Relentless Health Value

Chief Information Officers (CIOs) are not just "the computer people" anymore. Technology is no longer relegated to the category of operational overhead. Technology is a strategic imperative. It's a competitive differentiator, it's a driver of success in today's connected era, an era increasingly dependent on outcomes-based revenue. On the other hand, when something goes wrong, technology gets blamed even if the real problem is a shabby process or insufficient training. Today, I have a candid conversation with Sue Schade from StarBridge Advisors about the what and how of being a CIO. Sue is the perfect person to have this conversation because she's had the opportunity to serve in the role of CIO or interim CIO at 4 health systems in 4 geographies with 4 different cultures and levels of sophistication and leadership teams. Sue is a Principal at StarBridge Advisors, LLC. A nationally recognized health IT leader, she recently served as interim CIO at Stony Brook Medicine on Long Island and at University Hospitals in Cleveland, Ohio. Prior to joining StarBridge Advisors, she was a founding advisor at Next Wave Health Advisors. Sue has more than 30 years' experience in health care information technology management, and was recognized as the CHIME-HIMSS John E. Gall, Jr. CIO of the Year in 2014. You can learn more at starbridgeadvisors.com or at sueschade.com.

Cyrus Maaghul is a serial entrepreneur currently applying distributed systems, blockchain, and cryptocurrency technology to the health care industry as founder and CEO of HealthCombix and Co-founder/Board Member at PointNurse. Cyrus' health care blockchain thought-leadership has appeared in articles on CoinDesk, Nasdaq, Distributed, and other media outlets. His experience as a payments technology entrepreneur and working inside world-class organizations like Fidelity Investments' Blockchain Incubator and Deloitte Consulting give him a unique perspective to advise, develop strategy, and build decentralized networks. HealthCombix is currently developing new foundational infrastructure and custom applications for decentralized health care, including identity, consent, privacy, smart health trusts, governance, and asset management capabilities. PointNurse is a digital decentralized autonomous-based peer-to-peer virtual health platform seeking to drive down the cost of primary care, streamline clinical trials, and nursing by displacing various intermediaries. Cyrus’ interest in blockchain technology began in 2013 after investing in Bitcoin. This led to his investigating how to use blockchain to solve problems related to privacy, peer-to-peer data sharing, security, administration costs, and virtual community governance.

You can learn more at healthcombix.com.

Cyrus Maaghul is a serial entrepreneur currently applying distributed systems, blockchain, and cryptocurrency technology to the health care industry as founder and CEO of HealthCombix and Co-founder/Board Member at PointNurse. Cyrus' health care blockchain thought-leadership has appeared in articles on CoinDesk, Nasdaq, Distributed, and other media outlets. His experience as a payments technology entrepreneur and working inside world-class organizations like Fidelity Investments' Blockchain Incubator and Deloitte Consulting give him a unique perspective to advise, develop strategy, and build decentralized networks. HealthCombix is currently developing new foundational infrastructure and custom applications for decentralized health care, including identity, consent, privacy, smart health trusts, governance, and asset management capabilities. PointNurse is a digital decentralized autonomous-based peer-to-peer virtual health platform seeking to drive down the cost of primary care, streamline clinical trials, and nursing by displacing various intermediaries. Cyrus' interest in blockchain technology began in 2013 after investing in Bitcoin. This led to his investigating how to use blockchain to solve problems related to privacy, peer-to-peer data sharing, security, administration costs, and virtual community governance. You can learn more at healthcombix.com.

Roy is Chief Innovation Officer at Penn Medicine, working to rapidly design, test and implement high impact health care delivery practices. His team crafts interventions to achieve dramatically improved patient outcomes, experience, and high value care. In the past 4 years, they have driven measurable progress in readmission rates, frequent use of the ER, medication adherence, screening rates, antibiotic stewardship, and making a population normotensive, among other advances.

Previously, Roy served as the first VP of Innovation for Intuit, a leading software company best known for Quicken and TurboTax. In this role, he led changes in how Intuit managed new business creation, allowing teams to experiment quickly at low cost.  Intuit now consistently appears on Forbes' list of the most innovative companies in the world.

Prior to leading innovation, Roy’s Quicken team achieved record profitability and product leadership while growing to 14 million consumers. Roy's 18 years with Intuit spanned the early years in software to their emergence as a leading SaaS provider.

Outside of his Penn role, Roy advises startups and Fortune 100 companies building new technology businesses focused on making a meaningful difference in people’s lives.

Roy received his MBA from Stanford and graduated with honors from Harvard College.

00:00 Article by Paul Graham “Do Things That Don’t Scale.” 01:30 Video from Alberto Savoia at Stanford about pretotyping. 02:15 Chris Trimble How Stella Saved the Farm. 03:15 Stories off of University of Penn’s Web site, www.pennmedicine.org

Roy is Chief Innovation Officer at Penn Medicine, working to rapidly design, test and implement high impact health care delivery practices. His team crafts interventions to achieve dramatically improved patient outcomes, experience, and high value care. In the past 4 years, they have driven measurable progress in readmission rates, frequent use of the ER, medication adherence, screening rates, antibiotic stewardship, and making a population normotensive, among other advances. Previously, Roy served as the first VP of Innovation for Intuit, a leading software company best known for Quicken and TurboTax. In this role, he led changes in how Intuit managed new business creation, allowing teams to experiment quickly at low cost. Intuit now consistently appears on Forbes' list of the most innovative companies in the world. Prior to leading innovation, Roy's Quicken team achieved record profitability and product leadership while growing to 14 million consumers. Roy's 18 years with Intuit spanned the early years in software to their emergence as a leading SaaS provider. Outside of his Penn role, Roy advises startups and Fortune 100 companies building new technology businesses focused on making a meaningful difference in people's lives. Roy received his MBA from Stanford and graduated with honors from Harvard College. 00:00 Article by Paul Graham "Do Things That Don't Scale." 01:30 Video from Alberto Savoia at Stanford about pretotyping. 02:15 Chris Trimble How Stella Saved the Farm. 03:15 Stories off of University of Penn's Web site, www.pennmedicine.org

