Ed Kacic

Ed Kacic, President and CEO| Irvine Health Foundation| Orange County Healthcare
Member Since: 2010

ABL is an environment that always provides great (and current) information and makes me think. A welcoming group of very smart, committed and terrific people.
     

Blog

A View from the Heart: 3 Doctors on the End of Life

In recent years, three life-affirming books have been written that should be “must reading” for anyone in healthcare. (Particularly if you’re the “go to” person in your family for all questions medical.) The first, Being Mortal: Medicine and What Matters in the End, was published in 2014 by bestselling author Atul Gawande, MD – and made into a full-hour PBS FRONTLINE documentary special a few months later. Although Gawande writes eloquently about mortality in the book, his real message is, “Our ultimate goal, after all, is not a good death but a good life to the very end.” In recent months two renown Bay Area physicians have released their books on the subject. The first received national attention as the star of the Academy Award-nominated documentary short, Extremis.

Keep Reading …

 


 

In Changin’ Times, Medicine Is Still “the Sweetest Joy”

During the University of Michigan’s 167th ceremony honoring its Medical School graduates, their memorable commencement speaker was the Director of the National Institutes of Health, Francis Collins, MD, PhD, Presidential Medal of Freedom and National Medal of Science recipient, and erstwhile Wolverine “gene hunter.” In his opening remarks he spoke eloquently and emotionally about his experience at the bedside of a very sick patient in an impoverished area of Nigeria, who, recognizing Collins’ frustration at his lack of modern medical tools, told him: “You came here for one reason; you came here for me.” Collins told the 174 med school graduates that that’s when he first realized that, “The sweetest joy that anyone can have is the opportunity, in a loving way, to reach out and help each other. That’s what your profession is all about. That’s what medicine is defined by. May it always be so. May those technologies and frustrating difficulties with Electronic Health Records never get in the way of what that means. It’s about that relationship and the sweet joy that it creates . . . “If love is your why, you can survive any how.” . . . Your times will be a-changin’; embrace those changes. Be prepared to make the best of failures and tragedies. Focus on character, not accomplishment. Think about those eulogy virtues, and not those resume virtues. And, don’t forget to have fun.”

 

He then went on to sing the conclusion of his address – who knew the Director of NIH is also a mean guitar player and folk singer? – applying his words to the music penned by Nobel Laureate Bob Dylan:

Keep Reading …

 


 

Creating A Compelling Value Proposition for Your Healthcare Business

When I mentioned to our San Francisco Healthcare Round Table Members that I’d recently written about “Creating more valuable value propositions” in ABL Technology Online, there was a unanimous request that I post a similar article – featuring great healthcare value props – in this week’s ABL Healthcare Online. So, here goes:

 

In Geoffrey Moore’s 2006 classic, Crossing the Chasm, he familiarized a new generation with the high value associated with “Value Propositions.” Today, they’re even more powerful when communicating with your target audience via a webpage or app. As Tor Gronsund summarized in his article, “7 Proven Templates for Writing Value Propositions That Work,” Moore’s Template goes like this:

  • For __________ (target customer)
  • Who _________ (statement of the need or opportunity)
  • Our (product/service name) is _________ (product category)
  • That (statement of benefit) ____________ (helps you gain; or, even better, treats a pain)

Keep Reading …

 


 

ABL Members’ Would Opt for a “Single Payer” Healthcare System

Over the past two weeks we asked both our ABL Healthcare and Technology Members to “set politics aside” and respond to our all-Member survey: “How would you prefer to see the U.S. healthcare system evolve?” While the 86% of our survey respondents* were Healthcare Round Table Members, as health-benefit-paying-employers, we’ve included our Tech Members’ tallies – and their thoughtful responses, too. Surprisingly, “Single Payer” tied with “Other” as the plurality favored response, with 33% of the total votes received from both our Healthcare and Tech Members. “Continue as it is today (under ACA)” garnered 19% of the total votes, and “100% consumer driven (no 3rd party payers)” trailed with 14% of the votes cast.  Keep Reading …

 


Only Adaptive Business Leaders Survive

In these uncertain times in Healthcare, in which we wrestle with questions like: Will the ACA survive? Or MACRA? Or any other governmental program we’ve put tons of resources into complying with? I’m reminded of how our Adaptive Business Leaders (ABL) Organization got its name. Keep Reading …

 


 

The ABC’s of Why the AHCA will be “Complicated”

With appreciation to the Los Angeles Times‘ Michael Hiltzik’s column, beyond the rhetoric, there are a number of reasons to be concerned about the Complications Associated with the AHCA.
Here are just six of them:  
A.   Comparing Health Plan Apples to Apples: As written, the AHCA would repeal the “actuarial value requirement,” so plans will be harder to compare. Yes, perhaps buyers will have a broader range of choices, but the metals (bronze, silver, gold, and platinum) – and what they “contain” – go away, so it won’t be as obvious as to what each health plan really covers.   Keep reading ...

 


 

Republicans announce the AHCA: what a difference a letter makes

For seven years House Republicans drafted a series of bills designed to “repeal and replace” the Affordable Care Act. None of them went anywhere – as long as President Obama resided in the White House. But now, with President Trump’s support, The American Health Care Act actually has the potential of being signed into law. Of course, there will be hurdles aplenty between Monday’s release of the 123-page “Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act” and actually making it out of Congress in a state the president will be proud to call “Trumpcare.” In fact, many of those hurdles will be bridging the ideological differences within the Republican Party, particularly in the Senate, where Republicans hold only a two member majority and already four moderate Republicans from “Medicaid expansion” states have signaled their concern that an earlier draft didn’t “provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.” And someone is sure to ask the Congressional Budget Office to score the bill for its anticipated savings or costs – possibly someone from the conservative House Freedom Caucus who already considers the tax credits a “new entitlement.”   Keep Reading …

 


 

MIMI GRANT’S POST: February 22, 2017

WII-FM: the Key to Changing Behavior

There’s an adage in sales that everyone’s favorite radio station is WII-FM: “What’s in it for me?” Turns out consumers/patients need to viscerally understand and appreciate what’s in it for them before they will muster the self-motivation to change their behavior – even when they’re not being called and cajoled into taking their meds, exercising, eating right, and undertaking other healthy behaviors.

 


 

MIMI GRANT’S POST: February 7, 2017

Trump Got the Memo: Healthcare is “Very Complicated”

Less than a month ago, President-elect Trump promised to repeal and replace the Affordable Care Act “essentially simultaneously,” shortly after Rep. Tom Price was confirmed as Secretary of Health and Human Services. Now, what appeared imminent in mid-January has moved to “maybe it’ll take till sometime into next year. . . it’s very complicated,” according to his interview with Bill O’Reilly of Fox News. In the meantime, there are now five competing “replacement” plans proposed by Republican leaders (Ryan, Price, Paul, Cassidy/Collins, and Sessions/Cassidy) from which President Trump can choose.
As the author of The Art of the Deal, Trump knows a thing or two about negotiating, and now it appears he’s dialoguing with representatives of the key players in the healthcare continuum. February 6th, Politico reported that the Trump administration is seriously considering changes, proposed by the insurance industry, which could stabilize the Marketplace exchanges to the point that key players would be willing to stay in them. While Congress tackles crafting a plan that can “Make Healthcare Great Again” without breaking the federal budget – or the health plans, providers, and suppliers (like pharma) participating in it, insurers have resurfaced who earlier proposed these rule changes, that were ignored under President Obama, and have brought them to the Trump administration. Among the stabilization proposals: boosting the older-younger age ratio to 3.49:1; cutting the enrollment period in half (from November 1 to December 15); tightening rules around the 90-day grace period for enrollees to receive coverage after they’ve stopped paying their premiums; and requiring that “Silver” plans cover only 66% of medical expenses, down from between 68% and 72%.

Corralling another major healthcare lobby, last week Trump met with Big Pharma execs who represent companies which he said – just last month – were “getting away with murder.” Now his focus appears to be on decreasing regulations, so it’s quicker to get drugs approved, and bring more drug manufacturing back into the U.S. Meanwhile, Trump’s “1 in, 2 out” Executive Order, directing federal agencies to repeal two existing regulations for every new regulation added, could prompt numerous regulatory changes brought to us by CMS, the FDA, HRSA, and the Office of the National Coordinator for Health Information Technology for starters. As Rick Pollack, CEO of the American Hospital Association, said, in praising its potential to reduce bureaucracy, “last year alone, the federal government added 23,531 pages to existing regulations affecting hospitals and health systems.” Ideally, fewer regs will lead to lower costs and less paperwork for everyone in healthcare – including the patients.

