Fierce Q&A: Technology is 'ubiquitous' in healthcare

The Institute of Medicine recently released a discussion paper in which 11 executive leaders from leading hospital and healthcare systems throughout the nation--including the Cleveland Clinic, Partners HealthCare, Kaiser Permanente and Intermountain Healthcare--shared their top 10 strategies for transforming the industry. The use of technology was a common theme on the list, but according to Lucy Savitz, Ph.D. (pictured), director of Research and Education for the Institute for Health Care Delivery Research at Intermountain, it's importance could not be overstated.

"Technology is ubiquitous in healthcare," Savitz, who helped write the paper, told FierceHealthIT in an exclusive interview. "What we really need to continue to do is figure out how to have the IT world and the healthcare delivery world work together as partners."

Savitz spoke to us specifically about some of the more prominent technologies making waves in the industry. She added that while in the past, information officers and their staff would work almost completely independent of clinical teams, now we're starting to see real traction in working together as a team.

FierceHealthIT: It looks like EHRs accounted for a good portion of the health IT quality stories listed in your report; what do you think that says about the direction we're headed in with regard to efforts like Meaningful Use?

Savitz: First and foremost, when we rely on data that comes from the clinical interaction, we don't use that data directly from the EHR. So the IT architecture of the delivery system has to be enabled in a way, regardless of whether they use electronic data warehouses, where the data is pulled together and can be used in some kind of relational file to do some of these analyses. Outside of the direct clinical decision support, where a physician is making an order, where there's sort of an event monitoring surveillance system that's put in place on top of the EHR, most of this stuff happens outside of that direct clinical architecture. It's happening in an electronic data warehouse.

I think that's the piece that people need to know and understand. For some of these more sophisticated applications where you're looking at, for example, population health management, where you're looking at supporting some of these newer applications like an accountable care organization, you really need a data architecture that supports that above and beyond the EHR. The EHR is one source of information that feeds into that. There are other sources, and I think we're really on the precipice of figuring out how we address issues like patient reported outcome measures.

FHIT: Open data has been a hot topic of late. Could you talk about the potential of open data for the industry?

Savitz: There are protections and regulations that have previously been put in place that, at the time they were adopted, made sense. But it's time to revisit them. It's time to revisit them to think about 'how do we provide the right care to the right person at the right time.'

One of the things we know is important is that, outside of an integrated delivery system like Intermountain, where you have a fairly stable population, there is a fairly fragmented delivery system. The medical clinics are not necessarily connected to the hospitals or the rehab facilities. So the ability at a community level to connect that information in a seamless way, and what we're seeing as we're transforming and thinking about managing a population health wellness is we really need to think about community-based organizations--schools might be important connection points.

Think about home monitoring of patients, particularly congestive heart failure patients. They tend to be frequent flyers and they get readmitted to the hospital frequently. Wouldn't it be better if there was a direct connection with a scale, for instance, so we could get direct feeds on changes in their weight? A medical team could be monitoring that and determining when they need to come in for a clinic visit. That would avoid a hospital admission, which would be a good thing for everybody.

FHIT: Going forward, what role do you envision mobile technologies playing in maintaining high health quality?

Savitz: In terms of the mobile applications, we haven't even touched the surface of the potential that exists there. I had the opportunity to attend a think tank meeting funded by the National Science Foundation a few months ago that was very interesting because there were several experts who got up and talked about this nature of ubiquitous feeds basically, and how this could be particularly helpful in managing chronic conditions. One of the examples they were using was, they looked at the technology that's available today that elite athletes use in their training, with heart rate monitors. They showed applications that had been piloted in California for example, of an asthmatic woman who, on her iPhone, would get an alert when the air quality was poor so she didn't go out running.

You could get weight, heart rate, blood pressure data; there's a lot of information you can get with these tools. I don't think we're anywhere near scratching the surface of using that technology. I think the younger generation is even more adept at it and more accepting of that.

This interview has been edited and condensed for clarity.


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