The chief executives of two of America’s most influential health care organizations urged health tech startups to involve physicians in the development process from the ground up to ensure that their products can gain a foothold in the market and meet the paramount goals of improving care and freeing up more time for physicians to spend with patients.
The question-and-answer session between Mayo Clinic CEO John H. Noseworthy, MD, and AMA CEO and Executive Vice President James L. Madara, MD, was held recently at MATTER, a Chicago-based incubator for emerging health care companies. The event drew a standing-room-only crowd of people working in the health care startup world.
Dr. Noseworthy began by describing Mayo’s illustrious 153-year-old history in medicine. He said Mayo’s focus is on complex care, what he called “the top of the pyramid of care rather than the base of the pyramid of care.”
The physician-led, $12 billion health care organization files hundreds of patents annually and doubled its research commitment to $600 million a year during the last decade while National Institutes of Health spending was flat. Mayo’s major research focuses include genomic medicine, regenerative medicine and engineering science. That includes “how to engineer the health care experience so it is safer, faster and so on.”
Mayo partners with large companies as well as startups, and 136 companies have been spun out from Mayo. These investments have “affected millions of patients lives” and returned to Mayo $547 million, Dr. Noseworthy said.
“We are forever trying to reinvent and extent that top of the pyramid and looking at how to use innovative technologies to advance care for complex patients,” Dr. Noseworthy said.
He pointed to one recent example of a successful partnership with Exact Sciences Corp., which developed Cologuard, a less invasive form of screening for colorectal cancer. In 2014, the Food and Drug Administration approved Cologuard, a stool-based DNA test, for use as another option in colorectal cancer screening.
“Colon cancer is the second leading cancer,” Dr. Noseworthy noted. “And 40 percent of the population at risk won’t have a colonoscopy, they can’t afford it, don’t like the idea or they live in a part of a country where it’s difficult to get. Working together and spinning out this company, our molecular physicians and scientists worked with them on this molecular test.”
But, he noted, that sort of success must arise from true partnership between physicians and health care innovators, whether they are working in the medical device space or in health information technology. It is no longer sufficient, as a Mayo Clinic colleague noted, “when someone comes and throws something over the fence without our having any involvement in it.”
Along those lines, Dr. Madara noted the AMA’s partnership with MATTER since the incubator’s founding. The AMA Interaction Studio at MATTER offers physicians a flexible space to collaborate on technologies. Through this partnership, physicians can connect directly with entrepreneurs who are seeking physician input on their ideas.
Another effort, still in development, is the AMA’s Physician Innovation Network, designed to give physicians and health tech companies a way to connect online to develop and improve health care solutions. The AMA also launched a Silicon Valley innovation studio, Health 2047, that applies rapid prototyping and design to achieve health IT tools based on practice and patient needs.
Dr. Madara said there is an urgent need for more physician input in the development of health IT because research conducted by experts at the AMA and Dartmouth has found that the status quo is a major source of physicians’ dissatisfaction. For every one hour physicians spend with patients, the study found, they spent two hours on clerical work or with their electronic health records (EHR) system.
“Surveys have shown that tools for physicians often have a sound theoretical base. But there is a complex system-engineering problem in moving it over the transom when you imagine that things in health care work more like a linear-manufacturing basis,” Dr. Madara said.
Dr. Noseworthy addressed the MATTER event crowd directly, saying innovators must appreciate that physicians and other health professionals, while optimistic about the promise of technology to improve care, demand evidence of efficacy before adapting to disruptive changes.
“Physicians are very data-driven,” he said. “Once you show them that what you’re doing is going to improve care, they will go along with you. It’s probably true that they’ve had a bad experience with EHRs. Then you come in and say, ‘I’ve got another good idea.’ Your job as inventors and engineers would be to show how this improves the joy of the work of a pharmacist or a nurse or a physician. You do that, and they’ll be all over you.”