However, at least one Executive Order has backfired rather badly: within a week of issuing a travel ban on citizens from seven nations, Federal Judge James Robart ordered a national halt to its enforcement. Now, it goes to the 9th U.S. Circuit Court of Appeals, in San Francisco – where opponents of the ban, including the state of Washington, have amassed “about a dozen friends-of-the-court briefs submitted by at least 17 state attorneys general, more than 100 companies, and about a dozen labor and civil right groups,” according to Reuters. Also, extremely vocal in their disdain for the order were healthcare execs decrying the impact on the national residency match program, where 260 applicants were from the seven countries covered by the ban, and communities where foreign healthcare workers provide vital primary care, especially in rural clinics and safety-net hospitals could be severely impacted.

One thing is certain, Trump is making the most of his first 100 days!

 


 

MIMI GRANT’S POST: January 24, 2017

“One Country, Two Systems” Doesn’t Work

  In the wake of President Trump’s Executive Order to “minimize the economic burden” of key Affordable Care Act provisions, pending its repeal and replacement, a new legislative proposal has emerged designed to mitigate the damage inflicted by a total repeal – especially to the (typically Blue) states that fully embraced the ACA: allowing, but not forcing, states to opt out of major parts of the ACA.
Since this approach would effectively create a “two system” policy, particularly looking at the Electoral College map, it reminds me of China’s “one country, two systems” policy promulgated as the 1997 date neared for the “return” of Hong Kong to Chinese sovereignty from the British. The idea being that the mainland, where over a billion people resided, would remain under the socialist system, while Hong Kong and Taiwan would continue under their capitalist systems.

In the U.S. version, Senators Susan Collins (R., Maine) and Bill Cassidy (R., La.), have proposed “The Patient Freedom Act of 2017,” which would effectively allow states to opt out of many of the provisions that form Title I of the Affordable Care Act, including the mandate that everyone must obtain health coverage or pay a penalty, and a provision prohibiting insurers from charging older people significantly more than younger folks. Further, the bill proposes that if a state opts out, it will get the federal funding it would have received to enact its own ideas instead. In states that chose to drop the ACA, insurers would be required to maintain some of the law’s most popular provisions, such as allowing parents to cover their children as dependents up to age 26, no annual or lifetime limits, and issuing policies to people with pre-existing conditions. Unfortunately, all of these “nice-to-haves” are unrealistic without insurance mandates.

As it turned out, China’s “one country, two systems” policy was never fully embraced by the Taiwanese. And, in recent years, Hong Kongers have taken to the streets to protest the attack on The Basic Law of their Special Administrative Region and the freedoms it guarantees. Our Founding Fathers struggled mightily to create the United States of America. It’s up to all of us in healthcare, who understand the basic economics of the industry, to help educate our legislators as to what’s feasible for America’s clinicians and payers to provide – at least under the current regulatory environment, and what’s not. And, what the ramifications are of tearing apart a structure that, while no doubt can be refined, needs to remain one system, for our one country.

 


 

MIMI GRANT’S POST: January 10, 2017

2,300 places healthcare’s less expensive – and more convenient

  Today, thanks to the Affordable Care Act, millions more people are insured, particularly against catastrophic medical expenses. However, fortunately, most of us, in most years, won’t need to be rushed to the ED with a heart attack or even a broken bone. Much more likely we’ll be dealing with “episodic, acute conditions” like a sore throat, cold, flu, sinus infection, allergy, sprained ankle, or will want a flu shot. And, best of all, at last count, there are 2300 convenient care clinics ready to serve us.
As recently as the turn of this century, getting in to see a doctor to deal with any of these relatively minor complaints was usually a major pain. Then, an enterprising entrepreneur opened the first retail clinic. Six years later, enough of these “convenient care clinics” had sprouted to create an association, and, voila!, an industry was born. Today, as the Convenient Care Association celebrates its 10th anniversary, walk-in clinics are located in retail stores, supermarkets and pharmacies, and are the fastest-growing source of healthcare treatment in the country. So far, more than 35 million patients in 43 states have been treated by thousands of board-certified nurse practitioners and physician assistants – and over half of them were seen after regular doctors’ office hours. And, when the problem diagnosed during the typical 15-minute visit was “out of (the NP’s or PA’s) scope,” they referred to local physicians – some of whom are in their same medical group, and others claiming that these local clinics are their largest referral source.

Among the specialty clinics emerging within this trend is Lean for Life by Lindora. With over 35 standalone clinics throughout Southern California, Lindora became the first medically based weight loss clinic to provide services within California grocery stores, now located in five Safeway stores in the Northern California cities of Danville, Dublin, Livermore, Menlo Park, and San Jose.

Best of all, since the typical posted “cash” price is $45-75 per visit to a convenient care clinic, the cost of care is 30-80% less than an ER, urgent care, or primary care physician would charge. In fact, some health plans have even eliminated co-pays for subscribers using these clinics because of their significant cost savings. It turns out convenient care is good for the health plans, as well as the patients.

 


 

MIMI GRANT’S POST: November 29, 2016

Tom Price, MD, Named ACA Dismantler-in-Chief

  Earlier this month, Bobbi Jindal, Ben Carson, Newt Gingrich, and Rick Scott were all being bandied about as possible Health and Human Services Secretary candidates. That was then. Last night it was leaked that Rep. Tom Price (R-Ga), current chair of the House Budget Committee, an orthopedic surgeon (and among the 18 members of the House GOP Doctors Caucus), avid Trump supporter, and ardent critic of the Affordable Care Act, has been nominated as the new Secretary of Health and Human Services. Who better to unwind all the “Secretary shall” provisions of the Affordable Care Act than one who has fiercely opposed them?
While others demurred in their support for candidate Trump, according to The Washington Post, Price was a loyalist from the start. And now it appears he’s being rewarded for his allegiance to the President-Elect, as the Jackson Democrats proclaimed in 1828: “To the victor belongs the spoils.” And, with a trillion-dollar budget, the HHS office provides a lot of “spoils.”

Among the 60 times the GOP-dominated House voted to eliminate all or part of the ACA, Rep. Price was involved in authoring several of them, including the “Empowering Patients First Act” – which he introduced to Congress four sessions in a row, “legislation that fully repeals Obamacare and starts over with patient-centered solutions.” As his website proclaims: “The Empowering Patients First Act puts patients, families and doctors in charge by focusing on the principles of affordability, accessibility, quality, innovation, choices and responsiveness. Those principles form the foundation of the solutions in H.R. 2300 – solutions including individual health pools and expanded health savings accounts, tax credits for the purchase of coverage and lawsuit abuse reforms to reduce the costly practice of defensive medicine.” In addition to his own legislation, the tomprice.house.gov site also features “A Better Way,” the blueprint for government reform (including healthcare) promoted by Speaker Paul Ryan (R-WI).

Price is not new to either politics or medicine. Elected to six-terms to the House, from his district in suburban Georgia, he was named the Budget Committee chair last year. Previously, he was a member of the Georgia state Senate, between 1996 and 2005, ultimately as its majority leader. A third-generation doctor, with an MD from the University of Michigan, he completed his residency at Emory University in Atlanta, then ran his orthopedic practice in Atlanta for 20 years, before returning to Emory School of Medicine as assistant professor of orthopedic surgery.

Strongly affiliated with the House Tea Party caucus, Price’s website proclaims him to be “devoted to limited government and lower spending.” In addition to the ACA, The Post suggests other programs likely to get his fiscal attention are Medicare and Medicaid. For example, for Medicaid, Price is an advocate of block grants to states, under which the federal requirements for eligibility and covered services could be modified by each state – including a requirement that “able-bodied” applicants meet work requirements to receive healthcare benefits. As for Medicare, Price favors “defined contributions,” giving older and disabled Americans financial assistance to assist them in purchasing private insurance policies.

If confirmed, Medicare and Medicaid will not be the only agencies within Price’s domain; the FDA, CDC, and NIH all report up to the Secretary. Sounds like, the times they’ll be a-changin’.

