5 Points of Health Care™ Conference: 2020 Recap

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Day One

The day opened with a Fireside Chat, moderated by Executive Director, Maura Little, welcoming William Weeks, MD, PhD, MBA, Principal Researcher at Microsoft Healthcare NExT.

Little didn’t miss a beat, getting straight to the point and posing the question to Bill, “Is change possible in health care?” A question that seems simple in the beginning, with the complexity being outlined throughout the remainder of the conference. Quick on his feet, Weeks shared that he believes

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change is possible, but the alignment of incentives within the health care system is critical.

With that, Dr. Weeks got the chance to pose a question to the patient panel, “What do Patients want out of a health care encounter?” and we were off to the races...

Patient panel: what do patients want out of their health care encounter?

They want to be heard and they want their needs to be met in culturally appropriate ways. This was an overwhelming theme throughout the day and included questioning of the widely used phrase “patient experience”. Specifically, patients are individuals that may have differing desires for their health care experience. For example, some individuals may care more about bedside manner, while others care mostly about getting the right care at the right time. The vast diversity of the patient population forces us to rethink blanket statements like “patient experience”.

The members of the patient panel also introduced the importance of language, another common theme throughout the conference. They pointed out that the word “encounter” is not one they would typically use to describe their health care experience. The word “patients” ties to the word “patience”, which is unfortunately often required of people during episodes of care. Meeting patients where they are, language, and culture are critically important as we look to innovate in health care.

Patient question to the provider panel: How do providers partner with their patients to address their health?  

The shift that providers are seeing in their care space is to focus on creating a partnership with their patients.

These partnerships involve greater focus on social and environmental factors, as well as the integration of behavioral health.

What we heard during the provider panel was the importance of looking at health care through a new lens (looking at your Michelle Troseth!). Eric Meyer shared that Children’s Hospital Los Angeles is starting to think through how best to care for patients outside of the clinical setting. Rachelle Daugherty added the need to take into account the EQ (emotional intelligence), in addition to IQ.

Provider question to the payer panel: What changes in health care workforces and technologies are payers prioritizing and how are they preparing?  

The payer panel emphasized a need to expand the definition of a payer from just the “person that pays your bills” to include overall managed care. This broader definition was supported by payer commentary on the need to include mental health services,

a desire to see a greater shift toward value-based care

and the ability for payers to have direct connections and meet consumers where they are with various applications (e.g. live chats to answer plan questions, etc.).

The need for trust was a strong theme. Customer sentiment and demands are changing, and the health care system isn’t keeping up. Point-to-point solutions aren’t going to keep up, the issue is more systemic. Investment alone doesn’t get the job done. Instead the infrastructure, incentives and culture need to be better aligned to advance impactful solutions. 

Ecosystem Panel

Taking a pause from the flow of the 5 points of Health Care framework, we invited health innovation ecosystem leaders from across the country to join the discussion about how each of their stakeholders view tranformation. Taha Jangda, General Partner at HealthX Ventures, Hayley Hovious President of the Nashville Health Care Council, and Nick Dougherty Managing Director of MassChallenge HealthTech, joined Cambia Grove Executive Director, Maura Little to discuss the barriers and opportunities facing healthcare innovation from a macro level. 

The panel mixed pragmatism with hopeful notes. Hayley underscored the importance of knowing your audience, and that no matter how trite it sounds, it is essential. Even the word ‘innovation’ is isolating for some stakeholders. 

Nick touched on the notion that, ideas and innovations, no matter how great or sensible, won’t inherently translate to impacts in health care. This became a common theme throughout the conference, serving as a guardrail to any innovation: don’t be a solution in search of a problem. 

Wrapping up on a positive note, Taha offered some insights regarding the outlook for progress in health innovation: “In 3-4 years, we’ll see vastly more information shared to create better communications between all parties” which, in turn will bridge many gaps hindering the free flow of innovation. 

And then we were back to the races with our purchaser panel…

Payer question to the purchaser panel: What are purchasers willing to pay for regarding products ranging from apps and wellness programs to services for SDOH? What are the employees willing to pay for?

Returning to the 5 Points of Health Care framework, the purchaser panel discussion kicked off with a look back at what a purchaser’s role used to be in health care: “It used to be that you just asked, ‘are you taking your vitamins? Are you exercising?’ What purchasers need to be looking at now is the ‘whole person,’ meaning financial, relationship and work health.” 

In response to the question from the payer panel, purchasers drew attention to the large amount of money that employers are already spending on health care. They also described the disconnect many purchasers feel from the end-user (their employees).

When purchasing benefits for their employees, they are making business decisions that may later impact an employee’s ability to receive health care.

In addition, education was touted as critical. You can empower employees by educating them on what questions they should ask of the health care system.

Purchaser question to the policymaker panel: Who are policymakers actually advocating for?

The panel essentially answered this in four words: those that show up.

People who organize and make a good case for the public good will win but,

if you don't show up, you lose by default.

