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At HLTH, a Candid Discussion of What the Federal Government Can and Should Do to Promote Healthcare Innovation

May 11, 2018
by Mark Hagland
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At HLTH, UPMC’s Rasu Shrestha spoke with HHS CTO Bruce Greenstein and former U.S. CTO Aneesh Chopra to talk about innovation

At the HLTH Conference held this week at the Aria Resort in Las Vegas, the session entitled “U.S. Government Investing in Health Innovations” stimulated candid, oftentimes-spirited discussion of the role of the federal government in promoting technological and service innovation in the U.S. healthcare system.

The session held on Tuesday, May 8, and led by Rasu Shrestha, M.D., the chief innovation officer at the 30-plus-hospital, Pittsburgh-based UPMC health system, and executive vice president of UPMC Enterprises, its technology test-bed division, included two other panelists: Bruce D. Greenstein, Chief Technology Officer in the U.S. Department of Health and Human Services, and Aneesh Chopra, former CTO of the United States, and now president of CareJourney, an Arlington, Va.-based consulting firm and solutions provider founded in 2014 to help patient care organizations transition to value-based payment models.

Dr. Shrestha and Messrs. Greenstein and Chopra discussed a wide range of topics, around how, to what extent, in which contexts the federal government can or might act as a facilitator and catalyst for technology and other progress in U.S. healthcare; as well as payment- and data security-related considerations around innovation.  As Shrestha said at the outset of the session, “We all know about the Washington in the headlines,” the Washington of political conflict and division. But beyond that Washington, he said, “There’s a quiet Washington that continues to do a lot of work.”

Rasu Shresta, M.D., Bruce Greenstein, and Aneesh Chopra on May 8 at HLTH

In that context, Shrestha asked Bruce Greenstein to describe the KidneyX Project, which is described on HHS's website thus: “Each year approximately 4000 organs recovered from deceased donors (nearly 3000 kidneys) were not used for transplant and instead were discarded. This project proposes to analyze the underlying causes of the high rate of kidney discards and identify tools to provide transplant physicians and patients with better information on kidney quality and expected outcomes to inform decision-making and reduce the risk of discard. Based on input from multiple end-users and stakeholders these may include improved information-sharing, data analysis tools, and proposed changes to organ transplant systems and policies. The goal” of the initiative,” the HHS website says, “is to increase the number of successful kidney transplants and reduce kidney transplant waiting times.”

Speaking of the initiative, Greenstein explained to Shrestha that “It’s not regular government innovation, or the kind where you have a little festival for a day and say you’re so innovative. My mom died in 2008 of kidney disease, at 59 years old, after 15 years with kidney disease. I remember taking her to the dialysis center, where the machines, the care, everything, was set up in the exact same way as 15 years before. In fact, for 60 years, there’s been no innovation in the end-stage renal disease care in 60 years. And there’s massive market failure. We spend more on kidney dialysis than the entire Department of Commerce, NASA, and you can throw in the FTC and FEC as well—so our idea was to change the market. We went out and asked investors and innovators why there hasn’t been change. They said, well, you guys seem to like it as it is. So we’re using the federal government’s X Prize funds to encourage invention and innovation, so we can pay differently for this. This is one example of an area where the government can address market concerns and innovations.”

“Is this perhaps a clever way also for the government to cleverly start working with the private sector?” Shrestha asked. “You’re very clever!” Greenstein replied. “Yes, this is a perfect way to start. And we also want to try to start to fix one piece after another, to use the power of investors, VC [venture capitalists], and material scientists and engineers, people from outside the industry, to address our issues.”

Turning to Aneesh Chopa, Shrestha said, “During your time as CTO, you saw a radical shift around data. Pace of innovation hasn’t caught up. What’s your perspective on this?” he asked, cited the potential for public-private collaboration around data analytics, information technology, and other forms of technology development.

“Bruce and I will do our best to demystify the avoiders,” Chopra said. “So here’s what I’m going to context: the government historically has been a participant in the innovation economy mostly by investments in infrastructure, setting rules of the road broadly, or setting a target like going to the moon. In 2008 when President Obama was running for president, he said he wanted us to close the innovation gap between the pace of change in the private sector and that of the government. So we had a theory of how we would make this shift, and that theory involves a new form of government investment that I want to make sure to communicate here.”


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