[Osdc-edu-authors] Article Heads Up

Jason Hibbets jhibbets at redhat.com
Fri Nov 4 21:45:53 UTC 2011


Remy,

Thank you very much! I've assigned this to an editor. Fabulous job. We 
really appreciate contributions like this.

Regards,
Jason

Remy DeCausemaker wrote:
> Here is a *very* rough draft... I am about to start another event, so I 
> can't put anymore cycles into this right now. The exciting news is that 
> Todd Park is very interested participating in a Hackathon at RIT 
> partnering with health2challenge.org <http://health2challenge.org> and 
> challenge.gov <http://challenge.gov>! Today was a great day, and here is 
> a decent transcript. I've got maybe another 10 mins to edit, but for the 
> most part I'm leaving this in capable hands of our editors.
> 
> hearts and minds,
> --RemyD.
> 
> P.S. - The osdctoddpark-draft.html file is the actual draft, and the 
> osdctoddpark.html is the draft with my raw notes at the bottom.
> 
> On Fri, Nov 4, 2011 at 2:35 PM, Mary Bitter <mbitter at redhat.com 
> <mailto:mbitter at redhat.com>> wrote:
> 
>     +1. This is super!
> 
>     On 11/04/2011 12:09 PM, Jason Hibbets wrote:
>      > Remy,
>      >
>      > This is great. We did a webcast with Todd Park in July. It would be
>      > awesome to have an article with your thoughts on his presentation
>     today.
>      >
>      > Let me know if you need any help. Feel free to send anything directly
>      > to me so that we can expedite this.
>      >
>      > Thanks,
>      > Jason
>      >
>      > Remy DeCausemaker wrote:
>      >> All,
>      >>
>      >> I'm at the Syracuse Tech Garden right now, about to watch Todd Park,
>      >> CTO of US Dept. of Health and Human Services give a presentation
>      >> titled "Unleashing the Power of Data, IT, and Innovation to improve
>      >> Health." Incase this fella isn't on your radar, check his bio here:
>      >> http://www.hhs.gov/open/discussion/todd_park_bio.html
>      >>
>      >> I have caught this guy on CSPAN dropping Open Source and O'reily, so
>      >> I know he "gets it." I will be taking notes, and probably put
>      >> together a post. It would probably be a good fit for the Gov
>     Channel.
>      >>
>      >> I'll keep you posted,
>      >> --RemyD.
>      >>
>      >> --
>      >> --
>      >> Remy DeCausemaker
>      >> Research Associate
>      >> Lab for Technological Literacy
>      >> http://foss.rit.edu <http://foss.rit.edu/>
>      >>
>      >> Rochester Institute of Technology
>      >> Center for Student Innovation
>      >> 159 Lomb Memorial Drive
>      >> Building 87-1680
>      >> Rochester, NY 14623
>      >
> 
> 
> 
> 
> -- 
> --
> Remy DeCausemaker
> Research Associate
> Lab for Technological Literacy
> http://foss.rit.edu <http://foss.rit.edu/>
> 
> Rochester Institute of Technology
> Center for Student Innovation
> 159 Lomb Memorial Drive
> Building 87-1680
> Rochester, NY 14623
> 
> ------------------------------------------------------------------------
> 
> Title: New Incentives + Information Liberation = Rocket Fuel for 
> Innovation & Progress Every time I come to The Syracuse 
> <http://thetechgarden.com> Tech Garden 
> <http://twitter.com/thetechgarden> there is always something new and 
> exciting happening. Today, I will have the privilege of watching Todd 
> Park <http://twitter.com/todd_park>, Cheif Technology Officer of the 
> U.S. Department of Health and Human Services <http://www.hhs.gov/open> 
> speak to the Upstate community about "Unlocking the Power of Data, IT, 
> and Innovation to Improve Health." Todd Park first got onto my radar one 
> very late night when I was trolling CSPAN around 4am. It was the first 
> time I had heard personally heard the words "Open Source" mentioned on 
> CSPAN, and I was more than excited to see the genuine article. Mr. Park 
> did not disappoint. "We started this conversation at SXSW 
> <http://sxsw.com> and I'm just hearing about all of the things happening 
> in Health and Entrepreneurship in Upstate NY," began Park. "I don't want 
> this to be a formal "Speechification process" so let me start with a few 
> questions:"
> 
>     * Who here has a background in HealthCare?
>     * Who here has a background in Health Care Management or Administration?
>     * Who here has a background in IT or Data?
>     * Who here is a Student?
>     * Who here is an Entrepreneur?
>     * Who here is a Technologist or Developer?
>     * Who here is a Researcher?
>     * Who here is a Doctor or Nurse?
>     * Who here has a background in HealthCare?
> 
> After seeing a forest of hands be raised, sometimes by the same person 
> for multiple categories, Park proclaimed "You are all in the sweet spot. 
> There has never been a better time to be an innovator in Health and IT." 
> Park says there are two trends that have really been locking in: Shifts 
> in incentives, and information liberation.
> 
> 
>     New Incentives: Meaningful Use
> 
> Medicaid and Medicare are paying $40-60K to physicians to improve data 
> capture and sharing, as well as outcome sharing through 2015. 100,000 
> providers have registered with HHS. While this is an exciting 
> development according to Park, it is just the warm-up for rewarding the 
> use of data and IT.
> 
> 
>     Payment Reform: Affordable Care Act
> 
> Historically, the payment system focused on a 'pay per visit' or 'pay 
> per procedure' model. Lots of people would say this is dysfunctional, 
> but I would say the system was doing what it was designed to do. We need 
> to shift from pay for volume, to pay for keeping people healthy. This is 
> being emulated across the private sector. Our biggest game changer, is 
> the Center for Medicare and Medicaid Innovation (CMSI). If you care 
> about this, this is the most important thing: go find out more about the 
> innovation center at http://innovation.cms.gov 
> <http:innovation.cms.gov>. This is a new center funded at $10 Billion to 
> execute R&D on how CMS can pay for ways to improve costs and health. 
> Most important is not the $10 Billion, but an obscure clause that says 
> that if there is a new way to pay for care, if that is born out in data, 
> the CMS office of the actuary's Secretary of Health and Human Services, 
> has the authority to turn that into how CMS pays nationally. This is an 
> objective scientific process to incentivize health care improvement. CMS 
> has never had the authority to decide how it pays for care before in an 
> objective and open process.
> 
> 
>     Why is this exciting?
> 
> If you look at patient centered medical homes, they take responsibility, 
> reach out, and save complications and years in the hospital. It both 
> educates AND takes care of you. This is what primary care physicians 
> have wanted, but have been inhibited by costs. New care delivery teams 
> and networks are emerging. We are moving past seeing more people and 
> more rapidly (pay per volume), and expanding to proactive health patient 
> optimization. People are analyzing information, and expanding the scope 
> to include care coordination.
> 
>     *5% of patients account for 40% of medicare costs!*
> 
> You've got to expand beyond the walls of the office, at home, and help 
> doctors realize they have to come in. That notion of proactive patient 
> health management, and engaging outside of the office will need to be 
> done to succeed financially in the future. From a technology standpoint, 
> how you do this can't be without data, and timely data, to integrate 
> care. The ability to engage is based on datamining and analytics. This 
> won't be just a 'ctrl+c, ctrl+v' process, but no new technology has to 
> be invented, we just need to take lessons from other industries and 
> apply it.
> 
>     * In a nutshell, this is an opportunity to reinstrument healthcare
>     systems, and is the greatest entrepreneurial opportunity since the
>     creation of the internet. This is a $3 Trillion industry*
> 
> 
>     Information Liberation: rising patient data liquidity
> 
> This is happening at multiple levels, but it does us little good if we 
> move to electronic records, and patient data can't move from provider to 
> provider. We need to turn manilla into electronic, but the data needs to 
> move with the patient.
> 
> 
>       The direct project
> 
> Park told us a story about an email from a doctor that he received. The 
> doctor said
> 
>     "I have a record for a patient, and that patient is going to another
>     doctor. We have the same record, from the same company, but all I
>     can do is print the record and fax it to the other doctor. I didn't
>     think, and I emailed the record to the other doctor, and I
>     understand now this is bad... Please help me with the basic
>     networking problem."
