The 2019 Healthcare Analytics Summit: Wednesday Recap

HAS 19 logoWednesday – MORNING GENERAL SESSION

Keynote 1 – HAS App Preview and Instructions

Paul Horstmeier – Chief Operating Officer, Health Catalyst

Andrew Frueh – Vice President, User Experience, Health Catalyst

On Wednesday morning, Health Catalyst COO Paul Horstmeier opened the HAS 19 general session with an introduction and a tour of this year’s HAS app. He also introduced Andrew Frueh, vice president of user experience and the one person that thinks more about the HAS app than he does. This year’s app is the connection to everything attendees want to do at HAS 19: learn about sessions, connect with speakers, network with peers, set up Braindates, write notes about presentations, and, of course, play the HAS game. And, back by popular demand, the app has a new and improved applause meter.

At Health Catalyst, one of the first things data analysts learn is to “listen to the data.” Last year’s data told us that one of attendees’ favorite things were the crazy, wild, and funny #SocksofHAS. This year’s #SocksofHAS competition is back and better than ever. Mr. Horstmeier, Stuart Gold (aka the voice of HAS), and Data Analyst Emily Tew each had their own pair of custom socks that took the competition to the next level.

Welcome and Overview

Dan Burton – Chief Executive Officer, Health Catalyst

Next, Health Catalyst CEO Dan Burton introduced this year’s theme for HAS 19: powering digital transformation in healthcare. HAS 19 attendees will learn from the digitization of other industries, find digitally driven disruption occurring in healthcare today, talk about machine learning and predicting/preventing problems, and look at organizational transformation by embracing data.

The shared challenge of healthcare today is transforming to survive and thrive; however, the transition to value-based care requires doing more with less. How can we reconcile these two facts to embrace digital innovation and disruption while still operating within the current constraints and realities of today’s healthcare environment?

Continuing his tradition of sharing inspiration from movies, Mr. Burton shared with attendees two movie clips from Apollo 13, including the famous quote: “Houston we have a problem,” a line that might resonate with those have encountered unforeseen challenges in their data analytics. Apollo 13 offers parallels to today’s challenges and introduces the notion that technology alone is almost never enough to create change—it must be coupled with a deep commitment to the mission that is bigger than each of us. Space exploration and healthcare analytics also share the lesson that overcoming challenges requires an extended team of committed individuals working together. Like space exploration, transforming an industry using data and analytics is not for the faint of heart. With the talented 10 keynote speakers and over 25 breakout sessions to choose from, Dan was confident attendees will leave HAS better equipped to face these challenges.

Keynote 2 – Is There an Avatar in the House? Changing the DNA of Health Care in the Age of AI 

Stephen Klasko, MD, MBA – President, Thomas Jefferson University; CEO, Jefferson Health

This year’s conference is about the future of healthcare, but Dr. Steven Klasko brought attendees back to 1979. The Rolling Stones played “You Can’t Always get What You Want,” Star Wars topped the movie charts, and Dr. Klasko wondered how to get physicians to embrace change to transform healthcare. Now, in 2019, Dr. Klasko recently saw the Rolling Stones in concert, there’s a new Star Wars movie coming out soon, and he still has the same questions about how to transform healthcare. While there has been incremental change, much of the industry remains stuck in the past. In 2019, 60 percent of hospitals still send patients their appointment reminders by mail. But Dr. Klasko says the biggest risk to healthcare is the inability to fundamentally transform its business model. While he says the goal isn’t for patients’ iPhones to become their doctors, much of what doctors do can and should be replaced by a computer.

Dr. Klasko emphasized maintaining a 2029-mindset in healthcare, in which he envisions healthcare has “smashed” the cost, access, quality, and patience experience curve through a series of disruptive changes, including the idea of healthcare at home. In his keynote, “Is There an Avatar in the House? Changing the DNA of Health Care in the Age of AI,” he suggested solutions for reshaping the industry through deep learning, machine cognition, and augmented intelligence and shared tips for how we can all be a part of this transformational journey.

He wrapped up the presentation with a reminder from our Star Wars friend, Yoda, “Do or Do Not…There is no try.” Lastly, he said that AI and telehealth won’t transform healthcare, it’s how we use it that will drive a real, long-lasting transformation. 

