Health IT innovations that marked 2011 continue to roll forward


To anyone involved in the health IT industry, the acceleration in the pace of change over the past year has been unmistakable. Among the major drivers of this change were the HITECH Act incentives for Meaningful Use of electronic health records, the federal grants to states for health information exchanges, and the other initiatives of the Office of the National Coordinator for Health IT (ONC). But government action was only part of the story. Equally important was the efflorescence of private-sector initiatives and technological innovation.

Perhaps the most significant and disruptive innovation was the rapid growth of mobile health. Employing devices such as smartphones and iPads, professional and consumer mobile applications have sprouted in every nook and cranny. According to one survey, 80 percent of physicians used mobile devices in their daily work, and 40 percent of hospitals supported the use of personal smartphones and tablets.

Meanwhile, mobile health applications mushroomed to meet consumer demand. Many were health and wellness apps, some of which were written for specialized devices. For example, a company called Wahoo Fitness announced a new mobile heart monitor that transmits data on a user's heart rate and the number of calories they are burning wirelessly to their iPhone via Bluetooth.

Mobile devices also were increasingly being used in remote patient monitoring. For example, Flagstaff (Ariz.) Medical Center began giving discharged patients with congestive heart failure a kit that includes a smartphone, software that transmits monitoring data, and digital devices that include an oximeter, a blood pressure cuff and a scale. This kind of approach promises to make remote monitoring more effective by allowing users to send data outside the home and without the use of landlines.

Social media did not have the same impact on healthcare as it had on other areas of society. This was largely because physicians, for legal and ethical reasons, preferred not to go on Facebook or Twitter with their patients. However, HealthTap, an "interactive health network" that allows patients to ask physicians medical questions online, began to gain traction. Claiming 6,000 physicians as participants, HealthTap avoids legal pitfalls by having doctors answer only general questions.

On the provider side, medical images rapidly moved to the cloud in 2011 as greatly expanded storage capacity and bandwidth reduced the cost of storage and increased the speed of downloading diagnostic-quality images. The clinical importance of this development will undoubtedly grow as health information exchanges spread.

Partly because of the evolution of population health management in the healthcare industry, clinical decision support (CDS) applications started to emerge from obscurity during 2011. For example, Allscripts integrated the CDS solution of DiagnosisOne into its EHR to provide real-time alerts to providers about their patients' care gaps. GE Healthcare promoted a similar application called Qualibria that it co-developed with Intermountain Healthcare in Salt Lake City. But a KLAS report said that many CDS applications in hospitals remain insufficiently integrated with EHRs and clinical workflow.

Some of the most interesting trends that began in 2011 have yet to bear fruit. Several companies, for instance, seek to apply IBM's Watson technology in healthcare. Nuance Communications is working with the University of Pittsburgh Medical Center to develop a form of natural language understanding that could be used to transform physician dictation into discrete data in an EHR. At the very end of the year, WellPoint announced a collaboration with Cedars-Sinai Medical Center's cancer institute to create a Watson-based CDS application that may someday help inform oncologists' diagnostic and treatment decisions.

All in all, 2011 was a spectacular year for all types of health IT innovations, and 2012 promises to bring even more wonderful inventions that could benefit patient care and wellness. - Ken

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