G. Abowd, M. Braunstein, S. Fleming, E. Mynatt, S. Rushing, and W. Rouse
December 3, 2009
Executive Summary
Through targeted investment and significant academic and research efforts over the last decade, Georgia Tech has become a leader in biomedical engineering and the life sciences. We are now targeting leadership in the adjacent but separate space of healthcare delivery. This effort engages individuals and organizations across the Georgia Tech campus, throughout the University System of Georgia, in other academic institutions across the Southeast, in state and local governments, and with major industrial partners. The objective is to transform the delivery of healthcare in Georgia, the Southeast, and the United States.
Chronic disease now accounts for 75% of all healthcare spending in the U.S. By virtually all measures of overall care quality, the U.S. is at or near the bottom in managing the majority of chronic and population health care needs when compared to the other major industrialized countries. This is despite spending up to twice as much as those other countries, whether measured per capita or as a percentage of GDP.
Most medical research to date is aimed at improving the diagnosis and treatment of disease—in other words increasing our knowledge in order to provide better (and often more expensive) “rescue care.” Most of this disease-oriented effort currently takes place in medical schools. Now, the country needs more research related to the problems of delivering our increasingly abundant medical knowledge through a healthcare system that assures accessible, high-quality, safe, and affordable care to all Americans. It also needs more research into preventing rather than treating the major chronic diseases.
Revolutionary action requires revolutionary thinking by people not embedded in the current system. The healthcare industry faces a collective innovator’s dilemma; the inability to envision the impact of future, consumer-oriented healthcare technology, and an unwillingness to cannibalize existing business practices. The Obama administration, faced with the crushing economic burden of the current healthcare system, has created an opportunity for revolution through the national strategy for health information technology (HITECH) as outlined in the ARRA stimulus bill.
As a respected but independent technological research university without a legacy medical school, Georgia Tech is taking a leadership position in a major transdisciplinary effort—involving individuals from every college and many other units across campus—to transform a substantial sector of the nation’s economy. Our core strengths align well with what is needed to help redesign and re-engineer this complex industry. In particular, the transdisciplinary effort at Georgia Tech is creating new models for structuring a value chain that begins with academic research but extends all the way to implementation in real-world health systems through a new kind of partnership.
Driven by the carrot and stick of the ARRA stimulus bill and statewide budget challenges, Georgia is taking a proactive role in transforming healthcare delivery. Georgia Tech, drawing on many of the capabilities highlighted above, is already deeply involved in several activities, including teaming with other organizations in Georgia to apply for significant Federal grants. There will soon be an HHS request for proposals aimed to fund three large-scale national research centers to design, deploy, and evaluate innovations in information technologies for healthcare. Georgia Tech is organizing a nationally-competitive proposal for such a center.
The talent at Georgia Tech coupled with our neutral position with respect to often-competitive healthcare systems creates a unique opportunity. With focused effort, we can convene the necessary research, practice, industry, and non-profit partners to carry out a successful and revolutionary research agenda while simultaneously creating and measuring impact on the real-world healthcare delivery in Georgia and beyond.
This research and deployment effort will involve multiple testbeds—a core competency of Georgia Tech. We are moving forward with establishing basic functionality as rapidly as possible along three parallel levels: interoperability, a model campus health community, and a statewide HIT testbed.
A campus-wide transdisciplinary and translational research program has the potential to be transformational for Georgia Tech. This effort is not merely a new research center, or just a new degree program. Crossing all organizational boundaries, the science and engineering of healthcare delivery will provide endless challenges for our faculty, students, and research staff. while serving our triple mission of education, research, and community service.
Introduction
Through targeted investment and significant academic and research efforts over the last decade, Georgia Tech has become a leader in biomedical engineering and the life sciences. We are now targeting leadership in the adjacent but separate space of healthcare delivery. This effort engages individuals and organizations across the Georgia Tech campus, throughout the University System of Georgia, in other academic institutions across the Southeast, in state and local governments, and with major industrial partners. The objective is to transform the delivery of healthcare in Georgia, the Southeast, and the United States.
