Events, Health IT, Hospitals, Payers

At Health 2.0, providers say lack of trust is major barrier in driving patient-centered innovation

Panelists at the Health 2.0 Provider Symposium pointed to the necessity of building aligned incentives to promote data sharing and drive innovation.

L to R: Megan Mahoney, Blix Rice, Charles Saunders, Anne Wellington, Shahid Shah

The wealth of data now being produced and collected about patients has often been held up as the holy grail to push forward innovation within the healthcare system.

The logic follows that with the move to electronic medical records, increasing consumer adoption of technologies like genomics testing and wearables, better decisions could be made to help improve patient outcomes and reduce costs.

When it comes to why this wholesale transformation hasn’t happened yet, more often than not technical issues – like the perennial boogeyman of interoperability — comes up as the answer.

But a panel at a provider symposium held at Health 2.0 that kicked off Sunday in Santa Clara, California honed in on a much more fundamental issue to solve: the building of trust among the stakeholders in the healthcare system.

The lack of trust in turn leads to data asymmetry between providers, payers, and patients and the inability to unlock all the potential of the accumulating information.

Anne Wellington, the managing director of the Cedar-Sinai Accelerator said complete transparency between patient and health insurers is difficult because of a lack of alignment around incentives.

“When people are thinking about whether patients should share more information with their insurance companies or their providers there’s a concern that that information isn’t being used with their best interest in mind,” Wellington said. “Until all of those are in alignment and we feel like we’re moving in the same direction there will be cultural barriers to all of these organizations wanting to openly share information regardless of the technical capabilities.”

She pointed to the example of consumer genetic data, which could reveal health risks that insurers may not want to cover.

Blix Rice, the vice president of innovation and transformation at the Care Coordination Institute, a nonprofit dedicated toward supporting the shift to value-based care, said when working with employers, his organization has run headlong into the problem of insurance companies’ reticence to exchange data.

“You would think that would be freely shared in the interest of the patient but what we’re finding is that those data become the currency with which we negotiate and they are often held hostage at times,” Rice said. “These data are often the source of value and if I give that up and don’t have full trust in the relationship, then that’s going to be problematic.”

Charles Saunders, CEO of value-based specialty care company IntegraConnect and former head of Aetna’s population health arm Healthagen, said the information disconnect doesn’t just end with the health insurers.

“It’s not just the payers that know about you than your doctor does, but the pharma companies probably know more about you than your doctor does because they’re buying data from EMR companies,” Saunders said.

So how exactly does the industry move past this?

One solution posed by the panel was moving toward integrated models where providers and payers are working in tandem together, or are one in the same. Employers can also use their business leverage to help align incentives in a way to promote data-sharing between stakeholders.

One pathway mentioned by Megan Mahoney, Stanford University’s Chief of General Primary Care, involve providers partnering directly with employers and prioritizing data-sharing efforts with payers.

Through more direct collaboration with employers, Mahoney said Stanford is better able to get information like stress and sleep data that provides a more complete picture with what’s happening with a patient’s health.

“In certain circumstances there are models in which we collaborate directly with employers and that’s been incredibly successful. In other cases we have to sit down with insurance companies and prioritize the biggest areas which are around quality and population health,” Mahoney said.

Photo: Kevin Truong, MedCity News

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