Trying something new here – soliciting your collective input, the proverbial wisdom of the crowd.
As you may have read in yesterday’s post, Chilmark is quickly approaching publication of the Health Information Exchange (HIE) report. One of the last tasks is final editing/polishing of report. Am now in the process of creating a definition for HIE that clearly articulates what the primary purpose of an HIE is, but also keeping that definition loose enough to reflect what a market that is evolving so quickly that in five years time, there will not be an HIE market as we know it today.
So, with that in mind, here’s the HIE definition for the report.
Definition of an HIE:
A Health Information Exchange (HIE) is a technology network infrastructure whose primary purpose is to insure the secure, digital exchange of clinical information among all stakeholders that are engaged in the care of a patient to promote collaborative care models that improve the quality and value of care provided.
Does this make sense to you? Does this definition resonate with your own view of the market? Any and all comments welcomed, but please be quick to get them in as we are on a fast track to have this report done within the week.
John Moore is an IT Analyst at Chilmark Research, where this post was first published.
You might want to expand the word ‘digital’ to include aspects of standard interoperable protocols ( e.g. XML with schemas / ontologies)
Thanks, Kim. And, again I agree with you.
Bobby G: of course, you’re right. I just wanted to make the point that it’s patient-centered, not just a cool technology play. Let’s make sure we get the blocking & tackling right first, and remember it is about helping the individual patient. Over time (hopefully not too much), much more is possible.
BTW, kudos on your blog!
You’re right, Kim, but there’s a huge overlapping positive feedback loop potential here. Again, quoting PCAST (pg 68)”
“…a synergistic combination of three health IT opportunities, each potentially revolutionary. The first is realtime decision support to the physician based on evidence driven best practice. The second is the realtime interaction of that decision support with com pletely current clinical data, without months or years of lag. The third is seamless integration of the clinical setting with the enrollment of patients into the clinical and comparative studies that will generate the next round of new data. Importantly, because these studies are adaptive (that is, they assign patients to treatments not arbitrarily, but rather based on the partial accumulated study data), they are consistent with the physician’s duty to give each patient the treatment believed to be best for him or her on the basis of the most current evidence…”
I think the first and foremost purpose should be that all the necessary parties involved in the patient’s care — including and especially the patient — have access to pertinent clinical data about the patient’s health and treatment. Having the data also be available to drive clinical effectiveness and quality improvement efforts is an important but second-order imperative.
The collaborative care models are a means to those ends, not ends in themselves.
First, a couple of nits:
“ensure,” not “insure,” and “who are engaged,” not “that are engaged”
Also, “primary purpose”? Why not be explicit regarding the “secondary”(?) purpose — i.e., data mining for CER. e.g., pp 65-66 of the PCAST Report:
“Comparative effectiveness research: Perhaps the greatest potential of the data that can be captured using health IT lies in the potential to fuel comparative studies of diagnostic and therapeutic approaches. Comparing treatment and management approaches in a way that can easily be accessed by both physicians and patients could improve patient outcomes and reduce healthcare spending…”
“…Methodological issues will need to be considered as data from EHRs become available for research studies of increasing sophistication. Practicing physicians are busy, not necessarily trained in research, and not always ideal collectors of patient data for research. Patients, exercising their right to opt in or out of studies, will cause data to be collected from incomplete, or incompletely defined, populations. Effects like these complicate the design and validation of research results. But the availability of data in quantities orders of magnitude larger than today will allow subtle and sophisticated experimental designs, more than compensating, we think, for the data’s complexities.”
While I’m a total advocate for point-of-care HIT availability, use of HIT for CER seems to me of perhaps equal importance. Say so.