Healthcare Delivery — An Opportunity Born of Crisis
America leads the world in what Dr. Brent James (a national thought leader recently profiled in a widely-read article in the New York Times) calls “rescue care.” Survival rates for acute problems like heart attack and major trauma are better here than anywhere else.
However, chronic disease now accounts for 75% of all healthcare spending in the U.S. By virtually all measures of overall care quality, the U.S. is at or near the bottom in managing the majority of chronic and population health care needs when compared to the other major industrialized countries. This is despite spending up to twice as much as those other countries, whether measured per capita or as a percentage of GDP.
In 2000, the Institute of Medicine issued an alarm that our delivery system was not only overly expensive, but suffers from systemic quality problems. To give but one commonly cited example: Only around 55% of chronic disease patients are prescribed what is known to be the best treatment for their condition.
Our system is also often unsafe. Deaths from preventable medical errors are the fifth leading cause of death in this country—for example, an estimated 44,000 to 98,000 American die in hospitals each year from preventable causes.
Care is also not equally accessible to all Americans, even those with insurance. A 2008 study by the National Association of Community Health Centers found that rural areas suffer from a particularly acute physician shortage, and that 56 million U.S. residents do not have a regular source of healthcare because of shortages of physicians in their areas.
Other research shows a direct link between the lack of a regular physician and high costs and poor outcomes in chronic disease. A 2007 Milken Institute report suggests that savings of $80 billion or more per year are achievable by improving the care of the seven most common chronic diseases. That same report claims that this number is dwarfed by the potential (over three times as great) to improve the productivity of the American workforce through better control of these conditions.
The Innovator’s Dilemma
Revolutionary action requires revolutionary thinking by people not embedded in the current system. The healthcare industry faces a collective innovator’s dilemma; the inability to envision the impact of future, consumer-oriented healthcare technology, and an unwillingness to cannibalize existing business practices. The Obama administration, faced with the crushing economic burden of the current healthcare system, has created an opportunity for revolution.
The national strategy for health information technology (HITECH) as outlined in the ARRA stimulus bill involves several major elements being done in parallel:
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To ensure that each patient is given the best available treatment and that their ongoing care needs don’t slip through the cracks, physicians in the front lines of the war on chronic disease—principally primary care physicians in medically under-served areas—are to be helped to adopt electronic medical records (EMR) with a goal of ubiquitous deployment by 2014. This assistance includes, for the first time, direct incentive payments to clinicians who demonstrate “meaningful use” of their EMRs in the treatment of patients. The assistance also includes direct advisory services delivered through regional extension centers modeled on the successful Federally-sponsored Manufacturing Extension Partnerships program.
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To facilitate this aggressive timescale for deployment, funding is to be provided for greatly increased training and workforce development in health information technology (HIT).
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To ensure that every patient is treated with the benefit of full information about their health status and prior care, these EMR systems are to be interconnected via a health information exchange (HIE).
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To provide the data to pay physicians for high quality and to fuel further research into the effectiveness of our approaches to care, data will be collected, aggregated and studied.
The Role of Academia
Academia mirrors the country in that most medical research to date is aimed at improving the diagnosis and treatment of disease—in other words increasing our knowledge in order to provide better (and often more expensive) “rescue care.” Most of this disease-oriented effort currently takes place in medical schools. Even without a medical school (but with a strong partnership with Emory for biomedical engineering), Georgia Tech has spent the last decade becoming a leader in life sciences, biomedical engineering, and related areas of medical research.
Now, the country needs more research related to the problems of delivering our increasingly abundant medical knowledge through a healthcare system that assures accessible, high-quality, safe, and affordable care to all Americans. It also needs more research into preventing rather than treating the major chronic diseases. There are glimmerings of such research programs at various institutions across the country—but none has established a preeminent lead and, paradoxically, many are hobbled by their existing medical schools which are heavily invested in the current approaches. As a respected but independent technological research university, Georgia Tech is taking a leadership position in a major transdisciplinary effort to transform a substantial sector of the nation’s economy. Our core strengths align well with what is needed to help redesign and re-engineer this complex industry.