 


 

MIMI GRANT’S POST: November 15, 2016

Searching for the Silver Linings in Trumpcare

  Coming out onto San Francisco’s Market Street, following our post-Election-day Healthcare Round Table last Wednesday, I was barraged with the sound and the sight of protesters filling the streets. Obviously, over 68 million people, myself included, were disappointed with the Electoral College results. Yet, in the midst of the storm clouds, a few silver linings appear to be peeking out – even for healthcare. For starters, President-Elect Trump won’t be inaugurated as President Trump until January 20, 2017 – long after non-cancelable contracts with health plans for providing care through the exchanges and expanded (managed) Medicaid are in place for 2017. Already, hundreds of thousands figured out they better take advantage of largely subsidized care by signing up on healthcare.gov the day after the election – the largest single-day enrollment this season.
Also, even though Trump actively campaigned to “repeal and replace” the ACA, he’s already signaling that he’s leaning towards preventing insurance companies from denying coverage due to preexisting conditions, and allowing children up to age 26 to stay on their parents’ health plan. (Of course, the reality is that doing either will ultimately require “mandates” for everyone to be in the “pool,” but it’s an ideological start.)

Here are a few more glimmers of at least some possible silver linings, from “the Trump plan,” recent news, and conjecture:   Continue Reading

 


 

MIMI GRANT’S POST: November 1, 2016

ABBY Awards are Signs of Their Times

  Since 1999, the ABL Organization has been presenting ABBY Awards to innovators whose healthcare delivery approaches, medical technologies, and digital health solutions are reducing the cost of quality care. For the majority of those 17 years, ABBYs were presented in those three categories – except in recent years. Out of the ~50 nominated organizations, and ~40 that made it to the “Finalists Selection Committee,” where the Finalist contenders were selected, the Committee has determined that rather than having three separate categories, to just have one category, with all of the highest ranked companies vying for the top Awards.
In the past, the ABBYs have reflected large “cap-x” expenditures for “ICU bunkers” and specialized radiation oncology equipment that required expensive housing. Other periods rewarded billion-dollar investments in EHR systems, or total make-overs of swamped emergency departments. In more recent years, apps, telemedicine, and robotics have walked away with the top honors. But this year, the winning innovations were largely consumer driven, and reflected how much “technology in our pocket” (or in the cloud) is changing the way – and the place – healthcare is delivered; and illustrated one person’s commitment to create a patient safety movement that has already saved over 20,000 lives. Here’s how:

The 2016 Gold ABBY Award was presented to Kelsey Mellard, GM of Honor – and a sharp millennial with a background with CMMI and UnitedHealth. As she said in her wrap-up interview, while originally designed as a B2C home care solution, the ease of use – and the need to avoid readmission penalties – is convincing many discharge planners to use Honor as well. Backed with $62 million in venture capital, Honor is now expanding from its roots in the Bay Area and LA, into Dallas, and turning the $45 billion, largely cottage home care industry, on its head.

Joe Peterson, MD and CEO of Medical Tactile, took home the Platinum ABBY for its SureTouch digital technology that enables a trained clinician (think nurse, not doctor or rad tech) to perform a painless, radiation-free breast exam virtually anywhere. The extremely portable system uses a device that looks like a computer mouse, which – as it transverses the breast being examined – feeds the data it’s “reading” onto an iPad for concurrent interpretation (and subsequent storage in the cloud). Results of the exam are immediate, with the 1-2% of the patients examined for whom further tests are indicated, being referred directly. 


The audience was wowed when Douglas Harrington, MD, CEO of GD Biosciences, presented the PULS Cardiac test, scoring the highest honor, the Diamond ABBY. Doug spent 15 years researching what causes heart attacks, and in the process identified protein biomarkers of the body’s immune response to arterial injury, which led to the formation and progression of unstable cardiac lesions – the #1 cause of heart attacks. The resulting PULS test identifies individuals with active, yet undetected subclinical coronary heart disease, who are at risk of experiencing a heart attack, and for whom early intervention can help. The $150 test also estimates “heart age” vs. chronological age – which can be a real eye-opener, and stimulus to necessary lifestyle changes. 


For the past ten years, ABL’s Innovations in Healthcare(TM) Awards Event has also honored leaders who have made substantial contributions to industry. This year’s Leadership in Innovation Awardee was Joe Kiani, CEO of Masimo, who won an ABBY Award himself, in 2003, for the company’s impressive Masimo SET® technology. Founded in Joe’s garage 27 years ago, today Masimo products monitor over 100 million patients a year. And, giving back, four years ago, Joe founded the nonprofit Patient Safety Movement Foundation, with a mission to eliminate the more than 200,000-400,000 preventable patient deaths that occur in U.S. hospitals annually. With an ambitious goal of attaining ZERO preventable hospital deaths by 2020 (0X2020), already executives representing 1,631 hospitals have made formal and public patient safety commitments to this mission, collectively saving 24,643 lives. 


So, as healthcare becomes increasingly focused on the triple aim, it’s gratifying to see more remarkable firms emerge and be rewarded for their focus – as well as that of CMS – on better care, with smarter spending, resulting in healthier people. 


PICTURED ABOVE, left to right: Christopher Godfrey, CEO of Bloodbuy; Douglas Harrington, MD, CEO of GD Biosciences; Mark Peterson, RPh, CCO of Genoa Healthcare; Charles Taylor, PhD, Founder of HeartFlow, Inc.; Kelsey Mellard, GM of Honor; Joe Peterson, MD, CEO of Medical Tactile Inc./SureTouch Breast Exam; Joe Randolph, CEO of The Innovation Institute; and Mehdi Maghsoodnia, CEO of Vitagene. 


 


 

MIMI GRANT’S POST: October 4, 2016

Lessons on How to Reach Millennials – from the White House & CMS

 millennialspic Ever since the ACA’s Health Insurance Marketplaces first opened in January 2014, young adults have been staying away in droves – even though “more than 9 in 10 Marketplace-eligible young adults without health insurance have incomes that could qualify them for tax credits to make plans affordable.” This year, instead of just lamenting the absence of the young invincibles – whose generally good health would go a long way towards stabilizing the entire risk pool, the White House is convening the “Millennial Outreach and Enrollment Summit.” Cognizant that millennials don’t read or watch the same media that Gen-Xers (let alone Boomers) do, HealthCare.gov’s CEO announced they’ll be rolling out “new tactics and strategies to reach young adults where they are.”
So where are they? White House strategists have determined they’re on “online platforms that cater almost exclusively to young adults.” Key among these is Twitch, a social video platform and community for gamers. Tactics will include a “HealthCare.gov pre-roll before videos, a homepage takeover, and ongoing efforts with streamers on Twitch to amplify our message” to Twitch’s 45 million active users who average 106 minutes daily on the site. Since 20% of millennials access the internet exclusively through mobile devices, the site’s programmers have worked overtime on an “end-to-end, mobile optimized experience,” including the ability to comparison shop on their phones. No doubt haul videos with teens “unboxing” their insurance plan will be next.

And, they’re not going it alone. CMS and partner stakeholders are organizing a young adult social media outreach campaign under one umbrella: #HealthyAdulting. Together the partners expect to reach nearly five million social media followers on Facebook, Twitter, Tumblr, and through dozens of “establishment” partners (e.g., American Hospital Association, March of Dimes), as well as the followers of social media groups like Mocha Moms, Young Invincibles, and the 1.3 million Muslim followers of My Halal Kitchen.

Not to be left out, the IRS is getting in the act: they’ll be reaching out to the 45% of taxpayers who paid a penalty or claimed an exemption for not having health coverage who are under 35. If they’re smart, they’ll follow CMS’ lead and do it through social media! 


 


 

MIMI GRANT’S POST: August 23, 2016

Finalists Selected for Innovations in Healthcare(TM) ABBY Awards; Winners to be Chosen October 26th in Long Beach

For the 17th time in as many years, nine of healthcare’s most innovative companies have been selected to present their health IT, diagnostic, and medical device solutions, along with novel approaches for reducing the cost of quality care, at the ABL Organization’s Innovations in Healthcare(TM) Awards Event, on October 26, 2016, in Long Beach. The event, which is presented by the Adaptive Business Leaders (ABL) Organization, is widely recognized for assembling and presenting organizations from across the country whose approaches and technologies are making dramatic inroads in the quest to improve health outcomes – while reducing its cost.
Originated before “Value” was a dominant word in the healthcare world, the ABBY Awards were inaugurated in 1999, in recognition of the fact that healthcare was simply getting too expensive. Clearly, if medical trends continued to escalate, quality healthcare would be out of reach for all but the country’s wealthiest citizens. And, even though today more Americans have health insurance, without innovations that enable the medical equivalent of “better, faster, cheaper,” medical spend will continue to spiral out of control, and tough medical problems will continue to go unsolved.

