- Former National Coordinator for Health IT Dr. David Brailer took the stage at Health 2.0 earlier this week, stating that digital health has failed health information.
- Clinical transformation is hugely dependent on health IT and is not sustainable without it, according to Brailer.
- He stated third generation data — data that are continuous, ubiquitous and physiological — will allow critical care to be delivered in near real-time and drive consumer engagement. Noting third generation data are not fully being generated or adopted, such data raise important policy questions, Brailer said.
The power of data will help drive clinical transformation, according to Brailer.
The former ONC chief began his address by framing the problem of the current state of healthcare data with the fact that healthcare costs are continuing to increase, and said the value realization from payment reform has left much to be desired.
And yet, the move to payment reform is making progress. Brailer mentioned there was the belief that former HHS Secretary Tom Price did not much support value-based payments. And HHS under Price's leadership did roll back many Obama administration efforts for payment reform. To Brailer, the next appointed secretary will signal how the administration will view initiatives such as bundled payments and other value-based payment changes.
He asserted the reason these industry shortcomings are occurring is because the manner in which IT and clinical transformation (how change within the industry is enacted and validated) interact has not worked. Brailer added he believes clinical transformation needs IT more than the other way around. From duplicate workflows to the lack of relevant information presented to patients and providers at the point of care, there are many inefficiencies within the healthcare industry.
So far, consumers are not truly involved in their care. "We're still living in a world where 10-12% of consumers being involved in their care, being engaged in that care process is actually successful. And it's not," Brailer said. But it doesn't have to be that way. And many of the panels and speakers at Health 2.0 noted the need and desire for patient engagement with products and health IT tools going forward.
A large problem is the industry doesn't have the right data, Brailer said. It's not for a lack of software, or visions or business propositions. Brailer said third generation data will be needed to drive lasting clinical transformation. This is data that goes beyond static EHR query data and draws from nodes such as remote monitors, social media and geolocation — data of "the living and life." While such data are vast and discordant, Brailer believes they will allow critical care decisions to be made in near real time and positively impact consumer engagement.
During a fireside chat, Brailer said third generation data are here now. "I don't think the pathway of that kind of data goes through the old generation," Brailer told Health 2.0 founder Matthew Holt. "I think we'll be struggling with enterprise and its integration and its sharing for a long time. Around that, this data is already been collecting in so many different places. ... It's just not being managing in a way that's like hospital data."
It's too early to see the "impact on the actual operations of the care delivery models, but that's where the experimentation will happen," Aneesh Chopra, former U.S. CTO, added during the fireside chat.
However, Bralier noted such data raise important policy questions for the future:
- Who will own and control this data?
- What rules will govern the use of this data?
- Will technology companies be good healthcare citizens with this data?