HHS' Bryan Sivak: We're still at the same tip of the iceberg for health data analysis

U.S. Department of Health and Human Services Chief Technology Officer Bryan Sivak believes that, despite all of the strides made in health IT over the last few years, data collection efforts have hit a lull.

"One thing that's struck me ... is that we're still at the same tip of the iceberg," Sivak (pictured right) said during a panel discussion at the mHealth Summit just outside of the District of Columbia on Wednesday. "My Fitbit and Misfit [Shine] and Jawbone and other devices basically do exactly the same stuff with none of the additional analysis that I think is needed to actually make these things much more useful for helping others live a better and healthier life."

To remedy that issue, Sivak said five topics must be addressed, including:

  1. Data ownership: "I think it's a big question: Who owns the data we generate?" Sivak said. "Is it the manufacturers of the devices? Is it the institutions that hand us the devices that want us to collect data? Is it the individual themselves?"
  2. Privacy: HIPAA's reach for securing data is limited to patient clinical information, Sivak said. "There need to be some rules thought about for privacy and around some of this data in order to make data flow much more seamless and in a frictionless way."
  3. Data types and standards: To use self-generated data in a clinical setting, it's going to be very important to understand what the differences are between devices and their functionalities, according to Sivak. "If we're looking at cohorts of populations, if we're looking at differences between people, we need to be able to analyze the data in a very similar way," he said.
  4. Incentives: Data shows that people who get one of these devices use it, on average, for about three weeks, Sivak said. So what are the incentives for using them? "Obviously one of those is better health, but that means that we need to figure of analyzing the data to help people get to better health."
  5. Clinician design: "I've talked to a lot of doctors about this," Sivak said. "The most common response I get is, 'I spend all day seeing patients, I go home and spend four hours charting every night, when do you want me to take a look at this constant stream of random data that is going to tell me whether Mrs. Jones is walking enough?' I think that's a fair point."

James Levine, a professor of medicine at the Mayo Clinic, disagreed with Sivak's notion that doctors often are technology averse, imploring the audience to consider the many continuous data channels used in modern intensive care units.

"I think healthcare professionals are actually very passionate about incorporating technology when it helps their patients and when it is effectively integrated into their workflow," Levine said. 

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