In preparation for this year’s event, 20 ABL Member Champions, each with deep domain knowledge in the areas represented by “their” Semi-Finalists, spent a recent afternoon presenting a total of 40 ABBY Award-nominated Semi-Finalist companies to the Group. Champions who had thoroughly researched the Semi-Finalists’ innovations and spoken with “their” companies’ CEOs, presented the significant healthcare problem each company’s innovative technology or approach set out to solve, along with the clinical and financial metrics that prove the innovation is actually improving the quality of care, while reducing its cost. Following discussions about each of the 40 Semi-Finalists, at day’s end the Champions voted by secret ballot to select the nine Finalists. It is these nine ABBY Award Finalists who will present at the ABBY Awards Event on October 26.

Mimi Grant, President of ABL, and creator of the Innovations Awards Event 17 years ago, commented: “In truth, all 40 of the ABBY Award-nominated Semi-Finalists were impressive (several nominees didn’t make it to the Semi-Finals). However, the nine ABBY Finalists are truly exceptional. This year, the Finalists’ companies span diagnostics, medical devices, health IT, and service solutions that address a wide range of significant health issues. As a requisite, all the nominees’ devices have been approved by the FDA for use in the U.S. market. But all the solutions, even if they didn’t require regulatory approval, demonstrated significant metrics that they are improving clinical outcomes, and reducing the cost of providing quality care. Increasingly, it will be innovative companies like these that will not only win ABBY Awards, but will be big winners as the healthcare industry continues its shift from ‘volume to value,’ and prepares for the costly onslaught of the ‘silver tsunami.'” 


At the October 26 Event, following the nine live presentations made by the leaders of the Finalist companies, the audience will cast their secret ballots to determine the three Winners who will take home the coveted ABBY Awards. Attendance at Innovations in Healthcare(TM) is open to all ABL Members, as well as non-Member senior executives of healthcare providers, payers, health IT, medical technology, and services firms. 


Click to find out who the ABBY Award Finalists are and learn more about them



 


 

MIMI GRANT’S POST: August 9, 2016

It’s a Drug, It’s Tech, It’s Bioelectronics!

What do you get when you team Google with a 150-year-old pharma giant? Galvani Bioelectronics, and a $700 million investment. The newco is the result of a partnership between Verily Life Sciences, Alphabet Inc.’s life sciences unit, and GlaxoSmithKline PLC, currently best known for their medicines, vaccines, and consumer healthcare products. But that could change as Galvani will be using bioelectronics to fight diseases by targeting electrical signals in the body. With a fusion of technologies that blurs the lines between the physical, digital, and biological spheres, bioelectronics aims to tackle chronic diseases using high-tech devices that combine biology, software, and hardware.
Not totally new, GSK presented their work with biosensors at SXSW last year. Yet, Kris Famm, the GSK scientist who’s been appointed president of the newco joint venture, believes “this is almost the epicenter of convergence because the technology is not only helping you to monitor a disease, but it is also actually the therapy.”

And, GSK is not the only pioneer in this arena. According to a Wall Street Journal feature, U.S. biotech firms Setpoint Medical and EnteroMedics have already shown the early benefits of using bioelectronics both to address inflammatory diseases like rheumatoid arthritis and dampen appetite in the obese. Already Medtronic’s PillCam camera-in-a-pill provides an alternative to colonoscopies; Proteus Digital Technology is working with pharma companies on pills with embedded microchips that measure drug usage; and manufacturers of lung treatments are developing smart inhalers. And over two years ago, Alphabet teamed with another Big Pharma, Novartis, to create a smart contact lens with an embedded glucose sensor to monitor diabetes. Alphabet is also playing the field with Sanofi, where they have a diabetes deal, and with Biogen, where they’re studying the progression of multiple sclerosis.

Reading the demographic tea leaves, Apple and Samsung Electronics are also trying to find health-related applications for a new wave of wearables. Among the benefits of tracking devices is real-time feedback on how patients are doing, which could be increasingly important information – particularly in a Value-Based reimbursement environment – for the health plans and physicians responsible for their patients’ health status. 


Over a year ago, a feature in Discover magazine, entitled “Tiny Electronic Implants Treat Arthritis, Diabetes and Obesity,” discussed bioelectronic implants that are designed to sit on or near nerve bundles, where they modulate the electrical impulses that travel between our brain and our organs, regulating everything from heart function to body movement. These new devices, most of which are in their early stages and have yet to be FDA approved, alter how specific nerves fire to modulate organ function, which in turn aims to treat ailments as diverse as sleep apnea, rheumatoid arthritis, diabetes, obesity, and hypertension. 


Among the medical devices that electrically stimulate tissues that have emerged into the medical mainstream in recent decades are Cochlear implants that help the hearing impaired by stimulating neurons in the brain’s auditory cortex. Meanwhile, deep brain stimulation improves mobility for those with Parkinson’s disease by delivering electrical pulses that inhibit abnormal nerve signals. And, people with paraplegia can control their bladder through sacral nerve stimulation that facilitates communication between the bladder and brain. Second Sight uses electrodes to stimulate the retina, partially restoring sight. And a research team in Ohio implanted an electrode in a paralyzed man’s brain, connecting it to a sleeve on his wrist, effectively allowing him to move his hand with only his thoughts. 


Some researchers envision combination treatments, part pharmaceutical and part bioelectronics. These would be pills that dissolve into particles in the body, while an external power source using magnetic fields remotely directs the particles to different nerves – ultimately eliminating the need for surgical implants. Ideally, these bioelectronic pills will be on the market as a cure for cancer and Alzheimer’s disease so that millions of Baby Boomers will still be able to take advantage of them. 


At that point, no doubt physicians – or their avatars – will be able to adjust device “dosages” via the Internet, as easily as they can track how many steps their patients are taking today. Truly it’s going to be a brave, new and wonderful bioelectronic world.
[Illustration credit: http://www.gsk.com/en-gb/behind-the-science/innovation/bioelectronics-at-sxsw-2016/


 


 

MIMI GRANT’S POST: June 28, 2016

Calling All Healthcare Innovators Whose Technology & Approaches Are Lowering the Cost of Care

This year, for the 17th time, the ABL Organization is searching nationally for companies whose products, services, and approaches are lowering the cost of quality care to honor with the 2016 ABBY Awards. Since 1999, ABBY Awards have been taken home by innovative providers, health plans, manufacturers of medical devices, robotics, diagnostics, telemedicine and telecommunications solutions, biotechs and pharma, health IT, dot coms and mHealth developers, governmental agencies, and an array of startups and institutional innovators who developed and applied approaches with the aim and results of improving clinical outcomes, while reducing costs.
Long before “Value Based Care” was a twinkle in Illinois Senator Barack Obama’s eye, in 1999, employers were seeing their health insurance premiums ratcheting up at an alarming rate. Meanwhile, Internet technology was starting to change the lives of Americans, who were being provided with better, faster, and frequently cheaper technology. So, at ABL, we thought certainly there must be some innovative solutions that could do the same for patients. Voila! We scouted them out, and nine finalists presented at our first Innovations in HealthcareTM that year. Back then, our first ABBY Award winners – selected by the audience by secret ballot – were MemorialCare, which introduced a mag-striped card for their patients with some key information to ease check-ins; it wasn’t a personal EHR, but it was a start. Blue Shield also won that year for MyLifePath – a sophisticated search tool that enabled their members to find their personal benefits, along with information on diseases, community providers, and drugs. And, OptiScan’s early work on a non-invasive glucose sensor system also garnered an ABBY. (While the audience still selects the ABBY winners from among nine Finalist presenters, today’s nominees must prove that their product or service is actually on the market chalking up impressive clinical outcomes – and, if required, already has FDA approval.)

In 2000, the CEO of HealthAllies.com, Andy Slavitt, took home an ABBY for his membership-discount program. United liked it so much, they hired him for their Optum team, and he is now the Acting Administrator for CMS. In 2004, Silverado Senior Living and InTouch Health submitted a dual entry for their “approach” of using a robot which allowed their headquarters-based geri-psych physician to make “room calls” on Silverado’s cognitively impaired patients located in sites throughout their system. And, in 2008, Alameda County Health System took home their ABBY for the life-saving turnaround of their ED, which previously was all too frequently on diversion. More recent winners have included telemedicine providers Doctor On Demand (2014) and Teladoc (2011); CNS Response (now MYnd Analytics), which helps psychiatrists prescribe the right medication the first time, rather than through trial-and-error (2015); and Cynvenio’s LiquidBiopsy approach to analyze cancer biomarkers though a blood test, rather than costly and painful biopsies (2014).

