An Outsider and Insider Perspective on the Healthcare System
Friends and colleagues often ask about my motivation to transition to the healthcare industry after spending much of my career in high-tech. I did well in the high-tech industry, where I built many successful cloud-based business applications. I was lucky to be involved with market-leading products that helped millions of users. So what motivated me to get involved with the healthcare industry? Why do I enjoy working with medical science and healthcare technologies so much?
Introduction
Before I answer the above questions — let me introduce myself and describe the purpose behind writing this article. I am incredibly passionate about data science, technology, and preventive healthcare. At the intersection of these lies a massive opportunity to transform the healthcare industry from a reactive, transactional system to a proactive, preventive monitoring system.
My goal is to contribute to a transformation that will enable people to live longer, happier, and healthier lives. I like to partner with healthcare professionals and leverage my data science, technology, and product expertise to further this transformation!
In this piece, I will detail my healthcare journey from a personal and professional perspective. I will share what I have learned and the FIVE changes I see imminent in the healthcare industry. Additionally, I will delve into my background and explain the driving force behind my passion for contributing to these changes.
My Professional Journey Into Healthcare
It started around six years ago and has been a fantastic journey.
The initial drive was simple. While in high-tech companies, I had the opportunity to solve complex business problems. However, I had the itch to work on something more meaningful, more personal. I witnessed friends and family members, who were doctors, interact with their patients, and I envied them for these deep and meaningful connections. I also saw, through personal experience, many of the challenges that healthcare professionals and patients were facing on a daily basis. I saw an opportunity to contribute to solving these problems and to build products that allow people to live happier higher-quality lives.
I am deeply passionate about data and technology. This passion led me to dive deep into data science and cloud-based software’s lean development (iterative/experiment-driven evolution). I had seen several high-tech companies reap the benefits of data and lean development to bring life-changing products to the market. I believe that data and technology would play a vital role in transforming healthcare. With that belief, I started diving into healthcare data and built a few health prediction algorithms.
Soon after I transitioned into the healthcare industry, I had the opportunity to lead the efforts to build first-of-its-kind remote patient monitoring products for diabetes and COPD patients. I saw firsthand the difference that 24/7 data can make to healthcare professionals (HCP) and patients. With real-time, accurate data, HCPs don’t have to rely on anecdotal stories to understand patient health.
For COPD patients, we prevented hospitalization with an algorithm-driven prediction of COPD exacerbation. As I worked on these products, I realized this was just the beginning. I saw firsthand the empathy of our HCPs and how hard they work to serve patients. They are swamped and time-constrained. If we can make these products cost-effective and scalable, we have the opportunity to aid our HCPs with more data and enhance the patient experience.
These experiences taught me that data and technology would significantly transform healthcare, allowing for faster innovation. They made me more excited to be part of this transformation. I learned that I could make an impact through my data science skills, high-tech experience, and product leadership.
My Personal Healthcare Journey
In the meantime, I also experienced the healthcare system firsthand. My dad developed dementia and other chronic diseases like diabetes and blood pressure problems. My daughter also experienced significant health issues, which led me to take a break from my job. Many of my close friends and family members were dealing with chronic diseases and were unclear on why or how to move forward. I myself then developed chronic sleep and thyroid issues. As a result, I went through a period of poor mood, energy, and sleep. Despite being very active and monitoring my food habits, I struggled with weight gain.
Motivated by these personal experiences, I leveraged my skills in data and technology and began a health transformation process. I researched and experimented with different lifestyle choices (e.g., nutrition, meditation, etc.). I made lifestyle adjustments and monitored the outcomes by tracking my physiological data and relevant biomarkers. I feel that I am now the happiest and healthiest I’ve been in 25 years, though I still have biomarkers to improve.
These personal experiences led me to dive deep into prevailing medical science and technologies.
Though I was amazed by the mainstream healthcare system’s acute and emergency care response, I had various open questions about chronic disease management and the overall wellness and happiness of patients. I started talking with colleagues at my healthcare companies, reading books, and listening to podcasts. I researched various chronic diseases — Alzheimer’s/dementia, Hashimoto’s thyroid disease, seizure, cardiac health, autoimmune conditions, gut health, diabetes, and overall mental and physical health. I soon realized that I was not alone in my questions.