Keynote Session 3 – Criminal Justice Analytics

Anne Milgram, JD – Former New Jersey Attorney General, Senior Fellow at NYU School of Law

Anne Milgram, JD, worked her way up in the criminal justice system, from prosecuting trivial cases to becoming the Attorney General of New Jersey. For years she believed that fighting crime equaled public safety. She pushed for more convictions and lengthier sentences, but crime rates and recidivism remained stagnant. She knew she had to do something different and began studying data to catalyze true change in the criminal justice system. She found remarkable parallels between the healthcare and criminal justice systems. In fact, they are often different pieces of the same puzzle: 67 percent of frequent users of the criminal justice system are also frequent users of the healthcare system. And, social determinants of health are also social determinants of justice. The “super utilizers” of both systems have inordinately high rates of substance abuse problems, mental health disorders, and homelessness.

Neither healthcare nor criminal justice systems are treating the underlying problems. Ms. Milgram has helped to create and implement a screening tool to identify mental health issues and substance abuse problems. But, she says, it’s not enough to build tools–we have to transform systems. One of the keys to doing so is eliminating the silos that exist between healthcare, criminal justice, education, public housing, and other industries. She challenged HAS 19 attendees to reach across these aisles as they look to solve the pressing problems of the healthcare industry.

Ms. Milgram said that data can be the turnkey for change, but more important than the numbers is what you do with it. She concluded with three Invitations to the group:

  1. Do what you do. invite and include people from other sectors
  2. Think about social determinants of health as social determinants of crime, social housing, policy, etc.
  3. Silos kill innovation, but analytics will save it.

Keynote 4 – Leadership and the New Principles of Influence

Daniel Pink, JD – Renowned Leadership and Change Management Expert; Best-selling Author

In this provocative keynote session, best-selling author Daniel Pink offered two big ideas, three guiding principles, and three actionable takeaways for HAS attendees. The first idea Mr. Pink presented was that, like it or not, we’re selling (persuading, influencing, convincing, cajoling) all the time. For example, 40 percent of people spend a significant portion of their workday trying to persuade, influence, and cajole, which is not typically in anyone’s job description.

The second idea is that we’re doing it in a remade landscape. Previously, buyers experienced what Mr. Pink called a landscape of “information asymmetry,” where the seller has more information than the buyer. Consumers now live in a time of information parity, and this has fundamentally changed every industry, from car sales to healthcare.

Referencing the famous selling philosophy from the classic movie Glengarry Glen Ross, “Always Be Closing,” Mr. Pink shared the new ABCs of selling in today’s remade landscape:

  • Attunement: People need the ability to see things from another’s perspective, understand different points of view, and find common ground.
  • Buoyancy: One of today’s biggest predictors of success is how well they can stay afloat in the “ocean of rejection” and bear rejection with grace.
  • Clarity: In a world of AI and machine learning, problem solving is becoming commoditized. Today’s world instead belongs to problem finders.

Lastly, Mr. Pink shared the following three actionable takeaways:

  1. To be more persuasive, be more like yourself.
  2. Consumers are most likely to buy an item when they hear a list of positives followed by a minor negative.
  3. Spend less time changing people’s minds and more time making it easy for them to act.

Wednesday – Afternoon Session

Wave 1 – 05 – Getting to Data-Driven Population Health Management: Four Innovative Outliers

Holly Rimmasch, Chief Clinical Officer, Health Catalyst

Lissy Hu, MD, MBA, Chief Executive Officer and Founder, CarePort Health

Azalea Kim, MD, MBA, MPA, Primary Care Physician and Medical Director, Health Data Science and Strategy, Duke Forge

Anant Vinjamoori, MD, MBA, Product Manager, Clinician and Patient Experience, Virta Health, and Internist, UCSF Medical Center

In this session, five panelists representing engagement with data-driven population health management (PHM) answered questions covering a range of topics:

1. How do you view value-based Care (VBC) through the lens of your organizations?

Dr. Hu noted that most organizations are trying to achieve a balance between innovation and consolidation. Panelists all emphasized that their organizations have carefully considered the definition of “value,” particularly from the patient perspective.

