Patrick O’Connor, M.D.
Lead, Health IT Core
HEALTH INFORMATION TECHNOLOGY (HIT) CORE
The importance of health information technology (HIT) and the potential for more effective use of increasingly sophisticated HIT technology to achieve improvements in diabetes prevention and care in the U.S. is widely recognized. The Health Delivery Systems Center for Diabetes Translational Research (HDS-CDTR) HIT Core provides access to key HIT tools, methods, and expertise with demonstrated potential to improve diabetes care and primary prevention of diabetes. HIT research done in the past decade, including many projects conducted by CDTR faculty within and among the multiple care delivery systems at which we work, has demonstrated clinically and statistically significant improvement in multiple clinical domains related to diabetes care and prevention, and been a critical part of multiple component interventions that have led to dramatic improvement in diabetes care quality in recent years, in both observational and interventional research studies.
However, translation of these “big data” approaches, and of and efficacious HIT single component and multiple component intervention strategies into broad use within the larger U.S. healthcare system is constrained by a number of factors. Constraints include interoperability issues, intellectual property issues, resource availability, and technological challenges. The overall objective of the HIT Core is to support and accelerate the translation of effective HIT systems and practices that are now used in limited settings to broader use in more healthcare delivery systems and medical groups.
The CDTR HIT Core focuses on the five types of HIT applications that we believe have the greatest potential for translation into clinical and public health practice. For each of these 5 types of HIT applications, our dual purpose is (i) to translate what works into brooder practice, and (ii) to carefully observe variation in impact across various practice settings to better understand and further accelerate implementation of effective HIT applications. The five HIT applications we identify for special focus include: (a) Web-based EHR-linked Clinical Decision Support (CDS) at various types of clinical encounters; (b) EHR-derived “smart” registries and population management tools that direct attention to specific patient subgroups based on clinical needs and potential benefits; (c) development of informatics infrastructure to support conduct of low-cost pragmatic clinical trials; (d) comparative effectiveness research (CER) that uses large databases and sophisticated statistical approaches such as marginal structural modeling to compare the effectiveness of both established and new approaches to diabetes care and prevention; and (e) HIT-enabled large distributed data networks that can accelerate research related to diabetes care, diabetes prevention and the success of translational efforts.
Patrick O’Connor, MD, MPH, MA (HealthPartners Instute)
Margaret Handley, PhD, MPH (University of California, San Francisco)
James Frank Wharam, MB, BCh, BAO, MPH (Harvard Pilgrim Health Care Institute)