How One Woman Is Working To Transform The Healthcare System From Within
The successful decoding of the human genome in 2003 was a historic achievement. Not only because it unlocked the biological code to life, but also because it marked a new fusion of life sciences and information technology, using powerful computers and analytical techniques to multiply scientists’ efforts many times over.
Today, a decade later, that fusion has become buzzworthy. We hear about IBM’s Watson system going to med school as well as a whole slew of wearable tech devices. There’s even an X-Prize to create a real life tricorder, similar to what Dr. “Bones” McCoy used in Star Trek.
Yet all of the technology won’t amount to much if the millions of people who work in healthcare can’t use it effectively. That’s the problem Dr. Lynda Chin is working to solve. By weaving together a diverse network of researchers, technologists, practicing physicians and other stakeholders, she’s creating a movement that she hopes will transform healthcare.
Shifting From Eminence-Based Care To Evidence-Based Care
For most of its history, the practice of medicine has focused on acute health events. A child gets the sniffles, a man collapses from a heart attack or someone breaks an arm and a doctor is supposed to cure them. Yet today, seven out of the top ten causes of death are chronic conditions, such as cancer, Alzheimer’s and diabetes, which are fundamentally different.
Unlike treating a communicable disease, reviving a patient or mending a bone, with a chronic disease, doctors can’t merely “see” a patient, prescribe a cure and move on to the next one. They must work with their patients on an ongoing basis—for years or longer— to monitor and manage the condition.
Dr. Chin calls this a shift from “eminence-based care to evidence-based care.” In the old model, doctors were seen as the primary sources of medical information and diagnoses. Yet today, they must partner with a network of caregivers and information sources, as well as an entirely new ecosystem of technology, data and analytics to ensure top quality care.
To improve medical outcomes significantly we need to transform the system as a whole, so that the latest in advanced treatments and techniques is tightly linked with patient care. That will take more than a bright idea or a flurry of reforms, it will take a movement that encompasses all of the stakeholders in the healthcare system.
The Labyrinthine Process Of Medical Discovery
The healthcare system is incredibly complex. In addition to the doctors and nurses that treat patients, there are legions of regulators, pharmaceutical companies, insurers, hospital administrators and others that are essential for delivering services.
The process of discovering new treatments is also multifaceted. There is a large cadre of scientists working in a wide variety of fields—ranging from cellular biology and chemistry to bioinformatics and genomics—pursuing separate lines of inquiry. Medical researchers mine their work to come up with potential new therapies.
Once a new discovery shows promise and a new treatment is developed, clinical trials—another specialty requiring specific skills and expertise—can commence. It is at this stage that the research phase begins to overlap with patient care, as patients with specific conditions are referred by their doctors to be candidates for experimental therapies.
It was at the nexus of experimental and existing therapies that Dr. Chin began, codeveloping, with IBM, an Oncology Expert Adviser at MD Anderson designed to integrate the latest scientific insights along with patients’ data. Yet to make the system work, integrating knowledge is not enough. You also need to integrate the people who need to use it.
And that’s what Dr. Chin set her sights on next.
Forging Shared Values
Traditionally, health care reform efforts have focused on greater access to care and lower costs. While these may seem to be in conflict, in the context of the system, they can often be mutually reinforcing. Lowering costs can improve access to care, which in turn improves health impacts. At the same time, more effective care can itself also lower cost.
Yet Dr. Chin realized that there was an additional axis that is often ignored: access to expertise, which is what drives effectiveness of care. When does a primary care physician need to consult an expert? When will a trusted source, such as WebMD, suffice to support a patient to self monitor versus seeking licensed professional care?
The disconnect only becomes more acute when you include a world class research center like MD Anderson, which focuses on cutting edge science to develop advanced treatments for cases that have no reliable cure. Getting new insights and discoveries from researchers to translate into better overall health outcomes is yet another bottleneck in the system.
To resolve problems like these, Dr. Chin saw that in addition to health impact, cost and care, the medical community needed to adopt measurement, data and analytics as core values. That’s what drove her Oncology Expert Advisor project with IBM. However, in order to make a wider impact, she knew that she needed to drive change throughout the system.
That takes more than just fancy technology, it takes a network of professionals collaborating effectively together.
Weaving The Network Together
Introducing a new technology like IBM’s Watson—the core technology of the Oncology Expert Advisor that Dr. Chin developed—into a world class research facility like MD Anderson is not an easy sell.
Medical researchers, especially prominent ones, tend to be passionate people, with a laser-like focus on their work. Getting them to collaborate with other groups of people can be a challenge. Convincing them to work with an artificial intelligence like Watson? Much more difficult.
So rather than try to introduce a large scale program across the organization, Dr. Chin started working with a single group researching leukemia that was enthusiastic about the project. As their work progressed, it gained traction and another group working on lung cancer joined in. Now, Dr. Chin is expanding the network further to include diabetes treatment.
Dr. Chin also used the complexity of the healthcare system to her advantage. While medical research is divided into separate silos of researchers, clinicians and practicing physicians, she noted that there is also an intricate web of links connecting them all. By strengthening those linkages through data sharing, she began to create a movement to transform medicine.
At first, her efforts were concentrated at MD Anderson’s main campus in Houston. As the work progressed, the scope was expanded to regional care centers and eventually will go to affiliated hospitals within the MD Anderson network. At each stage, the success of the program with both doctors and patients helps it gain momentum.
Scaling Up The Movement
Dr. Chin sees a need to shift from provider centric care to patient centered care and she believes technology and data can help. She told me, “Rather than wait for Darwinian evolution to happen, why not create an integrated infrastructure, from hardware and software to data and analytics, that can disrupt the thinking and center care around each individual patient.
Now Dr. Chin has moved from MD Anderson to lead a new Institute for Health Transformation at the University of Texas system, which includes MD Anderson, where she is leveraging the technology and approach she developed for cancer treatment across a range of therapeutic areas.
Her new focus is at the other end of the spectrum from a top cancer center like MD Anderson—improving treatment of diabetes and obesity in Cameron county in South Texas, one of the poorest areas in the nation. Here, rather than working with complex diseases, her task will be improving access to care for the most underserved patients.
That will require will require a true transformation of the system, creating an ecosystem of the patient, the family and the community, while infusing technology, data and analytics in a real world setting, under less than ideal conditions. Even with the resources of the University of Texas healthcare system and world class technology partners, it will be a challenge.
Let’s hope she succeeds.