Transdisciplinary
Georgia Tech has earned a reputation for supporting interdisciplinary research. But reinventing healthcare delivery is a big problem that—like energy and sustainability—will succumb only to a transdisciplinary approach. From Wikipedia:
Transdisciplinary studies are an area of research and education that addresses contemporary issues that cannot be solved by one or even a few points-of-view. It brings together academic experts, field practitioners, community members, research scientists, political leaders, and business owners among others to solve some of the pressing problems facing the world, from the local to the global…. What sets transdisciplinary studies apart from the others is a particular emphasis on engagement, investigation, and participation in addressing present-day issues and problems in a manner that explicitly destabilizes disciplinary boundaries while respecting disciplinary expertise.
Computer Science alone won’t solve the problem of changing the behaviors of physicians and patients that generate or complicate many of the problems cited previously. Industrial Engineering alone won’t advance our ability to mine the mountain of data that HITECH will produce for the insights and wisdom we need to advance. We recognize that a transdisciplinary approach is the route to leadership in this field. We are establishing a platform that all faculty from all disciplines and all academic levels can stand upon, along with healthcare providers, political leaders, and corporate partners. We need to gather together disciplinary knowledge coupled with practical implementation expertise. Just inside Georgia Tech alone, this transdisciplinary effort involves individuals from every college and many other units across campus:
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College of Architecture
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Center for Assistive Technology and Environmental Access (CATEA)
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Center for Quality Growth and Regional Development
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Healthy Places Research Program
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Center for Integrative Healthcare Design
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Industrial Design Program
College of Computing
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School of Interactive Computing
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School of Computer Science
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School of Computational Science and Engineering
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GTISC
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GVU Center
College of Engineering
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School of Industrial and Systems Engineering
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School of Electrical and Computer Engineering
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Department of Biomedical Engineering
College of Sciences
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School of Psychology
College of Management
Ivan Allen College
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School of Economics
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School of Public Policy
Georgia Tech Research Institute (GTRI)
Enterprise Innovation Institute (EI2)
Global Center for Medical Innovation (GCMI)
Stamps Health Services
Tennenbaum Institute
and probably others!
In particular, the transdisciplinary effort at Georgia Tech is creating new models for structuring a value chain that begins with academic research but extends all the way to implementation in real-world health systems through new partnerships with GTRI and EI2. GTRI has traditionally worked to develop faculty research into practical technologies, with an emphasis on contract research for the Department of Defense. Healthcare presents significant opportunities to expand the portfolio of GTRI and leverage its strengths. EI2 has focused on commercialization, outreach to industry, and community policy assistance. By combining these proven capabilities with the development of compelling testbeds (see below), we are creating a new kind of model for taking ideas all the way from the lab to the community.
Potential New Transdisciplinary Research at Georgia Tech
Below are just some of the more obvious transdisciplinary research thrusts where Georgia Tech is poised to lead:
Patient-Centered Healthcare
As mentioned above, a simple way to subdivide health is into acute and chronic problems. Acute medical problems are, by definition, self -limited and/or treatable. A common cold will go away on its own. A fracture will heal once set. Appendicitis can be surgically corrected. A century ago, problems we now consider acute were life-threatening and most people died relatively young, quickly and cheaply. Today, we avoid or survive acute problems, only to develop the chronic diseases that eventually kill us years or decades later. The best we can do is to slow or—ideally, but not typically—arrest their progression and mediate the symptoms they cause. As a result, we live longer, but much more expensively.
But chronic disease is often preventable. Over the past twenty years, obesity rates in the US have doubled. In 1985, a state with a 15% rate was an outlier on the high side. Today, not one state has rates that low! Lifestyle issues like obesity are estimated to drive at least half of all chronic disease. Changing the behaviors that lead to this will require novel strategies that almost certainly must leverage technology to reach the tens of millions of people beginning in their youth who are putting themselves at risk for chronic disease later in life. By addressing peoples’ health issues before they are patients in a “rescue care” situation, we will save money, save productive hours, and save lives.
