Innovation and Technology for Healthcare (Aneesh Chorpa)

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					Innovation and Technology for
         Healthcare
                        August 18th, 2010


                         Aneesh Chopra
   U.S. Chief Technology Officer & Associate Director for Technology
          White House Office of Science & Technology Policy
A Presidential Commitment to Technology
Healthcare.gov a Model for Simplifying Access to Information




                                                                  Simple interface to
                                                                    access relevant
                                                                       insurance
                                                                 information; pricing
                                                                   data available in
                                                                 version 2.0 launching
                                                                       in October




“My Administration is committed to creating an unprecedented level of openness in
Government…and establish a system of transparency, public participation, and
collaboration.”                              –President Barack Obama, Jan 21st, 2009
Source: www.healthcare.gov; www.whitehouse.gov/open
  President’s Strategy for American Innovation
  Health Innovation an Opportunity for Growth and Efficiency

                 Health IT applications                                                     Catalyze
                 innovation that drive                                                   Breakthroughs
                   lower cost, higher                                                     for National
                   quality, improved                                                       Priorities
                      satisfaction                                            •    Unleash a clean energy revolution
                                                                              •    Support advanced vehicle technology
                                                                              •    Drive breakthroughs in health IT
                                                                              •    Address scientific “grand challenges”

                                                                Promote Competitive Markets that Spur
                                                                    Productive Entrepreneurship

                                             • Promote American exports                              • Encourage high-growth and
                                             • Support open capital markets that                         innovation-based entrepreneurship
                                                allocate resources to the most                       •   Improve public sector innovation
                                                promising ideas                                          and support community innovation

                                             Invest in the Building Blocks of American Innovation
                        •   Restore American leadership in fundamental research
                        •   Educate the next generation with 21st century knowledge and skills; create a world-class workforce
                        •   Build a leading physical infrastructure
                        •   Develop an advanced information technology ecosystem




Source: www.whitehouse.gov , “Strategy for American Innovation”, September, 2009
Technology Approach to Spur Market Solutions
Three Levers to Deliver on the Promise of Healthcare IT
                I                                  II                                 III
     Provider Adoption                 Data Interoperability             Application Innovation

#Meaningful Use Incentive           #NHIN Connect: Open               #Community Health Data
Payments: Flagship Recovery         source standards-based            Initiative: Flagship open
Act initiative offering $20+BN      software to promote federal       government initiative to spur
provider reimbursement for          agency health data exchange       “mash-ups” on health data to
HIT adoption                                                          spur local improvement
                                    #NHIN Direct: Voluntary,
#“Modular” Health IT                consensus driven standards to     #Payment Innovation Center:
Applications: Certification         govern simple, secure data        Estimated $10BN CMS center
program encourages flexible,        transmission over the Internet    focused on shifting provider
innovative approaches to EHR                                          payment based on quality
                                    #“Blue Button”: Simple
architecture
                                    standardized file format to       #Advanced IT Infrastructure:
#Privacy & Security                 allow consumers access to         Strategy to leverage ultra high-
Provisions: Patient privacy         health data on federal websites   speed broadband, mobile
protected by best-in-class          (VA, Dept of Defense, CMS)        broadband, and R&D
electronic data security, and law                                     commercialization
  Incentive Program Tied to “Meaningful Use”
  Health Providers Eligible Based on Demonstrated Use, not Adoption

                               Meaningful Use                       “Deep Dive”
                                          Five Pillars           Patient Engagement

                                   Quality, safety,        #1: Timely access to an
                                     efficiency            electronic copy of your data

                              Patient and family           #2: Clinical summary after
                                 engagement                every visit
                                                           #3: Alerts or reminders for
                                Coordinated care           preventive and follow up care
                                                           #4: Electronic access to patient
                              Improved public &
                                                           specific education resources
                               population health

                               Privacy & security


Source: Office of the National Coordinator for Health IT
  Modular Applications Supported Through R&D
  Open Development Framework to Spur Substitute-Able Apps

         SHARP Grantee - SMArt Apps                                                              Leadership Team




               Harvard researchers focused on                                                  Advisory Council includes
               health platforms (like Indivo) to                                                Professors Christensen,
                 support substitutable apps –                                                  Herzlinger (HBS); Dossia,
               prototypes by 2011; aligned with                                                   Microsoft, Cerner,
                  “modular” certification for                                                    CVS/Caremark, IDEO,
                      “meaningful use”                                                            Anvita Health, etc.


