Panel: Taking the Providers’ Perspective

Jim Peters, System Vice President, Geisinger Health System

Roy Rosin, Chief Innovation Officer, University of Pennsylvania Health System

Healthcare providers need help to address the burning issue of improving patient outcomes while reducing healthcare costs. Access to the pharmaceutical industry’s data analytics capabilities and channel power, as well as support for large-scale research projects, are needed, but such collaboration won’t happen until the pharmaceutical industry changes its business model. These were the conclusions of two representatives from healthcare providers: Jim Peters of Geisinger Health in Danville, PA and Roy Rosin of the University of Pennsylvania Health System (Penn Medicine) in Philadelphia.

Understanding the providers’ perspective provides insights in point-of-care patient interactions, but “there is a strong awareness that we ourselves cannot bring a solution to the marketplace,” Peters said. “The tremendous resources of pharmaceutical companies make them logical partners to help us provide these solutions to the marketplace.” And not only can pharma bring solutions to the marketplace, but Peters believes they should be the ones introducing such solutions. The synergy gained when research from pharma and academic centers are combined is the boost needed to replace today’s floundering business model. The key asset pharma brings to collaboration is the “quality of science and process that does not exist in academia,” noted attendee Amanda Christini, Director of Strategic Initiatives at Penn Medicine’s Center for Health Care Innovation. “Pharma understands what is needed to get from A to B; this know-how can be brought to bear in a very powerful way.”

While the pharmaceutical industry is a logical group to provide beyond-the-pill solutions, it’s clear that most pharma companies are not ready to make this leap. “Large pharmaceutical companies are driven by MDs and PhDs, who are extremely data-driven and used to having 95% confidence intervals before they do anything,” Peters said. “With medicine, that’s the right approach, but in business decisions, we go with something if we believe with 50.01% certainty that it will be successful. You need to have this attitude with innovation.”

Geisinger Health is a mid-sized managed care provider that has the advantage of having one board and one CEO to handle decisions on both the physician and patient sides. Penn Medicine, on the other hand, is a $4 billion provider system tasked with growing by 10% each year—the same challenge faced by many pharmaceutical companies. “Our real challenge is to build an organization that loves $20,000 projects again,” Rosin said. “Find out where you have traction with small projects and then place larger bets. It’s important to get it right before getting it big. You need to change your dashboard, change your metrics.”

Geisinger, Peters said, has no plans to grow outside of its geographic area. But it is growing a culture of innovation. “Geisinger did not have a culture of innovation when I came there,” Peters said. That began to change in 1995 when the healthcare system became Epic System’s second customer for electronic health records that can be shared across geographical and organizational boundaries. Over time, its longitudinal patient customer base has grown. Peters spun off a business that normalizes and de-identifies its patient data, which is then licensed to companies who use the information to conduct pharmacoeconomics studies. “This example shows how you can utilize the latent assets in your company to bring about sustainable innovation.”

“Whatever solution you are building needs to be co-designed with physicians who understand their patients’ preferences and attitudes toward health and disease,” Peters said. Geisinger has worked with several pharma companies in co-creating Level 3 models; their successes have stemmed from the companies’ ability to directly address these challenges.

Rosin, the Chief Innovation Office for Penn Medicine, admits his industry is changing at a fundamental level. It’s important to get the 360-degree view of all of the players in the industry, he said. What are your company’s competencies? Do your customers see the same competencies?

“There are Level 3 models with 360-degree solutions,” Rosin said. “A study we are running now at Penn, which uses the Way to Health technology platform, is looking at ways to increase medication adherence rates. At the start, only 40% of patients were taking the prescribed medicine,” Rosin said. “All patients had suffered a myocardial infarction (MI) and were given the same medication, which was low priced and had few side effects.” The study’s intervention uses a blended model of technology and human interactions to help improve patient adherence to the post-MI medicine, which is vital for preventing another heart attack. At the 30-week time point in the study, which will run for 5 years, adherence rates had climbed to 96%. Interventions based solely on people-to-people interactions gets results, Rosin noted, but usually there is lower ROI. Technology-only solutions have the advantage of being new and “exciting,” Rosin said, but in the end, “they don’t really change things. Look into the middle,” he said. “Get the right people at the right time in the right way. That’s what we believe we’ve done with our MI medication adherence study with our Way to Health platform.”

Innovation is much easier at start-ups, Rosin acknowledged. As start-ups morph into large companies, the pace of innovation and decision-making slows. As one of the founders of Intuit before joining Penn, Rosin gained insights for making innovation part of business-as-usual. “There’s more to innovation than just throwing dollars at it. Look at your manager’s calendars and see where they are spending their time. Are the big deals still what are celebrated and rewarded? Many companies say innovation and then emphasize the usual business model. With few exceptions, most pharma companies don’t even acknowledge the barriers to reaching a total customer solution. They must be willing to make the magnitude of investment that the transformation will need. Pharma companies need to invent products that are used, not just products that are useable. They need to develop an appetite for risk sharing,” Rosin said.

While providers are building databases of patient behaviors, Rosin noted that the pharmaceutical industry has a unique perspective on what motivates patients. “As healthcare providers and payers we need that information,” Rosin said. Patients need more than just reminders to take their prescriptions. For instance, some medicines increase the need to urinate. What if the patient is a bus driver and is expected to be on the bus for hours at a stretch? Rosin asked. What that patient needs is help finding bathrooms on his or her route or even a portable bathroom.

Both Peters and Rosin agree that pharmaceutical companies can and should take an active role in developing Level 3 customer solutions. “Pharma companies and patients are the key to improving outcomes while decreasing costs,” Peters said. Payers and hospitals are looking for partnerships with pharmaceutical companies that will give them access to industry data analytics capabilities and patient information from clinical trials. “We want to improve adherence rates because the medicines pharma creates work, and they help people stay alive and lead better lives,” Rosin said.