The ITDotHealth Conference

Today, I participated in the ITDotHealth Conference in Boston, discussing one simple question with a selection of the nation's EHR and PHR experts :

How we can best innovate/change our EHRs while also operating them to transact daily patient care?

Here's what I suggested:

1.  Federal

Meaningful Use Stage 3 is likely to include bidirectional exchange between patients and providers to ensure patient generated data is incorporated into EHRs.  It's also likely to include federated query capability (see Query Health for details) supporting quality measures, population management, and public health.    Meaningful Use Stage 2 requires many core interoperability features including 1) specific implementation guides for content, vocabulary, and transmission standards supporting transition of care exchanges among different vendor products 2) patient view/access/download/transmit and 3) ability to export summary records to aid in migration from one EHR to another.    Combine,  these requirements will create a new level of data liquidity which will inspire new modular "apps" that supplement core EHR functionality and will even be used in the certification process to fill gaps in EHR capabilities.

2.  State

Next month, Massachusetts goes live with a Statewide HIE that includes a comprehensive provider directory, Public Key Infrastructure trust fabric, and gateways supporting the Direct protocol.   Payers, Providers, and innovative third parties companies (including those which connect to patients) can all participate in data exchange as long they are trusted members of the community which sign the participation agreement and follow HIE security/privacy policies.   This ecosystem will result in many new innovative applications that leverage the frictionless data exchange to create value added services for all stakeholders.

3.  Local

BIDMC and its affiliated practices are preparing for the globally capitated future of medicine by embracing healthcare information exchange, analytics, and patient/family engagement.  We serve as the pilot site for many Federal, State, and Accountable Care Organization initiatives .   To us, innovation is a requirement for success.  Without a foundation of data liquidity, we cannot survive in a healthcare reform world.

My colleagues on the panel offered their own insights into the future of iPhone-like application platforms that extend the capabilities of EHRs by offering bidirectional interfaces and APIs to the thousands of agile start ups eager to change healthcare.   A great conference.