Various leading doctors, clinical researchers, and academicians (check the reference section at the bottom of this blog)are already researching these questions and advancing our scientific knowledge of chronic disease management. As I dove into their research, I became excited about the future of our healthcare system.
There are massive opportunities to combine progress in medical science, data science, and technologies to transform the healthcare system for chronic disease management.
Based on my experience and learnings, here are five shifts in the healthcare system that I would love to see happen and contribute to:
The goal of the healthcare system should be to enable people to live happy and healthy lives. Based on systematic issues in our healthcare system, too many patient and HCP interactions have a transactional, reactive feel. The patient meets the HCP periodically (i.e., yearly, six months, etc.) or when sick. The HCP relies on anecdotal updates from the patient to understand the patient’s health. Such interactions place the healthcare system’s focus on managing sickness rather than on maintaining a healthy lifestyle. Continuous monitoring of a patient’s physiological biomarkers and data will allow patients and HCPs to understand their overall health and manage it proactively.
Take, for example, Hashimoto’s thyroid disease — an autoimmune condition. The thyroid gland releases triiodothyronine (T3) and thyroxine (T4); these hormones regulate weight, energy levels, skin, hair, metabolism, and sleep. The standard treatment for Hashimoto’s is to take medication daily and test TSH levels (a biomarker for thyroid hormone production) every six months. Even if TSH levels are within the correct range, the patient may still have low energy, poor sleep, or other metabolic issues.
Without continuous monitoring, it is difficult for HCPs to see the complete picture of a patient’s health. Low energy, sleep, and other metabolic issues may indicate other autoimmune conditions or problems. Even though the HCP is managing the symptoms of thyroid hormone production, the patient’s goal of happiness and wellness is still not being met. This same scenario is seen with senior care. We are elongating people’s lives by managing their diseases and symptoms but ignoring the quality of life component, which greatly impacts patient happiness.
2. Treating the root cause rather than the symptoms
Advancements in acute and emergency care are allowing people to live longer. But the quality of life is impacted by chronic disease. According to Rand Corporation, 60% of adults in the US live with one or more chronic conditions. 42% of adults live with multiple chronic conditions, and this number jumps to 81% for adults 65 years and older.
The healthcare system works very well for acute and emergency care. For example, I used to run a lot, and I tore my Achilles tendon. My podiatrist performed surgery and fixed it. I am thankful for the healthcare system because I can walk, run, bike, and hike again without problems. Similarly, my family’s lives have changed with surgeries such as knee replacement, aortic valve replacement, etc.
However, I believe that our healthcare system’s approach is not optimal for managing and preventing chronic disease. The focus is typically on short-term symptom management rather than on treating the root cause. Unlike my torn Achilles, chronic diseases are complex, difficult to correct and involve the whole body.
Chronic diseases develop for many reasons. They can originate from genetics, physiological disorders, psychological issues, environmental exposure, and lifestyle choices. Our approach to chronic disease should be more holistic. Rather than seeing multiple specialists in isolation, it may be more appropriate to have an integrated, multi-specialty therapy targeting the root cause. Ignoring the root cause of a disease may result in further degradation and manifestation into other diseases (i.e., comorbidity). By addressing the root cause of chronic diseases, we will not only live longer, but also improve quality of life.
3. Data-driven personalized health management to prevent chronic disease
The onset of the chronic disease typically happens long before the official diagnosis is made. By the time a chronic disease is diagnosed, it’s often too late for many effective treatments. For example, neurodegeneration in dementia and Alzheimer’s patients may begin 10 to 20 years before it gets diagnosed. By leveraging the latest medical science and technology advancements, we can build a healthcare system that proactively monitors individual physiological and psychological biomarkers and identifies chronic diseases early. In most cases, prevention is much simpler than a reversal of the advanced disease.