Rescue care of an acute medical problem takes place in a small window of time, entirely within a specialized unit of a hospital. In contrast, managing and preventing chronic disease is a complex logistical and information management problem. It requires that healthcare professionals collect and manipulate data across time and space, and analyze and present that data to patients, families and other professionals in actionable form. A recent study highlights this challenge. Patients with five or more chronic diseases—a group that accounts for half of all Medicare spending—receive care from 14-15 sources in a typical year but we lack systems to coordinate this care so it is often duplicative or erroneous because it is not based on a complete picture of the patient’s situation.
The Academy of Family Physicians and others now envision the “patient-centered medical home,” a team-oriented model (including the patient and their family) for the continuous and proactive care that is so often lacking but which has been shown to work. Research shows that the small medical practices that deliver over half of all care in the U.S. lack the economic base or the management skills to implement this model. There may be an opportunity to leverage the HITECH infrastructure to virtualize the model and make it viable in these small practices, but much research is required as to how to do this safely, effectively, and affordably.
With substantial expertise in ubiquitous computing, including current research efforts in technologies for diabetes, asthma, autism and nutrition, Georgia Tech is well positioned to act as a major thought leader in creating information technology for patient-centered healthcare directly aimed at the challenges of chronic disease management and prevention. Current research at Georgia Tech demonstrates the potential to significantly improve out-patient care for adults with diabetes and children with asthma. Patient-centered healthcare must also advance practices for preventing chronic disease and promoting wellness. Educating individuals about nutritional choices is best done when the decisions affecting diet are made, that is, when grocery shopping or ordering food at a restaurant. The near-ubiquity of smartphones provides many opportunities for reaching out to individuals with critical and persuasive health advice “just in time” to impact those decisions. Georgia Tech is already demonstrating this capability through innovative interventions on its own campus through the work of the GVU Center.
Organizational Transformation
Health is a complex adaptive system as described by Bill Rouse which, almost in Alice in Wonderland fashion, does not behave the way one would expect. For example, driving down the costs in one part of the system may substantially increase costs in another part. Decisions that lead to quality health outcomes—for example activities, aimed at disease prevention—may not be supported by economic incentives within the system. Implementation of a new software system will involve multiple constituencies—doctors, nurses, IT departments, billing departments, insurance payors—any one of which can say “no” but who must all simultaneously be convinced to say “yes.”
The health system challenges presented by chronic disease are fundamentally different from rescue care. But our healthcare system is designed and incentivized to remain focused on rescue care. As a result, it is now widely perceived that no simple fix will work—the system must be substantially re-engineered.
With the nation’s best school of industrial and systems engineering, and as the home of the Tennenbaum Institute, Georgia Tech is well positioned to explore and implement new organizational models in transforming the healthcare system.
“Smart” Healthcare
Georgia Tech led the way towards innovation in healthy aging in 1998 with the establishment of the Broadband Institute Residential Laboratory and the Aware Home Research Initiative. Since then, many other universities have followed with research agendas that integrate technologies in the home to support awareness and prevention of problems that lead to a reduction in quality of life and loss of independence. Other lifelong chronic conditions, such as diabetes, asthma, autism, and cancer can also be supported through the infusion of smart technologies in the home and other nonclinical spaces (the office, public spaces).
Smart healthcare involves the creation of new sensing platforms for creating awareness of an individual’s health status that can be practically deployed in any home, school, or workplace. It also involves the development of artificial intelligence applications that can merge sensed information to create knowledge of health status. Much of the national HIT strategy involves the development and integration of clinical electronic medical records, but there is an increasing commercial interest in personal health records. Improving our ability to collect and reason about health-relevant data in homes and other nonclinical spaces will quickly create as much, if not more, data that needs to be merged effectively with electronic medical records.
