Brainstorming the Future of Healthcare

Doug Given
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Health innovation conferences and events often disappoint due to the gap between expectation and experience. We seek with our limited personal time resources, venues for technologists and health professionals to maximize potential synergies. But there’s a tendency to collect either plenty of technology prowess and not enough healthcare expertise, or vice versa. Thus, the anticipated perfect blend of both, which is a central premise for how we designed Health2047, rarely materializes.

Fortune’s inaugural Brainstorm Health event in San Diego, themed “seizing the disruptive opportunity,” sought to provide that well-balanced mix and showcase the problem-solving power of new technologies to transform the medical field. There were some well-informed and resonant discussions amongst thought leaders in both health and technology arenas that echoed Health2047 principles and provided ample food for thought. Among the more interesting highlights:

  • Dr. Kathy L. Hudson, Deputy Director for Science, Outreach, and Policy at the National Institutes of Health, spoke about managing implementation of the Precision Medicine Initiative and the responsibilities inherent in secure access to such massive amounts of detailed data. She also discussed the oft-overlooked difficulties around “small data” — getting access to your own medical record is very hard, and getting access to information about provider quality is very hard, although it is collected. This extends to academia and the NIH, which promote data sharing, but as a community, ironically practices pre-publication data secrecy. Everything is supposedly connected. There’s still a tremendous amount of data blocking where what we need are mechanisms and incentives for more data sharing. To seize the benefits of big data, we must also solve for small data.
  • James Park, CEO and cofounder of Fitbit, talked about moving biometric data collection from consumer to professional markets (and from individual to physician use). He noted that physician adoption of any innovation requires an easy fit into current workflows (and they can’t and won’t entertain side-by-side systems). But popular consumer devices like Fitbit (of which there are nearly 40 million already in circulation) present tremendous potential for making correlations. With consent (patient privacy being a cornerstone), and when we can securely monitor both individually and en masse, we open new avenues for both research and application.
  • Dr. Dana Goldman, Chair and Director of the Schaeffer Center for Health Policy and Economics at USC, illuminated a bifurcated system with broken incentives and clashing interests around adopting digital health innovation and in paying for it. To wit, individuals are interested, employers are interested, and health plans are interested. But excepting Kaiser, which tends to hold membership for around a decade, individual health plan tenure now averages just two years. There is no incentive for the plans to make long-term investments in, say, behavioral technologies for patients who won’t realize those benefits for several years, by which time some competitor will capture the ROI. If we can’t get the incentive right, we aren’t going to get investment in changing the system.
  • Deborah DiSanzo, General Manager for IBM Watson Health, provided specific examples of the applicability for cognitive technology in healthcare. Cognitive systems, such as Watson, continuously learn. They can consume vast references quickly, find patterns, automate probabilities, and act on them. When applied to healthcare, such technologies can provide immediate physician augmentation, particularly in cases where time is of the essence (simply because they can speedily process so much more information than humans) and cases concerning notoriously difficult diagnosis (where human misses are relatively high).
  • Jonathan Bush, CEO of athenahealth, touched on the disconnect between potential and reality in the healthcare technology ecosystem. During a discussion about the promise of artificial intelligence, he reminded the crowd about the current state of data automation and transmission in the community — his clients alone still get eight-million faxes a week. His point was that technologies should first operate at a very rudimentary level to have broad impact. In terms of data handling, his software has over 90 descriptions just for blood count/CBC, and even more types of appointment scheduling data elements than the ICD-10 code lexicon. The lack of semantic interoperability is limiting. One proposal was that AI could be much more effectively aimed at the super low end of routine visual diagnosis (using radiology as the example) because that’s where its reliability could produce the most immediate positive return.
  • Sue Siegel, CEO of GE Ventures, discussed approaching healthcare evolution as hyper local. As a large self-insured employer, GE has begun to self-assemble and self-direct programs for assessing the impact of promising interventions that reduce cost and improve the health of their built-in target employee populations (the company spends three billion annually on healthcare for its employees). While deciding on metrics is ongoing, their discoveries include finding that physician-centered medical care is most effective, interoperable systems that leverage big data do benefit providers (though they’re not yet evolved enough to include patient participation), and that evaluating solutions associated with specific geographical populations has measurable impact (Houston, for example, addressing obesity, and Cincinnati targeting pediatric asthma).

I encountered well-reasoned and like-minded analysis, as all these themes are central to the mission of H2047 and allow for the bridge-building that needs to be going on between healthcare experts and technology trailblazers. The patient-physician relationship is the special lens through which my colleagues and I view these same issues and the unique perspective from which we contribute to the innovation ecosystem.  It’s clear that none of us can do this alone, but through partnerships, collaboration, and joint problem solving, a brighter healthcare future will be realized.

— Doug Given is Board Director at Health2047.

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