At issue is a 2022 bulletin that prohibits HIPAA-covered entities from using technology that captures the IP address of people visiting public-facing websites.
Healthcare organizations are pushing back against a federal rule restricting hospitals from using tracking technology to collect data from consumers visiting their web portals.
The American Hospital Association (AHA), Texas Hospital Association, Texas Health Resources, and United Regional Health Care System have filed suit against the federal government, charging that the Health and Human Services Department has exceeded its statutory authority in preventing providers from collecting the IP addresses of people visiting public-facing websites.
The lawsuit calls for the elimination of “an unlawful, harmful, and counterproductive rule that has upended hospitals’ and health systems’ ability to share healthcare information with the communities they serve, analyze their own websites to enhance accessibility, and improve public health.”
“The Department of Health and Human Services’ new rule restricting the use of critical third-party technologies has real-world impacts on the public, who are now unable to access vital health information,” AHA President and CEO Rick Pollack said in a press release “In fact, these technologies are so essential that federal agencies themselves still use many of the same tools on their own webpages, including Medicare.gov, Tricare.mil, Health.mil, and various Veterans Health Administration sites. We cannot understand why HHS created this ‘rule for thee but not for me.”
The suit targets a bulletin issued in December 2022 by the HHS Office for Civil Rights (OCR) highlighting the use of online tracking technologies by Health Insurance Portability and Accountability Act (HIPAA) covered entities and business associates. The bulletin states that regulated entities such as hospitals “are not permitted to use tracking technologies in a manner that would result in impermissible disclosures of PHI to tracking technology vendors or any other violations of HIPAA Rules.”
According to the AHA and others supporting the lawsuit, that interpretation of HIPAA rules would prevent hospitals “from using commonplace web technologies to analyze use of their websites and communicate effectively with the populations they serve.”
“Simply put, OCR’s new rule harms the very people it purports to protect,” Pollack said. “The federal government’s repeated threats to enforce this unlawful rule tie hospitals’ hands as trusted messengers of reliable healthcare information.”
The suit alleges that common technologies used by healthcare organizations such as analytics software, video technologies, translation and accessibility services, and digital maps would be rendered ineffective without access to IP-address information.
“That statute allows hospitals to rely on third-party tools that capture IP address information because that information cannot reasonably be used to identify an individual whose healthcare relates to the webpage visit,” the AHA says. “By restricting use of these common tools on public-facing webpages on this basis, OCR violated HIPAA and has acted without legal authority. In addition, the suit alleges that OCR unlawfully issued this Bulletin without providing any reasoning supporting its novel legal assertions, without acknowledging the government’s own use of implicated third-party technologies, and without following required notice-and-comment rulemaking processes.”
Healthcare organizations and tech companies say the President's Executive Order is a good first step toward establishing AI policy, but will actions support the words?
The order "directs the most sweeping actions ever taken to protect Americans from the potential risks of AI systems," a fact sheet accompanying the order states. But there's little detail about how it would affect healthcare organizations or technology companies working with them.
Across all industries, Biden's order seeks to balance regulations with encouragement, establishing guidelines for controlling risk while giving the green-light to grants and other funding models to support research.
Specifically for healthcare, the President is giving the U.S. Health and Human Services (HHS) Department six months to draft a strategy to determine whether AI meets the standards for delivering healthcare, and he asks HHS to create a task force within the year to create a plan for responsible AI use.
In addition, the order calls on companies developing generative AI tools to notify the government when they are testing those tools and to share the results of those tests.
Through HHS, Biden's order envisions grants that would cover, among other things:
Developing AI-enabled tools that create personalized immune-response treatments.
Improving the quality of data used in AI tools.
Addressing administrative tasks that improve efficiency and contribute to stress and burnout.
Improving care for veterans and developing nationwide "AI Tech Sprint" competitions to support start-ups and small healthcare tech companies.
