Academic medical centers are helping drive EHR interoperability
Deputy National Coordinator for Health IT Jon White, MD, says universities are playing a key role in the development of interoperable healthcare systems.
"University research serves at least three useful purposes," says White. "First is innovation: Many products, standards and people got their start in an academic setting. Second is evidence on the effect of IT on health and healthcare. Third is implementation, as academic medical centers play a significant role in the nation's healthcare."
Philip Payne and Peter J. Embi agree. Leaders of the biomedical informatics department at Ohio State University, they spent 13 years and $20 million in university funding to incubate AVEC, a commercial federated data integration platform.
"University research is a driver of early-stage, high-risk, high-yield research that transfers to the private sector. There are a number of examples of innovations in the healthcare IT space that happened at universities, including most of the early development of what are now major commercial electronic health records organizations," says Payne.
Embi concurs: "What's not often recognized is that many of the greatest leaps forward actually originated at universities," he says.
"The very nature of what we do as faculty and researchers is to push the envelope and figure out solutions to problems that haven't been solved – and a lot of times doing that is 'risky' from a private-sector perspective," he adds. "A lot of research results in practical solutions but we also sometimes find a particular approach doesn't work all that well."
Payne says AVEC research stemmed from "a confluence of innovative research, unique funding opportunities and identification of a number of critical research and operational problems we felt we could solve. It was the perfect combination, which led us to compete for a number of grants and contracts and start looking at how to bring that technology to market at scale."
"As is common with projects like this, funding came from OSU institutional resources as well as various federal grants," Embi adds. "The beginnings of the technology were actually spurred by initiatives happening at the National Institutes of Health, including the National Cancer Institute. Early initiatives sought to develop technologies that would enable sharing of knowledge across cancer centers for the purpose of accelerating research and discovery.
"Our group at OSU was one of the key groups funded to develop the underlying technology to enable interoperability between systems," he says. Eventually, (AVEC) got so big we recognized the need for disseminating that technology into the private sector."
In 2014, Payne and Embi started Columbus-based Signet Accel in partnership with OSU. The company licensed software technologies for healthcare data sharing and analytics through the Ohio State Innovation Foundation.
Payne says "Startups can act upon new technologies with agility and speed. They are a really important bridge between university-based research and broader-scale corporate partners. That's why you see such an explosion of healthcare IT startups that often have very close ties to academia and university-based researchers."
Julia Adler-Milstein, assistant professor in both the school of information and school of public health at University of Michigan, agrees.
Citing last year's partnership between the University of California and Cisco to develop an interoperable healthcare IT platform, she says, "These types of partnerships help connect the technology side with the realities and complexities of frontline healthcare to ensure the interoperability solution can work in the real world.
"The value of an academic medical system versus a large non-academic system is that more informatics and research expertise can be leveraged and is likely useful," she adds.
"A broad array of actors need to work together to tackle the interrelated barriers to interoperability," says Adler-Milstein. "So, there is not going to be a single organization or partnership that will swoop in with the silver bullet," she warns.
Embi, believes solutions to meeting federal regulations such as meaningful use, can arise from either the public or private sector, calls collaboration "the way of the future." Whether R&D is funded at a company or a university, either could come up with a solution.
The reality is this tends to happen at universities because it's a key part of our mission – to make discoveries, innovate and push the envelope to come up with new approaches and new solutions and then disseminate and teach about them."
Payne also sees no difference in the ability of private start-ups or university-led research to meet federal standards.
"I fundamentally do not believe there are major divisions between the public and private sector when it comes to delivering these types of healthcare information technology innovations to end users," he says. "The most successful projects are the ones where all of these parties work together at the right time and the right place to bring the solution to people who need it."