June 4, 2018
The Future of Healthcare Tastes Like Broccoli
Lessons from the HLTH Future of Healthcare conference in Las Vegas
“We have 13 hospitals in our system. I think my job is to close all of them.”
With that, David Feinberg, MD, CEO of Geisinger Health, put an exclamation point on his remarks at The Future of Healthcare conference in Las Vegas earlier this month.
“For us, what really matters [for good health] is so much about what’s happening outside the clinics or outside the hospitals. We spend too much time talking about great doctors and hospitals and treatments. Access to healthcare probably has a 20 percent effect on your overall health.”
So, what matters more? Your genetic code. Your zip code. Who you are. Where you live.
“Your genetics,” says Dr. Feinberg, and “your ‘zenetics.’”
This theme threaded through the four-day conference self-described as “an industry event creating a much-needed dialogue focused on disruptive innovation in healthcare” where “NextGen Healthcare” can be achieved (along with word salads, apparently).
It’s a theme with two notes:
- Genetic sequencing and digital technology will radically customize medicine and inform people about their health, and,
- Social determinates of health (your community and lifestyle, in the human tongue) will, well, determine your health.
The conference coupled the latest in medical and digital advancements with disciplines and wisdom as old as healthcare itself.
There’s an underlying theme: In the future of healthcare, hospitals are no longer the center of gravity.
Here’s Lloyd Minor, MD, Dean of the Stanford School of Medicine: “Traditionally, academic medicine has been focused on tertiary care. Increasingly, empowered by digital health, we can now be focused on prediction and prevention. This very much requires each of us to be engaged in our own health. That’s where it’s all going.”
Dan Buettner, the “Blue Zones” author who found places throughout the world where people live long and well: “How do they do it? They move 30 minutes a day, they have a sense of purpose, they eat right, they have a social network. They live a decade longer than we do. It’s not one thing. It’s not a silver bullet. It’s silver buckshot. They don’t call it healthcare. They call it life.”
Troy Brennan, MD, Chief Medical Officer for CVS Healthcare: “CVS wants to create a new chassis for population health management. We want to combine data with convenience, we want to combine digital with the easy retail experience and human touch so important to any healthcare outcome.”
And, finally, John Driscoll, CEO of CareCentrix: “Social determinants of care is a ridiculous phrase. It just means the things that surround a person so they can be healthy. Broccoli is cheaper than drugs. Cracking the genomic code is hard. Cracking the zip code is easy. It’s not wow healthcare innovation, but what if we start by just feeding people who are hungry?”
What might this future look like practically? Geisinger now offers all its patients genetic screening, free of charge. “It should be routine clinical care, like a colonoscopy and mammography,” Feinberg said. “Let’s take your blood. Let’s take your temperature. Let’s take your genome.”
How do you treat a zip code? After all, your zenetics can shape your income, your access to healthy food, the likelihood that you’ll exercise, the size of your social circles and more.
“Twenty to 30 percent of our patients are worried about whether they will have enough food, whether they are commercial patients or not,” Feinberg said. “And when you are food insecure, you buy high-calorie food that increases your chance of Type 2 diabetes. Diabetes is a foodborne illness.”
So, Geisinger transformed one (and then many) of its pharmacies into “Fresh Food Farmacies” where patients can have food prescriptions filled with fresh produce. “We want our pharmacies to look like Whole Foods,” he said. Though the program started small, by next year it will have served 1.5 million meals to families in the Geisinger service area.
“Typically, those diabetics were costing us $200,000 a year,” he said. “Within three months of this program, their healthcare costs plummeted to $40,000 a year and it costs us about $1,000 a year to do it. Now we’re scaling the program for folks who have pediatric obesity and heart failure.”
The future of healthcare will be a marriage of the radically new and the terribly old; leveraging the latest medical advancements, eating your vegetables, and avoiding traditional “healthcare delivery” at every turn.
Hospitals will need to find their place in all of this. Geisinger operates with a great advantage: Its system includes a health plan, multiple hospitals and thousands of doctors spread across rural Pennsylvania. Still, its holistic vision of the future of healthcare is compelling.
Feinberg, one last time:
“In my lifetime, life expectancy has gone down. That’s criminal. I know that out of the 2,000 beds we have [at Geisinger], if people ate right, used alcohol in moderation, didn’t use illegal drugs, wore seatbelts, ate healthily, had access to broccoli and blueberries and didn’t shoot people with guns, 1,000 of those beds could be gone. We could do a lot of breakout sessions talking about reducing the cost of pharma, or we could get people off drugs in the first place.”
Future will focus, he said, on what really matters.