Friday, November 1, 2019 | John S. Rumsfeld & Rashmee U. Shah
Authored by: John S. Rumsfeld, MD, PhD, FACC, American College of Cardiology’s Chief Innovation Officer & Rashmee U. Shah, MD MS, University of Utah Health, Division of Cardiovascular Medicine
Cardiovascular medicine is inherently “high-tech”. The profession has a long history of adopting new technologies (i.e., transcatheter valvular therapeutics) to improve patient outcomes. However, healthcare delivery to improve efficiency and optimize prevention and health outcomes has not advanced in the same way. As a result, the U.S. still holds the title of most expensive, least effective healthcare system among developed countries. With CV disease a leading driver of healthcare costs in the U.S., we need solutions to improve care delivery.
Enter digital transformation. Successful digital transformation is not simply using a new digital technology – such as an app or biosensor. It is definitely not just having an electronic health record (EHR). In fact, some would argue that EHRs are an example of failed digital transformation, increasing inefficiency and dis-satisfaction. Successful digital transformation is the adoption of technologies that make you better at what you do, whether that’s improving efficiency or optimizing health and health outcomes.
Outside of healthcare, major sectors of the economy have undergone some form of digital transformation, such as finance, retail, entertainment and transportation. Companies like Cisco have cited that successful digital transformation can yield major benefits in client satisfaction, engagement, system efficiency, and employee efficiency and satisfaction.
The time is ripe for the digital transformation of healthcare delivery. Kamal Jethwani, senior director of Connected Health Innovation at Partners Healthcare, has suggested that healthcare digital transformation should be centered on virtual care, remote monitoring (i.e., wearable or non-wearable biosensors), and “Artificial Intelligence-driven care” – using advanced analytics like machine learning to improve image interpretation, risk prediction, and support diagnostic and treatment decisions.
The technology for this innovation largely already exists. Hundreds of digital health start-up companies, in addition to the large tech companies, with billions of dollars invested to date, are in the healthcare delivery market. Yet, a number of barriers have held back the transformation. A few examples: too many “technologies in search of a problem to solve”; lack of payment model alignment; too much focus on data (i.e., continuous physiologic monitoring) and not enough focus on clinically actionable information; and significant barriers to getting information from digital tools into clinical workflow.
So how do we “get there” with digital transformation for cardiovascular care? In 2017, we published a “roadmap” in the Journal of the American College of Cardiology – a health policy statement on innovation in the era of digital health, along with an editorial outlining the American College or Cardiology’s (ACC) new, ambitious innovation strategy. The core of this strategy centered on three pillars: lead, facilitate and partner. Two years later, the ACC has a rapidly growing member Section on healthcare innovation, has become a thought leader in the digital health space, and has developed multiple successful partnerships. These partnerships are both direct with technology companies – including co-development of digital solutions – and with other innovation programs and innovative organizations in the U.S. and globally.
Partnerships between tech, clinicians and patients are key. Alone, we cannot accomplish the successful digital transformation of healthcare. And this is not just about “disruption”, as healthcare is fundamentally different than other sectors of the economy. Rob Coppedge, CEO of Echo Health Ventures, said it best in a 2017 CNBC commentary: “Disruption is sexy, but given the complexities of the market, cooperation is more likely to move the needle for transforming healthcare.”
As clinicians, we can provide key clinical and scientific insights into the most pressing problems and inform technological solutions that can move us forward. We can also facilitate use and testing of new technologies, whether through our own practices and institutions or through community and networking activities offered by the ACC and MedAxiom. The ACC innovation strategy is still young, but we are already showing that we can have a leadership role in the digital transformation of healthcare.
Rumsfeld presented “The Challenge of Digital Transformation in CV Care” at the CV Transforum Fall ’19. Watch the full presentation here.
Illustration: Lee Sauer