Digital Disruption Part 5, Frictionless Healthcare, Full panel discussion

Digital Disruption Part 5, Frictionless Healthcare, Full panel discussion

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Good, morning, and welcome to Scheller College of, Business at Georgia, Tech my. Name is Maryam. Alavi Dean, of the college, and I'm, delighted, that you, could join us this morning. Today's. Program, is, the fifth part, of fifth, session, in, the, digital, disruption series. The. Series explores. Digital. Trends and how technology. Can. Be leveraged, by successful. Firms to. Create, value, and, to. Basically. Train the workforce of the future. This. Morning's program is, a collaboration. Between Scheller. College. Accenture. And anthem, and focuses. On the topic, of, frictionless. Health care, so. As we. Most, of us know and believe I. Healthcare. Is one of those industries, that, is. Going to touch every, single one of us at a, point in time in our lives and, I. Think probably, one, of the things that we can really agree upon, is that. Healthcare. Is too, costly and. It's. Very hard to navigate, so. To sort, things out we, have a great program for you today of, course all. Of us know that cost. Is a key motivator. For making, changes, and looking at ways, to, enhance and change and streamline, healthcare. Industry, for, example, in, 2017. The. Estimates, for the cost for, health care in the u.s. was, three. Point five trillion. Dollars. That. Translates. To about eleven. Thousand, dollars for each person and. There. Are estimates, that if unchecked the. Cost is going to rise to six, trillion. Dollars, by. 2027. And that. Would be roughly about 20%, of the. GT, GDP. So. One. Of the resources, one, of the elements, that viewed. As a possible. Way of. Reducing. The cost while, hopefully. Enhancing. Access and. The. Quality, of healthcare or this. Whole arena of digital, technologies. And I'm really using, the terminology, very, broadly. So. All various. Types of hardware software. Techniques. Data that, could be brought to bear on. Enhancing. The healthcare. Healthcare. So. That. Said there. Are lots of challenges, that need, to be addressed in this particular. Industry to. Name a few some of the regulatory. And privacy, issues so. To help us sort, things out this morning, we, will start with a panel, of experts, that, are gonna, help us understand. They're going to define for us this concept of. Frictionless. Healthcare, and discuss. Various aspects. Of this particular, topic and. After. The panel discussion that I will be moderating, we. Have we are fortunate to have two keynote. Presentations. Babka. Fury of Accenture. Will. Discuss, digital. Disruptions. In healthcare and, his. Presentation. Is going to be followed, by another, presentation. By. Warez, Bukhari, from, Anthem his. Topic, will be the, near future of AI, artificial. Intelligence in. Healthcare, I will. Now take just, a few minutes to very, briefly introduce, our panelists. They. Are amazing. And esteemed. Panel. Members that you have seen their BIOS and you, are aware of many of their accomplishments. Either, online or in. The programs, that were given to you so. I will keep my introductions. Very brief because I know you're here to listen to our panelists. And to our, keynote speakers not here to listen to me, talking, about them so, in.

Alphabetical. Order the. First panelist, is avery, Ashby, Avery, is the manager, Director of Applied, intelligence. Southern, Market payer, and provider for. Accenture. Having. Worked in payer and provider, organizations. His entire career he. Is passionate about how analytics, may. Enable change in people's, health and improve. Their experience in, the broader healthcare, system. Next. We have Katie. Baker Katie's. The director. Of innovation digital. Care delivery. For Anthem, in. This role she is responsible, for leading academic. Partnerships. Establishing. A strategy. And framework, for intellectual, property sourcing. And serving. As a liaison. For. Digital, teams and universities. Next. We, have Elizabeth, Minard. She. Is one of our own Beth is a distinguished. Professor in, the College of Computing and the, executive, director, for, the Institute, for people, and technology. At Georgia Tech in, her. Research, dr.. Minard, investigates. The design, and evaluation, of health information, technologies. Including. Creating personalized. Mobile, technology. For breast, cancer patients and, evaluating. Mobile sensing, and M health, engagement. For, pediatric. Epilepsy patients. And their. Caregivers. So, panelists. Please join me on this stage and let's, give him a warm, Scheller, College welcome. Okay. Welcome, again and thank, you for being here this morning and. I. Will. Just ask a number of different questions and, as a protocol. For our interaction. If, I ask a question and let's say if I direct, it to Avery and somebody. Else has something interesting to add to that please, don't hesitate just. Jump in so don't necessarily. Wait for me to call on you okay, all. Right so in, healthcare industry, there are three. Primary. Stakeholders. Of. Course there are patients. And their caregivers. There. Are payers and, then. There are providers, three. Different major stakeholders. So. Let. Me start by asking each, of you to define, this concept of, frictionless. Healthcare. From. Various, three, stakeholders, perspective. So, Avery. I'm going to start with you and ask, you what does the term frictionless. Healthcare, mean. From. A patient's. Perspective. So. You. Know I think we've all experienced, friction. Try. To leverage healthcare, systems, in the past right so. I think it really has to do with removing, non-value. Add steps and tasks, in the process, of seeking. Receiving. Or delivering, care, so. An example you know just recently my. Son was was, ill on the weekend. Wanted, to find obviously. Some care for him urgent, care and where we live we have a health system that has. An urgent care search, capability. That, also allows you to go ahead and put your your, name you, know in. The queue and so I was able to find, the place that had the the wait time that matched my drive time so, I was able to optimize and, reduce or limit the amount of time that my, child had to wait for care so. This is this one example where, you know previously, you'd. Have to call around they'd have to answer the phone there would have to be estimates, on how long the weight would be is very inefficient. And, so you. That's that's just one example I think that hits home for me great. Example. Beth. Could. You define the concept, of friction. Frictionless. Health care from. Prospective of, payers. And. Health, care providers, all right so I'll start with thinking of this in terms of health care providers but payers are complicit. Or integrated, into this okay because right now what we have is. A system optimized, for previous. Model of care past. Century model of care and as. We, want to create a frictionless system we're looking, to identify barriers, as, we, have to, tackle. The cost that, you were speaking of and the domain major demands. On that system so. If we're removing, the barriers to care for. Me what that means is expanding, the traditional, model of the walls of the healthcare system just. As you said even having a network of Urgent Care being, able to extend out through technology. Into, people's homes into, people's daily lives and, looking. To how, people. Patients. But they're people the rest of the time how people manage their health and how do they engage the healthcare system in that way so. As we move to optimize, to this new system we're finding, barriers. In our siloed, traditional. Model and we, have to figure out how to reengineer. Around, those barriers that's. Great, Katie, your thoughts on that I. Can. Hear you fine. Okay. So, what. I said before was brilliant and I'm sorry you missed it. So. I was just saying that I'm, not sure that we can actually define frictionless, healthcare very, well yet I think, we have some ideas of what it could look like I was actually talking to a colleague of mine last night hello, Brent and, we were talking a little bit about Amazon, and thinking.