> 
> Park told that doctor that "we can help you, but we don't know the 
> answer." In prior years, Park says in the past, the typical answer would 
> have been "we'll appoint a commission, and come out 8 months later with 
> an answer." We told him, says Park "We're confident we can crowd source 
> a solution." An entrepreneur then opened a wiki, and within less than 3 
> months, HHS had a spec for secure health record emailing.
> 
> 
>       BlueButton
> 
> Another intresting project mentioned by Park was Blue Button 
> <http://va.gov/bluebutton> launched by The Department of Veteran Affairs 
> <http://va.gov>. This project enables veterans and military personnel to 
> press a button and download their own health data. They didn't think it 
> would be a big deal, and projected that 25,000 veterans would use the 
> download service. Today, over 450,000 veterans and military personnel 
> have downloaded their own data. We got calls from people within 
> government asking "We're allowed to do that?" We said "yes," and it is 
> infact legal. The fact that we did it sends a strong signal. 
> Organizations like AETNA and United Health, as well as the States of 
> Indiana and Vermont are now doing this same thing. BlueButtonData.org 
> <http://bluebuttondata.org> explains how to do it, and where you can 
> commit to joining the movement. HHS also announced a new clear rule in 
> September to allow patients to get their own test results from 
> laboratories!
> 
> 
>     Increasing Market Transparency
> 
> "What defines a market?" asks Park to the audience. "When a customer 
> knows what choices there are, know their value, and can make choices. If 
> this is a market, has healthcare really been a market before? Not so 
> much, so we bring transparency. July 1st we launched Healthcare.gov 
> <http://healthcare.gov>, which provides detailed vendor information for 
> insurance, down to the zipcode level. This is important, and delivers 
> better results."
> 
> 
>     Health Data Initiative
> 
>     "This is something we are really excited about. Launched 20 months
>     ago, this will turn us into the NOAA <http://noaa.gov> of health
>     data!" proclaimed Park. The National Oceanographic and Atmospheric
>     Association (NOAA) collects all weather data, and chooses to publish
>     all the data in machine readable Free formats, for free. This has
>     spawned innovation in private sector (the weather channel, apps,
>     websites, etc...) and is a wonderful example of a symbiotic
>     public/private relationship." When president Regan liberated GPS
>     data, it paved the way for innovations like foursquare and others.
>     *Take billions of dollars of data, and make it into fuel--open
>     computable fuel--that entrepreneurs can turn into magic that help
>     patients and doctors."* PDF's and books are useless. We're making
>     API's and machine readable data. We also realized that 98% of
>     innovators have no idea we had this data, and I've been marketing
>     the bejeebus out of it all over the country." 
> 
> Park then went on to answer the question "What kinds of data are we 
> liberating?" with the following list:
> 
>     * Community Health
>           o 1200 metrics and indicators of performance at the national,
>             regional, state, and local levels. (i.e. smoking and obesity
>             rates)
>     * Provider Directories
>           o Medicare/Medicaid numbers, mental health providers,
>             community health centers, meals-on-wheels, counselling,
>             hospital quality, home quality, and many others. We've added
>             API's for this to allow developer to link to and extract data.
>           o Section 10332 is a provision that allows Medicare to make
>             available detailed files to qualified private organizations
>             and do research. This program will go live January of 2012.
>     * BlueButton
>     * FDA Recall Data
>     * All products of healthcare.gov as a single downloadable file
>     * National Library of Medicine <http://nlm.gov>
>           o Clinical Trials
>           o pillbox - API for a growing repository of tablets with pictures
>     * Medline Plus - ecyclopedic information
>     * Medical Connect - patient content broken down into individual
>       diagnosis and drugs, that spits back an .xml package
>     * Government Spending
>     *
>     * Claim files publicly available
>           o Claim files have been redacted to ensure that data can not
>             be rejoined with other datasets later
> 
> "To track all of this, we have one site Healthdata.gov 
> <http://healthdata.gov>; a one stop shop for all of our data. It is 
> controlled access, so the blue button data is not here for example, but 
> all of the FOIL-able data is catalogued on Data.gov <http://data.gov>.
> 
> 
>     We publicize the heck out of our data
> 
>     * Health2Challenge.org <http://health2challenge.org>
>       "Any company can launch a competition or code-a-thon, and I highly
>       recommend going to one if you haven't yet. We've had several
>       organized by health2challenge" explained Park, and then went on to
>       describe one held at Georgetown University <http://georgetown.edu>
>       where a team of Pittsburg students drove down and won the
>       code-a-thon with their project "Food Oasis."
> 
>           Food deserts are places in America where you cannot get access
>           to healthy food. They decided to solve this problem in eight
>           short hours. They did a mashup of text messages and farmer's
>           markets. You text in 'I want 5 zucchini and 3 tomatoes" and
>           the app will notify you of farmer's markets. They are testing
>           in 7 cities, and I don't know if that idea, in that form will
>           work, but it is their first. *What is exciting is that these 5
>           kids are now addicted to leveraging data to help.*
> 
>               I've founded many companies, but I've divested since. The
>               thing I've learned is if you get the best people, you win.
>               If you attract all of the best innovators in America into
>               Healthcare, we can invent our way out of any problem.
> 
>         * Annual Health-data-palooza
>           "Hosted by Secretary of HHS, our 2nd annual event will be June
>           9th. These are large scale festivals, open invitations to
>           anyone who uses our data to help doctors, patients, or
>           journalists. They also have to have a sustainable business
>           model, (i.e. they can't try to show off a concept car that
>           will never be built) and they have to be able to deliver to
>           actual people. This is only 20 months old, and has tough
>           criteria, but even so, we had more people than were able to
>           fit into our auditorium. We then did an 'American Idol' style
>           virtual event, with judges to narrow down the field to the
>           best 50. What I would say, if your faith is wavering in
>           America, go to the Institute of Medicine website, search for
>           'health data initiative forum' and watch as many videos as
>           possible. Let me describe a few:"
>               o itriage
>                     + A company out of Denver, CO that makes powerful
>                       mobile and web tools. Early on, they took our
>                       directory and put it into their app. They now have
>                       65 employees, over 3 million users, and they were
>                       just bought by AETNA, who is investing tons of
>                       capital for them to expand.
>               o Healthline
>                     + Useful for healthsearch. If you have ever googled
>                       for heath advice, you know how dangerous it can
>                       be. Healthline ingests huge amounts of government
>                       dat, to make healthsearch more viable and accurate
>               o Vitals.com
>               o Shopping services for consumers to know quality and
>                 costs. PatientsLikeMe.com
>                 120,000 patients voluntarily sharing information about
>                 their illness, which is integrated with clinical trails
>               o data. They won datapalooza. Asthmapolis
>                 Single person team, a CDC <http://cdc.gov> veteran.
>                 Simple and brilliant idea to attach a GPS to an inhaler,
>                 to track where you have attacks. 80 patients tested it,
>                 and after several months, their usage of an inhaler more
>                 than 2 times per week dropped from 75% to 40%. This cuts
>                 costs by $3,000 per person. These were unscientific
>                 tests, with a small amount of people, but it is
>                 attracting a number of Angel Investors. Imagine doctors
>                 prescribing an asthmapolis device! 
> 
> 
>               Care providers providing better care
> 
>               o AETNA
>                 Cool app rollout, it wasn't even an app, but a nurse.
>                 Nurse 2.0. They built an IT cockpit for nurses, to help
>                 nurses help people better. Imagine a call center nurse,
>                 assigned to a patient with multiple illnesses.
>                 Demonstrated how a nurse can pull up various pieces of
>                 government data, to be a more omniscient care provider.
