Having discussed the values inherent in open source, it is interesting to overlap them with the values that are inherent to healthcare itself. While official “Healthcare Values” have never been defined, I think the NHII efforts of 2003-2004 helped put some of the general themes on paper and are instructive:
The guiding purpose of this NHII initiative is making possible the appropriate use of data, information, and knowledge in support of optimal health and quality of life for all Americans. This purpose emphasizes that the full potential of the NHII will not be achieved until its benefits can be shared equally by all. This means that technology and electronic information and services must be available in all homes and communities. This purpose also reflects the importance of privacy and confidentiality, [patient’s] control of their personal health information, cooperation, respect for the doctor/ patient relationship, and prudent use of resources to minimize both overuse and underuse as the underlying values of the NHII.
This paragraph can be summarized into five general themes:
- Support optimal health and quality of life for all
- Make the benefits of healthcare IT accessible to everyone anywhere anytime
- Patient control, security, and confidentiality of personal health information
- Interoperability of information between healthcare data consumers
- Incorporation of and reimbursement for evidence-based best practices and best outcomes
I believe this is a good starting point for defining healthcare values. Others who have taken a stab at defining healthcare values include the Health Train Manifesto (patterned after the “Clue Train Manifesto”) and our own Health and Human Services (largest healthcare payer in the US – ~$500B in 2006 ) which focuses on “transparency” as a driver of cost and quality improvements (more on transparency later).
The reason why values matter have previously been discussed. Not only do they “represent humanities progress through the ages”, but clearly stated values can also help influence a movement by directing our limited resources (time, money, and effort) into those area that really matter. If we truly believe that “optimal health and quality of life for all” really matters, then we can begin directing the development of technologies that will empower individuals to obtain that goal. Furthermore, it can help direct the creation of those technologies so that they are maximally accessible, distributed, and usable by as many people as possible (sound familiar?). Finally, it can help direct us in developing a financial and legal framework that rewards the efforts to accomplish those objectives.
I have a personal conviction regarding these general healthcare values, and have chosen to dedicate my professional life to the achievement of this vision. In so doing, however, I am reminded that while the bits and bytes can help us improve healthcare, it is always a bit of the “human touch” that proves to be so effective in preserving the “well being” of those entrusted to our care.
Scott Shreeve, MD 