This avalanche of electronic health information presents grand challenges for automated means of understanding that data and merging it effectively with the constantly growing body of medical knowledge. It currently takes up to 17 years for any evidence-based medical treatment to make its way into the healthcare delivery system, and then on average only be prescribed 55% of the time. There is surely an opportunity to use information technologies to substantially shorten that interval. More importantly, since we already know that a large percentage of patients do not receive state-of-the-practice medical advice for managing their health, we see a great opportunity to use automated means to connect doctors and patients to the best known practices for managing health.
Smart healthcare would enable the devices and technologies used in healthcare to be intelligently connected via the patient-centered medical home. Even today, an IV pump delivering blood-pressure-lowering medication is not connected to the blood pressure cuff monitoring the other arm. Asthma medications are not automatically calibrated to current indoor and outdoor air quality. Diabetics are required to constantly shift medications and diet based on combinations of schedule, food intake, sleep, and stress levels. The potential for improving many common healthcare routines is tremendous.
Open Innovation
One of the advantages of Georgia Tech is that it can position itself as an objective player in the science and engineering of healthcare delivery, primarily because it does not have an exclusive arrangement with any healthcare system. In the past, the lack of a medical school would have been viewed as a major obstacle to doing health-related research. Now, it is an opportunity to focus on the problems of healthcare delivery that can address some of the idiosyncratic challenges of the predominantly third-party payer system in the U.S. Federal investment is trying to spur the deployment and integration of clinical electronic medical records, and one of the key challenges will be the adoption of appropriate standards to support that integration. As we have explained above, personal health records provide an important opportunity when merged with clinical records because they provide better longitudinal records of health practices to support the management of chronic disease.
Science and engineering research in the U.S., and particularly at Georgia Tech, has flourished because of the innovative thinking of independent minds. The translation of those innovative ideas into a complex health system relies on the establishment of practices that facilitate the integration of innovative ideas into working systems. This is a tremendous challenge and opportunity, and we have to figure out ways to support such open innovation at every level of health research, from discoveries of new devices to support diagnosis and treatment, all the way up to information mining and operations research that can inform data-based decisions for healthcare policy. The ultimate goal is to create a U.S. healthcare system that inherently supports open innovation akin to the revolutionary power of the Internet.
The Internet began as the ARPANET, a very limited testbed to explore messaging protocols and interfaces. It emerged as a disruptive force that transformed entire economic sectors because of the creativity of thousands—and then millions—of individual researchers, software developers, and commercial enterprises who took advantage of the open-systems underpinnings of the Internet to provide new types of services. In the process, the Internet triumphed over any number of closed network protocols and architectures.
The transformation of healthcare delivery will echo this history, and that we are now seeing the earliest evolution of an “Internet of Healthcare.” This open-systems network of networks will support local and national health services as well as clinical, behavioral, and operational research. Such a system will give researchers and clinicians the ability to ask and answer questions about efficient and effective healthcare practices. This capability will not be possible unless we provide ways for those outside of the medical establishment to apply their innovative ideas on the real system itself. Critical to the success of such a strategy is a way to handle the unique security and privacy issues of highly-sensitive personal health data.
With our strong presence in the development of open Internet standards and information security, Georgia Tech is positioned to lead the way in establishing increasingly larger healthcare testbeds and demonstrating interoperability that encourages innovative research.
Transforming Healthcare Delivery in Georgia
Driven by the carrot and stick of the ARRA stimulus bill and statewide budget challenges, Georgia is taking a proactive role in transforming healthcare delivery. Georgia Tech, drawing on many of the capabilities highlighted above, is already deeply involved in several activities:
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Before any transformation can take place, the state must have an appropriately-trained workforce. GT has submitted a proposal to the Department of Labor to lead a statewide coalition—including the technical colleges and K-12 systems—in creating an innovative HIT training program.
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To support deployment, GT has submitted a proposal to the Office of the National Coordinator for Health Information Technology to participate with Morehouse School of Medicine’s National Center for Primary Care (NCPC). NCPC will lead Georgia’s effort to assist primary care physicians—the frontline of defense against chronic disease—to intelligently acquire and deploy electronic medical record (EMR) technology.
