connecting dots: how open data, payment reform,...
TRANSCRIPT
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@aneeshchoprawww.innovativestate.com
Connecting Dots: How Open Data, Payment Reform, and Consumer APIs
will Accelerate Precision Medicine
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Connecting Dots ~ Payment Reform, Open Data1
2 The Emerging “Connected Apps” Era
3 Implications for Precision Medicine
Agenda for Discussion
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David Van Sickle collaborates with Mayor Fisher (Louisville) to micro-target air quality improvement opportunities; patient inhaler GPS data informs action to lower particulate matter
10%; results in 27% reduction in asthma risk area
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Democratize Government Data via Open APIsFrom Jefferson to Health Datapalooza
On July 4, 1776, the weather in Philly was
clear and mild with a high of 76 degrees
Source: http://celebrating200years.noaa.gov/foundations/climate_data/image1.html; healthdata.gov; iTriage
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Source: https://innovation.cms.gov/initiatives/Million-Hearts-CVDRRM/; https://millionhearts.hhs.gov/data-reports/data.htm;
Medicare Reporting CoverageCMS EHR Incentive Program 2011-2013
Connecting the Dots on Care Delivery Reform“Million Hearts” campaign invokes open data, connected apps, pmt reform
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Medicare Program Reveals The Challenge AheadACOs incentivized, but not wired up to close feedback loops
~40% of hypertensive patients (~4500 in one Medicare ACO) received their last E&M visit
of the year at an out-of-network provider
Widespread variation across physician practices in the percent of hypertensive patients with the last visit of
2015 out of networkSource: NavHealth
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PG&E’s CIO leads industry adoption, scaling through national movementThe Emerging “Connected Apps” Era
Source: http://energy.gov/eere/sunshot/sunshot-initiative ; http://www.pge.com/en/myhome/addservices/sharemydata/customers/index.pagehttp://www.pgecurrents.com/2012/08/14/pg-topic-is-dealing-with-data-that-comes-with-smart-grid/
“Chevrolet Volt…led to his developing the app...in…three months…his electric bill reduced an average 20 percent;” one of 50 registered apps with open access to customer energy data without fees or IP constraint
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Hoover’s “Associative State” model boosts nascent air sector
Source: http://history.nasa.gov/SP-4219/Chapter1.html;
After dramatic reduction in aircraft manufacturing following WWI, then-Secretary Hoover encourages industry collaboration on engine, wing standards, commercialized on popular DC-3, Boeing 247
Convening the Private Sector on Standards
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“All-in” Embrace of Open APIs for Data ExchangeRegulations, industry response aligned on technical capability
Source: argonautproject.org; healthIT.gov; https://www.healthit.gov/policy-researchers-implementers/health-it-legislation-and-regulations; http://www.vita.virginia.gov/Library/default.aspx?id=6442474293
“The purpose…is to rapidly develop a first-generation FHIR-based API and Core Data
Services specification…based on Internet standards and architectural patterns and styles.”
“…a system in which the consumer has access to his or her own information in a format that can be
used and re-used,… may be the highest-value approach to transferring account…information from
one Exchange to another.”
Section 1561 of the Affordable Care ActTechnical Recommendations (2010)
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Opening Up While Locking Down
Source: The Ponemon Institute, “Fifth Annual Privacy and Security of Healthcare Data Report”, May 2015
“Built-in” Security–APIs enforce a consistent protection mechanism across all
channels with built-in authentication, authorization, and threat protection
API-first approach to facilitate controlled access to data
1
2 Single point of “truth” for connected mobile, web apps
3 Real-time analytics to monitor use vs. shipping “blind” flat files
API vs. “Point to Point”
“API-First” approach adds security protection by monitoring use
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Entering the “Burger King” Era – Have it Your Way!Hackensack Meridian tests many digital paths for patient data access
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Enable consumers to assemble their health data regardless of care setting
Implications for Precision Medicine
“MeTree” Assessment Tool: Duke Center for Applied Genomics and Precision Medicine expands the traditional “data model” by running deeper on family history, among other topics, to better understand risk
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Source: http://syncfor.science
“All of Us” Sync-for-Science initiative paving the way on methodEnabling Consumer-Directed Enrollment “Apps”
“All of Us” Initiative: Health systems contracted by NIH to enroll 10,000 participants – inclusive of EHR, claims, assessment data; emphasis on the entire HIPAA-regulated “designated record set”
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Source: Basepair.io; https://www.ncbi.nlm.nih.gov/clinvar/
ClinVar collaboration model enables lower time, cost to insightEncouraging New (Digital) Services
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“Digital Health Advisor:” a tech-enabled service that provides patients advice about how to maintain their health, respond to health concerns, deal with insurance and financing
questions, choose providers, and manage their own condition
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@aneeshchoprawww.innovativestate.com