Relentless Health Value

Stacey is co-president of Aventria Health Group, specializing in helping employer, pharmaceutical, device, and pharmacy clients by creating partnerships with other healthcare organizations. For 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and most of all, the patient. 00:00 The largest healthcare payers in the country. 01:45 Asking Patients to be good Healthcare Consumers. 03:30 Labeling Healthcare Consumers. 04:10 “A significant portion of the population does not consider themselves a healthcare consumer.” 06:00 Identifying vs. not identifying as a Healthcare Consumer. 07:40 What most marketing behavior is motivated by. 09:10 The need for employers to demand change. 10:15 What to do to build and encourage Healthcare Consumerism. 10:25 Refer to Dave Chase’s book, or his interview on our podcast, EP107. 10:50 Our podcast interview with Richard Steinhart, EP149. 11:10 The one type of person who might actually consider themselves a full-time Healthcare Consumer. 15:45 “What do we need to do to help everyone in this country realize that we are Healthcare Consumers?” 16:00 “How can we improve the scales to actually be the agents of change that everyone is depending on?”

Gidi Stein, MD, PhD.  A practicing physician, researcher and serial entrepreneur. Co-founder and CEO of MedAware, dedicated to eliminate prescription errors and promote patient safety, using big-data analytics and machine-learning algorithms. Gidi also teaches medicine in Tel Aviv Medical School and treats complex patients in Rabin Medical Center, Israel. You can learn more by visiting medaware.com.

Dhruv Khullar, M.D., M.P.P. is a physician at NewYork-Presbyterian Hospital and a researcher at the Weill Cornell Department of Healthcare Policy and Research. He is also a contributor at the New York Times, where he explores the intersection of medicine, health policy, and economics. He recently worked in the ABC News Medical Unit, helping to curate and communicate evolving health stories, and was previously at the White House Office of Management and Budget (O.M.B.), focusing on Affordable Care Act implementation. Dr. Khullar completed his training in internal medicine at the Massachusetts General Hospital and Harvard Medical School, and earned his medical degree (M.D.) at the Yale School of Medicine. He also received a Masters in Public Policy (M.P.P.) from the Harvard Kennedy School, where he was a fellow at the Center for Public Leadership.  His work has appeared in the New England Journal of Medicine, Journal of the American Medical Association (JAMA), New York Times, Washington Post, Wall Street Journal, USA Today, The Atlantic, Slate, and other lay and academic publications. He was recently recognized by LinkedIn as one of the Top 10 Healthcare Professionals Under 35. Thank you to Jim Klus-Salisbury for his help with this episode. @Outcomes_guru ; outcomesguru.blogspot.com You can learn more by following Dhruv’s writing in the Well section of the New York Times and The Upshot.

Pramod John is team leader of VIVIO Health, a company that is reinventing the therapeutic use and supply chain for the specialty drug space. VIVIO Health’s solution is challenging the current framework of efficacy and extending it to true effectiveness in the real world. It also offers significant drug acquisition savings and simplicity for the patient by integrating the supply chain into a unified and data driven process. Prior to VIVIO Health, Pramod was founder of Oration PBC (acquired by Pokitdok) which was focused on giving back consumers control over their drug purchasing by capturing the prescription in the physician’s office and providing real time pricing options and automatic routing capabilities.   Pramod was also VP of Strategy and Innovation at McKesson, the world’s largest healthcare company. At McKesson, Pramod helped develop solutions that leveraged advanced technologies and business process improvements to optimize healthcare delivery systems, infrastructure and supply chains. Earlier, Pramod founded and served as CEO of PacketMotion, Inc., a venture-funded startup in the enterprise network information and policy management industry. The company was later acquired by VMWare. In addition, Pramod founded netExaminer.com, a managed-vulnerability assessment company acquired by SonicWALL (owned by Dell). Pramod earned his Ph.D. in Electrical Engineering from the University of Illinois at Urbana-Champaign. He serves on the Boards of Mission Aviation Fellowship, a global relief organization and 3 Crosses Church in Castro Valley, CA. He also serves on the advisory board of Folia Water and as a mentor at StartX. You can learn more at www.viviohealth.com.

Ethan Basch, MD talks today about a randomized clinical trial where 766 patients used a web-based system to self-report symptoms, triggering alerts to clinicians. The results were impressive. There are learnings and inspiration in this episode for anyone pursuing better patient outcomes, with special relevance for organizations rolling with a value-based care model. Dr. Ethan Basch is an oncologist and Director of Cancer Outcomes Research at the University of North Carolina.  His research group established that up to half of patients’ symptom side effects go undetected during cancer treatment and clinical trials, and that patient engagement and questionnaires substantially improve detection. His team determined that integrating web-based patient-reported symptoms into oncology clinical practice improves clinical outcomes and reduces health service utilization. His team created a system for the National Cancer Institute (NCI) to collect patient-reported side effects during cancer trials called the ‘PRO-CTCAE.’ Dr. Basch is also involved in efforts to bring PROs into comparative effectiveness research, routine care, and quality improvement. He is a member of the U.S. National Cancer Institute’s Board of Scientific Advisors, PCORI’s Methodology Committee, and is an Associate Editor at JAMA.  Dr. Basch will discuss results of a widely cited randomized controlled trial testing a “PRO intervention” in routine cancer care, that was a Plenary session at the ASCO annual cancer meeting and was published in JAMA earlier this year.  In this trial, 766 patients receiving routine outpatient chemotherapy for metastatic solid tumors were randomly assigned to self-report 12 common symptoms via the web, or to usual care. Treating physicians received symptom printouts at visits and nurses received email alerts when participants reported severe or worsening symptoms. Overall survival was tabulated based on medical records and Social Security Death Index data, estimated using the Kaplan-Meier method, and compared between arms using a log-rank test and Cox proportional hazards regression adjusting for age, sex, race, education level, and cancer type.  Cancer types included genitourinary (32% of patients), gynecologic (23%), breast (19%), and lung cancer (26%).  Survival results were assessed after a median follow up of 7 years and 517/766 (67%) of participants had died.  Median overall survival in the PRO intervention arm was 5.2 months longer than the control arm (31.2 vs. 26.0 months, p=0.03).  These results demonstrate that systematic symptom monitoring during outpatient chemotherapy using web-based patient-reported outcomes confers overall survival benefits.  These results are being further explored in a U.S. national implementation trial.

