Perspectives: The World of Cardiology in 20 Years

Health Care Outcomes and Patient-Focused Innovation

Karen Ellen Joynt, MD, MPH

In coming years, outcomes research will change in terms of data, methods, outcomes measured and context. We will see increasingly complex and real-time data collection; new methods to increasingly examine longitudinal and hierarchical datasets; increasing measurement of patient-centered outcomes like quality of life and functional status; and greater focus on measuring value in addition to measuring quality.

I can't even begin to guess where we will be in terms of technology at that point, but I hope we will have made similar strides in health care delivery as we will have in drugs and devices, because we won't ever reap the full benefits of our scientific discoveries if we can't improve the ways that we deliver care. I think that in 20 years we will have made major progress in integrating wellness and behavioral health into cardiovascular medicine, and in delivering care in ways that resonate more closely with our patients' needs. I think we will be practicing in a more connected, team-based system that leverages shared information.

I think we will have found new strategies to help our patients have an easier time being adherent to their complex medication regimens, or that we will have found ways to streamline those regimens. Finally, I think we will have changed how we interact with data, and how we use huge amounts of it in real time to help deliver better care.

The Future of Big Data in Health Care

James E. Tcheng, MD

Simply put, the world of cardiology will be quite different in 20 years. One of the biggest differences is that data will permeate everything we do. Electronic health records and other health information systems will have evolved to become companion tools focused on clinical care, rather than administrative documentation. Principles of user-centric design will be central to how clinicians interact with health information technologies, with an emphasis on using the right device (e.g., tablet, mobile device, workstation, wearable device) to accomplish the right task. Patient-provided information will be a rich source of data, whether via direct reporting or through wearable or implantable sensors. A myriad of other data sources – especially from the genomics-related disciplines, will tune our interpretation of clinical and patient-provided information to better individualize care. We will also be immersed in a medical device innovation ecosystem that reduces the costs of medical device development while simultaneously serving as an early warning system for device surveillance. Key to our use of this river of data will be real-time analytics that will distill the information and identify actionable from surveillance information. Without this automation, we will drown in the data! All of this data could populate a living computerized textbook of medicine that could be queried anonymously to anticipate best approaches to patients by finding those with similar clinical profiles and understanding their outcomes. In other words, Big Data will be central to health care in 20 years – ever-increasing volumes and varieties of data aggregated and analyzed in ways that augment the effectiveness and efficiency of the clinician and the clinical care process – thus improving patient outcomes while reducing costs.

Keywords: ACC Annual Scientific Session, Data Collection, Delivery of Health Care, Electronic Health Records, Health Information Systems, Medical Informatics, Outcome Assessment (Health Care), Quality of Life

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