So, if you are aware of a company whose innovative approach or technology is providing what CMS now calls “better care, smarter spending,” nominate them here (by July 12). And if your company – or division – is using an approach or has developed a health IT or medical technology that is reducing the cost of quality care, nominate your company here (by July 19). With all the exciting new ways of providing higher quality care at lower cost being developed in incubators, on the floors of hospitals, and in well-established companies, we’ll be looking forward to celebrating with another group of innovators at the 2016 Innovations in HealthcareTM ABBY Awards on October 26th, so hold the date now! 


 


 

MIMI GRANT’S POST: June 15, 2016

Living Lessons from “HillaryCare”

First Lady Hillary Clinton testifies for the final day before the Senate Finance Committee on Health Care September 30, 1993. REUTERS/Mike Theiler

An insightful article by Reuters’ Susan Cornwell, headlined From ‘Hillarycare’ debacle in 1990s, Clinton emerged more cautious, stirred memories of a September evening, nearly 23 years ago, when a KABC news van pulled up in front of our house to record ABL Members’ reactions to Bill Clinton’s televised announcement of what would become the Health Security Act. The local television station wanted to record the reactions of a mix of payers, providers, and healthcare suppliers to Clinton’s proposal for health reform, designed by the Task Force on National Health Care Reform, which had been headed by First Lady Hillary Clinton. It turned out the Group’s skeptical response that evening was a harbinger of what was to come.
As details of the plan emerged, industry backlash and the devastating “Harry and Louise” commercials trounced all of Hillary’s hard work – and that of her “Committee of 500,” that controversially met behind closed doors to hash out the plan.

However, as Cornwell points out in her article, while the country didn’t get health reform in the early 1990s, Hillary did take away some invaluable lessons. Key among them: incrementalism, and (as she demonstrated during her terms in the Senate) bipartisanship, and consensus building.

A copy of the 1342-page Health Security Act still sits in my bookcase as a testament to a bold initiative. And while the HSA failed, the lessons taken from the debacle also served President Obama well 17 years later, including: the critical importance of Congressional support (at least in your own party); and if you’re going to disrupt an industry, get some of its key leaders on your side first. Today, as the standard bearer of her party, 23 years after her humiliation on the Hill, no doubt the former head of the Task Force on National Health Care Reform will be much wiser and shrewder as she aims to “build on” (or “Hillaryize”) Obamacare. 


 


 

MIMI GRANT’S POST: June 1, 2016

Michelson’s Movement to End
‘Our Medical Error Crisis’

Yesterday, US News ran “Our Medical Error Crisis” by Leslie D. Michelson, author, patient advocate, and CEO of Private Health Management. With Leslie’s permission, we’re linking it here, because we’re firm believers in his crusade to enlist physicians, clinicians, payers, administrators, academics, political leaders from both parties, patients, their families, and people like us, to start preventing the nation’s third leading cause of death: preventable medical errors.
You may recall that in 1999, the Institute of Medicine shocked the world by reporting in “To Err is Human,” that nearly 98,000 lives were being lost annually. Surely, you’d think, with all the medical advances of the past 17 years, those stats have improved. Guess again. In his article, Leslie updates us on the stunning news that, according to Johns Hopkins researchers and a Journal of Patient Safety study, not only has the error rate not decreased, it’s much worse now: with between 250,000 to 400,000 Americans dying from preventable errors annually.

In his bestseller, The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love, Leslie teaches patients how to become more empowered healthcare consumers. Now it’s time for those of us who provide and pay for healthcare – who are in a much better position to make the kinds of lifesaving changes Leslie proposes be made at the bedside, in the physician’s office, and everywhere else “the healthcare system” touches people – to step up to the challenge of making healthcare safer.

If 700 lives were lost each day due to accidents in the air or on the streets, Americans would demand action – just as they have with safer planes and cars. In this important article, Leslie shares a number of ways to start turning these numbers around, including making it a national priority to start putting an end to this crisis in our hospitals and other centers of care. What can you do to join in? 


 


 

MIMI GRANT’S POST: May 17, 2016

Prince’s Legacy: Purple Pain

While the toxicology reports are not in yet, and the County Sheriff’s, DEA’s, and the U.S. Attorney General’s investigations are ongoing, the tabloids are convinced that 57-year-old singer Prince succumbed to an overdose of pain pills. At a time when the politicians – both on the stump and those already in office – are decrying the national epidemic of opioid painkillers and passing bills to fight addiction, it’s the press swirling around the 5’2″ superstar that’s generating the most attention to our nation’s greatest public health issue.
No doubt reports will eventually emerge from the Toxicology Lab, either confirming the rampant suspicions, or putting them to rest. But, in the meantime, millions of Americans who disregard both CNN and Fox News, will learn plenty about the severity – and prevalence – of the problem. And, to the extent that awareness deters teens and adults alike from treating their pain with Percocet and other easily addicting opiates, that may well be Prince’s greatest legacy.

 


 

MIMI GRANT’S POST: May 3, 2016

What’s Killing America’s White Women?

The chart shows “Deaths from Drug Overdose and other accidental poisonings”; Source: Centers for Disease Control and Prevention (nytimes.com, 1/17/16)
OK, so maybe living one month less than we used to, is no big deal. After all, living to an average age of 81.1 years is still a good run. Yet, this is the first time since the government began keeping records that white women saw their life expectancy decline, according to a CDC National Center for Health Statistics report. This is particularly startling given the increase in life expectancy for African Americans (to 75.2 years), and particularly that Hispanic life expectancy rose from 81.6 to 81.8 years, in the same 2013-2014 time period.

So what’s going on here?

Is it money? America’s white women enjoyed an average income of $36,556, compared to $26,936 that the average Latina pocketed, in 2011. 


Or is it stressing over getting the kids ready for school – and getting to work? Well, Census data would have us believe that Latinas should be more stressed out – due to having 2.6 children, while white moms only have 2.3 kids to stress over.

Or is it that we’re trying to put “pain” – both physical and mental behind us? NPR reports that the past 15 years have brought with them an increase in suicides, overdoses, and unintentional poisonings (primarily by alcohol and drugs). We’re literally killing ourselves: From 1999 to 2014, the overall death rate increased by 24%. That’s bad enough, but for white middle-aged women, it increased 63%. Worse, the number of girls aged 10 to 14 who committed suicide actually tripled. From 2000 to 2014 nearly half a million Americans died from drug overdoses. In 2014 alone, over 60% of those deaths involved opioids, including pain relievers and heroin. Not surprisingly, opioid pain reliever prescribing has quadrupled since 1999.

So what’s the answer? Interviewed in the New York Times, Eileen Crimmins, a USC gerontology professor, believes the causes of death in these younger people were largely social – “For too many, and especially for too many women, they are not in stable relationships, they don’t have jobs, they have children they can’t feed and clothe, and they have no support network. It’s not medical care, it’s life. There are people whose lives are so hard they break.”

Sounds like it’s time for white women to reach out to our Latina sisters to learn about the importance of having support networks, family, and how to capture a greater sense of Joy – without drugs – in the beauty of the world and the people around us. And, for all of society to recognize that opioid addiction largely stems from a physician’s pen, and to start putting a break on a prescribing practice that’s literally killing us before our time.

 


 

MIMI GRANT’S POST: April 19, 2016

What “The Money” Wants Now

Barry Didato, CIO of The Innovation Institute, presents at ABL’s recent “Meet the Money” event
In the 32 years since ABL presented its first Meet the Money(SM) event, the “types of money” available have morphed substantially – from traditional VCs to this year’s crop of incubators, accelerators, niche venture funds, and multi-staged Private Equity funds.

