The Future of Healthcare: “What Healthcare Can Learn from Amazon”, With Brad Bostic, CEO of hc1

Learn from Amazon — Amazon has built the most successful business model of our time by being customer obsessed. Amazon treats delivering a teddy bear to you on time like it’s life or death. Why do we treat patients, when it may be life or death, like a number? Healthcare needs to follow this model by reconfiguring processes and incentives to be sure each patient is treated as a unique individual.

I had the pleasure to interview , Chairman and CEO of , the bioinformatics leader in precision testing and prescribing.


Thank you so much for joining us Brad! Can you tell us a story about what brought you to this specific career path?

My mom was diagnosed with an advanced cancer in her 50’s. Despite receiving care at a leading healthcare institution, I observed how disconnected the entire experience was for patients and their families. My mom benefitted from an abundance of committed caregivers with clinical expertise, but due to the siloed healthcare environment, she was treated as a number rather than a unique individual who could benefit from personalized medicine and service.

After seeing the state of healthcare first-hand, I knew we needed to do much better. Unfortunately, back in 2001, healthcare still operated almost exclusively in a fee-for-service model. Health systems had no economic incentive to personalize care delivery. I decided to focus on healthcare data interoperability and telemedicine over the next several years since the industry wasn’t ready for the type of bioinformatics solution I was envisioning.

Fortunately, the industry started to transition from fee-for-service to a value-based care model several years later. So, once the right incentives were finally in place for healthcare organizations and payers, I saw an opportunity to tap into lab data to generate personalized healthcare insights. And that’s why I founded hc1 in 2011. After many years in cloud and healthcare tech, I chose to focus exclusively on bringing the personalized approach to healthcare that could have saved, or at least extended, my mom’s life. Today, our goal at hc1 is for each patient to receive personalized care leading to faster, and more accurate diagnoses with targeted lab testing and precision prescribing that utilizes an individual’s unique genetic makeup in developing the optimal drug regimen. Consequently, by taking these steps, every individual feels like they are the most important healthcare customer. I know we can accomplish this as an industry.

Can you share the most interesting story that happened to you since you began leading your company?

When I first started hc1, I didn’t have a crystal ball, but I knew lab and genomic data were extremely valuable because it told the story of patient health across the population. Back then, there were a lot of naysayers who thought of the lab as a commodity cost center and questioned the impact that hc1 could make to improve outcomes. After we had built critical mass by generating personalized insights across hundreds of labs, including a national drug testing lab, I was introduced to an expert in prescription drug monitoring and learned about their key challenges. My conversations with him about the relationship between lab data and prescribing played a key role in identifying a massive, unmet need. I believed if we could directly utilize drug screening information from labs, we could identify which patients were at risk for certain issues based on the medications they were taking, including any that may not have been prescribed but were detected by the lab test.

A few years later, I was invited by Amazon Web Services to participate in a panel on the opioid epidemic and substance use disorders at the Sorensen Impact Conference in Salt Lake City. The panel followed the showing of a documentary about two young women with substance use disorder — both of whom had come from your typical American middle-class families — who ended up addicted to pain medications after receiving prescriptions in a healthcare setting. During the panel discussion, I shared my thoughts on how the industry could better use lab data to get people on the right prescriptions. At that moment, it was clear that hc1 was uniquely positioned to launch breakthrough precision prescribing capabilities that could first tackle controlled substance prescribing and, ultimately, personalize all prescribing utilizing an individual’s DNA.

It was really the combination of our belief in the power of lab data, plus a few chance discussions along the way, including at the panel on substance use disorder, that informed the decisions that have made hc1 what it is today.

What do you think makes your company stand out? Can you share a story?

As healthcare organizations have been pressured by the developing transition to high-value care from fee-for-service, a natural reaction is to focus on cutting costs. At hc1, we believe that sustainable value enhancement can only come from improving outcomes which ultimately results in lower costs. While there have been many attempts to harvest EMR data, hc1 started by tapping into the heartbeat of healthcare — laboratory data. We believed if labs could access specialized cloud technology to organize information intelligently, they could unlock unprecedented insights to power clinical decision support to personalize care for patients. Our prediction was right. Today, the hc1 Platform personalizes care and eliminates waste for more than 1,000 health systems and diagnostic laboratories by turning previously static lab data into actionable healthcare insights.

We do this better than anyone. This year, hc1 hit an important milestone as we eclipsed 1 billion lab results processed by our cloud bioinformatics platform each month. This unrivaled scale fuels the intelligence of our machine learning technology to improve lives with high-value care for people across the country. Our team is incredibly passionate and the positive impact we have on people’s lives makes hc1 an incredibly fulfilling workplace.

What advice would you give to other healthcare leaders to help their team to thrive?

To thrive in healthcare, you’ve got to have a precise focus. At hc1, we are focused on precision testing and prescribing. Due to our intense focus on ensuring patients receive the right test and the right prescription, we can innovate faster and more effectively than much larger competitors that are trying to solve a broader set of challenges. My advice is to focus on a segment of the value chain that you can significantly impact and recruit outstanding team members who are passionate about improving outcomes. With a clearly defined focus, you have a chance to go deeper and make a meaningful impact that surpasses the capabilities of larger competitors in your niche.

