Sunday, January 9, 2011

PCAST Report on NIT

The President’s Council of Advisors on Science and Technology (PCAST), a group of presidentially appointed experts from academia, non-governmental organizations, and industry just released the report “Designing a Digital Future: Federally Funded Research and Development in Networking and Information Technology”.

The report includes several sections on Networking and Information Technology (NIT). The report makes recommendations on how NIT and the Nation’s Networking and Information Technology Research and Development Program (NITRD, a collaboration of more than a dozen Research and Development agencies working together, can help improve healthcare and the quality of life.

According to the report, the U.S. is spending considerably less on NIT research and would benefit both from a larger investment. The report makes it clear that although NIT has thoroughly infiltrated the business and some administrative aspects of healthcare, NIT has not come close to fulfilling its potential. The current push for meaningful use of EHRs, the increasing use of NIT as a surgical tool, the revelation of the structure of the human genome and the biomedical insight flowing from the information, and the increasingly broad and pervasive access to health information online are all promising starting points for future advances.

The business side of clinical care already makes wide use of NIT. The U.S is moving towards a future in which all health information sources, all professional and non-professional care, and most non-pharmacological interventions will be NIT-based.

Research in the field is needed on methods to use for the semantic analysis of natural language, for the extraction of semantic information from raw data, and for translating among different terminologies and categorizations used for the same kinds of information.

Making use of potentially huge quantities of health information of all kinds requires novel techniques to abstract higher-level concepts and explanations from lower-level data to determine relevance in context and to resolve conflicting information.

According to the report, the federal government has recognized the importance of NIT for health and has embarked on an aggressive program to institutionalize EHRs. The Strategic Health IT Advanced Research Projects (SHARP) program currently funded by ONC is excellent but it addresses relatively short-term problems.

Other agencies however, have initiated promising longer-term programs such as NSF’s Smart Health and Wellbeing Program, NLM’s health data standards and telemedicine projects, NIST’s Healthcare Infrastructure Integration projects, but still larger investments in these efforts are needed.

The report’s recommends that NSF, HHS with participation from ONC, CMS, AHRQ, and NIST, the Veterans Health Administration, DOD, and other interested agencies should invest in a national long-term, multi-agency research initiative on NIT for health that goes well beyond the current national program to adopt EHRs.

PCAST recommends that these agencies should build on national activities that promote the adoption and meaningful use of EHRs that are usable by all appropriate organizations, complement the shorter-term ONC programs, and augment the research investments that the various agencies are currently able to make.

The agencies should give increased attention to using NIT for wellness and for addressing chronic conditions, continue to investigate novel uses for NIT, such as NIT-assisted surgery to deliver care for acute conditions. They should also continue to pursue advances in sensing and monitoring to understand the basic biological and psychological mechanisms that underlie disease. The agencies also need to continue to address NIT research opportunities that support work by HHS and NSF on transformational innovation in healthcare delivery. Lastly, the funding levels and project durations must be sufficient to foster substantive collaborations between NIT researchers and clinical experts.

Go to to view the report.