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Favorite Health IT Quotes of 2017: A Baker’s Dozen

December 19, 2017
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Machine learning, population health, FHIR and Open Notes were focal points in 2017
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Each year I like to look back through my interviews at some of the quotes from industry leaders that intrigued me the most to see if they help elucidate any patterns that I might miss in my day-to-day reporting on informatics trends. Often the ones that stand out to me are from people who reject the accepted wisdom or offer some controversial or blunt comments about the state of our healthcare system and the role technology is playing in it. I may not always agree with them, but I appreciate the fact that they are challenging established notions and making us rethink our assumptions. From the following quotes, presented in no particular order, it is clear there is plenty of change afoot, matched by a healthy dose of skepticism and frustration.

1. “Given how much we spend and how much technology we apply, I was struck by how much manual processing is going on. On the issue of measurement burden, that is an area for significant improvement. I wince when I see how much physician time is devoted to data entry. I think we can all agree that makes no sense in 2017 and we can do better.”
-- Lewis Sandy, M.D., UnitedHealth’s executive vice president for clinical advancement

2. “One of the reasons it takes so long for a drug to get to market, or any finding to lead to a change in clinical care is because of this lengthy cycle we go through of hording our data and hiding our algorithms in order to publish a paper so we can be first and get tenure and promotion. The patients deserve better than that. If we can address the attribution and contribution problem, you can be first just by posting it on GitHub or the web.”
-- Melissa Haendel, Ph.D., an associate professor in the Department of Medical Informatics and Clinical Epidemiology at Oregon Health & Science University, and one of the leaders of the new National Center for Data to Health (CD2H)

3. “The idea that machine learning is about to be launched in our healthcare system is tremendously exciting. It could really turn the system on its head. Ever since healthcare was something humans did, the patient has had to hold up his hand and the system would respond. The idea here is that if you have rich enough data you can instead predict who may need help and do outreach and move care upstream. That is a goal for healthcare in general, whether it is dealing with cancer or a person heading toward self-harm. I am excited and thrilled to see how clinicians will use it.”
-- Don Mordecai, M.D., Kaiser Permanente National Leader for Mental Health and Wellness

4. “For my doctor to use my data with me on an individual level advances the quality of care in and of itself, but when you can aggregate data within an institutions and across institutions, there become increasing opportunities to conduct comparative effectiveness research and outcomes research.”
-- Claire Snyder, M.H.S., Ph.D., a professor at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health and co-author of a “Users’ Guide for Integrating Patient-Reported Outcomes in Electronic Health Records: Design and Implementation Considerations”

5. “Every American needs to have the totality of the medical information available to every physician and hospital at every point of contact. It can be done. It's called ATMs. But it won't get done.  Why is that? Because the people who manufacture and sell the electronic health records are not going to open up what's called APIs, the application processing software that's necessary for third-party developers to come in, because they know it will break the stranglehold they have on those who have purchased the systems already.”
-- Robert Pearl, M.D., former CEO of the nation's largest medical group, The Permanente Medical Group

6. “We spend more time shoveling coal than steering the ship. We want to shift our energy to looking at the data and navigating where we are going.”
-- Robert Kagarise, director of population health informatics and IT for the Delaware Valley Accountable Care Organization

7. “You need big data to drive you to the right place. Once you know who is at risk, that is where little data comes in. You need the boots on the ground. Large data sets are good, but it comes down to messaging the provider or patient. Then you can use care management to drive provider behavior.”
-- Terri Steinberg, M.D., chief health information officer and vice president of population health informatics, Christiana Care Health in Delaware

8. “At Mount Sinai, we are a big academic medical center, but like most of America, we have an Epic system that is not necessarily easy to get data out of en masse. If you need data out of Epic, you take a ticket and get in line.”
-- Mike Berger, vice president of population health informatics and data science at Mount Sinai Health System