Fridsma: Build standards for the future

ONC’s Office of Science and Technology at work on fueling innovation
By Anthony Brino
06:22 AM
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Doug Fridsma, MD, director of the ONC’s Office of Science and Technology, likes to tell his staff: “If we’re going to make mistakes, lets make new ones; let's not make old ones.” Fridsma, a former Mayo Clinic internist in Arizona, told attendees at the 2013 Government Health IT Conference that his office has several goals in fueling health IT innovation – not as a creator, but as a curator.

Gathering IT developers and stakeholders at a sort of technical roundtable, the Office of Science and Technology has helped reduce the time it takes to develop and implement technical specifications from between three to five years to between six to 12 months, Fridsma said.

Through that office and the ONC’s Standards & Interoperability Framework, Fridsma is trying to encourage the health IT and standards communities to develop systems with an eye toward the future.

[See also: Fridsma highlights doubling of digital docs.]

“We have to think about where we are now and where we need to go to,” Fridsma said. Today’s current systems are “tomorrow’s legacy systems.”

The Office of Standards and Technology has focused on fostering innovation with the recognition that there’s “going to be some heterogeneity,” Fridsma said. “Health information exchange is not one-size-fits-all.”

Charged with supporting the harmonization of interoperability, Fridsma sees the ONC’s standards work as gathering, enabling, curating and supporting. “Our job is not to determine what the solution is, but to define what success should look like.”

With the U.S. healthcare system on the trajectory of mass digitization within the next decade, Fridsma said he thinks it’s s ripe time for the development of novel health data uses.

[See also: Onward and upward: ONC to automate Blue Button.]

“Once we start exchanging the information, we can start using it in interesting ways,” he said.

The Standards & Interoperability Framework’s Query Health initiative is identifying standards and services that would allow distributed population health queries to certified EHRs or HIEs – with the aim, Fridsma said, of “bringing the question to the data, rather than the data to the question.”

The Query Health initiative is part of the larger goals of the ONC, often articulated by Farzad Mostashari, MD, to not only help providers manage their data digitally but to use it to improve collective medical knowledge.

Query Health, which has a pilot program in New York, is envisioned as a technology that would help automate and possibly expand the datasets for comparative effectiveness research and also help improve disease outbreak monitoring.

Another initiative with evolving technical standards under the Office of Science and Technology’s wing is the Structured Data Capture project, which is working on specifications for merging one set of structured EHR data with another comparable set.

“Wouldn’t it be great if EHR data could be used for clinical research?” Fridsma asked. “We’ve made tremendous advances in pediatric oncology because 70 to 80 percent of children cancer patients are part of clinical trials.”

Only about 4 percent of adult cancer patients participate in clinical trials, but Fridsma thinks that number could grow, or at least that more patients could be contributing their health data to research, if not participating in experimental therapy trials.

“If we could double participation in clinical research," Frisdma said, "think about how much we could learn.”