Discover the transformative power of technology and digital health in driving value-based healthcare with insights from the president of the American Medical Association, Jesse M. Ehrenfeld, in this captivating podcast.
Guest: Jesse M. Ehrenfeld, M.D., MPH, President, American Medical Association [@AmerMedicalAssn]
On Linkedin | https://www.linkedin.com/in/doctorjesse/
On Twitter | https://twitter.com/DoctorJesseMD
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Host: Marco Ciappelli, Co-Founder at ITSPmagazine [@ITSPmagazine] and Host of Redefining Society Podcast
On ITSPmagazine | https://www.itspmagazine.com/itspmagazine-podcast-radio-hosts/marco-ciappelli
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Episode Notes
Hey everyone, it's Marco Ciappelli here, and I am delighted to bring you an episode of the Redefining Society podcast that is dedicated to the upcoming CES conference in Las Vegas. CES is known as the place where you see the future, and technology plays a vital role in shaping that future. Today, I want to explore how technology fits into the societal structure, particularly in the healthcare industry.
I am thrilled to have Jesse Ehrenfeld, the president of the American Medical Association, joining me on the show. He will be hosting a panel at CES on enabling the new era of value-based care for digital health. But before we dive into the topic, let's understand what value-based care really means.
Value-based care focuses on the quality of care, the performance of healthcare providers, and the patient experience. It prioritizes what patients value the most, and technology plays a crucial role in achieving this. Through the use of digital health tools and AI, we can enhance efficiency, effectiveness, and patient engagement, ultimately delivering value-based care.
One of the key benefits of technology in healthcare is telehealth. Virtual consultations save time and eliminate the frustration of traffic and long waits at the doctor's office. Patients can interact with their healthcare providers from the comfort of their own homes, making healthcare more convenient and accessible.
However, the adoption of new technologies comes with challenges. Physicians want to know if the tools actually work, if they are covered by insurance, what happens in case of failures, and how they integrate into their practices. We need to ensure that the tools meet their expectations and address these concerns.
From a patient's perspective, value and success are measured by factors such as convenience, quality of care, and cost. Telehealth and other digital health tools provide patients with a more satisfying experience, saving them time and delivering higher quality care. Lowering out-of-pocket costs is also a priority, as healthcare expenses continue to rise.
While we often associate AI with cutting-edge advancements, it is already embedded in healthcare operations behind the scenes. AI-powered tools are streamlining supply chain management, scheduling, and insurance processes. In research, AI is accelerating drug discovery and improving diagnostic accuracy.
Events like CES play a crucial role in driving innovation in digital health. They provide a platform for entrepreneurs, innovators, and healthcare professionals to connect and collaborate, ensuring that the technologies developed meet the needs of patients and practitioners.
I hope you find this glimpse into the role of technology and digital health in driving value-based healthcare insightful. If you want to learn more about this topic, make sure to check out Jesse Ehrenfeld's panel, "Digital Health Enabling the New Era of Value-Based Care," at CES.
I am excited to record and share these episodes about the evolving healthcare landscape, and I look forward to bringing you more discussions on the intersection of technology and society in the future.
That's all for now. Stay tuned for our next episode, and until then, take care!
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Resources
Digital Health: Enabling the New Era of Value Based Care: https://www.ces.tech/sessions-events/dhth/dhth02.aspx
Learn more about CES 2024: https://www.ces.tech/
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Please note that this transcript was created using AI technology and may contain inaccuracies or deviations from the original audio file. The transcript is provided for informational purposes only and should not be relied upon as a substitute for the original recording, as errors may exist. At this time, we provide it “as it is,” and we hope it can be helpful for our audience.
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[00:00:00] Marco Ciappelli: Hello, everybody. This is Marco Giappelli. Welcome to an episode that is on Redefining Society podcast, but also particularly dedicated to the CES conference that is going to happen very soon in January in Las Vegas, which is what a lot of people call it the place where you see the future.
Now, I don't know if there are crystal balls there or time machines. But definitely technology is a way to look at the future. And for me, it's all about the way it fits into the societal structure that we live in. A lot of things going on lately with artificial intelligence, advanced technology. And of course, there is one industry, one sector where technology is really relevant is certainly in the healthcare.
So today, I am very happy to have Jesse Herrenfeld on the show. He is the president of the American Medical Association and he's going to run a panel. at CES about enabling the new era of value based care for digital health. So that's a mouthful, I think we'll figure out what that is.
But before we even go any further, I want to welcome Jesse to the show. And so here you are. Welcome to the show.
