Last week I was fortunate enough to attend New York eHealth Collaborative’s Digital Health Conference 2013 in New York City. The hustle and bustle of New York still amazes me- how can there be this many people in one space? Why are all 8 million New Yorkers headed to Penn Station at the same time? This wild and beautiful city is a magnet for all types of industry, so it’s no surprise that it’s a hotbed of digital health technology innovation. I had 48 hours to absorb as much as possible.
While my boss probably sent me with the purpose of evangelizing the idea of telehealth at each opportunity, I spent much of my time in wonderment of the brilliant (and often bizarre) world of health information exchange. Here we are on the cusp of 2014, the golden age of instant global communication- it seems there is literally nothing you cannot find on the internet- and yet, there is a tremendous deficit in the field of healthcare informatics.
While your health information belongs to you, it’s not exactly central to you- it’s fragmented and scattered in all sorts of places: static paper medical records, home-grown and incompatible electronic medical records, a revolving door of health insurance carriers, community pharmacies, and medical centers that may not communicate with each other. Often, information is just missing. It’s like your three year old dumped a puzzle on the floor, fed some of the pieces to the dog and scattered the rest of the pieces around the house. This puzzle holds the key to your best health, and collectively, holds the key to massive longitudinal health data that has the potential to spur unknown medical and technological breakthroughs.
New York eHealth Collaborative (NYeC, pronounced “nice”) is tackling this through the development of the Statewide Health Information Network of New York (or SHIN-NY, pronounced “shiny”). This is a network of health information that is shared by New York hospitals, private practices, nursing homes, clinics, and pharmacies that have chosen to join this information hub to facilitate health information exchange. What does this mean to you? NYec says it best:
“The patient returning to her family physician for follow-up care after a trip to a radiologist will not need to make any phone calls to request a copy of her results. Neither will her physician. The patient will not need to remember to have images or lab results sent, nor will she need to carry her own records to different doctors by hand. Her primary care physician, when securely connected to the SHIN-NY, will have complete, accurate, and private access to the information carefully gathered by each one of the specialists the patient has visited. Fewer mistakes will be made, fewer tests repeated, and money and time will be saved on administrative details. Most importantly, the patient and doctor will have more time together to discuss treatment options and recovery.”
The ingenuity of the SHIN-NY lies in one of its core features- it has an Application Programming Interface that allows software engineers, academics, and entrepreneurs to develop some truly innovative tools utilizing the robust data contained in the network. Throughout the conference there were untold numbers of innovators discussing their research and development of applications that deliver better disease management systems, high-tech visualization tools, analytical applications, and many more clinical health tools that were either too theoretical or nuanced for me to describe in any detail here. The opportunities for innovation are truly limitless, and to-date over 20% of the people in New York have given consent to have their information contained in the network.
While the idea of integrated health is not revolutionary, the practice is. Perhaps the best example of a highly functioning clinical network currently in existence is Kaiser Permanente, headquartered in California. Now, part of me feels I should own up to my personal bias towards Kaiser since I was a Kaiser patient for several years right out of college- my healthcare was top-notch and cheap– but I think my fondness is solidly just. Not only was Kaiser a pioneer of electronic medical records, they are the largest private sector electronic medical record system in the world and the largest nonprofit integrated health system in the nation with almost 9 million members.
To my sheer delight, George Halvorson, who served as Chairman and CEO of Kaiser Permanente from 2002-2011 was the keynote speaker on the first day of the conference (I know, I need to get out more). I already knew, as many in the healthcare industry do, about Kaiser’s delivery model and its benefits. What I did not know was how much data mining could be done in a vertically integrated delivery system that has a world-class electronic medical system. Kaiser has mountains upon mountains of longitudinal, real-world health information. With this information Kaiser has cut HIV death rates in half, improved heart disease survival, reduced the rates sepsis and pressure ulcers, and reduced the number of broken bones in the Kaiser population. Kaiser has made health information useful, actionable, and has truly improved the lives of its members. At the end of the day, isn’t that the goal?
I do have one question for Kaiser: Those e-visits you promote as an alternative to steep in-office visits, are they high-definition video visits on your iPhone?