4 Strides Forward using Data in Healthcare, HIMSS 2018
This time is different! No really, it is! Attending HIMSS this year, the topic of how to share, spread, and analyze data centered around four key areas: Artificial Intelligence (AI), Interoperability, Value Based Care, and how the government can lead innovation from the front. The topic of data was ubiquitous across all the presentations and keynotes and was exciting to hear how progress is being made. I begin to peel the onion back a bit deeper into these 4 areas and show measurable case studies and progress in each.
AI becoming real, Powered by the Cloud
The machines are not taking over, but they are…assisting! Eric Schmidt, former chairman of Google, said it all when he opened HIMSS with a keynote saying that we have all the right tools now to make Artificial Intelligence (AI) very useful in the doctor office. Run to the cloud, he proclaimed, because ours is more secure, cheaper, and virtually unlimited. He laid out a framework to create an AI assistant named Dr. Liz (named after Elizabeth Blackwell, the first female physician) to make the lives of physicians better in 3 ways:
1. Help recall history and apply to the now. Computers have better memories than people
2. See the unseen. Computers have better eyesight than people
3. Assist in diagnosis. When combined, AI can supplement diagnosis and the patient/doctor conversation by once you have combined the extra brain power and sight into a meaningful application.
What has been done in the real world to make strides forward? Multiple case studies already exist where AI is supplementing diagnoses, including pointing out brain cancer, prediction of cardiovascular risk factors from retinal photographs, as well as assisting to diagnose breast cancer with diagnosis based on the latest research. The future is bright with Dr. Liz!
FHIR FHIR FHIR!
FHIR (Fast Healthcare Interoperability Resources) was introduced in by the HL7 organization to “support 4 different paradigms for exchange: the RESTful API, Messaging, Documents, and Services.” The benefits can be found here, and are many, including open source, developer friendly, and easy to understand.
The industry giants are starting to collaborate to get to open source solutions in the interoperability that can scale quickly. The Blue Cross Blue Shield Association (BCBSA) is leading an effort with Cambia Health, Rush University Medical Center, and Surescripts called the Da Vinci Initiative to fast track FHIR open source use cases. The charge of the Da Vinci Initiative is the need to establish a rapid multi-stakeholder process for addressing value-based care delivery use cases that can be implemented on a national basis. The idea is that the BCBSA can leverage its network of Blues plans to rapidly expand the use of FHIR and make the data exchange between Payers and Providers in value based care programs standard, opening up more thorny problems like actually saving money on care.
Fee for Value Initiatives, Powered by Payer/Provider Collaboration
Everyone is signed up with the idea that Michael Porter made popular with his publication “Redefining Health Care: Creating Value-Based Competition”, Harvard Business Review Press (2006). That’s no longer a question. Commitments from the Health Care Transformational Task force signing up 75 percent of the committee’s respective businesses operating under value-based payment arrangements by 2020, which includes Anthem, Ascension, and Aetna to name a few. There were a couple of highlights during HIMSS that are pushing the field forward.
UMass Memorial Health Care’s Renee Broadbent, AVP-Population Health IT & Strategy, laid out a step by step framework of how to set up a value based care organization within a Provider System. A must read for any COO of a system looking to get this jumpstarted. She lays out not only the operating model, but also the investment strategy, logistical barriers, and change management.
On the Payer side, an innovation was announced by Highmark Health called the VITAL (Verification of Innovation by Testing, Analysis and Learning) Innovation Program. VITAL’s overall goal is to make new technologies and services available through commercial insurers to the public sooner. In a joint session with BCBSA, the VITALs project will be leveraging Highmark’s Payer/Provider vertical integration (owning Allegany Health Network) to fast track innovation from both sides of the table to lower medical costs. The Association can then use its partner Blues plans to quickly spread proven cost savings initiatives across the US. This is a great testbed for ideas for a win-win-win (payer-provider-patient).
Who owns Patient/Member data?
The short answer is, you, said the HHS Chief Technology Officer Bruce Greenstein to a round of applause from the audience. The patient data is yours, not owned by the payer, hospital, or a provider’s Electronic health record. When asked, “What is your Moonshot project for this administration?” Bruce answered in two ways: curing or greatly advancing dialysis and kidney disease treatment and making your data available by breaking down the silos that exist within HHS. This sentiment was echoed by the Chief Data Officer, Dr. Mona Siddiqui. The former being one very focused on how we can make an affordable treatment for that costs billions of dollars a year (site), while the latter focuses on opening the data so other treatment areas can be revealed, and entrepreneurs can begin the next target.
Continuing the Momentum
We are making positive strides in these four areas, which has led to informed diagnosis and expanded access to data. The next steps must be centered around standardization, open sourced solutions that can scale, resulting in bending the cost curve and improving health and patient experience.
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