About How, can Amazon be replicated, in the healthcare model and how do you how. Do you how, do you know what you need or, have a system, that knows what you need before you know that you need it and can, bundle things together for you maybe, even perhaps create, a subscription. Model for you that, would allow you to, be able to better. Take care of yourself it would be more personalized, it would be preventative. And it would allow for more, human to human interaction which. Is really what we want between a provider. And a patient is that human to human interaction so. That we can really solve for, the, chronic or non, chronic conditions that they're experiencing, great. I'm really, hoping that you can get there as fast as possible. The next question, is I'm, going to ask the same questions, from. Three of you the next question. And. This has to do with the we, kind of started to talk about it a little bit the benefits, and challenges in. Healthcare, or, new, models, of healthcare, so. Every what are some of the potential, benefits, of frictionless. Healthcare, for, patients and patient, care you did talk a little bit about that in terms of optimization. And, time-saving, in your the example, you gave us in relation to your to. Your child. But how, can we generalize that if you were to come up with some general categories of benefits, to patients, what. Would some of those be I, think, you, know what we're seeing is with the availability, of new types of data whether it's genomic, or social determinants, and, then some of the advanced analytic. Techniques that, were able now to really, start, to think about what precision, medicine can look like and so from a friction perspective, as a patient if I have to try lots of different treatments. To really find the one that works for me now. By using you. Know more available, information we might be able to get there much faster so as an example the. Way that a person metabolized. Is medication, is different. Some people can metabolize it very quickly some people you, know it'll last in their system longer and. So you know we were building a model around trying. To predict. Readmissions, with people with COPD and found, that GERD or chronic. Acid reflux, is one of the main contributors to that, and so when you dive, in to understand, why that would show up as a signal, for it it's, because people that metabolize, the.

Over-the-counter. Anti-reflux. Medicines, quicker, may, have an exacerbation while, they're sleeping that, then interacts, with their COPD, and may cause them to go and seek medical treatment or emergency, medical treatment but there's a very simple surgery. That can be that can be done to those people that. Would benefit them too to alleviate that so I think it my point is is it's trying to move away from sort of you, know one or two size fits all to, really leverage new data to. Make sure that we can get more precise medicine, to the people that need it great, example, Beth what are your thoughts on that I want to continue this thread because I want to look at both notions, of healthcare being more personalized, and being, more holistic, so, from a personalized, perspective, continuing, on with this of understanding. That we've traditionally had, and even the notion of expertise, in healthcare has, started with a one-size-fits-all. Like, this is the standard treatment of care and then, we kind of debug, yet with. Each patient, very, ineffectively, and especially, when you're looking at issues such as chronic disease where, care. May be episodic. Or may be you come in once a month with respect, to, some. Forms, of treatment or maybe even just once a year for something like asthma, epilepsy, that, debugging. Cycle is horrendously, slow, so. What can we do with this so moving, to personalized, care models, allows. Us to use digital technology. Analytic. Technology, mobile and home technologies, so that the person is feeling that they are getting that the, recommendations. Solely. Directed, at them the. Holistic care model also means that instead of only focusing on traditional. Healthcare. Challenges. That. We also take into account every, aspect, of that person's, life and integrate, that so you know the Amazon, example, is not, the, person being required, to go, to the particular store. Bricks, and mortar store and and, having, to engage only. With what they offer and how they offer it but it's having this abundance, and, being able to structure. Those recommendations so. As an example we've working, in Rome, Georgia so, rural area. Of north, northwest, Georgia on treatment. For breast cancer patients, and part. Of what we identified, by this notion of removing, friction was to work with cancer care navigators, these, are precious human, beings, unfortunately. There's not enough. Of them but, their job is to figure out how do we move barriers, to care we. Studied what cancer, navigators, did and then, took those practices. It encapsulated, those into digital tools so, that when a patient comes in they, now get mobile, technologies, that takes all of that advice, and, all of that knowledge and they bring that home with them but, then we use personalized, and adaptive, techniques that are based on their diagnosis. And on their treatment path and that on patient reported outcomes so we're continuing, continually. Refining, those, recommendations, to, care so, they feel that instead of Cancer Care being located in a particular physical. Place with, particular experts, that are only available in, certain times they. Feel that they're always connected, to they care and it's more personalized, to them that's. Great comforting. Very comforting, for patients. Katie. Your thoughts on that first. Of all isn't that so cool like that's so cool when you think about that um and, and, in that same vein thinking, about how we can deliver. Interventions. And monitor. People so, that they are in you know their own homes and they feel safe but. Also being. Able to have access. To. Things that they otherwise wouldn't, have been able to have access to you know telemedicine. Is a huge huge. Part, of that relationship, management, tools for caseworkers, and doctors, I think there's lots of benefits of, frictionless. Health care and. And even reducing.

