Thought Leaders in Healthcare IT: CareJourney CEO and President Obama’s CTO Aneesh Chopra (Part 3)

Sramana Mitra: What is your analysis of their potential to weave them into society?

Aneesh Chopra: We are going to continue down the curve on the cost side. Early in the Obama administration, it cost roughly $2,000 to sequence a genome. We set a goal to get that profitably delivered for under $100 and we’re well on the way to democratizing gene sequencing.

The premise here is that if we bring the diagnostic cost curve down, it would increase the demand signal for organizations to interpret those sequenced genomes for flagging individuals who are not yet feeling sick enough to call the doctor’s office but to receive an outbound message to altering the lifestyle or to begin medication on account of certain risks that can be identified.

In addition to the genome, there’s a wave of innovation on blood screening. I’m helping a firm that’s a CareJourney member to think through what it would mean to use our blood to determine early cancer detection so we can avoid some of the more severe concerns and risks if we were to detect it earlier in life. For diseases of kidney, heart, and cancer, we are still in the early days for a more data-driven technical path for identifying disease early enough to intervene.

Sramana Mitra: As far as I know, the insurance companies don’t cover any of that.

Aneesh Chopra: Some do. If you’re 55 years old and employed and have health insurance, should the employer bear the brunt of that cost or should there be some kind of partnership with the government when, in 10 years, you’re going to be on Medicare and the government is going to pick up that cost. If and when you enter Medicare with cancer, you’ve got a head start. Would society be better off if we shared some of those costs?

I think there are some profound policy questions that need to be addressed that would change the access equation. In both parties, we’ve had a desire to accelerate FDA approval and shorten the time between FDA approval and medical reimbursement under CMS. There is another promising avenue where insurance organizations, including the US government, may be more tolerant of the reimbursement models for new technologies if there is a commitment to disclose the performance on the backend.

Instead of it feeling very binary, we could have more of an algorithmic model where the best-performing interventions get reimbursed the most to reflect the value created. We’re not there yet. Once we sort that out, we’ll see an innovation engine pointing a lot more towards wellness and prevention versus where we are today that’s focused on cures. If you showed up in the ER, our society requires you to get covered in the services that you need.

Aneesh Chopra

Sramana Mitra: The planet at 10 billion people is not going to be able to cure disease at that level and at that scale?

Aneesh Chopra: Wouldn’t that be an inspiration if there are entrepreneurs listening where we can find ways in which the South Asian genomic risks for heart could be altered with genetic engineering techniques. I don’t want to give up on the idea that curative options at scale are emerging. I’m also realistic that it maybe further down the road than some of the low-hanging fruit activities.

This segment is part 3 in the series : Thought Leaders in Healthcare IT: CareJourney CEO and President Obama's CTO Aneesh Chopra
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