Let’s jump to the main focus of our interview. According to cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us why you think the US is ranked so poorly?

While a complete answer to this question would require more than what can be addressed in an interview, low-value care, or care for which the potential harm outweighs the possible benefits, is a huge contributor to this poor ranking. Case-in-point, the Institute of Medicine recently that is wasted on low value-care, excess administration and healthcare fraud each year. We have to shift to a high-value care model to change this dynamic and improve the rating of the US healthcare industry.

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.

  1. Focus on delivering high-value care — By eliminating waste and personalizing care delivery, we can make huge strides to improve outcomes and reduce costs. As healthcare payment models increasingly shift from fee-for-service to value-based payment models, the US healthcare system will benefit from what the defines as “the best care for the patient, with the optimal result for the circumstances, delivered at the right price.”
  2. Decrease medication therapy failures — Medication therapy failures cost $8,700 per case on average, and we know that a significant percentage of individuals today are taking the wrong medications. In total, illnesses and deaths resulting from non-optimized medication therapy cost the U.S. healthcare system more than per year. One specific type of medication therapy failure occurs when an individual has a genetic mutation that prevents them from metabolizing a certain drug. For example, , but you won’t know who unless you conduct a proper pharmacogenetic (PGx) test. If we are going to meaningfully improve the US healthcare system, it is crucial to address medication therapy management (MTM) and PGx issues.
  3. Maximize the value of lab data — At least 70% of diagnostic and treatment decisions are informed primarily by lab results. By transforming lab data into actionable, personalized healthcare insights at scale, more patients can receive tailored treatment resulting in improved outcomes.
  4. Learn from Amazon — Amazon has built the most successful business model of our time by being customer obsessed. Amazon treats delivering a teddy bear to you on time like it’s life or death. Why do we treat patients, when it may be life or death, like a number? Healthcare needs to follow this model by reconfiguring processes and incentives to be sure each patient is treated as a unique individual.
  5. Consider what’s good about our healthcare system, and do more of it — Rather than fixating on the issues, a great way to find solutions is to focus on what is working well. For example, compared to other countries, in the U.S. we enjoy same-day access to medical care when an immediate need arises. Additionally, the mortality rate for conditions like are lower in the U.S. than in other countries. By sharing and expanding upon our successes, we can take an important step toward consistently bringing the world’s best healthcare to our patients.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

For individuals, it is obviously important to focus on diet, exercise and mental health. One often overlooked step we can all take is to get more sleep. Exercise and sleep are extremely powerful medicine. Additionally, routine health screening directed by your primary care physician is imperative. My mom died at 56 from colon cancer so I started getting routine colonoscopies at a relatively young age. This is one example of a routine screening procedure that can quite literally save your life and save the healthcare system millions.

Corporations must increase their focus on wellness programs that incorporate physical and mental health. For example, one of our partners, Quest Diagnostics, has created an employee wellness to control healthcare costs while by .

From a community standpoint, we must place a larger emphasis on “food as medicine” through initiatives that bring healthy food and eating habits to families. In Indianapolis, where hc1 is headquartered, Eskenazi Health leads an initiative that includes urban farming, a food pantry where primary care physicians can prescribe food and cooking classes for young people to learn about nutrition so they can make healthier choices for the long run. This is impacting tens of thousands of people and is a great model for communities to replicate.

Finally, healthcare leaders within health systems and health plans must commit to delivering high-value care that rewards quality over quantity.

Are you working on any exciting new projects now? How do you think that will help people?

We recently , a world-leading provider of diagnostic information services. The Quest Lab Stewardship offering, powered by hc1, is an innovative new service that employs machine learning to harmonize laboratory testing across healthcare locations and laboratories to help ensure the right patient gets the right lab test leading to expedited treatment, improved outcomes, and reduced waste. It is exciting to be personalizing lab testing for millions of patients across the US through this partnership.

The hc1 Platform was built from the group up to support innovative solutions that personalize healthcare and eliminate waste. This enables our team to work collaboratively with health systems and health plans to deliver solutions on an ongoing basis that improve healthcare. For example, hc1 will soon be announcing the world’s most powerful solution for optimizing prescribing for patients using both medication therapy management (MTM) and pharmacogenetic (PGx) testing.

How can our readers follow you on social media?

Readers can on Twitter, or they can also follow hc1’s social media accounts for new developments and company news on , , and.

Authority Magazine

Leadership Lessons from Authorities in Business, Film, Sports and Tech. Authority Mag is devoted primarily to sharing interesting feature interviews of people who are authorities in their industry. We use interviews to draw out stories that are both empowering and actionable.

Christina D. Warner

Written by

Author of The Art of Healthcare Innovation. Order it at amzn.to/31TBrZM or christinadwarner.com

Authority Magazine

Leadership Lessons from Authorities in Business, Film, Sports and Tech. Authority Mag is devoted primarily to sharing interesting feature interviews of people who are authorities in their industry. We use interviews to draw out stories that are both empowering and actionable.

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