The Burden on the system, as a whole will allow, more quality, care and allow us to think more about, a whole person, if, we can you, know reduce barriers on the whole system's from the ER to, the. Ambulance, and the first. Responders, all. The way through the system that, eases that system for, us and some, of it is even when you're thinking about like the. The. Records for instance you know how can we just. Just the simple something so, simple well in theory so simple you. Know if we, can reduce that barrier. I mean what a huge, benefit, to the system as a whole, but. I think that personalized and preventative and allowing people to feel that, it's it's. Medicine, for them, and. That they're being heard and that they're being cared for is the. Biggest benefit, so. Beth you talked about all these different. Ways that technology, can, really. Be provide, holistic, and personalized, care. For patients. One. Of the challenges, that immediately, comes to my mind as this idea of issues, around privacy and, data security. All. Of that requires. Having. A lot of detailed, data about each individual. In terms of their health care or their challenges, treatments. Etc. In. My mind at least I'm not sure if we are even close to addressing these, issues around privacy and. Information. Privacy, and security, if. You have many thoughts about that to, share or where do you see this challenge, or where do you see potential, solutions. So that might be certainly. So. Everything. That we've talked about is about more, and more information, from. The patients from their caring network from their socioeconomic settings. And. We run a real danger, I'm not gonna talk about security, as much some, sense we know how to do this we just don't necessarily do it well in industry. But. How, we operationalize. That, data is really important, so, one, of the things that we have to watch out for is, looking. At what machine learning. Algorithms. Would predict in terms of certain forms of treatment but, then also understanding what, data. Is layered, into, that so, for example. It. Can be the case that different cancer, treatments. Require. Different. Forms. Of burden on a patient, and on their families and you. Could use, socio-economic. Data that would be able to depict that this person is from a you, know well-off, family, they. Have a living. Spouse in the home with, they have a robust, network of, care. Algorithmically. This, person, is probably a better, case, study for, a higher burden treatment, than someone who lives alone who, is still working, maybe. Doesn't have a great record with adherence to other, their. Treatments, and algorithmically. Will decide well this person should get a different, treatment. That. Is something, that happens with human bias in health care now so, this is not a new problem but, now we are, including. It in the systems, where. That decision-making, may not even be apparent. And. So your, your new, physician, or your cancer. You're a nurse navigator and, you're just getting the recommendations, coming out of the system you may not realize kind of all the variables, that have been encoded so, as we take our existing, systems.

There, Are tremendous. Biases. Built, into that data there's tremendous human, bias built, into our existing practice, and we, can actually create the worst of both worlds by combining, those together instead. Of creating the best of both worlds so we have to be very, careful, in understanding the, assumptions, that are laid in into, the work that we're doing now and. One. Of the things that I've. Been. Really impressed with is that a criteria. For any machine learning. Algorithm, is that you immediately assess it so that the, question is do the most vulnerable in the system, get. The essentially, the highest opportunities. Right, can you run the system to see if, people, of certain races are certain socio-economic, conditions. Are being left out you, reject that algorithm you rework it and figure out what it's doing so, we, have to push more on our, data centric approaches, that, it's not just pure data or pure optimization. Because we will actually exacerbate. The, the deepest challenges, we have in healthcare now so, in fact you identified, yet another issue and challenge. Around, data and analytics. Use. But. Again having. All those that under all that data. Personally. I keep thinking who has access to that data how, is it being protected, how, is going to be possibly. Monetized. In different ways so they can now advertise, to me so there, are lots of issues around. Data. It could be a, very, positive powerful. Thing in. A positive, way and it could kind of create all kinds of challenges so, let me turn to Avery and Katie now and see if I can get you to focus on the. Benefits, and challenges. Of. These, new models and new ways of doing things for providers. Because. They play a key role in this whole scenario as, well, as payers, so, Avery. Let me start with you sure and I would I just wanted to say you know what you're describing is, what we refer to as Responsible, AI and. Making sure that the transparency, and the audit ability is available, right to understand, and make sure that the bias and the the, models aren't just being reflected, due to the human, biases that you described and, so there's, a whole approach that, that we have you need to talk about this a little later. But. Yeah I mean as far as, as. Far as payers. As an example this is something I get really excited about as a as a statistician, and, thinking, about all the different you, know deep learning models that are available now convolutional.

Neural Networks, that can look at images whether 2d or 3d and, really, help augment, the physicians, so it's not something to replace doctors. Or. Nurses and their expertise, but really to help complement. And supplement them, one. Of the biggest ways is to is that the machines can just continue. To work right so they, don't need to sleep they don't need to eat they're not going to be fatigued so they can do things at scale that, really helped to make, diagnosis. More efficient, and effective those. Type of things the, other thing that we're seeing especially, on the payer side you know when I when I speak to pay our leadership, they often ask you know how can we make our, operations more, efficient, you. Know not particularly to reduce, our you. Know our FTEs, or that sort of thing but really things. Take a long time human, take so humans take a long time to do things and so, some, of the some of the solutions, that we're building now are, really pretty. Advanced, you know using graph technology. Being. Able to do natural. Language processing, to surface. Up information. For a clinician to react to and then, the input from the human is then recorded, and used to make the predictive, models or the machine learning algorithms, in the background, learn. Over time and. So we found this to be a very, effective, very, cost, savings, type. Of solution, that then allows you, know capital, to be used for other things like lowering, healthcare. Broadly. Or investing. In other kind, of human focus interventions, like care management some of the things that you guys are describing as well great. KT, much. Like Avery was saying I mean I think I've done well and done right, will, be able to provide a better service to, our members. And, you. Know in theory, if we can reduce dr.. Time ER, visits other things we. Have a massive cost savings so I mean it's a it's a quite, a clear benefit on the one hand for a payers perspective. And. Thinking, about like how can we impact. And. Allow. For a person to lead a healthier, happier life like, that's a win-win for everyone, it, I mean it makes a ton of sense that's, great so. We, have already started to talk about technology. Digitization. Potential. Benefits, of it in terms of how it can change services. In healthcare so let's dig a little deeper, into that and Avery. I kind, of stopped you from getting into a lot of ml kind, of machine learning kind of thing but, just. Give. Us a better sense of you have already given us a couple examples but, at. Least perhaps. In the near future what are some ways that technology can, help us to. Make things better less, expensive, and more accessible. Well. You know I think, it kind of goes back to some of the things we already talked about right virtual, care so, allowing, you know people, that live in rural areas to have access to you know to a, very, talented specialized. Physicians, whether, it be cardiac care etc, I. Think you know again where we try to where. We try to leverage the analytics, and, in.