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We’ve had preliminary discussions with NCPC about using this opportunity to define and implement a new “virtual” patient-centered model for chronic disease management in the practices we automate (as discussed under “Patient-Centered Healthcare” above).
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We recognize that Georgia is home to the nation’s largest concentration of HIT companies, and we’ve begun to reach out to the leading local companies as potential collaborators.
Ahead is the role GT can play in creating a statewide health information exchange (HIE) for Georgia. Taken together, electronic medical records connected through a regional health information exchange can create a testbed for research into the design and deployment of a more effective system for care delivery and chronic disease management. We are only in the early stages of developing a strategy for this, but we’re already talking to potential partners for advanced research into optimal care processes, virtual technology-driven patient-centered care, clinical effectiveness and others.
This planning effort is also the basis for discussions with Open Health Tools (OHT, a Federally-endorsed health open source community). OHT is seeking a limited number of foundational university relationships designed to educate and support “innovators.” These innovators will drive rapid and agile development of new HIT applications connected to the National Health Information Network (NHIN); these “edge” applications will enable near-term policy and business model transformation formulated on clinical-effectiveness research. This level of education for NHIN and OHT will also be the basis for a new round of HITECH workforce improvement funding. A future GT proposal will leverage the Department of Labor and the Technical College System of Georgia while expanding our role as the source for curriculum and educational content.
Moreover, there will soon be an HHS request for proposals aimed to fund approximately three large-scale national research centers across the U.S. to design, deploy, and evaluate innovations in information technologies for healthcare. Georgia Tech is organizing a nationally-competitive proposal for such a center; we’ve already had discussions at varying levels of detail with potential partners including Vanderbilt, Columbia, UCLA, the Mayo Clinic, the Morehouse School of Medicine, Emory, and the Medical College of Georgia.
Political Situation
At the Federal level, we have already met with multiple agencies, including:
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National Institute of Standards and Technology (NIST)
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National Library of Medicine
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Agency for Healthcare Research and Quality
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Office of the National Coordinator for Health IT
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Health Resources and Services Administration
In addition, a senior EI2 employee has been seconded to HHS to help develop the plan for the national HIT research centers mentioned above. There is much more work to be done, but Georgia Tech has been welcomed into the national debate both prior to and after the passage of the ARRA act.
Here in Georgia, our state partners include:
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Georgia Department of Community Health (DCH)
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Georgia Department of Health Policy and Management
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Morehouse School of Medicine (MSM)
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National Center for Primary Care (NCPC)
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Emory University
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School of Medicine
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School of Public Health
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School of Nursing
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Center for Comprehensive Informatics
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Emory Healthcare
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Predictive Health Institute
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Medical College of Georgia (MCG)
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Other units of the University System of Georgia
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Technical College System of Georgia
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Global Center for Medical Innovation (GCMI)
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Georgia Research Alliance
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Piedmont Hospital
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St. Joseph’s Hospital
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Children’s Healthcare of Atlanta (potential GCMI member)
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Georgia Medical Care Foundation
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Georgia Hospital Association
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Patient Safety Center (new Tech Square tenant)
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Lowndes, Paulding, and Troup counties (each of which has a “healthy community” initiative underway)
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Georgia Department of Economic Development
The talent at Georgia Tech coupled with our neutral position with respect to often-competitive healthcare systems creates a unique opportunity. With focused effort, we are convening the necessary research, practice, industry, and non-profit partners to carry out a successful and revolutionary research agenda while simultaneously creating and measuring impact on the real-world healthcare delivery in Georgia and beyond.
Testbeds
“Translational research” has been an organizing principle of medical research for several years, where the popular buzzphrase is “from bench to bedside.” An expansion into the adjacent area of healthcare delivery will bring the concept of translational research to a new set of researchers, clinicians, and industry partners.