Reaction to the announcement was, for the most part, positive, with health system executives and industry analysts praising the administration for taking action. But at the same time, many noted that the nation is lagging behind Europe in developing AI policy, and many healthcare organizations are already testing and even using AI tools.
"While many general principles of AI ethics apply across industries, the healthcare sector has its own set of unique ethical considerations," he noted. "This is due to the high stakes involved in patient care, the sensitive nature of health data, and the critical impact on individuals and public health."
"It is critical that AI in healthcare benefit all sectors of the population, as AI could worsen existing inequalities if not carefully designed and implemented," he added. "It's also critical that we ensure AI systems in healthcare are both accurate and reliable. Ethical concerns arise when AI is used for diagnosis or treatment without robust validation, as errors can lead to incorrect medical decisions."
To that end, many of the tech giants developing AI tools—sometimes in partnerships with health systems—pledged at a July meeting at the White House to adhere to a set of voluntary guidelines, including allowing independent experts to assess tools before public debut, researching societal risks related to AI, and allowing third parties to test for system vulnerabilities.
Among health systems, Duke Health announced the launch of an AI and Innovation Lab and Center of Excellence in a five-year partnership with Microsoft "aimed at responsibly and ethically harnessing the potential of generative artificial intelligence (AI) and cloud technology to redefine the healthcare landscape."
Among those weighing in on the President's order was Bill Gassen, president and CEO of Sanford Health, who attended Biden's press conference at the White House.
“We believe that emerging AI technologies have the potential to positively transform the future of care delivery [and] advance rural health equity and are key to the industry's long-term sustainability," he said. "While we need to be appropriately cautious in our adoption of these technologies, we are supportive of the development of frameworks and guidelines that would enable healthcare providers to responsibly and safely use AI-enabled technology so that we can address some of the most pressing challenges in healthcare today related to our workforce, access to care and quality improvement for all."
"It will be critical that the guidance strikes the right balance between setting appropriate guardrails but is not unnecessarily stifling so we do not impede innovation and progress where it’s needed most," he added. "We look forward to collaborating with industry leaders, elected officials and the Administration on these efforts to ensure we can harness these technologies in the best interest of our patients and caregivers.”
One organization taking advantage of the hype surrounding Biden's Executive Order was the American Telemedicine Association, which published its guidelines for responsible use of AI in telemedicine programs.
"With today's Executive Order issued by President Biden to ensure the safe, secure, and trustworthy use of artificial intelligence, our timely release of the ATA's AI Principles can help chart the way forward as the administration works to create new standards for AI's potentially game-changing capabilities," Kyle Zebley, the ATA's senior vice president of public policy, said in a release. "AI is already being used in telehealth and its future potential is endless, especially to harness the reams of data that our healthcare system produces, including data collected from virtual care technologies, to improve healthcare delivery."
Several AI companies also chimed in, praising the administration for starting the conversation.
"Overall, the executive order is a great start and begins to lay a policy foundation to harness the benefits of AI, while addressing key challenges," Rajeev Ronanki, CEO of Lyric, said in a message to HealthLeaders. "By integrating it with ethical frameworks, liability, training/upskilling, AI literacy, oversight & auditing, data interoperability, and transparency, policy-makers can create a more comprehensive framework for AI."
But the question is whether HHS or another government entity has a plan—or the muscle—to go after a vendor or health system that runs afoul of the guidelines, and whether they can step in before serious damage is done. How will healthcare executives feel about HHS oversight? And will there be enough guidance from the government to help health systems map out and execute reliable and effective AI strategies?
HealthLeaders Senior Editor Eric Wicklund discusses the benefits and challenges of implementing innovation strategy during a tough economy with John Couris, president and CEO of the Florida Health Sciences Center, which includes Tampa General Hospital.
The proposed penalties, if made final, could be levied on healthcare organizations that knowingly and unreasonably interfere with the access, exchange, or use of electronic health information.
