Q&A: To manage or prevent chronic disease, connect the data dots

More than half of all U.S. adults have at least one chronic disease. We have a growing number of ways to prevent or manage these diseases. But there’s room for improvement. More coordinated care, driven by data sharing and sophisticated technology like artificial intelligence, could help more people get and stay healthy.

Data about a patient’s interactions with different providers often stays with that provider, so no one can see the bigger picture. Highmark Blue Cross Blue Shield (Highmark) is partnering with Google to pioneer a new way to connect the dots. The ingredients include technology and data, of course, but also a new design for personalizing a patient’s healthcare journey. The project is called Living Health. Dr. Tony Farah, MD, chief medical and clinical transformation officer for Highmark, discusses what the Living Health experience might look like for a patient and the technology that powers it.

Kristin Gourlay: The prevalence of chronic diseases, like diabetes and high blood pressure, is growing among so many populations in the U.S. We can help prevent or reduce the suffering from these diseases, but we seem to be missing opportunities to do that. Why?

Dr. Tony Farah: Individual healthcare providers are doing their best. There’s nothing wrong with the one-on-one interaction with a patient. The problem is the rest of that care is quite fragmented. The data is not available to physicians or to patients. Patients may be going to multiple doctors, or visiting the hospital, because of these conditions. But because those health systems don’t talk to each other, the data is fragmented. That makes it hard to follow a patient’s progress, to head off problems before they get worse or understand treatments a patient might already have received that worked or didn’t work. Those are missed opportunities to take action.

Gourlay: Highmark has made big strides in breaking down barriers to sharing data—in other words, improving interoperability. But you’re saying it’s not enough to have access to data. It has to be actionable. How will your new project Living Health make that happen?

Farah: The goal of Living Health is more proactive, less reactive, healthcare. Right now, most healthcare providers and health insurers can only react for the most part when patients present to a doctor’s office or in the hospital. Living Health will flip this around and fix this reactive ecosystem. Data is a critical component, but it’s not the only component. With Living Health, our goal is to improve population health at scale, meaning we are building a system to help all of our members receive proactive care.

Essentially, we’re making data accessible from anywhere, personalizing it, and putting it to work for more preventive and coordinated care. Here’s how it works:

• Putting the pieces together: We are going to move claims and clinical data, including data from wearables like Fitbits and others, and move it to the cloud. The cloud is a secure, decentralized way of storing data so it can be accessed anywhere, by those who have permission to access it, regardless of the software they use or the organization they belong to. We need data on one platform.
• Personalizing it: Once we have data on this platform, we can organize, or curate it, so that what’s shared is personalized for each patient based on their health needs.
• Getting proactive: Having data in one place and personalizing it will help us share certain information with physicians or patients on a proactive basis. That might be alerting a patient that they are due for a screening, for example, or that a patient’s blood sugar readings were high and a physician might want to follow up.
• Heading off health risks: We will also use data analytics and machine learning to try to predict a patient’s risk for certain health problems so that we can work with them and their physicians to take proactive steps and mitigate those risks. When our members receive information like this, it will be in plain language. And we’ll offer concrete ways to take action.

Gourlay: You mentioned predictive analytics and artificial intelligence. Can you talk a bit more about what those are and how they might help you take care of not just one patient but a whole population?

Farah: When you have large sets of data points about a patient population, you can look at trends in that data. You can look for patterns. Machines can be taught, and can then continue to learn on their own, how to do this better and better. Being able to spot patterns will improve our ability to predict the risk of certain health events before they happen—events such as a fall, or a heart attack. But the key is personalizing this information so we can help individual patients.

We’re partnering with Google and its health company Verily on something called “the next best actions,” which means what we can do next to follow up with patients after a doctor visit or event about the next step they or their healthcare provider can take to keep them healthy. Big data sets help us learn what those actions might be in general, but then we tailor them for individual patients.

Doctors and nurses and other healthcare providers will always take care of patients one on one, face to face in person or virtually. That relationship is essential. What we can do is move care “upstream,” or, in other words, identify what it takes to address certain conditions before they become bigger problems.

Gourlay: The idea that there’s a team of healthcare providers and your health insurer taking care of you, powered by data that can help you be more proactive about your health, sounds great. It might also make some nervous about the security of that data. What can you tell us about the measures you take to safeguard data?

Farah: We take a patient’s privacy extremely seriously. We already follow federal privacy laws under the Health Insurance Portability and Accountability Act (HIPAA). But we also have several levels of privacy controls that go above and beyond. Our partnership with Google in creating this new program, Living Health, stipulates that Highmark controls access to all of the data. We also have an ethics advisory body at Highmark dedicated to monitoring and assessing patient data privacy.

Highmark Blue Cross Blue Shield is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.