Information technology is changing health-care system

January 12

With the implementation of the Affordable Care Act, health care was a hot topic in 2013. Rising costs and continued challenges make certain health care will continue to be a big issue in 2014. Recently, Capital Business sat down with experts from the University of Maryland and the Arlington consultancy Evolent Health to talk about health care and the opportunities ahead for information technology to improve efficiency and quality of care.

Joining the conversation were Ritu Agarwal, founder and director of the Center for Health Information at the University of Maryland’s Robert H. Smith School of Business; Karoline Mortensen, assistant professor of health services administration, University of Maryland Public Health; and Shandy Guharoy, vice president for information technology for Evolent Health.

Here are excerpts from their conversation with Dan Beyers, editor of Capital Business:

What are some of the issues right now for consumers — what should they be thinking about?

Mortensen: “The biggest challenge right now facing consumers is how do you get the information about these exchanges to that population? Recent surveys report that as many as 70 percent of the uninsured responding to these surveys are not familiar with what the exchanges are designed to do. And this is a critical issue because the exchanges are beyond just purchasing private health insurance coverage for higher-income populations: They’re also about Medicaid enrollment for lower-income populations. This is a big step forward in terms of one-stop shopping.”

Is mobile a wave of the future in health care like so many other industries?

Agarwal: “I’m incredibly bullish on the potential of mobile technologies for helping us achieve the goals that health care has set for itself. Mobile technologies give us a way of really addressing one of the persistent problems in health care, and that is patient activation and engagement. As consumers of health care, we have been completely disengaged from the process of taking care of our own health, and we rely on experts — our doctors — to tell us what to do.

“Mobile technologies I think offer the potential to flip that equation, and essentially through tracking, maintaining information, being reminded what you need to do to stay healthy, we can achieve a lot of the quality and cost goals that we’ve set for ourselves.

“If we could have a mobile technology that engages consumers and reminds them every once in while, motivates them, puts them in social settings where they can compete — all of those kinds of opportunities, I think, will bring us to a health-care system where patients are watching out for themselves on a daily basis, and then meeting with doctors only when there is a clinical encounter or clinical need that really needs that expert intervention.”

Give me one big idea that you think that we can really help change the nature of health care right now.

Agarwal: “Personalized medicine. It’s the natural progression and advancement of health care. It says that all treatments, all therapies, all health care, all health-care instructions — everything related to the management of a person’s health — is going to be tailored specifically for you, rather than saying these are vast populations and we’re going to use the same kind of treatment for them.

“So how do we get to the goal of personalized medicine? One, we have to understand every human being’s genome, and we’ve made remarkable progress with the human genome project on that. Second, we have to understand your behavioral patterns; we have to understand the specific situation contingencies that you live in. All of the data that’s needed to drive personalized medicine is now in the process of being collected, stored and digitized.

“We have advanced technologies that will allow us to discover patterns that we’ve never seen before — so at the end of the day, we can really take care of somebody’s health from a personalized perspective.

“That’s a very big idea. It’s going to take us two, three, maybe even four decades to get there, but I think all the pieces that are needed for personalized medicine are slowly going into place and I’m very excited about the future.”

How do you keep up on the technology, and create architectures that get us to where we need to go in the future to have something like a personalized medical system?

Guharoy: “It’s data versus insights. The data is already there; what is the insight from the data? From population health management where you are aggregating the data, you are seeing the trends in the data, you are being able to predict and forecast. And the next part of it is personalization. It’s a step by step.

“These are lifestyle changes. Look at how our mobile and our cellphones that we carry with us have changed our lives. The same thing will happen in health care.”

Hear the full conversation on health care at the Smith School’s Web site, www.rhsmith.umd.edu.

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