We are rapidly approaching the inflection point for the next generation of healthcare. Our journey toward the concept of P4 (Predictive, Preventive, Personalized and Participatory) medicine requires rethinking of the overarching technology, interoperability, processes and people that will need to be in place to support outcomes-focused care.
While a formidable undertaking, the good news is that we already have many of the foundational elements, such as electronic health records, clinical information systems and CPOE systems, in place, or at least on the drawing board for deployment. Following the passage of the HITECH Act, much of the focus in the healthcare community centered on the deployment of foundational health information technologies as organizations work toward satisfying the requirements of meaningful use. The implementation of such technologies has enabled us to automate baseline functions and begin to develop and track enterprise quality standards. As with any kind of major transformation, however, just because we've taken the first step doesn't mean that we'll continue to move forward.
[Editor's Desk: This Week in Government Health IT.]
The next phase of our journey, and I would say, the first critical step on the road to P4 medicine, is to focus on the fuel that will propel us toward transformation - in this case it's data, liquid data. The amount of data that today’s healthcare systems are gathering is staggering. However, it does little to advance care if it remains isolated in information silos of old. In other words, today, we have the raw data, but it remains largely frozen.
On the road to personalized medicine and improved population health, our next milestones include the ability to assess performance/outcomes, clinical effectiveness and comparative effectiveness. As important is widespread secondary use of health data to improve outcomes as well as externally to advance new treatments and overall population health. Liquid data is essential to achieving each of these goals.
In the simplest terms, liquid data is information that can flow to where it's needed in a form that can be easily accessed, is semantically interoperable and has the ability to be acted upon. It requires trusted access, exchange and the ability to recombine data to drive new insight. Sounds simple enough, but we've faced some hefty roadblocks along the way, including competition among those providing and consuming healthcare information that has led to data lock-in.
[Commentary: Will HITECH money be ther tomorrow?]
To get liquid, healthcare must strongly consider four foundational tenets when evaluating solutions:
- Open Standards
- COTS-based
- Interoperable
- Integrated
The key enabling technology to achieve the liquidity is interoperative information exchange that will aggregate and normalize data from core transactional systems, and enable healthcare providers and researchers to act on it. In today's multi-vendor environments, integration standards and repeatable processes are critical to providing adequate data management capabilities. A COTS approach helps to ensure more rapid implementation as well as a less expensive path forward as best practices improve.
[See also: 10 lessons learned from linking VLER to private health org's.]
Building the right infrastructure to support data collection, integration and transformation is essential to enabling new insight and accelerating our journey to highly effective and efficient personalized care. Once we've achieved an integrated health platform, the possibilities for achieving predictive, preventive, personalized and participatory care, and the many benefits it affords, will begin to unfold before us. As participants in healthcare - consumers, providers, payers and partners - it is our responsibility to ensure we are building a sustainable system to improve outcomes and lower costs. Otherwise, the opportunity to demonstrably improve healthcare may be lost.
