Welcome to Medgadget‘s coverage of Health Datapalooza 2017, an AcademyHealth event, in Washington, DC. The now annual event was launched in 2010 by the Obama administration as a hackathon-style program where attendees were challenged to develop prototype applications in 30 days from 30 data sets. Today, Health Datapalooza includes presentations from government and private sector healthcare experts, breakout panel sessions that dive into specific areas of interest, and an exhibit hall. The common thread of discussion throughout these activities is how health data is, can, or will eventually be used to improve health outcomes. Over the next two days, we’ll be giving you a snapshot of the presentations and topics being covered at this year’s event with a few specific highlights as we find out what’s on the horizon for health data technology.
A series of morning plenary sessions were kicked off by this year’s Chairs Niall Brennan, Former Director and Chief Data Officer at Centers for Medicare and Medicaid Services (CMS), and Amy Compton-Phillips, Executive Vice President and Chief Clinical Officer (COO) at Providence St. Joseph Health.
Starting off on a strong note, Academy Health’s President and CEO Lisa Simpson introduced the highest ranking government official at this year’s event, Dr. Tom Price, Secretary of the US Department of Health and Human Services (HHS). The Secretary’s charge to attendees prefaced what looks to be a common theme at this year’s event, “we need true interoperability – the free flow of data is critical to making the impact of health information technology as big as possible.”
Following Secretary Price, the main stage had its first panel of the day on the topic of “What’s Next in Healthcare Delivery Systems” moderated by Susan Dentzer, President and CEO of The Network for Excellence in Health Innovation (NEHI).
Panelists included Sachin Jain, CEO of CareMore, Josh Rosenthal, Co-Founder and CSO of RowdMap, and Jaewon Ryu, EVP and CMO of Geisinger Health System. Josh spoke about how healthcare data can be used to differentiate between low and high value care. His company, RowdMap, analyzes providers and practices against no-value care and population health benchmarks to identify physician and practice performance. By prioritizing high performance physicians at the center of healthcare networks, health plans, physician groups, and hospitals can avoid costs spent on care that does not result in better outcomes. Jaewon, representing a health system known for piloting healthcare innovation, spoke about the intersection of healthcare delivery and genomics, a focus area at one of the morning’s breakout sessions.
A few comments from Texas Congressman Michael Burgess, a proponent of putting more mobile health apps into the hands of patients, led into the second morning panel on How Social Media Will Democratize Healthcare. This panel was moderated by Mandi Bishop, Chief Evangelist and Co-Founder at Aloha Health, and featured panelists Amy Edgar, Founder of the Children’s Integrated Center for Success, Casey Quinlan of Cure Forward, Dr. Justin Smith from Cook Children’s Health Care System, and Audun Utengen, Co-founder of Symplur. The panel collectively recognized how healthcare is sometimes blind to the growing knowledge and awareness patients accrue from frequent social interactions between individuals, especially between those dealing with similar medical conditions. Audun goes so far as to claim that social media data metrics are almost as important as hard clinical data. His point seems particularly poignant for patients with mental health given existing research into how a patient’s GPS location and mobile phone usage can be used in the assessment of anxiety and depression.
The final two main stage speakers of the morning were Elizabeth Cohen, Senior Medical Correspondent with CNN’s Health, Wellness and Medical Unit, speaking about The Empowered Patient, and Roger Severino, Director of the Office for Civil Rights (OCR) within HHS, speaking about HIPAA as a trust foundation for health data exchange. Elizabeth spoke about the need for transparency between patients and clinicians while acknowledging that the data patients receive should be tailored to what the patient needs to know. Overloading the patient with data can lead to analysis paralysis and confusion, which benefits neither the clinician nor the patient in the long run.
Following the morning sessions, attendees broke out into the first of many small group sessions focused around topics such as genomic data and data-driven hospital performance. A few months ago we covered how Dropbox is supporting data management sharing at CEGIR. Exploring this topic a bit further with some specific examples of the outcomes that can be realized when data is collated from multiple silos, was a breakout session titled “Innovations in Data Sharing” moderated by Abdul Shaikh from PricewaterhouseCoopers (PwC). Each panelist gave a short presentation on their work before taking questions from the moderator and audience.
