Sunday, July 18, 2010

PCAST to Issue HIT Report

The President’s Council of Advisors on Science and Technology (PCAST) held a meeting July 16, 2010 in Washington D.C. Both John P. Holdren Co-Chair and Assistant to the President and Director of the Office of Science Technology Policy (OSTP) and Eric Lander Co-Chair and President, Broad Institute of Harvard and MIT, chaired the meeting to discuss and advise the President and the Executive Office of the President on several current issues.

Health IT was one of the issues discussed as the Advisory Committee has been working for the past seven or eight months on a report to help advise the President. A working group was chaired by Christine Cassel M.D., President and CEO, for the American Board of Internal Medicine and Craig Mundie, Chief Research and Strategy Officer for Microsoft. The Health and Life Sciences Subcommittee under the direction of William Press Ph.D, Rayner Professor in Computer Science and Integrative Biology at the University of Texas at Austin brought their ideas forward on the subject to present to the PCAST meeting on July 16th.

As Dr. Cassel pointed out, they began the study on health IT by looking at examples where health IT has been used successfully. They concentrated on the Veterans Administration’s health technology undertakings, and also studied how Kaiser Permanente operates their program. The group also looked at smaller physician offices and their specific needs to deliver medical records electronically.

As Dr. Press noted, the working and subcommittee looked very closely at privacy and security issues. As he reported, the Markle Foundation 2006 survey found that 80 percent of people are very concerned about theft and fraud as it pertains to their medical records. He continued to say that privacy was engineered from the start through legislation such as HIPAA, but that the current thinking is that HIPAA needs to be changed and simplified to meet future needs.

The current thought is that the patient should be allowed to consent to their information being used for research. Also, the patient should be notified when researchers are using the data and be able to choose whether they want to continue to release their information throughout their lifetime.

Discussion centered on small practices and the enormous amount of paperwork they are required to handle which is many cases necessitates the office to hire more staff. Many small practices find it difficult to deal individually with operational issues when installing EMR systems.

Mundie envisions that the computer industry will have large scale cloud facilities to host and handle operational issues for practices. The smaller practices could then take advantage of cloud computing to host their services and have their services delivered via the internet.

The biggest change is that the data would be owned by the patient and exchanged, but the data itself would not be centralized in any one location. Patients would control their preferences as to who sees the data and these preferences would move along with the data.

PCAST members heard about new ideas and innovative concepts that are likely to take place in the future such as creating patient centered medical homes, accountable care organizations, and efforts to encourage more value-based purchasing.

The Co-Chair of PCAST called for a vote and PCAST approved the health IT report. The report will be revised where needed and formally released.

For more information on PCAST activities, go to