To get to appropriate use, which drives quality and keeps cost down, we must first completely understand our current care models and outcomes, to determine what changes must be made to improve. The caveat is: you cannot improve what you cannot measure. The HITECH Act is paying providers (Meaningful Use) to report on key measures while no structure or incentive exists to capitalize on and learn from the data now being collected. Providers are being paid to simply report on collecting basic data. It's a wonderful start but there is no process or plan that we know of, to actually learn from the data. Larger than that is the lack of interoperability between information systems in health care which, by the way, is driving some of the duplication of services, waste, and cost through a lack of access to complete patient histories between providers.

Without a standard for collecting and communicating longitudinal patient records for analysis, learning and feedback, it's going to be tough to learn from the data. Compounding the problem is a lack of a national patient identifier and a well-founded concern for protecting health information.


To drive pre-encounter clinical decision support based on actual patient outcomes, to propel appropriate use; to minimize cost and maximize positive patient outcomes, we need to connect patient data nationally and learn from it to make decisions. It's a simple concept, a feedback loop.



Feedback loops, sometimes thought of as Artificial Intelligence, by design, learn from themselves by constantly evolving and adjusting, using historical and new data, as defined by the analytics design, to deliver actionable measures. This technology is no longer Star Trek fiction - it exists today. These approaches can allow the bi-directional connection of health IT systems and deliver the advanced automated analytics clinicians can use to make decisions based on accepted criteria. The result is appropriate tests (bring down cost) that reveal the answers to the clinical questions (based on past and current results) that direct clinicians to treat for the best (proven through data) outcomes. The new outcomes feed back into the data because health care data are standardized and connected. Sound like a circular reference?

Healthcare Act