Federal officials are proposing penalties for healthcare organizations accused of information blocking.
The Health and Human Services Department has released a proposed rule that would establish three specific “disincentives” for healthcare providers found by the HHS Office of the Inspector General (OIG) to have knowingly and unreasonably interfered with the access, exchange, or use of electronic health information except as required by law or covered by regulatory exception. Public comments on the proposal will be accepted through January 2, 2024.
The proposed rule complements information blocking penalties established by the OIG in June for other parties, such as health information technology vendors, health information exchanges, and health information networks. Companies found by the OIG to have violated the rule can be fined as much as $1 million per violation.
With that penalty in place, HHS is now targeting health systems.
“HHS is committed to developing and implementing policies that discourage information blocking to help people and the health providers they allow to have access to their electronic health information,” HHS Secretary Xavier Becerra said in a news release. “We are confident the disincentives included in the proposed rule, if finalized, will further increase the appropriate sharing of electronic health information and establish a framework for potential additional disincentives in the future.”
The disincentives, coordinated through the Centers for Medicare & Medicaid Services (CMS) are as follows:
Under the Medicare Promoting Interoperability Program, an eligible hospital or critical access hospital (CAH) would not be a meaningful electronic health record (EHR) user in an applicable EHR reporting period. The impact on eligible hospitals would be the loss of 75 percent of the annual market basket increase; for CAHs, payment would be reduced to 100 percent of reasonable costs instead of 101 percent.
Under the Promoting Interoperability performance category of the Merit-based Incentive Payment System (MIPS), an eligible clinician or group would not be a meaningful user of certified EHR technology in a performance period and would therefore receive a zero score in the Promoting Interoperability performance category of MIPS, if required to report on that category. The Promoting Interoperability performance category score typically can be a quarter of a clinician or group’s total MIPS score in a year.
Under the Medicare Shared Savings Program, a health care provider that is an Accountable Care Organization (ACO), ACO participant, or ACO provider or supplier would be deemed ineligible to participate in the program for a period of at least one year. This may result in a health care provider being removed from an ACO or prevented from joining an ACO.
The proposed rule is set ty be published in the National Register on November 1, after which the public comment period will be set for 60 days. The Office of the National Coordinator for Health Information Technology (ONC) and CMS will host an information session on the proposed rule within the next few weeks.
The health system is using a federal grant to analyze how a virtual care platform can be used to coordinate care after ICU discharge and reduce negative health outcomes.
Vanderbilt University researchers are using a $3.6 million federal grant to explore how health systems can use virtual care to improve care coordination and management after an ICU discharge.
The study, funded by the National Institute on Aging, focuses on post-intensive care syndrome (PICS), which can affect as much as 80% of discharged patients and leads to reduced clinical outcomes, poor quality of life, and rehospitalizations. Researchers led by Leanne Boehm, PhD, RN, ACNS-BC, FCCM, an assistant professor of nursing, will study how hospitals can coordinate care after ICU discharge with primary care physicians to reduce PICS and boost care management.
“Following ICU discharge, patients have problems lasting months to years that often go unaddressed,” Boehm said in a press release. “Primary care providers—and even ICU clinicians taking care of these patients—do not know much about PICS.”
“Only recently have we started to characterize what PICS assessment and management looks like across ICU recovery clinics,” she added. “We’re seeing so much variation in what clinics are doing. This made us wonder which screening intervention elements were the most important in ICU recovery clinics.”
The results of the study could help healthcare organizations develop new strategies for collaborating with PCPs and other resources, including caregivers, to improve the patient’s journey from the hospital to the home or other care site, such as a skilled nursing facility. This includes using virtual care and perhaps remote patient monitoring platforms to track patients more closely and identify and address care gaps before they become serious.
While large health systems often have ICU recovery clinics to help with the transition, smaller and rural health systems often don’t have that resource. The research could not only help ICU recovery centers refine their strategies for connected care, but give those smaller hospitals and networks the guidance they need to improve care and reduce rehospitalizations.
