Adventures at the Andaz

By ROBERT WHITCOMB (This piece originated at www.cmg625.com).

NEW YORK

I wandered down to the Wired (magazine) Data/Life conference here on Nov. 5-6 on the suggestion of a Cambridge Management Group colleague. There was a lot of interesting stuff that can help people understand where health care, health-care economics and health-care technology are going. And, perhaps especially, where health-care capitalism is going; how fitting that the conference was held at the Andaz Hotel, on Wall Street.

There was remarkably little talk about Obamacare or even about Accountable Care Organizations.

Personal- and population-health data, behavior modification and neat new devices were in the spotlight, and the attendees saw them as considerably more important than Obamacare in the long run. The confab was sponsored by Poland Spring (healthy product, except that oil is used to make its water bottles), IBM (whose Watson computer, with its impressive analytics ability, seems to hold considerable promise for improving health care) and Withings, which makes self-monitoring health devices. Such self-monitoring was a big theme (and marketing play) of the conference.

The first major speaker, Rushika Fernandopulle, M.D., set the stage by noting that great challenges in improving the bad (for the Developed World) U.S. health-care system outcomes and the system’s bankrupting costs include boosting primary care and moving from focusing on acute care to chronic care of diseases, especially such lifestyle-related ones as diabetes, heart disease and certain cancers. As later speakers made clear, new technology and better date are revolutionalizing, by rationalizing, such care already.

Then there was Dr. David Agus, a sort of rock-star (big on TV) cancer doctor and a pioneer in new technologies for personalized health care. The doctor, wearing blue jeans, said it was important to get back to the focus on being able “to die of old age’’ instead of highly preventable diseases. To do this, let’s make far more use of population-health data – think like a climatologist, looking at the earth from above. And let data be your skeptical guide. (Remember when margarine was said to be less bad for you than butter?) And look at the data associated with inactivity -- for instance, that sitting for five hours every day does as much danger to your health as smoking a pack and half a day, he told the crowd.

And, he said, such seemingly small things as going to bed and getting up, and having meals, at the same times of day can be very health-improving. There are real data about this.

Remember, he said, that 50 percent of our health problems are environmental. And read data showing how statins and a baby aspirin cut your risk of heart attack and cancer. (But a later speaker, Dr. David Newman, raised some questions about claims for the routine use of these substances.)

At the same time, Dr. Agus said, some stuff is over-rated or worse, such as taking supplemental doses of Vitamin D. He noted that America spends more on badly or untested supplements than it does on cancer research. Watch the data, with more and more of it available weekly!

While pressing for more data, and pointing to greater patient access to their own personal health data, he also raised the point that constantly watching these data can cause stress…. (Which another new device will monitor?) Which brings up an issue of the whole conference: We’re all supposed to be monitoring ourselves much of the time. Can that get out of control? Will it lead patients to drive doctors and nurses crazy?

It also occurred to me that much of what the conference speakers touted seemed to assume, wrongly, that virtually all Americans can be digital-saavy. In fact, many still don’t have computers and have no idea how to use the Internet. (Going digital is, however, a handy way to lay off more employees and jack up operating profits in the health-care sector and other industries.)

In any case, having much more peer-reviewed data transparency – for medical professionals and patients alike – will be key to improving America’s health outcomes, he suggested.

Then there was David Newman, M.D., of Mt. Sinai Hospital in New York and editor of the very interesting www.TheNNT.com – a data-based site focused on, among other things, on the need to be wary of such panaceas as statins (which, he noted, can give you diabetes). If one has already shown that he or she has heart disease statins can be helpful, but for those who don’t, it can do more harm than good, he said. (The present writer has “severe arterial disease’’ and recently had a triple bypass after many years of taking statins. He’d like more data himself!)

Dr. Newman lauded Affordable Care Act incentives to encourage more skeptical use of stents. He said they’re overprescribed (because lucrative). Indeed, many folks at the conference cited favorably the ACA’s interest in incentives that encourage cost controls that simultaneously improve outcomes. And a more personalized approach to individuals’ risk is needed. We must learn how to better customize treatment.

Beware, he said, of industry-tainted promotion of certain lucrative drugs and procedures.

All in all, he said “Health care has under-treated those without easy access to the system and over-treated those {affluent and/or with insurance} those with it.’’ And what he called “information asymmetry’’ (Iack of transparency) explains much of the medical and economic failures of America’s system.

Ronald DePinho, M.D., president of M.D. Anderson Cancer Center, in Houston, spoke of Anderson’s ambitious plan to sharply reduce some major cancers in the next decade through better use of data (such as using IBM’s Watson artificial intelligence) and public education (e.g., reducing sun exposure amongst children to reduce the likelihood of melanoma later). The idea is to be able to reduce the number of people who go to Anderson and instead be able to diagnose and treat from afar through better data use. Physicians and hospital officials should monitor the Anderson plan carefully. Anderson is, after all, the world’s biggest cancer center.

Martin Blazer, M.D., of New York University, for his part, spent most of his time talking about the beneficial uses of bacteria and the overuse of antibiotics, especially in early childhood. We must, he said, restore our internal “eco-system’’. And we must learn more about our “metabolic pathways.’’ Again, Big Data makes this easier.

Then there were the new medical systems being promoted by some businesspeople. Elizabeth Holmes, of Theranos, talked up her company’s full-service, very patient-friendly laboratory services for drugstores, with only pin pricks needed to get enough blood for full analysis. Theranos has an agreement with Walgreen’s.

Sean Duffy, for his part, talked up Omada Health, which helps patients at risk of diabetes track their behavior through such things as coaching and digital tracking. And Mike Huang talked up Glow, with its mobile app used to predict a woman’s daily fertility cycle, thus, he says, making it easier for couple to conceive. There’s even a financial-assistance program for those who fail to conceive naturally after 10 months!

Life gets more and more intense.

My favorite was Neurotrack, which, as co-founder Elli Kaplan explained, is developing a cognitive test that can detect the earliest neurological effects of Alzheimer’s, thus allowing patients to act to delay its full onset.

Finally, there are devices, discussed in much detail at the conference, with the hope, of course, that venture capitalists there would bite. The conference reminded a little of a car dealership promoting its new models.

Consider David Icke’s company, MC10, which is developing new flexible electronic devices to be worn externally or internally to help diagnoses and therapy. An interesting one is a device to be worn on a football helmet to monitor concussion danger. Then there’s Jawbone, represented by its vice president for software, Jeremiah Robison, like most of the speakers young (and newly rich). It makes wearable devices and audio devices to, among other things, get people to take walks and go to bed to improve their health. (Orwell for president?)

In other words, we and medical professionals will be tracking ourselves every minute. Self-consciousness raised to new levels.

Several speakers suggested that it’s past time to even let the patients, of all people, know what their procedures will cost ahead of time – in the face of secrecy by many health-care institutions and insurance companies, which will fight such transparency all the way because its means they won’t make as much money. Speakers and attendees saw great promise in getting patients to start asking what medical stuff costs. Such questions will change the course of treatment.

The conference made it clear that more transparency was coming with better and better measurement of health-care outcomes. “You can’t improve what you can’t measure,’’ as David Icke of MC10 remarked to the conference.

With wearable health-monitoring devices, much more data and better ways to monitor and analyze it and heightened consumer participation through social media and other new tools, it’s clear that the revolution in health care – and health-care financing -- can only accelerate. It all almost makes the ACA seem inconsequential.

Meanwhile, a bunch of people might become billionaires based on what they learned at the Andaz conference. They’ll be selling stock up the street at the New York Stock Exchange.