Reena Jadhav interviews Fran Ayalasomayajula (Population Health Technologies and Innovations Lead, Worldwide Healthcare, HP) at SplashX Invent Health Behavioral and mental health at HP
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[00:01] REENA JADHAV: Hi everyone is Reena Jadhav here the founder of health bootcamps here at SplashX Invent health at the HP headquarters and I am chatting with lovely Fran who is the global lead for population health at HP. Fran what the heck is population health global lead anyway?
[00:17] FRAN: I liked you ask the question that is so funny, actually population health is sort of a new terminology for what really is public health. So my background is epidemiology and what we really focus on is looking at the entire end of an individual. What we find is that what I should say the reality is that only 20% of individuals in our actions with the clinical care system actually has the direct influence on the outcomes for patients and so it’s really within the context of that looking at the individual from a holistic perspective and leveraging technologies as well as the interconnectedness of an entire eco system that sort of supports an individual which again is centered around the environment which they live, basically where people live, work, play and pray and being able to utilize that environment to be able to influence them in terms of the things that ultimately matter; their environment, their lifestyle, looking at their social-economic situation, all of the factors that really lead to well basically one eating well and also helping one to come back to a state of wellness.
[01:28] REENA JADHAV: And a lot of us are getting ill Fran, you know, we are getting more and more sick as a nation, we are here for the mental health conference but to broaden that out you know, you look at numbers for chronic illness, you know, we have got over 100million Americans with some form of chronic illness. We’ve got this now creeping into the kids, teens. We’ve got 30% jump in depression and anxiety and mental health illness so you are right it’s not just genetics and of course now we have talked about epigenetics as a whole new field as well. When you look from an HP standpoint at what are those factors so you mentioned environment, play, pray. Where are you focused and what technologies are you excited about that if you can actually move a needle.
[02:15] FRAN: So that’s a big question right. So I will try and break it up into a couple of different elements. So first off there are some really unique things that we are doing from a solution standpoint that are actually not just within the healthcare arena or with that sector, there are other verticals from which we also focus. Education as well as the workplace of the future. These are all big environments, in which we are integrating our technology so that when people are in their work environments, they are feeling good in those environments so taking that notion of economics to a whole new different level. But taking it back to the space that I am in and how we influence it, we really have the strategy that are centered around 3 key components; care delivery, patient engagement, population health management and across the continuing of that what we do is we take technology and these innovations and we interject them so from a care delivery perspective. Putting technology right in the hands of clinicians to help them not only be able to practice medicine better from a standpoint of diagnosing and treating but also down to where they are communicating and interacting with their patients. From a patient engagement perspective leveraging our technology so that from the moment that the individual steps to the clinical environment, that they are given the opportunity to have a good experience in that environment. And then further taking it to population health where sort of that intersection between the clinicians and the patients such that both are able to derive at the insights that are necessary for both shared decision making as well as for self-directed care where the individual is actually empowered to take on a more engaged kind of exercise if you will and better health.
[04:00] REENA JADHAV: And we really do have to get back to where the patient controls their health destiny. We have somehow thought that the doctor fixes our health but really that’s not the case, the patient has to fix their health themselves with the help of the doctor and the team. Let’s talk diagnostics which is sort of the first element you mentioned. I don’t believe we have cracked the code on accurate comprehensive diagnostics. What do you see coming down the pipe, what technologies are you excited about that can help us solve this diagnostic challenge?
[04:30] FRAN: Oh sure so one I wanted that first jumps out for me is the area of artificial intelligence in medicine. Great so really being able to start to gather insights and one way by which doing that is through patient generated data so if you think about it from the standpoint of the individual so common, the patient will go in and say they have got problems. And when they are in front of the clinician they are not exhibiting any of those symptoms we are talking about and so everybody is sick and they are crazy or in the old days they will tell you that you are just fatigued. So it’s from that standpoint we are able to take that intelligence and also being able to create things like data links where data is coming in from multiple sources and we are able to then layer on top these new tools, these new algorithms that allow for us to gain new insights that we were unable to do before. And then further beyond that level leveraging things like machine learning so to really be able to get to entirely different level with where we are going and a lot of sophistication which we are also seeing in areas like virtual reality, use of holographic imaging for 3D view of the body, just a lot if you think about it; the human body is 3D and think about for all these years we have been relying on 2D at the human anatomy and now to know that in the very recent years that we have been able to leverage 3D holographic technology. To begin to view the body and the way that the body truly is formed and exists has lent us to be able to do things that we just haven’t been able to do in that past.
