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Doug Fridsma on evolving health IT infrastructures

Departing ONC Chief Scientist Doug Fridsma explains why more data is good for healthcare and confirms meaningful use stage three is in the works.

SAN DIEGO -- This is the second installment of a three-part interview with outgoing ONC Chief Scientist Doug Fridsma, M.D., at the American Health Information Management Association Convention and Exhibit. Read part one here.

Speaking of wearables like Fitbit, Nike FuelBand and Apple Watch, and looking at other mHealth initiatives from the likes of Apple, Google and Microsoft, when do we hit information overload for doctors?

Doug Fridsma: There's a big challenge with the amount of data that's being produced [versus] the amount of data [that actually] helps us. How do we take complex, multi-factorial data sets and summarize that down into the key elements that people need to pay attention to? People were talking 29, 39, 50 years ago about information overload, and we were still using paper charts. It has only accelerated.

People were talking 29, 39, 50 years ago about information overload and we were still using paper charts.
Doug Fridsmachief scientist, ONC

I don't believe the solution is to limit the data or prevent the data from being. This represents an opportunity, not a barrier. We need to continue to figure out ways to allow patients and doctors to collaborate about the information they have. I believe, I trust, that the innovation community and those that are out there in the analytics world will come up with some good solutions for us, but I don't think the answer is to say we need to separate these things or not allow the data to flow.

How can CIOs, in particular, pitch in and leverage technology to achieve the learning system endpoint in the 10-year interoperability roadmap?

Fridsma: Ten years ago, a flip phone was a pretty novel and interesting device. Nobody had any idea that we'd have a phone that we could take pictures with or that we could have opportunities to share with the world in 140 characters our experience at the conference we were at this morning. Change is going to happen, and it's going to happen probably faster than we feel comfortable with. We need to make sure we don't approach the problems to say, 'If we only install the system, it will solve all our problems and we don't have to worry about it.' In fact, I think we need to approach the problem as if this will be a continual and iterative evolution, and we have to build our systems to be resilient to that change.

Those folks that are able to see this not as a once-and-done solution but, in fact, an ongoing evolution, will likely make different choices and will likely get ahead of the curve. They will, in an incremental way, grow their IT infrastructure to meet the increasing demands, rather than put in a system, cobbling it through for 10 years, and then throwing it out and starting with something new.

So the idea is not to rip and replace across the board, but maybe add to what they have or fit in the pieces for what they need?

Fridsma: Yeah. For example, if you had to buy a device that did word processing and another device that did your email, and another device that did your presentations, and telephones -- we used to have telephones, you know -- when a new technology came along, you'd have to throw it out and start with something else.

Now we have platforms like the Apple health app, and we have platforms that allow you to add an app until it's no longer useful. Then you find another app that can help. But the platform is still there. It's usable. It's still stable. I think we need to start thinking about the way we start managing information not so much as in, 'Here's a top-down giant system,' but in fact, 'Here's a series of functional units that we want to be able to deploy,' and that over time, what we want to do will change.

What about meaningful use stage 3? Is that still going to happen?

Fridsma: Oh yeah, stage 3 is still going to happen. Folks have been working on that over the last couple of months and I know that they've been trying to work with both the HIT Standards Committee and the HIT Policy Committee to do two things: One, listening to the community to really hear what have been the challenges in meaningful use stage 1 and stage 2 and to see what we can do in meaningful use stage 3 to address some of those things. Two, realizing we are on a mission to get where we want to go and also to continue to move incrementally along the path to better health information exchange and interoperability.

Continue on to the final part of this interview.

Let us know what you think about the story; email Shaun Sutner, news and features writer, or contact @SSutner on Twitter.

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