[00:01:16] Jesse Ehrenfeld: Marko, thanks for having me. I'm super excited about CES in January and to have the opportunity to talk about how do we get to value based care using technology, critically important topic for all of medicine and all of health care.
Which I think a lot about in my role as leading the American Medical Association.
[00:01:37] Marco Ciappelli: Yeah, absolutely. And I feel like a lot of people that follow the show and they are passionate about CES, they, they already know. We had a few conversation where we say, you know, CES is not really, as I was talking about the future, not about the gadget anymore.
It used to be about the radio at the beginning. And then it grows with technology. Now we're really looking at the intersection with society. So let's start with defining what is the value based care model.
[00:02:05] Jesse Ehrenfeld: Yeah, it's an important place to start. So value based care is a term that really describes health care that is designed to focus on the quality of care.
The performance of the people delivering the care and the patient experience. And, and, and that word value in the phrase value based care really refers to what the individual patient values the most. And as we, we think about how do we elevate quality. Elevate performance efficiency, uh, prioritize what patients want.
There is no way we can do this without embracing technology, embracing digital health tools, thinking about leveraging the power of, of AI to make things more efficient, more effective, and to get us to a paradigm of delivering value based care.
[00:02:52] Marco Ciappelli: Well, that's an ideal situation and I hope we will get there.
And I think technology can definitely help with that. Um would this be possible conversation, let's say, five years ago? I'm going into generative AI and all the things that happen lately.
[00:03:11] Jesse Ehrenfeld: I mean, I, I think so, but we have different set of opportunities today because the technology stack is, is very different.
Having patients engaged in their own care is, is one really important element. Um, a value based care. Um, and so as you think about the tools and the technology and how we interact with patients, you know, I'll, I'll see a patient. Uh, you know, I'm going to be the operating room tomorrow. Um, they'll spend a little bit of time with me having surgery.
I'm anesthesiologist, so they'll be asleep for most of it. Um, but my direct interaction with the patient is a tiny, tiny fraction, right? of their life. Um, and then there's the rest of patients walking around, being at work, being at home. Um, and the way that we can use tools to help keep patients on a journey to health, help them engage and take ownership, um, of, uh, any medical problems they have, um, is becoming increasingly possible through the use of technologies and apps and algorithms that allow us to have much, much more high touch and interaction with patients in ways that just, just wasn't possible five, 10 years ago.
[00:04:15] Marco Ciappelli: Yeah. So here is like a personal way that I see things. If I can do a video call with my specialist, with my doctor, I'm happy to do that. I saved a lot of time. Yeah. I don't have to drive in on the 101, the 405 here in LA. So it's like, you know, it's good value
[00:04:32] Jesse Ehrenfeld: and you can do it. Your PJs
[00:04:34] Marco Ciappelli: exactly. On top of that. You, you still have that interaction. I think we got used to, to do some of this thing, work remotely nowadays, but the question may come into, are they tools? Are the tools available for everyone, or when they will be so that, you know, you don't even have to really go to, to the lab. I mean, I don't even know if we're ever going to get there where you can pinch your finger and do your blood
test at home.
[00:05:04] Jesse Ehrenfeld: There are companies that will send you a kit in the mail that you can do some of the testing at home and send it in hasn't really hit scale yet. What I'll tell you, though, is, is it comes down to the tools, uh, in the technology, in, in, in the devices and the apps. And, um, we're seeing a lot of movement in this space.
Um, I talked to physicians all over the country. AMA does a lot of survey work. We know a lot about. Physician priorities for the adoption of digital health tools. Um, and, and the fundamental priorities are actually quite simple. Physicians want to know. Does the thing work? If I buy something, I put it in my practice, I integrate it in my workflow, is it actually going to live up to its expectations?
And, and that actually is a foundational question because we have had a lot of hype around a lot of tools that have just not lived up. right to real world experience. And the case in point is the electronic health record, the bane of most physicians existence, the number one pain point for at least a decade running because of usability problems, lack of interoperability, adding lots of check boxes and clicks without really adding a lot of value.
We can't let that happen if we want people to actually adopt and use these tools. The second issue is, you know, who's paying for it? You know, if I go through the acquisition cost of acquiring a tool or an algorithm, you know, is insurance covering it for, for the patient? For me, as the practice, you know, those payment issues are, are obviously important.
Um, the third issue is what happens when something goes wrong? Um, you know, if, if there's a failure of, of an algorithm that's embedded in a device, a medical device, Um, if, uh, you know, something's not anticipated with a patient who's on the hook, um, and in our perspective, obviously, is that there's likely to be a shared liability in most circumstances.
