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On the flip side, current incentives are driving many of healthcare's worst behaviors.
Improved data sharing between pharmaceutical companies could solve some of healthcare's biggest problems. An easy-to-use electronic medical record (EMR) could save physicians thousands of frustrating hours every year. So why don't we share data and build better EMRs? Because the incentives aren't driving the innovation needed to drive change.
The good news? Outside disruptors have their own incentives for pursuing innovation in healthcare.
A Healthcare Analytics News® Peer Exchange®
Kevin R. Campbell, M.D.: I would also go back to the pharmaceutical comment. Does the pharmaceutical industry drive innovation? Absolutely. The problem is that Johnson & Johnson does not share data with Pfizer or Merck. Until we have open data and open access, which we may never have, innovation will remain at a very slow rate in those areas because Pfizer may have a piece that Merck doesn’t have. There’s a hashtag on Twitter called “open access." We started it at American College of Cardiology, and we’re trying to promote that type of data sharing. The Duke Clinical Research Institute basically opened its data banks and said, “We’re not going to charge you. Anybody who wants to use our data to innovate, use our data,” and I think that’s critical. Because right now, and I’m not bemoaning it, pharmaceuticals are about pharmaceuticals. They want to put money in their shareholders’ pockets because they have to go answer to Wall Street every single day.
John Nosta, B.A.: Thank you, comrade, for that. You have wonderful insight into sharing data. It’s not going to pay my mortgage.
Kevin R. Campbell, M.D.: That’s the problem, and I think it’s a big issue. With pharmaceutical companies siloing data, innovation is lagging behind when we could be much further ahead.
John Nosta, B.A.: I think that economics and IP (intellectual property) are certainly big problems. But just as you would argue that the democratization of data and the transference of data from one silo to the other silo is important, the economics of innovation are just as powerful. The ability to make money and to develop drugs …
Kevin R. Campbell, M.D.: It’s the incentive.
John Nosta, B.A.: It’s the incentive. I think it’s a tricky, tricky idea.
Kevin R. Campbell, M.D.: Here’s the flip side. I have a child with type 1 diabetes. Insulin has gone through the roof. Why has it gone through the roof? Because the three main makers of insulin, who force you to use analogues, have sued the companies that are making biosimilars to make them stop so that they can’t make a cheaper version of insulin. I have insurance. There are kids out there and adults out there who don’t take the necessary insulin they need because they can’t afford it.
John Nosta, B.A.: Is that discussion, Kevin, part of the innovation discussion, or is it part of the litigious environment?
Kevin R. Campbell, M.D.: No. I think it’s part of blocking innovation through greed.
Geeta Nayyar, M.D., MBA: It’s also about responsibility, right? When we look at some of the larger tech legacy systems—EPpic, Cerner, Allscripts, NextGen, eClinicalWorks—they have all those data, right? They have all data.
To your point, even one of them can start to disrupt in this space and look outside of the EMR space in a truly disruptive way. You’ve been following Allscripts for some time, and they made an acquisition of a company called HealthGrid. They do our patient engagement. It is fascinating that they have actually, from an EMR standpoint, accepted that fact that people are not going to their portal. They’re not going to the portal.
So how do we get another company in here that’s going to text patients, “You turned 40. Happy birthday. Here’s your mammogram,” right? “You’re not going to the portal. No problem. Here’s a text, here are your lab results, here’s your discharge summary.” I think we have to look at companies like Allscripts and we need to turn to a company like Cerner or Epic and say, “What have you done for the industry lately?” It’s very similar to pharmaceuticals. They have an opportunity to make more money. Please make more money. Please innovate so that you make more money.
John Nosta, B.A.: I agree. I won’t argue with that.
Jane Sarasohn-Kahn, M.A., MHSA: Maybe Apple Health Records will help solve that as well. One of the words we haven’t mentioned yet in these disruptive companies is design. Design is very, very important. It’s the secret in the sauce of Amazon. It’s the patient engagement, the customer experience. It’s why people like Wegmans grocery stores and Chick-fil-A, because they get customer experience right. Apple Health Records has that opportunity, so maybe people will engage more if it’s a sexy, fun portal that’s relevant to me.
John Nosta, B.A.: Maybe that is the domain of Amazon. To me, Amazon doesn’t want to be a pharmaceutical company, and quite frankly, pharmaceutical companies don’t want to be Amazon either. Yet they fight over the same turf in this abstract notion defined by patient centricity, which makes me crazy. Let Apple be patient centric. Let pharmaceutical companies be the bastion of brilliance where innovation can percolate. Again, we mush them together, and it’s funny.
Geeta Nayyar, M.D., MBA: I think to your point about design, Jane, it’s about keeping it simple, right? In health care, we all think it’s special and really sensitive information. Look at the banking industry. Look at the airline industry. Look at the hospitality industry. You don’t have to stand in long queues at airlines anymore. You check in before you go. When’s the last time you actually physically went into the bank? You don’t have to.
John Nosta, B.A.: You’re spot on. Do you know the Apple store? The inspiration for the Apple store came from hotels.
Geeta Nayyar, M.D., MBA: Exactly.
John Nosta, B.A.: It came from the concierge model. Steve Jobs recognized that the concierge is the greatest thing, so they invented the Genius Bar. Why can’t we have a Genius Bar in our doctor’s offices?
Geeta Nayyar, M.D., MBA: The thing about Apple is that it’s a great example, because with any Apple product, when you open it, do you get trained on it? Do you have to do training?
Jane Sarasohn-Kahn, M.A., MHSA: You don’t have to.
Geeta Nayyar, M.D., MBA: There’s no patient portal training. You don’t need to get trained on how to open a text message so that you can get your clinical data. I think with the industry, we have to keep it simple.
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