In December, the Department of Health & Human Services (HHS) will launch a Web-based bonanza of healthcare data " leading health indicators on the national, state, regional and county level that can be sliced, diced and mapped in a variety of ways.
HHS's Community Health Data Initiative (CHDI) will release all of this data in a standard format that can be exported automatically to Web-based applications. In doing so, HHS hopes to spark the next generation of healthcare applications that will lead consumers, doctors, policymakers and others to make better decisions and improve the quality and reduce the cost of healthcare services.
"We are offering up HHS as a data platform that makes more and more data available to a growing ecosystem of innovators," said HHS Chief Technology Officer Todd Park. "The ecosystem is already blossoming. It's at a point where we're not even conscious of everything that's happening out there with our data."
Innovative healthcare applications that exploit government data are already emerging: from inhalers equipped with GPS systems that track when and where asthma patients need their medication, to iPhone apps that locate the nearest emergency rooms and dashboards that rank counties by the quality of their healthcare systems.
But as exciting as it sounds, the HHS initiative is not without its challenges.
Healthcare application developers are unsure of the quality and timeliness of government data that will be released. Turning the government's raw data into applications that are usable by the public is another significant hurdle for developers. And they fear HHS may face an ongoing battle to procure funding to gather, scrub and release healthcare data.
"A data warehouse is only as good as the data that goes into it," said Bridget Booske, project director for the County Health Rankings and a senior scientist at the University of Wisconsin Population Health Institute. Booske's County Health Rankings are available through the Community Health Data Initiative Web page.
"From a data perspective, there are challenges in the way that measures are defined. There are lots of nuances when calculating measures, and it's going to be a challenge within the data warehouse to accommodate all the different ways you can do calculations," Booske said. "You could have a hundred different definitions of a single measure. People like us that use the government data are going to have to compromise in order for this to happen."
David Van Sickle, a post-doctorate fellow at the University of Wisconsin School of Medicine and Public Health who has developed the GPS-enabled inhalers under an effort dubbed Asthmapolis, also says it remains to be seen how useful the raw government healthcare data will be.
"One thing that the Community Health Data Initiative has emphasized is how much data has been collected that hasn't been easily accessible or at all accessible," Van Sickle said. But it's taking some time to sort out the wealth of data and just how helpful it can be.''
Van Sickle says data relevance is critical for the initiative to be a success. "It's not only about data becoming more available, but also about data becoming more timely, more granular and more relevant, not only to public health officials or clinicians but to patients," he added.
A glimpse of the beginning
HHS has already offered what it calls "a glimpse of the beginning" of the next generation of Web-based healthcare applications. On June 2, the agency showcased more than a dozen cutting-edge healthcare applications at a Washington D.C. event when it unveiled the Community Health Data Initiative.
"I'm incredibly excited about what innovations have been done in the early stages of the Community Health Data Initiative," Park said in an interview. "I've been struck by the diversity of the innovations that people have come up with " even just what was shown in the early stage. It was stunning to me what people with different perspectives, mindsets and orientations could come up with."
Park is modeling HHS' efforts after the weather data provided by the National Oceanic and Atmospheric Administration (NOAA). He hopes to foster a similar partnership between the government and commercial providers that will result in the availability of useful, quality healthcare information to consumers.
"What NOAA does is provide a really high-quality stream of weather data for free to anyone who wants to use it," Park said. "There's a whole ecosystem of innovators and organizations that use that data, ranging from the local newscaster to The Weather Channel to iPhone applications to the hotel that prints out the weather forecast and slips it under your door to tell you that it's going to rain tomorrow.
"That's how different people use that data to create value to the public " it's a very elegant public/private ecosystem," he said.
Most of the applications demonstrated at the June event were under development for months or years before the launch of the Community Health Data Initiative. Now the developers of these healthcare applications are trying to figure out how they can use government data that will be released through the HHS initiative or share some of their own data with the public.
Pillbox, for example, was started in 2004 by the National Library of Medicine as an image database of tablets and capsules that could be used by poison control centers and pharmacists to identify unmarked medications.
NLM researchers have been developing a standard high-resolution image that can be integrated with the Food and Drug Administration's structured product labels. So far, NLM's online pill identification system includes around 1,000 images " about one tenth of the tablets and capsules manufactured for the U.S. market.
"We have somewhere around 40,000 users, across the entire spectrum of patients, concerned citizens, clinicians to public health officials, doctors and pharmacies," said David Hale, project manager for Pillbox and a Technical Information Specialist with NLM.
Hale says Pillbox was demonstrated at the Community Health Data Initiative event because it is a model for how innovators can create new applications using government data. "We share the goal of not just releasing data in mass, but releasing it in a way that it promotes solutions to challenges,'' Hale said.
Data Quality, Quantity Concerns
Start-up Healthagen has already run into quality problems with federal government data it is integrating into its iTriage Smartphone application. Available for 18 months, iTriage is a free service that provides consumers with information about medical emergencies and guides them to the nearest hospital, acute care facility, doctor's office or pharmacy.
Similar to white page listings, iTriage has around 1 million places that provide healthcare services in its database. When Healthagen tried to add 7,000 Federally Qualified Health Centers that accept Medicare and Medicaid patients from a government list, the start-up discovered that the list included centers that don't actually provide healthcare services.
"The data is not quite what we need it to be because it has homeless shelters and food shelters," said Jonathan White, vice president of sales and business development at Healthagen. "So we moved it out of the application's decision tree. Instead of being listed as a Government Health Center, we put it in a special category called Government Help Center until we can scrub the data."
Nonetheless, White sees potential for iTriage taking advantage of government data made available through the HHS initiative. If, for example, the government had a list of geo-location coordinates for defibrillators, Healthagen would be interested i