That's appropriate. You know, if I use a tool or an algorithm or an app as directed, either as a patient, um, or a practitioner. Um, you know, in many cases it probably is the manufacturer, the developer, the implementer who ought to hold most of the liability. Um, but those questions are actually unsettled. Uh, and they're federal proposals that actually have indicated that, um, it may not be what you would expect it to be that, that we need to work through.
Um, and the last question is, does it actually work In my practice and, and you know, I, I see adult patients and, and I, I, I will. I will own it. I've made this mistake. I, you know, I I'm an informaticist. I've developed algorithms and tools and technology. Um, and I once back in the day, you know, 15 years ago, develop some software and the thing they teach you this in medical school.
You know, children are just not little adults. They're different. Um, and they behave differently. The workflows are different. And, um, and I, I completely ignored that. Um, and we deployed our software in a children's hospital that we developed in the adult hospital, and it just failed miserably. Um, the workflows were different.
We didn't anticipate that. And it was an important lesson that I learned, and I should have known better. Um, and we see this problem over and over and over where. Technologies are developed in one setting, um, in one health care system, in one region, in one population. And then when we try to scale them to all patients, they just don't, they just don't hold up.
So those are the real questions that the physicians want to know. Does it work? Is it covered by insurance? What happens when something goes wrong? Does it actually work in my practice? Um, we want to make sure that we, as an AMA, uh, connect. Entrepreneurs and innovators directly to physicians, directly to doctors so that as we're getting new technologies brought into the marketplace, um, that we have excitement for tools that actually work.
And there are a lot of ways that we're doing this. We're doing this through our Physician Innovation Network. We're doing this through work in venture capital, a technology incubator that we created in Silicon Valley called Health 2047 that's spinning off companies. And obviously there'll be a lot of conversation at the show about how do we do this in a way that makes sense for patients.
[00:08:52] Marco Ciappelli: Yeah, that's, uh, that's the point. It's, it's like other field. I mean, in an autonomous car, I feel like the technology is there, all the conversation I have about that, but we haven't kind of pulled the plug on, on say, okay, we're comfortable to have these cars on the road. We know that they're At least good enough or better maybe than us to
avoid accidents.
[00:09:13] Jesse Ehrenfeld: Well, Marco looks at, I, I fly all the time as I, as I travel around the country. And, um, you know, there's still a pilot sitting in the front of the plane and, and, and we have autopilot, not just for in flight, but, you know, autonomous takeoff landing. Those systems exist. There's a reason that we haven't, as a society said that, that we want.
That to be in command and control. Um, and I think we have a similar trust issue in in health care. You know, health care is so personal, right? Um, you know, there's nothing more personal, um, than, than, than health care, your genetic code, disease and illness and health. And we want to make sure we get it right.
So, you know, our perspective on AI is, is, you know, we ought to have a human in a loop like the physician or the health care team member. Um, we want to use these tools to boost capacity, to move performance. To that definition of value based care, where we can focus on high quality, we can elevate the performance of our teams.
We can shape the patient experience to be more meaningful, more engaged, more frictionless. Um, but we need to do that in a way that obviously makes sense and works for everybody.
[00:10:15] Marco Ciappelli: Yeah, so let me put it from this perspective because I like to think on putting myself in the shoes of both sides, right? So you told me what on your side of the medical practice and what all the things that you guys are doing.
Now, let's put ourselves for a second in the shoes of the people. patient. So how, how do the patient measure value or success when he adopts a new technology that you say, look, you can do it this way. You can, you can come in the office, but you can also call me from home or use this tool or how society you feel like us.
psychology of the patient need to be moved to start adapting to that and get the value of it.
[00:10:59] Jesse Ehrenfeld: Yeah. Well, so it's interesting. And of course there's, there's a lot of data on this. Um, but, but the, the experience of the patient is paramount, right? Um, the frustration of, of, as you mentioned, you know, sitting in traffic, driving to the office, people are running late, you know, you spent half a day, you know, having a 30 minute visit or a 20 minute visit.
That, that is a very, um, Unsatisfying experience for, for a lot of patients. So using telehealth remote tools to, to solve some of those challenges is obviously a big satisfier. We see this in, in patient survey data, um, quality, right? The, the tools ought to make things better, make things more efficient, make them higher quality so that, you know, when you go in for, for a diagnosis, uh, cause you're not feeling well, that you get the right answer and we ought to get the right answer.
