HIMSS14: In current wave of health IT, workflow and security issues loom large

ORLANDO—Health IT is advancing and improved use of healthcare data, along with new sources of information, is enhancing care, but challenges related to workflow and security must be met, according to Robert Wah, MD, who delivered the opening keynote for the Physicians’ IT Symposium ahead of the Health Information and Management Systems Society's annual conference.

Wah, chief medical officer of Computer Sciences Corporation, based Falls Church, Va., described the current era of health IT investment as occurring in three waves: health information exchanges, EHRs and tools for health analytics. As systems mature, they will go from simply reporting information and providing basic business intelligence to being truly predictive and offering better care coordination.

Better information means improved decision making, said Wah, and this occurs at multiple levels. Most obvious is that physicians will make better decisions for their patients, but patients also will be empowered to make better decisions about their own care. Governments will have a deeper understanding of quality care, resource utilization and biosurveillance, while payers can offer members revamped services to promote wellness.

One area Wah singled out as advancing especially rapidly is the study of genetics. The cost of DNA analysis is dropping even faster than what would be suggested by Moore’s law, which is the observation that the capabilities of computing hardware advance at an exponential rate.

As the use of big data in healthcare matures, new ways of putting information together and detecting patterns in non-traditional data will emerge, said Wah. For example, credit ratings and patient care compliance could be compared against each other to uncover any correlations.

This evolution in data mining will not be without challenges, and Wah stressed that while the technological aspects will be hard, workflow and business processes will be the major issues. “The people aspect of this change are much harder and much more important than just the technology,” he said.

Security is another concern, and one with higher stakes in the digital age. “We all know that paper was not secure,” said Wah, “but it wasn’t possible en masse to move information on paper the way that you can with digital.”

Breaches in the security of healthcare data are perhaps even graver than those that occur in the banking industry, which has grown adept at quickly shutting down stolen credit card numbers. Wah noted that credit card information and monetary losses are recoverable, but a confidential medical history being shared is a “bell you can’t unring.”

This is reflected in the prices being paid on the black market among identity thieves for various types of stolen data. The street value of health information is 15 to 20 times that of a stolen credit card number, because the credit card number will quickly become useless but criminals can take their time with a health record to steal an identity and commit fraud, according to Wah.

Wah, however, framed efforts to improve security in a positive light. Rather than view security as a bother, cost or add-on, he suggested security be seen as an enabler; security enables integration, mobility and patient access. Ultimately, security technologies are required to enable better patient outcomes.