Source: Office of the National Coordinator for Health IT – SHARP program, smartplatforms.org
New England Journal of Medicine, March 26th, 2009
  Privacy & Security Standards Atop the Agenda
  Provider Incentive Payments Tied to Best-in-Class Protections
                                                                 ONC Privacy & Security Tiger Team
                                                           • Deven McGraw, Center for Democracy & Technology, Co-
                                                             Chair
                                                           • Paul Egerman, Co-Chair
                                                           • Dixie Baker, SAIC
                                                           • Christine Bechtel, National Partnership for Women &
                                                             Families
                                                           • Rachel Block, NYS Department of Health
                                                           • Neil Calman, The Institute for Family Health
        Joy Pritts, Chief                                  • Carol Diamond, Markle Foundation
       Privacy Officer for                                 • Judy Faulkner, EPIC Systems Corp.
      Health IT – supports
                                                           • Gayle Harrell, Consumer Representative/Florida
       “Tiger Team” with
                                                           • John Houston, University of Pittsburgh Medical Center;
     recommendations due                                     NCVHS
            8/19/10
                                                           • David Lansky, Pacific Business Group on Health
                                                           • David McCallie, Cerner Corp.
           Topics include                                  • Wes Rishel, Gartner
        consumer choice or                                 • Micky Tripathi, Massachusetts eHealth Collaborative
         consent; sensitive                                • Latanya Sweeney, Carnegie Mellon University
          data; interstate
             exchange

Source: Office of the National Coordinator for Health IT
Nationwide Health Information Network
 Social Security Administration Delivers Early Results
                        Open Collaborative                                                               NHIN CONNECT in Action




                                                                                                            Early Results: mean
                   Quarterly 2-day workshops                                                                case processing time
                     to build code, deliver                                                                   savings of 42% as
                   interoperability solutions                                                                  compared to the
                     at your pace, interest                                                                 Virginia state average



Source: www.connectopensource.org; Using the Nationwide Health Information Network to Deliver Value
to Disability Claimants: A Case Study of Social Security Administration and MedVirginia Use of MEGAHIT
for Disability Determination, Feldman, Horan
  Convening Stakeholders to Accelerate Exchange
  Open Collaboration Delivers Technical Specs in 90 Days
               NHIN Direct Project in Brief          Secure, Direct Communication
                                                                                Clinical info &
                                                                                 summary record
                                                                                exchange
                                                     Doctor        Consultant


                                                                                Receive lab
                                                                                results

                                                      Lab           Doctor


                                                                                Clinical info &
   “A set of policies, standards and services that                               summary record
   enable the Internet to be used for secure and
                                                                                exchange
                                                      Doctor          Hospital
   meaningful exchange of health information
   to improve health and health care”
                                                                                 Provide
                                                                                electronic clinical
                                                                                summary
   SMTP-based specs for all providers; intended       Doctor          Patient
     as a stepping stone to NHIN Exchange



Source: www.nhindirect.org
  “Blue Button” to Liberate Personal Health Data
  Previewing New Tool for Veterans, Medicare Recipients this Fall




“…veterans will be able to go to the VA website, click a simple “blue button,” and download or
print your personal health records so you have them when you need them and can share them
with your doctors outside of the VA.”                 –President Barack Obama, Aug 2nd, 2010

Source: www.va.gov/open; www.mymedicare.gov; http://www.whitehouse.gov/the-press-office/remarks-president-disabled-veterans-america-conference-atlanta-georgia
  The Birth of an Open Government Ecosystem
  HHS Launches Community Health Data Initiative (CHDI)




           HHS launches CHDI June 2nd -                                                                  Example: Microsoft
              demonstrating 20+ apps                                                                announces Bing Health Maps
            recently built or improved by                                                              and the incorporation of
           innovators across the country                                                             “Hospital Compare” data in
          using data HHS has made public                                                              search results – “bringing
             (with much more to come)                                                                      the data to you”




