Issue link: https://beckershealthcare.uberflip.com/i/1353232
98 98 THOUGHT LEADERSHIP Yes, I want to get married. But what about the prenup? By Stephen Klasko, MD, President and CEO, Thomas Jefferson University and Jefferson Health W e need a new, refreshing, ethical and ultimately empowering "marriage" of healthcare and technology. And we need it now. You can't go anywhere without hear- ing about the digital transformation of healthcare. And yes, I believe that in order to move from a sick care to a health assurance model, we need a fundamental reorientation of how we in the healthcare system view ourselves and our colleagues in the technology sector. We need a new, refreshing, ethical and ultimately empowering "marriage" of healthcare and technology. And we need it now. is marriage is critical. Health assurance means a profound rethink- ing of how we see people. We have to shi from seeing "people as patients" to a "people as people who want to thrive without healthcare getting in the way." Much like climate change, healthcare's inequities, access and cost have become a worldwide existential crisis. But this rethinking will not happen unless there is a true marriage between healthcare providers, technologists, founders and executives dedicated to the concept of health assurance, using data, technologies and talent to provide individuals and populations a path to living their healthiest lives. Healthcare will not be transformed solely by Silicon Valley entrepre- neurs, artificial intelligence and extreme innovation. We've all attend- ed conference showcases where hundreds of talented young minds offer the latest revolutionary solution or app to every imaginable problem. And yet, healthcare delivery in the U.S. remains confusing, piecemeal, occasionally unsafe and deeply inequitable. And yet — the revolution is coming. As Bill Gates and others have said, we overestimate technology in the short run and underestimate it in the long run. Within our health centers, there are insider rev- olutionaries ready to build transformation. And there are entrepre- neurs committed to long-term creative partnerships, not just selling a new thing. We believe the revolution of connected care is only a few years away. We will indeed see "healthcare at any address," using the tools of AI-driven data analysis to develop highly personalized screening and action plans for each individual. We believe healthcare will be called on to help people thrive in their pursuit of happiness, not wait to in- tervene when someone is acutely sick. We believe people will demand the ease of access and integration that they see throughout their lives as consumers. But this marriage clearly needs a prenuptial agreement. Aer all, mar- riages only work when they are based on trust. For a marriage be- tween those leading the fourth industrial revolution — drones, robot- ics, personalized medicine, genomics — and the traditional healthcare ecosystem, "trust trumps technology." We are in a historic industrial cycle. Industry transformation, new business models and the digital economy will require all of us to fundamentally change our strategies, just as a successful marriage requires both partners to shed some of their previous ways of doing things. We are seeing the digital transformation of all industries, of all elements of life, indeed of work itself. Even the arts, so dependent on legacy buildings, are finding new ways to engage audiences online. It is time to understand what's gone wrong in the relationship between Silicon Valley and traditional healthcare. • You do not need to "fail fast" to "learn quickly." • Healthcare needs system solutions, not one-off apps. • Trust comes first in healthcare. • Equity matters. So far, too much of digital medicine has been fo- cused on making the wealthier healthier, fitter or happier. Now for the prenup. Each of those problems suggests an answer: • Re-imagine what "integrated health" means. We call it health as- surance — the focus on using high-level data analysis and digital tools to support people (not patients) to thrive. • Seek creative partnerships for transformation, not vendors for one-time deals. At Jefferson Health in Philadelphia, we have a repre- sentative of Silicon Valley's General Catalyst sitting on the president's cabinet, positioned to see the full picture and offer linked solutions. • Ethics must be part of the design of any product — at the be- ginning of development, not at the end. Too oen compa- nies wait until the product is ready, and then ask marketing to make it appear trustworthy. Put people in the middle as "online meets offline." • Healthcare has a mission to combat the disparities caused by pov- erty. Social determinants and health inequities need to move to the mainstream of clinical care, payment models and medical education. e research studies are clear. People who are poor or people of col- or can too oen be offered therapies different from those offered to wealthier individuals. We have an incredible opportunity to use the tools of AI-driven personalized medicine to reverse discrimination. It is our mandate to do that. Despite the rocky "first dates" of Silicon Valley and traditional health- care, COVID-19 did in fact call the question. Overwhelmingly across the U.S., patients were supported via telehealth, as if it had been dis- covered only in the pandemic emergency. Technology allowing peo- ple with chronic conditions like diabetes, such as Livongo, went from luxuries to necessities and have resulted in better care at a lower cost. So, what could go wrong? What scares us about the acceleration of the digital revolution in healthcare is that we won't get this marriage be- tween technology and healthcare delivery right. It is our responsibility to create the restructuring of the next 100 years that will leave the world a better place. Shame on us if there are congressional commit- tees five years from now asking us why we didn't see the bad and ugly of what we were creating as well as the good. In other words, how do we create a consumer-driven "healthcare at any address model" that relies on responsible innovation. Story continues on page 99