In this context, translational research will require testbeds—controlled environments that allow rigorous testing and data gathering while providing a pathway towards delivery of healthcare to the public. Testbeds are a core competency of Georgia Tech (including GTRI), and we are establishing basic functionality as rapidly as possible along three parallel levels.
Interoperability Testbeds
The first level will be to test novel information technologies and device technologies, to prove their interoperability, and to encourage their (initial or continued) development here on campus. Several of these testbeds are already located at Georgia Tech; others are being invited to set up facilities here:
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Professional Societies and Open Source Community. Currently, the opportunity to test and prove basic interoperability between application software packages is fragmented across multiple societies. Interoperability “showcases” are annual or quarterly events. In addition, the open source community is early in its lifecycle and does not yet have a permanent development, testing, and interoperability testbed for new applications or connectivity to legacy platforms. GT is leading collaborative discussions regarding the creation of comprehensive and permanent interoperability testbeds that improve upon servicing the needs of the societies’ members, sponsors, and the open source community
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Patient Safety Center (already in formation adjacent to campus; being managed by St. Joseph’s Health System)
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Global Center for Medical Innovation (already in formation here; being incubated by EI2)
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Aware Home (already in place; jointly managed by GVU and HSI)
Taken together and properly integrated, having these five facilities at Georgia Tech creates a unique technology platform for the development of novel applications, and proof of concept that their technologies integrate and interoperate with the systems already deployed in the real world. Major industrial partners such as Humana, McKesson Provider Technologies, Google, Intel, and IBM may locate R&D facilities at Georgia Tech to take advantage of these testbeds.
Model Campus Health Community Testbed
The second level will provide a convenient facility for alpha and beta testing of new concepts. Georgia Tech’s campus will become a model healthcare delivery community. This delivery system will link to the proposed interoperability testbeds so that new ideas and concepts can be tried here first within our community of students, faculty, staff, and retirees.
Indiana University has already announced a first step in this direction by encouraging all students to create a personal health record. Georgia Tech will not stop there, but is creating a campus-wide electronic medical record system and health information exchange—both implemented to the maximum degree possible using OHT technologies and NHIN architecture. Participants can choose to contribute new data to their personal and electronic health records and a comprehensive view of their health will become available to their care providers on or off campus. The Stamps Health System will allow testing of EMRs for security, reliability, and ease-of-use within the campus environment; later, a HIE will allow testing of the interconnection of EMRs to other healthcare providers, clinics, and hospitals within metro Atlanta.
Taken together, this provides a platform for ideas that focus on wellness and prevention as well as the treatment of disease. For example, new ideas such as “Dr J Says”—an innovative, personalized nutritional advisor developed by GVU students—will in the future be developed using standards that will allow them to plug into this infrastructure where they can link to data already known about members of the GT community. We are working with Emory’s Predictive Health Institute to broaden their research into personalized health to include our entire campus community.
If we are successful in realizing even a small part of the results that some companies have achieved using similar but less technology-intense efforts, this testbed will have the unique ability to pay for itself through cost savings once it is up and running. When successful, this system will be extended to other units of the University System of Georgia.
Statewide HIT Testbed
The third level will prove new ideas and technologies in the real world beyond our campus. We will work through GTRI and EI2 to move the most promising ideas out to the statewide health information network created under the HITECH programs that will be underway in 2010. This network will initially reach approximately 1600 primary care physicians, spanning 20% of Georgia, through the Health Information Technology Extension Program. Focused efforts on achieving a virtual patient-centered medical home model of care in at least a few test counties will create a futuristic model for more advanced research for the nation’s healthcare system of the future. We are also partnering with established or new Georgia companies in the HIT space to commercialize ideas that prove themselves across the three testbeds.
Conclusion
Georgia Tech is targeting leadership in the science and engineering of healthcare delivery. It builds upon our history and our strengths. It is a “big idea” consistent with our strategic plan. It addresses all three components of our triple mission: education, research, and community service. And it is a transdisciplinary challenge with great societal impact—worthy of a great academic institution.
