June 07, 2013
I attend a pretty good number of healthcare and health policy conferences over the course of a year so I can say with confidence that it’s rare to find an event with the crackling energy seen at the fourth annual Health Datapalooza earlier this week. I was pleased that some of the more vivid and memorable impressions were made by Healthcare Leadership Council member companies, demonstrating new ways in which data-driven innovations can address some of this nation’s most daunting health challenges and enable consumers to take more control over their own healthcare.
• There was Sanofi’s role in leading the Data Design Diabetes Innovation Challenge, offering a $100,000 prize to the innovator who could develop the best way to use data to improve care and health outcomes for patients with diabetes. The winners developed a program called Connect and Coach that enables health providers to develop nutritional assistance programs for patients, incorporating an array of features from electronic patient records to letter-writing programs to tools that enable better nutritional decisionmaking when shopping at the supermarket.
• iTriage, a subsidiary of Aetna, displayed its consumer-friendly mobile application that, among other features, enables smartphone users to look up possible causes and treatments for symptoms they are experiencing, choose healthcare providers and access their own medical records.
• Surescripts issued a challenge to data innovators to develop programs that will use electronic records of prescriptions to track influenza cases in real time. This will be invaluable to public health officials trying to track the movement of flu episodes so they can take pre-emptive action. An interesting facet of this challenge is that Surescripts is calling for entries from women and women-led teams, seeking to encourage more females to enter the healthcare, data and science fields.
• Healthways took a different approach to health innovation and focused on its book of daily challenges. Simple daily challenges are an effective way to improve one’s well-being, and Healthways has done an excellent job connecting social media to this day-by-day approach to better wellbeing.
The Datapalooza event is a vibrant reminder of how healthcare is transforming before our eyes. With the expanded use of social media, smartphones and other tools to disseminate information, innovative uses of data are exponentially increasing the venues in which people can connect to their health providers and take greater responsibility for their own wellness.
May 07, 2013
I’m pretty certain that no one has ever successfully made the case that life-changing advances in modern medicine have come as the result of physicians and researchers keeping their heads buried in the proverbial sand.
Yet, a guest op-ed in the Wall Street Journal last month suggests exactly that approach. The head of a major healthcare organization wrote that patients are at risk for “potential harm” unless physicians completely stop participating in collaborative relationships with the healthcare industry. He added that the 7,000 physicians in the medical group he heads were banned from engaging in any consulting arrangements with pharmaceutical or medical device companies.
So this is the ideal future of American healthcare? An environment in which the companies that make lifesaving medicines and technologies can’t communicate with the brightest doctors who will use those innovations and whose insights can make them better?
God help the patients of the future if that philosophy becomes the accepted standard.
There is a superb opinion piece published today on The Atlantic website in response to the Wall Street Journal guest op-ed. It’s written by Dr. David Shaywitz, an adjunct scholar with the American Enterprise Institute and a strategist with a San Francisco-based biopharmaceutical company (not a Healthcare Leadership Council member company). I recommend you read Dr. Shaywitz’s writing in its entirety, but I wanted to pull two quotes from it that are worth highlighting. The first:
“To advance even a solid idea requires, ideally, close communication between industry and outside experts: university researchers, who often developed the science and understand it the best; practicing clinicians, who can describe where the medical needs are the greatest, and what properties an ideal therapeutic would have; and patients, of course, who understand better than anyone else what they need, and where existing approaches may fall short. We should strive to cultivate, not demonize, these sorts of interactions.”
And at the conclusion of his piece:
“Drug development is far too important, and far too difficult, for anyone to do by themselves. To have even a fighting chance, stakeholders — pharma companies, university researchers, clinicians, and patients — need to work together, and collaborate as if our future health depends upon it. It probably does.”
This is a one-sided argument. In an environment in which chronic disease is on a path of rapid escalation, we need to constantly develop new and better technologies and biopharmaceutical therapies to advance wellness and prevent serious illness. Talented physicians should be part of this process in a principled, transparent, independently-minded fashion – one that we’ve addressed through the National Dialogue on Healthcare Innovation.
This will do far more for patients than a head buried in sand.
April 11, 2013
In a week that has featured the back-and-forth crossfire between pundits and lawmakers over budget priorities, it was refreshing to have a genuine healthcare expert, Mayo Clinic President and CEO John Noseworthy, M.D., come to Washington and share a comprehensive vision of the steps needed to improve our nation’s medical system.
In his speech at the National Press Club, Dr. Noseworthy said that we are facing “the most profound challenge in our history” in terms of the state of healthcare in the U.S. and that a growing senior population , rising costs, fragmented care and uneven quality are presenting a “threat to the economic health” of the nation.
The Mayo CEO cited three imperatives that must be addressed in order to achieve health care progress. The first, he said, is to put proven medical knowledge into practice more consistently. He said this require better tools for synthesizing the massive amount of new health care information that inundates medical professionals. Dr. Noseworthy, who defined knowledge as Mayo’s “most scalable asset,” said it is necessary to deliver new information as fast as it is known to assist health care providers in their communities.
