Special Guests:
………Highlights, Sound bites, Tachyons, Pulses from this show conversation………….
Political and Leadership Challenges in Healthcare Data Integration
……..I think I can start. Actually, this is a fantastic panel, and I really appreciate putting this together, Michael. So I have a question for everyone, but I want to start by Sergio, if that's OK. So you mentioned about some of the problems are stemming from the political and more people issues, not the actual technology issues. And I hugely agree with that. Coming back to the main topic of this panel, harnessing data and technology for next generation healthcare solutions. I've been thinking actually it may not be just the technology issue and it may be more of people and leadership issues, whether actually they understand all the details in the real intricacies of the complexity and noisy nature of the data. That's kind of what I've been feeling, but I don't think actually if that's kind of pervasive opinions out there. But yeah, I just wanted to hear your thoughts, Sergio. What's blocking for us to go to the next phase? Yeah. I mean, that is a phenomenal question. And I stand by my answer. I do think that they are largely political and business, right? I mean, when I was at Stanford Healthcare, if somebody would have told me 10, 15 years ago, that there would be a mechanism or a methodology to a method to effectively share data between two quote-unquote rival or competing interests right i that i would have laughed i would have said there's no way yet here we are that that that that is happening today so i think that there is a like anything there's no such thing as an easy answer right i think that there is largely a sector of the industry that probably underestimates the complexity and layers of data. Not all data, access to data and data access are not the same thing, right? And a USCDI and a CCDI and a summary, whether we're translating it and pursuing it via, you know, HL7 or FHIR, there are some level of depths that exist.
Regional Challenges in Healthcare Digitization
……….Yeah, I think we have mind readers on this call. That's kind of where I was going with that. In line with planetary health, I think if you really look at global health and global health system interactions, most of us or many of us have had the opportunity to work with different health systems. And so some of the challenges that we are talking about is very regional. It's USS. And I remember my first startup, and I'm not going to date myself, but just let's say it was, you know, a number of years ago when we started to kind of like digitize electronic health records. And we started to build care pathways and we built EMR system to actually help capture data along care pathways. And then we used to talk about how do we really share this data between, let's say, UPMC and Geisinger, for instance, in the local region……………….
Digital Therapeutics: A New Frontier in Healthcare
……………And the last dimension is something that, you know, Randy spoke about. I am pleased. very excited about the software as a medical device, more specifically digital therapeutics. Because especially the biotech side, we say with the pill, around the pill, and without the pill strategies. And I think digital therapeutics is supplementing care delivery to especially a lot of neurological conditions, substance abuse, ADHD, and some of these things. And I think it's getting to be a main line of defense for us in treating some of these conditions. So I think digital therapeutics and, of course, software as a medical device. We've had that for quite some time, and I think it's only going to go and get better. So these are some of the things that really get me excited about it……………..
Timeless Principles of Economics in the Digital Age
…………….The book is called Information Rules. And basically this was late 90s. And he said, everybody's walking around saying the rules of economics don't apply anymore because the Internet changes everything. and all these different things. He said, actually, they apply quite well. It's just the things in economics that apply are things that were really obscure before that nobody really talked about except academics. He talked about network effects and lock-in and all these kinds of things. I've realized I'm going to have to go back and do a lot more studying of those kinds of things and reading some of those books to understand this because I feel like if I don't have a good mastery of those principles... it's gonna be awfully hard to kind of be strategic in this space……………..
AI's Potential to Revolutionize Healthcare
……..I think it's going to... I want to piggyback on something that Dr. Park mentioned. Chad GPT completely and fundamentally changed the model. And I think it behooves us to deal with the challenges of privacy, security, data integration, and data quality, because the very first organization that effectively, I'm going to use this word, weaponizes Chad GPT or AI or ML will win. And they'll be a market leader. And once you do that, the rest will follow. So I think it has, I think policy and staying the course is helpful. Now, the last ONC administration did more for interoperability arguably than the last four previously combined in terms of it's live, it exists. It's up to us as the ecosystem to effectively use it………..
