Adam Clark is the Director of Research and Policy at the Lance Armstrong Foundation and also serves as a patient advocate on the Health IT Policy committee and its certification and adoption workgroup. He recently sat down with us to discuss the “meaningful“ use criteria and future health IT trends.
GovConExecutive: Could you briefly tell us your background in health IT?
Adam Clark: I actually am a cancer biologist. I was trained at the National Cancer Institute before coming to the Lance Armstrong Foundation. My focus at the NCI was on cancer biomarker programs and some of the advanced medical technologies. A lot of this included aligning IT platforms that had both patient information and clinical research data so that we could really try to move some of the research from the bench to the bedside. At the Lance Armstrong Foundation I've been involved in a number of areas of health IT.One of the areas was the recent development of what is called the Livestrong Care Plan (www.livestrongcareplan.org). This is an electronic treatment summary and care plan for survivors that helps give them a portable electronic record that they can take with them that they can show and work with their doctors as they move and transition beyond cancer treatment. We are also working with the National Cancer Institute on the BIG Health Consortium. BIG stands for Bio Informatics Grid Health Consortium and it tries to coordinate various groups leveraging a lot of the IT platforms out there. We are working with them specifically on building adolescent and young adult cancer biorepository. Researchers will be able to plug into this program, identify where these specimens are, what the patient record may have identified but allows some more integrated research to be leveraged nationwide in a federated model.
GovConExecutive: There has been a lot of talk about certification processes and your certification and adoption work group recently released their ideas. How do you believe we should go about certifying EHRs and other software?
Adam Clark: The committee itself is I think taking precautions to ensure that certification achieves two core goals. The first one is to achieve meaningful use that is designed by the policy committee and the second is to ensure security, privacy and interoperability. From my end, I look at an EHR as a tool that the patient trusts is secure that it addresses the individual patient health needs and it is there to really improve the communication and care coordination between the patient and the patient's healthcare team.
GovConExecutive: How can we include softwares that have patient access and PHR to the “meaningful use“ criteria?
Adam Clark: I think patient access is going to be critical and personal health records are going to be critical. These are objectives that the [Health IT Policy Committee] is looking more at incorporating in 2013. I truly believe that this is where we are going to see a revolution in healthcare and healthcare reform when the patient has access to the records, to interpretations of the records and is able to communicate back and forth with his or her doctor, with his or her healthcare team and really trying to leverage that coordinated care approach getting feedback on what the care should be moving forward.
GovConExecutive: How do you think that meaningful use criteria is going to affect the adoption of health IT?
Adam Clark: I think the ultimate goal of meaningful use is to improve the patient's health, the patient's care, and ultimately the American population's health. When we look at how it is going to affect the adoption of health IT I think that the definition is going to have to be broad enough to include small or even individual practices as well as large practices. I think the committee is taking precautions to ensure that we can include those groups. The definition is also going to need to be adaptable to the primary care settings as well as specialty services. We are looking into a lot of those areas. We're trying to talk with sectors out there about what those needs are going to be.
GovConExecutive: Are there any new technologies that you are excited about or that you see as the future of health IT?
Adam Clark: From the cancer end, I see health IT as a leverage platform to revolutionize medical research and practice in the years to come. I think it enables us to have what I refer to as a learning healthcare system, where information is coming in in real time to inform doctors and patients alike. Health IT is actually also going to be the foundation for personalized medicine, which means targeting a treatment and/or an intervention to an individual. For example if you have a gene that increases your risk for colorectal cancer, health IT will enable your doctor to identify this gene and maybe change a recommendation for colorectal cancer screening to begin at age forty instead of the standard at age fifty. Health IT will allow that information to pass from maybe a genetic record back to your EHR to inform the doctor. Subsequently you could see health IT including an individual's cancer genome or their individual genome and when they go through sequencing maybe identifying a particular mutation in the gene that is going to be specific to a new drug being developed in the clinical trial. Health IT could alert the doctors that this patient could be a candidate for this new drug so it really can facilitate new methods of care, identifying responders to drugs and subsequently identifying people who won't respond to a drug so that we can avoid putting them on a treatment that won't work.
GovConExecutive: Is there anything you would like to add?
Adam Clark: I think one of the most important things for health IT in moving forward is that we get the patient population involved, that we get their feedback on what this new technology and new technology platform can do for them and that really we ensure that they are comfortable with the privacy and the security of these systems and that they remain the sole source of control over any of their electronic health records or electronic medical records moving forward.