Plenary - Making Waves: Trends and Technologies Transforming Health and Research
How Innovation is Fueling the Health Care of the FutureRecent years have seen rapid change across health care, as stakeholders increasingly work to harness the power of digital technology for transforming treatment and delivery of care through personalized medicine, mobile-enabled care and more. Yet this promising outlook has also been clouded by harsh realities that have frustrated patients, organizations and researchers, forcing the health care industry to approach old problems in new ways.
Hunch Analytics co-founder Aneesh Chopra, who served as chief technology officer during President Obama's first term, held a front-row seat as the administration sought to shape this future and overcome some of the obstacles, and he guided a discussion on the topic at Partnering For Cures' second plenary session Monday. Kicking off the conversation, Chopra said the president's strategy to build the digital health care framework of the future rested on three principles. First, the United States had to build the necessary infrastructure, in the form of expanding connectivity, improved R&D and increased human capital. The second was a commitment to build a legal, ethical and regulatory framework that defined the 'rules of the road' for this new infrastructure. Finally, Chopra said, the administration wanted an 'all hands on deck' approach, meaning the government 'would open up this underlying infrastructure for use by all parties,' public and private. It's a vision that Chopra said in many ways has and will continue to guide the health care industry's approach toward delivering on the promise of digital health.
From sick care to wellness and preventionOpening up discussion, Chopra asked the panelists to describe their visions for the future of health care. Catherine Oyler, vice president of strategy and external innovation for Janssen Research and Development at Johnson & Johnson, started by asking the audience if they believed that their car had better health care than they do. She went on to explain that the future of health care will look a lot like maintenance for cars. Ideally, the "check engine" light comes on to signal an issue with the vehicle before serious problems arise. "We don't have the same level of knowledge info about our health – and our doctors have less info to treat us than our mechanics do to treat cars," she said. "When we go to doctors, it's usually after we're already sick."
A system focused on wellness and providing care before people become patients opens up new possibilities, Oyler said, asking the audience to imagine our world without disease: "It's possible, but it needs to be enabled by getting better info about our health care, who's susceptible to certain diseases and why, and acting on it."
Building on the same theme, Larry Gold, founder and board chairman at SomaLogic, drew an important distinction between cars and people. "Cars are designed by engineers," he said. "But biology has been evolving for 3 billion years under unknown conditions." That means it is incredibly difficult to design the type of sensors and algorithms that would make a "check engine" function possible in health care. Great advances have been made in genomics and harnessing those insights as predictive instruments, yet he stressed that genomics isn't the only "-omics" discipline that offers insights, and there is also value in proteomics.
Incentivizing a better systemDan Mendelson, president of Avalere Health, emphasized the importance of evolving payment delivery systems in shaping the future of health care. Fee-for-service has long been entrenched as the dominant payment model in health care, prioritizing volume over value. Now, however, value-based models, including those used in Medicare Advantage, are fueling development of a system that incentivizes the right outcomes. Mendelson said that the future of health care depends on how quality is managed, experienced by patients and incentivized. "We will create the system we incent," he said.
And incentivizing the system we want requires government buy-in, Mendelson said, calling for agencies to be more aggressive in pushing payment systems that align with patient outcomes. "Government can't be shy about putting these measures in place with rapid time frames," he said.
Enabling innovationClaudia Williams, senior advisor for health technology and innovation at the White House Office of Science and Technology Policy, agreed the patient experience is critical, calling patients "enablers of innovation." The key, she said, is developing an open system where patient data is available to the researchers and clinicians who need it. This requires that more patients take part in clinical trials, but Williams said many people don't because they can't take their data with them. "We need to work toward an economy of abundance, where patients should be able to take their data at the end of the study, to be used in other tests." In other words, technology is there but the barriers to access this data hinders its usefulness.
This problem surrounding patient data, so vital to a patient-centric health care system, is one all panelists agreed is a major challenge. But it's not only a problem that concerns patient access and free flow of data. Chopra noted that too many health care organizations miss a critical opportunity to gain insights because they simply don't ask patients for their data before beginning treatment. Gold agreed, saying that this restraint is cultural and contrasts starkly with single-payer systems where health records are willingly shared. However, he said his company has had great success overcoming data challenges by engaging rare-disease communities, where patients tend to be highly motivated to pursue innovative solutions. "We're doing trials with groups that are so motivated that many of these problems [with patient data] just go away," he said. "It's a model for how things might work."