT, health information exchange, and the open app market.

Shahid Shah, also known as "The Healthcare IT Guy" online and consultant to various federal agencies on IT matters, moderated the Twitter Chat and introduced Chopra as someone having “what we sometimes lack in health IT—a vision that IT in the medical field is not a far-off dream but is here now.”

Before tackling questions from the Twittersphere, Chopra, dubbed the Indian George Clooney by The Daily Show’s Jon Stewart (see clip below), admitted that the biggest obstacles he’s faced since leaving his CTO post have been being disconnected from the inspiring stories of health innovation and their lack of media coverage. But he did say he’s met more providers on the ground since leaving, and that even though many are confused about the future of healthcare, they are “keen on building a better delivery system.” Chopra foresees three post-meaningful use trends: the lowering of the cost to maintain healthcare IT systems; the increasing value, coupled with the necessary payment reform, derived by the providers using these systems; and the continued growth of a new economy of health apps.

Through the prism of his optimistic health IT future-view, Chopra said that providers’ biggest roadblock to connectivity was their own internal realization that it is the best path to deliver value-based care. He also said the biggest source of confusion is how to achieve this vision with IT tools already available and without creating new legislation. He debunked the myth of physician resistance to new technology by admitting that most were “rational folks responding to market incentives,” and that payment reform was key for adoption. Chopra said that communities were also critical to drive the value of HIT investment and referenced a speech by the new U.S. CTO Todd Park, in which he spoke about the success of Cincinnati providers who were collaborating to set up common performance metrics to measure care providers.

Open App Market
Chopra said he had faith in the market to reward vendors for adopting standards-based APIs—rather than by pushing them with regulatory nudges—to promote open innovation for the myriad apps necessary to support ACOs. Chopra named a few open app projects that he sees changing the healthcare IT landscape and hope there to be others that will create a substitutable apps market.

Chopra cited the Direct project as a great example of a "lean startup" that birthed consensus and standards that is now scaling through Stage 2 meaningful use and gaining voluntary adoption. Another project that held great promise he said was the Open Source Electronic Health Record Agent (OSEHRA), an online resource that supports a collaborative community of users, developers, and companies that are engaged in advancing EHR software and health information technology. He added that OSEHRA had been a strong custodial agent for the VISTA code base.

Chopra referenced Blue Button a few times as a powerful application and a form of health information exchange that allowed patients to “view, download, and transfer” their medical records. He also said the HHS Office of Civil Rights has been unequivocal in that patients are entitled to their own their data and that Blue Button reinforces this mission. Chopra made a very salient point that sustainable HIE, like the Blue Button and Direct projects, focuses on verbs—the actual exchange—not nouns—the organizations set up to facilitate the exchange.