Healthcare systems in the USA and in many other countries around the world, are not working, and the members the Biomedical Informatics Think Tank(c) also called BITT(c) want to do our part to provide real solutions.  With extensive experience in biomedical informatics including health informatics and analytics, clinical research informatics, and bioinformatics, we think that many of these solutions are based in improvements in the health IT infrastructure. I envision a digital infrastructure that supports the Learning Health System concepts as defined by the Institute of Medicine.
“…a learning healthcare system in which each patient care experience naturally reflects the best available evidence, and, in turn, adds seamlessly to learning what works best in different circumstances.”
(Also see their report Digital Infrastructure for the Learning Health System: The Foundation for Continuous Improvement in Health and Healthcare: Workshop Series Summary and their Series on the Learning Health System).
Envision a health system that is personalized (i.e. individual-centric vs. patient-centric) with a focus on prevention and health information privacy. Â Envision a health system which minimizes the number of people who need to see a doctor, show up at an emergency room, need admission for surgery, or even require medication. Envision an individual having various touch points through which they can learn to become healthier individuals, through their churches and other community organizations, as well as through mobile phone apps, social networking, and, of course, their family and primary care provider. Consider that BITT pursues interests in health social networking and their use by a broad set of stakeholders in providing health to the individual in various settings.
Envision that an individual’s personal health information will only be shared with those who the individual wants to see it, and those who see it may not share it with anyone else without that individual’s permission. Envision that the individual does not need to give protected health information to anyone, not even their primary care provider since they can manage their care without it. Envision that an individual’s entire history of health information is available to that individual and their assignees at any location, and that any individual can discover easily who has accessed that information and why it has been accessed. Envision that an individual can even make money by allowing researchers to access their unidentifiable health information, increasing their motivation to support research. Â Consider that BITT is creating technology as part of a proposed “universal exchange language” that would allow secure aggregation with that allows for a never identified patient.
Envision researchers, care providers and even individuals easily accessing ALL “consented” health information in a secure health data cloud, not just the “consented” health information available at a particular health institution, and that health information can not give away anyone’s identity.  Envision that access to this information happens so quickly it can be used to assist in making personalized decisions about an individuals care while a patient talks to their care provider about options and their likely and unlikely outcomes, all based on real evidence pulled from the health data cloud. Consider that BITT has various activities to encourage the development of just such a health data cloud for a “new exchange architecture” (NEArch) that would include a “universal exchange language” (UEL) which would support improved comparative effectiveness research and other types of clinical and translational research (white paper here).
Envision clinical decision support systems (CDSS) apps for individuals as well as physicians that help in accessing and making sense of the information in this health data cloud. Envision that these tools can provide care plan options with additional sources of information for the individual or provider to pursue. Envision that these tools estimate the likelihood of specific outcomes based on various input factors which can be personalized for a particular individual possibly through a tie between the CDSS applications and an individual’s personal health record (though not their protected health information). Envision CDSS applications that model the functions of the human body considering various environmental and genetic factors. Envision these tools allow physicians to predict the outcomes of various behavioral, drug, or surgical interventions. Envision that these applications base their advice on the latest Clinical Practice Guidelines. Consider that BITT pursues opportunities to fund the design and development of such applications as defined in the National Research Council’s report titled Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions.
The Biomedical Informatics Think Tank works towards these goals “changing healthcare one BITT at a time.”
â„¢ Biomedical Informatics Think Tank and BITT are trademarks of Projectivity, Inc. Â BITT is a division of Projectivity, Inc.
