Trump appointees cheered by both Republicans and Democrats. Venture capitalists venting about too much investment cash. Data nerds decrying the deification of artificial intelligence.
For two days, Health Datapalooza 2018 offered a glimpse of a Washington where all sides work in harmony “to improve Americans’ health through better data,” in the words of Eric Hargan, deputy secretary of Department of Health and Human Services (HHS).
Not to mention the goal of improving health care economics. Enable digital health entrepreneurs to earn millions of dollars in profits, goes the logic, and their innovations will help the feds and others avoid paying many more millions of dollars in health care bills.
Health Datapalooza began nine years ago as a showcase for public-private data partnership. The shining example back then was the way the release government meteorological data had paved the way for online apps like weather.com. What was significant at this year’s event was not so much the sweeping rhetoric as the signals sent by HHS that it will accelerate the push by previous administrations towards value-based payment.
So, for instance, Seema Verma, the administrator of the Centers for Medicare & Medicaid Services (CMS), said CMS will ask private insurers and state Medicaid programs to require hospitals to provide patients with their own data electronically. The Medicare program wants to make that requirement part of the “conditions of participation” for hospitals in Medicare; i.e., do this or you can’t participate in the program that’s your largest customer.
“The expectations of CMS have changed,” said Verma. “Patients can never again be kept in the dark with regard to their health care information.”
This CMS requirement would have enormous economic consequences. Information is power, and consumers would gain the power to share information in person or online with other hospitals and doctors anywhere. Patients might even be able to access a direct-to-consumer decision support tool of the type that could benefit from the streamlined approval process for digital health products announced by Dr. Scott Gottlieb, commissioner of the Food and Drug Administration.
“If we need disruption to deliver the care Americans deserve, then disruption is on the way,” declared Hargan.
This was impressive, but more deeds need to follow the words. For example, Verma’s assertion that the form in which data is released will easily sync with online apps does not appear to be part of the formal proposed changes. We’ll have to wait and see how well the rah-rah of Datapalooza survives the reality of Lobbyist-palooza.
Meanwhile, as the conservatives were countenancing disruption, the venture capitalists were bemoaning the allure of easy money. Emma Cartmell, who heads her own firm, told of a non-health care company that had come to her seeking a $1 billion health care acquisition simply because the health care market is so alluring. Venrock’s Bryan Roberts summarized the situation this way: “The capital environment is as permissive as it’s ever been,” with more money than good ideas.
Even with a good idea, the daunting health care sales cycle has not changed. The VCs emphasized that entrepreneurs must be “brutally honest” about ensuring that their product can provide a concrete return on investment in just 12 to 18 months. That’s a formidable hurdle.
In a similar reality check, Sumit Nagpal, a veteran entrepreneur and managing director of Accenture, said his firm’s consumer survey found that individuals still prefer in-person care to online artificial intelligence (AI) tools. In that same vein, Jen Horonjeff, founder of the Savvy patient coop, noted that while AI is popular in theory, consumers remain “very skeptical” about privacy and monitoring issues in actual practice.
Health Datapalooza has always been more technocratic than partisan. This year was more sedate than some. (At the end of the 2015 event, as I chronicled, three exuberant participants pulled out flasks of whiskey to share.) This time, what stood out was the atmosphere of collegiality and shared goals, even among those with genuine (and expressed publicly) disagreements on how to reach those goals.
For me, one small moment away from the spotlight stood out. Backstage, Susannah Fox, the last HHS chief technology officer under the Obama administration, greeted her successor in the Trump administration, Bruce Greenstein, with a hug.
That’s not the kind of camaraderie you see on either CNN or Fox. And yet, for all that, it was not in any way fake news.
Michael Millenson is President, Health Quality Advisors and a contributing editor to THCB.