Orion Health has been the Health Information Exchange (HIE) business around the world for more than 15 years. In this podcast, Chief Medical Officer Chris Hobson and I discuss the past, present and future of health IT.
(0:12) There are a lot of buzzwords in health IT: interoperability, population health, precision medicine. What is their relevance?
(3:07) What new buzzwords will we encounter as we head into the new decade?
(8:07) Health Information Exchanges have been around for 15 years. Have they succeeded? How will they evolve?
(12:05) You operate around the world. What are some differences and similarities you see with the US system? What can we learn from abroad?
(17:00) How do the priorities of payers and providers differ?
(20:16) What are the implications of new legislation focusing on interoperability? TEFCA? 21st Century Cures?
A quiet revolution is underway in healthcare data. A decade after the HITECH Act spurred the rapid adoption of electronic medical records, we are seeing the resulting data being integrated with other sources such as insurance claims, clinical registries and social determinants of health to produce richer data sets for analysis and action.
As we’ve noted in our own consulting work, Datavant has emerged as a key player in connecting disparate data sources at the patient level while protecting privacy. The company’s methodology anonymizes patient identifiers with a unique patient key, matches records across data sets, and enables data exchange.
So I was excited to attend Datavant’s Future of Health Data Summit in Washington, DC earlier this month. As one would expect from a company that strives to organize and present data efficiently, accurately, and clearly, it was a quality event. The day featured 40-minute panels with strong moderators and 3-4 expert panelists along with keynotes from luminaries such as former FDA Commissioner Robert Califf, CDER Director Janet Woodcock, and former Senate Majority Leader Tom Daschle.
The closing panel, Healthcare Policy, Value-Based Care and Data Sharing was typical of the program. Moderator Neal Katyal (former Acting US Solicitor General) made the most of the expertise of panelists David Shulkin (Former VA Secretary), Mona Siddiqui (Chief Data Officer, HHS) and Andrew von Eschenbach (former FDA Commissioner).
They were all passionate about the ability to finally leverage healthcare data at scale. Shulkin talked about using data to prevent suicides of veterans. The highest incidence is in the first year after discharge, when they risk falling between the cracks as they transition from the DoD to VA system. Siddiqui bemoaned the difficulties of confronting the opioid crisis with 2-year old data, and von Eschenbach spoke of the potential to transform the whole healthcare system by improving care and reducing costs.
Shulkin seemed the most skeptical about where things are headed in the near term, predicting incremental change in the healthcare system as the most likely outcome of the fight between Medicare-for-All Democrats and Republicans who want to crush federal involvement. When Siddiqui gushed about the potential to use the planet’s largest healthcare data set (from CMS) in hackathons and challenges and system redesigns, Shulkin interjected that working with the government was, “not for the feint of heart,” and “,not a great strategy for a young company.”
There was an interesting back and forth about how to get the public comfortable with data sharing, how to overcome the decline of public trust in general, and how to address privacy from a policy and technological standpoint.
The panelists generally agreed that patients would be on board if they saw how use of data could help with their own care, and that even spectacular data breaches wouldn’t completely erode patients’ trust in the system. We have become accustomed to such breaches with our financial data, after all.
Shulkin thought people would get really upset if they learned that their data was for sale. I disagree -I think consumers are already coming to terms with their data being sold throughout the rest of the information economy; it’s by no means unique to healthcare.
In closing, von Eschenbach said he was “incredibly optimistic” due to the tremendous energy coming into the process right now. It’s a chaotic environment, he said, but we’ll look back in five years and be grateful for today’s chaos.
Shulkin pointed to the large number of healthcare data companies formed over the past three years, using that as an indicator of the level of optimism in the field. It wasn’t evident to me that he fully shares this optimism.
And Siddiqui presented herself as a realist but also a bit of a visionary and optimist, who is thinking about the healthcare system that we want to have. For her –and many of us– it’s one that’s more technology enabled, virtual care enabled, and homecare centric.
I’m heading to the HLTH conference in Las Vegas next week. I hope it’s as worthwhile as the Datavant event!
