July 16th, 2014 · Leave a Comment

Modernizing the Clinical Trial System to Meet the Needs of Patients

By Sundeep Khosla, M.D.

Sundeep Khosla, M.D.The future of health care in the United States requires modernization of clinical trial regulations and processes. On July 9, I had the opportunity to deliver that message and stress its importance in testimony on behalf of Mayo Clinic before the U.S. House of Representatives Energy and Commerce Subcommittee on Health. As part of the full Committee’s 21st Century Cures Initiative, the Health Subcommittee held a hearing focused on policy issues surrounding clinical trials. I applaud the Committee’s interest in this issue and urge continued focus on the need for reform to reduce the length of time from target discovery to approval of new drugs and treatments.

As I reported to the Committee, the average length of time from target discovery to approval of a new drug currently averages approximately 14 years, the failure rate exceeds 95 percent, and the cost per successful drug exceeds $2 billion, after adjusting for all of the failures. This situation must change.


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Tags: futureofhealthcare, CCaTS, clinical trials, Dr Khosla, Dr Sundeep Khosla, Future of Health Care, Health Care, patient care, Sundeep Khosla MD

July 10th, 2014 · Leave a Comment

Telemedicine and the Future of Health Care

By Admin

telemedicine word cloudThe future of health care is moving towards providing safe, quality care via telemedicine; however, the patchwork of state-by-state medical licensing rules inhibit the delivery of medical services through telemedicine. Patients should not have to take a road trip to access Mayo Clinic’s medical expertise and knowledge. “Cross-border licensure is a strategic imperative as we move forward in this brave new world,” said Kathleen Harrington, chair of government relations at Mayo.

Mayo’s vast cadre of subspecialists — who diagnose and treat very rare and complex conditions — should be available to physicians in any location to help them bring safer care, better outcomes, fewer redundancies, and ultimately higher quality and cost savings for their patients.  Mayo Clinic provides subspecialty expertise through telemedicine to physicians in its Mayo Clinic Care Network of more than two dozen hospitals and health systems, including Dartmouth-Hitchcock in New Hampshire; NorthShore University HealthSystem in the suburbs of Chicago; Baptist Health Care in Pensacola, Fla.; and ThedaCare in Wisconsin.

In stroke telemedicine, also called telestroke, neurologists remotely evaluate people who have had acute strokes and make diagnoses and treatment recommendations to emergency medicine doctors at other sites. Having a prompt neurological evaluation increases the possibility that a patient may receive clot-dissolving therapies (thrombolytics) or other clot-retrieving procedures in time to reduce disability and death resulting from stroke. 

telerobotResearchers recently found that telestroke appears to be cost-effective for society, and study findings were published in The American Journal of Managed Care. "This study shows that a hub-and-spoke telestroke network is not only cost-effective from the societal perspective, but it's cost-saving,” says neurologist Bart Demaerschalk, M.D., director of the Mayo Clinic Telestroke Program and the lead investigator of the telestroke cost-effectiveness study. “We can assess medical services, like telemedicine, in terms of the net costs to society for each year of life gained."

The study estimates that compared with no network, a modeled telestroke system consisting of a single hub and seven spoke hospitals may result in the appropriate use of more clot-busting drugs and more catheter-based interventional procedures and other stroke therapies, with more stroke patients discharged home independently. Despite upfront and maintenance expenses, the entire network of hospitals realizes a greater total cost savings.

The improvement in outcomes is associated with reduced resource use (inpatient rehabilitation, nursing homes, caregiver time). Although treating patients in a telestroke network is associated with higher upfront costs due to the setup of the telestroke network and more costly treatments during the initial hospitalizations, it can potentially lead to cost savings over a lifetime. “The results serve to inform government organizations, insurers, health care institutions, practitioners, patients and the general public that an upfront investment in telemedicine and stroke network personnel can be justified in our health system,” Dr. Demaerschalk says.

For more information on telemedicine, please view the videos featured in the following Mayo Clinic YouTube playlist:

Tags: futureofhealthcare, Bart Demaerschalk, Dr Bart Demaerschalk, Future of Health Care, Mayo Clinic, Mayo Clinic Care Network, telemedicine, telestroke, telestroke network

July 2nd, 2014 · Leave a Comment

Measuring Value: From Theory to Practice

By Jayant A. Talwalkar, M.D.

