Healthcare held its own version of March Madness earlier this month with three major conferences showcasing innovators and innovations attempting to transform the industry. There was the inaugural ViVE event, a joint venture between HLTH and the College of Healthcare Management Executives, which we attended in Miami Beach. A week later, SXSW kicked off its health and medtech track in Austin, while HIMSS opened its weeklong event in Orlando, both of which we monitored from afar.
Although the conferences played to slightly different crowds, some common themes emerged. Gone were presentations about the pain of deploying computerized provider order entry or decision support. Instead, the spotlight was on a broader set of opportunities and challenges: sustaining the growth of virtual care, avoiding fragmentation as more digital startups flood the market, easing clinician burnout, propping up the public health infrastructure, ensuring investors get a return on investment, and more. Below we explore three trends that emerged at ViVE, SXSW, and HIMSS.
1. The new front door
We’ve all seen data about the rapid uptick in virtual care during the COVID-19 pandemic. In 2020, HHS data showed telehealth visits for Medicare beneficiaries increased 63-fold. Nearly 85% of physicians said they connected with a patient virtually during the pandemic, according to the American Medical Association. And in our Consumer Health Survey, 85% of patients said the pandemic was the first time they used any kind of virtual care — video, telephone, chat or text. But for many health IT leaders, the future is not about creating a digital-only front door, it’s about adopting an omnichannel approach and figuring out which front door is best for the patient.
“There is no single front door,” Eren Bali, CEO and Co-founder of Carbon Health, said on a panel at ViVE. Carbon is one of a growing number of hybrid startups entering the industry, offering a combination of in-person and virtual services. “When you go to a provider, and then you need to do other things, for example, you might start with a telemedicine visit, but then you need a urine test or a lab test. And then you need to go to another location. There's a broken handoff there because you just throw the ball back to the patient to figure it out.”
That sentiment was echoed by Marijka Grey, MD, System Vice President of Ambulatory Transformation and Innovation at CommonSpirit, who pointed out that patients “hate” those broken handoffs, but often love their doctor. Grey acknowledged that large incumbent health systems like CommonSpirit need to respond in-kind to evolving consumer preferences. People get upset if an Amazon delivery doesn’t come within 48 hours, those same expectations are seeping into healthcare, she noted.
The point is, patients want on-demand care, whether it is virtual, in-person at a clinic or their home. Virtual care is a tool that enables innovations like hospital at home to be scaled, Monique Reese, Senior Vice President, Home and Community Care, Highmark Health, said at ViVE. But healthcare organizations need to think strategically about when and how patients use those various touchpoints — when is it OK to do a virtual visit versus a telephone call versus in-person? Understanding those considerations will shape a strategy for creating multiple front doors for patients.
2. Making health equity a priority
The proliferation of artificial and machine learning has sparked concern that the algorithms used to power those tools may perpetuate inequity and racial biases. “Garbage in, garbage out,” Mona Flores, MD, Global Head of Medical AI, NVIDIA, said during a ViVE panel.
Most datasets used to inform AI and machine learning lack information on racial minorities; there are also gaps in data based on socioeconomic status, among other things. It’s important to expand the data that underpins AI and machine learning, something a growing number of researchers are discussing. Doing so requires connecting with underrepresented populations. For instance, researchers need to take a comprehensive look at why there are significant divides in populations that participate in clinical trials, Dana Rollison, Vice President, Chief Data Officer and Associate Center Director of Data Science, Moffitt Cancer Center, said at ViVE. Are there socioeconomic factors that prevent people from participating, are the protocols too rigid, are people with comorbidities being kicked out?
Concern over bias in AI algorithms has caught the attention of policymakers. The Federal Trade Commission last year warned developers not to deploy AI that could lead to discrimination. And during remarks at HIMSS, HHS Secretary Xavier Becerra said he’s directed the Office of the National Coordinator for Health Information Technology to “take a deep look at algorithmic bias,” noting, “We’re putting health equity at the center of every decision we make.”
Investors also need to be thorough as they assess companies that profess to have a business model for addressing health equity. During a talk at SXSW, Myechia Minter-Jordan, MD, President and CEO of the CareQuest Institute for Oral Health, cautioned that investors could end up backing a solution in search of a problem if they aren’t careful, Fierce Healthcare reported.
3. Cleaning up the EHR and data sharing
“We have a moral imperative to get this right,” David Feinberg, MD, said during a general session at ViVE. He was talking about the need for health IT vendors to vastly improve their products and the user experience. Feinberg, who became CEO of Cerner last October following a stint at Google Health and before that was president and CEO of Geisinger, acknowledged that electronic health records have contributed to clinician burnout. They weren’t designed for the end user, he said.
His point on the user experience extends beyond EHRs, especially with so many applications being layered on top of the EHR. Data must be presented to clinicians in a way that doesn’t slow them down, Martin Stumpe, Chief of AI at Tempus, said during a ViVE panel. Tempus uses AI to help promote precision medicine. Stumpe pointed to an analysis the company did assessing how physicians were utilizing data when working with breast cancer patients. While they trusted the data, he said, they did not like the interface and using it slowed them down, he said. Tweaks were made and physician adoption picked up.
Fixing the usability problem also requires pulling in and providing new data points that are relevant to clinicians. Social determinants of health, for instance, need to become integral parts of the patient record, Feinberg said. Improving the kind of data physicians receive is a major goal of the deal Meditech and Google Health announced at HIMSS. The two are partnering to bring Google’s search power to Meditech’s platform.