2. What are the major obstacles that provider organizations face in shifting from fee for service (FFS) to fee for value (FFV)?

Pulling together the disparate parts of the care delivery system is a challenge for everyone, as organizations lack the data they need to truly manage across the continuum of care. Dr. Kim noted a fundamental mismatch between the jobs that need to be done to provide value to patients and the way healthcare systems are designed.

Dr.Vinjamoori acknowledged several challenges fundamental to the notion of VBC:

  • Agreeing on what value actually is.
  • Accruing some types of value.
  • Attributing the value.

3. What advice can panelists offer for innovative ways to use data and analytics to support the transition from FFS to FFV?

Dr. Vinjamoori spoke about the importance of aligning and coordinating the pillars of success that his care management service company, Virta Health, has identified:

  • Right payment model.
  • Right technology model.
  • Right operation model.
  • Right organizational design.

Panelists also agreed that integrating analytics into the workflow is key. Start with what the clinicians need to do to care for patients; be creative about redesigning care delivery as needed to deliver value; then make data and analytics support that work. Also, be sure you build in ways to measure the value your work.

4. What organizations are panelists following closely around work to advance VBC? What developments in PHM are panelists most excited about?

Panelists mentioned Aledade and Iora as an impressive innovators for value-based primary care and were enthusiastic about using social determinants of health (SDOH) data and telemedicine to deliver value to patients. All were enthusiastic about the future of PHM as innovation—and demand for change—continue to accelerate. 

Wave 1 – 06 – Designing Effective Clinical Measurement: Recognizing and Correcting Common Problems

Brent James, MD, MStat, Clinical Professor, Department of Medicine, Stanford University School of Medicine; Senior Adviser, Health Catalyst

Dr. W. Edwards Deming, the father of quality improvement theory, famously noted that “aim defines the system.” This is especially true for clinical measurement. In this breakout session, Dr. Brent James examined the principles that underlie effective clinical measurement, starting with the very idea of “transparency.” He discussed data for selection versus data for improvement and the proven methods for selecting appropriate subsets of measures. There are fundamental problems with the underlying science of measurement for selection and, as a result, they produce unreliable rankings. For instance, there are 150 groups that rank hospitals, each reporting very different results. Across these rankings, 31 percent of hospitals in the U.S. are in the top two percent of performers, demonstrating the inherent flaws with measurement for selection.

Deming noted that when people are pressured to meet an external target, they can work to improve the system, suboptimize the system by working harder, or game the data. Examples of this include the VA waiting list scandal, the Wells Fargo credit card scandal, and countless others. After addressing how to choose the right data elements and the importance of doing so. Dr. James turned his attention to turning theory to reality. Gauge theory says that measured performance is always a blend of the measurement system and actual performance. Given the complexity of clinical care, Dr. James concluded that any legitimate clinical outcomes measurement strategy will always include a mechanism for data system validation and a feedback mechanism for the systematic improvement of the data system itself.

Wave 1- 08 – Meaningful Measures: Prioritizing Patients Over Paperwork (Clinical, Financial, Course Level: Beginning)

Kimberly Rawlings, MPP, Measures Management System Lead, CMS

The widespread concern that providers are busier with computers than they are tending to patients drove CMS’s Meaningful Measures initiative, with the end goal of prioritizing patients over paperwork. Kimberly Rawlings, measure management system lead at CMS, informed the group that the primary goal of the new initiative was to remove obstacles that prevent clinicians from spending more time with their patients.

One of the biggest barriers was interoperability—the inability to share data between systems meant a black box that ended in disconnected patient care.

The Meaningful Measures Initiative—launched in 2017—aimed to improve patient outcomes while reducing both the data reporting burden on clinicians and hospital costs.

CMS rallied its team around the Meaningful Measures objectives, created a concrete framework, and agreed on key levers to drive quality reporting. With the patient-provider relationship at the center, CMS was ready to focus on effecting change in the identified areas of improvement.

For example, in the Consideration List section, CMS saw dramatic results. In the past two years, CMS narrowed the initial 184 measures to 32 measures and decreased the submitted 67 measures to 39 measures, resulting in a reduction in stakeholder review efforts and faster reporting.

