How real is blockchain’s potential to improve healthcare? “It’s really real,” said Tony Scott – the former chief information officer of the United States and senior advisor for Squire Patton Boggs – at W2O Group’s 4th Annual Digital Health Luncheon. Held in tandem with the J.P. Morgan Healthcare conference (JPM18) – which effectively marks healthcare and life science’s annual pilgrimage to San Francisco, CA – this year’s luncheon explored what practitioners and patients alike can expect from blockchain, AI and genomics, and where we will continue to see the digital health investment dollars flow in 2018.
Jonathan Bush, athenahealth’s chief executive officer, kicked off the event, talking to attendees about how AI can help reduce healthcare’s state of friction. He also spoke about the industry’s tendency to put the cart before the horse when it comes to advancing new technologies.
Jonathan noted that “when we see a break, when we see an invention, when we hear a new keyword, we run with it in our minds so much faster than the gears of society and marketplace can move, that we find ourselves alone on a deserted island, with none of the things that we wanted.” However, he was also candid in saying that, when it comes to AI, “it’s okay to get excited.”
“Any time you have millions of examples, and a relatively infinite set of outcomes, you can use machine learning,” said Jonathan, though designing for data flow is a necessary piece of the puzzle. With the right flow of data and application of AI, “we can take tens of thousands of hours of work, and make it instantaneous,” he said.
What about blockchain? As John Moore, founder of Chilmark Research, shared at the start of the panel, “Frankly, there’s a lot of noise and not a hell of a lot of signal,” noting that most people do not yet understand blockchain technology in the context of healthcare.
Chief technology officer and co-founder of PokitDok, Ted Tanner, was clear to make the distinction that blockchain is not bitcoin, explaining that the former is an infrastructure and the latter is a cryptocurrency. Ted described blockchain, a distributed ledger technology, as a distributed database that allows all participants on a network to see operational transactions in a secure digital environment. So secure, Ted said, that blockchain “adds a level of resilience over and above anything that was previously applicable in tech.”
Tony, who was responsible for federal cybersecurity strategy and is credited with creating the first government-wide open source policy, agrees with Ted in terms of blockchain’s potential to disrupt the industry. Tony predicts that blockchain will change the way that the healthcare ecosystem works, highlighting the billions of investment dollars going into the space as one indicator of what is to come.
Something to watch for when it comes to blockchain’s impact on healthcare, said Tony, is elimination of the middle-man. He believes that blockchain will facilitate a more direct connection to the ultimate service provider, cautioning attendees that, “If you’re in the middle, you’re on thin ice.”
Sutter Health’s chief of digital patient experience (how great is that title?), Dr. Albert Chan, introduced the concept of human ROI to the blockchain panel discussion, explaining how blockchain can help combat the crippling effects of physician burnout. “Fifty percent of doctors have more than one sign of burnout,” said Albert, who spoke to the findings of a Sutter Health study that found for every 3.08 hours of patient visits, doctors spend 3.17 hours on a desktop medicine each day.
“You want your doctor doctoring,” said Albert, who discussed how blockchain can take dollars away from transactional and administrative costs and allow those resources to be spent on patient care. He also noted that what the industry really wants is better data utility and access, which blockchain can help facilitate.
Rounding out the discussions, David Ewing Duncan, author of When I’m 164, pondered the future of direct-to-consumer genomics with fellow industry experts Jessica Richman, chief executive officer and co-founder of uBiome, and Dr. Michael Nova, chief innovation officer of Pathway Genomics.
Michael considers medicine to be “a big systems problem”—genetics data cannot be used in a vacuum—and requires “a lot of other systems to make sense out of it.” In 2009, Michael was the doctor of record for the first human that Illumina ever sequenced, which at the time carried a price tag of US $300,000. In 2018, he says that will run a patient around $1,000.
Looking further at how the consumer genomics space has evolved over the past decade, Michael shared that, “When we first started this journey, I used to get a lot of questions,” but that now those questions are simply “who pays, and how much.” Jessica noted that, while wellness genomics tests are covered by insurance about 50 percent of the time, “we had to do a lot to get there.”
Clinicians attitudes and appetites for genomics have increased in recent years, with much of that having to do with patient engagement. “Compliance and patient engagement are two sides of the same coin” said Jessica, who noted that patients coming to their physicians and asking for testing is a good thing. “One in five women don’t get screenings they should,” and any kind of awareness that can drive them to stay engaged with their health over time is a positive.
In looking ahead at what is to come – and where he is focusing his writing these days – David shared that he is looking more at metanomics, or multinomics, which he described as starting with genomics and expanding to other areas, such as the microbiome. David believes that genomics is just the starting point – an important base, but one requiring far more dynamic systems (e.g., the other “omics”) to be built out on top of it.
“I’ve long been a skeptic, as you might be able to tell, of a lot of this data,” said David. But what he is no longer skeptical about today is the technology itself, nor does he feel it is what’s holding progress in genomics back. “In a lot of ways, the technology isn’t the barrier anymore. It’s really how society is going to receive this… It’s policy and politics less than technology, at this point.”
For more information on W2O Group’s 4th Annual Digital Health Luncheon, held in partnership with Squire Patton Boggs, please see the Facebook Live replay and follow #W2ODH18 for updates. Curious what happened at the 3rd Annual Digital Health Luncheon and if the predictions about value-based care driving investments came true? Find out here.