Disrupting The Status Quo In Healthcare

There’s no shortage of ideas on how to transform the nation’s healthcare system. Nor is the industry devoid of a desire to make significant change. The burning question facing leaders is how. With the multitude of challenges facing the industry, combined with the incredible pace of technological and scientific advances, it’s difficult for leaders to know which road they should take to create a delivery system that improves access, offers more personalized care, and lowers costs.

The answer? There isn’t a single path to progress.

“The power is picking a path,” Sam Glick, the Global Leader of Oliver Wyman’s Health and Life Sciences practice, said kicking off day two of the Health Innovation Summit. “The power is having conviction and saying, ‘I’m taking the organization in this direction.’”

Glick’s remarks set the tone for a series of center-stage presentations that challenged the nearly 350 attendees at this year’s Summit to pick a direction and, as the Summit theme says, do what matters.

Designing a healthcare system for the next decade

Planning for the next year is difficult enough in a volatile healthcare environment, let alone looking more than 10 years into the future. But that is exactly what Oliver Wyman did in its Designing for 2035 project. The idea is to dig deep into the forces influencing the industry and develop an ambitious agenda for redesigning how care is delivered, consumed, and paid for.

Oliver Wyman Partner Rachel Zeldin examined the barriers, ranging from unsustainable spending and increased demand from an aging population to workforce shortages. Those challenges will only get harder in the coming years, she said.

“It is not all bad news. The 1s and 0s will make us smarter,” she said, referring to rapid advances in science and technology, adding that organizations will be able to augment their workforces and “we will be able to cure what was once uncurable at scale.”

Zeldin described how healthcare will change in 2035 across five major markets — more accessible care in rural areas, better care for underserved urban populations, new delivery models for seniors, consumer-centric care that wraps in behavioral health, and health plan options that accommodate whole families. This executive summary of the Designing for 2035 project further details those changes.

Acknowledging that naysayers will argue wholesale change is not realistic, Zeldin countered that industry leaders must “have the courage to act.”

Extending genomic sequencing far and wide

A key driver for changing healthcare by 2035 is attaining broader utilization of genomic sequencing and embracing more personalized care.

“Today, we have the ability to know everything that makes you you,” Susan Tousi, chief commercial officer, Illumina, said. And the industry must use that knowledge to treat patients as “individuals, not averages,” Tousi added, suggesting greater personalization is needed to drive more effective care delivery.

Although genomic testing can now be done for $200, Tousi said three key shifts are necessary to ensure the technology reaches more people. Greater diversity is needed in data sets, a pivot must be made from sick care to healthcare, and treatments have to be developed at a faster pace to ensure they are getting to the right patient at the right time.

Where Tousi sees genomic sequencing reaching more parts of the world, Joe DeRisi aims to dig deeper into our understanding of infectious diseases. We should use data, not preconceived notions of what we think is true to treat infectious disease, DeRisi, President, Chan Zuckerberg Biohub San Francisco and Professor of Biochemistry and Biophysics, University of California, San Francisco said. DeRisi and his team pioneered metagenomic sequencing that furthers understanding of and treatment for infectious diseases. During his speech, DeRisi announced the launch of Delve Bio, which aims to scale the technology across the industry.

Know the problem you want to solve

One technology that has captured the attention of every sector of the economy over the past few months — generative AI. The tremendous attention overshadows progress that was made over the past 10 years to get to this point. For instance, an algorithm launched at Johns Hopkins Medicine in 2015 to improve the early detection of sepsis patients, said Suchi Saria, Founder and CEO, Bayesian Health and Professor and Director of the Machine Learning, AI, and Healthcare Lab at Johns Hopkins University.

Now, however, changes in technology are coming much faster. What took six or seven years is now happening in the span of months, Saria suggested. Organizations need to be thoughtful about how they approach AI and not just run to the shiny new object. Leaders should first figure out what problem they are trying to solve and then determine what technology solution they need and how it should be deployed.

“We need to think of an AI strategy, not just a generative AI strategy,” she said during a conversation with Glick.

Partnerships and patients

Ultimately, healthcare is about people and people need to be at the center of how care is redesigned, Scott Frisch, Executive Vice President and Chief Operating Officer, AARP, said during a panel discussion on senior care. He made the stark comparison of the relative simplicity people face when getting their car fixed after an accident versus dealing with the healthcare system. With a single call, a driver can usually get their car towed to a body shop, have the repairs done, and know how much they’ll owe. That is rarely the healthcare case where patients are forced to navigate a complex maze of finding the right provider, getting authorizations, and lacking full cost transparency.

Ali Khan, MD, Chief Medical Officer of Value-based Care Strategy, Oak Street Health, echoed those concerns especially when it comes to low-income, underserved, and uninsured populations. In the communities he serves, patients often have to balance paying for medication with keeping the heat on.

“We need to start thinking about those seniors,” he said, or we won’t truly overhaul the system.

An important aspect of expanding reach to different populations is forging true partnerships with community groups, said Camille Harrison, Executive Vice President, Medicare, and Chief Innovation and Experience Officer, GuideWell. That means going community by community to understand people’s needs. Then working with community organizations to augment services provided by traditional healthcare players.

“Let’s interrupt our norm by partnering smartly,” she said.