Wolters Kluwer Health’s Peter Bonis talks healthcare data

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This week’s Making Rounds spotlights Peter Bonis, chief medical officer at Wolters Kluwer Health, a healthcare information company that creates decision support tools. Its main product is a point-of-care medical resource called UpToDate, which gives providers evidence-based answers to clinical questions. UpToDate covers more than 12,400 topics across 25 different specialties and has more than 2+ million users worldwide, according to the Massachusetts-based company.

Bonis discussed the challenges that come with building a healthcare information service and other health technologies.

This interview has been lightly edited for length and clarity.

What’s the biggest misconception people might have about your job?

Building and maintaining state-of-the-art information services for healthcare professionals and patients requires enormous commitment. What I’ve found is organizations that have not attempted to create such information services often grossly underestimate the complexity and the expense involved in doing that right.

You have to thoughtfully understand how to assess the global information database—that’s not just the biomedical literature, but the experience of healthcare professionals who are on the front line and then taking care of patients—and to maintain that database. I think if one doesn’t understand the complexity of the evidence itself, how to separate the wheat from the chaff, how to combine it, and how to synthesize it, and then finally to render it in ways that can be consumed by healthcare professionals in their workflow, then you cannot achieve the mission of earning trust and having healthcare professionals change what they do as a result of reading that guidance.

What’s the most fulfilling aspect of your job?

I am immensely gratified to see that the very simple paradigm of providing a resource to answer questions at the point of care or near the point of care can change decision-making and will measurably lead to improved healthcare outcomes and quality of care—and not only in the United States, but literally in every country in the world. Where we are not available commercially, we collaborate with the labs at Harvard Medical School to donate copies of UpToDate elsewhere. So that impact is palpable; it comes every day. We get feedback from the users for it, and we get feedback in those international arenas all the way from our tiny little mountaintop clinic in Nepal to the most sophisticated academic medical center in the United States and elsewhere in the world.

What healthcare trend are you most optimistic about and why?

The whole field of “omics.” Pharmacogenomics and medical omics, and understanding the microbiome, and of course, information services including artificial intelligence. If you can’t get excited by those things—in all the innovation that we’re seeing—you’re asleep. But I also recognize that healthcare is very, very slow to change. You can read about those things, but when it’s actually adopted in a coherent way into care, it’s a very slow process.

What healthcare trend are you least optimistic about and why?

The place that there’s the potential to be optimistic that hasn’t been delivered is the role of technology. Some of these challenges can be improved with technology, and one area that deserves focus is data liquidity across healthcare settings, which in my view remains frustratingly inadequate. We are creating a tremendous amount of healthcare data from various sources—when I say various sources, that’s your medical record and might be apps or monitoring devices, a whole variety of inputs that can help you understand health and disease.

But access to healthcare data alone does not improve care. We need to better understand how to make use of such data across care settings, and especially at that interface where care is delivered.