Another factor to consider in chronic disease management is the cost. According to the CDC, 90% of the nation’s $4.1 trillion annual healthcare expenditure is for people with chronic physical and mental health conditions. If we can use technology to reduce chronic diseases, we can drastically reduce healthcare costs while improving our quality of life.
4. Integrated care for mental, neurological, and physical health
Currently, our healthcare system and most individuals consider mental health separate from physical health. Several doctors and clinical researchers are discussing the fact that mental, neurological, and physical health are closely connected.
In his book, “Brain Energy”, Dr. Chris Palmer talks about the fact that risk factors for metabolic, neurological, and mental disorders are the same. The list includes biological, psychological, and social factors ranging from diet, exercise, smoking, drug/alcohol use, and sleep to hormones, inflammation, genetics, epigenetics, and the gut microbiome. The list also extends to relationships, love, meaning and purpose in life, and stress.
All of the treatments in the mental health field (i.e., biological, psychological, and social intervention) likely work by affecting metabolism. People with metabolic disorders are more likely to get neurological/mental disorders and vice versa. In our healthcare system, psychiatry, neurology, cardiology, and endocrinology are treated by separate specialists. However, a single integrated treatment plan may help treat all of these problems together.
Take stress, for example. It exerts its influence on various bodily systems, encompassing the musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and reproductive systems. Prolonged stress places a continuous burden on the body, leading to the development of chronic ailments such as high blood pressure, diabetes, cardiovascular disease, and more. Moreover, these conditions elevate the susceptibility to other mental and neurological disorders. A single integrated treatment plan to manage stress may prevent many illnesses.
5. Empower individuals to better self-manage their health
As I journeyed through this process of discovery, I learned that there are three dimensions of personal health management:
- Mainstream medicine (our healthcare system)
- Lifestyle management (diet, exercise, stress management, meditation, etc.)
- Physiologic data monitoring through wearables
We all prioritize these dimensions differently, but they are not integrated into our individual healthcare plans by an HCP. As an individual, it isn’t easy to understand how lifestyle choices impact physiologic data and biomarkers. We can enable individuals to manage each of these dimensions better by using data and an integrated user experience. This will allow individuals to make lifestyle choices that align with their personal health goals.
In Conclusion
Now, back to the original question — why do I enjoy working with medical science and healthcare technologies so much? There are three aspects to it -
- As described above, I am not alone in how I think about healthcare transformation. Several doctors, clinical researchers, academicians, data scientists, and IT professionals believe the same way. The healthcare system is complex and regulated; it will require a massive team effort of healthcare and technology professionals to bring about the abovementioned changes. I enjoy such partnerships and am excited to be part of teams that will significantly impact people’s lives, including my family and friends.
- Most importantly, I enjoy doing what I do. I have many aha moments going through medical science podcasts, books, or papers. I am amazed by medical science’s progress and get excited about how we can help get that progress to the masses in a meaningful and cost-effective way. I love data science and technology. Combining data science and technology with medical science to lessen the burden of chronic disease is an unparalleled experience. I will never retire if I am doing this.
- Finally, I love building data-driven products that solve complex problems. Healthcare transformations will require meticulous planning and an agile, lean approach. There are multiple challenges. Medical science is constantly evolving, and we will need to define the strategy around unknowns. Given the healthcare regulatory and economic framework, we can’t follow the typical high-tech implementation model. But, the fundamental approach to product development should still be the same — one doctor, one practice, and one patient at a time and then scale to a large number. I love this challenge and am excited to drive meaningful innovation at regulated healthcare companies and improve people’s lives.
