CITIH 2011 Summit:CITIH 2011 Summit: Wrap-upApril 18 2011April 18, 2011

Tremendous opportunity for collaboration at the intersection of HIT, Biomedical Informatics, , ,Government, and Industry

L d hi d i ti i thiLeadership and innovation in this space will require constant adaptation and the formation of multi disciplinary teamsmulti-disciplinary teams

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Improving Healthcare Quality with HIT

Challenges are not primarily technology relatedTransparency and innovation are critical to addressing quality and p y g q ysafety of careDiscussions of HIT in the context require a broader aperture

Beyond the EHRy

CDSS is both an opportunity for improving care, but also a major barrier in terms of provider/staff acceptance of HIT platformsData ≠ information ≠ knowledgeData ≠ information ≠ knowledgeRe-engineering of the healthcare delivery system requires a systems-level approachT i i d d ti d t d t t th iTraining and education programs need to adapt to the emerging information and knowledge-centric, team-based approach to healthcare delivery that is emergingAll of the above items have major socio cultural implicationsAll of the above items have major socio-cultural implications

Balance of power between providers and patients

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Creating a Learning Healthcare System (1)

There is a need for a comprehensive approach to creating learning healthcare systems

TechnologyTechnologyWorkflowBusiness Models (pay for value, sustainability)Education

There is an increasing demand to “liberate” dataReduce barriers between producers and consumersFormat and structure of data is a major factor

Economic model for learning healthcare systems is constantly shifting

Data, information, and knowledge overload is a major barrier

We must create a “Trust Fabric” spanning all major stakeholdersWe must create a “Trust Fabric” spanning all major stakeholdersIT culture is not uniform (e.g., IT professional may use the same language, but viewpoints differ by professional home)

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Creating a Learning Healthcare System (2)

Challenges regarding the balance of public and private good are not unique to healthcare

We must engage in the national policy discussion on this topicWe must engage in the national policy discussion on this topic

To realize the benefits of a learning healthcare system, do we need to?Standardize customization of EHR platforms; orCustomize the standardization of EHR platformsCustomize the standardization of EHR platforms

Real benefits and business model for the learning healthcare system will likely be indirect

Indirect Return on Investment (ROI)( )

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Health Information Exchange (1)

Thinking about HIE in the context of “tribes”“…people who care about healthcare but don’t necessarily talk to each other ” (Brammer 2011)other… (Brammer, 2011)

Major stakeholdersPayment reformersConsumer energizersConsumer energizersHealth IT champions

ONC is driving a significant portfolio of initiatives to catalyze HIE development and innovation

Requires active participation by stakeholders!

How do we benefit from HIE’s beyond core clinical use cases?Challenges surrounding data ownership, stake-holder concerns, and regulatory f kframeworksCan current secondary use models that extend beyond immediate care delivery and billing be upheld in the courts?

Sustainable, reproducible business models remain a challengeSustainable, reproducible business models remain a challenge

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Health Information Exchange (2)

Ongoing and vigorous discussions concerning opt-in or opt-out models of participation

How to provide sufficiently understandable information regarding choices toHow to provide sufficiently understandable information regarding choices to potential participants?

Patient identity reconciliation is a major challengeNo perfect algorithms, but many well established best practicesp g , y pNeed to ensure the perfect does not become the enemy of the good

Variety of technology and data management models being usedData transport and deliveryp yData storage/retentionHybridsNeed to address needs of community-based, primary care providers

P ti l l ith d t i f lParticularly with regard to meaningful use

Need to better understand stakeholder motivation and value propositions in order to make HIE participation successful and sustainable

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Thanks To All Of OurThanks To All Of Our Speakers and Panelists!

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Thanks Again to Our Sponsors!

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Thank you for attending CITIH 2011 http://citih.osumc.edu/Save the date for CITIH 2012

4/16/2012

Please remember to complete your attendee surveysPlease remember to complete your attendee surveysPlease join us for a networking reception!

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