Health IT Summit: Debating the best uses of data

CAMBRIDGE, MASS.—“Behavior change is happening at many different levels but the lack of continuum of care means we don’t connect these pieces together,” said Rajni Aneja, MD, MBA, strategic executive and clinical transformation leader for Humana, speaking May 7 at the Boston Health IT Summit hosted by the Institute of Health Technology Transformation.

How data are structured and entered and how they are collected depends on the associated motivation, said Thomas D. Sequist, MD, MPH, director of research for Atrius Health based in Newton, Mass.

Healthcare needs new tools to make it easier for physicians to document, analyze and measure metrics, said Jonathan Leviss, MD, CMO of the Rhode Island Quality Institute. “If we want to succeed, we need to make it easier for physicians to do the right thing and not just with the technical side but we need to address the value focus as well.” The value piece is evolving, he said. “Some providers are much more welcoming about performance data. They will do the extra work when they see the value.”

Some chronic disease outcomes aren’t getting better even with all the available information, said Sequist. “We have gotten to the point where we can give doctors reports but it doesn’t really help them. They’re not driving better performance. We need to start to think what we can give them to get to a better care plan.” Learning more about patients’ lives outside of the healthcare system is important, too, he said. That includes access to healthy food and exercise venues. “The primary care system doesn’t really have access to that information but that information is gettable. We should be able to incorporate that better into the EHR to create whole person plans.”

“We’re drowning in data,” said Reid Coleman, MD, CMIO for Nuance Communications, headquartered in Burlington, Mass. When he practiced medicine full time, he received reports saying that 80 percent of diabetics had their A1C checked in the past month. The conclusion, he said, was to try harder. It would be more effective to analyze that data and turn it into information that can be used at the point of care in real time, he said.

“Thirty percent of the prescriptions I write are never filled,” he said. Those people not filling their prescriptions, he said, are not going to log into a patient portal—they are more likely to use Twitter or Facebook. “We need to figure out how to use social media to communicate data back to our patients.”

Payers are doing a lot of this kind of work, said Aneja.  “Health plans are generating incentives to get patients to fill generic prescriptions and make other behavior changes.”

“We all get these notices from health plans about our patients but the problem, it’s not in real time,” said Sequist. “It’s often really out of date.”  

There is a huge market for apps that can make data more useful, said Raj Dharampuriya, MD, CMO and co-founder of eClinicalWorks. “We shouldn’t limit this to anyone—healthcare is a $1.3 trillion industry and there is no consumer-centric care yet.”

“We’ve been using the EHR to determine the best relationship,” said Sequist. Some patients prefer a one-on-one relationship and some benefit from a more networked set of providers. He said that patients from lower socioeconomic backgrounds often do not connect with their primary care provider but feel more comfortable with a medical assistant or nurse for many reasons but those people tend to be in the same set of social circumstances.