The American Medical Association has launched a new digital platform designed to improve, organize and share health information among healthcare stakeholders through a common data model.

The Integrated Health Model Initiative (IHMI), which is open to all organizations, has several early participants including the American Heart Association, American Medical Informatics Association, Cerner, IBM and Intermountain Healthcare.

“We spend more than $3 trillion a year on healthcare in America and generate more health data than ever before. Yet some of the most meaningful data—data to unlock potential improvements in patient outcomes—is fragmented, inaccessible or incomplete,” said James Madara, MD, CEO of the AMA.

“The collaborative effort of IHMI will help the health system learn how to collect, organize and exchange patient-centered data in a common structure that captures what is most important for improving care and long-term wellness, and transform the data into a rich stream of accessible and actionable information,” added Madara.

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Michael Hodgkins, MD, the AMA’s chief medical information officer notes that the healthcare industry is awash in data. However, he contends that the lack of a universal terminology standard is a major barrier to communication between different electronic health record systems and the ability to derive clinical meaning from shared EHR data.

“The problem is useful information, meaningful data,” says Hodgkins, who points out that disparate EHRs have their own inherent clinical terminologies. But, by leveraging a common data model, he believes these systems can “talk” to each other in the same “language,” providing the ability to share clinical information and use it meaningfully.

“We’re creating a data model, unlike other models before it, that can achieve true semantic interoperability,” contends Hodgkins. “Semantic interoperability means that you’re actually transferring knowledge—you’re transferring data in context so that it has meaning.”

Stan Huff, MD, chief medical informatics officer at Intermountain Healthcare, has been a longtime advocate of standard clinical data models and terminologies to achieve true semantic interoperability, whereby EHR data is consistent through standardization of information models that are mapped to clinical terminology standards such as LOINC and SNOMED.

“I am excited about IHMI because it builds on the foundation of interoperability standards that are being created by HL7, LOINC and SNOMED International,” said Huff. “If we persist, that approach will lead to the ability to exchange medical knowledge as executable software rather than as journal articles. If we can do it, it will be a historic evolutionary step for medicine.”

EHR vendors have typically not been willing to make a commitment to that level of standardization. However, Cerner is an early IHMI collaborator.

“Ensuring the accuracy and completeness of the information used to manage a person’s care is a priority for Cerner, so we are happy to support this AMA initiative to improve the semantics of clinical data models,” said David McCallie, MD, senior vice president for medical informatics at Cerner. “This represents a bold attempt to advance an important aspect of interoperability.”

Overall, the online IHMI platform offers three capabilities to participating organizations:

  • Collaborative communities focused around costly and burdensome care areas such as hypertension, diabetes and asthma.
  • Physician-led validation process to determine and apply appropriate clinical frameworks in which participants will submit contributions and feedback online to specify data elements and relationships that will be reviewed for clinical applicability.
  • A data model for organizing and exchanging information with clinical content, enabling configurations of the model and reference value sets that will be distributed.

“A common data model with clinically validated data elements can accelerate the development of improved data organization, management and analytics,” the AMA said in its announcement of the initiative. “This collective effort will foster patient care models that achieve better outcomes, as well as technical innovations to address poor interoperability, cumbersome or inadequate data structures, and an overload of point-and-click tasks that dampen clinician morale.”

Hodgkins says IHMI is creating a platform for collaborative communities of “like-minded individuals,” bringing together the health and technology sectors to help build the common data model, as well as a clinical review process led by physicians to “validate what comes out of that collaboration through the online platform to make sure that it’s scientifically valid.”

According to the Hodgkins, additional communities will be developed and added to the digital platform throughout 2018 based on market needs. “The benefit accrues to everyone because this is going to be a market-driven event,” he concludes. “That’s what this platform is about—having these virtual communities contributing to the development of the model which, as it gets out to the world, will provide feedback and real-world evidence on how the model is working that will allow us to refine it.”

Hodgkins adds that the AMA intends to license the common data model at no cost. Information on how to join IHMI can be found here.

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