Thought Leaders in Healthcare IT: CareJourney CEO and President Obama’s CTO Aneesh Chopra (Part 2)

Sramana Mitra: The innovation engine of the country also applies to the middle layer, right?

Aneesh Chopra: Now it will be. Earlier in the Obama administration, we launched an initiative called Startup America. You could imagine that you’re building Startup Global is to drive more entrepreneurs into the economy.

As we know, startups have been the engine of net new job creation. When we explore what makes the entrepreneur story work in America, a researcher at Stanford provided the much needed clarity that when the rules of the road of a particular industry change, it’s the entrepreneur who can get there faster because there’s an economic return on a new way.

This middle bucket of slowing disease progression or earlier detection is in the category where today’s fee-for-service economic model may not reward incremental investment at doing a better job. As we pivot to value-based care, it will create enormous opportunities because, if you make those investments and slow down disease progression, that entrepreneur will capture a large share of those expected savings.

This is a story of an investment bet by entrepreneurs to dig into the innovation engine applied to a new ROI model that is not currently in place in the US system today.

Sramana Mitra: I observe from many such discussions that the two big killers – cardiac disease and cancer – do not have enough preventative care. There is some. If you layer in DNA testing and the whole area of precision medicine from an early detection and disease management point of view, there are enormous gains to be had, but no doctor today is prescribing any of this.

Aneesh Chopra: Let me separate heart disease from cancer. I slightly disagree. Heart disease remains the single biggest killer in America. It is, in fact, heavily tied to lifestyle as well as lower intensity interventions to slow disease progression. We launched an initiative called the Million Hearts Program. The premise of it was, there are some very simple things we can do to remove one million heart attacks, which translates into hundreds of thousands of potential lives saved or less intensive treatment options for those individuals.

Sramana Mitra: For example?

Aneesh Chopra: Taking your aspirin, monitoring your blood pressure more regularly, addressing your cholesterol levels, and stopping smoking. These strategies are relatively low cost. Some of them are medications. Some of them are lifestyle.

Sramana Mitra: The Apple Watch has become a big part of that.

Aneesh Chopra: There is a role for technology, but technology isn’t always the answer to some of these more fundamental questions. If we ate healthier and monitored our blood pressure more regularly, we can maintain life with a modest degree of heart concerns without it resulting in heart attacks. In the digital environment, we don’t really have low-cost methods for glucose monitoring. That’s on a higher expense side for diabetic monitoring.

We have relatively low cost blood pressure cuffs that are internet-enabled so that our more regular readings can be interpreted by physicians. Today, if you email or fax these results to your doctor, it would overwhelm the practice. This is an opportunity for big data, analytics, digital connectivity so we can keep people monitored to avoid sudden deterioration in disease progression.

Cancer is a different matter. We haven’t quite cracked the code on prevention. We certainly understand that earlier detection is better than later detection. In the pandemic, we saw higher rates of decline in cancer screenings among the African-American population. We got societal issues to confront. Hopefully, our economic engine for care delivery will reward investments in innovation to close some of those gaps.

Sramana Mitra: On both of those, what is your take on two facets of innovation that are making a lot of progress? One is DNA testing and early screening. You are from a South Asian origin gene.

Aneesh Chopra: We have heart issues.

Sramana Mitra: Exactly. That’s something that clearly has opportunities for early detection and disease management. Secondly, immunotherapy on the cancer side. Both are making good progress.

This segment is part 2 in the series : Thought Leaders in Healthcare IT: CareJourney CEO and President Obama's CTO Aneesh Chopra
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