This week’s 10th Annual World Health Care Congress in Washington, D.C., saw a lively discussion April 9 involving a panel of experts on innovation, including Bryan Sivak, chief technology officer of the U.S. Department of Health and Human Services, and Joe Pleasant Jr., senior vice president and CIO of the Premier health alliance.
Sivak said he sees his team’s role in HHS as first, recognizing that data is an undervalued HHS asset and second, liberating that data so that others in the health care system can develop transformative applications around it.
He cited meaningful use as one example of a way that HHS is using its position to encourage use of data for lots of clinical purposes. Before the program began, he said, approximately 15 percent of providers had EHRs; that number is now north of 70 percent. “We initially incentivized adoption,” Sivak said. “Now we are focused on making them useful in bending the cost curve and delivering better outcomes by incentivizing interoperability.”
Sivak mentioned the great potential of Blue Button and now Blue Button Plus, which standardizes the format of data that individuals can download about their own health. Changing the format of the data from an asciii text dump to something machine-readable should spur applications developed to add value, he explained. Blue Button Plus also helps develop a framework for trust and defines a transport mechanism on how data gets from one point to another. “This will enable an ecosystem of ‘view, download and transmit’ with Blue Button,” he added.
He said internally at HHS, the focus is on the liberation of data. “Three years ago the default setting was closed. It wasn’t the first thought to share,” he said. “But we are changing that mindset from closed to open. As we curate data, we are thinking about how to make it available.” Healthdata.gov is a platform to allow for dissemination. It has about 1,000 data sets, and Sivak said HHS is working to make sure as much as possible is API (application programming interface)-available, so that innovators can build apps and transform care.
Premier’s Pleasant said that meaningful use has made a huge difference in terms of hospitals beginning to pass data back and forth to do analytics. “It has also allowed us to look at problems associate with that,” he added. EHRs are not designed to accumulate data for population health or bundled payments. Hospitals are still grappling with departmental systems that leave data siloed, and IT departments writing interfaces between systems. “We still have challenges doing analytics,” he said, “but we are off to a good start in getting data in electronic format.”
Premier has 345 hospitals submitting comparative information on cost, harm, and quality. “They are seeing unbelievable results from comparing with each other,” Pleasant said. By focusing on best practices and evidence-based care, costs go down and quality goes up, he said. Premier is also working on hospital collaborations with the goals of lowering hospital-acquired infections and readmissions.
Pleasant said eventually we will see “surveillance analytics,” in which a sensor looks at data and in real time gets information to the right person in the care system. “Then we will see real benefits at the point of care.”
Their talk was followed by a presentation by George Halvorson, Kaiser Permanente chairman and CEO, who talked about the work of innovation centers within KP. He said that KP has committed itself to care delivery that is grounded in continuous improvement strategies based on the study of data.
“We need American healthcare to evolve to continuously improving itself,” Halvorson said. “We have had a system that has been static and too often frozen and bureaucratic.” With new science and technology developments coming out all the time, we need to take make sure we are taking advantage of them. “We need to make sure it is happening not just sporadically,” he said, “but as a systematic process where in the end care is better.”