Kim concluded the presentation with a reminder that all of CMS’s efforts, including emphasizing outcomes and patient population measures, improving electronic infrastructure, and optimizing measure sets, share one primary goal—to prioritize patients over paperwork.

Wave 1 – 09 – Serving the Traditionally Underserved with Population Health Improvements (Clinical, Financial, Analyst, Course Level: Beginning)

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP, Director, Waiver Quality Operations, The University of Texas Medical Branch

Andrew T. Herndon, MHA, CSSGB, Senior Business Manager, Office of the President, The University of Texas Medical Branch

Based on current U.S. health statistics, population health is an increasing urgent competency for healthcare organizations, particularly around improving care for traditionally underserved populations. Among the figures Susan Seidensticker and Andrew T. Herndon, both from The University of Texas Medical Branch (UTMB), cited include that 6 in 10 U.S. adults have a chronic disease (and chronic diseases are the leading cause of nation’s $3.3 trillion annual healthcare costs) and that 30.3 million Americans have diabetes (the seventh leading cause of death).

To support its goal to help people control their health conditions and stay out of the hospital, UTMB had to overcome common population health challenges (e.g., patient engagement, provider attribution, etc.). The organization built an analytics application to provide near real-time insight into improving care for underserved populations. It focused on outcome-driven measures that tied payment to performance (per DSRIP) that impacted underserved population (e.g., those on Medicaid or who are low income). Stakeholder buy-in was key to improvement for underserved population, and UTMB used timely analytics to earn provider buy-in around population health improvements. Using analytics, UTMB engaged providers to support breaking down silos, prioritized interventions and resources, ensured standard work across multiple clinic locations, and increased pay-for-performance dollars while improving patient outcomes.

Wave 2- 10 – Expediting Mergers & Acquisitions: The Role of Data and Clinical Evidence (Strategy, Financial; Course Level-Intermediate)

Hani Elias, JD, MPH
Chief Executive Officer, Lumere

Amy Whitaker, RN
Vice President, Supply Chain Clinical Integration Accountability, Bon Secours Mercy Health

During healthcare mergers, expectations of cost savings are high; in reality, most healthcare systems achieve just 1.5 percent of their expected cost savings. When Bon Secours Mercy Health merged in 2018, the supply chain team was determined to leverage clinical evidence and analytics to accelerate the benefits of their merger and realize cost synergies.

Shortly after the merger, the team received a mandate to come together to determine the estimated cost savings. After a steering committee’s careful review, they set the savings target at 10 percent for the first fiscal year.

The team’s first steps were 1) creating a “source of truth” for the combined data of both systems; 2) aligning the workflows of the two systems using Lumere; and 3) leveraging clinical analytics to accelerate the benefits of the merger.

As they began working with physicians to gain buy-in, they started conversations (e.g., around quality metrics, safety issues), then connected the supply chain associated with that outcome.

Through effective communication with the entire healthcare system and support from executives, Bon Secours Mercy Health is on track to save 90 million in cost savings across the organization.

Wave 2- 11 – New Ways to Improve Hospital Flow with Predictive Analytics (AI, Operations, Analyst, Course Level: Advanced)

Michael Thompson, MS, Predictive Analytics Executive Director, Enterprise Data Intelligence, Cedars-Sinai Medical Center

Two years ago, when Michael Thompson started working at Cedars-Sinai, long-term leadership were retiring, and he recognized this transition as a perfect opportunity to create a new team called the Enterprise Data Intelligence Team. The new team’s primary goal was using data to improve decision making. Their data science platform, ALEx, or Cedars-Sinai Automated Learning by Example, tracked the data journey through an end-to-end ML pipeline leveraging a mix of best-of-breed open source and proprietary technologies.

Like many hospital systems, Cedars-Sinai was experiencing capacity strain on their resources, causing it and, most importantly, its patients to suffer negative consequences like delays for surgical procedures, ICU readmits within 24 hours, ED crowding, and staff burnout. In response, Thompson and his team created a predictive analytics model to prevent diversions, eliminate wait time, improve staff time, and increase the number of patients admitted, and more.

Thompson and his team built a data infrastructure that captures all the data from multiple sources, including historical data, to tackle each unique challenge. It proved to be incredibly more accurate than the human-based predictive models. ALEx’s predictions proved to be the most accurate overtime:

  • 93.1 percent accurate for admission prediction.
  • 97.1 percent for census prediction accuracy.
  • 91 percent discharge prediction.

