The Future of Healthcare

I had the privilege of attending Fortune Brainstorm Health last week, an innovation conference working to bring together the best minds in Healthcare, Technology and Business to make a difference in healthcare.  The theme of this years conference was “Accelerating the Health Revolution.”  The topics were broad and thought provoking.  I found myself at the event wondering how I could do more on a day to day business to help.  Since the conference the question has only gotten louder in my mind.   In reflection, I think that the starting point is to write down my top observations after review of my notes.  Maybe this exercise will lead my somewhere…

  • There are amazing people who work in healthcare:  scientists, physicians, innovators and investors.  I met people brave enough to tackle life or death situations with a gusto every day that most of us don’t muster at our best moments.  People with an insatiable quest for learning.  These people provide me a great deal of hope for the future despite the rhetoric of politics.  
  • This conference reinforced my belief that healthcare is a fundamental human right.  You can often get lost in the public debate over healthcare finance, which is what most of the political conversations center around.  The media doesn’t help, covering the politics of healthcare, and grabbing on to often non-core issues.  This conference allowed me time to simplify it for myself.  All people deserve access to care.  In order to afford this as a country, investment must shift from treatment to prevention.  This will ultimately bend the cost curve.  That said, the reason to have health care for all isn’t economic, it is ethical.  
  • Despite what I said above, costs are a major problem.  As a nation, we over invest in late stage healthcare and under invest in prevention.  Dr. Sandro Galea, physician and currently Professor and Dean, School of Public Health at Boston University, made a compelling case for the investment in creating health versus treatment illness as our priority.  When ranked versus 17 peer countries, the US mortality rates are ranked #15 – 17 for all age groups under age 60 and we quickly rise to the lowest mortality rates in the world for over age 80.  We invest a large portion of our healthcare dollars into this treatment and it is what is incentivized by our healthcare payment system.  The alarming thing is that it doesn’t increase longevity.  
  • Healthcare is about so much more than clinical care.  We were joined at the conference by Mark Bertolini, CEO of Aetna.  He shared that  “Only 10% of life expectancy is driven by clinical care – 30% by genetic code, 20% by the social determinants of health, and 40% by lifestyle choices.”  Dr. Galea, who I mentioned above, spoke of this as well.  In follow up to his talk, I read a great piece he wrote last fall.  Within this article, you can also find the chart to support the mortality rate information I shared above.  Improving the health of our nation is as much about investments in our social infrastructure (e.g. education, clean water, public transportation, a living wage) as it is investment in medical advancements.  I feel incredibly lucky for the good fortune that my family has had.  
  • One of the best comments from the audience at the event was about hospitals and their role at the center of healthcare improvement. The quote was something like…”Isn’t it ironic that our healthcare system is hospital-centric? Particularly given that a trip to the hospital is the failure of care.” Prevention, prevention, prevention. Our role must be to influence behavior so that people do not reach the point of needing the hospital.  
  • Corporations have a critical role in improving healthcare.  It is the right thing to do to focus on employee health and wellness.  If moral responsibility doesn’t convince you, employees that are well – getting enough sleep, eating well, exercising regularly – are more productive. The power of top-down leadership to drive a culture of wellbeing for our employees will be the pressure our healthcare system needs to evolve. On a side note, I crossed paths again with a former leader of mine, Chip Bergh, who is now the CEO of Levi Strauss. I remember his dedication to well being 20 years ago, and it was amazing to see his continued commitment to wellness as a driver of employee engagement and productivity. 
  • Fertility issues are a health crisis. The awareness of the breadth of fertility issues is low, and there is still a stigma to discussing these challenges.  A world-renowned fertility physician, Dr. John Zhang spoke about a controversial procedure (the three-parent baby) that he led last year.  It was a fascinating discussion, which prompted me to talk with him on a break.  We had a great conversation about this awareness issue.  His point…there is a Breast Cancer Awareness month, an MS walk, a Lymphoma/Leukemia organization all of which are doing great work to raise awareness of their disease, and funds to help reach a cure.  Yet, fertility issues are still taboo, unfunded, and impact over 6 million women in the US alone.  Fertility issues are reported to be as stressful as dealing with cancer for a family. Solutions are expensive, and the path to the solution is complex. Long-term this is decreasing wellbeing, and increasing costs within our healthcare system.  
  • Our company (CHG Healthcare) has a critical role in helping physicians to perform at their best.  With all of the challenges in healthcare, physicians are working harder, showing signs of stress and burnout and more focused on administrative tasks than ever (less time on patient care).  I sat next to a surgeon who said that given all of the electronic charting that she has to do, she sees about 40% less patients per day now than she used to.  Helping physicians to be successful and delivering to their maximum contributions well help save lives. 
  • Technology and data will be a propelling force for change.  Amazing people are investing in amazing things.  We got two live demonstrations that were particularly impressive.  The first, a matchstick size device that slides under the skin currently in development from Intarcia.  This device, combined with chemical innovation that allows medicine to stay good at 104 degrees for up to three years, enables medicine to be dispensed into the body automatically for up to a year post implementation.  Imagine chronic disease treatment improvements via increased drug compliance if this could be installed once a year in a less than a one minute procedure.  The second was a partnership between Tricog Health and GE Healthcare to provide EKG support to rural Indian clinics via a connection to the cloud for immediate diagnosis.  Both of these were amazing innovations, but just the tip of the iceberg in terms of what could be.  
  • Genomics.  All I can say is wow.  This field is moving through years of progress in weeks and months.  To envision its role in the future is for people smarter than me.  Refer to the first point above. 
  • Finally, there are people in this world who are way braver than me. Two physicians, Dr. Nahid Bhadelia and Dr. Raj Panjabi discussed the Ebola breakout in 2014. They were both on the front lines of the disease in Africa.  Dr. Bhadelia spoke of the impact of global security decisions on their work on the ground. As a country, we were began acting with an “abundance of caution” and airlines stopping flying into this part of the world.  Although well intentioned, this created immediate supply issues for healthcare workers on the ground. At one point, she and her team were out of personal protective equipment and had to make the decision to either use tarps to cover themselves and go back to work, or to let more people die.  They went in with tarps.  The bravery that this requires is something that I cannot fathom. I leave this week with an even further appreciation of the difference healthcare providers make for patients every day.  

An amazing, thought-provoking event to say the least.  What do I do with it?  I don’t know.  What I do know is that we all have a role in the Future of Healthcare.  Whether as a consumer of care, the owner of our own personal health or as an activist for a cause, we are all leaders in this challenge.  That said, senior corporate executives have a unique role given their influence.  I will paraphrase (and adjust) a quote from Mark Bertolini:

“The role of a CEO (substitute any senior executive leader in my point of view) is the power to convene, and the power to set the agenda.”   – Mark Bertolini, Aetna

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