Looking at Physician Training Through a Wide(r) Angle Lens

July 27, 2021
10:49 pm

Historically medical school curricula have, for the most part, revolved around the actual practice of medicine and not the business aspects that will also affect a physician’s work life and financial viability. Independent physicians, of course, need an understanding of how to make their practices sustainable successes, and even doctors in large group practices or institutional settings can benefit from the skills that create a pathway to organizational leadership. Many physicians are now returning to school to earn MBAs. This is becoming an increasingly-seen trend across the nation since MBA programs help further physician knowledge in key areas such as finance, accounting, and microeconomics.

Many medical schools are beginning to incorporate business concepts and training into their degree programs. For instance, the Mayo Clinic and Arizona State University (Alliance for Health Care) developed a dual MD/MBA program. This program is specifically structured to help train physicians in the intellectual disciplines and practices of medicine and management. For the future of healthcare, physicians should not only be seen as doctors who treat patients, “but also economists, administrators, and problem solvers working toward improving patient care.” This unique MD/MBA program is deeply rooted in helping individuals become future physician leaders. Likewise, the Cleveland Clinic and Western Reverse University have joined forces to create a healthcare master’s degree program in response to the evolving healthcare field and the higher volume of clinical doctors graduating from MBA programs. The curriculum includes instruction and practical experience in the general management fields of leadership, strategy and innovation.

As healthcare becomes increasingly integrated, medicine and business are moving toward a hand-in-hand relationship. The business side of healthcare offers new and innovative solutions to better manage and improve organizational operations. At the same time, these programs offer insights on how to better provide cost-efficient care to patients. As healthcare organizations recognize the need for business sense among clinicians of medicine, the number of specialized degree programs combining the two will grow. This evolution within the healthcare industry can lead to improvements in processes alongside quality of care.

Blockchain Technology and its Current Status in the Healthcare Industry

July 15, 2021
11:12 am

Blockchain technology is an anticipated medium in the healthcare industry because of its ability to secure patient data, streamline care and prevent costly mistakes. This trusted technology is a database which stores blocks of digital assets that are not copied or transferred, but distributed, which preserves the integrity of the document. With this type of security, people can feel more comfortable with how their records and personal identity information are shared and secured.

While blockchain is currently used as a way to preserve data integrity and transparency, there is exploration into utilizing it to create a network that increases ways to manage and exchange skills-based credentials. Healthcare leaders have shown interest in its potential to improve transparency and interoperability in care networks. Some organizations, such as Aetna, Cleveland Clinic and Healthcare Service Corp. plan to use blockchain to decrease administrative costs correlated with transferring data between payers and providers. Avaneer Health, a utility network created by Aetna and Healthcare Service Corp., along with IBM and PNC Bank, uses blockchain to ease the transferability of data among payers and providers. The healthcare industry is experiencing challenges in regard to unnecessary costs and inefficient payment processing and Avaneer Health’s partner companies hope it can find a solution to those challenges.

Change Healthcare, a leading healthcare technology company that focuses on simplifying and improving data services and enhancing clinical decision-making, has invested significantly in blockchain. Its first incorporation of this technology was to speed claims processing. The company has now expanded their efforts to improve healthcare payments and revenue cycle management processes. In 2017, Change Healthcare forged the use of enterprise-scale blockchain technology with Intelligent Healthcare Network™ and today, processes up to 50 million transactions daily. Through concerted efforts, they have been able to increase efficiency, which in turn lowers the cost of administering claims. A year later, Change Healthcare collaborated with TIBCO to create healthcare’s first smart contract system.

Blockchain technology is still evolving–it can be costly for industries and it takes time to work out complications to adapt to the different hospital needs–but the advantages and security it provides broadens its appeal in multiple sectors. Its impact is expected to increase exponentially in the next few years.

The Innovation-Competition-Affordability Connection and its Importance to Patients

June 15, 2021
12:49 pm

One of the biggest headlines in healthcare this month occurred when the Food and Drug Administration gave approval to a new treatment for Alzheimer’s disease developed by Biogen. This is a development that brought hope to the millions of individuals and their loved ones who have or will have a terrible and complex disease that is taking an increasing toll on our society.  The Biogen approval speaks to the importance of biomedical research and development in this country as well as the FDA’s Accelerated Approval Pathway program, which makes novel treatments available in areas of unmet need.

But the good news is not without controversy.  There is already criticism of the recommended market price of this product.  In that light, I found the blog post below from Genentech CEO Alexander Hardy to be relevant and insightful.  As he points out, the most effective pathway to achieve greater affordability for breakthrough medicines is to encourage more innovation and the development of competing therapeutics.  Remember the firestorm that occurred over price levels when Gilead Sciences developed a cure for Hepatitis C?  Those prices dropped precipitously when other biopharmaceutical companies developed competing products.  It’s an important lesson for policymakers that innovation is a more effective and patient-centered tool for achieving affordability than heavy-handed regulation.

I am pleased to share the perspectives of Genentech’s chief executive.


Innovative Medicines Demand Responsible Pricing

The FDA approval of Biogen’s new Alzheimer’s disease medicine will be, I hope, the first of many new treatment options for patients to help combat this devastating condition. With this news, there has also been much commentary on the price of the medicine.

