Health IT, Hospitals

Partners Healthcare and Persistent Systems join forces to produce clinical decision support tools

They are developing an open-source platform that will spur the creation of a new generation of clinical decision support apps.

Collaborative Team Building Innovation

Clinicians, growing weary of valueless box checking and unnecessary complexity, complain that information technology has not lived up to its promise of improving patient care. But a major health system and global software developer are teaming up on a four-year health IT effort that they say will improve medical decision making and speed up innovation.

Partners Healthcare, a Boston-based integrated healthcare system, and Persistent Systems, based in Santa Clara, California, and Pune, India, announced this week that they are developing an open-source platform that will spur the creation of “a new generation of decision support apps” – including some that may become proprietary.

Samuel “Sandy” Aronson is the executive director of IT at Partners Personalized Medicine. He offered some ideas for how the apps could be used. One example would be to apply the trends detected by population-based health analytics to a single patient by comparing them to other patients with similar characteristics in order to figure out their optimal treatment.

What they are not looking to do is replace clinicians by creating an app that will render medical decisions, Aronson said in a phone interview. Instead, the goal is to provide physicians and other providers with focused data – not necessarily more data – through an easy-to-use interface.

“It’s not to intervene in the decisions they’re making, but to provide them context that could be very difficult to provide any other way,” said Aronson, whose team at Partners works on integrating genetics and genomics into patient-facing care.
The effort will utilize the Substitutable Medical Applications & Reusable Technologies (SMART) platform. SMART is maintained by the Harvard Medical School Department for Biomedical Informatics and the Boston Children’s Hospital Computational Health Informatics Program (CHIP). It is designed to facilitate the creation of apps integrated into an institution’s electronic health record (EHR). The platform will also be based on the Fast Healthcare Interoperability Resources (FHIR) data-sharing facilitating standards.
Aronson hesitated to compare the new effort with VistA, the open source EHR developed internally by the Department of Veterans Affairs, but he said that being open source “makes everything transparent.”

“Other institutions can identify problems and either highlight issues or build fixes for those issues,” Aronson said. “It creates a world where things can be continuously validated and improved on by the community.”

Rahul Patel, executive vice president of digital products and services at Persistent Systems, agreed. He also noted that taking an open source approach avoids “vendor lock-in”.

There are two inherent problems with vendor lock-in, Patel said in a phone interview. Interoperability can be hindered when vendors’ products can’t communicate with each other. Also, an institution’s “velocity of innovation” is slowed by a vendor who can’t keep up.

“It allows you to move at your own pace which, in this environment, is very critical,” Patel said.

Financial considerations were not disclosed, though Aronson said some institutions or individuals may profit from proprietary apps created under this initiative. Patel said Persistent Systems “will participate in the market” created by the effort. This includes providing maintenance services for hospitals who implement the technology.

Aronson would not estimate how many hospitals may have the appetite or ability to implement the platform, but he said the fact it can be implemented incrementally at an institution’s own pace and according to their unique set of priorities will be helpful.

“I don’t see a predetermined limit on who’s going to be able to use this,” Aronson said. If the platform shows it can help clinicians save time while helping to improve patient care and reducing costs, the platform will get used, he noted.

“It really comes down to demonstrating value,” said Aronson. “That will push adoption.”

Patel said there are three factors that will encourage use of the platform.
The first driver is that the technology is “cleaner and faster” than before. Another is the move from volume- to value-based care.

“Those two give you opportunity to attack,” Patel said, adding that the involvement of Partners, a trusted healthcare provider and a reliable source of IT innovation, is the third driver.

The biggest risk in technology development is often the validation of your ideas. “Partners brings that (validation) to the table more than anyone else,” Patel said.

Aronson added a fourth driver to the list: clinical readiness.

“You have a whole generation of clinicians now identifying where care is suboptimal and who want to do something about it,” Aronson said.

In a Feb. 24 post, Dr. John Halamka noted on his post-HIMSS 2017 observations that “Big data has morphed into care management and population health.” He seemed to predict collaborations like the Partners-Persistent Systems platform development were imminent.

“We’re at a point in history when healthcare data has become digital but few are sure how to turn that data into wisdom,” Halamka, the chief information officer and dean for technology at Harvard Medical School, wrote. “Decision support services that analyze problem lists, medications, and genomic data, producing customized care plans are emerging. The challenge is connecting them to the electronic health record workflow.”

Patel did not disagree and reference Halamka’s blog post.

“Actually, it’s very consistent with our observations on technology readiness and economic drivers in healthcare coming together.”

Photo: 9amstock, Getty Images

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