Monday, February 02, 2015

#ONC2015 finish the day with a Fireside chat by @KBDeSalvo with Tom Daschle and #BFrist

Fireside Chat with Former Senate Majority Leaders Tom Daschle and Bill Frist (International Ballroom)

How can we support Information Exchange across the care continuum?

Tom Daschle and Bill Frist have been involved in Health Policy since before it was topical.

Tom Daschle:

Technology may be the biggest impact on the Health Care sector. Policy and Technology have to work hand in hand. The ONC Roadmap is indicative of the importance of policy. Governance, Privacy and Security are all required.

Wide recognition that value-based payments are needed but technology is needed to support this.

Bill Frist

At an inflexion point that comes from the history from the Hitech and ACA acts and other legislation. How does congress create legislation that is flexible and agile enough to adapt to rapidly changing technologies.

Technology has the potential to bring us back to patient-centered care.

True innovation comes from Government setting the framework while the private sector drives innovation.


ONCHIT was created in the Bush Administration of 2004.

The HITECH Act was a classic example of how legislation was created (it rarely happens today). Three converging issues in 2009:

  1. Rapid acceleration to technological advancement
  2. Application of innovative new policy
  3. Need for economic stimulus

Policy and technology could create new opportunities.

Bill Frist agreed with Tom on the confluence of events and added that the understanding of science isn’t what it should be in congress. Prior to Bill’s arrival in the Senate the last physician in the Senate was in 1928.

The US has been innovator in many medical areas: Pharma, Imaging etc. But has been woeful in improving medical services. Very few people in congress had any understanding of the demands of caring for a patient.

It also takes Presidential leadership, part symbolic and part real. It establishes national priorities.

Strategic Plan to enhance interoperability. But what comes next?

TD: Integration of payment and delivery reform we will see new opportunities but We will need better data management. Enable Value driven factors to be applied in analytics. We need transparency because you can’t improve what you can’t see.

TD: Telehealth has a lot of potential to improve service in rural areas. However, we need broadband access. We also need payments for telemedicine and we need to simplify state-based legislation and harmonization.

BF: “Love the shift to patient-centered approach. That is smart. It is where the action is”

BF: Many determinants of health are not medical. We need to embrace the power of the consumer.

BF: Empower the consumer. Consumers are the big lever. Not everyone has to be a smart shopper but a small percentage can change the market.

TD: Government has a role in policy by setting standards. Medicare is by far the largest consumer and so can drive change. Still al ong way to go in measuring quality and performance.
Help to build the infrastructure. Always worried about siloization of health. We need more collaboration.

BF: 2005 to 2009. Big lesson was to listen to the outside world – outside the beltway. Standards have to be set at the national/federal level but need to reflect the reality from the field. Government sets standards but allows innovation from the Private Sector.

80% of ER visits do not result in referral visit. Many of those can be dealt with via telemedicine. State-based prohibitions are an impediment to adoption. Privacy issues need to be addressed when online transactions take place.

VA is using Telehealth and these lessons can be learned and applied elsewhere.

Q: Most of the nation don’t have a clue about the innovation that is going on.

TD: Polarization in politics is worrying. There is however a lot of quiet conversation that goes on by politicians that want to find a way out of this challenge. There is a lot of consensus about achieving the Triple Aim.

BF: “We have to get out of Washington” There is a disconnect with the real world. Listening tours are important. Reach outside Washington is hard but necessary.

Q: Three industries working against health care improvements (Food industry, Pharma, Medical Devices)

BF: FDA – regulates 25% of all consumable goods in USA. It needs to be modernized.
How do you reach people when the power has shifted to the consumer. These big entities know how to reach the consumer. That means embracing social media. Also how do we reach out on the non-medical aspects of social determinants of health.

TD: Two pieces of Advice: 1. Ask yourself if you will be a constructor or destructor in politics. Be a C. 2. Don’t be a spectator. Be Involved. Get engaged. Your voice matters.

Q: States have created Innovation Zones. Can we pass laws for to enable legislative exemptions.

BF: Innovation is hard in Health when stripping away legislation related to health. Focus on safety and efficacy.

2.3% of healthcare spend on drawing blood. affects 8 out of 10 decisions. Use technology to reduce 20% of errors.
Use It to monitor and reduce variation. This allows you to detect minor changes in glucose allowing diabetes to be diagnosed years sooner.

TD: As we go through Transofrmation. We need to value:
1. Resiliency
2. Engagement
3. Collaboration
4. Innovation – How do we create the environment for innovation.

Risk Adversity is something we have to contend with. we need better balance and reduce risk adversity.

Q: What is ONC Role in Precision Medicine?

BF: Shout out to Tom Daschle and the start of the Human Genome Project. Projected to cost $8M and only took $3M but it has created the platform for analysis of the data. Big data focused on the diversity of the individual patient.

Transforming the billions of bits of genetic information not something that improves the health of the individual.

TD: Leadership is needed to drive the Precision Medicine initiative forward. We need a lot more done than said.

[category News, Health]

[tag health cloud, blue button, ONC2015]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Stay up-to-date: Twitter @ekivemark

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.
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