>                 'Here are the nearest community health centers' and
>                 other data customized to help each patient, delivered
>                 through the most effective user interface: talking to
>                 another human being. Application of data is at any level
>                 that helps people make better decisions to improve
>               o health and healthcare. Doximity
>                 They use government data to build a GPS map of all
>                 providers in America. You can use that data set, as a
>                 doctor, to figure out who to refer patients to, and even
>               o integrates text messages. Essence Group/Lumaris
>               o Press Ganey
>               o Rise Health
>               o ElizaLIVE
> 
> 
>               Communities Improving Healthcare
> 
>               o Ozioma
>                 Built by a team of University of Washington St. Louis
>                 students, it is virtually free for bloggers and
>                 journalists. It takes 98% of the work out of raising
>                 public awareness. Journalists can't afford their own
>                 health services researchers, and Ozioma directly
>                 categorizes stories about disparities in health to help
>                 mobilize action.
> 
>                     HHS didn't pay for, or coordinate any of this stuff.
>                     We just put out data, publicize it, and folks like
>                     you dive in and kick butt! You leverage your talent
>                     and build amazing stuff. In just these 50
>                     innovations, no one or even ten companies could not
>                     have /thought of/ all of these ideas, let alone
>                     /built them/.
> 
>               o Walgreens
>                 announced they are going to install people to be "health
>                 guides," or free health concierges. Walgreens wanted to
>                 build an IT cockpit for these guides, so they issued a
>                 challenge and got 50 submissions in about 90 days, and
>                 chose one startup to equip them. The first 16
>               o installations are happening in Chicago as we speak.
>                 Startup Health
>                 A combination of a seed accelerator and incubator, they
>                 will help start 100 companies over the next 10 years.
>                 Venture Capitalists are very efficient, but incubation
>                 systems for healthcare companies is very hap-hazard.
>                 Organizations like Startup Health, fill this gap, and
>                 help startups find support, through a rolling
>               o applications process. Health Data Consortium
>                 Launched as a new private/public partnership through the
>                 Robert Wood Johnson Foundation <http://rwj.org>, they
>                 have hired a small cadre of health data evangelists.
>                 These are the Johnny and Jane Appleseeds of Open Data
>                 who walk the ground, run datapalooza, and expand the
>                 scope and breadth of health data. 
> 
>               Our goal is to not only expand the data, but catalyze the
>               ecosystem of innovators who will create the jobs of the
>               future. I'd love to get to know you, and see how we can
>               help you. If we can't connect here, please contact me at
>               todd.park at hhs.gov <mailto:todd.park at hhs.gov>
> 
>                   Q: What are you thinking about when you say we have
>                   all the technology?
>                   A: I didn't mean that electronic health records can do
>                   all this, or that healthcare itself has all the tech.
>                   In the world in general, the tools exist, and it is
>                   feasible to be applied. Has it been done yet? No.
> 
>                   Q: Is location based data like asthmapolis being
>                   shared with city planners and other public officials?
>                   A: Patients have to opt-in, but they have done some
>                   preliminary work like this, crowdsourced at the
>                   community level and combined with sensor data.
> 
>                   Q: How do you like working in the biggest bureaucracy
>                   in the world?
>                   A: I love it. I can't get enough of it. I don't have a
>                   background in government, and when they contacted me,
>                   I said 'I don't know anything about politics or
>                   government' and they said 'Great! It's an entrepreneur
>                   in residence position to lead big initiatives' If you
>                   work in the Federal Government, and you have an idea,
>                   here is my advice; Find 3 or 5 other people who had
>                   the idea a long time ago, who know how goverment
>                   works, and stitch them together in a virtual startup
>                   team. Give them permission to do the things they want
>                   to do, and things rapidly get done.
> 
>                   The thing that distinguishes top entrepreneurs is they
>                   /believe/ in what htey are building. Leaving a legacy.
>                   Leaving their mark. Making the lives of their
>                   grandkids better. That is what is required to deal
>                   with the craziness and to make change, in the public
>                   or private sector.
> 
>                   Q: What would happen if we were to innovate our way
>                   into a more proportionate amount of GDP into "per
>                   patient services?"
>                   A: People talk about going from that 2.5 to 1.5
>                   (trillion dollars), and they talk about changing
>                   growth rate. I don't have a problem with spending 20,
>                   30, 40 percent on healthcare. What I do have a problem
>                   with is large portions of that spending being wasted.
>                   It is up to society to decide how much to spend on
>                   healthcare. Nobody thinks we are getting our money's
>                   worth. I talk to primary care doctors, and ask "can we
>                   get more for what we spend?" The laugh and say "of
>                   course, but our system is not geared toward keepign
>                   people healthy." I focus on return on investement.
> 
>                   Q: What is the process for our students at RIT and the
>                   Upstate Community to participate in one of the
>                   hackathons you mentioned?
>                   A: I have 2 anwers: 1) go to health2challenge.org and
>                   challenge.go and you can see the challenges happening
>                   all over. 2) If you want to do your own, we'd love to
>                   help. We can collaborate with you, and I'd love to
>                   come if I can.
> 
>                   One thing we have learned from running these kinds of
>                   events is that you need both IT/Data/Dev folks AND
>                   healthcare folks in the same room. Otherwise devs
>                   spend time learning basic things. That intersection is
>                   important, if schools of public health and medicine
>                   got involved, it could be very interesting.
> 
>                   Q: What is your fundamental message?
>                   A: Never has there been a better time to start a
>                   company at the intersection of data, health, and IT.
>                   Information is being liberated at an epic scale.
> 
>                       *Never has there been a better time to start a
>                       company at the intersection of data, health, and
>                       IT. Information is being liberated at an epic scale.*
> 
> 
>                   ------------------------------------------------------------------------
> 
>                   Title: New Incentives + Information Liberation =
>                   Rocket Fuel for Innovation & Progress Every time I
>                   come to The Syracuse <http://thetechgarden.com> Tech
>                   Garden <http://twitter.com/thetechgarden> there is
>                   always something new and exciting happening. Today, I
>                   will have the privilege of watching Todd Park
>                   <http://twitter.com/todd_park>, Cheif Technology
>                   Officer of the U.S. Department of Health and Human
>                   Services <http://www.hhs.gov/open> speak to the
>                   Upstate community about "Unlocking the Power of Data,
>                   IT, and Innovation to Improve Health." Todd Park first
>                   got onto my radar one very late night when I was
>                   trolling CSPAN around 4am. It was the first time I had
>                   heard personally heard the words "Open Source"
>                   mentioned on CSPAN, and I was more than excited to see
>                   the genuine article. Mr. Park did not disappoint. "We
>                   started this conversation at SXSW <http://sxsw.com>
>                   and I'm just hearing about all of the things happening
>                   in Health and Entrepreneurship in Upstate NY," began
>                   Park. "I don't want this to be a formal
>                   "Speechification process" so let me start with a few
>                   questions:"
>                       o Who here has a background in HealthCare?
>                       o Who here has a background in Health Care
>                         Management or Administration?
>                       o Who here has a background in IT or Data?
>                       o Who here is a Student?
>                       o Who here is an Entrepreneur?
>                       o Who here is a Technologist or Developer?
>                       o Who here is a Researcher?
>                       o Who here is a Doctor or Nurse?
>                       o Who here has a background in HealthCare?
>                   After seeing a forest of hands be raised, sometimes by
>                   the same person for multiple categories, Park
>                   proclaimed "You are all in the sweet spot. There has
>                   never been a better time to be an innovator in Health
>                   and IT." Park says there are two trends that have
>                   really been locking in: Shifts in incentives, and
>                   information liberation.
> 
> 
>                       New Incentives: Meaningful Use
> 
>                   Medicaid and Medicare are paying $40-60K to physicians
>                   to improve data capture and sharing, as well as
>                   outcome sharing through 2015. 100,000 providers have
>                   registered with HHS. While this is an exciting
>                   development according to Park, it is just the warm-up
>                   for rewarding the use of data and IT.
> 
> 
>                       Payment Reform: Affordable Care Act
> 
>                   Historically, the payment system focused on a 'pay per
>                   visit' or 'pay per procedure' model. Lots of people
>                   would say this is dysfunctional, but I would say the
>                   system was doing what it was designed to do. We need
>                   to shift from pay for volume, to pay for keeping
>                   people healthy. This is being emulated across the
>                   private sector. Our biggest game changer, is the
>                   Center for Medicare and Medicaid Innovation (CMSI). If
>                   you care about this, this is the most important thing:
>                   go find out more about the innovation center at
>                   http://innovation.cms.gov <http:innovation.cms.gov>.
