Big data will transform healthcare, says ONC
The plan, released for public comment on March 25, says that clinical information captured from electronic health records in machine-readable format can be used to rapidly speed-up the creation and diffusion of medical knowledge--creating what ONC dubs a "learning health system."
"Through a learning health system, the right information will be available to support a given decision, whether it is about the efficacy of a treatment or medication for an individual patient, predicting a national pandemic, or deciding whether to proceed with the research and development for a potential new treatment," the plan states.
Today, only a quarter of physician offices and 15 percent of hospitals have EHR systems in place, according to ONC, but that number will likely increase as the Health and Human Services department distributes up to $27.4 billion in incentive funding to the private sector for EHR adoption over a decade. Medicare payments to providers will start to drop in 2015 unless providers demonstrate "meaningful use" of EHRs. So far, the department has paid out $37.57 million in EHR incentives, according to the Center for Medicare and Medicaid Services.
The plan envisions ONC working with a few federal agencies to create a federated model for data exchange in what would be the first instantiation of the learning health system, and later expanding participation to other public- and private-sector organizations.
Among the initial agency efforts that could form the basis of the learning system are the Food and Drug Administration's Sentinel Initiative, which will track and monitor all FDA-regulated products; the Center for Disease Control's health surveillance network; and an HHS database that will use insurance claims as a basis for medical research.
The plan also calls on caregivers to provide patients access to their electronic health information. Although individuals have a right to access their health information under current law, the plan says providers have had little financial incentive to proactively share data since doing so creates additional costs for them. Under the first stage of meaningful use requirements, individual caregivers must provide patients with summaries for each office visit and hospitals must provide an electronic copy of hospital discharge instructions to patients who request it. "Future stages of meaningful use will build on these requirements," the plan states.
The plan also references a current effort to create a national standards and interoperability framework for health information exchange. The S&I Framework will use the National Information Exchange Model, or NIEM, a Homeland Security Department-led Extensible Markup Language set of schemas. NIEM is not, according to ONC head David Blumenthal, some kind of Trojan Horse for government control over health information. Blumenthal announced in February in a memo to his staff that he plans on leaving ONC this spring to return to a teaching post at Harvard University.
ONC is accepting public comments on the plan through April 22, 2011.