Envisioning a digital infrastructure for a Learning Health System
I wonder whether the author of the Healthcare Technology News blog post called “Think Differently – the sequel” thinks that the ONC and their PCAST Workgroup is actually “Thinking Differently”? Â Though it was a good summary of the PCAST HIT Report and the PCAST Workgroup Report released in mid-April, the blog suggested this was thinking differently. Â Would Steve Jobs (Mr. Think Differently) say that they are thinking differently? Â I think not. Â Certainly PCAST thought differently when they published their treatise about health information exchange; however, the ONC and its delegates in the HIT Policy Committee are constrained by legacy thinking. Â How do we best go from where we are now to there? Â That’s legacy thinking and that’s what ONC is doing with the PCAST Health IT Report.
The Biomedical Informatics Think Tankâ„¢ thinks differently: that knowing where we are going does not require knowledge of where we are, but only what we want to be able to do with this new exchange architecture. Â We are conceiving a technology that will create a Health Data Cloud (see my latest blogs:Â Why Build a Health Data Cloud andÂ A Health Data Cloud is a Powerful Tool for Health Research), which will attain the objectives set out in the PCAST Health IT Report:Â Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward:
The technology will be based in the latest thinking with a mathematical foundation for medical semantics, privacy and security in a cloud, social networks that empower individuals, and health ontology. Â We start our thinking with what we want and think about the best way to meet those needs with technology that will serve us for a long time into the future. Â That thinking is not constrained by current ideas about EHRs and time frames to get new technology standards implemented, a clear constraint of the Health IT Policy Committee’s PCAST Workgroup. Â We will be part of a transformation health information exchange through our efforts, just as Apple has been part of the transformation of personal computing since the 70′s. Â We think differently, and we invite you to think differently with us.
Here’s some different thinking: ONC should invest in a major effort, exceeding the scale of The Human Genome Project (HGP), to define a New Exchange Architecture with a Universal Exchange Language, and then they can actually build and manage the Health Data Cloud that will be required. Â This is just as important as the HGP, and in fact, a continuation of the personalized medicine movement that is partially driven by the results of the HGP. Â The HGP cost taxpayers $2.7 billion (HGP Frequently Asked Questions, Oct 2010) and much more was contributed by international government agencies from the UK and other countries, as well as by private and non-profit organizations towards this same goal. Â HITECH put ten times this amount, $27 billion into motivating healthcare providers to move into the 21st century of health IT and electronic health record technology. Â Only 10% of this funding could transform with a New Exchange Architecture.
Let’s think differently!