And, thanks to the wizardry of Chesney Communications, even if you missed meeting the money in person and the impressive Q&A session that followed each Investor’s presentation, Bob Chesney captured the video highlights of the entire Meet the Money: What Investors Want Now event here. Presenters include: Barry Didato, the Chief Investment Officer of The Innovation Institute (and host of the event), sharing how their fund is investing and incubating innovations that can be used by the nonprofit hospital systems founders (and funders) of the Institute. OCTANe’s CEO Bill Carpou, explaining that Orange County’s principal accelerator is now launching its first niche fund: Visionary Ventures, which will focus on funding ophthalmic innovations. Tom Giles, Frost Data Capital’s General Partner for Healthcare, profiling the world’s largest funds focused on Healthcare Big Data startups. Mark McWilliams, CEO of Medipacs, and Scott Hutchinson, with StoneCreek Capital, introducing us to their strategic planning approach for Medipacs’ Series C – and what it’s taken to grow the company from tech transfer startup to medtech clinicals. And at the later stage of the financing spectrum, John Lanier, a Partner with Excellere Partners, and Ed Gibson, CEO of Gibson Investment Group, Inc., discussing how they’ve taken existing companies to the next level – and next exit. After hearing from “the Money,” the entire Investor Panel gave Dirk Soenksen, CEO of Ceresti Health, an opportunity to take a dip in the “dolphin tank,” sharing helpful and cautionary insights in response to his “pitch” for Series B financing for Ceresti’s solution for improving both the Alzheimer’s patient’s experience.

While none of the Investors’ companies even existed in 1983, when we held our first Meet the Money, one thing surprisingly hasn’t changed over the year: virtually everyone in the audience wore a suit! 


 


 

MIMI GRANT’S POST: February 23, 2016

Racing to the Moon: Through Collaboration

“We will not tolerate losing this war against cancer.” Patrick Soon-Shiong, MD
Last month, in separate announcements, President Barack Obama and biotech superstar Patrick Soon-Shiong, MD, announced the Cancer MoonShot 2020. The president, in his State of the Union address on January 12th, echoed Vice President Joe Biden’s plea for a unified endeavor to cure cancer and announced the creation of the National Cancer Moonshot, primarily NIH-funded with $1 billion to jumpstart the program, and declared Biden “in charge of Mission Control.” But, while Biden may be on the ground, clearly the person leading the teams that are building the rocket ship will be Dr. Soon-Shiong.

The day before the president’s address, across the county at the JP Morgan Health Conference, Patrick Soon-Shiong, CEO of NantWorks, led the announcement of the formation of Cancer MoonShot 2020, by The National Immunotherapy Coalition (NIC), a consortium of large pharma and biotechs (like Celgene, Amgen, and Nantworks), insurance companies (Independence Blue Cross), self-insured employers (Bank of America), academia, and community oncologists, who are joining forces to “accelerate the potential of combination immunotherapies as the next-generation standard of care in patients with cancer.” Founded by Soon-Shiong, from this massive coordinated effort of companies in the private sector – with a commitment of government agencies to reduce red tape – the NIC’s QUILT (QUantitative, Integrative Lifelong Trial) has emerged. The immediate goal of QUILT is a trial that will diagnose and sequence the genomes of 100,000 cancer patients with 20 types of cancer, assigning 20,000 patients to next-generation immunotherapy care; the ultimate goal of the initiative is a vaccine-based immunotherapy tailored to the unique tumor signature of individual patients.

In the aggregate, cancer is the nation’s #2 killer, following heart disease. But, while we’re bombarded with ways we can proactively tame heart disease (largely through diet and exercise), cancer seems to target the innocent – including the otherwise most healthy among us. Obviously, this is why Vice President Biden is the point person for the government’s effort. And why it’s “personal” to me, too; because, like Biden, I lost a child to cancer. 


In the past, the race to the cure has been an individual sport; Cancer MoonShot 2020 creates a team sport. As Soon-Shiong explains: “Currently both large pharma and biotech companies are developing dozens of immunotherapeutic agents. The problem is that while these drugs are being developed individually in silos by each entity, they need to act together when it comes to activating the immune system. If we follow the current path of drug development, it may take 40 or 50 years before we have worked out the right cocktail combination and countless lives will be lost as a result of this inefficiency.” Just as AIDS became a chronic disease with the advent of drug “cocktails” that could target the virus at multiple vulnerable points, it’s likely that immunotherapies will truly usher in the era of personalized medicine that will be able to target cancers that are unique to each individual living with them.


Soon-Shiong knows something about the power of combining therapies, since his development of Abraxane, an adjunctive therapy for breast, lung, and pancreatic cancer treatment – and the cornerstone of his company Abraxis, was instrumental in making him a multi-billionaire and the richest man in healthcare. Just last week, Children’s Hospital of Orange County announced they – and nine other pediatric health systems – have joined the Cancer MoonShot 2020 initiative, and plan to share data with other participants in the NIC. Another development in this new era of collaboration is Seven Bridges, a biomedical data analysis firm, which announced that it has uploaded the complete DNA data and other molecular and medical information on cancers from 11,000 patients to the cloud and made it available to any scientist.


Just as Eric Siegel defines the power of “the Ensemble Effect” in his bestseller, Predictive Analytics (“when joined in an ensemble, predictive models compensate for one another’s limitations, so the ensemble as a whole is more likely to predict correctly than its component models are”), so too will this shot to the moon be accelerated by the thousands of brilliant minds, using the latest technology, with access to each other’s path-breaking work. It can’t happen fast enough.


 


 

MIMI GRANT’S POST: February 10, 2016

Biotech & Genomics to the World’s Rescue

During ABL’s recent Top Tech Trends event, Dave “Mr. Trend” Berkus shared the stage with Cynvenio’s CEO, André de Fusco (pictured here), to talk about the near-future implications and applications of Biotech. As Dave detailed in this video clip, “biotechnology will help, heal, fuel, and feed the world.” Industrial biotech alone is projected to be over a $500 billion industry by 2025; and, on the healthcare front, enable us to treat over 7,000 rare diseases, that are beyond our scope today.
Cynvenio’s diagnostic devices enable “Liquid Biopsies” – determining, with a couple of vials of blood, the presence and staging of disease that previously was only available through a biopsy. Now that “cancer” is known to be a disease, not of organs, but rather one of over 280,000 genetic mutations, tools like Cynvenio’s will be key players in both Vice President Joe Biden’s and Patrick Soon-Shiong’s “CancerMoonShot 2020” race to find a cure for cancer. (And, once again – just like sequencing the genome, it will be interesting to watch which “team” gets to the finish line first: NantWorks or the government.)

As André explains in this video clip (starts at 3:54), while liquid biopsies are being used for theranostics (personalized medicine) and monitoring today, the largest opportunity is for screening – as Angelina Jolie famously did – and recommended for anyone concerned that the BRCA gene mutation runs in their family. While in the U.S., the medical system has not embraced the idea (let alone the cost) of universal screening, China has – leading the way to a shift to prevention of disease, rather than just identifying its presence once it’s manifested, and going for a cure.

What is leading the way in this country are “smart consumers” who will demand the right to know about their own genetic make-up, and – just as Uber has disintermediated the taxi industry, will support companies with Direct-to-Consumer business models, like 23andMe, who will enable individuals to know “everything about me, with me” – not without me. 


And, when this happens, how will it impact your healthcare business?


And, how will it impact you?


 


 

GUEST POST: January 26, 2016

Inspiring a New Generation to Defy the Bounds of Innovation: A Moonshot to Cure Cancer.

A “Guest Post” from U.S. Vice President Joe Biden: His Moonshot to Cure Cancer was originally posted on January 22, 2016:   Three months ago, I called for a “moonshot” to cure cancer. Tonight, the President tasked me with leading a new, national mission to get this done. It’s personal for me. But it’s also personal for nearly every American, and millions of people around the world. We all know someone who has had cancer, or is fighting to beat it. They’re our family, friends, and co-workers.
If this disease has touched your life, I want to hear your story.

Today, cancer is the leading cause of death worldwide. And that’s only expected to increase in the coming decades – unless we make more progress today. I know we can.

From my own personal experience, I’ve learned that research and therapies are on the cusp of incredible breakthroughs. Just in the past four years, we’ve seen amazing advancements. And this is an inflection point. 


Over the course of the past few months, I’ve met with nearly 200 of the world’s top cancer physicians, researchers, and philanthropists.


And the goal of this initiative – this “Moonshot” – is to seize this moment. To accelerate our efforts to progress towards a cure, and to unleash new discoveries and breakthroughs for other deadly diseases.


