Chopra: secretary of collaboration

Soon after Annesh Chopra became the nation’s chief technology officer he promised to use his high-profile perch to advocate for health IT. Since then he has missed few opportunities to press his government and private sector audiences to seek out innovative ways to collaborate on new health services and applications.

President Obama charged Chopra to concentrate on three priorities, and health IT fits in each: to help deliver on healthcare reform through game-changing innovation; collaborate with the private sector to build a reliable digital infrastructure; and push federal agencies to practice openness and innovation in their operations.

To hit these marks, Chopra says he wants to tap the traditional levers of government—what he calls the “gray areas” of research and development, procurement
and grants—as springboards for developing innovative healthcare technologies and applications.

“It’s about marrying ideas with relevance,” he said. “When we listen to providers who actually want to achieve outcomes goals, there may be a different approach. New ideas will emerge that will price differently and structure differently, but will still achieve the goals that have been outlined.”

Chopra brings a mind for public-private collaboration to the national arena from his experience as Virginia’s secretary of technology. His recent history there provides a snapshot of his approach to fostering healthcare innovation.

One illustrative project: In one year, with a grant from the Health Resources and Services Administration, Virginia created a $1 million innovation fund for which Chopra put out a call for healthcare outcome goals and ideas about how organizations would deliver results. The approach was to use the fund to create “coach-able” moments instead of as a straight grant.

“We accepted ideas, and then had a kind of mergers-and-acquisitions period in which people could share each other’s ideas, talk with each other and collaborate,” he says.

As a result, Centra Health of Lynchburg, Va., formed a partnership with the American College of Cardiology (ACC) to take a business problem-solving approach to improving cardiac treatment outcomes. At the time, the ACC had inpatient and outpatient registries that could not be shared. The lack of integration made it difficult to ensure that best practices were followed once patients left the hospital.

Centra engaged local physician leaders to develop a template that prompted physicians to add data and best practices about their cardiac patients’ care while in the hospital and afterward.

“We catalyzed an innovation in the market that is on time, on schedule, delivering preliminary results and sharing data with the American College of Cardiology,” Chopra says.

Going a step further, he believes that the intellectual property Centra developed should also be shared so other companies and organizations can build on it and innovate.

Another idea: entrepreneurs might be able to take raw computer-readable federal data that has become publicly available through the newly established www.
data.gov and use it to design new online applications.

Chopra said the sources of such ideas are not as important as whether they circulate widely. “I am not as wedded to whether the foundation is open source or is a proprietary platform,” he says. “I care more about the sharing and reuse of intellectual property.”

He views the federal government’s Connect portal project as an example of reaching that goal. The Connect software lets government as well as private healthcare organizations access the nationwide health information network. More than 20 federal agencies under the auspices of the Federal Health Architecture project collaborated to build the NHIN gateway application. In April, the group released the source code for the Connect gateway to the open source community.

For Chopra the project is a treasure chest of potential health IT tools and applications. To maintain its momentum, he asked Brian Behlendorf, an open source pioneer and a consultant on Chopra’s Open Government initiative team, to develop an open-source strategy for the portal.

While Chopra’s portfolio is outwardlooking, he is also a member of the administration’s internal health IT policymaking organization. He sits on the HIT Standards Committee, a public-private panel that advises national health IT coordinator Dr. David Blumenthal on health IT standards and certification.

The standards panel and the HIT Policy Committee are working toward finalizing aset of rules providers must follow to qualify for a share of federal health IT stimulus funds.

Chopra is aware policymaking will pave the way to reforms in healthcare payment systems, incentives and programs for wellness and chronic care. “But underneath all the concepts of healthcare reform, and for improving healthcare outcomes,” he notes, “everything that one would want to do in making those changes will have some relationship to a more modern, robust technology platform.”