>                   This is a new center funded at $10 Billion to execute
>                   R&D on how CMS can pay for ways to improve costs and
>                   health. Most important is not the $10 Billion, but an
>                   obscure clause that says that if there is a new way to
>                   pay for care, if that is born out in data, the CMS
>                   office of the actuary's Secretary of Health and Human
>                   Services, has the authority to turn that into how CMS
>                   pays nationally. This is an objective scientific
>                   process to incentivize health care improvement. CMS
>                   has never had the authority to decide how it pays for
>                   care before in an objective and open process.
> 
> 
>                       Why is this exciting?
> 
>                   If you look at patient centered medical homes, they
>                   take responsibility, reach out, and save complications
>                   and years in the hospital. It both educates AND takes
>                   care of you. This is what primary care physicians have
>                   wanted, but have been inhibited by costs. New care
>                   delivery teams and networks are emerging. We are
>                   moving past seeing more people and more rapidly (pay
>                   per volume), and expanding to proactive health patient
>                   optimization. People are analyzing information, and
>                   expanding the scope to include care coordination.
> 
>                       *5% of patients account for 40% of medicare costs!*
> 
>                   You've got to expand beyond the walls of the office,
>                   at home, and help doctors realize they have to come
>                   in. That notion of proactive patient health
>                   management, and engaging outside of the office will
>                   need to be done to succeed financially in the future.
>                    From a technology standpoint, how you do this can't
>                   be without data, and timely data, to integrate care.
>                   The ability to engage is based on datamining and
>                   analytics. This won't be just a 'ctrl+c, ctrl+v'
>                   process, but no new technology has to be invented, we
>                   just need to take lessons from other industries and
>                   apply it.
> 
>                       * In a nutshell, this is an opportunity to
>                       reinstrument healthcare systems, and is the
>                       greatest entrepreneurial opportunity since the
>                       creation of the internet. This is a $3 Trillion
>                       industry*
> 
> 
>                       Information Liberation: rising patient data liquidity
> 
>                   This is happening at multiple levels, but it does us
>                   little good if we move to electronic records, and
>                   patient data can't move from provider to provider. We
>                   need to turn manilla into electronic, but the data
>                   needs to move with the patient.
> 
> 
>                         The direct project
> 
>                   Park told us a story about an email from a doctor that
>                   he received. The doctor said
> 
>                       "I have a record for a patient, and that patient
>                       is going to another doctor. We have the same
>                       record, from the same company, but all I can do is
>                       print the record and fax it to the other doctor. I
>                       didn't think, and I emailed the record to the
>                       other doctor, and I understand now this is bad...
>                       Please help me with the basic networking problem."
> 
>                   Park told that doctor that "we can help you, but we
>                   don't know the answer." In prior years, Park says in
>                   the past, the typical answer would have been "we'll
>                   appoint a commission, and come out 8 months later with
>                   an answer." We told him, says Park "We're confident we
>                   can crowd source a solution." An entrepreneur then
>                   opened a wiki, and within less than 3 months, HHS had
>                   a spec for secure health record emailing.
> 
> 
>                         BlueButton
> 
>                   Another intresting project mentioned by Park was Blue
>                   Button <http://va.gov/bluebutton> launched by The
>                   Department of Veteran Affairs <http://va.gov>. This
>                   project enables veterans and military personnel to
>                   press a button and download their own health data.
>                   They didn't think it would be a big deal, and
>                   projected that 25,000 veterans would use the download
>                   service. Today, over 450,000 veterans and military
>                   personnel have downloaded their own data. We got calls
>                   from people within government asking "We're allowed to
>                   do that?" We said "yes," and it is infact legal. The
>                   fact that we did it sends a strong signal.
>                   Organizations like AETNA and United Health, as well as
>                   the States of Indiana and Vermont are now doing this
>                   same thing. BlueButtonData.org
>                   <http://bluebuttondata.org> explains how to do it, and
>                   where you can commit to joining the movement. HHS also
>                   announced a new clear rule in September to allow
>                   patients to get their own test results from laboratories!
> 
> 
>                       Increasing Market Transparency
> 
>                   "What defines a market?" asks Park to the audience.
>                   "When a customer knows what choices there are, know
>                   their value, and can make choices. If this is a
>                   market, has healthcare really been a market before?
>                   Not so much, so we bring transparency. July 1st we
>                   launched Healthcare.gov <http://healthcare.gov>, which
>                   provides detailed vendor information for insurance,
>                   down to the zipcode level. This is important, and
>                   delivers better results."
> 
> 
>                       Health Data Initiative
> 
>                       "This is something we are really excited about.
>                       Launched 20 months ago, this will turn us into the
>                       NOAA <http://noaa.gov> of health data!" proclaimed
>                       Park. The National Oceanographic and Atmospheric
>                       Association (NOAA) collects all weather data, and
>                       chooses to publish all the data in machine
>                       readable Free formats, for free. This has spawned
>                       innovation in private sector (the weather channel,
>                       apps, websites, etc...) and is a wonderful example
>                       of a symbiotic public/private relationship." When
>                       president Regan liberated GPS data, it paved the
>                       way for innovations like foursquare and others.
>                       *Take billions of dollars of data, and make it
>                       into fuel--open computable fuel--that
>                       entrepreneurs can turn into magic that help
>                       patients and doctors."* PDF's and books are
>                       useless. We're making API's and machine readable
>                       data. We also realized that 98% of innovators have
>                       no idea we had this data, and I've been marketing
>                       the bejeebus out of it all over the country." 
> 
>                   Park then went on to answer the question "What kinds
>                   of data are we liberating?" with the following list:
>                       o Community Health
>                             + 1200 metrics and indicators of performance
>                               at the national, regional, state, and
>                               local levels. (i.e. smoking and obesity rates)
>                       o Provider Directories
>                             + Medicare/Medicaid numbers, mental health
>                               providers, community health centers,
>                               meals-on-wheels, counselling, hospital
>                               quality, home quality, and many others.
>                               We've added API's for this to allow
>                               developer to link to and extract data.
>                             + Section 10332 is a provision that allows
>                               Medicare to make available detailed files
>                               to qualified private organizations and do
>                               research. This program will go live
>                               January of 2012.
>                       o BlueButton
>                       o FDA Recall Data
>                       o All products of healthcare.gov as a single
>                         downloadable file
>                       o National Library of Medicine <http://nlm.gov>
>                             + Clinical Trials
>                             + pillbox - API for a growing repository of
>                               tablets with pictures
>                       o Medline Plus - ecyclopedic information
>                       o Medical Connect - patient content broken down
>                         into individual diagnosis and drugs, that spits
>                         back an .xml package
>                       o Government Spending
>                       o
>                       o Claim files publicly available
>                             + Claim files have been redacted to ensure
>                               that data can not be rejoined with other
>                               datasets later
>                   "To track all of this, we have one site Healthdata.gov
>                   <http://healthdata.gov>; a one stop shop for all of
>                   our data. It is controlled access, so the blue button
>                   data is not here for example, but all of the FOIL-able
>                   data is catalogued on Data.gov <http://data.gov>.
> 
> 
>                       We publicize the heck out of our data
> 
>                       o Health2Challenge.org <http://health2challenge.org>
>                         "Any company can launch a competition or
>                         code-a-thon, and I highly recommend going to one
>                         if you haven't yet. We've had several organized
>                         by health2challenge" explained Park, and then
>                         went on to describe one held at Georgetown
>                         University <http://georgetown.edu> where a team
>                         of Pittsburg students drove down and won the
>                         code-a-thon with their project "Food Oasis."
