This week’s Health 2.0 conference was held for the first time in Washington, DC, plunging Health 2.0’s community of IT geeks into the heart of the land of policy wonks. The feds’ Chief Technology Officer, Aneesh Chopra, joked about the gap between the two cultures: where the Health 2.0 crowd says “there’s an app for that,” the government says “there’s a form for that.”
Chopra and officials from the Department of Health and Human Services outlined their goals and plans related to health IT and extended an invitation for the two communities to work together more closely. The feds described a transformation of the economy and an improvement in the lives of Americans, and gave examples of initiatives that open access to health data and/or provide incentives for innovative uses of it, including:
- The Blue Button Initiative – A CMidentifying S and VA initiative that lets consumers download data for use in a personal health record (PHR)
- Pillbox An NLM and FDA program releasing data that helps in pills
- VAi2 — An $80 million VA innovation competition focused on areas including telehealth and adverse drug events
- Community Health Data Initiative — An HHS and IOM initiative that releases data sets about communities (and which provides the data for the Health 2.0 Developer Challenge).
- Apps for Healthy Kids A White House competition to create software tools and games toimporve kids’ health
As the Department of Health’s Farzad Mostashari said to the crowd, “We’re watching. We want to learn. Show us what is possible.”
But not everyone was impressed. Jamie Heywood of the online health community PatientsLikeMe bristled at the idea that technology entrepreneurs should step up and fix problems that rightly belong to government, such as collecting and analyzing better population health data. “Don’t look to us to save you,” he said, arguing that the feds need to build better markets for innovation. He has said, for example, that government could offer to buy data generated by the private sector that furthers public health goals.
Jamie’s contrarian spirit was refreshing, but his criticism was somewhat misdirected. Based on what I saw, this Administration and its officials are doing a pretty good job with the tasks in their purview. The people at ONC (the Office of the National Coordinator for Health IT) are trying to spend about $2 billion on health IT in intelligent, innovative ways under tight deadlines. Aneesh Chopra, Farzad Mostashari, Todd Park, Josh Seidman, Wil Yu and others who spoke at the conference already get it. They are the proverbial choir. While engaging with them is an excellent start, it’s not enough.
There are two fundamental policy issues that fall outside of health IT but that are at the core of health and healthcare in this country – and therefore critical to health IT’s success, too:
1.) Realigning Financial Incentives. Even after health reform we’re still in deep trouble if healthcare providers get paid based on the volume of patients they see, tests they order, or prescriptions they write. They need to be paid for the quality of their care and for getting results: better health in patients and populations. Get that right and health IT will follow. (While “Meaningful Use” is a valiant attempt to use technology to work around the problem, a more fundamental realignment of the system is needed.)
2.) Addressing the “Bad Healthcare” Market. In her conference remarks, investor Esther Dyson described the market of products and services that work against health and healthy behaviors on the part of consumers: processed foods, cigarettes, TV, cars and gas instead of walking. We need government to end subsidies that support these negative influences, and look for creative ways to support healthy eating, exercise, the growth of communities, and other healthy environmental factors. (IT can help, but here, too, a more radical overhaul is needed.)
So while I was thrilled to see the Health 2.0 community engaging with people like Aneesh and Farzad, in the future it must also reach out to a broader network of policymakers—including Congress and other officials who are better positioned to tackle the root problems with health and healthcare. Wouldn’t it be great if they, too, said they were watching and willing to learn?
Lygeia Ricciardi is the founder of Clear Voice Consulting (www.clear-voice.com) and part of the leadership team of Clinovations (www.clinovations.com). She’ll be commenting on Health 2.0 Goes to Washington. Follow her on Twitter @Lygeia.