Jayant Talwalkar, M.D.As the future of health care moves forward, patients, providers and policymakers have converged on the shared goal of creating value in the U.S. health care system — high quality health care that contributes to favorable patient-centered outcomes and lower costs. Although these various stakeholders may define value in slightly different ways, all views are important and interrelated.

Since the Affordable Care Act was passed four years ago, the government has made efforts to identify innovative models of care tied to quality and reimbursement. However, it remains difficult to define and measure the value of care provided by individual providers or health care organizations.  Current measures of clinical performance may not be producing better quality or reducing costs.  For example, emerging data suggest that measuring individual provider performance (i.e. achieving optimal blood hemoglobin A1C levels) bears little relation to the health of patients with diabetes mellitus.


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Tags: futureofhealthcare, Future of Health Care, Institute of Medicine, Jayant Talwalkar

June 25th, 2014 · Leave a Comment

The Future of Health Care and Social Media

By Admin

Can social media sites such as Google+, Facebook, and Twitter impact the future of health care? Ask the Mayo Clinic experts and over 300 participants who joined last week's Twitter chat, #CIMChat, to discuss immunotherapy, and their resounding answer would be, "yes!"

Health care Twitter chats have the potential to reach millions of individuals on a wide variety of topics ranging from general health and wellness to cutting-edge research and treatment options for rare diseases.
We're ready to tweet from @MayoClinic Bring your ?s to the #CIMchat w/ @TIME's @AliceParkNY pic.twitter.com/nqr3L7lRKa

— Dana Wirth Sparks (@danawsparks) June 18, 2014

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Tags: CIMchat, futureofhealthcare, Alice Park, Cancer Center, Future of Health Care, immunotherapy, Mayo Clinic, Social Media, Twitter, Twitter chat

June 18th, 2014 · Leave a Comment

Concussion Summit at the White House

By Admin

A concussion word cloud in  the shape of a brain including numerous words related to concussion such as striking, neurologist, and sensoryThe future of health care at Mayo Clinic continues to raise awareness of concussions in youth athletes with the goal of preventing concussions and protecting our athletes' brains. A step forward in accomplishing this goal on a national level occurred at the White House Healthy Kids & Safe Sports Concussion Summit, where more than 200 participants including medical experts, coaches, parents and players joined President Barack Obama in Washington, D.C., to talk about ensuring children's safety in sports.

David Dodick, M.D., a neurologist at Mayo Clinic in Arizona and an expert in concussion care and research, joined other medical experts and President Obama at the summit. Dr. Dodick shared how the summit, "highlights this as a public health crisis, and elevates this to a national health priority." [...]

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Tags: futureofhealthcare, Arizona, concussion, concussion summit, David Dodick, Dr Dodick, Future of Health Care, Mayo Clinic

June 10th, 2014 · Leave a Comment

Surviving and Excelling During Health Care Reform

By Admin

Mayo ClinicThe future of health care faces challenges as fragmented patient care and uneven quality of care contribute to rising health care costs and excessive spending. For more than a decade, Mayo Clinic has anticipated and prepared for the confluence of these challenges that has arrived on our doorsteps today. Health care leaders throughout the country must manage these complexities in order to sustain their medical practices during this period of profound change and maintain excellence in our health care delivery system.  [...]

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Tags: futureofhealthcare, ACA, Affordable Care Act, Center for Innovation, Dr John Noseworthy, Dr Noseworthy, Future of Health Care, Harvard Business School, Innovation, John Noseworthy, Mayo Clinic, Mayo Clinic Care Network, Michael Porter, Noseworthy, patient care, Professor Porter, telemedicine

June 3rd, 2014 · Leave a Comment

Apple Unveils HealthKit and Highlights New Mayo Clinic App

By Admin

Apple Mayo appThe future of health care embraces mHealth — medical services delivered via mobile devices — as nearly 100,000 health-related smartphone apps are helping people improve their overall health with tools to track their personal health and fitness data as well as connect with their physicians. At the WorldWide Developers Conference (WWDC) 2014 keynote address, Apple unveiled HealthKit, a digital repository for various types of health- and fitness-related data. Apple will also collaborate with Mayo Clinic through a new Mayo app under development that would offer users a more personalized experience and make their health data more actionable in supporting healthier lifestyles.

