Newswise — Lawrenceville, NJ, USA—May 19, 2020—ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR) held its second Virtual ISPOR 2020 plenary session this afternoon, “HEOR and Clinical Decision Making—Advancing Meaningful Progress.” Virtual ISPOR 2020 is the Society’s first completely virtual conference that was redesigned as an online event when the COVID-19 pandemic required a necessary cancelation of the in-person conference.
The rise of big data and artificial intelligence bring wide-ranging opportunities for HEOR to become a relevant part of clinical decision making. In this plenary, panelists explored data-driven, collaborative approaches to clinical decision making and ways that HEOR can help strengthen health service delivery and enhance the patient experience.
- Moderator: Jan Hansen, PhD; Genentech; South San Francisco, CA, USA
- Marc Boutin, JD; National Health Council; Washington, DC, USA
- Rachael Callcut, MD, MSPH; University of California, San Francisco Medical Center, Center for Digital Health Innovation; San Francisco, CA, USA
- Nigam Shah, MBBS, PhD; Stanford University; Stanford, CA, USA
Nigam Shah, MBBS, PhD was the first to provide introductory remarks. He outlined a patient journey that has the potential to generate a wide variety of disparate data sources—including claims, ICD codes, medications, procedures, lab tests, clinical notes, and more—that can be used to inform artificial intelligence (AI). He pointed out that AI can be used to automate a tedious task or to take a proactive action. He also provided a topline overview of the Stanford Green Button project that aims to provide personalized medical practice guidelines in real time.
Rachael Callcut, MD, MSPH spoke next, outlining the extraordinarily expensive US healthcare system—with costs of $3.3 trillion US (2016) or $10,348 per person—that spends more than any other country while achieving poorer outcomes in terms of life expectancy in years. Healthcare is the only industry where consumers don’t know what they are paying for. Addressing healthcare research, she remarked that the science has been built around the response to average patients, when we know that most patients are not average and will have a range of responses to the same treatment. Viewing her role as merging outcomes research with data analytics, Dr Callcut discussed a variety of issues being addressed with AI, including predicting disease trajectories, designing therapies, automating triage, expediting clinical workflow, etc.
Marc Boutin, JD spoke next describing personalized health as the fusion of data, AI, and behavioral science. He noted that for centuries, medicine has taken a very paternalistic approach toward patients. Historically, medicine has regarded healthcare as something done to patients versus with patients. He views AI as a huge opportunity to blend data and behavioral science to actually personalize health for individuals while improving outcomes, reducing costs, and assuring that people are able to live their best possible lives.
Jan Hansen, PhD moderated the panel discussion that began with the COVID-19 pandemic. Dr Callcut expressed two concerns as a clinician. First, the virtual cessation of elective procedures that provide a revenue stream to support hospitals (and universities) has been economically damaging. Second, as many race to find diagnostics and therapies for coronavirus, these have not gone through the standard processes to assess their safety and efficacy. Dr Shah noted that AI should be used to help inform the response to COVID-19, but that he hasn’t seen this happen yet. He believes that AI could help shear through the noise of the mass of publications and media reports and help answer many important questions that are currently unanswered. Mr Boutin pointed out that during this emergency, we have tended to jump into our old model of doing things and so have missed the huge opportunity that AI could provide in addressing the crisis.
Addressing the issue of patients living with chronic diseases, Mr Boutin provided perspective on the impact of COVID-19 on these patients. He noted that chronic disease patients, who are at much higher risk of the virus, still require ongoing care during the pandemic. When seeking healthcare, they are now potentially exposed to coronavirus. Dr Callcut agreed that clinicians delivering frontline care are very concerned about these patients living with chronic diseases. She has seen many patients avoiding care for fear of the coronavirus with many who view seeking healthcare as more dangerous than going to the grocery store (when the data don’t support this). Additionally, a number of patients need therapies that have been touted to treat COVID-19, causing access issues for some patients trying to obtain their medications.
The panel discussed how AI can help reduce the cost of healthcare. Dr Callcut provided two examples where AI can contribute. In chronic disease management, AI can help determine who is most likely to benefit from expensive care and also help patients know when they need to engage with the healthcare system. Another example is how AI and advanced machine learning can move some of the most expensive care now conducted in hospital to lower-cost, out-patient care. Dr Shah spoke about how the “home shift” can reduce healthcare costs. Moving technology done in expensive settings into the privacy and comfort of a patient’s home (without compromising safety) can result in significant cost savings. Dr Callcut also noted that AI can help identify and address some of healthcare’s inefficiencies, which can reduce waste and costs.
In closing, Dr Hansen asked the panelists to address how the HEOR community can engage with AI. Dr Boutin talked about the work the National Health Council and ISPOR have been doing in partnership to more actively engage patients in HEOR. He sees a lot of opportunity to add the patient perspective in AI and HEOR overall. Dr Shah views the HEOR community as indispensable. He noted that AI is subject to the same economic restraints as all other aspects of healthcare and encourages researchers to “claim their stake” in AI. Dr Callcut agreed with the critical importance that HEOR will play in AI, stressing that both economic and outcomes perspectives are what will give AI a footprint and long-lasting impact in healthcare.
Virtual ISPOR 2020 is being held May 18-20. Registrants will have access to the nearly 60 hours of on-demand recordings of all conference sessions through June 30. In addition to the plenary sessions, Virtual ISPOR 2020 features issue panels, workshops, podium presentations, and educational symposia. Research abstracts from the conference will continue to be published in the Society’s journal, Value in Health, and will be available in the ISPOR Presentations Database. The ISPOR Short Course Program is also be presented virtually with a variety of course topics and dates offered in June and July.
ISPOR, the professional society for health economics and outcomes research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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