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• The data ecosystems require a library of data definitions and cohorts defined by leaders in specialty
medicine and surgery so that all platforms and EHRs
will have the necessary metadata needed for use in
•Apps or data outflows for numerous purposes need
to be defined such as to identify a specific moment in
clinical care during a patient visit or for more broadly
tracking a surgical population outcome, such as in
cancer care or results from total joint replacements.
Surgeons need to be involved in designing clinical
alerts, outputs for MOC, EHR to registry feeds, and
more. The data ecosystem must also fit the payor system for assuring outcomes, driving improvement,
optimizing costs, and creating public transparency.
• The governance of the data ecosystem must ensure
that EHR vendors do not limit the availability of data
needed by patients and clinicians to optimize care.
Silos of information with data standards defined by
EHRs would not create the broad data ecosystems
needed for digital data to reach its full potential.
Big data in health care—if allowed to flourish in
an environment conducive to the secure analysis and
use of that data—holds great promise for improving outcomes and informing decisions at the point
of care. Surgeons have the experience and expertise
to create this environment and to use it to improve
efficiency and outcomes. This could represent the
next evolution of the College’s century-long cycle of
continuous quality improvement, putting into the
hands of individual surgeons the capability to meaningfully analyze amounts of data that would have
been inconceivable to Dr. Codman and his peers. It
is up to the College and today’s Fellows to continue
to lead and innovate in this realm. ♦