The American Medical Association announced a new initiative yesterday that promises to “unleash a new era of patient care.” The Integrated Health Model Initiative (IHMI) is a collaborative effort to support a continuous learning environment that enables interoperable technology solutions and care models that evolve with real-world use and feedback.

While at first glance IHMI looks a lot like existing efforts to improve health information exchange, there are two important features that set it apart – IHMI is led by physicians and emphasizes patient-centric information.

Developing standards

We can think of IHMI is the latest effort to standardize data in healthcare. Standards are important – they provide the fundamental definitions and structures that allow data to be communicated across a wide variety of healthcare use cases.

But what makes the IHMI different from existing initiatives to create interoperability standards, such as those led by HL7, LOINC or SNOMED International? Put simply, IHMI builds from standard data elements already in nomenclatures by developing conventions around types of patient-centric data that are missing.

As Laurie McGraw, Senior Vice President of Health Solutions for the AMA explains in a video, IHMI builds from a recognition that existing standards don’t include certain types of data that are important to patients. “Today there’s still particular data that’s missing – things like patient goals, function and state. Those things are critical to describe the patient outcomes, patient wellness, things that are critical from a patient perspective.

IHMI consists of a digital platform that serves three main functions:
1. Building collaborative communities to identify costly and burdensome clinical areas
2. A physician-led validation process to review clinical applicability
3. Developing a data model for organizing and exchanging information

Capturing data that matters to patients

A defining feature of IHMI is the project’s emphasis on data that matters to patients – specifically three elements that AMA describes as “function, state and goals.”

Take goals for example. Currently, there’s no standard way to capture and record what the patient desires in terms of outcomes and actions.

One patient’s goal following knee-replacement surgery might be to run, while another patient might aspire to walk comfortably. Creating standards for organizing information about patient goals can give providers further insight into what devices, procedures and surgical centers will deliver the best outcome.

“We spend more than three trillion dollars a year on health care 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.”

“Function” refers to the ability to complete a task that can be assessed before and after treatment. For the patient hoping to run after surgery, the knee functions to facilitate running and practitioners should record information about how knee-replacement affects running. “State” refers to the patient’s health at any given point, so the knee would be in a poor state before knee-replacement.

IHMI brings together stakeholders to standardize how health systems organize and exchange these types of patient-centered data. The project aims to organize 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.

Physicians take the lead

The AMA is the largest association of physicians and medical students in the United States, so IHMI aims specifically to support innovation built around what is meaningful to physicians and patients.

“Patients deserve — and the marketplace should expect — physician input on the real-world value and feasibility of products and health technologies,” AMA Senior Vice President of Health Solutions Laurie McGraw explained in a statement. “With a proven track record as a trusted, neutral convener, the AMA is uniquely qualified to lead and facilitate a collaboration that helps physicians take on a greater role in leading changes that will move technological innovations forward.”

IHMI will expand physicians’ role in health technology innovation through a clinical validation process where participants will provide submissions to specify data elements and relationships. Clinical content submissions will be reviewed by a physician panel to evaluate clinical applicability. If a submission is found to be clinically valid based on the supporting science, it will be distributed as clinical content on the IHMI platform.

“IHMI is a physician-led initiative but not a physician-exclusive initiative,” McGraw explained in a video. The initiative is open to all health care and technology stakeholders. Early collaborators include IBM, Cerner, Intermountain Healthcare, American Heart Association and the American Medical Informatics Association, among others.

Ultimately, the AMA’s project aims to make health data more accessible, conceptually organized and supportive of patient outcomes. As james Madara, MD, Executive Vice President and CEO of the AMA put it, “We spend more than three trillion dollars a year on health care 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.”

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