The Denver Post (Tracking your pregnancy on an app may be more public than you think) has published an interesting and disturbing article about the rise of Ovia, an app that collects detailed and personal data from pregnant women and those hoping to conceive. I’m not surprised that the business model is to provide data to employers about their workforce in order to save on medical costs and reduce time away from work. But I am a little surprised at how much data employees are willing to enter on topics like their sex life, color of cervical fluid, miscarriages and so on, while the app also track things like what medical conditions they looked up.
“Maybe I’m naive, but I thought of it as positive reinforcement: They’re trying to help me take care of myself,” said [Diana] Diller, 39, an event planner in Los Angeles for the video-game company Activision Blizzard. The decision to track her pregnancy had been made easier by the $1 a day in gift cards the company paid her to use the app: That’s “diaper and formula money,” she said.
As I remind people using “free” apps –or ones they are paid to use– you’re not the customer, you’re the product. There’s plenty written on this topic so I won’t bother to rehash it here, but it’s worth remembering that the data provided by Diller and others can be combined with tons of other data from their use of Google, Facebook, Waze, exercise trackers, and more to create incredibly detailed and personal profiles.
In 2008 I wrote a brief blog post called Baby formula in the mailbox. “Honey, is there something I should know?” I was puzzled to see that it still gets a lot of hits in 2019 and that readers are still commenting about their own experiences. Back then, an au pair who worked for us had received baby formula from Abbott Nutrition. Somehow, some marketer thought she was pregnant. It was kind of embarrassing and of course could be problematic for a family relationship or if the pregnancy had ended prematurely.
Online data gathering has come a long way in the past decade. If Abbott once guessed you were pregnant, imagine how much more they –or many others– knows about you now. Maybe the users of these apps aren’t naive, just fatalistic about the idea that everyone knows everything anyway, so why not just take the formula and diaper money and run?
In a few years, Diller’s child will probably find the Denver Post article or maybe even this blog post. If that person is you, I’d be interested to know how you feel about it.
Belong.life bills itself as the largest social network for cancer patients and caregivers. With over 100,000 participants, Belong is approaching the scale at which it can generate meaningful insights, and leverage machine learning and artificial intelligence to create a “hyper-personalized” experience.
I spoke recently with Irad Deutsch, Chief Technology Officer. He described how his personal experience as a caregiver led him to co-found the company, and talked about what makes Belong valuable and differentiated.
(0:12) What are some of the main unmet needs for cancer patients and caregivers? Why was there a need for Belong in the first place?
(2:15) What, specifically does Belong do for patients that they can’t get elsewhere?
(4:23) How are providers and payers involved with Belong? Is this mainly a branding and cost-saving tool for them?
(7:03) What about pharmaceutical companies?
(8:00) You recently released a cancer fatigue survey. Why did you conduct that and what did it show? Any real surprises?
(10:08) You talk a lot about big data and machine learning but it’s not readily evident how those play in to Belong. Can you explain?
A huge ecosystem of technology companies has sprung up with tools to shop for health insurance, search drug coverage, administer HR and benefit plans, make physician appointments and more. They all need accurate, accessible, and detailed data on topics such as health plan design and rates, provider network participation and drug formularies in order to succeed. It’s remarkably difficult and expensive to obtain and maintain the data, and this has created an opportunity for a specialized company —Vericred— to perform the function as a utility for the whole industry.
I’m excited by the opportunity and recently joined the board of Vericred to help guide the company’s growth. In this podcast, I interview founder and CEO Mike Levin about the market and how Vericred is addressing it.
(0:15) What are some of the key data challenges in the health insurance market?
(1:53) Why are these problems so tough? Don’t other industries have similar issues?
(6:23) So what’s the problem? With consumerization you have all these new players springing up and health plans just need to work with them, right?
(7:40) What are the typical approaches to addressing these problems? Are the problems being solved?
(9:16) You talk about “liberating” the data. Doesn’t that scare health plans?
(11:11) What does Vericred do to address these issues? Are you gaining traction?
(15:03) Who are your customers?
(17:10) Are there analogs in other industries or this is a unique beast for healthcare?
(18:13) What changed with the passage of Obamacare and emergence of the marketplaces? And what is the impact of recent actions to undermine Obamacare?
(20:23) How did you get involved with founding the company? How did it go from concept to implementation?
(22:44) What changes do you expect in 2018? How is the company evolving to keep pace?