JASON report: 'Learning health system' must go beyond EHR interoperability

The healthcare system needs to focus on health of individuals, not the care they receive, to create a culture of health, according to a new report from JASON, an independent group of scientists that advises the U.S. government on science and technology.

The report, "Data for Individual Health," builds on JASON's 2013 report on robust data infrastructure.

The new report, prepared in partnership with the Agency for Healthcare Research and Quality and the Office of the National Coordinator for Health IT, with support from the RWJF, states that the ultimate goal is to achieve an "agile, national-scale 'Learning Health System' for identifying and sharing effective practices of care." EHRs and personal health records would be augmented with other information. Strategies to meet this goal include improving data exchange among a patient's healthcare team, leveraging the work of focused nonprofits, such as AARP, developing reliable indices of health and community and allowing a "nimble" regulatory environment.

The report makes several recommendations, including building upon ONC's interoperability roadmap, having the U.S. Department of Health and Human Services adopt standards and incentives to allow data sharing, supporting proposed open API standards and including training in health informatics as a part of provider accreditation.

"A robust data infrastructure that can enable a 'Learning Health System' requires the ability to ingest all the data, keep the data safe, understand it, integrate the data, and communicate the knowledge gained," the report states. "This concept requires scalability that goes well beyond the interoperability of EHR systems."

A Health IT Buzz blog post by National Coordinator Karen DeSalvo touting the report reiterates the need to expand the concept of health beyond physicians' offices. "If we're to have an accurate picture of health, we need more than what is currently captured in the electronic health record," DeSalvo writes.

The report may be a glimpse of ONC's priorities in future years, now that the Meaningful Use program has used up much of its funding and come under increased fire regarding its usefulness in a post-Meaningful Use era. DeSalvo recently noted that ONC intended to expand its sphere beyond EHR adoption into other efforts, such as incorporating patient-generated data.

To learn more:
- read the JASON report (.pdf)
- here's the blog post