Dr. Bob Crittenden shared that there can be a lot of influence and money in politics that doesn’t always have the patient at the center. He also shared that this can be combatted by getting out and organizing the patient voice so it can be heard! Public health and patient centered perspectives can be fragmented, but there are a growing number of umbrella organizations to streamline advocacy. 

Policymaker question to the patients to start the Fishbowl:

We reconvened all of the 5 Points of Health Care panelists for a final conversation at the end of Day 1. We were excited to see how, after deep dives on each of the segments, the conversation would evolve when all the perspectives came to the stage at once. To keep the patient at the center of our discussion, the fishbowl kicked off with a question from our policymakers for our patient panelist (seated in the center of the group).

From the policymaker panel: What do patients need to feel more involved in the policymaking process? 

Fishbowl Conversation 

This year’s format was unique and offered us the opportunity to bring all the panelist back to the stage in a fishbowl conversation.  The goals were to truly de-silo, to ask critical questions and to highlight where innovation is most needed. Emcee Maura Little lobbed in questions from the audience that were gathered throughout the day during each panel.

 

The fishbowl kicked off with a question to the patient panelist: What do you need to feel more involved in the policymaking process? 

Patients acknowledged that they must engage in policy because action is what matters most but voiced the concern that it is not easy nor does it always seem effective. Not seeing enough progress or results is frustrating but in order to maintain engagement, a deeper understanding of what is and isn’t possible is an opportunity to bridge gaps between the patient and the policymaker. 

Key Takeaways & Outstanding Questions

  • Our Medicaid population is a high utilizer of the ER. We try to intervene upstream, but we need to (as a larger health care system) find more solutions to make an impact (Minute 14:45)
  • This doesn’t often sound too sexy for innovators, but it is important: 
integration of data from a HR benefits payroll administrative side. From a benefits perspective, a lack of real-time information sharing between vendors is a real challenge.

“We need a solution that allows the right person to make the right intervention at the right time.” (Minute 19)

  • How do we do public-private collaborations to address workforce issues in the provider system? (Minute 24)
  • Quality measurement is complex and challenging (Minute 31-40)
    • Common quality indicators are needed.
    • Interoperability and standardization tied to quality are needed. We’re starting to move that way but there are still huge gaps. (Minute 34)
    • When we’re looking at quality both in measuring and defining, claims data is often used as a substitute. That data is imperfect and not intended to measure quality. New metrics are needed. (Minute 48)
  • What if we looked at the low hanging fruit and cut cost on basic items? This would align purchasers, patients and providers to have real impacts (Minute 42)
  • Who moves first to fix the broken system? (Minute 53) 

Next steps and the work ahead:

The conference was conceived to achieve three goals: 

  1. Present the innerworkings of the entire health care system, 
  2. Identify common barriers,
  3. Set priorities to focus system-wide transformations.

Based on feedback from the audience and our internal evaluations, we believe that the communities’ efforts were successful. The conference sold out nearly a week before it began. We saw a spike in online engagement, there were over 50 audience questions submitted during day one, and we were thrilled to host a full house of participants for day two breakouts. 

Most critically, we saw the community rally around these key themes:

  1. Data integration and agreed-upon measurement frameworks are critical to drive change in a meaningful way
  2. Incentives must be aligned to enable innovation and improve health
  3. We must identify problems before jumping to solutions, and solutions must be culturally appropriate – we must meet people where they are

Innovating in health care can take many different directions and without clear priorities and a roadmap, innovation efforts can spiral. These three priorities have given Cambia Grove a clear call to action allowing us to more closely support the health care innovation community in our collective efforts to realize a more patient centered and financially sustainable health care system. 

This is, always, an iterative process. We rely on your feedback, participation and accountability. Please take this survey, and if you are not already, please sign up for our weekly newsletter <link> to more easily access our programing and events. Our next major gathering will utilize the 5 Points of Health Care™ to dive deeper into the subject of paying for health. Please join us in June.

"Health care is about us and for us and when it is done without us, that is a problem."

- Robin Shapiro

Conference Wins: 

  1. Patient conversations kicked off the day and, for the most part, was threaded through all the discussions 
  2. Attendees enjoyed the convergence of all of the 5 Points of Health Care™ 
  3. Opportunity for breakout sessions and deeper dives on Day Two

Need to Improve on: 

  1. Need diverse representation on panels, this includes racial diversity as well as individuals that may not fit the mold of the 5 Points of Health Care but are disproportionately impacted by the social determinants of health (SDOH) (for example people experiencing homelessness, food insecurity, financial instability, etc.)
  2. We need less sitting and more fluid discussions, more breakout sessions, more Q&A
  3. Each of the 5 Points of Health Care should provide a problem to entrepreneurs/innovators in the room that needs solving/they need help with 

 

Cambia Grove commissioned a graphic recording artist to illustrate the discussion surrounding the health care system over the day and a half conference. Click on the graphic if you would like the ability to zoom in and out on each of the 5 Points of Health Care.

To see the other images click the following links below:

2018 Commissioned Graphic recording: