When Medicomp chief executive officer David Lareau hears U.S. chief technology officer Todd Park talk about the need to find the right technology to set data free and make it usable, Lareau wants to tell him he has just the thing.
Medicomp's MEDCIN engine, which had its start 40 years ago, has been in use by the Department of Defense since 2005 (with about 25,000 users every day, according to Lareau), and it is embedded in electronic medical record systems with familiar names: Allscripts, athenahealth, Pulse, Vitera, Success EHS and MED3000.
Lareau is bullish on MEDCIN, but, by way of explaining why Park and others might have overlooked it in their talks about data, he says, "We have been a quiet company." That is about to change, he says, as Medicomp goes global. Lareau and his colleagues traveled around the world last January, taking the pulse of healthcare, scouting for new customers and blogging from Bangkok.
"People are just beginning to realize the implications of, as Todd Park said, 'freeing up all this data," Lareau says. "Freeing up is one thing, but when it starts coming back in a tsunami, with a patient with six or seven problems, and you've got to put your finger on what are the implications that this person has SNOMED code 90688005, which is renal failure, how do I find the thing in this data tsunami that relates to renal failure. That's really what our engine does."
"The tools are available today to provide clinically intelligent presentations of data at the point of care in a way that doesn't slow the provider down, fully involves the patient and proves outcome," Lareau says. Moreover, MEDCIN "organizes all this data in an effective view at the point of care. ICD-10, meaningful use, all that stuff, that's mapped into these concepts that are linked in our index, but that's done in the background. It's just there. They don't even have to think about it."
ONC chief Farzad Mostashari, MD, takes the opportunity to trumpet the power of data in healthcare when the occasion presents itself. The morning after the 2012 presidential election was one of those times. Mostashari asserted that the way the Obama campaign used data helped the president win the election. Data had also helped transform marketing and baseball, he noted.
"How is it possible for us to imagine a world where that power of data is not brought to bear on life and death, clinical care, on population health, and affirming the path that we are on with health IT and bringing data to life?" Mostashari asked at the Nov. 7 Health IT Policy Committee meeting.
Lareau believes in the power of data, yet he recognizes that it can be dizzying.
"It can be overwhelming," he says, "Each patient is a mix of different things, different problems, co-morbidities, clinical sequelae, complications, health status issues, and you've got to have a way to filter that in a clinically useful way while you're with the patient."
Peter S. Goltra, who founded Medicomp in 1978, works on perfecting MEDCIN to this day, and also leads Medicomp's knowledge team.
"The technology wasn't there 10 years ago - even for us," Lareau says. "We had an engine, but it took things like XML and browser-based technologies to make this stuff distributable and deployable, and customizable in a way that was economically feasible for the vendors and providers."
The technology has arrived at a time when the Institute of Medicine (IOM) is calling for better data at the point of care. In releasing the IOM report last September, Mark Smith, MD, president and CEO of California HealthCare Foundation and chair of IOM's Committee on the Learning Healthcare System in America, said two fundamental issues are facing the U.S. healthcare system: cost and complexity. Thus the mission of the report was "to find the foundational characteristics of a system that is efficient."
One report recommendation: embracing new technologies to collect and tap clinical data at the point of care. "Health professionals and patients frequently lack relevant and useful information at the point of care where decisions are made," the report notes.
As it goes global, Medicomp is incorporating genetic data into MEDCIN's diagnostic index, and it is also going beyond patient engagement to patient involvement, making it possible for patients to participate in the management of their own conditions, Lareau says, by building patient involvement protocols into the MEDCIN engine.
"We're just doing our first few pilot projects with it," Lareau says. "We like to do these pilot projects with small, agile vendors." n