This study follows research recently done by Boehm and others on the value of a telehealth-based multidisciplinary ICU recovery clinic. That research identified the health concerns that accompany an ICU discharge and the value of care coordination and management in reducing negative clinical outcomes.
PICS consists of a variety of physical and mental health problems that remain after critical illness, and affects one-third of patients on ventilators, half of all patients admitted with sepsis, and as many as half of those patients who stay in an ICU for at least a week. One-third to half of those patients develop ICU-acquired dementia, which the NIH now classifies as Alzheimer’s Disease or Related Dementia.
Boehm will be partnering with Carla Sevin, MD, director of Vanderbilt’s ICU Recovery Center and co-chair of the Critical and Acute Illness Recovery Organization’s (CAIRO’s) post-ICU clinic collaborative, and James Jackson, PsyD, director of behavioral health at the ICU Recovery Center, on a telehealth-based model to assess how interdisciplinary teams may be used to transition patients from the hospital and monitor them as they recover from an ICU stay.
“Providers will talk with the patient about their assessment, care plan, what they can expect and the resources to help them in their journey,” Boehm said. The interdisciplinary team, consisting of a physician and/or nurse practitioner, psychologist or psychiatrist, social worker, and pharmacist, “have a multidisciplinary view of ICU-started problems and serve as a bridge in the transition of care from the ICU to their PCP or specialists.”
“Our primary aim is to see if this intervention can improve cognition, mental health, physical function, their social network, and patient activation,” she added.
In a push to improve margins, the utilization of contract labor is declining.
Reducing labor costs is a top concern for CFOs, so pulling back on agency use has been a major theme in 2023, especially since the money CFOs pumped into contract labor during the pandemic is now majorly stressing the bottom line.
As HealthLeaders has been reporting, a new survey is showing there’s a major reduction in contract labor and an increased interest in recruiting and retaining home-grown staff.
According to Kaufman Hall’s 2023 State of Healthcare Performance Improvement report, the utilization of contract labor appears to be majorly declining. Only 4% of organizations are experiencing increased utilization of contract labor, compared to 27% last year, the report says.
In fact, 61% of respondents to this year’s survey say contract labor utilization is decreasing, compared to 44% in last year’s survey.
How are CFOs achieving this?
The ability to reduce reliance on contract labor may be driven in part by the significant percentage of organizations that are using such tactics as internal or enterprise float pools (64%) or a greater number of per diem or pro re nata employees (45%) in lieu of more expensive contract labor.
Organizations are also strengthening their recruitment and retention strategies. Almost all surveyed (98%) are pursuing one or more recruitment and retention strategies, including raising starting salaries or the minimum wage (90%), the report says.
These aspects are exactly what Scott Wester, president and CEO of Memorial Healthcare System, a South Florida-based nonprofit system, prioritized for his organization.
“COVID changed the landscape of how we dealt with the workforce, predominantly the reliance on agency nurse travelers, outside contractors, and not having enough personnel to meet the demand that was out there, mostly on the clinical side,” Wester said.
“We spent almost $280 million a year utilizing outside contract or incentive pay and heavy reliance on nurse travelers. We recognized we needed to get people back to wearing our Memorial badge. Over the course of 12 months, we've dropped about 80% of use of outside contract labor. We're now about a $200 million savings just on that perspective,” Wester said.
So how did Memorial pull it off? The organization did it by bolstering its talent acquisition team, making sure to play more offense than defense, and by reaching out to the work community to try to figure out what was limiting people from joining the organization.
While the reduction in contract labor will help, Kaufman Hall experts expect that it will be a slow climb for hospitals to return to the 3-4% operating margins that help ensure long-term sustainability.
While staffing and capacity challenges have clear implications for revenue, an increased rate of claim denials—reported by 73% of respondents—has had the most significant impact on hospitals’ revenue during the past year, the report says.