At Genentech, we’re well aware of the challenges of developing treatments for Alzheimer’s disease. We’ve spent the last decade researching potential targets and have experienced a number of scientific setbacks. But we’re proud to remain in the fight and are currently developing three investigational medicines – two in Phase II and one nearing Phase III completion. Despite the challenges, we remain optimistic about our potential to launch one or more medicines in the future.

Alzheimer’s is one of the biggest public health challenges of our time. The impact of the disease on patients and caregivers is truly tragic and we applaud Biogen for their efforts to develop a treatment.

We believe, like many others in the industry, that the price of a medicine must be based on the benefits it provides to patients and society. Ultimately, the price must enable patients to have rapid and broad access and provide a reasonable return that will fund future R&D investments.

Given the growing worldwide incidence of Alzheimer’s disease, it’s imperative that people with the  disease have multiple treatment options to choose from. Hopefully, a number of additional medicines will be approved that deliver more benefits to patients and society. With those advances, the resulting competitive market dynamics will prevail and bring a decline in prices. The availability of more therapies should drive healthy competition, delivering savings to the healthcare system overall and ensuring patients and doctors have important choices in the medicines they receive.

There is an opportunity now for lawmakers and industry to work together on policies that will fuel efficient market-based competition. We must also provide a safety net in the form of a cap on Medicare out-of-pocket costs to ensure that patients have access to life-changing medicines.

At Genentech, we’re committed to working every day to bring even more hope for patients and caregivers living with Alzheimer’s disease. If we are successful, we will price our medicines responsibly so that they reflect the benefit they provide to people with Alzheimer’s disease and society as a whole. We’re committed to working with the U.S. Administration, Congress, and others to find sustainable, system-wide solutions that lower costs while also protecting scientific innovation and ensuring patients have access to the life-changing medicines they need.

Investing in Non-Traditional Access to Care

May 25, 2021
2:26 pm

Even before COVID-19, our healthcare system was evolving to expand remote and in-home care.  The pandemic has underscored the importance of providing quality care to people where they are.

Leading by example, Mayo Clinic, a Healthcare Leadership Council member, and Kaiser Permanente have partnered to invest in Medically Home Group, a technology-enabled services company which offers a virtual and physical care delivery model including a 24/7 medical command center staffed by an array of clinicians and an integrated care team in the community who deliver care to patients at their bedside. Using this platform, providers can address clinical conditions of greater acuity without the patient needing to enter the hospital. Results have shown that patients who still need to be hospitalized using the integrated Medically Home model have a lower need for recurring hospitalization at 30 and 90 days following a care episode.

Gianrico Farrugia, M.D., president and CEO of Mayo Clinic stated, “Our partnership with Kaiser Permanente and Medically Home will create the next generation of patient-centric, compassionate health care that seamlessly integrates advanced technology with clinical expertise. By bringing best-in-class clinicians and services to patients in their homes, we’ll be able to provide more people with individualized care that’s tailored to meet their specific needs.”

This model increases health system capacity and resiliency and helps close gaps in care for vulnerable populations. Medically Home estimates that 30% of hospitalized patients can benefit from this model. Both Mayo Clinic and Kaiser Permanente have launched programs to ensure complex, comprehensive care is available outside hospital walls, engaging patients in their homes and integrating information such as social determinants of health into their care plans. This is the way of the future, and Mayo Clinic and Kaiser Permanente are demonstrating how healthcare institutions can effectively expand their reach beyond traditional settings.

Improving Patient Care by Applying Lessons Learned from a Pandemic

May 19, 2021
4:57 pm

The COVID-19 pandemic and its social distancing requirements have necessitated changes in the delivery of healthcare over the past 14 months.  As we begin to transition back to normalcy, policymakers and health system leaders are assessing the lessons learned during this period to determine what kind of short-term changes should become permanent healthcare reforms.

At a Senate Finance Committee hearing this week dedicated to this topic, executives from two Healthcare Leadership Council member companies discussed steps that need to be taken to enable individuals to continue receiving quality care in their own homes.

Linda DeCherrie, M.D., clinical director of Mount Sinai at Home, a program developed by New York’s Mount Sinai health system, discussed the benefits found through an innovative care delivery model that provides treatment to patients in home settings.  According to Dr. DeCherrie, the Hospital at Home model reduced the average hospital stay from 5.5 days to 3.2 days while also cutting the percentage of patients who require readmissions nearly in half.

Dr. DeCherrie said the Centers for Medicare and Medicaid Services approved waivers to allow healthcare providers to offer these services to Medicare beneficiaries, but that some health systems are reluctant to establish Hospital at Home programs unless they are assured those waivers will be made permanent or at least extended.

Similar regulatory action is needed to strengthen telehealth access, according to Narayana Murali, M.D., executive vice president of care delivery and chief strategy officer for Marshfield Clinic Health System in Wisconsin.  She told senators that telehealth has increased access to care for vulnerable communities. Marshfield, she said, performed 240,000 telehealth encounters in 2020 compared to 12,500 in 2019.

Dr. Murali said, though, that access to telehealth services remains limited by existing regulatory barriers determining where telehealth can be offered.  She also said telehealth won’t reach its full potential until greater investments are made in broadband access.

I want to give credit to the Senate Finance Committee for scheduling this hearing.  We can’t undo the tragic devastation created by COVID-19, but we can utilize the lessons learned from the pandemic to provide better healthcare to the American people.