Taking on Healthcare: The Time is Now

June 14th, 2010 by Erwin Gianchandani Post a comment »

The Computing Community Consortium recently prepared a white paper titled, “Information Technology Research Challenges for Healthcare: From Discovery to Delivery,” as a follow-on to the Discovery and Innovation in Health IT Workshop that the CCC co-sponsored with various Federal agencies in October 2009. The paper describes basic research opportunities that can catalyze transformations in healthcare — an enterprise that costs U.S. taxpayers $2.3 trillion (yes, that’s trillion!) each year but, by all accounts, is poorly equipped to handle the evolving needs of patients and providers.

A multitude of factors — poor diet habits, stressful lifestyles, aging populations, etc. — is causing chronic diseases like cancer and arthritis to soar, and our twentieth century healthcare delivery infrastructure is simply not designed to handle the surge in these types of ailments. We need far better ways to mine huge volumes of patient data from multiple sources, and to effectively present the critical pieces of information to the right person at the right time to help yield the right decision, all the while ensuring privacy and security. We need ways to improve process flows, to create feedback loops, to establish care “control rooms,” etc. We need ways to monitor (sense) and assist patients’ health, activities, and behaviors in their homes, offices, and churches. We need an entirely new social infrastructure, one that builds off of today’s “connected” world and incentivizes integration and adoption of new technologies, a belief in wellness management (“prevention is better than a cure”), and the role and persuasive effects of one’s social network. And we need to do all of this work in the context of the incredibly complex organizational structures, payment plans, policies, and regulations underlying the healthcare enterprise. Health information technology is not just about electronic medical records (EMRs), in which the Federal government has invested significant resources over the past year (see ongoing programs); it’s also about robotic surgery, telemedicine, home monitoring, Health 2.0, and much more.

But we can’t revolutionize care delivery overnight. To achieve a safe, effective, reliable, and far less expensive system five, 10, or 15 years into the future, we need groundbreaking research now in areas like data management, data mining/machine learning, human-computer interaction, modeling and simulation, software engineering, reliability engineering, process engineering, sociotechnical systems, etc. Yet, to date, Federal investment in health IT research has largely been fragmented.

As we’ve articulated in the white paper, the recent passage of healthcare legislation makes a broad research initiative in this space incredibly timely. There is no better time like the present — and, frankly, with chronic disease on the rise, doctors and hospitals increasingly overburdened, and friends and families lost in an abyss of uncertainty about their loved ones’ conditions and care options, we can’t afford to delay any longer.

As a community, we are calling for a large-scale, comprehensive, coordinated, collaborative, and multi-disciplinary basic research investment by the Federal government. We believe this investment must involve computer scientists, but it should also include allied areas of systems engineering and the social sciences. As these areas are core constituencies of the National Science Foundation, the agency must be heavily involved. (Indeed, NSF’s CISE Directorate just announced a Smart Health and Wellbeing Program for FY 11, which “aims to facilitate large-scale discoveries that yield long-term, transformative impact in how we treat illness and maintain our health”: http://www.nsf.gov/pubs/2010/nsf10575/nsf10575.htm.)

The work can’t proceed without medical practitioners either, as they need to inform the technologies as they are being developed — and consequently the National Institutes of Health, the primary Federal agency for conducting and supporting medical research, must be at the table as well. And there are a whole host of other Federal agencies that should be consulted: the Office of the National Coordinator for Health IT (ONC) and the Agency for Healthcare Quality and Research (AHRQ), which have invested billions in developing and deploying EMRs around the country; the Centers for Disease Control and Prevention as the nation’s public health agency; and the Food and Drug Administration, which must regulate technologies emerging from our nation’s research labs and arriving in hospitals and clinics.

Let’s do something big in health IT today — so that we can enhance the quality and length of life tomorrow. It’s critical for our society, for our economy, and for our success and prosperity as a nation. For more, I encourage you to review the CCC-led white paper.