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IBM Research

Healthcare Information Infrastructure

Computer Science


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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