The Machine type, of automatic. Processes, it's, going to be it's going to pull or Freight throughout the whole hell our system in a myriad of ways right so making, sure that there's. Clear use cases that are being defined so, that once, they're put in place they can actually be evaluated, to see if they are having the intended benefit or not and be, able to then you know pivot to something else or make some changes it's not just a panacea, that you. Know technology, is gonna fix everything and frankly. You know we. Were talking about social. Determinants of health sometimes you don't need a model, to, make an impact sometimes, just knowing that someone can't, go to the doctor due, to travel restrictions, or the, inability to to. Travel, you. Know breaking down that barrier maybe. All they need to get the care that they that they deserve and that they you know have, to have. Please. Absolutely because, I think I feel. Like we've spent a lot of time on the kind of the personalise aspect, but I'd, like to push more on this notion of the holistic aspect, and meeting people where they are and using technology to do that. So there's virtual, models of care, there. Are ways, of just meeting people at the point where they're making decisions that are relevant to their health so, some of the work that we've done with people with diabetes you. Know we can show that you're newly diagnosed diabetes you go into this class so we've already now created. A subset of people who are willing to take the class but, you go into the class and they can learn about kind, of the book knowledge of diabetes, do. Their habits change no all right at best, maybe they follow the prescription, prescribe, diet for a couple of weeks and then they just very quickly, assume. Previous, previous, habits. However. What we've seen is in the design of mobile technologies, which is just, enough mobility just, enough AI but increasing, those touch points of care into. The daily decision making then people will start to, work to changing, their their habits and their decisions, but, they're in the grocery store trying to decide what to buy they're in the restaurant trying to decide what to order they're, you. Know at breakfast, the next morning trying. To figure out kind of the compromise, between what the doctor has said and what they're willing to do so, if you can create that continuum. Of care through, technology. Through analytics. Through virtual touch points and the trick is they don't actually think they're interacting with the technology, per se they think actually they're interacting with their healthcare system through.

The, Technology, when you can create and, mimic all of those touch points then, you start to change people's behavior, and then you start to change all the cost curves around this really, trying to figure out how do we reduce understand, the barriers and then, reduce the barriers and make the technology, that's allowing for that invisible, yep so. Interesting, Beth you started, to get into the, ways to influence behavior yes and. Compliance, of patients and I. Happen. To be married to a physician and he always tells me these stories about how patients do not comply. They. Don't take their medication, I mean as simple, as that and, you. Know the funny story is sometimes he, once shared with me was was, an elderly, patient, who had come with a nice to, see him and, he said brought her and so. My husband asks, Henry asks the patient, are. You, taking your medication and. A patient yes of course are you taking it as I prescribed, it yes, of course and then the nice kind of goes behind the patient and keeps going. No. No. Which. Is really a funny, situation but. You, know if if they are not complying with medication. And they are not open, about that to the physician, and then a physician, is saying oh my god this medication, is not working so I have to change it to a different one or increase, the dosage it creates all kinds of issues so this. Concept. Of being able to influence, behavior. Of. The, patients, is really important, and how can we do. That because unless, people change their behavior the outcomes, are going, to be the same and they're not going to be improved so, a great point so, Katie. One of the things that you do in your role is. Partnerships. With universities, so. How do you see collaboration. And partnership, with universities, is going to help us in this, arena of. New. Models of health care and making things better I love. This question because I love my job so yeah. I get the I get the joy of working with universities, daily to figure out how can we use technology to close, some of the gaps that we might have that. Could be you know reducing.

Well. Really reducing any gap that we might have but the goal of rural goal is to better serve the populations. In which we're trying to help so, thinking about what are the gaps that we have whether. That be knowledge, or talents, or. Even. The. Intellectual. Property and, figuring, out how can we partner with universities, to best fill those gaps so it, could be partnering, on studies, it could be publishing, partners for. Policy change. IP. Sponsored. Research all sorts of different ways but I really view our academic, partnerships, as an extension of our, anthem family and really, allowing us to push. Faster. Harder. And deliver, products. That make a difference in people's lives as quickly, as we can because it's so desperately needed because, to your points, you know right. Now healthcare is it's. Very antiquated. In a lot of ways and so if we can almost leapfrog, where we're at right now to, be able to make a super. Huge impact, I think it's without. Universities. I don't think we would be able to do that that's great. I. Knew. Best do you have any thoughts. On that this. Is where I get to brag about all the Georgia, Tech students, because. It's it's just so phenomenal to, have student, innovation, to be part of this equation. And so just some great examples of the things that are that are happening here so first is you, know the touch points with how technologies. Are changing, our. Experience, of health in daily life so some, of the work that has come out of Georgia Tech and others has looked, at the role and influence of social media technologies, on mental health and, you. Know to be. To, be blunt. You, know my engagements, with the healthcare system for example just, really had a blinder. Blinders. On with, respect to understanding how. Social media technologies, were exacerbating. Mental. Health especially around eating disorders and some of the work that we're doing and, I was talking to clinicians and they're like yeah funny, because you know when they're in our waiting room they're constantly. Connected, to those devices but. Not understanding. The impact, that they would have and so that came out of you know our students, working, actually with high school students to look at how these technologies were, framing. And actually creating, a new normalization. In their, minds, around the. Role of an. Attitudes, around eating disorders so that was, one example we're. Doing amazing, work in virtual reality where. You're able to simulate, the experience of providing health care so, an extreme example but people who are working in for example an ebola word are not. Quite as scary but we're getting there with with the corona virus which, is we trained public, health workers.

