C-Suite Q&A: CEO Robert Garrett on How Powerful Analytics Enable Value-Based Care

Ryan Black

"It truly can transform how we diagnose and treat cancer patients. They've just never had these kinds of tools before," says the Hackensack Meridian Health co-CEO.

In light of the recent announcement of a collaborative pilot program between Hackensack Meridian Health, IBM Watson, and Cota, Healthcare Analytics News spoke with Hackensack Meridian’s co-CEO, Robert Garrett. Garrett has held the role since last year, and is frequently recognized for his acumen, frequently chosen on lists of the most powerful people in New Jersey health and business and participating in the invite-only Wall Street Journal CEO Council.

In conversation, Garrett detailed the necessity of leveraging technology like IBM Watson’s “unprecedented” artificial intelligence and Cota’s precision medicine expertise in order to develop the best, most value-conscious care for patients. The program at hand is looking to develop best-treatment practices for cancer in one health system, but Garrett believes such efforts can prove themselves and be expanded to other health systems and diseases worldwide.

First of all, I would say it’s a very innovative, exciting collaboration between three organizations for the purpose of providing better decision-making tools for clinicians, particularly physicians, in making the best possible clinical decision and treatment plans for cancer patients. What IBM Watson possesses is a global database of information on patients who are treated throughout the world for different types of cancer. Their artificial intelligence capabilities are unprecedented.

Cota is a company that has an expertise in precision medicine and precision analytics, so they can help the clinician, and coupled with IBM Watson’s information on how the masses are being treated for a particular cancer or disease entity, they can then take that specific patient that the physician has in front of them and do their personalized type of plan based on how they responded to treatment or medications in the past.

It really brings together very powerful tools for physicians to participate. The pilot itself will be with Hackensack Meridian Health exclusively, and it will be for 500 cancer patients over the next several months. We hope during that period of time that we prove out this concept, that it does have incredible value, and if it does I think this is something that can be rolled out throughout Hackensack Meridian Health, first to our cancer physicians but it could also have applications outside of cancer as well. That same combination of IBM Watson, Cota, and Hackensack Meridian could really focus on other disease entities outside of the cancer world.

I would also say that if it’s successful, this type of program could be available to other cancer centers and other healthcare providers in the US and beyond.

And how does that partnership fit into Hackensack Meridian’s mission?

I think it fits in with our mission in two ways. Number one, as I just mentioned, is we’re about patient-centered, value-based care, and these tools really can help us deliver on that part of our mission.

The other part of our mission, and our culture, is that we are a culture that embraces technology and that is framed by innovation, and we think that this is a disruptive type of initiative that really makes Hackensack Meridian very innovative in this particular space. In both respects it’s very complimentary to our mission.

Can you tell us about the level of specificity you’re looking for in the recommendations that the combination of tools will put out?

We’re going to be measuring various metrics. We’re going to be looking at a large number of patients and seeing how the clinicians might have treated these patients, or how they were treating these patients prior to this information and seeing how the treatment plan has differed. Also, we’ll be looking at outcomes too, to see how those patients have responded to the treatment plan based on these tools helping the physician to design it.

Will it produce full treatment regimens?

It could give up to a full treatment regimen, or it could give clinicians part of one. Ultimately, they’re going to be the ones who are going to make the final decision in terms of the treatment regimen.

It’s a powerful tool, the other piece I wanted to point out is that because the database is so vast, and there’s so much variation in treatment that occurs today, this will also, we believe, help to reduce some that variation and therefore it will help to reduce costs of healthcare as well. Sometimes a particular treatment protocol is started by a physician and if they’re not responding to it or they’re having adverse complications they may go to another form. Hopefully the decision up front will have all this information thanks to this vast database and they won’t have to change course, if you will, during the course of the treatment.

And what are the dimensions of the pilot, in terms of length and number of patients?

It’ll run until October. There will be 500 patients, there are 10 oncologists who are participating in it, and we expect it to run through October based on those particular physicians and their patient load. We’ll be publicly reporting those results, and as we said, this is something that we want to share with other clinicians within our health network, but well beyond as well because we believe it could be really very transformative in terms of how cancer care is delivered.

[Results will be reported] probably in 2018, because the data would have to be aggregated. We’re educating the physicians now, in terms of the databases that are available. We hope to actually get started within the next couple of weeks. There’s physician education going on, the team is getting together and meeting the IT statisticians, the clinicians, the nurse navigators, and the advance practice nurses are all learning about the capabilities of both IBM Watson and Cota. Cota we have some more experience with at Hackensack Meridian because we’ve been partnered for some time and using their data analytics.

Can you speak to how you’ve used, in the past, their technology?

We’ve been able to use their technology pretty effectively, again, within our John Theurer Cancer Center. The precision analytics that that database and that company provides have been very helpful in really enabling our clinicians to put together more personalized cancer treatment plans for patients. What’s lacking is the vast database that IBM Watson has so that clinicians can see what worked globally across the world, in terms of cancer care, so that’s why this combination is so powerful. Cota by itself is also a very powerful tool that’s been value-added, and by adding IBM Watson on top of that is just gives clinicians just about all the tools that are available today to make the best possible decisions.

How much interaction with the systems will the clinicians have to have?

There’s going to be inputting that will be going on. There’s a lot of education that has to happen, because our clinicians are not familiar with IBM Watson so the IBM Watson team is working closely with our team in making this pilot as effective as possible.

What do you think is the most exciting part of this relationship?

I think the most exciting part is really giving physicians information that they’ve never had before in designing treatment for cancer patients, and possibly even in the area of diagnosis, based on some information. I think the most exciting thing is that it truly can transform how we diagnose and treat cancer patients. They’ve just never had these kinds of tools and this kind of information before, to me that is so exciting.

We’re all about innovation, we embrace technology to make the best possible clinical decisions, and at the end of the day what we’re here for is to get the best possible outcomes for our patients, and this really has the potential to be a game changer.

Speaking to the value-based effort, the phrase is thrown around a lot to the point that it might become abstract. Are we starting to see the effort progress to the point that these analytics techniques are showing verifiable impact?

I believe they will. They’re helping us design, based on the data analytics, bundles of care in the arena of cancer. We’re in the process of finishing 27 distinct bundles of care at John Theurer at Hackensack Meridian. Those bundles of care, when they’re rolled out, are really all about value, all about providing what the patients want from a quality and experience perspective, and we’re able to deliver that as efficiently as possible. So the value proposition we believe is tied to the development of the bundles, and the bundles could not be developed without analytics tools like Cota and IBM Watson.

This is something pretty new and pretty unique. We’re in the process of trademarking those 27 bundles, they’ve just been developed. Getting back to the economics and the value proposition, that shows the best promise for really creating value for patients and to the whole healthcare system.