> 
>                             Food deserts are places in America where you
>                             cannot get access to healthy food. They
>                             decided to solve this problem in eight short
>                             hours. They did a mashup of text messages
>                             and farmer's markets. You text in 'I want 5
>                             zucchini and 3 tomatoes" and the app will
>                             notify you of farmer's markets. They are
>                             testing in 7 cities, and I don't know if
>                             that idea, in that form will work, but it is
>                             their first. *What is exciting is that these
>                             5 kids are now addicted to leveraging data
>                             to help.*
> 
>                                 I've founded many companies, but I've
>                                 divested since. The thing I've learned
>                                 is if you get the best people, you win.
>                                 If you attract all of the best
>                                 innovators in America into Healthcare,
>                                 we can invent our way out of any problem.
> 
>                           o Annual Health-data-palooza
>                             "Hosted by Secretary of HHS, our 2nd annual
>                             event will be June 9th. These are large
>                             scale festivals, open invitations to anyone
>                             who uses our data to help doctors, patients,
>                             or journalists. They also have to have a
>                             sustainable business model, (i.e. they can't
>                             try to show off a concept car that will
>                             never be built) and they have to be able to
>                             deliver to actual people. This is only 20
>                             months old, and has tough criteria, but even
>                             so, we had more people than were able to fit
>                             into our auditorium. We then did an
>                             'American Idol' style virtual event, with
>                             judges to narrow down the field to the best
>                             50. What I would say, if your faith is
>                             wavering in America, go to the Institute of
>                             Medicine website, search for 'health data
>                             initiative forum' and watch as many videos
>                             as possible. Let me describe a few:"
>                                 + itriage
>                                       # A company out of Denver, CO that
>                                         makes powerful mobile and web
>                                         tools. Early on, they took our
>                                         directory and put it into their
>                                         app. They now have 65 employees,
>                                         over 3 million users, and they
>                                         were just bought by AETNA, who
>                                         is investing tons of capital for
>                                         them to expand.
>                                 + Healthline
>                                       # Useful for healthsearch. If you
>                                         have ever googled for heath
>                                         advice, you know how dangerous
>                                         it can be. Healthline ingests
>                                         huge amounts of government dat,
>                                         to make healthsearch more viable
>                                         and accurate
>                                 + Vitals.com
>                                   Shopping services for consumers to
>                                 + know quality and costs. PatientsLikeMe.com
>                                   120,000 patients voluntarily sharing
>                                   information about their illness, which
>                                   is integrated with clinical trails
>                                 + data. They won datapalooza. Asthmapolis
>                                   Single person team, a CDC
>                                   <http://cdc.gov> veteran. Simple and
>                                   brilliant idea to attach a GPS to an
>                                   inhaler, to track where you have
>                                   attacks. 80 patients tested it, and
>                                   after several months, their usage of
>                                   an inhaler more than 2 times per week
>                                   dropped from 75% to 40%. This cuts
>                                   costs by $3,000 per person. These were
>                                   unscientific tests, with a small
>                                   amount of people, but it is attracting
>                                   a number of Angel Investors. Imagine
>                                   doctors prescribing an asthmapolis
>                                   device! 
> 
> 
>                                 Care providers providing better care
> 
>                                 + AETNA
>                                   Cool app rollout, it wasn't even an
>                                   app, but a nurse. Nurse 2.0. They
>                                   built an IT cockpit for nurses, to
>                                   help nurses help people better.
>                                   Imagine a call center nurse, assigned
>                                   to a patient with multiple illnesses.
>                                   Demonstrated how a nurse can pull up
>                                   various pieces of government data, to
>                                   be a more omniscient care provider.
>                                   'Here are the nearest community health
>                                   centers' and other data customized to
>                                   help each patient, delivered through
>                                   the most effective user interface:
>                                   talking to another human being.
>                                   Application of data is at any level
>                                   that helps people make better
>                                   decisions to improve health and
>                                 + healthcare. Doximity
>                                   They use government data to build a
>                                   GPS map of all providers in America.
>                                   You can use that data set, as a
>                                   doctor, to figure out who to refer
>                                   patients to, and even integrates text
>                                 + messages. Essence Group/Lumaris
>                                 + Press Ganey
>                                 + Rise Health
>                                 + ElizaLIVE
> 
> 
>                                 Communities Improving Healthcare
> 
>                                 + Ozioma
>                                   Built by a team of University of
>                                   Washington St. Louis students, it is
>                                   virtually free for bloggers and
>                                   journalists. It takes 98% of the work
>                                   out of raising public awareness.
>                                   Journalists can't afford their own
>                                   health services researchers, and
>                                   Ozioma directly categorizes stories
>                                   about disparities in health to help
>                                   mobilize action.
> 
>                                       HHS didn't pay for, or coordinate
>                                       any of this stuff. We just put out
>                                       data, publicize it, and folks like
>                                       you dive in and kick butt! You
>                                       leverage your talent and build
>                                       amazing stuff. In just these 50
>                                       innovations, no one or even ten
>                                       companies could not have /thought
>                                       of/ all of these ideas, let alone
>                                       /built them/.
> 
>                                 + Walgreens
>                                   announced they are going to install
>                                   people to be "health guides," or free
>                                   health concierges. Walgreens wanted to
>                                   build an IT cockpit for these guides,
>                                   so they issued a challenge and got 50
>                                   submissions in about 90 days, and
>                                   chose one startup to equip them. The
>                                   first 16 installations are happening
>                                 + in Chicago as we speak. Startup Health
>                                   A combination of a seed accelerator
>                                   and incubator, they will help start
>                                   100 companies over the next 10 years.
>                                   Venture Capitalists are very
>                                   efficient, but incubation systems for
>                                   healthcare companies is very
>                                   hap-hazard. Organizations like Startup
>                                   Health, fill this gap, and help
>                                   startups find support, through a
>                                 + rolling applications process. Health
>                                   Data Consortium
>                                   Launched as a new private/public
>                                   partnership through the Robert Wood
>                                   Johnson Foundation <http://rwj.org>,
>                                   they have hired a small cadre of
>                                   health data evangelists. These are the
>                                   Johnny and Jane Appleseeds of Open
>                                   Data who walk the ground, run
>                                   datapalooza, and expand the scope and
>                                   breadth of health data. 
> 
>                                 Our goal is to not only expand the data,
>                                 but catalyze the ecosystem of innovators
>                                 who will create the jobs of the future.
>                                 I'd love to get to know you, and see how
>                                 we can help you. If we can't connect
>                                 here, please contact me at
>                                 todd.park at hhs.gov
>                                 <mailto:todd.park at hhs.gov>
> 
> 
>                                         Q: What are you thinking about
>                                         when you say we have all the
>                                         technology?
> 
> 
>                                         A: I didn't mean that electronic
>                                         health records can do all this,
>                                         or that healthcare itself has
>                                         all the tech. In the world in
>                                         general, the tools exist, and it
>                                         is feasible to be applied. Has
>                                         it been done yet? No.
> 
> 
>                                         Q: Is location based data like
>                                         asthmapolis being shared with
>                                         city planners and other public
>                                         officials?
> 
> 
>                                         A: Patients have to opt-in, but
>                                         they have done some preliminary
>                                         work like this, crowdsourced at
>                                         the community level and combined
>                                         with sensor data.
> 
> 
>                                         Q: How do you like working in
>                                         the biggest bureaucracy in the
>                                         world?
> 
> 
>                                         A: I love it. I can't get enough
>                                         of it. I don't have a background
>                                         in government, and when they
>                                         contacted me, I said 'I don't
>                                         know anything about politics or
>                                         government' and they said
>                                         'Great! It's an entrepreneur in
>                                         residence position to lead big
>                                         initiatives' If you work in the
>                                         Federal Government, and you have
>                                         an idea, here is my advice; Find
>                                         3 or 5 other people who had the
>                                         idea a long time ago, who know
>                                         how goverment works, and stitch
>                                         them together in a virtual
>                                         startup team. Give them
>                                         permission to do the things they
>                                         want to do, and things rapidly
>                                         get done. The thing that
>                                         distinguishes top entrepreneurs
>                                         is they /believe/ in what htey
>                                         are building. Leaving a legacy.
>                                         Leaving their mark. Making the
>                                         lives of their grandkids better.
>                                         That is what is required to deal
>                                         with the craziness and to make
>                                         change, in the public or private
>                                         sector.