If you ask average Americans, "Do you receive good health care?" most will likely say yes. But if you then ask, "How do you know?" you'll be met with silence. This is the topic of Dr. Robert Pearl's new book, Mistreated: Why We Think We're Getting Good Health Care—And Why We're Usually Wrong.

Co-hosts Stacey Richter and Alex Akers talk with Dr. Robert Pearl about the consequences of mistaken health care quality, and he walks us through his 4 pillars of getting American health care on the right path.

Dr. Robert Pearl is the former CEO of the Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of the Mid-Atlantic Permanente Medical Group (2009-2017). In these roles, he led 9,000 physicians, 35,000 staff, and was responsible for the nationally recognized medical care of 4 million Kaiser Permanente members on the west and east coasts. Recently named one of Modern Healthcare's 50 most influential physician leaders, Robert is an advocate for the power of integrated, prepaid, technologically advanced, and physician-led health care delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. In 2017, he authored Mistreated: Why We think We're Getting Good Health Care—And Why We're Usually Wrong, a Washington Post bestseller that offers a road map for transforming American health care. All proceeds from the book benefit Doctors Without Borders. As a regular contributor to Forbes, Robert covers the business of health care and the culture of medicine. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News. He has published more than 100 articles in various medical journals and contributed to numerous books. He is a frequent keynote speaker at health care and medical technology conferences, Robert has addressed the Commonwealth Club, the World Health Care Congress, and the Institute for Health Care Improvement's National Quality Forum. Board certified in plastic and reconstructive surgery, Robert received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, he served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation's largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, DC. Stacey Richter is Co-President of Aventria Health Group, a marketing agency specializing in helping pharmaceutical, device, and pharmacy clients gain access to patients by creating and leveraging partnerships with other health care organizations. For 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and, most of all, the patient. Alex Akers is Vice President for Business Development with Health Catalyst, a Utah-based, next-generation data, analytics, and decision-support company. He has been with Health Catalyst since 2015. Alex began his career in health care consulting, working for KPMG and Accenture in their health care strategy practices, and then shifting to revenue cycle reengineering with Stockamp & Associates. His passion for technology in health care really took off after he joined Microsoft and was responsible for health care strategy in their payer segment. After a stint with Grand Rounds in San Francisco, Alex landed at Health Catalyst. 00:00 Dr. Robert Pearl, author of Mistreated: Why We think We're Getting Good Health Care—And Why We're Usually Wrong. 01:30 How bad is the problem in American health care? 04:35 How our health system lags in overall health, according to third-party, objective data analysis. 05:20 Rampant overtreatment, and how this adds to the problem. 08:30 How can context improve health care? 09:00 The 4 pillars of improving health care outcomes. 12:40 Integration as a crucial step to maximizing quality. 13:00 Pay-for-value as the second pillar of improving health outcomes. 17:20 Technology as the third pillar. 17:45 How current health care tech being utilized is 50+ years old. 19:30 Why video isn't utilized more in health care, despite being relatively inexpensive. 21:20 Do doctors hate technology? 22:30 "All of medicine is probability." 24:50 "We fail to do the things that we know we should do." 27:00 Physician and clinician-led as the fourth pillar. 28:45 "We don't have a system; we don't have a structure." 29:35 "To do that is going to require leadership." 30:00 Dr. Pearl's advice for actionable change. 31:00 "This is the time to change; don't wait for disruption to occur."

I speak with David Guy, Senior Vice President Oncology and Specialty Markets, and Paul Pochtar, RPh, Senior Vice President and Pharmaceutical Commercialization and Access Strategies. Both have extensive experience in leadership positions within the specialty therapeutics space focusing on oncology/hematology. We talk about the major trends in oncology today, especially trends that impact how patients get access to some of the new innovative therapies and how much patients pay for said therapies.

Prior to Aventria, David held several commercial leadership roles, including Head of Oncology Marketing at Genentech and VP Strategic Marketing at Schering AG, specializing in commercializing oncology and specialty products. He was also instrumental in the commercialization of Taxotere, Fludara, Herceptin, and Rituxan. Paul has extensive experience leading successful market access commercialization strategies of specialty pharmaceuticals throughout their life cycles, including several landmark oncology products and other specialty therapeutics. Paul is a former Vice President of Payer Marketing with Bayer and former Vice President and Head of Oncology Managed Markets and Market Access at Novartis Pharmaceuticals. He is an RPh and a graduate of Rutgers University's Ernest Mario College of Pharmacy.

Real World Data is not a synonym for Real World Evidence. Dr. Julie Locklear from Genesis Research explains why and what both mean. Today, we focus on the impact to pharmaceutical manufacturers primarily… but what Pharma does affects us all and many of these concepts are universal. Julie was on the podcast once before, Episode 144. We talked about value-based agreements and innovative contracting so this episode might be the prequel to that one.