Frist, DeSalvo on healthcare's future

While one can approach innovation in healthcare from many different angles, “the transformative use of technology in an appropriate, timely way is real,” said Sen. Bill Frist, MD, former Senator majority leader, senior fellow and co-chair, Health Project, speaking Dec. 3 at the Bipartisan Policy Center’s (BPC's) Health Innovation Initiative policy forum.

“We can disrupt in a very positive way the way healthcare is delivered and that ultimately means the health and wellness of an individual patient. New technologies are helping in so many different ways.”

Frist also cited the variety of social networks that “offer motivation, inspiration and emotional support which is most fundamental in changing behavior.” Online communities didn’t even exist five years ago but now they help patients and caregivers share tips, nuances and even prayers. Smartphones allow patients to look up just about any detail of treatments and diagnoses. All of these advances “don’t just help us become more informed and better educated but they’re also beginning to create new care delivery models to enable individuals to connect with their doctors and nurses in their own homes and still capture some degree of intimacy,” said Frist.

The explosion of data offers “a true promise that will ultimately become a reality of personalized medicine. The explosion in new technology requires us to develop new ways of assuring safety in the development, implementation and use of these products.” The old way of regulating probably won’t work, said Frist, because they were designed before this technology.

The BPC released a bipartisan framework almost two years ago and has seen stakeholders across the healthcare spectrum find common ground, engage in rigorous and robust analysis and reasoned negotiation, he said.

“We’re on the cusp of creating a regulatory environment that rewards innovation, promotes accountability, creates more certainty, encourages capital investment, creates jobs and, most importantly, improves the health of people and families in this country.”

Furthering health IT will require collaboration between the federal government and the private sector, said National Coordinator Karen DeSalvo, MD, MPH, MSc, who also participated in the policy forum. There has been a concentrated effort, she said, to “weave federal government work together with others to really see the ball moving forward. Quite frankly, the country is counting on us.”

A grant program led to about $2 billion in technical assistance for the Meaningful Use program which picked up ONC’s momentum through its financing from the HITECH Act in 2009. “That was an opportunity given to us by Congress to make an investment in the health IT infrastructure—not just the technology but people and processes.”

Workforce development, research, the HIE infrastructure “have all laid the foundation for what will be the next chapter of work together with the private sector.”

When she stepped into her role as national coordinator, she said it was a pivotal time because “we had reached a tipping point around EHR adoption. We stopped, took a breath and tried to see the horizon.

We wanted to make sure we were really understanding what was happening so we could make sure we were supporting consumers. Our mandate was always to work in public-private partnerships and stay out of innovation where it matters but catalyze where we can be helpful.”

As the office continues its work, DeSalvo said candid feedback is important to ensure everyone is thinking about health beyond healthcare, health IT that goes well beyond EHRs and levers that go well beyond the Meaningful Use program. “The more we can do to get back to the early roots of ONC of sending the right signals and being efficient is really tantamount to our responsibility.”

Because health is so much more than patients visiting their doctors, “a platform that can capture that for consumers based on their own consent and their own expectations is increasingly important and is happening in other sectors so we need to get ahead of that in healthcare.”

DeSalvo said the future of healthcare involves building from what already works rather than reinventing the wheel.” This cannot be a federal plan. We need to come up with a shared approach and collective action.”