I was asked by the US Commerce department to attend and present at a roundtable that took place in Sofia, Bulgaria on February 27th. This roundtable included people from president's office, National Healthcare Fund, Patient Groups and key vendors. Bulgaria had many efforts to kickstart eHealth. This was an overview of US legislation and lessons learned as well as a look forward into healthcare innovation trendds
3. What is eHealth?
โข Lack of clear and precise definition
โข Set of disparate concepts, including health, technology and communication
โขMeaning varies with context in which the term is used
โขMeant to enhance the quality, improve access to health care services at
lower costs and strengthen healthcare systems as a whole
#digitizing #collaborating
#connecting
#personalizing
#empowering
#improving
3
4. Wired Healthcare
Source: An Overview of eHealth Initiatives -Strategies and Lessons from Around the
World by GE Healthcare IT (2011)
4
5. eHealth ecosystem
Source: An Overview of eHealth Initiatives -Strategies and Lessons from Around the
World by GE Healthcare IT (2011)
5
8. Meaningful Use: Impact
โข As of 2012,Use Stage 1 Corephysicians adopted EHR technology capable of meeting twelve
Meaningful
half or more of
objectives
Source: โPhysician Adoption of Electronic Health Record Technology to Meet Meaningful Use Objectives: 2009-
2012,โ Health and Human Services Dept. Office of the National Coordinator for Health Information Technology,
8
9. Open Health Data: United States
Health Data Initiative (HDI)
Launched in 2010 by the Institute of Medicine (IOM) and the U.S. Department of Health and
Human Services (HHS)
HDI is a public-private collaboration that encourages innovators and entrepreneurs to utilize
HHS data to help improve health and health care
A growing inventory of public health data resources easily available and accessible at a
central location: HealthData.gov
Includes clinical care provider quality information, nationwide health service provider
directories, databases of the latest medical and scientific knowledge, consumer product
data, community health performance information, government spending data and much
more
In addition to publishing and promoting the availability of health data, HDI is preparing the
data for use by developers while protecting privacy and confidentiality
HDI is seeking to identify, encourage and accelerate the meaningful uses of the published
data by organizing forums, public competitions or hackathons
Policy Developments Support Openness
The Affordable Care Act, signed by President Obama in 2010, authorized HHS to release
new data sources
9
10. Beacon Community Cooperative Agreement Program
โข$250 million over three years to 17 selected communitiesand Innovation
progress in Beacon Pursuits linking Health IT, Improvement,
that make
โข In 2012,Michigan and Greater Cincinnati โ launched an innovative mobile
Southeast
three Beacon communities - Crescent City (New Orleans),
health application for individuals at risk of developing Type 2 diabetes
โข"txt4health" campaigns aim to support patients with:
โข Assessing their diabetes risk levels
โข Engaging in and managing their health
โข Accessing resources on wellness and diabetes care
โข Part of a broad effort to leverage mobile health technology to empower self-
management of chronic disease
โขIn Prevention, the Office of theDiabetes Association, the Health IT for Disease Control
and
cooperation with American
National Coordinator for
Centers
and Voxiva (a 10
11. Health IT: Progress mixed and savings elusive
โขcould save the U.S. more than in 2005 that rapid adoption of Health
IT
RAND Corporation estimated
$81 billion/year
โข According tocost-saving promise of Health IT has not been
investments the
a 2013 RAND Corporation study, despite wide
reached
โขAccording to the same study, empirical data on the Health ITโs
impact on health care efficiency and safety are mixed, and annual
health care expenditures in the U.S. have grown by $800 billion
โข The study attributes poor HIT performance to:
โข Sluggish adoption of Health IT systems
โข Systems that are neither interoperable nor easy to use
โข Failure of health care providers and institutions to reengineer
11
12. Health IT: Lessons Learned
โข Health IT adoption is critical but not adequate alone to improve healthcare
โข Need for a broad-based use of EHRs and robust health information
exchange (HIE)
โข Ensuring EHRs integration and interoperability identified as a key to maximizing their benefits
โข Need for coordination and monitoring of the regional connectivity across providers
โข Implementation of safety and privacy framework
โข Building the necessary infrastructure is a first step, yet there are many social,
economic, and cultural barriers to overcome
โข Workflow changes need effort and determination to succeed
โข Incentives measures can encourage Health IT adoption among providers
โข Timely implementation and achievement of full benefits require training and education
โข Need for engagement, collaboration and clear communication across all levels
โขHealth IT is an investment in health and health care
โข Need for commitment to transparency
โข Quality metrics have shown to be challenging to meet, yet should not be discouraged
โข Emphasis on accuracy of measuring and monitoring of outcomes
12
13. Recommendations
โขDo not make this initiative a health IT project
โขEngage all stakeholders form the beginning, including patients!