Ongoing labor cost management, revenue cycle optimization, and strategic planning will be key for CFOs in 2024.
CFOs will need to continue to focus on labor cost management. The declining utilization of contract labor and the emphasis on recruitment and retention strategies suggest a future trend of hospitals intensifying their efforts to manage labor costs even more so in 2024.
Leaders may explore innovative workforce models, invest in employee development, and collaborate with educational institutions to address contract labor costs and talent gaps.
Revenue cycle optimization will still be the key to financial health in 2024. With increased claim denials having a significant impact on revenue, CFOs will likely continue to heavily invest in technologies and processes to improve revenue cycle management.
Not only will tech investments help revenue cycle performance, but it can play an important part in staff retention strategies as technology can reduce administrative burdens.
CFOs will obviously need to continue to focus on achieving and maintaining long-term financial sustainability as margins are not where we want them. This may involve cost containment, revenue diversification, and strategic financial planning to gradually recover and maintain healthy operating margins into 2024 and beyond.
Health systems are just beginning to develop digital models of everything from organs to people to whole neighborhoods to improve and personalize patient outcomes.
A technology first used by NASA to map out space travel is now giving healthcare providers a better look at how to treat patients.
Digital twin technology creates a digital model of a person, object, system, or process, which can be used to simulate the real thing for testing, monitoring, and other processes. Healthcare has only recently caught on to the potential for digital twins, which can be used to map out complex surgeries, test the efficacy of a treatment, and anticipate the progress (including possible side-effects and setbacks) or a care plan.
“We know the technology is capable of great things,” says Steve Levine, senior director of virtual human modeling for San Diego–based Dassault Systèmes, which drew large crowds with an exhibition at the CES 2023 show in Las Vegas last January. “Many medical centers are only recently becoming digitized, so the adoption curve is going to be long.”
Digital twin technology was first used by the American space program in the 1960s to model spacecraft development and simulate the moon landing. Since then, it has been used to design buildings and other structures such as dams, roadways, theme parks, automobiles, planes, planned communities, and a wide range of manufactured products.
The concept first entered the healthcare lexicon roughly 10 years ago with the launch of the Living Heart Project, a collaboration between Dassault Systèmes and the U.S. Food and Drug Administration (FDA) to gather cardiovascular researchers, medical device developers, cardiologists, educators and others to “develop and validate highly accurate personalized digital human heart models.”
Levine, who founded the project and serves as its chief strategy officer, says the goal is to create a 3D model that replaces animal testing, reduces the cost and complexity of clinical trials, helps guide medical device makers in designing cardiac technology, and can be used to plan out surgeries, treatments, and other procedures.
“Simulations are extremely expensive, limited, and not personal,” Levine says. “This will give us a much better model of the human heart.”
Levine says several organizations are using lessons learned from the Living Heart Project to develop digital twin models for other parts of the body, including the brain, liver, kidneys, lungs, and musculoskeletal system. In addition, Boston Children’s Hospital is partnering with Dassault Systèmes on applications of the technology for pediatric care, and Johns Hopkins is exploring the potential for digital twins in remote surgery and treatment.
“Ten years ago, no one had heard of digital twins,” he says. “Now [healthcare organizations] are interested in it and are looking at how they can use it. The pandemic raised a lot of awareness around the need for working virtually, so the focus on this technology has accelerated phenomenally over the past few years.”
Several health systems are testing the technology, including the University of Miami Miller School of Medicine, which is using funding from the National Institutes of Health (NIH) to create a digital twin, or MILBox, of a patient through data gathered from wearables and sensors.
“We want to demonstrate that this kind of individualized data capture can spur a new line of research and personalization in healthcare,” Azizi Seixas, PhD, founding director of the Media and Innovation Lab (TheMIL), and associate director for the Translational Sleep and Circadian Sciences Program at the Miller School of Medicine, said in a press release. “With the capacity to discover everything we can about the individual, we can change the relationship between people and their health.”
