Change Agents at Work; Catalysts to Improve Our Health System

There are days that I love my job (not every day yet), and last week I had one of those special days. I participated in the Forum for Sustainable Health, an event hosted by Arizona State University’s Biodesign Insitute with a bunch of incredibly smart people -- all change agents in their respective areas -- talking about the policy, scientific, clinical and consumer changes needed to transform the health delivery system and leverage the knowledge coming from scientific discoveries to predict and prevent disease. I was there because many of the stakeholders recognize that scale software is a critical component to enabling discovery and transformation and because consumer engagement is critical.

At the center of the event was the launch of an effort called the Global Biosignatures Network, a global network/confederation of public and private sector groups -- clinical care sites, clinical research investigators, academic research laboratories and medical technology and biotechnology companies in the US and elsewhere -- all collaborating to drive better diagnostics and accelerate applied research. Imagine the world’s best and brightest working together to share knowledge about the science and how to apply it to solve real world problems quickly…that is the goal of the GBN.

The forum was basically a brainstorming session (with a lot of big brains -- Lee Hartwell, Denis Cortese, David Lawrence, Alan Nelson, Spyro Mousses to mention a few) around how this network could help drive the use of information more effectively to enable earlier detection, intervention and ultimately the prevention of disease.

We talked about a lot of the issues… When you think about healthcare today, most systems -- whether in the U.S. or elsewhere -- dedicate most of their resources to what David Lawrence calls “sick care” and the late stage treatment of disease. And in those areas -- we apply pretty generic “treatments,” which produce a wide variation in terms of outcomes. We don’t have very good feedback loops and therefore can’t drive “continuous improvement.” So, we end up with poor health outcomes and skyrocketing costs. Not to mention that we’re totally not set up to handle or deliver on the promise of personalized medicine.

And we talked about solutions…. We have to develop better diagnostic capabilities to transform our ability to prevent and respond to disease -- being able to identify diseases at their earliest and most curable stage, and for those who develop disease, be able to have tests that predict who will respond to which therapies before they are given. As part of this, we have to be able to connect and engage with consumers in new ways -- to accelerate research, to educate on how lifestyle actions affect health and disease and on their role in engaging with the medical community around “shared decision making.” As is pointed out in The Innovator’s Prescription, with greater precision and predictability, wecreate the opportunity to develop innovative and disruptive ways to deliver less expensive and more reliable care using non-physician health professionals, consumer “self-serve” models and other types of technology services and solutions.

And for an old philosophy major, it was interesting to me that the discussion also traversed into the areas of Epistemology and Philosophy -- really fascinating to think about the intersection of bio-medical science and philosophy. I even added a few books to my list of upcoming ‘reads’: On Intelligence and The Origin of Consciousness in the Breakdown of the Bicameral Mind

The science is really exciting (at least what I could understand from it) -- there is a ton of exciting work advancing our understanding of how the body works and the efforts are really spread out around various centers in the world -- which is a good thing. The conversation amongst the stakeholders was powerful, and there were frank discussions about the challenges in implementing the kind of changes necessary to accelerate real world solutions -- changes in the regulatory environment, in the incentives of stakeholders, funding, business models, aggregating/sharing this data, and other policy issues. Often I feel that the most significant barriers are those around policy, and ironically, I had the opportunity to spend some of the day talking to Aneesh Chopra and Todd Park on the phone -- they are true change agents, trying to push the envelope inside our government in so many ways. While I’m often a skeptic, I couldn’t help but leave this meeting hopeful -- with all these incredibly smart people working to find practical solutions to make improvements to our systems, I can’t help but feel that we can make a better health future for our kids.