The predictive models resulted in better numbers, but more importantly better patient outcomes. Cedars-Sinai is utilizing the discharge lounge more often, freeing up more hospital rooms, increase discharges before 11 am and decrease average minutes spend in the ED.

Wave 2- 12 – Be a Change Agent for the Next Healthcare Revolution: Payment Model Redesign

Will Caldwell, MD, MBA
Senior Vice President, Physician Market Development, Health Catalyst
Senior Health Advisor, Zanmi Lasante/PIH

Dr. Caldwell started his presentation with a simple question to the audience: “How are we doing?” The “we” is U.S. Healthcare—and unfortunately the answer is “not so well.” The U.S. is number 1 in healthcare spending, and costs have risen faster than those of other countries for the past four decades, mostly attributable to a disproportionate increase in administrative burden. It’s an unsustainable situation.

The good news: Dr. Caldwell believes that we’re in a good spot here in the U.S. to reform healthcare—and that payment model redesign (e.g., shared savings) is the catalyst. While many view shared savings as just a phase, Dr. Caldwell presented data that shows otherwise. The percentage of total healthcare payments linked to some sort of value-based payment reached 34 percent of total dollars paid to providers in 2017. And the move to value is working: for example, in 2018 Medicare showed a gross reduction in utilization of services by $1.1 billion and $800 million in shared savings bonuses paid to ACOs.

Because it’s estimated that by 2022, 40 percent of our population will be part of Medicare and Medicaid, the federal government has a role to mandate needed change. The Medicare Shared Savings Program (MSSP) is a step in the right direction. Dr. Caldwell summarized the core changes in 2019 and challenged the audience to be the change agents we need. He stressed that the currency of change is data—and if we aren’t willing to take up the mantle, maybe we should find another job.

Wave 2- 13 Panel: The Case for Advanced Activity-Based Costing: How Cost Accounting Technology Must Evolve to Meet the Future of Value-Based Care (Innovation, Financial, Course Level: Advanced)

Robert A. DeMichiei
Executive Vice President and Chief Financial Officer, UPMC

Bob Alexander
Sr. Director, Financial Implementation Services, Health Catalyst

Migdalia Musler, MHSA
Chief Operating Officer, University of Michigan Medical Group

Dan Unger, MBA
Senior Vice President and General Manager, Financial Transformation Business, Health Catalyst

Healthcare costing has historically relied on relative value units (RVUs) and cost-to-charge—leaving systems unable to perform in-depth analysis and identify variation. As healthcare systems move from fee-for-service to capitated models, they need to capitalize on the vast data available in today’s source systems—EMR, general ledger, and so on. Across-the-board costing initiatives punish high performers.

Activity-based costing (ABC) not only reduces variation, it can also help systems grow with the same resources, identify how to manage patients more efficiently, and evaluate the cost effectiveness of high-risk contracts.

In analyzing whether ABC would help your system, consider questions like these: Can you analyze service-line financials on a repeatable basis? How do you measure success and clinical outcomes? How do you track physician variation and evaluate efficacy between different service lines? You simply can’t perform these analyses with RVUs because you don’t have the right data. If you don’t have costing data—which accounts for about 98 percent of your revenue—you could be making the wrong decision.

Two key audiences are critical to gaining buy-in for ABC:

  • C-Suite. Having robust ABC helps fulfill one-third of the Triple Aim. If your CFO is saying “RVUs are enough,” they’re simply not focusing on the Triple Aim.
  • To engage these stakeholders: 1) Expose them to variation and allow them to “self-correct,” and 2) Help them understand and gain trust in the data.

Session 14: Unlocking More than $15M in Improvement Across an Integrated Delivery Network

Patrick McGill, MD. EVP Chief Analytics Officer, Community Health Network

Travis Lozier, CMBB, PMP, VP Performance Excellence, Community Health Network

Patrick McGill and Travis Lozier opened the session by introducing the audience to Community Health Network (CHNw), an integrated delivery network with more than 200 total sites of care, explaining that the challenges they faced implementing meaningful improvements across such a large and complex system.