> 
> 
>                                         Q: What would happen if we were
>                                         to innovate our way into a more
>                                         proportionate amount of GDP into
>                                         "per patient services?"
> 
> 
>                                         A: People talk about going from
>                                         that 2.5 to 1.5 (trillion
>                                         dollars), and they talk about
>                                         changing growth rate. I don't
>                                         have a problem with spending 20,
>                                         30, 40 percent on healthcare.
>                                         What I do have a problem with is
>                                         large portions of that spending
>                                         being wasted. It is up to
>                                         society to decide how much to
>                                         spend on healthcare. Nobody
>                                         thinks we are getting our
>                                         money's worth. I talk to primary
>                                         care doctors, and ask "can we
>                                         get more for what we spend?" The
>                                         laugh and say "of course, but
>                                         our system is not geared toward
>                                         keepign people healthy." I focus
>                                         on return on investement.
> 
> 
>                                         Q: What is the process for our
>                                         students at RIT and the Upstate
>                                         Community to participate in one
>                                         of the hackathons you mentioned?
> 
> 
>                                         A: I have 2 anwers: 1) go to
>                                         health2challenge.org and
>                                         challenge.go and you can see the
>                                         challenges happening all over.
>                                         2) If you want to do your own,
>                                         we'd love to help. We can
>                                         collaborate with you, and I'd
>                                         love to come if I can. One thing
>                                         we have learned from running
>                                         these kinds of events is that
>                                         you need both IT/Data/Dev folks
>                                         AND healthcare folks in the same
>                                         room. Otherwise devs spend time
>                                         learning basic things. That
>                                         intersection is important, if
>                                         schools of public health and
>                                         medicine got involved, it could
>                                         be very interesting.
> 
> 
>                                         Q: What is your fundamental message?
> 
> 
>                                         A: Never has there been a better
>                                         time to start a company at the
>                                         intersection of data, health,
>                                         and IT. Information is being
>                                         liberated at an epic scale.
> 
>                                         *Never has there been a better
>                                         time to start a company at the
>                                         intersection of data, health,
>                                         and IT. Information is being
>                                         liberated at an epic scale.*
> 
>                                     Thank Dr. West for that
>                                     introduction, and Elizabeth for
>                                     organizing this. We started this
>                                     conversation at SXSW. I'm just
>                                     hearing about all of things
>                                     happening in health and
>                                     entrepreneurship. I don't want this
>                                     to be a formal "speechification"
>                                     process. Let me start with Qs: Who
>                                     has background in HealthCare? Who
>                                     has background in IT or Data
>                                     Student? Tech Dev? Researcher Doctor
>                                     Nurse Healthcare Management and
>                                     administration This gives me a good
>                                     sense of who is here, and it looks
>                                     like you are all in the sweet spot.
>                                     There has never been a better time
>                                     to be an innovator in Health and IT.
>                                     2 trends are locking in: shift in
>                                     incentives information liberation
>                                     rocket fuel for innovation New
>                                     Incentives: Meaningful Use
>                                     Medicaid/care paying 43K-60K
>                                     physicians to improve data capture
>                                     and sharing, and outcome sharing,
>                                     through 2015. 100,000 providers
>                                     registered with us. While this is
>                                     exciting, and builds a biz case for
>                                     health IT, it is just the warmup
>                                     appetizer, that rewards the use of
>                                     data IT. Payment reform - Affordable
>                                     care act Historically, pay per
>                                     doctor visit, per procedure. Lots of
>                                     people would say this is
>                                     dysfunctional, but is doing what it
>                                     is designed to do. Exponential
>                                     growth in health and quality health.
>                                     We need shift from pay for volume to
>                                     pay for keep people healthy. Being
>                                     emulated across prviate sector.
>                                     Biggest game changer, cener for
>                                     medicare and medicaid innovation. if
>                                     you care about this, this is the
>                                     most important thing: go find out
>                                     more about the innovation center
>                                     innovation.cms.gov? new center
>                                     funded by 10Bil to executre RD, on
>                                     how CMS can pay for ways to improve
>                                     costs, and health. Most important is
>                                     not the 10Bil, an obscure clause, it
>                                     says that if there is a new way to
>                                     pay for care, if that is born out in
>                                     data, the CMS office of actuary, the
>                                     sec of HHS, has the authority to
>                                     turn that into how CMS pays
>                                     national. Objective, Scientific
>                                     process to incentive health care and
>                                     improvement. CMS never had authority
>                                     to decide how it pays for care. This
>                                     is an objective and open process.
>                                     Why is this exciting? If you look at
>                                     Patient centered medical homes,
>                                     takes responsibility, reaches out,
>                                     saves complications and years in the
>                                     hospital. Educates and takes care of
>                                     you. This is what primary care
>                                     physicians wanted this, but this
>                                     push for primary care was inhibited.
>                                     Clinical depression is on the rise.
>                                     Bundled payments, etc... new care
>                                     delivery teams and networks
>                                     emerging. Move past seeing people
>                                     more and more rapidly, but expand to
>                                     proactive health patient
>                                     optimization. Analyzing information.
>                                     Expanding the scope to include care
>                                     coordination. 5% of medicare
>                                     patients accoutnf ro 40% of medicare
>                                     costs!!! What is the coordination
>                                     efforts like? YOu can't, you'll go
>                                     bankrupt. Doctors are being paid to
>                                     optimize and coordinate with other
>                                     doctors, to do this holistically.
>                                     75% of spending is on illness(not
>                                     sure) YOu gotta extend beyond the
>                                     walls of the office, at home, and
>                                     help them realize they have to come
>                                     in. That notion of proactive patient
>                                     health management, and engaging
>                                     outside of the office, will need to
>                                     be done to succeed financial. From a
>                                     tech standpoint, how you do this,
>                                     can't be without data, and timely
>                                     data, to integrate care. Ability to
>                                     engage is based on datamining and
>                                     analytics. if I were to give this
>                                     talk to another industry, it would
>                                     sound like space age stuff. No new
>                                     tech has to be invented, we just
>                                     need to take lessons from other
>                                     industries and apply it. It is not
>                                     just a ctrl+c and ctrl+v process. In
>                                     a nutshell, this opportunity to
>                                     reinstrument healthcare system, is
>                                     the greatest entrepreneurial
>                                     opportunity since internet. 3
>                                     Trillion dollar industry. People who
>                                     raised their hands for tech, health,
>                                     data, and entrepreneurship, this
>                                     could be the best time to be alive.
>                                     Q: What are you thinking when you
>                                     say we have all the tech? I didn't
>                                     mean electronic health records can
>                                     do all this, or that healthcare has
>                                     all the tech. In the worl din
>                                     general, the tools exist, and it is
>                                     feasible to be applied. Has it been
>                                     done yet? No. the EHR's are like the
>                                     1890's. It is not clear what the
>                                     mode of the tech people will move
>                                     to, but the runway. There is still
>                                     time to innovate. Q: How would you
>                                     incentivize all these people to
>                                     communicate with eachother?
>                                     Basically, it's not my goal to
>                                     microengineer more fees for service,
>                                     Kaiser, or intermountain company,
>                                     they have total accountability. They
>                                     do the "stitch in time" to save
>                                     hospitalization. Built a massive
>                                     database, and quality outcomes
>                                     better, and lower costs than
>                                     anywhere in america. They still have
>                                     a long way to go. Orgs do what they
>                                     are paid to do, and the current
>                                     system does not reward care orgs. If
>                                     you shift to a system where care
>                                     coordination is essential, hopefully
>                                     over time or rapidly, processes and
>                                     people will optimize. There is a
>                                     long way to go. If I were telling
>                                     you the problem is solved, it would
>                                     be much less exciting. there is a
>                                     market now. I can testify to you,
>                                     from being the manager, to building
>                                     a company that builds software,
>                                     innovation is the systematic... even
>                                     if people want to innovate they
>                                     can't. This will make babies
>                                     healthier and mom's happier. Folks
>                                     like me, back in the day, had ideas
>                                     and we had a chance, because the
>                                     incentives are being stacked in our
>                                     favor now. It is a huge opportunity.