The Mayo Clinic app, connected to HealthKit, has the potential to more effectively deliver high-quality, affordable health information, guidance and care to everyone. Mayo Clinic continues to lead the digital future by better connecting providers and patients while sharing our medical knowledge more broadly than the 1.2 million patients who come to Mayo each year. John Wald, M.D., a Mayo Clinic diagnostic radiologist who attended the conference says, "We are proud to be at the forefront of this innovative technology." Watch the keynote address below for more details on this exciting new development in mHealth technology!

Tags: futureofhealthcare, Apple, Dr Wald, Future of Health Care, health apps, HealthKit, Innovation, John Wald, Mayo Clinic, Mayo Clinic app, mHealth, mobile apps, mobile health apps, patient care, Tim Cook

May 27th, 2014 · 2 Comments

Mayo Clinic Explores Google Glass

By Admin

Mayo ClinicThe future of health care at Mayo Clinic welcomes Google's new wearable mobile technology, Google Glass — a miniature electronic device incorporated in glasses — that allows users to interact with the internet without using their hands. Glass wearers can use spoken language to view, record, and transmit information.

Glass is currently in beta-test stage, says Alfred Anderson III, Mayo Clinic Center for Innovation (CFI) technology director, and not yet commercially available. Approximately 10,000 people have Glass, early adapters who participate in Google's Explorer program. At Mayo Clinic, several physicians and administrators are testing Google Glass across different specialties and departments:

  • Vernon Smith, M.D., emergency medicine physician, received an invitation to participate in the Explorer Program from Singularity University, a Silicon Valley-based group of educators who use technology to address humanity's hardest problems.
  • Mark Henderson, IT division chair, and Eric R. Ihrke, with Endpoint Technology, developed a prototype Glass application for searching patient records triggered from a bar code on hospital room door cards. "This was an exploratory effort to learn more about the capabilities of the Glass device," says Henderson. He has also used Glass' hands-free function for routing and navigation, and to access how-to video services, such as YouTube, for step-by-step vehicle maintenance.
  • Timothy Sewell, with Information Security, applied directly to the Explorer program and was accepted. "Information Security is analyzing Glass to understand how information is collected and stored by the device," says Sewell, "and developing strategies to safely use Glass at Mayo in a variety of settings, including patient care."
  • Nita Sharma, operations administrator, confirms that Mayo Clinic in Arizona hopes to explore how the technology may be helpful for use in providing teleophthalmology services for patients in the ambulatory setting for acute issues of the anterior of the eye.
  •  Roseanne Kho, M.D., a former Mayo Clinic gynecologic surgeon, uses Glass in vaginal surgery to allow simultaneous projection of the procedure to overhead monitors in the operating room. This allows trainees and other personnel to follow the surgery and anticipate needs. In addition, Glass not only promotes operating room efficiency but also facilitates teaching and learning of what, otherwise, can be a challenging procedure.

Dr. Smith says that several applications already promise great potential, including:GoogleGlass

  • Patient identification for exams and especially in the Emergency Department (ED), where providers can view information before entering the unit.
  • Photographs in the ED of patients' injuries.
  • Access to EMR, care team personnel and family information that removes the computer as a barrier between provider and patient.
  • Hands-free audio and video streaming for education, including the ability to project what is seen on a screen to share with others and access lab work, documentation and resources during surgical applications.

Anderson says that multiple companies are experimenting with Glass. "They're making it suitable for health care by removing the Google software and replacing it with medical-grade security. These changes allow medical information to be safely transmitted." Much of the experimentation has occurred at Brigham and Women's Hospital in Boston.

From a security perspective, says Sewell, Glass may enable tremendous new work flows in a physician setting, but it also creates incredible challenges. "Any data involved goes directly to a internet-based cloud for storage," says Sewell. "And it's crucial that only those who should see patient data can see it."

If you or your health care organization are using Google Glass in the work place, share your experience in the comments below.

Tags: futureofhealthcare, Alfred Anderson, Arizona, Center for Innovation, Future of Health Care, Glass, Google, Google Glass, health care innovation, Innovation, Mark Henderson, Minnesota, Nita Sharma, Roseanne Kho, Timothy Sewell, Vernon Smith

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