The development and dispersion of cost-effective medical technologies that promise to boost wellness, prevention, and precision care are pivotal to the transformation of healthcare, experts say.
A tsunami of healthcare innovation is sweeping the globe, according to three dozen experts who gathered this week in Boston for a forum organized by The Economist.
"We are in an amazing time. The transformation that is going on in the United States and around the world is unprecedented," Walter Capone, president of the Multiple Myeloma Research Foundation, told forum attendees.
Several of speakers said the biggest global change in healthcare is a growing realization in both developed and developing countries that boosting wellness, prevention, palliative care, and outpatient services are essential elements of establishing sustainable healthcare systems.
"[Developing countries] simply can't replicate the kind of health system we see in the United States," said Peter Berman, DPH, a professor at the Harvard School of Public Health in Boston. "They will not be able to afford in the near-term treating heart disease and cancer the way we have in the West… It really will be more about creating a health system with emphasis on outpatient care and prevention."
Bruce Broussard, president and CEO of the Louisville, KY-based payer, Humana, cited Medicare Advantage as a prime example of an insurance business line that places a premium on prevention. "If we can eliminate the need for care in the first place, we can cut costs," he said.
Humana has deployed about 8,000 nurses who visit health plan members' homes on a daily basis to help them stay healthy, Broussard said. "We help people move furniture, build ramps," he said. "Those little steps have a big impact."
To promote wellness at an early age, Humana has helped build 50 playgrounds across the country. "We've set the goal of improving the health of the communities we serve… and to do that we have to partner with communities," Broussard said. "We're actually improving the community overall."
R. Sean Morrison, MD, professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York, advocated for palliative care as part of the solution to treating the world's aging population.
"One of the greatest challenges we face as a country and globally is the [population] growth of older adults," Morrison said. He believes palliative care improves quality, lowers healthcare costs, and increases patient survival rates when combined with interventional treatments such as surgery.
Morrison, in an interview after the event, elaborated on that message, describing palliative care as one of the best examples of a patient-centered approach to medicine.
"In palliative care, we meet with patients and families. We discuss and outline their goals for medical care, and we match our treatments to those goals," he said.
"When goals are unrealistic, for example living for an additional five years with advanced pancreatic cancer, we work with patients and families over time to help them establish more realistic goals while always preserving hope."
Anita Goel, MD, PhD |
Technology to the Rescue
Beyond the bedside, the development and dispersion of cost-effective technology is playing a key role in transforming healthcare, several forum speakers said.
Anita Goel, MD, PhD, chairman and CEO of Cambridge, MA-based Nanobiosym, spoke about the convergence of several technological developments including the Internet, mobile devices, and emerging communications platforms having the potential to revolutionize healthcare on a global scale.
"I see this whole new generation of infrastructure that's going to usher in a whole new era of healthcare, not just in the developed world, but also in the developing world," she said.
Technology, she says, has become a driving force for decentralization and personalization in the medical field. "Anyone, anywhere, any time can have access to information about their healthcare."
Albert Bourla, group president of vaccines, oncology, and consumer healthcare at the pharmaceutical giant, Pfizer Inc., told attendees of the forum that the biopharmaceutical industry is in the vanguard of technology-driven change in healthcare.
"Cancer is the area where science will develop the most meaningful treatments in the years to come," he said.
The Pfizer executive said biopharma is a leader in precision medicine. "We are developing products that are relevant to a small part of the population, but the effects will be profound," Bourla said. Worldwide, there are about 2,000 cancer drugs currently in development.
"We can't wait ten years for medication; we need it today," said Capone. His organization, the Multiple Myeloma Research Foundation, is working with biopharma companies, regulators, academic centers and other top stakeholders involved in producing medications to shorten development time lines and reduce costs.
Seeing the Light
Transparency was another hot topic at the event.
"The idea that we're going to push data out and make it available to people is revolutionary," said Mitch Rothschild, CEO of Lyndhurst, NJ-based Vitals. "A few years from now, it will be viewed as madness not to know how much a doctor is going to cost before we go."
Harold Miller, president and CEO of the Pittsburgh-based Center for Healthcare Quality and Payment Reform, said it is critically important to boost transparency in a meaningful and methodical manner. "Price transparency is a critical element to improving healthcare," he said. But, he cautioned, "price transparency alone could actually be a bad thing."
Miller said price transparency will help drive beneficial change in healthcare as long as it is crafted alongside payment reform efforts.
In addition to publicizing healthcare prices, he said it is necessary for transparency efforts to be paired with paying for healthcare in a different way than has been done in the past.
"Today, it's very difficult for people to know what the total cost will be," Miller said of patient billing. "We pay for healthcare in a fragmented way. We pay for everything separately… Typically, patients don't pay anything near the total cost of care."
The key to making price transparency an effective agent of change in healthcare is getting patients to be "price-sensitive," he said. Miller cited the California Public Employees' Retirement System (CALPERS) requiring patients to pay out-of-pocket for the difference between a low-cost hip replacement physician and higher-cost doctors.
The result? "The expensive healthcare providers changed their costs," he said.
Christopher Cheney is the CMO editor at HealthLeaders.