CHNw has resourced eight permanent improvement teams, trained more than 800 leaders in their new improvement approach, and now have 35 active improvement projects in process. Although they report outcomes to their leadership in terms of lives impacted and saved, key financial outcomes to date include the following a $15.5M in savings from sepsis improvement work, $3.2M in orthopedic service-line savings, and more.

The presenters offered lessons and recommendations for others looking to transform their organization’s ability to reliably create, scale, and sustain meaningful improvement:

  • Run it like a marathon, not a sprint
  • Get help for the hard work.
  • Engage senior leaders.
  • Support one another.
  • Fuse a solid improvement method to the latest analytics.

In the Q&A session, the presenters also emphasized the importance of having financial analysts on improvement teams to help calculate ROI and to boost credibility of business cases made to senior leaders.

Wave 2- 15 – How Real-World Data Can Rescue Clinical Trials and Save Lives (Panel) (Clinical, Life Sciences; Course Level-Beginning)

Jessica Federer – Former CDO, Bayer

David Putrino, PT, PhD – Director, Abilities Research Center; Assistant Professor, Rehabilitation and Human Performance, Icahn School of Medicine, Mount Sinai

Sadiqa Mahmood, DDS, MPH – Senior Vice President of Medical Affairs, Health Catalyst

Elia Stupka, PhD – Senior Vice President and General Manager, Life Sciences, Health Catalyst

Recently, FDA support of real-world data (RWD) and real-world evidence (RWE) for approval of new drugs in therapies has paved the way for use of RWD and RWE in clinical trials.

Traditional clinical trial methods are outdated and slow. It’s difficult to enroll the right people. Pharma companies “put all their eggs in one basket,” focusing on developing very few therapies and at great cost. With RWD/RWE, trials will be faster, better, and cheaper. For treating people with rare diseases, RWD/RWE can be invaluable. As that data sets grow, more people with that disease can be identified and studied.

All panelists were optimistic that RWD/RWE will be used increasingly to develop new therapies; however, challenges exist:

  • Healthcare systems can be reluctant to share their data. But it’s important to realize that one system’s data is only a very small piece of a much larger and richer puzzle.
  • Bias can exist in data sets. Currently, the majority of data is for white, wealthy, and mostly American patients, meaning that EHR data has implicit bias and is not future proof. Researchers should correct for this.
  • People fear data security issues. But if patients understand the research effort, they will usually give their permission for their data to be used, especially if they get reports on the research’s findings.

Wave 2- 16 – Using Net Promoter Score Patient Loyalty Tracking to Improve Health Outcomes and Revenue (Clinical Financial, Operations, Course Level: Beginning)

Michelle Babcock, PT, MSPT, Chief Experience Officer, Spooner Physical Therapy

Russell Olsen, Vice President, Innovation and Product Management, WebPT

Michell Babcock and Russell Olsen have adopted a patient loyalty-first strategy to improve reputation, health outcomes, and revenue. Following the perspective of Janet Robinson, former president and CEO of the New York Times, “Repeat business or behavior can be bribed. Loyalty has to be earned,” Babcock and Olsen have tracked patient experience. But to effectively leverage patient experience, they’ve needed a data-driven measure of patient loyalty using a net promoter score (NPS).

Using NPS, Babcock and Olsen have identified unhappy patients early and worked with them to improve their experience. NPS is a more reliable measure of patient experience than traditional standards (e.g., satisfaction). It’s easy to digitize, operates with one questions (e.g., How likely are you to recommend practice to family member or friend?), is highly sensitive, identifies trends, has available benchmarks, and is repeatable during care. A one-star improvement in NPS can translate to a 5- to 10-percent increase in revenue. For their organizations, Babcock and Olsen improved NPS from 79 to 90, increased ROI by almost 12-fold, and added $306,000 in added revenue and $234,000 in potential retention revenue.

Their NPS campaign highlighted the importance of data transparency (meaningful feedback improves the patient experience), taking time to work on business best practices in addition to clinical best practices, understanding the patient experience from “couch to claim,” and understanding there’s more about the patient experience than data.