Practically. With powerpoint and. So we tell, them how to do their job and then, you put them in a stressful situation, they. Quit the. First day right they're out of there well, that is not effective. Models. Of care but we're creating virtual virtual. Reality environments, that actually generate. That stress, we're simulating body fluids we're simulating everything, but, people, are then actually, trained, for what that situation is, is going to be like and. Then finally, looking at new new, mobile technologies, new home technologies, bringing in industrial, design bringing, in psychology, really having that multidisciplinary, perspective. Because, we're asking people to carry, technologies, with them to where technologies. We're asking them to have them in their homes to interact, with them in public spaces that's. Not just a medicine. Problem, that's a design challenge, and being, able to bring together the, psychology, and the design and the engineering, to make that happen it's, just there's such a wealth of talent at our University so I will start writing about how great well done thank you I think, the. Whole issue is, not, a point to point solutions, is that holistic, approach. Just. Like the. Treatment needs to be holistic for the patient and these kind of solutions, needs to be holistic just one point on that when you think about you, know if you have got health issues, and you go to a GI so. Many of them now are looking at your mental health because. You're if you're nervous if you're stressed if you're whatever, it may be causes. So many physiological. You. Know outputs. Of that like you're you're, really so they have, to look at a whole self absolutely. Every, I want to have you focus. On the economic, impacts. The economic, business models. Of all of these potential. Changes. And new ways of doing things again if you take it or you can take any of the perspectives, the payers the providers, the patients the, cost issues you know we are all hoping that the cost will be reduced, but. Who's. Gonna lose who's gonna gain how it's gonna work out ah. That's. The big, question I think right. You. Know what we've seen is that you, have to have a strategy around, implementing. Digital, solutions, in the healthcare space that, include, ways to pay for as well as ways to realize value. After they're in place so, I think a lot you, know we can look at things, like you. Know the movement over to data lakes as an example not particularly healthcare, related but, healthcare related in the sense that these large companies with, all the with all these data are looking for you know simple places to put it a lot. Of a lot of people win in that direction and, now they're struggling to actually get value, out of them right. Just. As as, a you. Know at an individual, level you know. If I'm able to optimize my time, like my my. Example, of going to the urgent care that, to me creates, a stickiness with that healthcare system, so now I want to I want when I have choices I want to you know use them again right so their. Investment. In a digital solution, that helped me get care, that I needed more, efficiently, makes, me want to be you, know sort of their their, patient, longer-term. I, think health care plans in, general, have a really negative no. No offense I used, to work with for. Several of them have. A pretty negative sort. Of connotation when, people think about you know I don't want them contacting. Me I just want you know to be able to go see a doctor and how my claims paid those sorts of things very, very low Net Promoter scores, we're, seeing quite a bit, invest, in sort, of omni-channel, digital.

Type Of customer. Relation management and, what, that does is it allows them, to be seen and. Really. To be thought. Of as, other. Consumer. Type companies. Like a Verizon, or someone else that has a very good customer relation management system. So, that is just easy right, people want easy people don't want to wait. And so just because it's healthcare doesn't, mean that those expectations change. And. So there are ways to build, out those capabilities, and realize, the value while increasing, the the. Satisfaction. Of the patient. Member or consumer, experience, that, I think there's there's ways to find those balances, so they offset one another so. As I'm listening to you. Talk. We. Have. Ways. Of approaching this problem we, have different. Ideas about, how. To reduce, the barriers how do you be more holistic how, do you. Be. More personalized, in terms of delivery of medicine. So. We. Have great ideas of how to move forward. What. Are we waiting for, what. Is the real barrier, for, making, these changes in healthcare I mean we have these, are used you heard so many examples of great solutions right great, ways of approaching this, and. I. Have, heard this for many years my, field is in digitization, my own field of study so that has been one of the industries, that probably. Starting, 20 years ago everyone looked, at technology. And said oh this is going to bent the curve and make all the differences, it. Really, hasn't or not at the speed or not at the scale that we, hope it would, by now. What's. Going on why is it what is what, is the real barrier, of making, these changes any, thoughts ideas. We. Have I, think it's always been described as perverse, incentives, in the healthcare space. So. So. Some of the times for example when we've been working, with healthcare systems, and. Here's. My app and it's going to help people better manage chemo. Treatment, and, it, will help them keep them out of the ER all, right almost, everyone, can nod their heads that that is a good idea except. For the people who make the money out of the, ER. The. Budget. Arena. Right it's like if I'm if my, technologies. Keep people out of the traditional, system, somebody. Loses, dollars. Stated with that so. That is the challenge which is and what I where I started, with at the beginning with, respect to you frictionless. Health care is that, we have a. Beautifully. Optimized. Outdated. System, and. Right. Now we're kind, of throwing different. Technologies. And different, approaches, and some analytics. And, some telehealth, and but, if we're, kind of just throwing things into, an existing system the, system, is. Is is pretty. Robust, to reject it knows yeah from, an economic, model point, of view and so, what we're slowly, starting to see at least in my 20-plus years of this is we're going from the, one-off points. And then, when, we're evaluating, partnerships. We're, actually looking, at partners, that can take a system, approach. Because. They have. To look at the business model the technology, model the patient touch model, you, know who is paying for those home technologies, who is paying for those virtual visits. How, are we taking event into the fact that less revenue, is here but more revenue, is there so. You have, to you. Have to look for partners and you have to look for folks who are willing to elevate, it to the system level approach otherwise. You just feel like you're just throwing things against a brick wall which. By the way it seems to be one of the major issues for a lot of large, major. Successful. Organizations. In different, industries. Because. They all want to change and transform. And innovate. It. Is. Not one. Element, and one piece, the. System, is truly, optimized, for doing what it's being done in terms of the outcome.