Data as the Foundation for AI and Quantum Computing
…….The second thing is, you know, data is always the underpinning. It's not like, you know, you're bringing data to AI, it's bringing AI to data. So once we get that layer right, and how do we do that fundamentally, I think we'll solve a lot of problems as we move forward. And the third thing that kind of, you know, is exciting is that as we are looking at the shifts, right, so we have data, we have AI, but we want the quantum on top of it. And I think it's going to provide us the ability to massively process, you know, exaflops of data to be able to solve some of the complex, like if I'm analyzing complex biological pathways and what takes now others, we could probably do it much quicker………..
Cultural Clash in Software and Medical Device Development
………Well, software, you know, is completely different. It's malleable, it's flexible, it does exciting things, but you don't want to move fast and break things with a medical device because you're breaking a human being, right? You know, we have hoodies, hoodie sweatshirts for our coders that say move faster and break nothing. And the challenge is how do you do that? Because software typically hasn't had this sort of lockdown view. And so you have these two different mindsets about engineering, about quality and about regulation, you know, that goes all the way from the government down to companies. How do you put these worlds together? And there's a lot of culture clash going on, candidly. And I think the good news is, and this is the message we've been trying to share for a while, is folks, if you look at the principles of quality, and you go back to where quality came from in the original concepts, software quality and traditional systems engineering quality are not very different……….
Enduring Relevance of Economic Principles
……….The book is called Information Rules. And basically this was late 90s. And he said, everybody's walking around saying the rules of economics don't apply anymore because the Internet changes everything. And all these different things. He said, actually, they apply quite well. It's just the things in economics that apply are things that were really obscure before that nobody really talked about except academics. He talked about network effects and lock-in and all these kinds of things. I've realized I'm going to have to go back and do a lot more studying of those kinds of things and reading some of those books to understand this because I feel like if I don't have a good mastery of those principles, it's gonna be awfully hard to kind of be strategic in this space……….
Randy Horton's Career Journey and Early Internet Experience
………Yeah, hi, so I work as Chief Solutions Officer at Orthogonal. You'd think of us as a custom software development firm that works on all the software that's regulated as a medical device, unless it's physically inside a device. We work on the connected pieces that are sort of very modern and very consumerized and being sent home. On the side, I also co-chair a AAMI standards committee that's working on a technical information report It'll be the first guidance on if you're putting functions of a medical device in a public cloud computer that you don't directly control. How do you know if it's working right? And I'll throw as a as a minor tidbit for you. 1993, I was a senior in college and couldn't figure out what I wanted to do in life. And I started playing around on the Internet a little bit pre web. And then one night I did an all nighter at the computing center on the very first browser mosaic. And I swear to you, I only went home when I clicked on every link on the Internet. I can't prove it. And I left and I said, I don't know what this is, but this is what I want to do with my life……..
Data Innovation in Healthcare and COVID-19 Vaccine
……..So I think, you know, a lot of that is already happening today, which is probably one of the reasons why, for instance, you know, in seven, eight months, we've had an mRNA vaccine for COVID-19, right? And so it took a lot of those, the underlying data pipeline and the AI pipeline. On the healthcare side, not just in the U.S., I just actually recently came back from a conference in the Middle East. And certain geographies and governments are investing a lot of money into actually delivering connected care and essentially connecting all the points of care for a particular patient and identifying the gaps in care. Right. And then how do you really better modulate and control outcomes for interventional medicine? Right. So which is another frontier where I think, you know, innovation can fuel a lot of good progress there. And the last one I wanted to make there was, I think, why are we spending about, you know, over a couple of three trillion dollars in health care is because it's like two percent of of, you know, the events and episodes and health care costs, 90 percent of the cost. So shifting from acute care to preventative care, right? And again, data plays a huge role. And I'm not going to deepen the conversation by going into epigenetics and all of those things. But I think, you know, those three are, to me, you know, fantastic examples of innovation and what data innovation can do………
Sergio Wagner on Data Aggregation and Intelligence in Healthcare
…………….Hi, thanks for having me and hosting me. Pleasure to be here. Sergio Wagner, I'm currently the chief strategy officer at Salient Healthcare. And at Salient, we use a platform to essentially track economic behavior. We use a solution that we believe that access to data has largely been solved. And now it's a matter of fact, turning data into intelligence and making that intelligence actionable. As a way of getting here, I've been in healthcare my whole life. I built and launched MSOs, sold MSO to what ultimately became Stanford Healthcare, was one of the co-founders of Health Guerrilla, which is serving as one of the very first QINs. And I live and die for business and data aggregation, and I'm very, very, very excited to be part of this panel. Awesome. Thank you, Sergio……….