Evening Orientation, and Analytics Walkabout and Digital Innovation Showcase Winners

Paul Horstmeier – Chief Operating Officer, Health Catalyst

Paul Horstmeier took the stage and wasted no time announcing the winners from the previous night’s Analytics Walkabout and Digital Innovation Showcase and the recipients of The Catalyst Awards.

He continued with a reminder of the evening’s events:

  • The HAS Fun Run.
  • A walking tour of Salt Lake City.
  • The “Dine on Us” dinner option.
  • The evening reception.

After a quick recap of the day and a reminder about tomorrow’s agenda, Paul concluded the first official day of HAS 18.

Keynote 17 – Netflixing Primary Care

Lyle Berkowitz, MD, FACP, FHIMSS – Chief Medical Officer and EVP of Product, MDLIVE; President, MDLIVE Medical Group

It’s time to bring the house call back, said Lyle Berkowitz, MD, FACP, FHIMSS. However, we have to do so using automation and virtualization. Referencing Netflix founder and last year’s HAS keynote speaker Marc Randolph, Berkowitz said we must “Netflix” Primary Care, which requires the ability to scale current telehealth practices. He also reiterated Mr. Randolph’s warning from last year: “The people that disrupt you will look nothing like you.” The healthcare industry must rethink primary care, including the healthcare pyramid that focuses care on the complex top five percent of patients and, instead, consider ways to automate care for the bottom majority of less complex patients.

To close the gap between what health systems need to do and how much time the staff has, the first answer was HIT-empowered team-based care. The best way to deliver care to the masses effectively—a world where people experience healthcare from wherever they want, and only a small portion experience healthcare in a brick and mortar.

Dr. Berkowitz listed five “Rs” to guide this new mindset:

  1. Relationship.
  2. Results.
  3. Referral management.
  4. Remote patient monitoring.
  5. Remote diagnosis Rx.

At the end of his keynote session Dr. Berkowitz joined Paul Horstmeier, COO, and Dale Sanders, CTO, of Health Catalyst for a Q&A Session. Dr. Berkowitz illustrated the lessons of virtualizing primary care using magic tricks and addressed questions such as “What happens to physician satisfaction with virtual care?” “What does a virtual physician’s typical shift look like?” and, “How is virtual care affected by quality measures?”

Keynote – 18 – Understanding “Thinking Biases” to Improve Decisions (Yours & Others’)

Tali Sharot, PhD – Author, Professor, Neuroscientist, and Authority on Human Behavior

Behavior directly effects health. With this understanding, healthcare providers have a vested interest in understanding what drives behavior and, in particular, the biases that effect our thinking and decision making. Studies show most people use suboptimal tactics when trying to change others’ beliefs. Using an audience example, Dr. Tali Sharot demonstrated how people quickly form biases using a limited data set. When we find evidence that agrees with us, we embrace it. But when we find people or evidence that disagrees, we are skeptical.

Sharot provided six proven strategies—based on her research—that providers can use to overcome biases when communicating with patients:

  1. Use common ground.
  2. Highlight the opportunity for progress than decline.
  3. Offer immediate rewards.
  4. Leverage social incentive.
  5. Expand agency.
  6. Consider the patient’s mental state.

Next, she discussed managing our biases and actual tactics:

  • Know your bias, plan ahead: use policy to guard against suboptimal plans and decisions.
  • Assess competence not confidence: confidence is not necessarily the best indicator of competence.
  • Change the way you communicate information: adjust your message to the individuals around you.

Sharot concluded by advising the group to focus on progress because the human brain is more likely to accept information that is focused on improvement. For example, instead of telling a patient that he could die from smoking, a more effective strategy is to say, “If you don’t smoke, you can run marathons.

Evening Orientation, and Analytics Walkabout and Digital Innovation Showcase Winners

Paul Horstmeier – Chief Operating Officer, Health Catalyst

Health Catalyst COO Paul Horstmeier closed out the day by announcing winners from Tuesday night’s events: Analytics Walkabout, Digital Innovation Showcase, and the Catalyst Awards. He also introduced details about the night’s events ahead including a Fun Run and Walk, the Dine-on-Us Dinner, and the Evening Reception. Lastly, he provided a preview of Thursday’s morning events, including the opportunity for attendees to vote on some of the best #SocksofHAS.

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