It’s rare you read an article about health tech and not see the word "interoperability" at some point, probably more than once. If that were a drinking game, we’d all be really drunk by now. Today I speak with Don Lee, a fellow podcast host about how Health Information Exchanges, otherwise known as HIEs, can assist us in the short term to get our data integration act together. This is a little bit of a reality check— blockchain and more elegant solutions might be coming, but today, right now, we need to meet quality measures. And you can’t meet quality measures without having a handle on the trips to the ER, eye exams, and specialist visits that are transpiring outside the four walls of any given provider office.  Don is an accomplished Health IT expert with a 20-year track record of driving value with technology. Don began his career as custom software developer and eventually built and lead a team of more than 30 engineers.  Later, he was the subject matter expert, product manager and head of sales and marketing for a digital health startup that launched a SaaS-platform focused on administrative simplification in healthcare. Today, Don is President of Glide Health IT, LLC, a consulting firm that helps forward-looking organizations align their Health IT and business strategies. The firm specializes in business and product development with a focus on data aggregation, interop, analytics and quality measurement. Don is also the founder, co-host and Executive Producer of The #HCBiz Show!, a podcast dedicated to unraveling the Business of Healthcare. You can learn more by going to glidehealthit.com or don.lee@glidehealthit.com or by going to thehcbiz.com to listen to Don’s podcast.

I talk with Scott Barclay today. Scott is a partner at Data Collective (DCVC), an early-stage fund that makes venture capital investments in data scientists and entrepreneurs working on hard big data problems. We discuss what it takes for an entrepreneur to succeed in the healthcare ecosystem today, including an essential ingredient: Empathy. Data Collective is a $1bn+ venture capital firm focused on early-stage investing in deep tech and data compute, based in Palo Alto and San Francisco but investing globally. Scott focuses on health and data and leads the firm's practice in Computational Care, envisioning and funding the future of special early-stage teams working on hugely ambitious problems in how health care is provided and applied with data and empathy. Current board or investment roles include Karius, Element. AI, Unity Medical, Enzyme, Medical Informatics, Noteworth, SafelyYou, PatientBank, BlueTalon, InnaMed and Subtle Medical. By background, Scott is a serial angel investor and adviser in health and data start-ups. Scott helped create and scale the first massive digital health platform (Surescripts) and served CVS Health as a GM and innovation leader across the company's health care and retail assets. Previous stints include the Boston Consulting Group, starting a capital markets desk in London for Banc of America Securities, and an MBA from Insead. Scott grew up in rural Virginia and worked many summers in a manufacturing plant, and graduated from the University of Virginia where he was militantly liberal arts and math and science. You can learn more at dcvc.com or by emailing scott@dcvc.com.

Alex Akers is Vice President for Business Development with HealthCatalyst, a Utah-based, next-generation data, analytics, and decision-support company, committed to being a catalyst for massive, sustained improvements in healthcare outcomes. He has been with HealthCatalyst since 2015, primarily focusing on clients in the southeast. Alex began his career in healthcare consulting, working for KPMG and Accenture in their healthcare strategy practices, and then shifting to revenue cycle reengineering with Stockamp & Associates, where he was a Senior Manager. His passion for technology in healthcare really took off after he joined Microsoft, and was responsible for healthcare strategy in their payer segment, working on projects such as improving care giver collaboration with next generation technology, how to gamify healthcare with Xbox Kinect and consumer engagement. He spent time working with the Microsoft-GE joint venture Caradigm, and worked in sales for their analytics platform. After a stint with a San Francisco company called Grand Rounds, Alex landed at HealthCatalyst, and continues to follow his passion for bringing analytics, evidence, and better care to the US healthcare system. Alex holds a Masters in Business Administration and a Masters in Public Health (Health Policy) from the University of Alabama, Birmingham, and attended Auburn University for his undergraduate degree. He lives in Charlotte, NC with his wife Lauren. You can learn more at HealthCatalyst.com.

Leela Barham is a Health Economist by training with an MSc Health Economics from the University of York and BSc Economics from the University of Nottingham. Leela has over a decade of experience in consulting, working with clients from across the world. Leela focuses on policy and health economic issues from pharmaceutical pricing to Health Technology Assessment and more. Leela has worked with patient organizations, the NHS, a health insurer, think tanks, the pharmaceutical industry, and the medical device industry and has been an expert reviewer for the Department of Health to support on issues on innovation. Leela has also worked for the Royal College of Nursing and NERA Economic Consulting, and has been a member of the Department of Health's External Advisory Group on Payment by Results and the HFMAs Costing Special Interest Group. Leela's work has been published in a number of journals and she also regularly contributes to pharmaceutical industry magazines. She has also been a peer reviewer for journals including the European Journal of Health Economics and The Patient. You can learn more on Leela Barham’s Facebook and her blog.