"...we do not know what we know about healthcare..." NO, this is not a statement from an industry outsider. In fact, it is a statement from one of the most powerful, influential and autoritative figures in the global healthare industry, who should and DOES know: Mr. Sidney Taurel, CEO of Eli Lilly. On October 2nd, 2007, Mr. Taurel gave a talk titled, "Knowing What We Know About Health Care" before the Cleveland Clinical Medical Innovation Summit.
In his frank, superb and 'about time' remarks, Mr. Taurel touches a wide range of issues facing pharmaceuticals and more importantly the healthcare industry. He not only articulates the pain points and challenges but also provides real solutions with optimism that is founded in case studies from Harvard, Roberwood Johnson Foundation and other institutes. Some of the key points are highlighted below:
"Very often, that’s because knowledge depends on two, less glamorous cousins that go by the names of “data” and “information.” When health-care data and information are not available … or when they are poorly organized and understood … then health-care knowledge is greatly diminished.
The necessary information and data simply are not available – and so the full knowledge of “what can be done” … is not brought to bear.
But frankly, those excuses are wearing thin. In fact – post-PC, post-Internet, and post-wireless technology … those excuses are getting rather embarrassing.
Data on patient outcomes is being gathered in many forms – for example by drug companies carrying out large clinical trials … by health insurers amassing claims data on the lives they cover … by doctors building files on patients … and by regulators collecting reports of adverse events.
As a result of such data collection – which has been going on for decades in some cases – along with exponential increases in computing and telecommunications capacity – we now have the theoretical ability to know more things, more quickly, about more patients, at a greater level of detail, than ever before.
And yet we’re not translating this ability from theory into practice. At best, some of us are seeing pieces of the whole, but the totality of insights that could emerge from this treasure chest of information … is being denied to everyone.
The inescapable conclusion is rather painful to admit: We do not know what we know about health care!
However, I’m convinced that we are still selling short the benefits of a true “Information Revolution” in health care … and, as a result, we are moving too slowly to realize those benefits.
The waste falls into at least four categories. There’s administrative overhead in health care – estimated at a third of all U.S. health-care expenditures. There’s the cost of unnecessary care – treatments that will contribute little or nothing to the wellbeing of the patients receiving them. There’s duplicative care – patients undergoing two or three diagnostic tests at the behest of various doctors, for example, when one test would do. And there’s poorly targeted care – such as the hit-or-miss prescribing of medicines that do not match patients’ genetic profiles or their progression in a disease.
By way of example: A professor at Harvard Medical School recently determined that networked data on 100 million patients … something that’s certainly feasible with current technology … could have produced a statistically meaningful “signal” of cardiovascular risk less than three months after Vioxx went on the market.
You still may be wondering why the CEO of a pharmaceutical company is talking about the future of health information. I cannot speak for the entire industry, but I can tell you why it matters to Lilly.
We’ve been feeling great pressures from our environment – pressures on pricing and market access along with reduced tolerance for risk in the use of our products. We’ve chosen not simply to lament this state of affairs … but rather to change our business accordingly.
Lilly’s vision is one in which individual patient outcomes are the measure of our success. We believe that is the best way to increase the value proposition of pharmaceuticals in the eyes of all of our customers – doctors, payers, and patients alike.
Improving individual outcomes means tailoring our therapies to the patient populations in which they clearly work … and in which their side effects are in reasonable proportion to their benefits.
It also means having courage to measure our products against other treatments … and accepting the results as an appropriate basis for how our products are used and priced. We’re doing just that … as those of you who follow cardiology may know … in our trial of prasugrel on a head-to-head basis against Plavix.
It means learning to communicate with patients – sometimes directly and sometimes through doctors or payers – not primarily to sell them our products … but rather to educate them on how lifestyle factors, genetic characteristics, co- morbidities, and adherence to larger treatment plans ... all contribute to health outcomes.
That’s a tall order – but it makes us excited about the promise of Lilly and our industry.
Notice that in every respect, our vision is much more likely to become reality if the Information Revolution finally reaches health care …
- if we can quickly mine not only our own clinical trials but all others – for clues about the tailoring of our molecules …
- if we can put rapid feedback loops in place – from post-marketing surveillance back into R&D …
- if we can point to hard evidence for the economic as well as therapeutic value of our products …
- and if patients are empowered with information about their own medical histories … and their treatment options.
Knowing what we know about health care … Lilly expects to be better off – to the extent that doctors, payers, and patients are better off as well."
Key Observations, Thoughts and Questions:
I applaud Mr. Taurel for his candid perspective on the current state of affairs in the healthcare industry.
- While the pharmaceuticals and healthcare industry is inundated with too much data, what good does it do if it is not turned into real life actionable intelligence? It is time that the Healthcare industry got its act together and put the data it collects to some good use.
- Instead of worrying about and fighting the pressure that our industry is facing, it is time for the leaders in the ivory towers to step back and as Mr. Taurel put it, “change our business” according to the new realities.
- Personalized medicine will soon become a reality – thanks to leaders like Mr. Taurel.
- ROC (Return On Care) will become a new metric in the near future.
- Anyone who has ever been to a hospital in the US, must be aware of the waste and the inefficiencies. There is significant room for improvements in the four key areas outlined by Mr. Taurel: (1) administrative overhead in health care (2) unnecessary care (3) duplicative care, and (4) poorly targeted care.
Recently, I saw an advertisement for Harvard Business School with the following statement, "Great minds think alike and that's the problem..." Well, I am glad that Mr. Taurel and a handful of other leaders do NOT think alike...
