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How 'a single source of truth' can get digital health back on track

Illustration of a phone wearing a doctor's coat and a stethoscope.

Illustration: Aïda Amer/Axios

Health tech risks replicating many of the mistakes plaguing the traditional care system, leaders told Axios at the J.P. Morgan Healthcare Conference. Luckily, there are ways to change course back toward innovation and improvement.

Why it matters: Digital health promises more convenience, healthier patients and lower costs — basically the opposite of what the traditional U.S. health care system currently delivers.

Yes, but: Our nation continues to spend more on health care per capita than virtually any other high-income country while ranking last on access to care, administrative efficiency, equity and health outcomes.

The details: Leaders from Morgan Health, Cityblock Health, Town Hall Ventures and Included Health offered some tips for digital health players at a Monday panel:

  • Rightsize models based on sub-populations.
  • Enable quality transitions between care.
  • Create a single source of patient data, such as an electronic medical record (EMR) that incorporates social determinants of health alongside clinical and claims information.
  • Put clinicians in positions of power and let health care workers do what they're trained to do.
  • Look to Medicaid as a model for holding providers to outcomes standards.
  • Fixate on patient-reported outcomes, including positive metrics such as the CDC's Healthy Days Measures and trust in caregivers.

What Morgan Health is saying: Its newly named managing director, Cheryl Pegus, told Axios she's focusing on allowing health care workers to do tasks they're trained to do and emphasized the importance of outcomes and data.

  • "With team-based care, pharmacists should be doing injections, not doctors," she said.
  • "To get outcomes, you need the right data, and that's not just claims data," she added, pointing to Kaiser Permanente's integrated model, which incorporates social determinants of health, such as homelessness and food insecurity, into its EMR.

What Cityblock is saying: Patients and caregivers would benefit from "a single source of truth," or an EMR that included lab results and diagnoses alongside elements of patients' social milieu, co-founder and CEO Toyin Ajayi said at a panel that Axios moderated Monday.

  • A common problem among dominant EMRs today is that "the social milieu is absent," she said. For someone with diabetes, for example, whether they are "sleeping on the street is just as important as their A1C [blood sugar] levels."

What Town Hall Ventures is saying: General partner Andy Slavitt said at the same panel that transitioning care environments often result in negative outcomes, including hospital and emergency department (ED) readmissions.

  • A 2016 study published in the Journal of Perioperative and Critical Intensive Care Nursing notes "serious quality problems for patients," including, for example, "high rates of re-hospitalizations and ED visits as consequences of ineffective care transitions."

What Included Health is saying: Doctors should play leadership and decision-making roles at digital health companies, chief health officer Ami Parekh said at Monday's panel.

  • "Invite them in," Parekh said. "Put them on the board, make them part of the executive team, give them decision-making roles."
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