Starting things off in the government sector was Patricia Lloyd from the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC-NCHS) to share her organization’s experience bringing together health and housing data from different agencies to assess the impact of housing assistance programs on improving adult health. Next was Steven Cohen from RTI International. Steven gave an overview of ProjectDataSphere.org, a repository of comparator and experimental arm data from Phase 3 cancer trials, including over 42,000 patient lives worth of data.
John Cuddleback of the American Medical Group Association (AMGA) followed to share the outcomes of his organization’s work assessing hypertension prevalence and diagnosis in partnership with Optum and Million Hearts. Using National Health and Nutrition Examination Survey (NHANES) data, the process used by AMGA began with developing a hypertension prevalence estimator based on factors such as age, sex, race, ethnicity, and other diagnosed chronic conditions. When comparing actual claim data from multiple healthcare organizations against the estimate, the number of claims was consistently smaller than the predicted number of incidences, indicating that clinicians may not be diagnosing hypertension as frequently as they should be. When looking at actual blood pressure values and specifically searching for those with Stage 2 hypertension, the number of patients whose vitals indicated they had hypertension was significantly closer to the upper limit of the predicted number of incidences. In addition to indicating that patients were not being diagnosed with hypertension despite recorded vitals indicating they should have been, this analysis also revealed a secondary concern in that 12% of patients had records of a visit without a blood pressure reading documented. With these insights in hand, the organization’s next steps involve reaching out to those healthcare organizations with a frequency of hypertension diagnoses below the estimated predictions, to begin identifying ways to improve accuracy.
Adding the voice of a young business to the conversation was David Vivero, CEO of Amino. Amino’s goal is to create transparency between patients, providers, employers, and health insurance plans through data sharing. Healthcare is often profiled using public data but if you want to talk about cost, David claims, you need private insurer data. And if you want to talk about quality, you have to combine the two. But getting that data is not easy, so Amino became the first company to become a Qualified Entity through CMS, resulting in access to national, physician-level Medicare claims data. Now Amino boasts a data platform with 9 million claims, including 100% of Medicare claims and 1.8 billion annual private insurance claims, which are updated on a daily basis. Patients can use the platform to search for the care they need and compare costs and quality across Amino’s comprehensive dataset.
Rounding out the panel was Philip Payne from the Washington University in St. Louis School of Medicine. Philip and his team in the Institute for Informatics created the CIELO project to address the need for exchange of findings and evidence between research stakeholders in a way that is consumable and actionable. The result is a data commons platform that can reduce the time and cost of research, while improving the reproducibility of data analysis.
Back on the main stage, the afternoon kicked off with the announcement of the Healthy Behavio(u)r Challenge by Dr. Siddika Mithani, President of Public Health Agency of Canada, and Donald Wright, Acting Assistant Secretary for Health, U.S. Department of Health and Human Services (HHS).
The competition is a collaboration between both Canadian and American government healthcare agencies to solve the question of how new sources of health data, such as mobile apps, wearables, and social media, can integrate into and improve public health surveillance.
Submissions to the competition should focus on one or more of four specific health indicators: physical activity, sleep, sedentary behavior, and nutrition. The competition will be run in parallel in both countries with Part 1 of the competition, a call for proposals, beginning now that runs through August 2017. Those who advance to Phase 2 (October 2017) will be invited to test and evaluate their prototype solutions. Winning applicants (March 2018) will have the opportunity to be integrated into existing public programs in both Canada and the US.