[Read More]

 


 

MIMI GRANT’S POST: January 12, 2016

3 Reasons ‘Dr. Watson’ is Excelling in Oncology

Recently, the American Cancer Society announced that cancer is the leading cause of death in California – and 21 other states, surpassing heart disease. And, while none of us are getting out of here alive, cancer has an evil tendency to claim its victims long before their time: David Bowie, Gilda Radner, Steve Jobs, Patrick Swayze, my daughter. Thankfully, beyond its dramatic win on Jeopardy!, IBM is putting its Watson computer to the test searching for the best treatments and cures for cancer. According to interviews with Watson medical pioneers (which became a research report) by Thomas Davenport of Babson College, here are the three outstanding cancer-fighting institutions working with “Dr. Watson” – and three good reasons to believe that research resulting in effective treatment – and ultimately a cure – are not that far away:
Memorial Sloan Kettering Cancer Center (MSKCC) has been treating and researching cancer since it was founded, as New York Cancer Hospital, in 1884, with the generous support of John Jacob Astor. Later, John D. Rockefeller provided the land on which it sits; and in the 1940s, Alfred P. Sloan (long-time CEO of GM), and Charles Kettering (prolific automotive entrepreneur and inventor), established the Sloan-Kettering Institute for cancer research, which later merged with the hospital, forming MSKCC in 1980. Fast forward to 2014: U.S. News & World Report (USN&WR) ranked MSKCC as the #1 cancer hospital in the country. While MSKCC hasn’t come up with a cure yet, oncologist Mark Kris, MD, has headed their Watson project since 2012, and is convinced “this is the way medicine is going to be practiced.”

The Mayo Clinic was founded as a clinic, in 1864 in Rochester, MN, by the father (William Worrall Mayo) of the famous Mayo Brothers (Will and Charlie). Today it is acknowledged as the first and largest integrated nonprofit medical group practice in the world, employing more than 3,800 physicians and scientists and 50,900 allied health staff – and spending over $500,000,000 a year on research. Not surprisingly, the Big C is among their areas of study. Steve Alberts, MD, is leading the Watson project at Mayo, matching patients with clinical trials – and feeding Watson both unstructured, as well as structured, data to learn from.

MD Anderson Cancer Center (MDACC), the new kid on the block, truly is an Academic Medical Center – founded by the University of Texas in 1941. Its namesake and founding benefactor was Monroe Dunaway Anderson, a banker who, with his brother and brother-in-law, owned the world’s largest cotton company. With his death, the MD Anderson Foundation matched the State of Texas’ initial half-million-dollar financial commitment to the new hospital – on the condition it be built in Houston’s Texas Medical Center, and named for MD. Fast forward to 2015, MDACC took home the #1 cancer hospital in the country ranking from USN&WR. Its “moon shot” use of Watson is to build a virtual expert called MD Anderson Oncology Expert Advisor, that’s trained to “share both the clinical evidence as well as the [MDACC] ‘art’ of cancer care,” according to Davenport. 


Unfortunately, it’s probably going to be awhile before all of us are benefiting from Dr. Watson. “He” is still in training. And, while it only took him five months to master veterinary medicine, turns out improving medicine for humans is endowed with a few additional complicating (and learning-time-lengthening) factors. As MDACC’s Lynda Chin, MD, who’s leading their Watson project, summarized what first needs to be undertaken before improving patient outcomes: “addressing the necessary network infrastructure, security and regulatory controls, data sharing/ access/ use contracts, and reimbursement, not to mention the culture of medicine and clinical adoption.”


A few nice features that Watson enjoys that the typical human does not: He doesn’t forget, he just keeps on learning, he doesn’t need to sleep, eat, or take a break to play video games. Yet, the physicians who have worked with Watson longest are unanimous in their assessment that he will “advise, but not replace, oncologists.” Turns out curing cancer isn’t as easy as winning Jeopardy!, but as MSKCC’s Dr. Kris concluded: “This is real and it’s going to revolutionize cancer and other types of medical care. It’s enormously complex, and we will never be finished until all cancers are cured. . . But I don’t doubt at all that it will provide enormous value.”


And the day that all cancers are cured can’t come a minute too soon.

[Photo Caption: Leanne LeBlanc, IBM Watson project manager, views analytics of healthcare data at Watson headquarters in New York City, on April 13, 2015. Photo Credit: ibm.com]

 


 

MIMI GRANT’S POST: December 15, 2015

Robots are Coming to an Elder Near You!

Last Thursday, several of ABL’s East Bay Round Table Members were given the opportunity to get up close and personal with one of CEO Steve Grau’s super “patient-friendly” Royal Ambulances. While its interior was more reminiscent of a Virgin Airlines plane than an “industrial strength” ambulance, what captured the Group’s attention wasn’t all the detailing to make the passenger feel like s/he was riding in a limo, but the life-like cat purring on the gurney. In turn, each of us had to hold and pet it, and ooh and aah over how cute it was.
Turns out, this “Joy for All” pet by Hasbro is the toy company’s first entry into the senior’s “companion pet” market. And Kitty doesn’t just purr; if the patient on the gurney – who is frequently being transported between facilities – pets it on its head, it will automatically move its head toward their hand. And, if the ride is long enough and the patient keeps petting Kitty’s back, it will roll over for a belly rub. And, like all felines, ignored for long enough, it will close its eyes and fall asleep (extending the life of its four C batteries). Given that the purring Kitty’s purpose in the ambulance is to reduce the patient’s anxiety, the passenger might also relax and fall asleep. 

This may be just one small robotic step closer to the loveable and exceptionally talented – if amoral – Robot in the 2012 sci-fi hit, Robot & Frank, in which Frank (a “retired” jewel thief) teaches Robot a “trade,” making it an accomplice in a couple of heists. The timing of this flick is the “near future,” and so it might be. In South Seattle, a former Microsoftee, Tandy Trower, has built a four-foot-tall rolling robot, equipped with cameras, radar, microphone, speaker, a tablet interface, and a movable tray. “Robby” may someday be able to serve as a mobile companion and even perform some light chores; in addition it could “monitor the health of its human companion and assist with tasks like keeping track of medicines,” plus “its screen could also be used for video conferences with physicians and other healthcare providers.”


And the government is getting in the act, too: the NSF recently granted Naira Hovakimyan, a University of Illinois roboticist, $1.5 million to explore the idea of designing small autonomous drones to perform simple household chores, like retrieving a bottle of medicine from another room. Naira believes that within 20 years, drones will not only be safe, but will become an everyday fixture in elder care: “drones will be today’s cellphones,” she said. According to the New York Times, she believes drones could ultimately be used to perform all manner of household chores, like reaching under a table to grab an object, cleaning chandeliers, and weeding the lawn. But, in the meantime, Hasbro’s purring Kitty will put a smile on grandma’s face – and probably those of her kids and grandkids, too!

 


 

FEATURED POST: November 3, 2015

The Future of Technology in Healthcare

WLSApostPic Our Guest Post is from the Wireless-Life Sciences Alliance, where Rob McCray is CEO.
The pace of medical technology advances boggles even the minds of the doctors and researchers involved. While the media seems to be focused on drug and treatment pricing inequities, doctors struggle to keep up with the array of new options they could (or should) offer patients. Insurers, healthcare advocates, government entities, and non-profits all face great challenges in creating coverage arrangements and delivery systems that keep up with the pace of medical advances and connected health. 

Here we cover recent advances in the treatment and diagnosis of the most challenging diseases of our time, including cancer, obesity, diabetes, heart and brain issues, lung diseases, and orthopedics.


Read Entire Post.

 


 

MIMI GRANT’S POST: October 20, 2015

The Power of Listening to Employees

Tomorrow we’ll be announcing the winners of ABL’s 16th Innovations in Healthcaresm Awards. Over the years, among nearly 50 ABBY Awardees, one who really stands out is Wright Lassiter III, CEO of Alameda County Medical Center, for his turnaround of the hospital, particularly its ER. When Wright was recruited to be the tenth CEO of Alameda County Medical Center in eleven years, the four-facility system was in a world of hurt. As a County hospital, it was the facility of “last resort” to care for the area’s medically desperate. Located in the heart of Oakland, California, its services were in high demand by members of the area’s “knife and gun clubs,” as well as those seeking cutting-edge surgeries and services from an impressive range of specialists, med students, and dedicated staff – even though most of its customers had neither the cash nor insurance to pay for them. The result was a $53.6 million deficit.
On any given morning, it was not unusual for the line of patients waiting to walk into ACMC’s Emergency Room to stream out the door and down the street, as triage delays would last for hours. As the County’s trauma center, 911 patients would literally die in ambulances, trying to get in – as the ER was frequently on “diversion,” when the Center’s Operating Rooms and clinicians were at capacity. 