References -
- Dr. Christopher M. Palmer MD (Assistant Professor of Psychiatry at Harvard Medical School) -
- Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health — and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More (Book)
- Podcast — https://open.spotify.com/episode/6GEZVm18mwx76rWJueFHGj
2. Dr. Dale Bredesen, chief resident in neurology at the University of California, San Francisco (UCSF) & Chief Science officer (Apollo Health)
- The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline (Book)
- The First Survivors of Alzheimer’s: How Patients Recovered Life and Hope in Their Own Words (Book)
- Dhru Purohit Podcast with Dr. Dale Bredesen: https://open.spotify.com/episode/1BtN7gw0CVQjlCMZ1PFke3
- Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project: https://www.apollohealthco.com/alzheimers-reversal/
3. Dr. Robin Berzin, MD (Founder and CEO of Parsley Health)
- State Change: End Anxiety, Beat Burnout, and Ignite a New Baseline of Energy and Flow (Book)
4. Dr. Mark L Hyman MD (The Head of Strategy and Innovation of the Cleveland Clinic Center for Functional Medicine, Board President for Clinical Affairs for The Institute for Functional Medicine — https://drhyman.com/)
- The Doctor’s Farmacy podcast — https://drhyman.com/blog/category/podcasts/
5. Dr. Justin L Sonnenburg (Professor, Microbiology & Immunology, Stanford — https://sonnenburglab.stanford.edu/)
- The Good Gut: Taking control of your long-term health (Book)
- Podcast: https://hubermanlab.com/dr-justin-sonnenburg-how-to-build-maintain-and-repair-gut-health/
6. Dr. Ayesha and Dean Sherzai, MD (Neurologists and co-director of the Alzheimer’s Prevention Program at Loma Linda University — https://thebraindocs.com/)
- The Brain Health revolution podcast — https://thebraindocs.com/podcasts/
7. Dr. Saray Stancic MD (board-certified physician — https://drstancic.com/)
- What’s missing from Medicine (Book)
- Documentary Codeblue — https://drstancic.com/codeblue/
8. Dr. David A. Sinclair, A.O., Ph.D. (Professor at Harvard Medical School)
- Lifespan Podcast — https://www.lifespanpodcast.com/
9. Dr. Andrew Huberman, Ph.D. (Neuroscientist, professor of Neurobiology at Stanford School of Medicine)
- Huberman Lab Podcast — https://hubermanlab.com/category/podcast-episodes/
10. Dr. David Perlmutter MD (a Board-Certified Neurologist and six-time New York Times bestselling author, Board of Director & a Fellow of the American College of Nutrition)
- Drop Acid: The Surprising New Science of Uric Acid (Book)
11. Dr. Robert H. Lustig, M.D., M.S.L. (Professor emeritus of Pediatrics, neuroendocrinology, UCSF)
- Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease (Book)
12. Dr. Emeran Mayer, MD (Distinguished Research Professor in the Departments of Medicine, Physiology and Psychiatry, UCLA)
- The Mind-Gut Connection: How the Hidden Conversation Within Our Bodies Impacts Our Mood, Our Choices, and Our Overall Health (Book)
- The Gut-Immune Connection: How Understanding the Connection Between Food and Immunity Can Help Us Regain Our Health (Book)
- The Mind-Gut Connection podcast — https://emeranmayer.com/podcasts/
13. Dr. Atul Gawande (General & Endocrine Surgery, Brigham and Women’s Hospital & professor at Harvard Medical School)
- Being Mortal (Book)
14. Dr. Brittany Henderson, MD, ECNU (board-certified in internal medicine and endocrinology — https://www.drhendersonmd.com/)
- What You Must Know About Hashimoto’s Disease (Book)
15. Dr. Steven E. Phillips, MD (Yale-trained, world-renowned expert on zoonotic infections)
- Chronic: The Hidden Cause of the Autoimmune Pandemic and How to Get Healthy Again (Book)
16. Dr. Dean Ornish (Professor of medicine UCSD & Physician Consultant of Bill Clinton)
- Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases (Book)
17. Dr. Kristen Willeumier, Ph.D (Neuroscientist with research expertise in neurobiology and neuroimaging — https://www.drwilleumier.com/)
- Biohack Your Brain: How to Boost Cognitive Health, Performance & Power (Book)
18. Dr. Aseem Malthothra (British Cardiologist)
- A Statin-Free Life: A Revolutionary Life Plan for Tackling Heart Disease (Book)
19. DUTCH (Dried Urine Test for Comprehensive Hormones) podcasts —
20. American Psychological Association —
21. Rand Corporation —
22. Centers for Disease Control and Prevention (CDC)
23. Sleep, Recovery, and Activity through several consumer devices