“Eventually, such digital twins could comprise sufficient detail about an individual so that a computer could test different treatment or wellness options against that model to predict which are most likely to produce the best outcomes for that person,” school officials said. “Instead of prescribing treatments based on a statistical model of outcomes across a large population, this new approach would provide each patient with a personalized recommendation calculated to produce the best outcome for them.”
This past January, the NIH awarded a $3.14 million grant to the Cleveland Clinic and MetroHealth to design entire “digital twin neighborhoods” based on the electronic health record data of 250,000 patients, to analyze how environmental, economic, and social factors create healthcare disparities.
“Where a person lives or works can shape their health outcomes, including life expectancy and risk of developing diseases like cancer or diabetes,” Jarrod Dalton, PhD, director of the Center for Populations Health Research at the Cleveland Clinic, said in a press release. “Americans from socioeconomically disadvantaged communities are more likely to have heart attacks and stroke, and are expected to live 10 fewer years than wealthier Americans. Our goal is to design an approach to help health systems, governments and organizations collaborate and strategize ways to address clear disparities.”
“This project aims to chart a new course for understanding place-based population health strategies and improving health outcomes,” added Adam Perzynski, PhD, of MetroHealth’s Population Health Research Institute (PHRI). “Evaluating technology like digital twins in the research space can make it easier for organizations to take a data-backed approach to public health interventions. Instead of building these models from scratch, other health systems and organizations can adapt the framework for their own needs.”
Levine, who is now working to develop a playbook on digital twin technology in healthcare, says the evolution of digital twin technology will move from designing models to using AI and predictive analytics to map out outcomes, both good and bad.
“We’ll move on from what does it look like to how does it perform to what it can and will do,” he says.
The biggest obstacle at present, he says, is unfamiliarity with the technology, alongside the reluctance among health system decision-makers to invest in something new.
“We need the pioneers to take on the work,” he says. “Once we start getting the qualitative assessments and the data … you’ll see a lot more interest [and engagement]. It’s going to happen.”
Driven at the age of 11 to educate himself on math, science, and computer engineering, he used college textbooks handed down from family members to learn calculus and college-level chemistry. He started his own training in computer engineering while in the 10th grade, learning to run certain software that required adding a different type of processor.
"By then I'd learned enough electrical engineering to make it feasible, and I ran that hybrid system for a couple years," he says. "I've never been happy with what computing has to offer. And so that's why I started designing computers to do things, so we can answer time-sensitive questions today, rather than waiting five or 10 years for the commodity market to give us what we need."
Nicholas Nystrom, chief technology officer of Peptilogics. Photo courtesy Peptilogics.
Nystrom received his PhD in computational chemistry from the University of Pittsburgh. Since then, he has created several innovative platforms, each enabling up to 30,000 users to conduct more than 2,500 projects, particularly in AI for the life sciences.
"I've been doing computational science for my whole career," he says. "I could see the ability of computational science to help us look at things we can't observe experimentally."
After 28 years leading scientific research teams at Pittsburgh Super Computing Center, Nystrom moved clinical-stage biotechnology company Peptilogics. He was excited by the opportunity to speed up lead compounds to patients.
"We're trying to get to those lead compounds as fast as possible," he says. "We are striving to make more of a difference."
He was also a part of the partnership between Carnegie Mellon University and the University of Pittsburgh, sponsored by the National Science Foundation (NSF), that created the supercomputer Bridges.
"Around 2014, I designed the first computer in the world that brought together high-performance computing, artificial intelligence and big data," he says.
This was at a time when high-performance computing had not yet been used by researchers in other fields, so Bridges was designed to enable these researchers to work easily with supercomputing.
