Table Of ContentTransforming Health Care
Better Data for Better Care
Written and compiled by the staf at Evolvent Technologies,
Incorporated, Falls Church, Virginia.
For more information about Evolvent capabilities and what Evolvent can do for
you, contact us via e-mail at
Transforming Health Care
Better Data for Better Care
© 2011 Evolvent Technologies, Incorporated
All rights reserved. No part of this publication may be reproduced, stored
in a retrieval system or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise without the prior written
permission of the copyright holder, Evolvent Technologies, Incorporated, Falls
Church, Virginia.
050 EVO
ISBN-978-0-9826568-1-5
Published by Evolvent Technologies, Incorporated
5111 Leesburg Pike, Suite 506
Falls Church, VA 22041
Printed in the United States of America
Signature Book Printing, www.sbpbooks.com
Dedication
Te Evolvent Team is proud to dedicate Transforming Health Care to
those we ultimately aim to serve:
Our wounded warriors who deserve the best, smartest care we can give
– supported by the most efcient, efective and data-rich technologies we can
ofer; and,
Our veterans of all times and ages who have borne the battle and who also
deserve the same attention and care; and,
Our ill and injured across this land who sufer, sometimes needlessly, and
who so desperately need better data, richer information, and smarter care to
return to health as fast as possible.
Note:
Any proceeds from this book will go to one of the following
charity partners of Evolvent:
Fisher Foundation
OurMilitaryKids.org
NIH Children’s Inn
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Table of Contents
Foreword ....................................................................................................................ix
Section 1
A Vision of the Future -
Transforming Health Care (Introduction to Section 1) .......................................1
A Tale of Two Futures .............................................................................................11
Section 2
Key Enablers (Introduction to Section 2) ............................................................15
Security and Privacy as Enablers of Better Health Care .....................................17
Sustainable Health Information Exchange ...........................................................59
Health Care Financial Reform:
Te Small Picture of the Health Care Financial Landscape ...............................73
Section 3
Transformation of Health Care (Introduction to Section 3) .............................85
Consumer Empowerment ......................................................................................87
Patient-Centered Medical Home ...........................................................................97
Telehealth................................................................................................................105
Health 2.0 and the Future of PHR .......................................................................115
Mobile Health Care ...............................................................................................129
Accelerating Clinical Research ............................................................................143
Clinical Decision Support ....................................................................................149
Aferword ...............................................................................................................155
Author’s Biographies .............................................................................................159
Glossary of Acronyms ...........................................................................................173
v
Acknowledgements
Each time we initiate a “book project,” it seems to draw out more talent
across our organization. Tis project was no diferent. Many hands have
contributed, and the ideas of all are brought together in the volume you see.
Without all the eforts of our myriad contributors, this compendium of thought
on how technology can help health care transform itself and deliver better care
through the better delivery of information would not have been possible.
My thanks frst to our core production team that kept this project on track.
Mr. Greg Parish, Jr., again served as research manager, coordinator, analyst and
writer, and did a magnifcent job. Greg’s intelligence, acumen and ability to
synthesize ideas across the spectrum of all that is going on in health care today
is remarkable and has made this book, I believe, an important work in our feld.
Closely aligned with our writing team have been three individuals who kept
this project moving and managed production activity on a very tight schedule
– Ms. Jenn Cupka, Ms. Brittany Palmer, and Ms. Kari Larsen. Tese three kept
us on track and made our ideas come to life in this fnished product! Tanks!
Finally, joining our production team this year has been Ms. Stella Ramsaroop,
who as production editor has really raised the bar in terms of the fnished
quality of our manuscript. Stella’s professional capability as a journalist, her
clear style and eye for quality communication have been of enormous help in
improving our work. Tanks, Stella!
And now, for the writers. I can hardly believe the talent and intelligence
that we have assembled at Evolvent. Each of our leaders has contributed to
this work and the combined power of this collaboration is clearly evident. Our
primary writing team included J.D. Whitlock, Steve Gantz, Bill Sorrells, Geof
Howard, Greg Parish, Jr, and Dave Parker. Contributing writers and reviewers
included: Greg Parish, Jr., Monty Nanton, Kent Stevenson, Paul Ramsaroop,
Joey Meneses, Dave Walton, Davis Foster, Anna Worrell and Anna Khizhnyak.
My thanks to all of these talented professionals for their time and intellectual
contributions. We are very proud to have all of them in the Evolvent corporate
family.
My continued and heartfelt thanks also to our client community for the
opportunities we share to do good work. It has been an honor and a pleasure
to work with our colleagues across federal health care for the last ten years and
while much has changed and will change – the force we can be together for
transforming health care is powerful indeed.
Tere is also an unsung hero at Evolvent, who – like me – is deeply
committed to our clients, employees and the future of health care – that is my
vii
partner of the last ten years, Paul Ramsaroop. Paul and I are proud of our team,
but most gratifed by the diference we are all making.
Finally, I would like to acknowledge and thank my family who gives me so
much motivation, encouragement and conviction on a daily basis – making it
clear how vitally important it is that we deliver better data to enable better care.
viii
Foreword
Why this book and why now?
Much has been said, written and continues to be written every day about
the successes and more ofen – the failings of our health care system. For those
of us who live in the world of health care and health IT every day, we are right
at the focal point of a lot of national attention. And, rightly so. From a cost
perspective, our health care system is fundamentally broken given its costs
and our health care performance compared to many developed countries that
spend signifcantly less.
Tis conclusion has ofen been stated, sometimes aggressively, and has
been a catalyst for much of the recent attempts at reform – yet we have not
focused the debate on the results we seek as a society, just merely on payment
methodologies and a few band-aids or attempts at moving to nebulous concepts
such as “evidence-based” or “accountable care.” Te results I would suggest we
seek are actually the improved delivery of care for all at a more reasonable
share of national income.
How much good conversation is actually occurring? How many good
questions are being asked? How would we know? I ask this because it seems
that in spite of all the national attention and the hyper-attentiveness of our
nation’s leaders to health care and in particular, electronic patient record
adoption – are we making much forward progress?
In some cases, clearly the answers are a resounding “Yes!” Electronic
record adoption is on the rise and certainly the incentives proposed by the
Federal government over the last few years will probably only accelerate this
trend.
In other cases, we still see health IT systems that are arcane and proprietary
and most importantly are fragmented within and across institutions. Most
health care delivery organizations have hundreds of separate and disconnected
technologies that do not share data even internally – let alone a full-fedged
health information exchange (HIE) capability at a local, state, or national level.
Why does this matter?
If we seek to improve care, extend access to all, and do both of these in a
more cost-efective manner – transformative change is required. Much of this
change may be systemic in nature and beyond the scope of fairly apolitical
health IT experts such as the authors of the book you are reading. Yet, we posit
clearly in this work the following principles:
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