The Latest Advances in Health Information Technology

On a sunny Tuesday in September, Health 2.0 concluded in the heart of San Francisco. For those unfamiliar, Health 2.0 is a conference focused on bringing together constituencies to improve health information technology (akin to, “HIT”).  At this conference, we were joined by government representatives such as the National Coordinator for HIT Farzad Mostashari, representatives from the payer industry ranging from the Chairman, CEO and President of Aetna, Mark Bertolini, to Chairman and CEO George Halvorson of Kaiser, medical care providers, patient advocates, mobile technologists, computer technologists, investors and entrepreneurs -- all working to join forces, learn what each other is working on, and ensure we are stepping forward synchronously to improve the state of health and medicine for our loved ones and our future. Of course, the key to accomplishing such lofty goals is "how?"

A Glimpse into the Future of Healthcare

There were two consumer segments focused on at this conference: the healthy consumer and patients (those diagnosed/entering the clinical care arena of health care). Some of the hottest applications were showcased, solving problems for these end-consumers -- including an application letting consumers ask questions to doctors right from your phone (HealthTap), Aetna’s medical information platform Medicity (I highly recommend watching this video from 7min 40 seconds until it’s close), GoodRx, PatientsLikeMe, Crohnology, Stickk, Basis, Mindbloom, and more.

Largely in response to three catalysts --

1. Meaningful Use incentives to providers of care for integrating electronic systems (Electronic Health/Medical Records or simply “EMRs”/”EHRs”) and utilizing those in a meaningful manner
2. The formation and funding of State and Regional Health Information Exchanges (“HIEs”)
3. The Department of Health and Human Services’ and the United States CTO Aneesh Chopra’s aggressive efforts to open public health and biological data to technologists and the public

--we are seeing a tremendous amount of buzz in the health and medical space, and subsequently transformative actions are being taken in the realm of information technology in medicine and health by entrepreneurs and more traditional, “old-school” companies.

The innovations forthcoming in health information technology can be summarized into HIEs, EHR/EMRs, and patient/consumer/practitioner-facing applications built on top of these HIEs and EHRs. Electronic health records refer to the software at the point-of-care, where doctors are interacting with patients -- noting symptoms, documenting physical examinations, sending electronic prescriptions to a pharmacy, ordering and receiving laboratory tests, and more actions related to clinician-patient interactions. Where Health Information Exchanges enter the scene is the need for interoperability (that is, when EHRs want to talk with each other). An example would be when patient Jane Doe wants to switch doctors but her new doctor is utilizing a different EHR software than her previous doctor. Now, how does she transfer her records over to the new software? Moreover, what if she gets into a car accident and is taken to the hospital? How does the hospital know this patient’s medical history and active medications if she is unconscious?  This data has to be in a standardized format and, furthermore, needs a secure mode of transport.  HIEs are specifically useful in and refer to systems bridging EHRs to other EHRs. Serving as information highways, HIEs might also be valuable as the homes of health / medical data. The future is unknown whether these HIEs will actually house people’s data or if they will just serve as the highway -- but it seems certain both EHRs ( the same as EMRs) and HIEs will have APIs for developers to make fun and useful applications from health data.

What’s this look like?

1. You wake up and look in the mirror as you get out the shower or get dressed.  While you're looking in the mirror, your vitals are recorded and sent to your Patient Health Record.  If they reach a certain, critical value, your physician and / or emergency parties are alerted (someone working on this)
2. You then take a jog in the morning and the calories burned, your pulse, blood pressure, and time are uploaded to your patient portal / Personal Health Record / HIE for you to visualize this data and share it with friends and your care providers (Runkeeper, Basis Watch)
3. You live a relatively sedentary lifestyle, and the data showing this is uploaded to your patient portal / PHR / HIE / a health motivation site to help you get active! (Basis Watch, Stickk)
4. You have a bad reaction to a food, and you can message/communicate with a/your doctor from your smartphone or a website to see if you should schedule an office visit (e.g., HealthTap).
5. You schedule appointments online/via phone and fill out forms before your office visit (Zocdoc or EHR providers), or meet with your doctor via a video conference.
6. You have real-time pricing transparency of what you, the patient, will pay for the drug you’re prescribed, tests your receiving, and office visits -- along with price and rank comparisons between competitors (e.g., GoodRx, CA Patient Advocate)
7. Doctors have real-time transparency on comparisons between laboratories and tests, as well medications, alternative remedies, education material for patients, etcetera.

In a nutshell, the future of health care holds promise of transparency, competition, fast-paced innovation, and efficient health and medical care marketplaces.  But, even more important are the implications for our loved one's and our health.  As participants in this effort, we will need to continue our fervent activity in shaping this new experience to ensure the implementation is the most efficient and best experience for patients and the end-receiver of care, and that this quality of care is received as soon as possible. It’s not about money for us, it’s about helping others. This is what I love about Health 2.0, because the people there are in attendance for the same and only reason -- they want to help.

“I do not want to foresee the future. I am concerned with taking care of the present. God has given me no control over the moment following.” -Mohandas Gandhi.  As we move forward, let us not frolic in the dreams of the future, but forge it day-in and day-out with each other.

About the author:

Ryan Witt currently works with DrChrono, an EHR vendor based in Mountain View, California.  At 20, he started Innovation and Choice -- a nonprofit dedicated to improving the quality of healthcare through education and empowerment.  He can be found on twitter @Ryanjwitt.