Dr. Keith Salzman

In order to benefit from the stimulus investment made in transforming healthcare, the government will need to support industry by incentivizing the effective use of tools and infrastructure that leverage information to improve care delivery. The groundwork in standards and interoperability laid by the Office of the National Coordinator (ONC) demonstrates that establishing a working infrastructure is challenging, but achievable.

Healthcare IT news is overflowing with discussions about standards and interoperability, two of the cornerstones for advancing the benefits of digitized healthcare. Behind the scenes, the Office of the National Coordinator (ONC) Standards and Interoperability Framework is moving forward with 39 pilots generated over the past three years.

Customer interactions model what can be done in healthcare for a number of reasons. White space -- the time that a patient lives life disconnected from the healthcare system -- is significant when many patients see their physician for only a few hours in a year. Because average interaction with the healthcare system is limited, the potential of social media, smart phones and gaming interactions to engage patients in their care and motivate them to improve their own health is significant.

Among the topics that I discussed in introducing this blog series was healthcare payment reform. Interestingly, HHS announced last week (Jan 26:) that they are moving their payment model from traditional “fee for service,” seeking to achieve a target level of 30% alternative payment model quality initiatives by 2016 and 50% by 2018. This move has great promise -- however, the change needed to accomplish reduced cost and improved care/outcomes is significant.

Listen to the interview with Keith on Federal News Radio. Transformation is a challenging process, sometimes painful. Healthcare transformation seems to be one of the most challenging, and painful for the workforce likely due to the many stakeholders, complexity of information, need for trust and privacy and so on. Indications that the industry is moving up the curve from high cost/low productivity solutions toward low cost, highly effective solutions that bring real gains in productivity, accuracy and enable the goals of delivering better healthcare and health are starting to appear.

In one of my previous posts, I referenced the Standards and Interoperability (S&I) Framework, which enables healthcare stakeholders to create standards, specifications, and implementation guidelines that facilitate effective healthcare information exchange. This will facilitate the adoption of interoperable standards.

Remember when businesses all kept their own ledgers, which required updates as each new business transaction occurred? How about the added expenses that had to be paid to intermediaries adding margin for services?  And what about the inefficiencies as each business in the network (supplier, buyer, seller) all recorded the same transactions in their individual ledgers? While many businesses and industries, including healthcare, still operate this way, an emerging technology has great potential to advance Healthcare IT across the economy and in the government, namely “Blockchain.”

The Surgeon General released a report, “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health” last December.  The report focuses on a variety of communities, including Veterans, as it discusses how government can work with the private and non-profit sectors to best address the growing addiction problem and the significant challenges posed by implementing effective, long term treatment.

Listen to the interview!

Dan Chenok:  Keith, as an experienced physician, leader, and innovator, can you describe your impressions of the health information technology (HIT) field?