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Kenneth D. Mandl, MD, MPH
Director, Intelligent Health Laboratory
Children’s Hospital Informatics Program
Center for Biomedical Informatics, Harvard
The App Store for Health:
Co-opting the Point of Care
in the Era of the Affordable Care Act

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US Spending per capita vs. Life Expectancy

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Learning Health System: Evidence Generated
from a Well-Instrumented Health System

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? How do we learn from
“All the Patients . . .
All the Time?”
(Instead of Some of the
Patients All of the Time . . . )
. . . or really, just a couple of
the patients, not that often.

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Dr. Collins discussing the
Rapid Learning Network

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WITHOUT ACCESS TO THE
POINT OF CARE,
EVERYTHING IS A ONE-OFF

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Intelligent Health Laboratory | Children‘s Hospital Informatics
Program

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Returning Genomic Medicine Results

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The App Store for Health
ONC Funded Research $15M Project under the
“SHARP” program

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Can EMRs behave
like iPhones or
Androids in that
innovators
readily create and
widely distribute
apps across
thousands of
installs?

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Our vocabulary
 Data Sources
Managed by containers
 Containers
Present data from data sources to apps in a uniform
fashion
 Apps
Completely substitutable

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18.12 Issue

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State-of-the-Art ???

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1 Design + 1 Developer + 1 Week

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1 SMART App in 3 SMART Systems

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Well-publicized

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SMART
BP Centiles App
Running on Cerner

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Medication adherence
JAMIA 2011

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Decision Support Integration
e.g., Immunization Forecasting

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Monograph app
e.g., Diabetes

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Mashups:
e.g., Genomic Medicine: There’s an App for that
 Linkage to external
decision support
services
 Pharmacogenomic
rule sets
 Decision support
for doctors—
associations

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Collaborators and Implementers
 EMR Vendors
 Payors
 Pharma
 Major tech companies complementing or competing
in the EHR space
 Large-scale health systems

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