Mind to Market

Friday, December 17, 2010

PCAST on Health IT

The President's Council of Advisors on Science and Technology (PCAST) has recently published a report to the White House on the impact of Health IT on Healthcare. PCAST is an esteemed group of appointed scientists and engineers whose mission it is to provide an unbiased assessment of matters technical and scientific.

PCAST's report comes at a crucial time in U.S. healthcare; after the passage of legislation (the Patient Protection and Affordable Care Act, PPACA and HITECH) intended to save healthcare and jump start health IT. This report provides a vision of healthcare in the near future; what obstacles prevent us from getting there and what should be done to surmount those obstacles.

There are a number of good use cases in the report that provide some very compelling arguments for better health IT and how it would benefit the population. It is not surprising that these use cases require that medical information be exchanged between healthcare providers, i.e. an exchange of a patient's information between hospitals and doctors. At this point, however, the government has not actually specified a standard language to be used. In this report, PCAST is recommending that the government step in and explicitly state those standards.

As in most silo'd industries, healthcare organizations cannot exchange information between organizations because each uses their own flavor of healthcare terminology. This is nothing new and many Standards Development Organizations (SDOs) have been working on interoperable healthcare terminology for some time, i.e. ISO, HL7 and IHE to name a few.

PCAST is advocating for health information to be represented as "meta-data tagged data elements" "some kind of extensible markup language (an XML variant, for example)." This is in contrast to the message and document structure used in current information exchanges. Information represented in this way would provide more flexibility, and security, than current methods.

Although it is never explicitly referred to in the report, this method of representing data starts to look like the semantic web technology of RDF. Indeed, one of the use cases could be taken as a vision of what the semantic web could do. One very compelling aspect of this method is the lack of a central data repository, that the data would be assembled from distributed sources as needed, reducing the huge effort of assembling and maintaining such a repository, not to mention the security aspects.

HHS has made a great effort in pushing through the first stage of the HITECH Meaningful Use Criteria which is to be implemented in 2011. They are now poised to move forward with stage 2. PCAST has laid down a considerable challenge but one where as patients, we could start to see some real improvements in our healthcare.

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