For. Example, if you go see it your doctors, even if you have an appointment what, happens, you first of all they tell you to come in at fifteen minutes earlier okay so you show up fifteen minutes late earlier, and you end up waiting 45, minutes, because. The, system is optimized, for the, providers, so they can run from one room to the next to the next and don't. Waste. In, their minds a minute so. It's. Really a rican, sexualization. Design, of, processes. Procedures. Business. Model, and by that I mean the economic, incentives. And economic, models and when. You are dealing with such a mammoth. Industry. That, is so well, you, know sort of well, designed and traditional. The. Idea, of changing, it by little. Tweaks, here and there it's just not gonna happen, and has. To be truly disruptive it, truly, has to be disruptive, that's why when you hear places. Like Google. Or Amazon. Kind. Of starting, to think about this health care issue it's. Interesting because, maybe, they can come up with something that is truly disruptive so, at. This point it looks like the changes, all these opportunities. Are. Not as much about technology, per, se that's, the tool, its. Cultural, its. Existing, system, its. Fragmentation. Of care the way it exists. Katie, you talked about this issue that you know the GI person, looks at this. Health. Care is really fragmented. Not only in terms of systems, that exist, but, also in terms of specialties, you. Know when you go to, a GI that's all they look at I mean you may have a real issue that is causing different things no you're focused on that how. Many times you have known to your doctor's, office, maybe. A bigger, great health care provider, system. And you. Go from one doctor's office they give you these little tablets now right they. Want your information, you fill it in maybe. Three months later you're going to see a different specialty, in the same system, you, get the tablet again one more time could, you input your system, and say I just did this I you know it's the same organization. So fragmentation. Is another real challenge. And. You. Know so great. Opportunities. So let me perhaps. And I want to make sure we allow, enough, time for interaction and questions was, there any question that you wished I asked but I didn't. You. Had a question about what were the potential, dangers, to, to, patients, and we took it around the data curity machine, learning analytics way, but, I think there's actually some just more fundamental, dangerous, that I worry about so. When. We take an existing system, and then we want to you, know disrupt. It or we optimize it we, don't tend to always look at the secondary. Benefits. In the existing system and we and we tend to albeit. Though so for example one version that we're looking at also in Cancer Care is, as. You move to, a. Pill. Based pharmaceutical. Base for chemo as opposed to coming in for chemo treatment so you can get highly, optimized care you're you're creating, a particular prescription and someone's taking it at home they don't even have to come into the chemo center it, sounds, perfect. Right what. We have done is, underestimated. The value of that social support care, within, the chemo center and the people that are encouraging, them and that are meeting them every time even. Interacting. With other patients and we've, taken that huge, social support, system and left, a person sitting by, themselves in their kitchen staring, at a bottle of pills that makes them feel bad and, we already know that people don't take their medication, and just because, you're going into cancer treatment doesn't mean you're even any better at, that, we're. Also taking systems, that are again. Around social networks of care and then, saying okay here's an app for you an app, is a solidary. Type, of experience, you know you set, your goals and you do all of this and you. Figure out how to make yourself better that. Works with certain socio-economic. Groups, it, fails horribly, with, others right, community. Based approaches, network, of care based based approaches, social, based approaches, so we tend to take. Out the sociality. That, actually is part of what magically, is making healthcare work and we don't see it and then, when we digitize.

We. We remove, that out of the system so, I worry, a lot and fight back, and forth a bunch on. Understanding. That, human approach, those, social, connections, the, social connections, in the network of care let's. Not. Let's. Not eliminate, those in our rush to create, technical. Individual. Approaches. Did. You have, not. Necessarily a question that you didn't ask but when when, I think, about the last question that you asked about. The. What, are the true barriers. While. I completely. Agree, the system as a whole needs to be disrupted, as you were saying and. We have to build something new while maintaining something, that we have which is that's. A challenge, right. Hard. Very expensive, challenge it's true yeah but you yeah and how do you then, how do you make that transition happen. But. Even within that like thinking very pragmatically. You know when you think about just like FDA trials for instance it's. One thing if you have a drug and you know the compound, isn't going to change when. You have a digital, intervention. And you can tune an algorithm, what. Does that look like app. How. Do you how, do you what, does that trial look like what are those constant. Approvals look like and really I know, that you're saying that digital, has been around for a long time and it has kind, of in theory, but, in practice it's not and, so we don't have a lot of those things in place that, we need to. Be able to advance, medicine, as quickly as we as we, want to great point and of course we can see that in all the other fields. You know this whole issue around the autonomous. Car if something goes wrong who is responsible. So. Again, so it's not only the existing. Systems, of healthcare delivery that needs to be disrupted, laws. Regulations. And, a whole policies. Around things. So. I think, the magnitude, if, you things few small things yes I think. Yeah. So. Prime. Example, of how technologies. Are moving faster, from, human systems, across. The board policy. Regulations. Everything. Incentives. So. A lot of interesting challenges, lot, of interesting, dissertation. Topics, for, our students, I bet, so. Let. Me stop here and see. If there are any questions that the audience says do.

We Have mics. Okay, so please write your hand high so they can bring you the mic Carrie. Hey. Guys, Julie Frye thank you guys so much for doing this this is awesome. One, of the things I was curious about you guys talked a lot about major future. Improvements. In disruption, on ways, you can and thinking. Like maybe five or ten years down the road with. Your roadmap but. One of the points that Avery had mentioned was saying people right now would like things easy I mean, which, I would agree and, then. Also mentioned, you know it is hard for healthcare providers to get a good rap. Since. So many issues so, just kind of curious what are you guys doing. To help people today, and an, example might be. Referrals. So if people have HMOs, especially, if they've gone on the marketplace and had to go buy stuff a lot, of those are HMOs where you got to deal with referrals so referrals. Might take 15, days to happen so, insurance. Companies are then dealing with people that have, gone with a minor issue maybe the day it's it's. Realized, so they have to get a referral to, two to three weeks later before they can even get a referral for it approved, so not only then is the insurance company potentially spending, more on an issue helping. The person but the person has soft and hard cost saying. I've got to pay more for an issue that's developed, over the course of three weeks and I. Might be missing work I might be missing, kids. Play I may be you know things like that so it's just kind of curious how is the industry actually working. On today's issues. So. And I, suggest. A preface so I think people trust their doctors and their nurses, right they're frustrated, at access, challenges. Of course the. Healthcare payer side, you, know for whatever reason, sort of has that that. Can. Sometimes have a more. Difficult. But. I mean to your point right so you bring, up you bring up the challenges, with this sort of holistic, aspect, of healthcare right you have network. Differences, between different. Plans right, people choose one plan because maybe it's more affordable than another but, then they have restricts, zhan being able to go directly to a specialist, in a like, in an HMO rather. Than being able to do that in a PPO plan right I think, if there if the reason, that it takes so long to, get from your, your PCP to a specialist, has.