The Transformative Power of Chad GPT
……..I want to piggyback on something that Dr. Park mentioned. Chad GPT completely and fundamentally changed the model. And I think it behooves us to deal with the challenges of privacy, security, data integration, and data quality, because the very first organization that effectively, I'm going to use this word, weaponizes Chad GPT or AI or ML will win. And they'll be a market leader. And once you do that, the rest will follow. So I think it has, I think policy and staying the course is helpful. Now, the last ONC administration did more for interoperability arguably than the last four previously combined in terms of it's live, it exists. It's up to us as the ecosystem to effectively use it……..
Global Health Systems & Policy Influence
I think if you really look at global health and global health system interactions, most of us or many of us have had the opportunity to work with different health systems. And so some of the challenges that we are talking about is very regional. It's USS. And I remember my first startup, and I'm not going to date myself, but just let's say it was a number of years ago when we started to kind of like digitize electronic health records. And we started to build care pathways and we built EMR system to actually help capture data along care pathways. And then we used to talk about how do we really share this data between, let's say, UPMC and Geisinger, for instance, in the local region. So many years, 15, 20 years later, and now I date myself, the challenge still exists. And so we had regional health information exchanges. We have a lot of these initiatives. And I am of firm belief that policy is never going to drive business strategy. I think business strategy has to influence public health policy. And Europe is a great example. And if you look at Europe, even though you have, you know, within the European Union, and if you look at their health system, I spent about six years, you know, teaching global medicine, health equity, Europe, and they have probably one of the best examples for healthcare data portability………
Bridging the Gap Between Software and Traditional Engineering
And there's a lot of culture clash going on, candidly. And I think the good news is, and this is the message we've been trying to share for a while, is folks, if you look at the principles of quality, and you go back to where quality came from in the original concepts, software quality and traditional systems engineering quality are not very different. And if you're running a good, mature software organization in any industry, if you're using best practices and you're agile and you're test-driven design in these things, you're kind of already 80, 85% of the way there to being a good medical device. And you just have to kind of layer on some extra documentation and risk management and validation. And I think that's the biggest single cultural change we're going through is getting these worlds to realize they're not so different and that they can work together.
Recent Innovations in Biotech and Healthcare
Excellent. Moving to you, Dr. Kumar, you're a leader in global healthcare, especially in the life sciences. What are some of the things you're really excited about and seeing? Yeah, Michael, I think Randy and Sergio and you've been doing a great job in setting up the foundation for my answer. So I think there's a lot of exciting activity that's happening both in the life sciences side and in the healthcare side, right? So the innovation in the biotech sector is very robust. If you look at 2023, for instance, we've had about 80 novel biopharma products that got approved by the FDA. And the 2024, the path is on track. And we see a lot of exciting developments in some of the new areas and drug modalities, for instance, in the area of antibody drug conjugates, ADCs, and as well as in cell therapies, right? The two big kind of interventions we are looking at for intractable kind of different types of cancer conditions over there………….
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119 "Harnessing Data and Technology for Next-Gen Healthcare Solutions"