In the realm of HIT, the ONC’s Federal Health IT Strategic Plan (Strategic Plan), in combination with related regulations and market forces, provides a useful guide to where the federal government hopes to see HIT move — and potential winners and losers. Taking into account recent technology and market trends, the government is actively supporting initiatives that could, and in some cases almost certainly will, lead to:
- Increased use of in-home, wearable and portable devices that monitor
your activities and health 24 hours a day and send that information to
your caregiver (or, potentially, your insurer and employer). As the Strategic Plan says:
“Existing and emerging technologies provide a path to make information and resources for health and health care management universal, integrated, equitable, accessible to all, and personally relevant. …[O]nly one in eight Americans track a health metric like blood pressure or weight using some form of electronic technology. Federal agencies seek to expand the ability of individuals to contribute electronic health information that is personally relevant and usable to their care providers so that both can use it effectively in health planning.”
- A Learning Health System (LHS) that will take the knowledge gained from millions of patients, their genetics and their every health service, applying it to individual patients’ specific conditions. The idea of the LHS has arisen from several sources, but particularly from the Institute of Medicine’s Roundtable on Value & Science-Driven Health Care (IOM Roundtable) and the Learning Health Community (LHC).
- Cutting-edge research finding unexpected causes and treatments for numerous diseases, without any test subjects, using nothing but data already on hand. If successfully developed and implemented, the LHS could collect data from every major provider of healthcare around the world, as well as every significant clinical research study, then analyze that data based on a particular patient’s demographics, genetics, history, diagnoses and symptoms and provide to the physician the most relevant available treatment options listed by likelihood of success.
- Patients directly accessing, controlling and even correcting their medical records, no matter who the provider. This trend will only be pushed further by new standards for the exchange of healthcare data and development of apps and devices in which individuals will be providing, and accessing, their records. Data stored in the cloud by an app developer, and automatically integrated into an EHR, can easily be integrated into any other EHR. Just as a website can be accessed by a number of browsers, numerous market players may enter with products that can access any EHR, organize the data in it in various ways and increase the utility of the data while decreasing the cost of access.
- A Faustian Bargain, faced by each individual or society as a whole, in which one must choose between personal privacy and the full benefits of available healthcare services. Perhaps the largest potential downside to a boom in HIT relates to our sense of privacy and the security of information shared. One could, of course, opt-out of sharing personal information, just as one may refuse to click “I agree” on end-user license agreements, refuse to carry a cell phone and stay off the Internet. For most people, however, permitting sharing of health information may become automatic, particularly when the potential price of opting out is one’s health.
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