From a Health Sector to a Health System through the use of Cloud Computing: Creating Virtual Medical Homes
Presented by Leslie Lenert, MD
DATE: Thursday, September 17, 2009
TIME: 11:30 AM – 1:00 PM
LOCATION: TSRB 132
"We don't have a health care system in the United States, what we have a health care business sector." -- Former Secretary of Health, Mike Leavitt.
As the United States struggles to find approaches to guarantee access to health care for all its citizens, and is confronted by the costs of this goal, its leaders must also face the reality of the “non-system” of health care delivery. U.S. health care is expensive, and lacks continuity of care, and as a result, the quality of care for any individual is often poor, with only less than half of patients with health insurance getting recommended services. The path forward, as described in the American Recovery and Reinvestment Act (ARRA), focuses on adoption of information technology, particularly within primary care practices, with promises of approximately $40B in government support for purchase and installation of electronic health records systems and approximately $2B in support for infrastructure for these systems. The success or failure of this investment hinges upon the degree to which national and state governments are able to capitalize on this investment to re-engineer health care process. This talk will examine one of the more critical theories about how to re-engineer health care processes—the concept of the “medical home” and how to re-engineer processes using cloud computing approaches to achieve its goals. A medical home is a model for primary care practice that provides continuity of care for individuals in a patient-centered environment. While re-engineering of the entire health sector is unlikely, it is possible to create, on a region by region basis, system-like features that provides the equivalent of a medical home. The talk will discuss past and current successes with the creation of regional systems for care from collections of data sources in the health sector and describe future opportunities, pitfalls and strategies for creation of new, value-oriented systems that provide high quality, patient-centric care.
Leslie Lenert, MD, MS, FACMI is graduate of the University of California, Riverside and the University of California, Los Angeles, School of Medicine and has completed residency training in Internal Medicine at the University of Texas Southwestern School of Medicine and fellowships in Clinical Pharmacology and in Medical Informatics at Stanford University School of Medicine. In 1990, Dr. Lenert became Assistant Professor of Medicine (and by courtesy) Molecular Pharmacology and Clinical Chief of the Division of Clinical Pharmacology at the Stanford University School of Medicine. There he conducted research to improve drug dosing and to enhance patient participation in clinical decision-making using computers. He also pioneered efforts to use patient populations on the Internet for medical research. In 1997, Dr. Lenert moved to the University of California, San Diego, where he was promoted to Professor of Medicine at and became Associate Director (Medical Informatics) of the California Institute for Telecommunications and Information Technology (Calit2), an interdisciplinary science institute with an annual more than 200 affiliated faculty and budget of more that $180M. At UCSD, he continue work to help patients with difficult clinical decisions and, after 9/11, worked with colleagues at Calit2 to develop a "location aware" wireless electronic medical records system for first responders to use to manage the care of disaster victims. In July of 2007, Dr. Lenert became the first permanent Director of the National Center for Public Health Informatics (NCPHI) at the Centers for Disease Control and Prevention (CDC), a Center with a $120M annual budget and more than 600 employees and contractors. At NCPHI, Dr. Lenert led the agency’s efforts to meet public health information needs through improved linkages with the clinical care system based on “cloud computing” technologies. His activities included leading CDC agency-wide efforts for integration of public health with the National Health Information Network (NHIN). As part of the this effort, he launched a five-year $40M program to fund regional NHIN compatible health information exchanges to work with public health departments on two-way data exchange. He created a new federated architecture for data exchange for public health surveillance that helped turn around an unpopular, politically-threatened national program for biosurveillance (BioSense), and won the support of public health partners and the U.S. Senate. Working with GE Medical Systems, he helped to create a service oriented architecture technology to bring alerts about outbreaks in a community to clinicians’ desktops. He also help to found a new Global Public Health Informatics program at CDC and championed the migration of public health systems to Open Source development methods. In August of 2009, Dr. Lenert became a Special Advisor to the Deputy Director of CDC. Dr. Lenert has published over 120 original articles and book chapters, is a Fellow of the American College of Medical Informatics (ACMI) and was a elected of the Board of Directors of the American Medical Informatics Association. He has serves on advisory boards for Robert Wood Johnson Foundation (Common Ground), Markel Foundation (Connecting for Health), Archimedes (Scientific Advisory Board), and on the editorial boards of the Journal of the American Medical Informatics Association, the Journal of Biomedical Informatics, and the International Journal of Medical Informatics.
Event with the GVU Brown Bag Calendar