Secondly, he said, it is necessary for all players in the health care system to embrace value, or higher quality at lower cost. And his third cited imperative was that government must fund excellence, support scientific discovery and create payment systems that reward quality, value, excellence and innovation at each level of care – primary, intermediate and complex.
He explained that government, in administering the Medicare and Medicaid programs, must find ways to reward those systems that provide excellence care, rather than try to achieve a sounder financial footing through across-the-board cuts. “If you pay everyone less, you turn health care into a commodity, and it isn’t a commodity,” he said.
Other significant comments from Dr. Noseworthy included:
• That federal budget sequestration will cost the Mayo Clinic $47 million in one year, half of it coming out of medical research. “It will slow us down,” he said, “and this is not a time to restrain racehorses in America.”
• That Medicare cuts to health providers have extensive ramifications. Dr. Noseworthy said close to 60% of Mayo’s patients are on Medicare. He said Medicare cuts slow the pace of research and make it more difficult to attract top professionals.
• The Affordable Care Act does much to improve primary care, “but sooner or later, and particularly as we age, most people will need intermediate care and complex care. More work is needed to create and ensure a high-quality continuum of care for Americans.”
March 27, 2013
When the U.S. Senate, in the course of adopting a budget resolution, overwhelmingly passed an amendment to repeal the Affordable Care Act’s medical device tax, Washington did what it does so well. It reacted with cynicism.
As David Weigel wrote in his Slate post, “Why Did Liberals Kill the Medical Device Tax?” the repeal vote could be considered a freebie. It was attached to a non-binding budget resolution and will not actually repeal the tax. That would have to be done in separate legislation. As Weigel and other skeptics portray it, this was a way for lawmakers to toss a bone to the medical device industry without actually doing anything of real consequence.
I think, though, that there’s another way to look at this vote. Let’s recall how the Affordable Care Act was created in the first place. It didn’t go through normal legislative channels. The Senate passed its version of the bill, and many Senators admitted it contained provisions they didn’t like, but they assumed it would be fixed in a Senate-House conference committee. That conference committee didn’t happen, though. Rather than risk another Senate vote, which would have been problematic after Senator Ted Kennedy’s seat was taken by Republican Scott Brown, the House simply passed the flawed Senate bill and sent it to the President, warts and all.
With full implementation growing closer, let’s give Congress the benefit of the doubt and say it is now trying to fix some of the law’s more egregious problems, the medical device tax being one of them. The Senate budget amendment may not have been binding, but it could also be the precursor to an actual measure getting rid of a provision that is already killing jobs in a medical innovation sector that has heretofore been creating them.
March 12, 2013
It’s widely accepted that the Physician Payment Sunshine rules, the final version of which was recently released by the Administration, are a good thing. When physicians have working agreements with pharmaceutical or medical device companies, patients and consumers should know that these collaborations are taking place.
But will they know enough about what these agreements entail or, asked more specifically, will citizens simply see columns full of dollar figures when the Sunshine website goes live in 2014 or will they be given an understanding of what these collaborations mean for quality health care, medical research and the improvement of our healthcare system?
Two highly-respected physicians, Dr. David Barrett, former CEO of the Lahey Clinic, and Dr. Harry Jacobson, vice chancellor emeritus of the Vanderbilt University Medical Center, addressed this issue in an op-ed last week in The Hill newspaper. They wrote, “The working relationships between doctors and healthcare companies have come under fire, and these frequently-unfounded criticisms may deter many of our country’s finest medical minds from participating in the innovation process. This would be a catastrophic trend for current and future patients.”
Drs. Barrett and Jacobson are exactly right. Many of the most significant medical innovations of the last several decades – from penicillin to pacemakers to cervical discs – have come as a result of collaboration between physicians and innovative companies. If these collaborations become increasingly rare because physicians and researchers don’t want the negative implications that accompany reports of contractual agreements, then patients and our healthcare system pay the price.
Everyone has a responsibility to make sure this is done right. Leading healthcare providers, health industry companies and associations, academic health centers and patient groups are doing their share by endorsing a set of principles – initiated by the Healthcare Leadership Council’s National Dialogue for Healthcare Innovation – calling for transparency, researcher independence and accountability in all collaborative ventures.
And, at the same time, policymakers and the news media need to avoid giving the impression that exchanges of value between physicians and industry are, by definition, nefarious in nature. As Drs. Barrett and Jacobson wrote, “We have seldom, if ever, read a news story in which it was fully explained how physician-industry collaboration led to a new medical breakthrough. The focus is almost exclusively on the money.”
The public deserves better. Yes, it’s essential to let the sunshine in, but it’s equally critical that the whole picture of physician-industry collaboration be illuminated so the public understands its value.