>                                     Ther eare use solutions being
>                                     developed. Infomraiton Liberation:
>                                     rising patient data liquidity The
>                                     direct project Happening at multiple
>                                     levels. Doesn't little good if we
>                                     move to e-records, but patient data
>                                     can't move. If it isn't able to move
>                                     from provider to provider, it makes
>                                     it more difficult. We need to turn
>                                     manilla into electronic, but the
>                                     data needs to move witht he patient.
>                                     Direct projec,t launached a year and
>                                     ahalf ago, the HHS is not your
>                                     father and mothers hhs. This story:
>                                     a doctor came to one of our meetings
>                                     and said I know you are having
>                                     powerful thoughts, but I have a
>                                     record, and a patient going to
>                                     another doctor. We have the same
>                                     record, from the same company, and
>                                     all I can do, is print the record,
>                                     and fax it to the other doctor. I
>                                     didn't think, and emailed the
>                                     record, and I understand that that
>                                     is bad... help me with the basic
>                                     simple networking problem. We said,
>                                     well we can help you, but we don't
>                                     konw the answer. In prior years,
>                                     we'd say "we'll appoint a
>                                     commission, and they'll come out 8
>                                     months later with the answer" We
>                                     said, we're confident we can crowd
>                                     source it. Entrepreneur opened a
>                                     wiki, and less than 3 months, had a
>                                     spec for secure health record email.
>                                     95% of record companies want to
>                                     participate. Blue button: Another
>                                     interesting project, luanched by Vet
>                                     affairs, enables millions of vets
>                                     and soldiers to hit a blue button
>                                     and download your own data. We
>                                     didn't think it was a big deal, but
>                                     the VA projected that 25K vets would
>                                     download... today 450K vets and mils
>                                     have downloaded. We got calls from
>                                     people, asking "We're you allowed to
>                                     do that?" "Are you allowed under
>                                     HIPPA, to allow people to download
>                                     their own records" We said yes, and
>                                     it is infact legal. The fact that we
>                                     did sneds a strong signal. Orgs like
>                                     AETNA and United health, Indiana,
>                                     and Vermont are now doing it.
>                                     BlueButtonData.org explains how to
>                                     do it, and where you can commit to
>                                     joining the movement. HHS announced
>                                     a new clear rule, in sept. to allow
>                                     patients to get their own test
>                                     results from labs! Increasing market
>                                     transparency What defines market?
>                                     Customer knows what choices are,
>                                     know the vlaue, and can make
>                                     choices. If this is a market, has
>                                     healthcare been a market before? Not
>                                     so much. We bring transparency. July
>                                     1st we launched healthcare.gov,
>                                     provides detailed vendor information
>                                     for insurance down to the zipcode.
>                                     This is important delievers better
>                                     results health Data initiative Heard
>                                     of it? This is something that we are
>                                     excited about, luanched 20 months,
>                                     turn us into the NOAA of health
>                                     data. NOAA collecgts all weather
>                                     data, and chooses to publish all the
>                                     data in machine readable free
>                                     formats, for free. Spawned
>                                     innovaiton in private sedctor,
>                                     (weather channel, apps, etc...)
>                                     Wonderful example of symbiotic
>                                     public/private relationship. When
>                                     regan liberated gps data, paved way
>                                     for foursquare and other
>                                     innovations. Take billinos of $ of
>                                     data, and make it into fuel, open
>                                     computable fuel, that entreprenuers
>                                     can turn into magic that help
>                                     patients and doctors. Making
>                                     existing data more accessible pdf
>                                     and books are useless. We're making
>                                     api's and machine readable data.
>                                     Realized that 98% of innovators, had
>                                     no idea we had this. We've been
>                                     marketing the bejeebers out of this
>                                     data. What kinds of data are we
>                                     liberating? Community health
>                                     indicators, 1200 metrics of
>                                     performance, national regional local
>                                     and state. smoking obesity rates,
>                                     etc... Provider directors medicare
>                                     medicaid numbers, mental health
>                                     providers, community health centers,
>                                     meals on wheels, counseling,
>                                     hopsical quality, home quality,
>                                     etc... we added API's for this to
>                                     allow developers to link and extract
>                                     data. section 10332 provision that
>                                     allows medicare to make available
>                                     detailied medicare files to
>                                     qualified private orgs, and do
>                                     research. Goes live Jan 2012. Blue
>                                     Button FDA Recall data Products of
>                                     healthcare.gov available as single
>                                     download NLM clinical trials,
>                                     pillbox - api growing repo of
>                                     tablets Medline plus encyclopedic
>                                     informaiton Medical connect patient
>                                     content borken down into individual
>                                     diagnosis and drugs "spits back an
>                                     xml package, a packet" like having
>                                     NLM plugged into your iphone for
>                                     free Goverment Spending Claim files
>                                     public available Redacted claim
>                                     files to ensure you can't rejoin the
>                                     data later To track all this, we
>                                     have one site healthdata.gov. One
>                                     stop shop for all of our data. It is
>                                     controlled access, the blue button
>                                     data is not here. All the foilable
>                                     data is catalogued on data.gov On
>                                     top of that, we publicize the heck
>                                     out of our data. working with
>                                     health2challenge.org any company can
>                                     launch a competition or code a thon.
>                                     Highly recoommened going to a
>                                     code-a-thon. Several organize dby
>                                     health20 pittsburg students won
>                                     codeathon at georgetown food oasis
>                                     Food deserts are where in america
>                                     you can't get access to healthy
>                                     food. They decided to solve this
>                                     problem in 8 hours. They did a
>                                     mashup of text messages and farmers
>                                     markets. You text in "i want 5
>                                     zuccini and 3 tomatoes" and it
>                                     notifies you of farmers markets. I
>                                     fyou don't demand in advance, and
>                                     there is no inventory, the cost of
>                                     food drops dramatically. They are
>                                     testing in 7 cities, and I don't
>                                     know if that idea in that form will
>                                     work, it is their first, but what is
>                                     exciting, is that these 5 kids are
>                                     addicted to leveraging data to help.
>                                     Founded many companies, but I've
>                                     divested since. The thing I've
>                                     learned is if you get the best
>                                     people, you win. If you attract all
>                                     of the best innovators in america
>                                     into healthcare, we can invent our
>                                     way out of any problem. Annaul
>                                     Health data palooza Hosted by
>                                     Secretary, our 2nd annual one June
>                                     9th. Large Scale festivals, open
>                                     invitations to anyone who uses our
>                                     data to help doctors, patients,
>                                     journalists. They also have to have
>                                     a sustainable biz model. They have
>                                     to be able to deliver to actual
>                                     people. This is about 20 months
>                                     onld, and is a tough idea. Even with
>                                     these tough criteria, we had more
>                                     people than could fit into our
>                                     auditorium. We did an "american idol
>                                     style" virtual event, to narrow down
>                                     with judges to the best 50. What I
>                                     would say, if you faith is wavering
>                                     in america, go to the institute of
>                                     medicine search for health data
>                                     initiative forum and watch as many
>                                     videos as possible. Let me describe
>                                     a few: Help cosnumers take control
>                                     of their own health, by giving them
>                                     their own data. I-triage, co out of
>                                     Denver. opwerful mobile/web tools.
>                                     early on took our directory and put
>                                     it into their app. 65 employees,
>                                     3million users, just bought by
>                                     aetna, tons of capitoal to exmpand
>                                     healthline useful for healthsearch,
>                                     ingests huge amounts of gov data, to
>                                     make healthsearch more viable and
>                                     accurate vitals.com shopping
>                                     services for consumers to know
>                                     quality/cost Patientslikeme.com 120K
>                                     patients voluntarily share info
>                                     about their illness integrated with
>                                     our clinical trials.gov data, won
>                                     the datapalooza asthmapolis single
>                                     person, cdc vet. SImple and
>                                     brilliant, attach a gps to an
>                                     inhaler, to track where you have
>                                     attacks. 80 patients did it, after
>                                     several months, dropped from 75% to
>                                     40%, use of inhaler more than 2
>                                     times per week. Cuts costs by $3K
>                                     per person. Unscientific tests,
>                                     small people. Attracing angel
>                                     investments. imagine doctors
>                                     prescribing an asthmapolis device!
