Health 2.0: Searching for Meaning in Health Data

by Rebecca Vesely, iHealthBeat Contributing Reporter

The vast amounts of health care data coming online must be meaningful, accessible and actionable, according to speakers at the 6th annual Health 2.0 Conference held in San Francisco this week.

The question is how to do that while adhering to regulatory requirements, supporting evidence-based medicine and satisfying providers, patients and payers.

It's a tall order. This pursuit was on display with the dozens of applications, websites, devices and other tools showcased at the conference, which had about 1,500 attendees.

Kaiser Permanente offered a glimpse of its vision of seamlessly incorporating data into people's lives and nudging them towards better health.

Nancy Vaughan -- vice president of national account management at Kaiser Permanente -- showed a video of a family engaging in daily activities while aided by smart devices that checked their glucose levels, offered nutritional tips, and gave alerts on an upcoming heat wave and tips to avoid heat exhaustion. A grandmother's visit to the emergency department showed the potential of inpatient care that integrates the patient's electronic health record with hospital work flow, telemedicine and a discharge plan to avoid readmission.

Admittedly, Vaughan said, some of these technologies aren't available today, but she said the potential is within reach.

Payers said technology is key to getting people to change their behaviors and thus bring down costs.

Mark Bertolini, chair, CEO and president of Aetna, said the insurer is trying to better connect members with the health care system. Last December, Aetna purchased Healthagen -- the maker of iTriage, a mobile app that includes a symptom navigator and appointment booking. Aetna will deploy iTriage as part of its accountable care organization with Banner Health of Phoenix in the first quarter of 2013, Bertolini said.

"The way to change behavior isn't to educate and educate and scare people but to make it very simple," Bertolini said in a keynote address at the conference.

Rapid acceleration and excitement in the health technology sector is meeting the reality of the regulations and slow pace of health care, Indu Subaiya, co-founder of Health 2.0, said.

"The tension between what's possible and the constraints is at the heart of Health 2.0," Subaiya said, noting that it can take a year-and-a-half for a technology company to sell its product to a hospital. "Can a young company keep its lights on for that long?," she asked.

For hospitals, the reality is much of the data they need are not available today.

Mark Musco -- chief medical informatics officer at Muir Medical Group in Walnut Creek, Calif. -- said the two-hospital John Muir Health system has about 10 terabytes of data from 200,000 patients over five years -- about equal to the entire U.S. Library of Congress.

"I really feel like, 'Where is my data?'" Musco said. "It's spread out. This makes getting an aggregated view of what's going on with patients almost impossible."

Much of the data are outdated -- about 90 days old -- and are "unstructured" in the form of hard copy documents like physician notes, test results, images, medication logs and reports, Musco and others said.

Employers, too, would like more actionable data.

"The data we need isn't available," Nate Randall, benefits manager at Tesla Motors, said. "There's a huge lag. Health plans give it to us once a quarter. It should be instantaneous."

Diego Miralles -- head of Janssen Healthcare Innovation, a division of Johnson & Johnson -- described the drive to collect, crunch and deploy data as a "feverish rush."

It's all meaningless if we forget the basics of health care: that it's about people, Steve Merahn -- senior vice president of clinical programs at ActiveHealth, an Aetna subsidiary -- said, adding, "We need to shift from the meaning of data to the meaning between people."

Companies Tout New Products

A major component of the Health 2.0 Conference is live demos, which happen during nearly every presentation over the four days.

Companies such as Apixio, Explorys, Lumeris and Phytel showed how they are packaging data from a variety of sources, such as electronic health records, claims, prescriptions, labs and even home monitoring or wellness devices, to deliver a clearer picture of individual and population health.

Lumeris, for instance, has a technology platform for accountable care organizations to drill down into metrics to reach individual patients and target them for specific interventions.

Many of the new apps and other products launched at the conference target a small slice of the health care system. Unfrazzle is an app that helps caregivers track daily activities. First Stop Health is a phone and online concierge service for health questions. And SharetheVisit allows family members to attend medical visits remotely.

There's a hunger for health care information, Melissa Barnes, head of interactive at Twitter, said at the conference. She noted that Twitter has seen a 50% increase in health care-related tweets so far in 2012. Twitter traffic spiked in June when the Supreme Court handed down its landmark decision on the Patient Protection and Affordable Care Act, she added.

That hunger is translating into dollars. Health 2.0 companies have raised more than $1 billion in the first three quarters of 2012, according to conference organizers.

Health care is changing rapidly, and technology is one of the root causes for this, health care futurist Joe Flower said during his keynote address. The system is getting "leaner, smarter and stronger," he said.  

Still, providers need incentives for widespread adoption to happen, according to Sarah Adler, a research fellow at the Stanford University Clinical Excellence Research Center.

Federal Officials Address Questions, Feedback

At the conference, top officials from the Office of the National Coordinator for Health IT answered questions and took recommendations on anticipated new industry guidelines.

The FDA Safety and Innovation Act, signed into law by President Obama in July, calls on FDA, the Federal Communications Commission and ONC to make recommendations on a regulatory framework for health IT, including mobile medical applications, that promotes innovation while protecting patient safety. The recommendations are due within 18 months of enactment.

Jodi Daniel, director of ONC's Office of Policy and Planning, said the relevant agencies plan to hold town hall meetings to solicit feedback. "We're trying to figure out what the right approach is," Daniel said of the recommendations.

Several conference attendees told Daniel that ONC needs to do a better job of reaching out to the technology community to educate them on existing and upcoming health IT standards.

Daniel agreed that the agency should find channels to communicate its work. "We don't expect everyone to come to us," she said. "We have to come to them."


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