Bridges beat the world’s best human poker players, improved predictions of severe weather to lengthen warning times, and offered gene researchers an easy-to-use tool to assemble the largest DNA and RNA sequences, according to Carnegie Mellon. In 2019, Bridges’ AI capabilities were enhanced with the latest GPU technology, fueling more sophisticated AI work on Bridges. In 2021, an advanced version, Bridges-2, was launched, integrating new technologies for converged, scalable HPC, machine learning, data, and more.
Nystrom was Peptilogics’ fifth employee, joining in 2021 as SVP and head of computation and data, with the goal to scale drug design using generative AI, HPC, and physics-based simulation. He was promoted to chief technology officer one year later.
He had met Peptilogics CEO and founder Jonathan Steckbeck in 2020 and discovered they had the same long-term vision: to use computational science to scale therapeutics design. Steckbeck's vision was to take what he had done through biochemistry and wet lab work to make that scalable through a machine learning approach.
"At Peptilogics, we recognize that AI is transforming the life sciences," Nystrom says. "Where we are focused today is in developing therapeutics. We are focused on being very general, being able to treat arbitrary targets and arbitrary therapeutic areas and that makes it scalable. That means we can go after much more in the long run than we were ever able to do historically. And that's what I was enthused to do."
Nystrom says the biotech is researching very diverse biological targets and diverse diseases that range from membrane proteins down through the target in the cell nucleus.
“We're looking at diseases covering rare disease or genetic disease, cancer and immunology, with others in the pipeline and we are focused on algorithms which led us to the capability to treat general targets and hence general therapeutic areas, rather than having a specific focus on the target class or disease,” he says. “In fact, we could not have done what we did just for one disease because there would not be the data algorithms that can work with finite biological data."
This progressive work environment requires a certain culture of open-minded thinkers, he says. As CTO, Nystrom has built these teams from the ground up.
"The team we have built is focused on people who are very inquisitive, who embrace continuous learning, because this field is moving so fast, and people who really want to make that transformative difference," he says. "It's a very interdisciplinary team.”
“As a leader, I bring a culture of thinking broadly, recognizing people have deep expertise in science and in machine learning, but that everyone is always learning something from others, because there's never anyone who's a master at all, including myself,” he adds. “The biggest challenge in this field is not the implementation, because we know how to do that. It's that continuous learning culture and finding the people that actually have this forward-looking mindset of doing things in a new, better way without saying this is the way I've always done it. And so that's what we hire for, people who embrace that constant curiosity."
This type of culture also requires tackling problems from a "monkey first" mentality, he says, referring to the theory of Astro Teller, the CEO of X, Google's innovation hub, who believes prioritizing the most difficult challenges of a project first is key to success. For example, if your objective is to have a monkey stand on a pedestal and recite Shakespeare, you start by teaching Shakespeare.
"If you build the pedestal first, you will feel like you're making progress because it's easy to build a pedestal," Nystrom says. "But in the end, the really hard thing is teaching a monkey to recite Shakespeare."
At Peptilogics, the principle is to start with the hard thing.
"We bring these different complementary pieces together between understanding science, understanding artificial intelligence, [and] understanding how to compute them, and make them run really well," he says. "And then get to work."
And there is plenty to work on. A 2018 paper, illuminating the druggable genome project, determined only 3% of known targets have been commercially drugged. It identified 62% of targets as having chemical or biological support, many of which Nystrom and his team expect to go after.
Development and application of machine learning architectures and models will create safer, more efficacious medicines and help us to understand key aspects of systems biology that drive disease.
"That's where AI-driven design can potentially make a truly meaningful difference," Nystrom says.
HealthLeaders strategy editor Jay Asser is joined by Gary Stuck, chief medical officer at Advocate Health, to discuss where value-based care is trending. Stuck shares Advocate Health's value-based care initiatives and offers insight on what still needs to be done to have widespread adoption, such as easing data capture barriers.
The HLTH conference reinforced the idea that collaboration may be a key element in the healthcare ecosystem of the future.
