AMA Launches Common Data Model Initiative

The American Medical Association (AMA) has launched a collaborative of healthcare industry stakeholders to create a "common data model." Called the Integrated Health Model Initiative (IHMI), the program is intended to make it easier to pull together a wide variety of patient data in a structured format and exchange it among electronic health records (EHRs) from different companies.

Participation in IHMI is open to all healthcare and technology stakeholders. Early collaborators include IBM, Cerner, Intermountain Healthcare, the American Heart Association, and the American Medical Informatics Association, among others. The participants will interact in an online platform hosted by the AMA.

"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," said AMA CEO James L. Madara, MD, in a statement. "The collaborative effort of IHMI will help the health system learn how to collect, organize, and exchange patient-centered 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."

Initially, IHMI will focus on three areas:

• Hosting clinical and issue-based communities that address costly and burdensome areas. The initial priority of these communities will be the development of data elements for chronic conditions such as hypertension, diabetes, and asthma.
• Creating a clinical validation process to determine and apply appropriate clinical frameworks. Participants will provide contributions and feedback online to specify data elements and relationships. Clinical content submissions will go through a validation process to review their clinical applicability.
• Specifying a model to encode information in the IHMI data model. The clinical content will enable configurations of the model and reference value sets that will be made available for free.

"Best Minds in Healthcare"

Laurie McGraw, senior vice president of health solutions for the AMA and the lead on the IHMI project, told Medscape Medical News that the AMA wants to organize healthcare data better, turn more of it into usable information, and expand beyond the current boundaries of coded clinical data such as diagnostic and procedure codes. The goal, she said, is to include patient-reported information such as mobile device data and functional status data, plus data on social determinants of health.

The common data model will also establish standard terms for medical concepts that can be described in many different ways, McGraw said. She added that the AMA is working closely with SNOMED, the organization that maintains SNOMED-CT, the most complete lexicon of medical terms.

The importance of this component was underlined by David McCallie, MD, senior vice president for medical informatics at Cerner, who said in a statement that IHMI is designed "to improve the semantics of clinical data models. This represents a bold attempt to advance an important aspect of interoperability."

Stan Huff, MD, chief medical informatics officer of Intermountain Healthcare, said in a statement, "I am excited about IHMI because it builds on the foundation of interoperability standards that are being created by HL7, LOINC, and SNOMED International. If we persist, that approach will lead to the ability to exchange medical knowledge as executable software rather than as journal articles."

The AMA expects EHR vendors to incorporate IHMI into their software at some point, McGraw said. So far, only Cerner and Care Cloud, a small EHR vendor, have joined the project. But she said she is confident many other software developers will come aboard.

McGraw acknowledged that a lot of resources will be required to validate clinical data elements, encode the data as specified by the data model, and so forth. But she noted that the AMA has a team of in-house informaticists and that it will also rely on help from other IHMI participants.

Regarding clinical validation, she pointed out, the AMA produces Current Procedural Terminology codes, which must be constantly updated for new medical knowledge. "A volunteer army of the best minds in healthcare" works together to make sure this is done right, she said.

The AMA has been trying to get physicians more involved in the development of health information technology (IT) applications for some time. In January 2016, for example, the association invested $15 million in Health2047, a San Francisco-based "innovation enterprise" that develops new applications and work with established companies to fine-tune their health IT products. Later that year, the AMA adopted principles to promote the use of "safe and effective" mobile health apps and related devices.