For several years, the US has grappled with the rising costs of healthcare, while seeing our global rankings, in outcomes like life expectancy and maternal deaths, fall to among the lowest of developed countries. Americans are paying more for healthcare without reaping the benefits. Routinely, newspapers and TV channels report on the newest cancer treatments or technological advances, but there is little discussion about the value of these new drugs or devices or the wide variation in their adoption across providers. For all the data collected on patients and in the industry, little in American healthcare is standardized or optimized, and the value of existing treatments is rarely investigated. And unlike most of our European counterparts, a significant number of Americans are without health insurance, often left on their own to shop for the best quality healthcare at a reasonable cost, but unable to do it. When pricing information can be obtained, there is typically no explanation for the variation seen from doctor to doctor, hospital to hospital.
It’s a lesson in contradictions: the country that arguably has the most advanced technologies in the world, doesn’t use them consistently to fix some of the most basic problems in healthcare. Patients with cancer are generally treated according to where their cancer originates, with little differentiation between patients for treatment, while a few hospitals tout state-of-the-art care based on genetics. Often, it’s only when a drug or device fails to work, that patients start to have their care tailored to their specific disease—a process that delays optimal treatment at a substantial cost system-wide.
For all the data collected on patients and in the industry, little in American healthcare is standardized or optimized, and the value of existing treatments is rarely investigated.
Meanwhile, medical centers spend hundreds of millions of dollars to buy electronic health records (EHRs) systems, but patients still can’t easily get copies of their records or share the information between providers. Important information that could impact patient care, such as how active someone is, their environmental exposures to pollutants or carcinogens, even how much food they are eating, is rarely included in their health record—a consequence of a system designed to handle claims and billing, not patient management.
Furthermore, hospitals are penalized for having higher-than-expected readmissions after certain procedures or for some conditions, yet identifying patients that are at risk of readmissions—before it happens—is still in its infancy because most hospitals don’t yet have systems in place to collect or analyze the necessary data. There are doctors who continue to perform unnecessary surgeries, order duplicate tests, and just don’t want to optimize care. And hospitals make the news when they report savings of tens of millions of dollars when they simply started to look for ways to streamline processes and standardize equipment—leaving us to wonder why they had to wait to make these changes until they started to see reduced revenues?
But what if doctors, hospitals, health systems, and even patients, had information easily accessible that allowed them to compare services based on price, quality, and patient outcomes? What if EHRs weren’t largely designed and functioning as billing systems, but could share all of the data relevant to patient care, from lab results and pathology reports, physician notes and medication information, to patient-derived information like supplement and vitamin use and physical activity data—a comprehensive health and wellness record? What if those records could be shared, not only between doctors in the same system, but between systems worldwide, regardless of the brand of EHR, similar to how the banking industry shares account information, so that consumers can visit an ATM in another country and still obtain money? What if oncologists (and their patients) all had access to the latest data on cancer treatments and genomic testing, whether the patient is at world-renowned cancer center or a rural community hospital? What if the healthcare industry took the lessons learned from the banking, manufacturing, and technology industries and used them to rethink how we deliver, pay for, and manage patient care?
What if doctors, hospitals, health systems, and even patients, had information easily accessible that allowed them to compare services based on price, quality, and patient outcomes?
This is the age of MoneyBall Medicine. When Big Data, new technologies, and advanced analytics techniques like AI and cognitive computing, are leveraged to help make it easier for patients to choose doctors and hospitals based on quality, cost, and how healthy they keep patients. A time when hospitals and health centers don’t just collect data on their patients and their staff, but use that data to rethink how they structure departments, employees, and delivery of care. When pharmaceutical companies shrink the time it takes to develop new drugs by using computers to model how a drug will work—before investing in costly clinical trials. When genetic testing can help patients avoid adverse side effects of drugs or even determine which medications are not likely to work in the first place. MoneyBall Medicine is already happening—is your organization a part of it?
By Harry Glorikian, M.B.A.
General Partner, New Ventures Funds
Harry is currently a General Partner at New Ventures Funds (NV). Before joining NV Funds, he served as an Entrepreneur In Residence to GE Ventures –New Business Creation Group. He currently serves on the board of GeneNews Ltd. He also serves on the advisory board of Evidation Health (a digital health startup launched with support from GE Ventures), and several other companies. He is also a co-founder and an advisory board member of DrawBridge Health (a revolutionary diagnostics startup launched with support from GE Ventures). Harry holds an MBA from Boston University and a bachelor’s degree from San Francisco State University. Harry has addressed the NIH, Molecular Medicine Tri-Conference, World Theranostics Congress and other audiences, worldwide. Harry is the author of two related books: Commercializing Novel IVD’s; A Comprehensive Manual for Success and MoneyBall Medicine: Thriving in the New Data-Driven Healthcare Market. He has authored numerous articles, appeared on CBS Evening News and been quoted regularly by Dow Jones, The Boston Globe, Los Angeles Times, London Independent, Medical Device Daily, Science Magazine, Genetic Engineering News and many others.