Following the exciting announcement, Charles Ornstein, Senior Reporter at ProPublica led a panel session on “Patients as Co-Pilots” to discuss the role of patients in their own healthcare. A common motif at healthcare conferences is the inclusion of the patient perspective to bring reality, empathy, and humanity to the discussion. This panel brought that patient point of view to the conversation in force with panelists Hugo Campos from ePatient Advisor and Stanford Medicine X, Dana Lewis, founder of OpenAPS and impressive creator of the Do-It-Yourself Pancreas System, and Brian Loew, CEO of Inspire. Hugo best captured the patient perspective quipping, “Who wants to engage with a portal?” before going on to say how patients really just want to engage with life, loved ones, and friends. Hugo believes healthcare needs to recognize this and meet patients where they are. Brian and Dana expanded that meeting patients involves understanding their needs and the things they are already doing on their own today. Brian conveyed the importance of not providing all patients with the same level of education and follow up materials but curating it to the right level. Some patients will do better with simpler, less complex guidelines while others want and need more detailed information, which clinicians should be prepared to provide, otherwise the patients will look for it themselves and might get it wrong. Dana emphasized the point that since patients do inherently use tools like Google to seek out information on their own, it’s important to help those inquisitive patients to know how to vet their sources to try and avoid misinformation that could adversely affect their health.
Next, former HHS CTO and White House Technology Advisor Todd Park introduced CareSet Systems CEO Fred Trotter to bestow this year’s Health Data Liberator Award. The award, in the vein of Secretary Price’s earlier comments, recognizes those individuals or organizations making health data broadly available for the development of technology and services to improve patient health and healthcare. This year’s winners were Dr. Tom Delbanco and Jan Walker, Co-Founders of the OpenNotes project, a platform using which patients can access the medical notes written by their medical providers. Tom and Jan spoke about their passionate advocacy of transparency in healthcare as a means of educating and empowering patients in spite of the challenges and push back they’ve received while trying to change the age-old clinician-patient paradigm.
Matt Butner from Stride Health introduced a short innovation showcase including Adam Moody of RowdMap, Abdul Shaikh of PwC, and Willian Moore of HealthCost.com. While we heard from RowdMap a little earlier, HealthCost, is a platform officially launching this week at Health Datapalooza. It is built on the premise that price transparency exists for most things a consumer purchases, so why isn’t that always true for healthcare? On the HealthCost website, providers can set their costs for various procedures, which they are free to change at any time, while patients can shop for care based on cost, location, quality, and other factors.
The last panel of the afternoon, “Consumer Marketplace,” explored the question of why consumer engagement with many of the existing consumer-facing healthcare technologies, such as those discussed in the previous session, has remained lower than expected. Moderated by Melinda Beck from The Wall Street Journal, the panel included CEO Marcia Tal of Tal Solutions, Amy Tenderich of DiabetesMine, and CEO Owen Tripp of Grand Rounds. One theme that stood out in the discussion was patient frustration with both the bevy of data available today and a lack of clarity and experience in knowing how to use it effectively. When it comes to what consumers really need, Owen highlighted the expectation and challenge of matching consumers with solutions to their needs in real-time, at the moment they need support.
Before switching back to breakout sessions, two final speakers took the stage: Philip Bredesen, Former Governor of Tennessee and Founder and Former CEO of HealthAmerica, and Dr. Tawfiq Alrabiah, Minister of Health for Saudi Arabia. Philip commented that no one does things that will intentionally reduce their income, which is a reasonable analogy to what happens in a fee-for-service world when clinicians are asked to innovate and do things that reduce the need for clinical care.
His point characterizes the need for the ongoing shift to value-based care and using quality, not quantity, to drive reimbursement.
Quality is also a priority in Saudi Arabia, as Tawfiq shared, where results from all branches of healthcare are published in order to use transparency to drive better outcomes. An interesting healthcare innovation currently in use in Saudi Arabia leverages Uber in order to deliver vaccines directly to patients’ homes.
The last plenary session of the day closed with a demonstration of an individualized clinical decision making support tool from the Clalit Research Institute in Tel Aviv, Israel by Institute Director Ran Balicer. The technology was the winner of the New England Journal of Medicine SPRINT Challenge announced earlier this month. The technology is initially being used for intensive hypertension treatment and takes the individual’s specific characteristics into account in their plan of care instead of defaulting to population-based care standards.
