Opening data, empowering consumers

WASHINGTON, D.C.—“This is the year of empowering the connected health ecosystem,” Aneesh Chopra, former U.S. chief technology officer, told attendees during a panel discussion at the 2015 ONC Annual Meeting on Feb. 2.

“The apps you're seeing out there are so exciting,” Chopra said, adding that it’s time to work with vendors to solve problems to allow data to flow freely between apps and EHRs.

Chopra said important developments signal the growing importance of consumer-empowered connected health. He noted that within the White House’s announcement for its Precision Medicine Initiative, it said it would use all tools in the regulatory toolkit to empower consumers to access and share data with their trusted apps. He also cited the work of a group of stakeholders to construct an open and free API for healthcare to allow providers and patients to connect and share data with trusted apps and third party providers.   

Neil Evans, MD, the co-director of Connected Health at the VA, echoed his excitement for consumer-mediated health information exchange. “I'm excited about putting data increasingly in the hands of veterans,” he said. Evans shared his own story about his five-year-old son with recurrent urinary tract infections, and the arduous task of getting an urgent care center to submit culture results required to see a specialist.

“So putting into the hands of consumers the ability to download their data and have that information is critical. I'm excited that we're able to provide to veterans the ability to download data and in 2015 to watch the ability to send that data via Direct to a provider,” he said.

Gregory Downing, MD, who is involved in public policy, said he believes that opening government data propels this movement. “We've done an enormous amount in the last couple years to make that data available from claims data to FDA data and this is the fuel for a lot of applications and the innovations that Aneesh has pointed to.”

As a provider, he said he wants to use information to make better and more accurate and timely decisions in critical care. “We're not there yet, and I think we've gotten very good at digital data collection systems, but we're not getting the way in which the tools interact in ways that make better decisions and better outcomes happen.”

Alice Borrelli, director of health policy at Intel, said the company is committed to creating a new platform for its employees that will give the best patient experience. She shared about a New Mexico-based Intel ACO called Connected Care. But while the value-based care model improved quality metrics, it did not move the dial on lowering costs.

“So it's hard to hit that Triple Aim. We're still learning, we're relooking at our measurements, and we know we need significant investment upfront in those patient-centered medical homes so that we could do a long-range approach to medical care,” she said. When the company last month launched a Connected Care program in Oregon for 18,000 employees, “It got more complicated," she said. "The complications are we're working with more than one hospital, we're working with clinics that are not connected, and of course this required us and all of our partners to step up our interoperability approach."  

Evans said that getting VA providers to integrate virtual care into their workflows is a challenge. “It's about making it appear simple even when underneath the hood it may not be entirely simple,” he said.

“If you don't get the data in front of the clinicians in a way that's understandable, that is computable and usable, they're less likely to invite their patients to utilize virtual care modalities and we're less likely to deliver that delightful experience to you as a consumer of healthcare that you deserve,” said Evans.

Investment in interoperability and open technologies will blossom now that the government is ramping up its payment reform that ties 50 percent of Medicare payments to alternative payment models by 2018. “Now, if you are aware of that future, you will be hungry for doing all the things that you want to do. You're going to want to stratify the population, you're going to want to engage patients, and you are going to want providers to have better access to information so they can make judgments either at the point-of-care or in between visits. The demand is driven by our incentives in the system," said Chopra.