[06:04] REENA JADHAV: And with far more accuracy colon cancer is a great example. Where finally we are starting to see a technology where you can actually do a 3D visual testicular spot on cancer and say this hugely invasive procedure.
[06:17] FRAN: Absolutely and that’s a great one because it’s introducing noninvasive, minimally invasive technology so it’s just this has been incredible.
[06:29] REENA JADHAV: I am going to ask you one more question on the diagnostics before we jump on to the others, which is 45% of women are told that their hypochondriacs when they go in with certain types of symptoms and it takes 5 doctors to get to finally a diagnosis and its always some form of auto immune. Are you focused on that because that’s hugely a female centric problem?
[06:50] FRAN: So you know I have to share something very personal around that and say first of all almost yes I am. My mother was one of those. My mother had myasthenia gravis and she was diagnosed very late and at the time she was diagnosed, she was in fact misdiagnosed the fact she was having a heart attack when she had what was called myasthenic crisis where her diaphragm actually had paralysis- that stopped functioning and so I am very familiar with that on a personal level. And this is why I go back to this concept of patient generated data from the standpoint that we are able to now level technology in ways. Look at it when a patient goes in, on average a patient might spend 7 hours with a clinician annually right. Seven hours on average so what happens the other thousands of hours outside of that environment that’s where real things are happening to real people. If you even go into think about a sports performance and arrhythmia Cinemax’s, high performance like athletes and yet we in the past we just stepped on a really poor job on being able to monitor patients and stay in touch with the patients population and I think this is where we have an opportunity to change things. Much of that change is coming through patient consumerism right. The consumer saying, “Look I want this electin to be very proactive”. And that is meant making an entire difference in the way things are happening. The other element to that is literacy. Everyone is going to doctor google we are so an increase in spite though it’s needed though right. We laugh about it but we think about the low rates of literacy and it has nothing to do with education levels but being able to put this information in the hands of the patients themselves, to better equip them to deal with the conditions they may be diagnosed with. To be able to take better preventive measures. These are the types of things that we do so as I had described these things, underneath it underlying are our technologies. So use of HP technology for telehealth medicines, virtual consoles, we engage with very large ecosystem of players in doing everything from pain management to patient education programs to retrospective studies on post Harvard and oblations basically atrial fibrillation patients or stroke patients utilizing our technologies in ways it significantly matter and that makes me feel good to know that we are doing that and it also makes me feel like I am doing something on behalf of my own mother who was just as you described diagnosed too late.
[09:39] REENA JADHAV: I am very sorry to hear about that but I am so glad that you are working on solutions. You know I come to conferences like this and I get so excited but then I step outside and it’s not fast enough, the change is not fast enough. I think earlier you and I were talking about the fact that our cellphone is too powerful now there is so much it can do and yet we are not leveraging its power for healthcare. Where do you see Fran? How can we get out faster with these technologies?
[10:08] FRAN: Look the reality is that there is cultural change that has to occur but there is also some fundamental things that we have to take into consideration and we can’t afford to overlook in health care and that begins with the oath right. First, do no harm so one of the things that we pride ourselves in particularly with HP is safer, smart and secure for health care technologies. It is not enough to say oh everybody has a cell phone, First of all not everyone has a cellphone. Secondly, even if they do have a cellphone, is that the cellphone that you want to use for a very complex chronic disease patient who is burdened with multiple disease states? Probably not. So we really have to be very conscientious about the type of technology we are looking at. Look, if you are inconvenienced by your bench walking all over sudden you get flick stops working on you, you might be inconvenienced. Your blood sugar might go up a little bit because you are frustrated but there is nothing really at risk right your life isn’t being threatened nor is on the line. So it’s really trying to make sure that in the expeditious manner in which we want to introduce these new technologies that we still uphold some standards and the quality of the products that we are introducing and those are the type of things that we are really putting heavy emphasis on and for which will then in turn seeing the medical community being more confident in embracing.