โขFocus on foundational components
โขFocus on driving standard for information exchange (ex. HL7)
โขEnsure security, integration and interoperability of the systems
โขEncourage national and international cooperation
โขTrack, compensate and communicate efforts
โขHealth IT adoption is not a race itโs a marathon
โขStart with OPEN first 13
15. Health Innovation Trends
โขSocial discovery
โขSelf-diagnosis
โขTelemedicine
โขPersonalized medicine
โขQuantified Self
โขRemote health monitoring
โขData analytics and clinical decision support (CDS)
โขAppscriptions
15
16. Health Innovation Trends
โขSocial discovery - to facilitate social learning, self-management
and improved decision making
โข Online platforms such as CureTogether and PatientsLikeMe allow people to
compare their symptoms with each other and share advice about treatments
and medical providers
16
17. Health Innovation Trends
โขSelf-diagnosishealth
patients in their
- to enable self-tracking and engagement of
โข iTriage help people to evaluate their symptoms, learn about possible causes and
seek appropriate and close-by care
17
18. Health Innovation Trends
โขTelemedicine - to extend the reach and accessibility of health care
โข American Well Online Care enables patients to conduct real-time video visits with
their care providers
โข Hello Health provides the EHR Patient Management platform for primary care
professionals that allow them simplify their businesses and increase patientsโ
engagement and convenience
18
19. Health Innovation Trends
โขPersonalized medicine โ to transform and improve disease
prevention and treatment
โข 23AndMe โ provides genetic testing for over 100 traits and diseases as well as
DNA ancestry
19
20. Health Innovation Trends
โขQuantified self โ to enable self-tracking and incorporate healthy
habits into life
โข Fitbit offers wide range of sensors and devices to motivate users to stay active,
live better and reach their healthy goals
โข Basis is a wirst-based health tracker and online personal dashboard that enable
users to capture heart rate patterns, motion, perspiration and skin temperature to
improve their sleep, diet and exercise
20
21. Health Innovation Trends
โขRemote health monitoring โ to enable self-tracking and disease
management
โข iBGStar is a blood glucose meter that connects to the Apple devices allowing
patients to view and analyze โreal timeโ information
โข Approved by FDA, AliveCor's Heart Monitor allows patients and care providers to
record, display, store, and transfer single-channel ECG rhythms
21
22. Health Innovation Trends
โขData analytics and clinical decision support (CDS) - harnesses real-
time medical data to generate fact-based diagnostic and
therapeutic decisions
โข โ Outcomes-based reimbursement is the future of the heath industry. To improve
patient outcomes, proactively identify chronic and high-risk patients in this new
environment, and effectively manage their financial performance, healthcare
organizations must be able to provide analytics at the point of service and rely
on historical and longitudinal data to manage patient populations.โ Health
Research Institute: PwC, February, 2012
โข Archimedes IndiGO is a Clinical decision support system that offers individualized
guidelines and outcomes
22
23. Health Innovation Trends: mHealth
โขAppscriptions โ to enable self-management, improve compliance
and allow remote monitoring
โข Digital โmedicinesโ prescribed as part of a course of treatment
โข Happtique is a mobile app store for healthcare professionals that offers an
electronic prescription app mRx which enables providers to prescribe, track and
remind use of apps assigned to their patients
โข Approved by FDA, Proteus Digital Health offers an ingestible medicine
compliance tracking sensor
23
Source: 1. Oh H, Rizo C, Enkin M, Jadad A - What Is eHealth (3): A Systematic Review of Published Definitions - J Med Internet Res 2005;7(1):e1 <URL: http://www.jmir.org/2005/1/e1/> 2. โ An Overview of eHealth Initiatives -Strategies and Lessons from Around the Worldโ by GE Healthcare IT (2011)
Source: 1. โPhysician Adoption of Electronic Health Record Technology to Meet Meaningful Use Objectives: 2009-2012,โ Health and Human Services Dept. Office of the National Coordinator for Health Information Technology, Dec. 12 (healthit.gov/sites/default/files/onc-data-brief-7-december-2012.pdf)
Source: http://www.ihealthbeat.org/articles/2012/1/31/beacon-communities-launch-texting-program-to-assess-diabetes-risk.aspx http://www.crescentcitybeacon.org/initiatives/txt4health โ Beacon Policy Brief 1.0 - The Beacon Community Program: Three Pillars of Pursuitโโ June, 2012 by Alison Rein, M.S., Director, Academy Health
Arthur L. Kellermann, Spencer S. Jones. What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology. Health Affairs , 2013; 32 (1): 63-68 DOI: 10.1377/hlthaff.2012.0693 http://www.sciencedaily.com/releases/2013/01/130107162153.htm
Source: โ Health Information Technology in the United States: Driving Toward Delivery System Change, 2012โ, Mathematica Policy Research; Robert Wood Johnson Foundation & Harvard School of Public Health at http://www.healthreformgps.org/wp-content/uploads/74262.5822.hit_.full_.rpt_.final_.041612.pdf Arthur L. Kellermann, Spencer S. Jones. What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology. Health Affairs , 2013; 32 (1): 63-68 DOI: 10.1377/hlthaff.2012.0693
Source: โ Health Information Technology in the United States: Driving Toward Delivery System Change, 2012โ, Mathematica Policy Research; Robert Wood Johnson Foundation & Harvard School of Public Health at http://www.healthreformgps.org/wp-content/uploads/74262.5822.hit_.full_.rpt_.final_.041612.pdf Arthur L. Kellermann, Spencer S. Jones. What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology. Health Affairs , 2013; 32 (1): 63-68 DOI: 10.1377/hlthaff.2012.0693