Upon his arrival, in late 2005, Wright’s Job #1 was to stop the bleeding. . . on the books. First, he established a clear Vision for what the Center could be. He then created cross-disciplinary teams of unionized employees (including trainers who taught caregivers the basics of accounting) with the mission to look into every department and identify common-sense ways to save money. Suddenly, cost-savings and efficiencies were identified throughout the hospital – like switching from a $96.50 device for drawing blood from newborns’ umbilical cords to its 29-cent comparable alternative, saving the Center a reported $322,000 a year. In all, these efforts resulted in a $23 million fiscal turnaround in Wright’s first year on the job.


He also realized the Center’s terrible reputation for long waits and diversions was in need of a major turn-around, too. But, rather than just looking at the numbers, Wright spent long hours in the ER, talking and listening to the physicians, nurses, social workers, aids, and “front office” personnel
. Read More. [Photo Credit: Fast Company]

 


 

MIMI GRANT’S POST: October 6, 2015

Ariadne: Out of the Labyrinth with Atul Gawande

Atul & Mimi Down the labyrinthine halls of a converted giant Sears building in Boston, every other week, really bright faculty, clinicians, and scientists from Brigham & Women’s, Harvard T.H. Chan School of Public Health, Harvard Medical School, and a few guests, gather to report their work in health systems innovation. The convener of this august group of think-tankers and doers is none other than prolific writer, surgeon, and public policy guru, Atul Gawande, MD, MPH [Pictured: Atul Gawande, MD/MPH (left) greets Mimi Grant at Ariadne Labs in Boston].Following his graduation from Stanford, his Rhodes Scholarship at Oxford, and work on Al Gore’s 1988 presidential campaign and on Rep. Jim Cooper’s “managed competition” healthcare proposal, Gawande enrolled in Harvard Medical School (HMS). But, mid-way through, he took a “gap year” to become Bill Clinton’s healthcare advisor during the 1992 campaign and, post-inauguration, a senior adviser in the DHS, and director of a Clinton Health Care Task Force committee, which defined the benefits packages for Americans and subsidies and requirements for employers. Not bad for someone in his mid-20s.
Following his HMS graduation, in 1995, Gawande was first published in Slate – while still a resident. The New Yorker magazine editors were so impressed, they started running his articles and, three years later, he was their staff medical writer. Fast forward – past three bestselling books: Complications: A Surgeon’s Notes on an Imperfect Science (2002); Better: A Surgeon’s Notes on Performance (2007); and The Checklist Manifesto: How to Get Things Right (2009) – the year before the passage of the Affordable Care Act, Gawande’s ground-breaking, New Yorker essay, “The Cost Conundrum,” was shown to a group of senators by President Obama, who said: “This is what we’ve got to fix.” And, last year’s “Being Mortal: Medicine and What Matters in the End” – and the Frontline episode based on it, are already upending many traditionally held notions about end-of-life choices. 
With all this – and an active surgical and speaking schedule, you wouldn’t think Gawande has time for anything else. But, enter Ariadne Labs. Read More.

 


 

MIMI GRANT’S POST: September 22, 2015

The ECHO That Will Touch a Billion

Even though a record proportion of the U.S. population is now insured, that doesn’t mean everyone has access to specialty care, especially for complex, chronic diseases. In fact, historically, if the newly insured has Medicaid/ Medi-Cal, they likely will encounter long waits, long drives, or suboptimal care, before they receive that of a specialist. But that’s beginning to change.

How?Thanks to the genius of Sanjeev Arora, MD, for conceptualizing the program 12 years ago – and the generosity of initial grants made by CMMI, RWJF, AHRQ, GE Foundation, and now with the support of the VA, DOD, CDC, other federal and state programs, and more – Project ECHO (Extension for Community Health Care Outcomes) is already enabling thousands of primary healthcare workers to bring a level of specialty care to underserved patients in remote and urban locations previously unimagined.Last week I had the opportunity to participate – along with an international group of about 50, representing  universities, multiple state and national departments of health, health plans, and physicians – in a Project ECHO Orientation, held at ECHO’s headquarters on the University of New Mexico’s Health Sciences campus. While I only stayed for an intense 10-hour day, most of the others remained for three days, with the purpose of setting up yet another ECHO hub.

So what does a hub look like?

Each week, panels of Project ECHO’s specialists (physicians, pharmacists, behaviorists, social workers, and others) convene in settings similar to the one depicted here (at UNM). ECHO’s specialists, who today are located in 63 hubs, anchored at 55 universities and 11 VA sites, train and mentor primary care clinicians, based in 2400 clinics located in 26 states and 11 countries, with “grand round” insights on how to best treat and manage patients with 40 different diseases and conditions. The “students” who attend these specialty-focused virtual sessions are typically primary care physicians, nurse practitioners, PAs, MAs, social workers, and community health workers, located in the equivalent of rural and urban community health centers.



During the course of a two-hour video-conferenced clinic, the participants from as many as 25 different clinics “converge” on a master screen courtesy of Zoom’s video conferencing technology (depicted here), armed with about 20 actual patient cases, which the experts – and other “field clinicians” – weigh in on. And, with each case presentation/ discussion (in addition to a brief weekly “didactic” on a related subject), everyone “attending” the clinic gains a deeper understanding of not just how to treat that particular patient whose case is being presented, but how that treatment protocol could assist others in their practice as well. (During the Orientation, we watched two clinics: the first focused on diabetes, the second on Hepatitis C, but we met the leaders of many others, including a pediatric epileptologist.)



And does this work?

 

In 2011, a study published in the New England Journal of Medicine found that the quality of care provided by Project ECHO-trained clinicians was not only equal to that of the care provided by university-based specialists, it was slightly better!


So why is Project ECHO of particular interest to ABL?

On October 21st, at ABL’s 16th Innovations in Healthcaresm ABBY Awards, it will be our privilege to present Dr. Arora with our “Leadership in Innovation” Award, and to hear his inspiring keynote on how Project ECHO is de-monopolizing specialized medical knowledge. Sanjeev’s goal is to “touch a billion people by 2025,” through the “force multiplier” power of leveraging Project ECHO’s democratization of specialty care. He’s well on his way already, with his estimate that “the idea that’s become a Movement” has already touched tens of millions.


 

MIMI GRANT’S POST: September 9, 2015

The Data Will See You Now

As a follower of healthcare innovations – including hosting ABL’s Innovations in HealthcareSM ABBY Awards Event for the past 16 years, I’ve been following the rise of healthcare apps from their beginning. As of June 2015, Apple claimed 1.5 million iPhone apps, “tens of thousands” of which are in the health and wellness space.


But tonight, at Matthew Holt’s Health 2.0 Meetup in San Francisco, I was struck like a bolt of lightning.




The inspiration was embedded in a presentation made by Cordelia Sendax (Stanford, 2013), marketing manager of Cellscope. The mHealth company already has Class 1 FDA approval for the Oto HOME, a device that’s similar to an analog otoscope – that connects to a smartphone and records a video as mom uses the device to peer into her child’s ear. A software algorithm guides her to point the camera toward the eardrum, where the video exam takes place. “Our app securely transmits the exam and associated symptom information [so a physician can] make a diagnosis and call you back to explain the treatment plan,” according to Erik Douglas, Cellscope’s CEO. Currently you can send these video images to your own pediatrician, or one aligned with the company, which promises a diagnosis within two hours for $49. All pretty straight forward.


But, here’s the lightning bolt: with 200,000 video images and counting, it’s the algorithm that will soon be able to make and give you the diagnosis, not the doc. With a Big Database of the spectrum of infected eardrums, soon algorithms will give moms all the tools they need to determine whether “watchful waiting” is in order, or if it’s time to get a prescription, or rush to the ED. All without calling on a physician, in person or remotely, or using IBM’s Watson.



ABBY Award Finalist George Carpenter, CEO of CNS Response, is also tapping the value of Big Clinical Data.
Specifically, CNS has compiled the largest database of neurophysiological findings correlated to medication response, with 38,000 outcomes for 10,000+ unique patients. While physicians are still actively involved in the prescription process, CNS Response – which is not an app – enables them to dramatically reduce treatment by “trial and error,” which is currently the dominant approach in the treatment of brain disorders.


Smart devices tied to Big Databases will soon make all of us smarter, and healthier.
[Photo from cellscope.com]