Technology Enabled Medicine

Healthcare and Data Need to Get Along

By Dr. Nick van Terheyden aka Dr. Nick
Twitter: @drnic1
Host of Dr. Nick: The Incrementalist#TheIncrementalist

On this episode I talked to Caesar Djavaherian, MD (@Caesardjava), an Emergency room physician and Medical Director and Co-Founder of Carbon Health (@CarbonHealth). Carbon Health is a modern, tech-enabled vertically integrated healthcare system designed from the ground up to put patient care first.

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Caesar’s path through medicine like many of us was driven by a passion to help and to heal with a desire to be closest to the patient but found the journey frustrated with technology that failed to deliver value to the patients and was constantly obstructing care and clinicians focus on the patient. As he points out training for most large scale healthcare technology requires taking clinicians out of clinical service for a day, sometimes more. So he teamed up to form Carbon Health creating a solution that was technology-enabled medicine.

On 23 January 2020 the Mountain View practice of Carbon Health saw a patient who had recently returned from Wuhan in China who presented with unusual symptoms that included tachycardia and fever. This was just 2 days after the CDC had confirmed the first Coronavirus case in Washington State. It took some weeks before there was a significant mobilization in the US (although notable that China locked down Wuhan around the same time). But for Carbon Health and their team, they were data enabled and had embedded data scientists and technologists who created a screening tool to be used on all intakes for patients in short order. A fact that to date has meant that despite finding over 200,000 cases they have not had a single infection in any of their clinician’s thanks to their integrated approach and the application of data and technology.

Along the way, they learned some incremental elements to a successful response to COVID19:

  • Everyone needs to pull in the same direction
  • Flat organizations facilitate better communication
  • Everyone’s input is valued
  • No Ass-hole’ Policy

Interestingly as Caesar notes all this has been very data-driven since all the above has been shown to reduce malpractice insurance rates. They shared their insights locally and as widely as possible in the hope that others could benefit from their insights.

As for fixing our response – we need to fix the payment mechanisms, or as I often put it;

Follow the Money

If you can’t send a patient’s test to any lab and be sure that the test will be reimbursed with a complex indecipherable network of payment regulations that preclude the use of certified and authorized testing resources you are essentially limiting any response by arbitrary geographical boundaries that inhibit efficient use scarce resources.

Listen in to hear his thoughts on the challenge of assessing risk and changing behavior (hint – this is not a new problem as we see in Hypertension patients) and the importance of data-driven decision making and the need for healthcare and data to get along.

About the Show
For years Dr. Nick van Terheyden aka Dr. Nick, has served as a voice on the impact of new technologies on healthcare, earning a reputation as a leading authority on where the future of medicine is going. Combining powers of observation and real world experience, Dr. Nick has seen many predictions come true and makes the case that innovations in healthcare can be accomplished incrementally, not just by moonshot events. Tune in to hear Dr. Nick: The Incrementalist and his guests discuss what the future of healthcare looks like, how we will get there, and what it will take to improve healthcare for all.

This article was originally published on the Dr. Nick – The Incrementalist blog and is republished here with permission.