History of Reactive instead of Preventive Care: Compared to other developed nations, the emphasis in the United States historically was on reactive coverage for sick people instead of focusing on investing in preventive care to avoid those high cost events down the road. Though strides have been made toward better coverage and focus on preventive care, there is a long way to go.
As a part of my series on The Future of Healthcare, I’ve had the opportunity to sit down with Amy Brown. Amy Brown is currently the Vice President of Product, leading the Health Intelligence program at Springbuk. A veteran healthcare analytics leader with 15 years in public and employer health engagement and consulting, she was a founding member of Truven/IBM Watson Health’s Emerging Analytics practice and is a listed inventor for two patent-pending analytic methodologies. With operations, finance, compliance, pay-for-performance and quality experience at large hospital systems, including New York — Presbyterian Hospital and Montefiore Medical Center, she brings a unique perspective to the health analytics space. Amy has an MPA from New York University in Health Management, Finance, and Policy and an undergraduate degree from Tufts University in Economics.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
My journey in healthcare began in a personal way when my father was diagnosed with a serious degenerative illness when I was in kindergarten. As his disease progressed, my family made it our mission to get him the best care possible, despite a sometimes infuriating and at best challenging healthcare system. In an effort to help my family, I learned everything I could about healthcare finance, provider quality, and clinical best practices. My brain was one that was drawn to solving complex problems and creating order out of chaos. When I attended college and graduate school, I found my place in the complex healthcare system where I could make the most impact centered around creating clinical analytics and methodologies to help people live their best lives. In some cases, that means identifying an individual that may have a disease but is unaware, in other cases it could mean making sure a member is educated before getting an expensive and potentially unnecessary surgery. The healthcare system has many strengths, but unfortunately there are still gaping holes that have the potential to have detrimental impacts on individual lives. I see it as my mission to help people live their healthiest and best lives. Today, I’m able to meet that goal by working with employers through Springbuk’s Health Intelligence program. The Health Intelligence Insights engine empowers employers to understand members that need interventions to avoid future disease, potentially unnecessary surgery, avoid inefficient care, and mitigate costs. Employers are uniquely situated to make an impact because their employees are at work every day and can benefit from programs, outreach and education at the workplace to help them. Physicians, by contrast, often only have a visit or two a year to impact an individual typically. We have made great strides to help our clients and their members to live healthier lives and avoid expensive complications and costs.
Can you share the most interesting story that happened to you since you began leading your company?
For me, a small moment at the office was a pivotal moment. Springbuk’s Health Intelligence team released several models that our data science team built to identify members that are likely to have a diagnosis of a condition in the future such as thyroid disease, diabetes or stroke. In some of these cases, a member may already have a disease but may not even know he/she has the condition, such as a thyroid disorder. According to the American Thyroid Foundation, “Up to 60% of those with thyroid disease are unaware they have the condition…undiagnosed thyroid disease may put patients at risk for certain serious conditions such as cardiovascular diseases, osteoporosis, and infertility.” I had the opportunity to present to my co-workers and share some of the great impacts and value of the models the Health Intelligence team had produced. After the presentation, a co-worker approached me and said that although he had always abstractly understood the potential impact of the work we were doing, he saw it in a whole new light today when I discussed our model for thyroid disorders. He shared that his wife had suffered infertility issues, and it was because she had an undiagnosed thyroid problem. He said that his wife could have directly benefited from the work we were doing, and it would have saved them a lot of time, stress, and money as a result. That conversation was really impactful and empowering. It helped me to see the true power we have to help people with our health intelligence program.
Can you tell our readers a bit about why you are an authority in the healthcare field?
Healthcare is ever-changing and growing, and I’m always learning. The industry is so complex that I’ve found there are authorities for different facets of the industry. I have worked in healthcare for approximately 15 years, a large majority of that time at IBM Watson Health before joining Springbuk. I was part of their Emerging Analytics group creating new methodologies and models, and also worked directly with large governments, employers, and health plans during my time there. I saw the enormous complexity that clients must wade through to get answers to simple questions such as “What’s driving my healthcare cost and what can I do about it.” I also attended NYU’s Wagner School of Public Service’s Health Care program, which allowed me to learn from leading experts in healthcare early in my career. I learned first-hand the challenges of poverty, inefficiency and healthcare access when I worked at Montefiore Medical Center in New York City. Through that experience as well as my time at NY-Presbyterian hospital, I learned about the complexities of the revenue cycle, operations, pay for performance, and other key pieces that create incentives in healthcare. I am also a healthcare policy junkie, which allows me to stay current on new innovations and trends in the space.
What makes your company stand out? Can you share a story?
I believe Springbuk is challenging assumptions and achieving breakthroughs that others viewed as impossible and insurmountable. We are fresh eyes in an industry that had long standing players, and because of that, we have been able to find new and innovative ways to empower our partners with the real answers they need to help their members. We listen to our customers in ways that others don’t typically do, and we innovate rapidly and iteratively to meet their needs. We have recruited some of the best minds to create our products, and that allows us to think differently. Springbuk’s award-winning culture is also a differentiator. From the company’s inception, we have company values that we live each day (Win Together, Never Settle, Raise the Bar).