>                                     Under HIPPA, it is covered, they
>                                     care compliant, and they have been
>                                     cleared with FDA. Is location based
>                                     data being shared with city planners
>                                     and other public officials? Patients
>                                     have to opt-in, but they have done
>                                     some preliminary work like this.
>                                     Crowdsourced at community level,
>                                     combined with sensor data. Care
>                                     providers provide better care Aetna
>                                     cool app rollout, it wasn't even an
>                                     app, but a nurse. Nurse 2.0. They
>                                     built an IT cockpit for nurses, to
>                                     help nurses help people better. Call
>                                     center nurse, assigned to a patient
>                                     with multiple illnesses.
>                                     Demonstrated how nurse can pull up
>                                     various pieces of gov data, to be a
>                                     more omniscient provider. Here are
>                                     the nearest community health, meals
>                                     on wheels, etc.. customized help for
>                                     patient, delievered through the most
>                                     effective user interfaces: talking
>                                     to another human being. I love
>                                     iphones, but that is too narrow.
>                                     Application of data is at any level
>                                     that helps people make better
>                                     decisions to improve health and
>                                     healthcare. Essence Group/Lumaris
>                                     Doximity Communication, speaking of,
>                                     interesting solution. They use gov
>                                     data to build a gps map of all
>                                     providers in america. You can use
>                                     that data set, as a doc, to figure
>                                     out who to refer patients to, and
>                                     even use text message. I was talking
>                                     to Jay Walker, founded priceline,
>                                     the thing about social netowrking,
>                                     enables people to mass communicate
>                                     at zero marginal cost. Simultaneous
>                                     mass communication with social media
>                                     and mobile. Press Ganey Rise health
>                                     ElizaLIVE Communities improve
>                                     healthcare Policy maker can change
>                                     strucutre of policy or neighborhood.
>                                     Ozioma built by team of UWashington
>                                     St. Louis. Vritually free for
>                                     bloggers/journalists, takes 98% of
>                                     work out of raising public
>                                     awareness. Journalists can't afford
>                                     their own health services
>                                     resaerchers. Youc an directly
>                                     categorize stories disperities in
>                                     healht, and mobile action. ESRI HHS
>                                     didn't pay for, or coordinate this
>                                     stuff. We just put out data,
>                                     publicize it, and folks like you
>                                     dive in a kick butt! You leverage
>                                     your talent and build amazing stuff.
>                                     Just these 50 innovations, no one or
>                                     ten orgs could have thought of all
>                                     these, let alone built them.
>                                     Walgreens announced they are going
>                                     to install people to be "health
>                                     guides." done in chicago already.
>                                     Free health concierge. Wnated to
>                                     build an IT cockpit for this guy,
>                                     and they issued a challenge and got
>                                     50 submissions in about 90 days, and
>                                     chose a startup to equip them. First
>                                     16 installations happening in
>                                     chicago as we speak. Consumer health
>                                     informatics build more people who
>                                     can build this stuff Startup health
>                                     combination of a seed excellerator
>                                     and incubator, help start 100
>                                     companies over next 10 years. VC is
>                                     very efficient, but incubation
>                                     system for healthcare companies is
>                                     very hap-hazard. These folks can't
>                                     find the support, but this org helps
>                                     alleviate that. Rolling applicaitons
>                                     to get support. Health Data
>                                     Consortium Launched a new pri/pub
>                                     partnership, robert wood johnson
>                                     foundation Hire a small cadre of
>                                     halth data evangelists Run
>                                     datapalooza expand scope and breadth
>                                     goal not to only expand the data,
>                                     but catalyze the ecosystem of
>                                     innovators. New Incentives +
>                                     Information Liberation = Rocket Fuel
>                                     for Innovation & Progress I'd love
>                                     to get to konw you, and see how we
>                                     can help you. If we can't connect
>                                     here, contact me at
>                                     todd.park at hhs.gov I'm continually
>                                     haunted by change of a complex
>                                     system. Inputs don't affect outputs
>                                     in a linear way. One of you will be
>                                     the butterfly that flaps it's wings
>                                     that changes healthcare. HHS in some
>                                     small way can help you. You are part
>                                     of a broader movement. I spend alot
>                                     of time on the road, talking to
>                                     thousands of innovators, and what
>                                     hundreds of them have already done.
>                                     More walking than talking. they have
>                                     already built stuff, that can
>                                     revolutionize healthcare in tangible
>                                     ways. Innovators from all sectors,
>                                     our job is to help you. Thank you
>                                     for all you've done already. Thank
>                                     you for everything you've done. God
>                                     bless you, may the force be with
>                                     you, and god bless america. Where
>                                     can we get a copy of this
>                                     presentation? Feel free to take it.
>                                     How do you find working in the
>                                     biggest beureuacracy in the world? I
>                                     love it. I can't get enough of it. I
>                                     don't have any background in gov.
>                                     When they contacted me, I said I
>                                     don't know anything about politics
>                                     or gov, and they said Great! "It's
>                                     an entrepreneur in residence, to
>                                     lead big initiatives" If you work in
>                                     the FEd gov, if you have an idea,
>                                     you first find 3 or 5 other people
>                                     who had that idea a long time ago,
>                                     who know how gov works, and you
>                                     stitch them together in a virtual
>                                     startup team. Give them permission
>                                     to do the things they want to do,
>                                     and they rapidly get things done. I
>                                     get calls from my friend on the
>                                     outside asking "do you have to fill
>                                     out forms to go to the bathroom?"
>                                     But I love what I do. The thing that
>                                     distinguishes top entreprenuers is
>                                     they believe in what they are
>                                     building. Leaving a legacy. Leaving
>                                     their mark. Making the lives of
>                                     their grandkids, better. That is
>                                     what is required to deal with
>                                     craziness, to make change, in the
>                                     public or private sector. I can't
>                                     stress enough. Even when it has been
>                                     brutal. If we were to innovate our
>                                     way into a more proporitionate
>                                     amount of GDP into 'per patient'
>                                     what would happen? People talk about
>                                     going from 2.5 to 1.5, they talk
>                                     about changing growth rate. B, I
>                                     don't have a problem with spending
>                                     20-30-40 percent on healthcare. I do
>                                     have a problem with large portions
>                                     of it being waste. it is up to
>                                     society to decide how much to spend
>                                     on healthcare. nobody thinks we are
>                                     getting our monies worth... I talk
>                                     to primary care docs, and ask "can
>                                     we get more for what we spend?" They
>                                     laugh and say of course, but our
>                                     system is not geared toward keeping
>                                     people healthy. I focus on return on
>                                     investment. FDA entreprenueriship in
>                                     residence Launched a month ago, team
>                                     asigned the job of redesigning how
>                                     FDA designs breakthroughs...
>                                     Previous to this process, they are
>                                     now looking at total end-to-end
>                                     cycle time, cut down time, and
>                                     impact safety. They are not sticks
>                                     in the mud. go to
>                                     health2challenge.org and
>                                     challenge.gov you can see the
>                                     challenges happening all over. We
>                                     love to get the word out. If you
>                                     want to do your own, we'd love to
>                                     help. WE can collaborate with you,
>                                     I'd love to come if I can. One thing
>                                     we learned, you need both IT data
>                                     dev folks and health care folks in
>                                     the same room. otherwise devs spend
>                                     time learning basic things. That
>                                     intersection is important, if the
>                                     school of public health/medicine and
>                                     others sponsored it, it could be
>                                     interesting. NAE and NLM Schools of
>                                     engineering and health encouraged in
>                                     a college bowl type hackathon.
>                                     Fundamental Message: Never been a
>                                     better time to start a company at
>                                     the intersection of data, health and
>                                     IT. Information is being liberated
>                                     at an epic scale. 

-- 
Jason Hibbets, RHCSA :: Twitter: @jhibbets
Project Manager, Red Hat :: Raleigh, NC

Open source is changing the world -- http://opensource.com




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