Unleashing the Power of Data, IT, and Innovation to Improve Health Todd Park, Chief Technology Officer U.S. Department of Health and Human Services

There Has Never Been a Better Time to Be an Innovator at the Intersection of Health Care & IT New Incentives Information Liberation Rocket Fuel for Innovation + =

New Incentives, Part 1: Meaningful Use Medicare/Medicaid incentive payments rewarding “meaningful use” of EHRs (not purchase of EHRs alone) Physicians: $44,000/$63,750 Hospitals: $2M plus bonuses for higher Medicare, Medicaid volume Escalating requirements – 2011, 2013, 2015

New Incentives, Part 2: The Affordable Care Act and Payment Reform True transformation of the health care system depends on changing how we pay for care The Affordable Care Act will drive a shift from “pay for volume of services” toward “pay for health and value” Law launches an array of key payment reform programs + a game-changer: the Centers for Medicare and Medicaid Innovation Center

Payment Reforms Will Motivate and Reward Innovation at a Whole New Level Data Mining/Analytics Timely Clinical Data, Decision Support Care Integration Tools Technology to Extend Physician Reach Consumer Engagement Tools/Platforms/Apps Organized outpatient care, coordination and team-based approaches Patient Centered Medical Homes Shared savings; redesigned care processes for high quality, efficient delivery Accountable Care Organizations Pilot program for episodes of care; incentivizes reduced costs around eight conditions Bundled Payments Motivates hospitals to engage with care coordinators and better organize delivery systems Readmission Reduction Programs Innovations Needed:

Information Liberation, Part 1: Rising Health Data Liquidity The Direct Project Collaborative project to develop a simple method for enabling secure transmission of health care information over the Internet Launched 3/10, specs posted 6/10, first production transaction 1/11, now being implemented by 65+ vendors Collaborative project to develop a simple method for enabling secure transmission of health care information over the Internet Launched 3/10, specs posted 6/10, first production transaction 1/11, now being implemented by 65+ vendors “Blue Button” The ability for any veteran or Medicare beneficiary to download an electronic copy of their own personal health or claims information Launched 10/10, utilized by over 200,000 unique users thus far The ability for any veteran or Medicare beneficiary to download an electronic copy of their own personal health or claims information Launched 10/10, utilized by over 200,000 unique users thus far

Information Liberation, Part 2: Increasing Market Transparency Key early requirement of the Affordable Care Act First website to compile comprehensive inventory of private and public health coverage options across the U.S. for consumers Initial version deployed 7/10 Key early requirement of the Affordable Care Act First website to compile comprehensive inventory of private and public health coverage options across the U.S. for consumers Initial version deployed 7/10 HealthCare.gov Insurance pricing and benefits info added 10/10 Enhanced clinical provider quality information on the way Insurance pricing and benefits info added 10/10 Enhanced clinical provider quality information on the way

Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” Community Health Data Initiative (CHDI) 3/11/2010: Vision for HHS as “NOAA of health data” outlined at an innovators summit. Shortly thereafter, initial HHS data sets published on CHDI website….

Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Community Health Data Initiative (CHDI) (cont.) 6/2/10: Less than 90 days later, 20+ new or upgraded apps utilizing HHS CHDI data showcased by private sector innovators at major public meeting

Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Community Health Data Initiative (CHDI) (cont.) 6/2/10: Less than 90 days later, 20+ new or upgraded apps utilizing HHS CHDI data showcased by private sector innovators at major public meeting

Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Community Health Data Initiative (CHDI) (cont.) 6/2/10: Less than 90 days later, 20+ new or upgraded apps utilizing HHS CHDI data showcased by private sector innovators at major public meeting

Community Health Data Clinical and Service Provider Data “Blue Button” Data Medical/Scientific Data Consumer Product Data Government Spending Data Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) CHDI Has Now Become a Broader Health Data Initiative (HDI) HHS publishing more and more free data and APIs, fueling a rapidly expanding ecosystem of innovation using our data

HHS Health Indicators Warehouse – launched 2/2011www.healthindicators.gov Contains 1,170 community health performance metrics for the country, states, hospital referral regions (HRRs), and counties Includes trove of new aggregate metrics of Medicare utilization, quality, prevention, and prevalence of disease (hundreds of indicators) across regions Includes proven interventions by indicator Available via website and API Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Liberating Community Health Data

Deployed APIs to Hospital Compare, Nursing Home Compare, Home Health Compare and Dialysis Compare at data.medicare.gov – 9/2010 Large-scale enhancements happening to Compare via the Affordable Care Act – including launch of Physician Compare Section of the Affordable Care Act: will make claim files available to “qualified entities” for purposes of provider quality measurement in 2012 Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Liberating Clinical and Service Provider Data

“Blue Button” launched by VA and HHS in 10/2010, allowing veterans and Medicare beneficiaries to download copies of their own data. Dept of Defense now also offering Blue Button as well for active duty military and dependents To date, over 200,000 unique users have downloaded their own data VA, Medicare, and DoD planning significant enhancements to available data in 2011 Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Liberating Personal Health Data Via “Blue Button”

National Library of Medicine API Portal deployed 9/2010 Includes APIs to ClinicalTrials.gov, Entrez Utilities, Medline Plus, Pillbox, PubChem, RxNorm, Unified Medical Language System, and more Medline Plus Connect service for EHRs/PHRs launched 11/2010 Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Liberating Medical/Scientific Data

FDA recall (drugs, devices, food) data in downloadable XML format published 10/2010 – with improved info on the way Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Liberating Consumer Product Data

Medicare claims “basic stand alone” files – first-ever claim-level files (“slimmed” for privacy protection) available for free public download – debuted 2/2011 with hospital claims “basic stand alone” file To be followed with claim “basic stand alone” files for all other care modalities (by 6/2011) “Medicare dashboards” – much more timely downloadable aggregate data Greatly enhanced HHS grants data tool (TAGGS 2.0) debuting soon Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Liberating Government Spending Data

HHS has committed to 2x/yr data publication review and amp-up process by each HHS agency

Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Launched 2/2011: HealthData.gov New “one-stop” resource: universal catalog of government- supplied health data and APIs, Apps Expo, online community, catalog of non-federal health data websites

Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) Marketing the Data Marketing the data to innovators who can turn it into supercool apps – through: -- Challenges (Health2Challenge.org): 21 issued to date -- “Codeathons” -- Startup America/DC2VC tour, conferences, meetings, etc. -- Annual Health Data Initiative Forum (next one: June 9) Marketing the data to innovators who can turn it into supercool apps – through: -- Challenges (Health2Challenge.org): 21 issued to date -- “Codeathons” -- Startup America/DC2VC tour, conferences, meetings, etc. -- Annual Health Data Initiative Forum (next one: June 9)

Information Liberation, Part 3: HHS morphing into the “NOAA of Health Data” (cont.) The Goal: a Self-Propelled Health Data Ecosystem The ecosystem is already becoming self-propelled: Expanding use of apps developed thus far New development work from startups and established companies “Platform jujitsu” Rapidly growing array of companies, ventures, programs emerging leveraging our data – 40 of the best to be showcased at the Health Data Initiative Forum on June 9 The ecosystem is already becoming self-propelled: Expanding use of apps developed thus far New development work from startups and established companies “Platform jujitsu” Rapidly growing array of companies, ventures, programs emerging leveraging our data – 40 of the best to be showcased at the Health Data Initiative Forum on June 9

A Historic Moment and Opportunity New Incentives Information Liberation Rocket Fuel for Innovation + =