Two rounds of breakout sessions closed the first day of Health Datapalooza. Breakout topics included the use of health data to innovate in public health surveillance, following up on the Health Behavio(u)r Challenge announced earlier in the day, innovations in consumer engagement, and national implementations of patient-facing mHealth applications.
One session, filled with individuals from the IBM Watson Health team including Irene Dankwa-Mullan, Jane Snowden, Amar Das, and Jose Morey, dove into the role of cognitive and AI technologies in the digital health transformation. Jane began the panelist presentations with an overview of the components of a cognitive system: big data and analytics, artificial intelligence, cognitive experience, cognitive knowledge, and computing infrastructure. A few use cases where Watson Health is being used today include oncology for evidence-based treatment decisions, genomics for harnessing of DNA insights, and clinical trial matching to accelerate clinical trial fulfillment. All three of these programs work in tandem as part of the Watson Health Cancer Care Catalyst. In initial use cases, Watson suggested a clinical pathway that was not even suggested by a clinician 30% of the time, revealing significant opportunities to get patients into treatment programs they may otherwise not be offered.
Amar took us through the use of Watson for Patient Record Analytics, which involves three steps: natural language processing (NLP) to understand the record, synthesis to organize the information in the record in a meaningful way, and cognitive insight to compare the patient record with broad medical knowledge to generate deeper insights. The output is the ability to ask questions that can directly affect a patient’s treatment plan such as “What is my patient’s risk of developing condition X?” and “What happened to patients similar to my patient?”
Thinking of the future, Jose completed the panelist presentations with how cognitive insight can play a role in moving humans and technology beyond Earth. As part of his work with the NASA iTech initiative and the Obama administration charge to reach Mars by 2030, Jose and his team are faced with the challenges of both how to prepare humanity to reach Mars and how to ensure they stay healthy once they get there. For the former, Watson’s cognitive intelligence is being used to identify genomic sequences that convey resilience to environmental factors like ionizing radiation. If those areas of the genome can be stimulated to enhance the benefits, perhaps the biological challenges of traveling to the Martian surface can be mitigated. Once on Mars, however, there is a 90 minute lag in communication with Earth, meaning that a clinician on Mars would have a significant delay when feedback from a sub-specialist is needed. Here again, cognitive intelligence can play a role in real-time decision making that addresses the need for expedient responses to medical issues and alleviates the effort of needing a large clinical team to always be on hand.
Another breakout session moderated by Former HHS CTO Brian Sivak brought together six healthcare startups for a Healthcare Startup Entrepreneur Expo and discussion. The six companies represented included:
- Health Cost Matters (Lois Hall, Founder) informs and educates consumers about healthcare in order to lower out-of-pocket costs to the individual or household.
- WebShield (Jonathan Hare, CEO) enables the frictionless pooling and analysis of regulated & proprietary data from disparate organizations and people, including those that don’t agree on policies or trust each other.
- 180 Health Partners (Justin Lanning, CEO) provides programatic support to pregnant mothers dealing with prenatal substance use in order to realize a successful, healthy birth and avoid neonatal abstinence syndrome (NAS).
- HealthCost.com (William Moore, CEO) is an open marketplace for setting, comparing and, in the future, locking-in healthcare costs.
- InputHealth (Dr. Damson Ramsey, CEO) is a patient engagement platform to streamline workflows and place the focus of care on patients and their outcomes.
- Valera Health (Dr. Thomas Tsang, CEO) creates personalized solutions for cost-effective behavioral health management to benefit patients, payers, providers, employers and caregivers.
And with that, Day 1 of Health Datapalooza comes to a close. We’ve covered a lot of ground in just one day and are sure to expect no less tomorrow. In addition to the main stage and breakout events, Medgadget had a chance to speak with some of the companies and innovations in the exhibit hall, so stay tuned for more coverage and technology profiles from Health Datapalooza 2017!
Link: 8th Annual Health Datapalooza info page…