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The HII project is a new IBM Research Joint program. In
partnership with S&D (Healthcare/Life Sciences), BCS, and SWG, we are working to
demonstrate how IBM technology can be used to transform the healthcare industry
and create new models for the handling of medical information that will improve
the quality of healthcare nationally and help advance medicine as a science.
The US provider market is a major
focus as the healthcare spend in the US is by far the largest in the world in
absolute dollars and in per cent of GDP ($1.5T – 15% of GDP). The US healthcare
market is also the most fragmented and complex healthcare market in the world.
Thus, solutions which address the complexity of the US market are expected to
also address the global market. The IT spend in this market is a few percent
of the total, leading to a $55B addressable opportunity, growing at 8.4% CAGR.
The healthcare market is in a great state of change, driven by consumer pressure,
regulatory pressure, governmental pressure and the availability of vast new
sources of healthcare data at the molecular level. Major initiatives to improve
healthcare through the use of IT can be found around the world, including the
launch of a National Health Infrastructure Initiative (NHII) in the US in May 2004
– with the goal of providing an electronic health record
for every American within the next decade. In January 2004 IBM launched a $250M
initiative to greatly expand our healthcare industry focus. This document
outlines how IBM Research will participate in this major new revenue initiative
from a technology perspective.
The major challenge to the market is to significantly improve the quality and success rate of healthcare delivery while decreasing costs to patients and payers and improving the overall positive
experiences of consumers and providers. The goal of the Research effort is to
address these issues. We believe that the state of a national healthcare
infrastructure can be vastly improved through better management of data and an
improved understanding of how healthcare services are delivered. IBM has the
technological leadership to establish itself as a preferred vendor in this
market while meeting this goal in the US and around the world. The key to
success may be found in the way we apply IT to healthcare data and to the
services delivered through that IT. IBM technologies can help medical
professionals ensure that critical healthcare data is delivered to the right
people, at the right time, in the right way, and in a cost-effective manner.
Consider three probable scenarios for the future of healthcare in the US. The first scenario is predicated on an evolution of the current Local Healthcare Information Infrastructure (LHII)
towards a National Healthcare Information Infrastructure (NHII) based on
development of cross-institutional and longitudinal healthcare and health
records. This infrastructure is expected to systematically scale from local
networks through regional and state levels until data can be effectively
exchanged on national – and ultimately international – levels. The second
scenario presents a more revolutionary change towards personalized
medicine where individuals have the option to store their complete health
histories in a choice of trusted Independent Health Record
Banks (IHRBs). This latter scenario also predicts a major change in the way
value and dollars flow between healthcare providers, payers, and consumers. A
third possible scenario represents a hybrid of the two above – in this scenario,
Public Sector (Global, Federal, and local) agencies and institutions maintain
and operate data repositories, exchanges, and networks and interconnect with
certified, participating Independent Health Records Banks. In addition to these
three US-based scenarios, other nations have ‘nationalized’ or ‘socialized’
single-payer healthcare models existing along side private and commercial
healthcare provider systems. We see this hybrid of public and private
persisting well into the future. Our research efforts are intended to support
any or all of the scenarios above.
The IBM Research Healthcare Strategy is predicated on our need to support numerous
possible views of the future with an appropriate technology Research platform and
testbed. Our strategy will also allow us to test more revolutionary scenarios, such as the
IHRBs. A key
element of this strategy is an effective partnership and joint program that
couples our research efforts with SWG, BCS, Healthcare and Life Sciences
Industry, and with customers.. In order to do this, we are developing a
core system based on IBM’s best current offerings for HC&LS. We will accomplish
this by jointly creating a multipurpose Health Information Infrastructure (HII)
test bed together with BCS, SWG and HC&LS. The core of this platform is
be defined by and derived from IBM’s Aligned Clinical
Environment (ACE)framework. This core HII platform will be used to bind
together IBM Research efforts across the Division and to showcase innovative new
technologies and develop new services based directly on IBM’s current best
practice offering. It will also serve as an infrastructure to integrate with
ISVs and to facilitate selected customer engagements. The research platform
will demonstrate cross-institutional integration by including major
institutional nodes at Almaden and Haifa and Rochester Minnesota,
with satellite nodes elsewhere (including Europe and Asia).
A National Health Information System is also needed
to improve population care and to guard against
infectious disease and bioterrorism. A modern information infrastructure can
help agencies detect the outbreak of infectious disease. Coupled with new tools for
epidemiological modeling it will be possible to move beyond detection and
toward forecast.
The time is right for Information Technology to help transform national healthcare
infrastructure. However, unlike IT for finance, which evolved over several
decades, the escalating cost, demand for, and error rate of our current health
care infrastructure dictates that a significant change in healthcare IT must
take place this decade as the baby boomers retire. We must achieve this rapid
change in a cost affective way that does not violate the social contract between
individuals and care givers, and we must get it right the first time. To
guarantee success, and to act quickly, we have established a new
joint program and IBM team that can create and innovate on a common IBM
platform. We must be responsive to current near term needs and marketing
activities, yet far sighted enough not to miss the opportunity to turn a
revolution in healthcare into a renaissance of healthcare that provides better,
safer, and more efficient care for all.
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