Monday, October 29, 2012

CHI 2012 Keynote Spotlight: Dr. Mark Smith, President and CEO, California HealthCare Foundation

Dr. Mark Smith
Dr. Mark Smith, a board-certified internist who has served as president and CEO of the California HealthCare Foundation since its formation in 1996, will keynote CHI 2012, the annual meeting of biomedical executives, entreprenuers, investors and policymakers. The event, happening Nov. 8 at Gilead Sciences in Foster City, Calif., brings together policymakers with representatives of CHI’s member organizations to discuss critical issues and opportunities facing the biomedical community. Click here to register by Friday, Nov. 2.

CHCF is an independent philanthropy headquartered in Oakland, Calif. dedicated to improving the health of Californians with special concern for the underserved.

Q: In a blog post for JAMA Forum earlier this year, you argue that, regardless of the Supreme Court decision or the results of the upcoming presidential election, health reform is already happening, and will continue. Explain to our audience, briefly, what you mean by this?

A: While the outcome of the presidential and congressional elections matters a great deal in some areas of healthcare policy, there are number of big trends in the delivery system that are a result of forces that are independent of these elections. In particular, cost pressures on every sector of healthcare will only intensify, no matter what the outcome of the election. Consolidation (of hospitals with each other, hospitals with physicians, and physician groups with each other) will continue. Novel arrangements between payers and provider systems aimed at reducing spend will persist; and consumers, spurred, in part, by growing out-of-pocket responsibilities, will become more and more price sensitive and more demanding of convenient customer service attributes which they have come to expect from other aspects of their lives.

Q: The ACA gave rise to a lot of talk about cost containment. How big of a role do you suppose personalized medicine will play in driving down costs?

A: Too soon to tell. I can certainly imagine circumstances in which the ability to accurately predict an individual patient's response to an expensive medicine, say chemotherapy or biologic anti-inflammatory, may reduce expenditures on ineffective medicine, despite the expense of the initial test. But I can also see circumstances in which breathtakingly expensive personalized approaches provide only marginal increases of effectiveness with dramatic increases in costs. The good news (from the perspective of cost control) is that I think the approval and reimbursement environment of the future will be more on evidence and less on marketing.

Q: We stand at a time when policy often lags the pace of scientific advance. Genetic sequencing and biomarkers are examples. How do we keep the two in unison?

A: We can't. No matter how much we'd like to do so, the policy environment will never be as dynamic, nimble, or unpredictable as the breakthroughs in biomedical science. So, the question is not so much how we keep them in unison as how we can keep the policy environment from getting decades behind the science, as it is in many areas now. It will require new approaches to conditional approval, post-approval surveillance, collaborative funding of trials, etc. The most hopeful development is the progress of digitized medical records, computing power, and rapid learning systems which can compress the time needed for thoughtful collection, review and analysis of clinical data and, in some instances, replace traditional clinical trials.

Q: If you could change a single healthcare policy, at the state or federal level, what would it be and why?

A: Begin to develop a single national policy with regard to scope of practice, so that improvements and advances in the productivity and capacities of healthcare workers and patients themselves would not have to be battled out board by board, state by state.

Q: What are you most looking forward to in anticipation of CHI 2012?

A: The election will be over, some uncertainty will be reduced, and we can look forward to how to work together to strengthen the healthcare system while making it more affordable.

CHI-Advancing California biomedical research and innovation

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Wednesday, October 10, 2012

Event Spotlight: USC Body Computing Conference 6.0

USC's Dr. Leslie Saxon and Ken Persen of Cameron Health showcase implantable defibrillation technology at the USC Body Computing Conference. Photo by USC Center for Body Computing.

To prosper as a competitive society, we have to become experts in managing data. For physicians, that data has to be clinically relevant.

Healthcare executives shared these insights and more Oct. 5 at the annual USC Body Computing Conference. CHI is a proud supporter of the annual conference, which gathers leaders from medicine, entertainment, telecommunications, kinesiology, and the regulatory world to shape the future of wireless medical solutions.

For the sixth year, Dr. Leslie Saxon, chief of the division of cardiovascular medicine at the Keck School of Medicine and founder of the USC Center for Body Computing, led a discussion about wireless health and how it is changing healthcare monitoring and delivery.

Thomas E. Jackiewicz, senior vice president and chief executive officer for USC Health, said he expects that personalization will be the standard of care for cancer care in the next five years. Genomic medicine will outpace the federal meaningful use electronic health records incentives program, he said.

Dr. David Agus, professor of medicine and engineering with USC and co-founder of personal genetics company Navigenics, shared how far the industry has come in advancing medical treatments by reminding the audience how early pregnancy tests were administered – using rabbits.

Today, he said, we can sequence tumors and gather data that informs healthcare decision-making.

“We now have the technology to look at all the proteins in the body,” he said.

Some of the technologies showcased by conference presenters included brain monitoring devices to get inside the minds of elite athletes, technology platforms that allow for better integration of the hospital patient in team discussions and treatments, and devices for wirelessly monitoring the body’s vital signs in real-time.

One of the more interesting concepts on display at the conference was Nigel, a Mini Cooper equipped with 230 sensors and an iPhone app to monitor driver habits and even create specific driving games or suggest activities for each of the car’s drivers. The idea could also apply to a driver’s health, said Saxon, by tracking the driver’s heart rate and increasing awareness about how the body responds to a song, for example. There is a “huge unmet need” for patients to be better connected with their own health, she said.

Sam Agutu says Changamka has changed the healthcare paradigm for uninsured Kenyans. Photo by USC Center for Body Computing.

Sam Agutu, managing director and CEO of Changamka Microhealth Ltd., captivated the audience with his healthcare “by the slice” approach to combining mobile money systems with prepaid health cards that allow uninsured Kenyans to pay only for the healthcare services they need, at pre-negotiated rates.

During a question-and-answer session with a senior level U.S. Food and Drug Administration representative, attendees asked about the various pathways for approval of these new technologies. Megan Moynahan, associate director for technology and innovation at the FDA, encouraged the audience to continue to push the boundaries of innovation so that the agency is forced to reckon with the latest cutting-edge ideas.

The USC Center for Body Computing, which runs the conference, studies, incubates, and creates wireless health products with other USC schools and corporate partners. It specializes in creating innovative solutions for chronic disease management, sports monitoring, mHealth and gaming and entertainment. Click here for more information.

CHI-Advancing California biomedical research and innovation

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