INDIAN WELLS — “Disruptive technology” and system integration dominated discussions led by former President Clinton at the Fourth Annual Health Matters Activation Summit last week in Riverside County.
Clinton led two panel discussions with leading health experts and Silicon Valley technologists at the conference, which focused on highlighting innovations and strategies for improving the nation’s health care system.
The conversations moderated by Clinton veered away from what Congress can do to improve the health system and instead focused on what companies, health insurers and philanthropic organizations can do to facilitate, as Clinton put it, “health care transformation and systematic innovation.”
Clinton and others at the conference contend that changing the way the health system handles information can help reduce the country’s health care spending and improve access for patients. Panelists discussed innovations that have replaced traditional or established technologies and processes within the health system. Such advances are commonly referred to as “disruptive technology” and have been known to improve efficiency and reduce costs.
With the rollout of the Affordable Care Act, national spending on health care as a percentage of gross domestic product has declined from 17.8% to 17.2%, a spending reduction of about $900 million per year, Clinton said. Still, the United States lags well behind Europe in reducing health spending, according to World Bank statistics.
“It’s clear that closing the rest of the gap … is going to require really creative partnerships in every community in the country,” Clinton said.
In conversation with Clinton, panelists speaking on disruptive technology stressed the importance of transparency and data sharing to ensure better access to care.
“Access to health information is a basic human right,” said Elizabeth Holmes, a young Silicon Valley entrepreneur who founded Theranos, a blood analytics and diagnostics company. Clinton, who applauded her work to provide low-cost testing to the general public, said the company is valued at $9 billion.
However, early interventions, such as those offered by Theranos, generally are not covered by insurance. Holmes said about 80 million Americans are pre-diabetic, but 90% don’t know it and would just need a simple glucose test to find out.
Josh Kushner — co-founder of Oscar, a health insurance startup that markets itself directly to consumers — stressed that access to information is critical for reducing costs, and central to his business model.
“If you think about health insurance, in reality, it’s one of the most important relationships that we have from a human perspective and a cost perspective,” Kushner said. “What we say often is that health insurance companies have done everything they can to acquire customers, but shortly thereafter avoid them.”
He said health care companies will need to transform into technology companies in the next decade or become obsolete.
“Amazon and Google know almost immediately when a woman is pregnant based on what she’s searching for, but a health insurance company doesn’t know until three months later when its claim is paid,” he said.
Connectivity, Integration Examined in Panel Discussions
Other panel discussions centered on integrating disparate areas of the health system.
One session addressed the challenges in linking behavioral health services with primary care. That discussion turned to who will pick up the cost for increased behavioral health services. William Emmet, executive director of the Kennedy Forum, said employers’ incentive to pay for preventive services is to avoid lost productivity and absenteeism when workers have mental health conditions.
He told California Healthline that the challenge of linking primary care and behavioral health hinges on undoing centuries of segregation.
“The [ACA] pushes further along the lines of a system that is integrated because it incentivizes providers to look at the whole person,” he said. “It really is going to take time for primary care providers to realize if they don’t treat behavioral health conditions, they’re not going to be getting the outcomes they need.”
Another panel took up the issue of connectivity and how to effectively interact with patient populations to improve services and health outcomes.
Vineet Singal, a young tech entrepreneur, said texting is “the equalizing force between the haves and have-nots of society.” He is CEO of CareMessage, a not-for-profit organization that uses mobile technologies to improve health literacy and self-health management.
To connect patients with caregivers, he said his organization built a platform that relies on texting for chronic disease management used by 100 clinics, hospitals and health plans. To get providers to adopt the technology he had to prove that low-income patients would use text messaging. Contrary to provider assumptions, 95% of their members have a cell phone, and 85% have unlimited text messaging, he said.
“They just did not understand how advanced their patient population was,” he said.
Health Care Economics
During the conference’s last panel, Clinton returned to the topic of data sharing as a means to reduce health care spending and improve preventive care.
Bruce Broussard, Humana president and CEO, stressed the link between patient engagement and data sharing.
“When people know their numbers, they make more effective decisions,” he said.
Meredith Rosenthal, a Harvard University health economics and policy professor, said changing national agricultural policies that affect food content and access to healthy food would have the biggest impact on improving the nation’s health system.
Clinton used diabetes, a preventable illness, as an example of the relationship between unhealthy eating and chronic disease. He said diabetes is consuming 25% of the Medicaid budget.
“It’s staggering,” he said. “It’s like trying to turn the Titanic around before it hits the iceberg.”
Clinton asked the panelists if any stakeholders would be willing to engage in a dialogue between the food industry and health care industry to improve wellness. Broussard pledged to participate.
New Initiatives Launched
During the conference, the Clinton Foundation announced a partnership with Kaléo, a pharmaceutical company that manufactures a naloxone auto-injector for reversing heroin and prescription opioid overdoses. The device can be administered without medical training and is expected to now be more affordable for many municipalities. The company has pledged to offer the devices at a reduced rate to colleges and universities, police departments and other community organizations.
As part of its Health Matters initiative, the Clinton Foundation chose the Coachella Valley in Southern California in December 2012 and central Arkansas in May 2013 as regions to launch pilot projects to improve community health outcomes. The foundation has since expanded its projects to Adams County, Mississippi, northern Florida and Houston.
Each region has developed a strategic plan to improve specific health outcomes in five years. According to the Coachella Valley’s plan, those goals — such as more access to healthy foods and lower health care costs — will be reached by 2018. Clinton seemed optimistic that the pilot projects have been effective locally.
“This is where we started this effort,” he said. “And we can already see improvement in a lot of health indicators.”