Healthcare’s disruptors are finding out that delivering healthcare isn’t as easy as selling retail goods or managing bank accounts or travel plans.
This theme became apartment at the recent HLTH conference in Las Vegas, where disruptors gather and conversations center around redefining healthcare. But amid the hype around AI, the potential of the growing ‘Food as Medicine’ movement, and the U2 show at the Sphere, much of the talk in the Las Vegas Convention Center was on the idea that disruption is not about competition but about collaboration.
A prime example during the event was General Catalyst’s announcement about its Health Assurance Transformation Corporation (HATCo) and to mold a “clicks and mortar” platform. HATCo’s co-leader Marc Harrison said the platform will combine technology with in-person care, mostly through partnerships with other health systems, to improve access and outcomes and reduce costs, especially waste.
The three projects are rooted in value-based care, but critics of the General Catalyst announcement at HLTH were quick to question how that value will be determined.
As the global law firm Sheppard Mullin noted in a recent JD Supra post: “For HATCo and Risant Health, data analytics and value-based care will go hand-in-hand, as their use of data analytics may help health systems unlock major care delivery and patient population insights that drive better care and better outcomes, ultimately lowering total costs of care, which is precisely the goal of value-based care.
“Bottom line: Sophisticated technology, including AI-driven data analytics, combined with deeper collaboration across health systems, may be the new capstone of health system transformation,” the firm wrote.
And while the concept isn't new, the focus on provider partnerships struck a chord with HLTH attendees. The idea that health systems can collaborate to improve care management and coordination takes aim at the long-standing issue of siloed care and competition. It also addresses the idea that companies like Amazon, Google, Microsoft, Walgreens, and Walmart aren’t necessarily competitors in the healthcare space but partners in redefining how care is delivered.
At HLTH, Walgreens announced the launch of a virtual primary care service, with Tracey Brown, the company’s EVP, president of retail and chief customer officer, saying the way forward requires “creating the partnerships that are required, the technology and the data, so that we can create personalized, effective care to improve the overall health and well-being for people in this country.” This came shortly before the company announced plans to slash $1 billion in costs and close 60 VillageMD clinics in the coming year.
To create those partnerships, healthcare executives are seeking expertise they don’t have. For example, HCA Healthcare earlier this year announced an alliance with Google Cloud and Augmedix to develop AI programs. Augmedix, the San Francisco company once known for developing smartglass applications, is now producing digital health tools that use natural language processing (NLP), large language models (LLM), and structured data sets to give clinicians on-demand support summarizing conversations and medical notes.
At the Augmedix booth on the HLTH floor, Augmedix CEO Manny Krakaris said the focus is now on finding the right partners to create a comprehensive platform that helps providers save time, reduce workflow stress, and improve clinical outcomes. It’s a lot like putting together a puzzle, with each vendor and each health system holding different pieces.
That’s what health systems are looking for now, and so a lot of the chatter at HLTH was among companies looking to complement other companies, creating platforms that address a number of needs rather than one pain point. A vendor with a unique app might see some initial success, but the company won't survive unless that app can integrate with other solutions across the enterprise.
Healthcare executives are also wary of taking on new projects, primarily because they don’t have the money to spend—but also because solutions to healthcare pain points are found in change management and workflow strategies. New technologies won't necessarily solve problems that are baked into standard operating procedure.
“It's not something you can just throw money at any more,” said Kimberly King Webb, senior vice president and chief human resources officer for CHRISTUS Health, during a session on new ways to address stress and burnout, still one of the biggest issues in healthcare.
This is perhaps HLTH’s biggest takeaway: Health systems can no longer just spend money on new technology to solve the industry’s most pressing problems. True disruption begins with an understanding that change is tough, and change management is vital. Instead of seeing competitors and looking to get ahead of everyone else, healthcare decision-makers should be recognizing opportunities to collaborate and forging partnerships that identify and affect value.