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
Employers are trying to manage the healthcare costs of their employees and dependents in order to save money and to allow them to live their best lives. We have heard consistently “we don’t need more data, we need more direction.” Springbuk is addressing that problem directly with our Insights product. Instead of sending large amounts of information that can often lead to analysis paralysis, Springbuk is curating the content for our customers so they can immediately see the most relevant information to help their populations. It has been the norm for vendors to provide a data warehouse, which requires clients to do heavy lifting to get answers in the best scenario, and in the worst-case scenario they will not get answers. Springbuk is disrupting the status quo by providing user friendly, aesthetically appealing, curated, flexible, and understandable information that leads to action.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
- It is crucial to understand the real “job to be done” that your user is trying to solve for when developing a product. This principle might seem obvious, but in the health analytics industry there has been a steadfast focus on reporting and dashboards. In my opinion, this was a treatment of the symptoms not the root cause of the need. The true need for our customers is to understand what’s driving their cost and what they can do about it. Reports and dashboards focus on delivering factual observations but there’s still a great amount that needs to happen after receiving this information to truly understand where action can be taken. Springbuk’s Insights product answers this question directly and addresses the true user need.
- Asymmetry of information is a huge challenge that leads to inefficient and sometimes unnecessary care. Profit motive can often get in the way of the best outcome: Certain stakeholders in the healthcare industry directly benefit from market failures, lack of transparency on pricing, lack of openness for patients to make informed decision-making about their care, financial incentives to prescribe certain medications over others, to name a few.
- The industry is mired in layers of complex politics and bureaucracy — bright-eyed youth begin in this industry excited and energized, and sometimes become disillusioned by the barriers to change that can exist in healthcare. I discovered this first-hand during my early career. My advice is don’t give up, find another path to make an impact. There are avenues to change this industry, but it may take time and exploration to find your way.
- Many problems with healthcare inefficiency have nothing to do with healthcare and everything to do with social supports. It is crucial to understand the barriers that individuals face so those hurdles can be appropriately addressed.
- Analytics is complex and complicated and, in many cases, far more an art than a science. Those new to healthcare analytics may be unaware of the imperfect nature of administrative claims data. Analytics relies on consistent and reliable coding of claims by providers, and good data provided by vendors that supply this information. It takes creative problem-solving to design robust analytics to isolate out the scenarios that clients are seeking with consistency and quality.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
1) History of Reactive instead of Preventive Care: Compared to other developed nations, the emphasis in the United States historically was on reactive coverage for sick people instead of focusing on investing in preventive care to avoid those high cost events down the road. Though strides have been made toward better coverage and focus on preventive care, there is a long way to go.
2) Perverse incentives: The US healthcare system’s history led to a path of fee for service reimbursement, which can lead to overuse instead of efficient use.
3) Lack of transparency: Patients have limited visibility into the cost and quality of the providers they are seeing for care. Often patients are also unaware of viable treatment alternatives. Though strides have been made in more recent years, there is a long way to go.
4) Siloed Information: providers aiming to act in the interest of patients often have limited visibility regarding the care that patient received elsewhere. Better methods are needed to unify information.
5)Patchwork system: The mix of commercial insurance and government plans (Medicare, Medicaid) creates a complicated web that leads to waste, inefficiency and lack of transparency.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Shift away from reactive and toward proactive care.
- Empower patients with clear and understandable information to help themselves
- Improve price transparency
- Improve data integration
- Overhaul old technology
Stories and examples of the above can be found in the previous question!
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
There seems to be a general acceptance of the dysfunction within healthcare. We need leaders that seek creative solutions to solve these complex problems. Individuals can and should advocate for themselves when seeking care and seek information regarding the quality of the provider. Corporations that insure their employee populations have the power to make sure their members are educated regarding treatment alternatives and are receiving interventions to help them live their best lives (such as disease management, mental health, telehealth, etc). Communities have the ability to create social supports so individuals at all levels of income have access to transportation and other necessary resources to seek needed healthcare. Leaders need to advocate for the underserved that need help. We all pay for those individuals when they have catastrophic events in the ER through tax dollars, so we should all own the responsibility to help them get the resources they need.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I am a huge fan of NPR in general, and really enjoy the Kaiser Health News segments that focus on healthcare industry topics. I also am a regular reader of Health Affairs and Modern Healthcare, among others. A book that really resonates with me is “An American Sickness: How healthcare became big business and how you can take it back” by Elisabeth Rosenthal. I’ve appreciated her work for some time and this particular piece provides great commentary on perverse incentives in healthcare, and how consumers can navigate the challenging system.
How can our readers follow you on social media?
Springbuk’s social media presence can be found here:
My social media presence can be found here: