The Mason Center for Health Information Technology performs research with its affiliates to introduce new policy, applications, architectures and systems into the healthcare arena.
Our current healthcare system — actually a system of systems — is largely transaction-oriented, with record keeping managed by the providers; there is a pressing need to move to Electronic Health Records (EHRs) and to provide applications, architectures and services that allow vital patient-oriented information to flow to those in charge of the patient’s care. This process will not be an easy one, because the players want to maintain control of their records, e.g., medical files at doctor’s offices, prescriptions at pharmacies, x-rays at imaging labs, MRIs at hospitals, and insurance claims and payments records at insurance companies.
Although some portions of the system are automated, they are comprised of heterogeneous and proprietary systems that are institution specific, and use heterogeneous data formats and proprietary standards. These systems have limited data sharing capabilities, nor do they interoperate effectively. The current data ownership model, coupled with privacy and security concerns, prevents the widespread sharing of information to support the primary healthcare consumer, the healthcare patient.
A number of studies point the way towards a new vision and architecture for healthcare in the U.S. A recent report from the Robert Wood Johnson foundation identifies several areas in which IT can have a major transformational impact:
- Electronic Health Records (EHRs);
- Health Information Exchanges,
- eHealth Initiatives, and
- Quality Measurement and Reporting.
The concept of “data liquidity” promotes the aggregation of information, primarily EHRs, prescriptions, and medical images, to improve patient care. The aggregation of vital patient data is crucial for informed, timely and collaborative decisions regarding patient care.
Initiatives such as Google Health and Microsoft’s HealthVault that allow patients to create their own health records are moving in this direction. However, one factor that is inhibiting the sharing of information is the need for trusted and secure data exchange. This remains an important challenge.
The Internet is revolutionizing healthcare! The characteristic silos of proprietary health data and information are emerging as new portals of standardized terminology, shared data and integrated electronic healthcare applications.
The architectural transformation initiated by the Nationwide Health Information Network (NHIN), also dubbed the “Health Internet”, is being realized with health information architecture research into data schemas and technical solutions that support the technology platform integration of an entire health community: practitioners, healthcare institutions, public health entities and other stakeholders.
As the volume of data captured, stored, and used electronically increases, it imposes new scalability and quality-of-service requirements. There is a need for flexible service-oriented architectures; multi-tiered analysis platforms; and object-oriented services for data and applications that integrate and organize data (and services) around patient needs. This demand requires better data liquidity, bringing relevant information to decision-makers just-in-time, and analytics to leverage application flexibility and scalability in the capture, storage and analysis of data for a higher level of data service integration. This new architecture will improve population health by improving healthcare quality, health status monitoring, and accelerating the dissemination of evidence.