Source: Community Health Data Initiative, Department of Health & Human Services; www.hhs.gov/open
   Helping Our Children Make Healthier Choices
   Prizes Policy Spurs USDA to Reward Apps Developers




                          95 qualified apps built on
                         data that feeds USDA site –                                                             Sample App: Smash Your Food™
                           judges include Zynga’s                                                                lets children see foods explode -
                              CEO, “Woz”, GE’s                                                                   while learning how much sugar,
                          Healthymagination lead                                                                      salt and oil are in them


“The Apps for Healthy Kids competition challenges… the most creative, talented,
and kid-savvy innovators across the country to build games that inspire and
empower kids to get active and eat healthy.” –First Lady Michelle Obama, March 11th, 2010

Source: www.appsforhealthykids.com; http://www.healthgameschallenge.org/ ; http://apps.usa.gov/myfood-a-pedia/
    Delivery System Reforms Powered by Payment
    “Pay for Value” Models Rely on More Robust Tech Infrastructure
                                                                             Implications for Tech

                          Community based; will drive greater             Data Driven: Democratize
      Patient Centered    organization of outpatient care, coordination   access to data mining/analytics
1     Medical Homes       and team-based approaches
                                                                          Care Integration: Centralize
                                                                          patient data, track
                                                                          performance (cost and
                          Shared savings (primary, specialty care);       quality), and analyze case mix
     Accountable Care     Redesign care processes for high quality,
2     Organizations       efficient delivery; vertical organization       Clinical Transformation:
                                                                          Provide physicians with
                                                                          standardized and timely data
                      Pilot program for episodes of care;                 needed to make clinically
3    Bundled Payments incentivizes reduced costs around eight             effective decisions and reduce
                      conditions                                          care quality variation

                                                                          Capacity Building: Extend
                          Motivates hospitals to engage with care         physician reach
       Readmission        coordinators and better organized delivery
4       Reduction         systems
        Programs
Unleashing a Mobile Broadband Revolution
FDA-FCC Announce Collaboration on Wireless Medical Devices


                                                  FDA - FCC Joint
                                              Statement outlines five
                                                   principles of
                                                 collaboration to
                                               facilitate innovation
                                             while protecting patients

                                                                                                                  Innovations: Text4baby
                                                                                                                    partnership serves
                                                                                                                   50,000+ moms since
                                                                                                                  02/10 launch; Secretary
                                                                                                                    Clinton announces
                                                                                                                   Russian collaboration



“[I] commit the Federal government to a sustained effort to make available 500
MHz of Federal and commercial spectrum over the next 10 years to foster
investment, economic growth…”              –Presidential Memorandum, June 28th, 2010


Source: text4baby.org; http://hraunfoss.fcc.gov/edocs_public/attachmatch/DOC-300200A1.doc; http://www.whitehouse.gov/the-press-office/fact-sheet-doubling-amount-commercial-spectrum-unleash-innovative-potential-wireles
  R&D Tech Transfer Programs to Close “Lab Gap”
  Commerce Department’s i6 Challenge to Find Next iRhythm

  Commercialize University Research                   Spinoff Pursues Health IT

                                      DOC/EDA
                                          $6M




           NIH                                  NSF
          $3M                                   $3M
                                                         iRhythm, spun out of
                           EDA grant program
                                                       Stanford, designs low-cost
                         focused on community
                                                        device to enable cardiac
                              innovation
                                                        rhythm monitoring and
                          ecosystems; winners
                                                      expand market access to care
                            announced 10/10



Source: Department of Commerce; iRhythm
“All Hands” - Health 2.0 Developer Challenge


                                                         A growing number of
                                                       “challenges” leading up to
                                                      Health IT Innovation Week –
                                                          October 3-10th, 2010




                                   WWHI catalyzes innovation -
                                     $10K for a personalized
                                    wireless health ecosystem;
                                   sponsors “Innovation Day”–
                                      highlighting Veterans
                                   Healthcare (VAi2) – 10/12/10




Source: www.health2challenge.org