The papers in this chapter explore the major trends toward and strategies for accelerating a nationwide HIT culture. The first paper, by David Blumenthal, formerly of Office of the National Coordinator (ONC) for Health Information Technology (now Harvard University) addresses the “meaningful use” of HIT—collecting data and disseminating them in such a way as to make science-driven care and value routine. As the concept gains traction, its meaning can broaden to include data sharing and more robust exchange.

Better types of data are also critical for success. Daniel R. Masys, Jack M. Starmer, and Jill M. Pulley of the Vanderbilt University School of Medicine describe three cases in which new classes of data support a learning health system and improved outcomes. Dashboard displays can improve the reliability of complex healthcare processes. Some electronic networks can link and use data that are scattered around the country, while others can track the experience with a particular drug after it has been approved.

Kemal Jethwani and Joseph Kvedar of Partners HealthCare report on how patients are reaping benefits as they use the Internet to connect with health systems. Notably, patients with congestive heart failure, diabetes, and high blood pressure are able to better manage their condition through electronic connectivity via cell phones, computers, and dialog with their patient team. Patients like this kind of connectedness. Also, as wireless technology grows, it offers promise for the development of many more new applications for learning.


David Blumenthal, M.D., M.P.P.
Office of the National Coordinator for
Health Information Technology (former)
Harvard University

As the entity charged with coordinating efforts to implement and use advanced HIT and develop capacity for nationwide health information exchange, ONC plays a critical role in laying the groundwork for a learning health system. In its work to meet these critical short-term requirements, ONC also seeks to provide a pathway for achieving the potential of HIT to serve as an engine for continuous learning and care improvement. This paper reviews ONC’s efforts to date and some of the key technical, human, and political challenges to making available the kind of information that could be used to provide real-time and retrospective feedback to the healthcare system. Meeting all of these challenges is critical for improving health and the quality of care delivered in the United States.

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