On Oct. 1, the 20-plus-hospital University of Pittsburgh Medical Center (UPMC) health system announced that it had completed an agreement with several IT vendor partner organizations that will involve UPMC investing $100 million over the next five years on a comprehensive enterprise analytics initiative to foster personalized medicine and improve the patient care quality and cost-effectiveness of the Pittsburgh-based health system.
In a press release published Oct. 1, health system leaders introduced the ambitious initiative by asking the following questions: “What if a doctor could easily predict which treatment would be most effective and least toxic for an individual breast cancer patient, based on her genetic and clinical information? What if an intelligent electronic medical record could flag patients at risk for kidney failure, based on subtle changes in lab results? Or what if physicians could tell from the medical records of a large population of patients when the next outbreak of flu might occur and have the right kind and quantity of vaccine ready? These are just a few of the scenarios” behind the initiative, the press release noted, as it announced that UPMC was partnering with the Oracle Corporation (Redwood Shores, Calif.), IBM (Armonk, N.Y.), Informatica (Redwood City, Calif.), and dbMotion (Pittsburgh), all well-known vendors with various levels of healthcare presence, to use “advanced analytic and predictive modeling applications for clinical and financial decision-making… to produce better patient outcomes, enhanced research capabilities, continual quality improvements across UPMC, and reduced costs.”
With this announcement, and this initiative, leaders at UPMC, a $10 billion annual health enterprise with more than 50,000 employees, more than 20 hospitals, more than 400 doctors’ offices and outpatient sites, a health insurance services division, and “international and commercial services,” are excited to take yet another step forward on their journey towards the new healthcare, which in their case continues an established strategy of developing broad partnerships with vendors to leverage IT solutions for performance improvement, and in many cases, broader commercialization of the solutions developed.
Most broadly, UPMC senior executives say, this step along the journey confirms the organization’s determination to remain on the leading edge when it comes to leveraging information technology to support more transparent, accountable, effective patient care delivery and organizational effectiveness. “We’re a little bit unique in that we don’t have to wait for healthcare reform to improve quality and lower costs,” says Steven D. Shapiro, M.D., UPMC’s chief medical and scientific officer, emphasizing the fact that UPMC has steadily been moving forward on delivery system and care quality reform in the past decade. “So really, our goal is to develop new care delivery models that will achieve those things, and that will leverage big data and science to do that. And now that we’re able to take all this information from the electronic record and turn all this information into intelligence, that moves us forward.”
Steven D. Shapiro, M.D.
Importantly, Shapiro says, “We’re trying to develop evidence-based pathways; and once we develop some standards around care delivery, we’ll see where that leads us. But it’s really about reducing variation and optimizing care models,” he emphasizes. “We also don’t really know how much things cost, so we’re going to be developing information on bundling and other elements. And then there’s the personalized medicine element.” Leveraging analytics to build on both macro and micro levels simultaneously, Shapiro says that, “From a population health standpoint, we need to standardize care delivery and reduce variations in care, and then add that variation back to the individual, once we understand the individual patient’s disease profile. And all these elements, we think will take years, but we are starting down that path.”
All of this activity speaks profoundly to UPMC’s core vision and mission, says Lisa Khorey, UPMC’s vice president, enterprise systems and data management, and one of the key leaders in the initiative. “The organization aims to really bring together new models of care, based on good science and smart technology,” Khorey stresses. “You can look at it as a triangle, with all three elements feeding each other. And that model really works for us, because we have a very integrated provider-payer system with close academic ties and a culture of innovation, and one that is trying to improve quality and decrease cost. So it forces an awareness of how we might be able to solve these problems.”
As for the prominent vendor companies partnering with UPMC health system on this initiative, Neil de Crescenzo, senior vice president and general manager, Oracle Health Sciences, at Oracle Corporation, has a ready answer, when asked what he and his colleagues at Oracle hope to get out of the UPMC partnership. “What we hope to obtain together is really a proof point for the vision of how the types of analytics we provide can really be used to impact patient health,” de Crescenzo says. “That’s why, even though it’s early days yet, our partnership with UPMC has been so fruitful, because we share the same vision. So if the kinds of systems they’re developing and we’re supporting become the norm in American healthcare in the next three to five years, that’s what I hope to get out of it.
Likening the collaboration to the partnerships that Oracle has with the countries of Singapore and Australia on their nationwide electronic health record (EHR) initiatives, de Crescenzo, who notes that Oracle will also be partnering in a similar way with the government of Norway, shares his perspective on the scope of the UPMC initiative. “I think that what’s unique about this,” he says, “is that UPMC, being an integrated enterprise, including with their health plan operation, they’re really second to Kaiser Permanente in this country” with regard to size and level of operational integration, “and the ability to do something on this size and scale, is a unique opportunity.”
Of course, UPMC’s leaders recognize that most patient care organizations nationwide won’t be able to afford $100 million on analytics initiatives like this, yet at the same time, they believe that the principles behind the new effort they’re embarking on can be widely applied. Asked what the leaders at organizations with fewer resources might be able to do in this area, Shapiro says that, “While they might not be in a perfect position to improve quality and lower costs, in some ways, we’re all being driven towards that [imperative]. So they need to understand the power of analytics, and structure and use data to learn about their business, to save money, and to move forward into the future. So,” he says, “I would tell them they have to highly prioritize their data and learn from it, because that will really help them survive and thrive.”