[11:35] REENA JADHAV: What about business model of liaison? Do you feel like we need to evolve the business models, the traditional models in order for these new technologies to get adopted or do you think we don’t really need to disrupt those models that we consider? Bring the new technologies in and slide them seamlessly in.
[11:52] FRAN: Well I mean you have to be accommodating right. I mean you go down to it and you are going to have some auditor who is looking at it from a claims adjudications perspective saying, “Wait a minute now what is this?” because the number wait a minute this is not the number plate associated with this particular car right. So we do have to begin to look at that. The other element is fundamentally we all recognize the need to move away from the episodic approach that we volume base medicine which is why there has been a brace around value based medicine and look it is not just at the United States, my prevue where I was responsible for is global and we see this around the world both in stronger industrialized nations as well as developing countries. This embrace of value-based system but what is unique about the models, is we see the bottles being most effective and most efficient in their ability to help improve outcomes is those which is much more comprehensive. So it is not just about treating one particular symptom or illness if you will but treating the whole individual and that really necessitates looking at an individual from a body, a mind and an emotional state of being and of course expending out of that all the other elements of spirituality and their components as well which in individual way one might recognize something that they need in order to be successful and the management of their care.
[13:26] REENA JADHAV: So in your role you have this fabulous eagle’s eye view of what’s happening in the phase and then what’s coming down. What is the one thing that you are most excited about as you think of that particular thing moving the needle and really changing lives of people in terms of them getting healthier?
[13:45] FRAN: Oh my goodness, you know there are so many I mean if I had to say first like three prints and the notion that we are able to print things in real near time, we are able to integrate sensor technology into that which enables us to do things like AI and machine learning and gather. It matters when you are getting a knee replacement or hip replacement surgery and we know the temperature, we can project whether we are going to have a failure and be able to go in and make those replacements very quickly. Those are real things that are happening. Yeah but when you look at the other end and you turn around you are like wow virtual reality and how we are able to leverage virtual reality to assist individuals with autism, to reduce senses of isolationism, reducing clinical depression, reducing symptoms of pain so it’s hard to pick one. It’s hard to pick one.
[14:46] REENA JADHAV: Make one prediction. What’s going to come true? What is something that the world doesn’t realize is going to come true in the space of mental health.
[14:57] FRAN: Specifically in the space of mental health, I think virtual reality is going to be it. I think that is something that we are really seeing, we are already seeing now right here at Stamford it is already being fully integrated in many areas including anesthesiology. We just had a conference on our artificial intelligence in Boston last week and we talked about how we are deploying with a non-environment and of pain management and using as a form of therapy. So I think these are the ones I can say very quickly there a lot of wins but let’s make sure that we don’t forget there are a lot of behind the scene things that are happening and so great examples of that are from a governmental perspective. The FTA’s their own acknowledgement in recognition of the rapid pace that’s with the technology as being introduced it’s a great indicator and them not wanting to slow down the progress that is being made.
[15:56] REENA JADHAV: Even for the current administration?
[15:58] FRAN: Yes absolutely. I mean in many respect they wanted to be very cooperative. They are seeking the inclusion and the prospective of not only large manufacturing enterprises like our own but also in the entrepreneurial community to understand the best ways in ensuring the safety because that’s what is really right safety first. Ensuring the safety of our citizens but at the same time being able to pick up the pace in terms of our ability to be able to make a difference. So there is a lot that’s happening on not only technology perspective but also on our policy and our regulatory perspective. We have got a win and the remote patient monitoring, we actually have our own code now for that so I mean these are big things that are happening. We don’t want to lose sight on that, they are not the obvious things that are going on. It’s not happening to everyone but those are the things that are behind the scenes that enable for this rapid adoption like the adoption of VR to come to intuition.
[16:58] REENA JADHAV: Absolutely, Fran thank you so much this has been fabulous.
[17:04] FRAN: Thank you!
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