Restoring Trust in Healthcare

If one quote reflects a day full of provocative commentary during at the Oliver Wyman Health Innovation Summit it might be this one from Amit Sabharwal: “Progress doesn’t need to take billions of dollars or years, it takes a connection to the people we serve in the moments that matter.”

Sabharwal, a Senior Partner at Oliver Wyman’s sister company Lippincott, set the stage for day two of the Health Innovation Summit by examining the need for healthcare organizations — and society as a whole — to restore connections that have unraveled over the past few years. Citing Lippincott research, he noted that people have lost trust and feel increasingly disconnected from other individuals, the media, celebrities, and the federal government. At the same time, however, there’s been an upswing in connections with employers, businesses, and brands. The shift creates an opportunity for businesses to fill a void.

That sentiment was reinforced by Justin Blake, Executive Director of the Trust Institute and Global Chair of Executive Positioning at Edelman. Blake detailed findings from the 2022 Edelman Trust Barometer, which surveys 36,000 people worldwide about their thoughts on business, government, non-governmental organizations, and the media. Findings from this year’s report showed that trust in government and media was declining, and even NGOs lost some ground. Conversely, trust in business was on the upswing. In fact, 45% of people said business was a unifying force in society, while 31% said it was disruptive. That compares to 36% of people who called government a unifying force and 48% who said it was disruptive.

High levels of trust also bring high levels of accountability — 60% of people choose a place to work and 58% buy or advocate for a brand based on their beliefs and values.

Meaningful Connections

Toyin Ajayi, MD, and Lisa Fitzpatrick, MD, offered concrete examples of how healthcare innovators can have meaningful impact on people’s daily lives. Ajayi is co-founder and CEO of Cityblock Health, a provider group that serves low-income populations; Fitzpatrick is the founder and CEO of Grapevine Health, a media company that is working to improve the health literacy. Both offered powerful perspectives on how and why healthcare organizations must do a better job of connecting with underserved communities.

Ajayi said that Cityblock, which spun out of Alphabet’s Sidewalk Labs in 2017, has been successful because it builds engagement with patients. “You can’t drive outcomes unless you proximate to the people who have the needs,” she said, adding, “You can’t just drag people through a broken healthcare system.”

She pointed to Cityblock programs that help pregnant women navigate their healthcare journey during and after delivery. And working with the care continuum to ensure real-time handoffs for behavioral health patients so they don’t fall through the cracks. There’s also the company’s mobile integrated care program, which uses video and phone visits, text messaging and in-home care.

Of course, outreach and engagement are just part of the puzzle. Fitzpatrick is attempting to bridge a gap at one of the most fundamental levels — health literacy, which she refers to as the stepchild of SDOH. Grapevine is working to deliver relevant, reliable, and relatable health information to communities.

Fitzpatrick has seen firsthand how the industry has failed to delivery that kind of information to patients. She moved from her luxury apartment in Washington, D.C., to one of the city’s poorest neighborhoods, where health outcomes and health literacy lag. Some samplings of things she’s heard on the streets in her neighborhood include: “I wasn’t sick before I went to the doctor,” and, “Is cancer contagious?” More pressing, one of her neighbors didn’t have a full understanding of how his heart condition could lead to him being out of breath. What’s she’s learned in growing Grapevine is that the message and messenger matter. People want to hear from others who look like them and have shared experiences. Information has to be authentic and developed in a manner that best suits that person’s needs.

A key takeaway from both Ajayi and Fitzpatrick’s presentations is that innovation without health literacy, without access, without engagement won’t succeed in restoring trust or building connections.

An Inflection Point

Technology is a critical component of the industry’s efforts to reconnect with patients and communities. Oliver Wyman Partner Heiyab Tessema outlined some of the opportunities and challenges facing the industry on this front. For instance, 5G opens a world of possibilities to extend access to rural and other underserved areas. It can result in more timely data coming in from Internet-connected devices and may level the playing field for competitors across the industry. But connectively alone won’t solve the problems facing healthcare, he said. Data for data’s sake won’t result in better outcomes. What’s needed are solutions that translate and synthesize information.

Tessema also addressed the problem of such tools as artificial intelligence and machine learning exacerbating the health inequities. The industry must solve for the issue of biases that exist in data if it is going to realize the full potential of these digital tools. “We need more transparency on where the data came from and we need to generate more data points,” he said.

Simultaneously, organizations should take a hard look at their technology stacks, suggested Manisha Gultai, Chief Growth Officer at Commure. Healthcare, she said, is approaching an inflection point with tons of data being generated, but little of it being connected or utilized to dramatically improve outcomes. One reason for that: data is siloed and stuck in legacy systems. And when it is put together, it usually isn’t actionable. She suggested that the industry learn from other sectors and leverage an operating system model. This would allow organizations to aggregate data from internal and external sources, improve workflow, and develop actionable prompts based on relevant information.

Turning data into action is exactly what Howard Jacob, Vice President and Head of Genomics and Data Integration, AbbVie, is trying to do. He detailed the pharmaceutical giant’s efforts to collect reams of data from preclinical and clinical trial data, public databases, data from scientific publications, and a million genomes to generate a knowledge base from which new therapeutics and treatments can be developed. That research is already resulting in some interesting findings, he said, pointing to potential new use cases for some drugs. But getting to market is a tricky question since there may not be clinical evidence. It will be incumbent on all stakeholders to figure out a path forward when that’s the case.

Cutting Out the Middleman

As Transcarent’s Glen Tullman said on day one of the Summit, eliminating the middleman in healthcare could lead to significantly lower costs. One company is trying to do just that in the drug market. Alex Oshmyansky, MD, shared his story of creating a company that would sell drugs at an affordable price. A cold email pitch to Mark Cuban resulted in a significant investment and the launch of the Mark Cuban Cost Plus Drug Company.
Oshmyansky’s desire to create the company grew out his frustration with the roadblocks patients had in getting affordable medications. One extreme example Oshmyansky noted: they sell a 30-day supply of the cancer drug Imatinib for $39 versus an average retail price of $9,500.

“What we’re doing is not a new idea,” he said. “We want to be able to step in anywhere along the pharma supply chain so we can fix problems as they arise, we’re slowly building up components of this stack.”

We also heard a powerful message from Anne Aslett, CEO of the Elton John AIDS Foundation, on efforts to end the epidemic by 2030. You can hear more about that in this interview with MedCity News, which is the media partner for the Health Innovation Summit: