Dr. Robert Jesse admires the recommendation engine built into the website of e-commerce giant Amazon.com. Not only can it suggest items to buy based on what a customer already bought, but it also can recommend items based on what other people (whom the customer has never met) bought in the past.
“Why in healthcare don’t we do the same thing?” Jesse asked attendees of the GITEC 2014 Summit in Baltimore.
The principal under secretary for health in the Department of Veterans Affairs noted that the VA has used electronic health records for 25 years, and in a system similar to Amazon.com’s healthcare providers and patients could learn about possible treatments and prognoses based on accumulated information and Big Data analytics. “We would be at the point some day where we can say, ‘Patients who presented like this person today, five years ago the ones who got this [treatment] are doing really well,” Jesse said.
That is because Big Data is coming to healthcare IT, Jesse said, aided in large part by the exploding number of healthcare options, including primary care in Walmart stores and vending machines that can dispense prescription drugs.
“Healthcare really is an information business and the most important thing is that we get coherence of that information,” Jesse said. “Right now, that information is all over the place.
“Where the true innovation is coming is in the reduction of information asymmetry,” he added. In other words, the more information that exists — and the more patients access that information — the brighter the future of healthcare.
Noting a trend in online consumer services that conduct laboratory tests, Jesse insisted the future is not about the lab tests themselves but about the management of information. In healthcare, the gap between knowing something about a person’s health and being able to do something about it is shrinking, but the healthcare industry can only improve upon what it can measure.
Population Health Means Big Data
“Population health, which is also called Big Data, is really a learning tool,” he said. “The ability to look across records is very important as we try and improve the system.”
Comparing a growing array of new healthcare services to Google and Facebook, Jesse said one of the next big challenges for healthcare IT is to be able to create a single health record for every patient that pulls together disparate information, regardless of source, location of service or the service provider. For example, these days patients can attach a blood pressure cuff to their iPads and take blood pressure readings multiple times a day. “Wouldn’t it be nice if that information went somewhere?” Jesse said.
New and innovative healthcare companies would certainly like access to the data. “It’s the health data, which is now still protected, that they’re trying to get access to” and market directly to healthcare consumers, according to Jesse. Moving ahead, patients need to interact with their health information and own their health records.
“Most of healthcare is still a clipboard business,” he said, although the clipboard today is a tablet or laptop. But the definition of primary care — and the ways in which people receive it — is being turned on its head. Although new healthcare services are coming to market, Jesse warns that too many organizations are developing applications and systems that support the existing structure of healthcare as we already know it. And that’s not where the future lies.
“The last thing we need is another electronic health record,” he said. “But the current electronic health record is essentially the digitization of the paper record, and that’s not sufficient to manage the healthcare systems of the future.”