For 3M President Jon Lindekugel, the fun part of what's about to happen is the innovation it will spark. Not coincidentally, that’s also something of an opportunity for 3M, which he describes as a "content company."
That content, in this instance, is the “recently licensed open source Healthcare Data Dictionary (Open HDD) originally developed by the 3M Company that is now available to contractors through an HDD Content Download License,” in the words printed in a Sources Sought Notice that the VA put in Federal Business Opportunities on May 10.
Initially, 3M declined comment on the matter when asked to respond to the Government Health IT scoop VA, DoD to use imminent open 3M health data dictionary part of iEHR back in April.
Now Lindekugel speaks with Government Health IT about his vision for the open source HDD, the enormous healthcare problems it can help to address, the various innovations he hopes it will inspire and the solar system of products surrounding it.
Q: From your perspective, what's the potential for how the VA and DoD using Open HDD within iEHR could affect the healthcare industry?
A: 3M is a content company. We innovate the language, primarily around coding and reimbursement, methodology and terminology. That’s really what we do. So our vision is combining that content with technology that enables the healthcare industry to get the maximum return on the big investment that’s been made creating and managing electronic health data. For the HDD we think it’s fundamental to making that happen. The use of HDD will help the industry drive consistent, complete and accurate clinical documentation.
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That clinical documentation, and having it be complete, consistent and accurate, really is the foundational data that gets used to communicate, diagnose, deliver, measure and, in terms of coding, pay for healthcare services. It’s also the foundational data throughout all the research that will drive care quality up and the costs down. So as you talk to the Stan Huffs of the world and others at Intermountain, for example, they’ll talk about exactly what I just described: Getting complete, accurate, consistent clinical documentation, getting it in an electronic form and being able to run comparative effectiveness studies to improve care and drive the costs down.
Q: Which is what Dr. Huff said in our story…
A: Yes, and being located a mile from him, we talk as a collective group, company to company, a good bit. And I just love what they’re doing with informatics. Again, it drives right back to having standardized, normalized and consistent clinical documentation as the foundation of really being able to drive those analytics, in addition to driving record sharing – Intermountain is an example where there’s great record-sharing capability – in most parts of the country you have a hard time if you’re taking your healthcare record across the street.
Q: Indeed, even if across the street is within the same health system.
A: Even in the same health system. HDD will help with that. Being able to transport records and have them understandable from one location to another is a big deal for patients in the immediate term but I really think that adding our content to the technologies that are starting to be deployed will enable new innovations in diagnosis, accuracy, care planning, procedures, workflow, as well as the sort of close to home for 3M basics in revenue cycle applications, coding, auto-coding and the like. I really view it as way to spur innovation from the back office of the hospital all the way through care delivery in a variety of different ways.
More of the interview on the next page.
Q: The VA is planning to implement iEHR in at least two hospitals within the next two years – will 3M’s HDD be part of that?
A: We would absolutely love the HDD being a part of those deployments.
Q: What happens moving forward here?
A: Once we see broader adoption of the HDD we have a wealth of new tools to really drive clinical documentation and back-office productivity in terms of auto-coding. Once the new EHR system is deployed between the VA and the DoD, we think we can bring some new tools to bear that will take a lot of cost out of the back-office.
Q: Which tools are those?
A: A tool called 360 Encompass, which delivers four things today: at a ground-level, common terminology via the HDD, which then enables ICD-9 to ICD-10 conversion tools and the like; baseline clinical documentation improvement to help make sure care is fully documented in ICD-10; and auto-coding so the staff increases needed as we go to ICD-10, which will require somewhere between 25 and 40 percent productivity in the coding space to offset the additional coders needed for ICD-10; and then, finally, it delivers some outcomes-based analytics, today there are retrospective analytics around quality indicators, PSIs [Patient Safety Indicators], potentially preventable readmissions, potentially preventable complications.
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By next February, we’ll be working predictive analytics into those spaces so when a patient presents a certain way and the care is documented, we’ll be able to work on predictive analytics around the likelihood that patient will be a readmission, or will suffer a hospital-acquired condition, for example. That predictive component will help with diagnosis and care planning.
Q: So might 3M make versions of those tools, like the HDD, available as open source components?
A: Open source is an idea, a business model shift that we certainly are interested in and, you know, we’ll take a look at. I don’t foresee anything in those specific toolsets in the near-term future.
Q: I’m envisioning this sort of solar system where HDD is the sun and the other tools are satellites around it?
A: Yes, the other tools are satellites around it. Our ability to open source those both technically and from a business model perspective are far more challenging. But we do have some other technology and content that we will look at an open source model for, things like an MPI [master person index], for example.
There are parts of our portfolio that we believe fit that model. There are areas where the cool part of that business model is that it’s going to spur innovation. Again, that’s something I think the healthcare IT space can use a lot more of. We expect to see that.
Q: What sort of innovations do you anticipate?
A: For me one of the fun parts of the model and watching that happen is there will be innovations that none of us thought of. We can’t sit down and think of all the crazy new ways people will use content and technology and be able to release that in a way the industry can pick up and run with.
