Dave’s “SO 2009″ line was repeated throughout the rest of the day – by David Blumenthal, by Paul Tang, by fellow panelists.

More later…Latanya Sweeney is now speaking!

John Chilmark recently tweeted about an example. His comment – why not say we will lower medical errors 50% by 2015 and then let innovation take over. Incentives need to focus of fixing the underlying issues and then let the technology/innovation/competition drive us there. Patient/consumers are wonderful at consuming the products that work for them and forcing innovation. This happens rarely in the health care industry.

This approach will also have a positive impact on the innovation rate that Dave points out above.

Just a couple of thoughts for the ONC meeting tomorrow. I second the points made by Gilles and Dave. I focus on health “content”, which in today’s digital economy is inextricably connected to health IT. It’s obvious to me that “meaningful use” cannot be defined without discussing the content or data that flow between IT systems. Dave makes this points eloquently.

I’d suggest emphasizing how e-patients can contribute to evidence-based medicine (EBM) and comparative effectiveness research (CER). As I’ve written in my comments about infodemiology on this site, patient-generated data represents a new pool of research data that has the potential to improve comparative effectiveness studies. ONC/HHS could help establish standards for data quality for patient-generated and outcomes data.

One last point. A more concerted focus on patient education/health literacy is needed. And there needs to be a range of authoritative information available. Motivated e-patients need more than pamplets designed for the lowest-common denominator population. There’s lots of information published, but some is not accessible to non-medical professionals, some is expensive, and much of what is available to consumers is of questionnable value in large part because of the bias of the person or organization that publishes the information.

In sum, I want to keep hammering on the point that meaningful use of health IT requires just as much focus on the “information” as it does the “technology”.

And you are right about the fact that we only know that mobile has the *potential* to be important in reaching diverse populations. I am an optimist, which is why I need to listen to people with, well, diverse perspectives!

Yes, “mobile is changing the dynamic among African Americans, erasing the differences between them and white adults when it comes to internet access.”

But we have no idea if the big change in Internet access is paralleled by a huge change in usage of the internet based medical resources that are available. I believe that the UX of many members of various minorities is still based on their lack of trust in the entire healthcare system.

So my addition to your presentation would be as follows: “Consumers with diverse perspectives, circumstances, capacities, and experiences must be included in the design of, and have meaningful access to, evidence-based culturally sensitive e-health tools”

BTW, this is quoted quasi-verbatim from ” Expanding the Reach and Impact of Consumer e-Health Tools June 2006″; DHHS

http://www.health.gov/communication/ehealth/ehealthTools/preface.htm

I’m not an advocate for any policy outcome, but it’s clear from our data that there are many, many people who agree with you and are looking for ways to connect with the best health information resources available to help themselves and their loved ones.

Cell phones and iPods wouldn’t evolve nearly as fast without interoperability and content that flows easily between tools. So I want to get my hands on ALL my data, so *I* can submit it to whatever tools I want.

I want to be able to check the accuracy of my data. All of it, including my billing records, which can be used against me.

Ultimately, here’s what it comes down to: information about me is MY property. It’s MY life (nobody else’s) that can be shortened or lengthened by the quality and mobility of that data. Think about that for your own children!

You bet I ought to be able to get my hands on all the data and proofread every last bit of it, show it to my own selected experts, and take it with me wherever I want.

I hadn’t planned to hit the access data hard tomorrow, but your comment is making me think that I have a responsibility to do so.

Mobile is changing the dynamic among African Americans, erasing the differences between them and white adults when it comes to internet access. But pockets of people remain offline – people living with chronic conditions being one example. I’ll release new data soon showing that there has been no significant increase in the last two years among that population when it comes to internet access. And since they are likely to be older, they are not jumping on the wireless device bandwagon.

the goal has never been to supplant the doctors but to supplement the traditional I/O chain the patients have traditionally experienced with their doctors.

By providing a growing number of tools specialized in knowledge/information surfacing the Internet has already allowed millions of patients to experience the benefits of direct patient engagement.

And now, the new systems designed for data collection, data sharing and data integration are once again pushing the envelope.

Just think how incredibly powerful innovations will be when we’ll be able to transparently fully integrate data into the conversations: “From Social Media to Social Data and Back!”

It is just very sad that this revolution remains a societal phenomenon of the affluent and educated. To tackle this problem, let’s work actively to build the science behind what we do. And then demand that help be provided to help build either similar systems for the digitally disenfranchised.