More of the time than before using the tools that we have that can support diagnostic decision making or, or imaging or, or procedures, you know, robots and endoscopies and all these things that are starting to incorporate more and more, um, AI, uh, and other technologies. Um, and then cost, right? We want things to be.
You know, lower cost out of pocket to the patient. And, you know, unfortunately, that has been a challenge. You know, health care costs continue to go up. Um, but that's a driver of the whole value based care movement is to try to create the efficiencies that can ultimately lower cost for patients, which are becoming unmanageable and unsustainable in a growing portion of domestic GDP.
[00:12:25] Marco Ciappelli: Yeah. So you mentioned how So we have already been living with
AI for a long time, but you didn't know it's backstage, kind of like I use the Disney world or Disneyland example. Everything is pretty, but there is a lot going on backstage to make things pretty. And we don't care as a user. Yeah. We don't really care.
[00:12:47] Jesse Ehrenfeld: Well, in fact, that's happening in healthcare today. So 40 percent of us medical practices use AI, but it's the unsexy stuff. It's supply chain management. It's scheduling. It's, it's dealing with insurance companies and prior authorization, things on the backend that aren't really visible, um, really visible to physicians or, or, or patients that the exciting stuff, right?
You know, when you, you walk in and you have a stethoscope that helps me hear the heart sounds and, and understand what I'm listening to. Um, if there's something that is, uh, you know, one in 100, 000, uh, you know, condition, those are applications, which I think people think about when they think about AI and AI tools, they're coming quickly and, and, and we want them, we need them.
Um, but the place that AI is in use today is that sort of stuff in the background layers you're kind of describing with the Disneyland example.
[00:13:34] Marco Ciappelli: Right.
How about in research, though? I mean, I talk a lot
about AI in terms of being the first layer of aggregating data and doing the job that would take a very long time to an individual, but then the individual still, obviously, In the loop, the professional in the loop to make that exact decision.
[00:13:53] Jesse Ehrenfeld: Well, you, you look at what, what the pharmaceutical industry is doing using AI tools around drug discovery, right? For, you know, rare diseases, common diseases, and they're, they're really exciting examples where companies have been able to very, very quickly identify Drug targets, therapeutic targets, protein structures, um, in ways that would never have been feasible before on a much, much reduced timeframe at much, much reduced cost.
So, uh, and there are lots of examples across biomedical research where, where this is starting to happen. So they're definitely research applications that will impact human health, uh, in, in the near term.
[00:14:31] Marco Ciappelli: Very cool. Let's CS. You said you're excited. about going there. I don't know if it's your first one.
I'm assuming it's not. But you tell me. And kind of like the old ecosystem of an event that Yes, it has all the different, uh, health care, the space, the food and the robotics, cars. I mean, there is everything that the whole society is represented there. What's the value for you of an event like these or a similar event like Viva Tech in Europe, for example?
[00:15:04] Jesse Ehrenfeld: Yeah, well,
I am certainly excited about it. I've only been virtually, I've never been to Vegas. So, uh, look out here. I come super, super happy to join 150, 000 of my closest friends, uh, that week. No, it's, it's exciting. And, and, and I think it's, it's so important. Uh, and I'm delighted that CS is really highlighting digital health as a part of the show this year, uh, and I think in an elevated way, uh, because it's foundational to so much of what's happening, uh, in technology development and so critical, uh, to obviously, uh, society, uh, without health, we, we have nothing, and it's such a growing part of the economy, um, that understanding how do we get tools That actually work.
How do we have development cycles? How do we connect entrepreneurs and innovators to health care in ways that lead to better products with better go to market results is absolutely essential. And I know that CS is going to contribute to that in a really productive way, certainly through our panel, but through other activities as
well.
[00:16:04] Marco Ciappelli: And that's exactly the last call we're gonna have. It's to remember that you will be leading that panel. It's called Digital Health Enabling the New Era of Value Based Care, Wednesday, January 10, 2 to 2. 40 p. m. and the North Level 2. I'm sure you already forgot about what I just said. That, but there will be links in in the episode notes with a way to get in touch, uh, with, uh, Jesse, and especially to know more about his presence there at, uh, at CES, uh, this year, which again, it will be happening.
Las Vegas, ninth to the 12th of January. Uh, Jesse, great conversation. I would love to have you back and with more time and, and talk about other things the way that. Uh, healthcare and society are so intertwined and, uh, a very, very important, uh, topic. Thank you for your time. Thanks, Marco. Appreciate it. All right.
Take care, everybody.