To Do with lack, of information around. Who. Is available, right within. A particular area, so instead, of having to go to this specific, physician, with this specific specialty. There, might be five or six others within a you know a reasonable, range that, could see you sooner, and so if those dots aren't being connected then, that's something that that. Either the Health System or the, health you, know payer has, to be able to solve now. Certainly there's ways of doing that using data and algorithms and that sort of thing as. Well as you, know portals, that. You can log into as a patient and be able to do your scheduling, and those type of things but it really is dependent, on you, know where you live and what options you have in terms of the, coverages you can get from your health plan I, can. Chime in a little bit too so. I ain't them we have four. Four, and I hear what you're saying a lot of the stuff that we're talking is five ten years out still, we. Do have for instance like an app today, called Sydney care that if you don't have it downloaded anyone, can member, or not insured, or not but. You can start to type in or put in your inputs, for your your, conditions, yourselves, and then, we can start saying here, are here's, what other people with your same conditions, have experience, would you like to learn more about those then, start referring doctors and things like that so you can get a little bit more, personalised care on that level but beyond that we have on our digital team so we have anthem, digital on. Our digital team we have people that are thinking about things that are five and ten years out and then we have things that are thinking about things my team for instance is thinking about zero to three years out so we're really thinking about like, how can we take the technology that is available today. Well--we're, while we're trying to seed technologies, that will be available, in the future what, are the technologies, that are available today, that we could deliver upon in the next year, to help reduce some of those barriers for people and allow for digital. Interventions, to be easy delivered. Okay. Hi. My name is Conrad Merritt is I'm a CEO of a software company I have to give Shella college to a plug oh my. Gosh I got my MBA from this school is a best investment, you can make I. Promise. You thank. You and please do say this was not planted. It. Was not I got my MBA 2003. But. About. Several weeks ago I met with the, Commissioner one Commissioner, of the FCC, Jeffery. Stocks I also met with Congressman, Hank Johnson and congresswoman. Lucy. Macbeth. The, camp tell to Georgia is talking about some of the challenges we have especially, now we talk about 5g. Network. Coming as well it's, not fully there fully, yet but talk about a disruption of technology, because, they're trying to reduce the latency as. Well especially in the rural areas, in Georgia as well how. Do we get this technology, out there what, can the FCC do as well or Congress, can, do when, it comes particularly, it comes to health care and we see a lot of consolidations. As. Well so. They're trying to figure out what can we do not just from latency. Because of security, - well we spoke about security, but, getting the best health care to people out there and the spoke about the, Millennials, nobody, wants to go to a doctor's office and spend two three hours we, want a doctor to come to us from our home as, well so those are some of the challenge before the final can you tell your perspective. What do you see for see how, do you find to maximize, 5g. As, to. Be part of this disruption, I, think.

You Know be interesting, to reflect. On this from an economic development perspective and, this is one of the challenges, with healthcare. Is such a large market. That. It tends to. Play. By itself right, as. Opposed. To taking a community-based, approach and, saying you, know access, to 5g, access. To these technologies in our community, they're important, for health they, were important, for education. They're, important, for bringing jobs you. Know they're important, for the overall vitality, the community how do we actually bring this together because. Your your critically, right we can of all of the innovations, within these digital technologies but, if you don't even have access to that infrastructure, what. Good is it for you, but. It also is very difficult, to say okay healthcare is going to pay for all of this, our our, school systems are going to pay for all of this our major employers, are going to pay for all this so how do we create state initiatives, where you know we understand, the importance of transportation. At least a little with. Respect to planning for the future of our cities in our state but, we need to actually understand, next the next layers of technology there's. Actually some beautiful. Similarities, between planning, the, internet, and planning, our, network highway, highway. System. Some. Of the same some, of the same people were involved in those in those blueprints, so we're gonna have to take this at an economic, development argument. But, partner, with the, large providers. Partner with the payers but then you. Know one of the best things that come, out of this is employers, say for, us to be able to attract, them future. Businesses, we, have to have good health care and we have to have good occasion, education. Focus. On that equation and work to make it happen in our communities, I think, the other part of it is when. We talk about infrastructure. A lot of people think about the traditional, roads, and roads highways I think. We need to think about infrastructure. The, physical, and then the digital, one and they really, impact, each other and. They interplay, so, it's. An issue looking, into the future people should not plan these differently. I mean they really need to come together they're. Intertwined. So. That's another thing that we, need to look at in, terms of who the designers, are and the design issue. Any. Other good there's.

One In the middle and one in here. Hi. Erin, Anton a recent, graduate of the Shiller MBA program also. Have to speak, praises, to it. Fragmentation. In, this industry is actually, incredibly. Profitable and. Horizontal, integration is. Very. Difficult, time-consuming and. Expensive, and, that's. Part of the reason why we have over, a thousand, EHRs, right, so I'm curious, what, technologies. Or groups, or pathways. You've. Seen that are really exciting, you that are bringing, together a, lot of the industry and helping to drive that disruption. Smart. Graduates, yeah. You. Would be you can lead the charge I. Again. If a system, exists, already and is profitable as, you suggest, we. Should not expect, the system on its own disrupt, itself right the. Incentives, don't allow that that's. Why I made a comment that when you see places, like Amazon, and, was at Google that. Are kind of thinking. About this, space, I, think. The disruptions. Are going to come external, to the existing. Situation. So. That's that's. Probably, the only way that I see it happening. I. Was, I, have one example one. Sorry. About that I have, one example of something that I can think about that is across. All, platforms, and, that's when. I was talking a little bit about those records, before. So. A lot of people anthem. Included, we're moving, our health records, to fire which. I, know, that's fairly, new it's a standardization, of record it would allow for everyone, to have access to the same record that I, think is gonna help reduce, so, many barriers for. Physicians. For, I, mean even, me when I think about like getting access, to my own children's, records is so. Childlike, this should not be this hard and this is really challenging so, something like that I think is gonna I really, do think it's gonna make a big difference so they, are interoperability. Such, as fire and other types of open platform, approaches, that are enabling, this, again. You. Know one story but when we started doing this tablet, work with our cancer, app the. First inclination, by the healthcare system was to lock it down like. It wasn't, an open platform because, oh my goodness somebody might go onto the internet and look for healthcare information and, we had to remind the doctors they're doing that already. Locking, down a platform. That you're providing, is not going to prevent people from working around it but if you opened, it up as a platform then. It could have value for other uses which, made it intrinsically. An. Important, investment as opposed to just a cancer investment. By the patients, and then you got prolonged use so this notion of how, do you create open, platforms. That these technologies, and this is why the partnerships, with the Amazon and Google and such are helpful, because. They're not thinking of this as you, know it's just, about this particular, treatment are just, about this particular healthcare scenario, it's, an engagement with thank, goodness we haven't said the word consumer yet but it's an engagement with people in their everyday in their everyday lives. You. Know I would when. You think about like Cerner right, or epic as an example in hl7, and the fire standard, you. Know part of it has to do with just, our natural, inclination to be competitive, right we live in a capitalist, society and, so, over, the last several years you've, seen major investments. By Cerner, and epic to really be the end-all, be-all for, the, health provider, right so everything. From predictive, modeling, right algorithms. That are presented, when, someone is admitted to to, a hospital, all, the electronic. Medical, records, being, able to create their own data models, and data warehouses. Right so, that people can use them for analytics, and reporting etc. And so, by by, creating. All of those type of capabilities, in a single, entity, has. Really has really prevented, I think you know to your point the, availability. Of other things to plug into it because they hold the keys to the kingdom I remember. Building you know multiple. Predictive. Models and, then it was so hard to be able to operationalize. Them into a production system like a Cerner or an epic because you couldn't access it right, and so, that that I don't think. That'll particularly. Change anytime soon because. It's, all about market, share and it's all about you know delivering. Value to their to their clients, so definitely.

Here You I think, there are going to be major, you know disruptors, we're talking about it last week at. Another meeting about, where the private equity is spending its money right. And so you're seeing these small, startups. That are taking a holistic approach that's. Built on technology, first, as opposed, to trying to retrofit, technology. In as you were describing this morning before we started into, their old systems, and it just it's just really hard to get that compatibility yeah, and. I think that's an issue that again a lot of large corporations, a lot of other industries there, have made, millions. Of dollars of investments. In these, systems of, course. They're going to defend it of course they're gonna open it to everybody it's, so. It's again the incentives, issue okay. A. Couple. More questions oh. And. Then we had the gentleman in the middle as well yeah, yeah. Okay. The. US, healthcare system I'm curious if you've seen anything on a global, perspective that, you either find really interesting or anything, that you've considered bringing back to the u.s. just. Any any innovation, that you've seen on the global scale I. Don't. Know if any yeah I don't know if any I think the biggest difference between, our health care system and you know we were hearing it all over the news right with, Bernie and and other, candidates, is you, know single-payer. Or. You. Know government-run. Health, care right, so in many, other, countries. They. Don't have the, types, of challenges that we have here, because. It is more. For. Better or worse it's. More consolidated. Now. Of course there's benefits, and and there's. Pros and cons to everything you, know as you're describing, can, we get can I get access to the doctor I need instead, of having to wait. You. Know the, same thing happens other places as well but that that's one of the biggest. Differences. That we see I do, think, and we're working on we're actively working on many. Projects, Joe, depe is leading, some and I know you know others like you are involved, as well where we're actually trying to break down the barriers globally, and bring, data together from. The various, other countries, that are doing similar research that, you know that our country is on these, chronic, illnesses or. Cancers. Etc, and so by using you, know a global. Familiar. Type of standard, we're able to to, be able to get higher, numbers, right, of records and people to study that. Hopefully will lead to cures. Or, at least treatments, faster, so. We see an opening of the globe in that in that perspective. Just a quick add to this I think, it's. Around having. An outcome centric model as opposed to a treatment centric, model and, so, what you're starting to see is other disruptions, in the u.s. system that are playing with that in different ways one. Of the advantages, of, the. Cost to employers that is employers, are moving to engagements, that are outcome centric as opposed to treatment centric, and. They're doing that more in preventive, in health and wellness ia. You. Know it also I need. To plug a new program that we're working with with Emory Healthcare around. Older. Adults diagnosed. With mild cognitive impairment, and, this is a holistic, model that, is around diet and, exercise. And compensatory, strategies. And. It's. Not around the pharmaceutical. Based treatment of Alzheimer's but, it's around everything, that patients, and their families can do to slow the progression of the disease that's. Very outcome, centric, and so that is that is a huge experimental. Program that is shifting in that direction so you. See you, see the experimentation. With that and then the question is how do you how. Do you integrate, that into the system while the plane is still flying in a traditional, model well. I can add one more thing I'm. Sad, to just. When. We talk about records so up to. Do a lot of these interventions, that we're working on we, need to have access to as many records as we can if you're trying to tune algorithms, and and try to do predictive, models and things like that the. More access and anthem, has larger a, lot, of access to those records you can't complain about the pinna but but, when you think about partner. With other countries Israel. Is a is a huge partner for us we. Have an anthem office there and when you think about their system, they, I mean their, health care they, have every, record of every single person that lives there so you see a lot of startup companies in the health and wellness space that, are coming out of Israel and they've, been really strong partners, for us.

You. Had your hand up ya know. We. Are trying to go. With a sequence, if we can keep track of it yeah, thank. You for taking the time to come talk to us I also. Am a recent graduate of the school. Put. Me up to this. Of. Course. So. In, my mind the, stuff we've been talking about the. Reducing. The. Barriers and. Seeing. A, whole list having a holistic approach, to health care in, my mind I kind, of categorize, my's attacking. Micro issues and I'm, thinking more at the macro level like big trends, especially in the US. I'm. Just asking about if you've, seen any example, of. The. Algorithms, that you've spoken, of and the, different analogy applied, to solve these problems and a, few, of them that I'm thinking about is a growing. Number of adults. A parents. Are choosing, not to vaccinate their kids and. Healthcare. Is being inaccessible, to a huge. Chunk of the population and the. Opioid, crisis, things, like that are your technology, being. Applied anywhere to, curtail. Those issues. So. I think some of the things that we're looking at so I will argue with you about the cost of chronic disease and shifting people's behavior not being a micro issue but. We can do that later but. I think. What. I've been really interested, in seeing is. The. Increased. Innovation and rapid pace around mental health so, I'm gonna, put that in terms of the opioid crisis, in terms of other we've, been looking at PTSD, you actually. Using Georgia, Tech as a, laboratory, because one of the mental, health crises in our in our country is actually with. Our young people and. Mental, health on our college campuses and, so to understand. Algorithmically. In technology, wise how, we can. Essentially. Create new. New. Diagnostic. Tools, and new, ways of understanding what, is happening in those settings you're, still trying to look at ways of then finding. Interventions. That would work within that space but, part of this is that we know is that if we can create better. Monitoring, within these situations, that you can create early interventions, and sometimes those are very much community-based, interventions, or social network interventions. That. Allow to intercep

2020-05-03 06:33

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