In general, systems coped and helped others out which were flooded or lost power; NS-LIJ took in patients from evacuated NY Health and Hospitals Corporation (NYHHC) facilities as well as NYU-Langone Medical Center. In opening remarks, NS-LIJ CEO Michael Dowling pointed out the large gap that had to be worked around–a torrent of new admissions, and being unable to access non-network EHRs. He also pointed out that what healthcare needs is the right data to make the right decisions, and that health care systems were liable to data overload–too much, not right and thus not actionable. Closing remarks by HHC’s CEO Alan Aviles returned to Sandy and were a blow-by-blow account of hospital disaster response, followed by what was being done (step by step) to restore services and lessons for the future.
Dan Cerutti of IBM’s Watson commercialization area presented the development of Watson’s deep Q/A in processing structured and unstructured data, and their tackling oncology first in partnership with WellPoint, and refining the decision making model through research with the Cleveland Clinic. [More in TA 27 Sept and 1 Nov] WellPoint’s CTO Rickey Tang extended the discussion into the wild and wooly world of utilization management, so dear to payers and so badly in need of streamlining in precertification, collection of missing information, cost transparency and post-service review. Both Watson and WellPoint are intent on redoing the UM process; eHealth developers should especially keep an eye on how this restructuring develops. A rather surprising factoid tossed out by Mr. Tang was that 81% of doctors spend less than 5 hours/month reading journals, which gave your Editor pause, especially with state and specialty continuing education requirements; does this account for how physicians are transitioning to consuming information via PCs and mobiles?
The Payers and Providers: Making Health Tech Work panel again returned to how to utilize data in moving to evidence-based care, and then moved forward into issues such as connectivity and patient engagement–extending care to the life of the patient outside the walls of the hospital and the doctor’s office. Managing massive amounts of data into workflow was also a major concern of the panel. Charles Saunders, M.D. of Aetna Emerging Businesses noted the fine line between Big Data and Big Brother. Aetna is developing a payer-neutral infrastructure with providers through Accountable Care Solutions to narrow population gaps in care and integrating its patient engagement application, iTriage [TA 24 Dec 2011], to fill what he termed the ‘white space’ between visits. In later remarks, he added case management and call centers to that mix; in total, more overlap, not less, between provider and payer. For providers, their approach is also affected by the composition of their patient population. Pamela Brier, CEO of Brooklyn’s Maimonides Medical Center, pointed out the special challenges of being both the largest Medicaid provider in the borough–now moving to a managed care vs. fee-for-service model–and having a major commitment to the seriously mentally ill, which are for now both roadblocks for Maimonides moving into an accountable care (ACO) model. Their focus is on the electronic transfer and integration of patient information between providers through the local RHIO (regional health information organization). Dr. Neil Calman of the Institute of Family Health and the Mount Sinai School of Medicine, from the primary care provider view, proposed that useful data is real time, alerting to patient status and responding to patients at the ER (ED), and will inevitably result in workflow changes. Marco Diaz, representing employers as VP Benefits for Thomson Reuters, thought the balance would come at the consumer level, in matching and integrating individual data, engagement and actions into records. In follow up questions from the floor, panelists were asked about their experiences with remote patient monitoring (telehealth) integration and the effect on same-cause readmissions. Ms. Brier’s experience has been about a 15% reduction, with a key factor the integration of care managers; Dr. Saunders claimed that the rate could be as high as 40% if transitions of care are managed effectively. A sobering note at the end concerned data tracking and a potential increase in liability, not only from the data capture but also from data breaches. However, Dr. Calman positioned this as more importantly, and inevitably, a manageable risk in an improved standard of care, with RHIOs and an ‘electronic trail’ being part of the security solution.
After a break, the shorter Innovations and the Market panel discussed what can be successful–and not–in health tech. David Blumenthal, M.D. of Partners Healthcare, which is heavily involved in innovative telehealth such as text reminders and startups such as Healthrageous [TA 17 Oct], told a cautionary tale about his encounter with a ‘Silicon Valley hotshot’ who thought his app was ‘the end’–it was, though not in the sense he intended. What is obvious to the developer is not necessarily that to the consumer. Patients don’t listen! Medivo, an early-stage monitoring/lab result tracking company founded by seasoned veteran Sundeep Bhan, has evolved its revenue model several times as it has grown. To Maria Gotsch, CEO of the NYC Investment Fund, the real revolution is coming with data analysis and the tools to make it actionable. Similar tools have been pioneered in the financial sector, and NY is rich in skilled people. However, the talent hasn’t yet migrated from financial to health tech–the VC mentality is still stuck in financial and shopping websites–but the outlook is improving. The panel agreed that for healthcare innovations, ROI in the traditional sense remains problematic, but is rapidly becoming part of a new standard of care delivery.
Tweetstream at #crainshealth. Many thanks to Crain’s event producer Courtney Williams for facilitating Editor Donna’s attendance.
Update 19 Nov: North Shore-LIJ–a healthcare behemoth in the making? Crain’s seems to think so here.