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Co-Founder and CEO

In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates. About Farzad Mostashari, MD:  Farzad Mostashari, MD is founder and CEO of Aledade, which partners with independent practices, health centers and clinics to build and lead Accountable Care Organizations (ACOs) anchored in primary care. Dr. Mostashari has spent his career at the forefront of health care policy and health information technology. He is the former National Coordinator for Health IT at the Department of Health and Human Services, and served as a distinguished expert at the Brookings Institute’s Engelberg Center for HealthCare Reform. Prior to his work at the Office of the National Coordinator, he founded the NYC Primary Care Information Project, which equipped 1,500 physicians in underserved communities with electronic health records. He has spoken and written extensively on issues affecting health IT, Accountable Care Organizations, and health care policy and delivery. He has been published in the New York Times, the Journal of American Medical Association, and Health Affairs, among others. Dr. Mostashari received his MD from Yale University School of Medicine and his Masters in Population Health from Harvard T.H. Chan School of Public Health.

COVID-19 Discussion with Farzad Mostashari, MD

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Health Systems Architect

A rapidly shifting healthcare landscape challenged local public health (PH), healthcare providers, community-based organizations (CBOs), and technology organizations to collaborate and reimagine how information improves care. When the COVID-19 pandemic began, Solano Public Health activated the <a href="https://www.californiahealthmrc.org/programs/health-equity-consortium/" target="_blank">California Health Medical Reserve Corps (CHMRC)</a>. CHMRC realized the need for and the benefits of real-time, bi-directional data sharing across the community, and, specifically between healthcare providers, CBOs, and PH. CHMRC leaned in on partners, like Microsoft, creating workflow improvements to share usable data to help guide the response and decision-making processes. Once connected and sharing data, community stakeholders could more effectively collaborate and tackle the challenges faced in helping Solano County’s rural communities, including the farm workers and their families.  “CHMRC has developed partnerships with entities that you might not think are willing to work together – pharmaceutical companies, IT companies, and they are able to blend solutions that benefit everybody. And that approach, I think is extremely powerful,” Dr. Bela Matyas, PH Officer, Solano Public Health. Formed in 2014, CHMRC is a federally authorized medical reserve corp and 501c3 nonprofit. CHMRC supports PH to educate and escalate disease prevention and improve community preparedness for disasters and threats. We operate year-round as a constant force, building bridges and key partnerships across CBOs, local healthcare providers, and the local PH authority.  In 2021, CHMRC was inspired to launch the Health Equity Consortium (HEC) with multiple partners, including Microsoft. Today, HEC convenes partnerships to drive innovative solutions, guided by the common goal of building resilient and sustainable public-private collaborations. HEC seeks actionable ways to impact fundamental health equity challenges through the equitable distribution of preventive services, education, support, novel business models, and technology, including Microsoft’s. With the use of Microsoft technology, HEC provides local situational awareness for healthcare systems and PH in a timely manner, allowing time to course-correct campaign messaging. HEC focuses on protecting the privacy of the data while realizing the opportunity for technology to support a common community need. It’s not technology first, but technology supporting and empowering individuals and organizations, to truly address health care inequities proactively and build trust going forward. Privacy Preserving Collaborations and Data Cleansing  “Trust is essential. Many individuals and organizations representing vulnerable and underserved populations are unwilling or unable to share data,” David Rhew, M.D., Global Chief Medical Officer &amp; VP of Healthcare, Microsoft. HEC innovated a secure, trusted, and federated data environment for privacy-preserving collaboration though identifiable and de-identifiable health information. This solution allows organizations to develop common insights and analytics, without disclosing source data or Personally Identifiable Information (PII).  HEC provides a secure enclave where data from multiple entities can be cleansed, analyzed, and insights extracted. Clean data and data providence are essential for trusting derived insights and analytics. HEC provides cleansing, with the use of Artificial Intelligence (AI), to ensure the data ingested adheres to the standardized Application Programming Interface (API) and desired formats, free of de-duplication - which in turn can be used to fill in missing data fields. Powered by the principle of privacy, HEC focuses on enabling data interoperability through a privacy-preserving environment; Compliance, Privacy, and Trust (CPT) are core to everything HEC delivers.  As a result, HEC enables real-time community-based surveillance to better manage local outbreaks and future pandemics. HEC assists PH in maintaining the integrity and privacy of data sets, and the AI that is running them. Seeking efficient and innovative ways to clean the data, we learned early on that the required infrastructure is extremely complicated. The broad scope of this work, coupled with the impact on care provider resources, reinforces the belief that PH should be focused on providing guidance and care, not data analysis and cleansing.  A Triumph of Human Touch, a Business Model, and Technology  “Our original belief was that providing better care would serve as our business model. However, we learned that by providing ‘cloud as a service to public health,’ the management of data ended up being the primary business value proposition for multiple stakeholders. By enabling bi-directional flow of data between CBOs, PH, and local healthcare organizations, we established the necessary infrastructure for care to be delivered anywhere, anytime. Applying AI to clean and help analyze the data made the data usable and actionable,” David Rhew, M.D., Global Chief Medical Officer &amp; VP of Healthcare, Microsoft. HEC’s initial value proposition was to increase vaccination rates, levels of screenings for conditions such as diabetes and hypertension, collect social determinants of health (SDOH), raise Medicaid enrollments and reach those with low levels of engagement in traditional healthcare. This focused approach continues to bring measurable benefits to local communities, PH, providers, and payers interested in improving community-based health outcomes and ratings. By leveraging Microsoft’s interoperability standards such as Fast Healthcare Interoperability Resources (FHIR), HEC facilitates the secure, bi-directional flow of data between CBOs, PH, and local healthcare organizations. This enables real-time case reporting and solves three problems for healthcare providers: <ol><li>Delayed reporting of cases to PH, which can lead to financial penalties. </li><li>Oversharing of entire medical records, which is a Health Insurance Portability and Accountability Act (HIPAA) violation. </li><li>Non-compliance with 2023 US Department of Health and Human Services (HHS) and Office of the National Coordinator for Health Information Technology (ONC) proposed rules which require automated case reporting to PH and alignment with Trusted Exchange Framework and Common Agreement (TEFCA).</li></ol> HEC’s model works for different populations and is designed to scale nationally and internationally. In addition to working in California, we are engaging with communities in Georgia, Mississippi, and Washington. If you want to know more about <a href="https://www.californiahealthmrc.org/programs/health-equity-consortium/" target="_blank">HEC</a> innovations and solutions, please visit us at <a href="http://www.healthequityconsortium.org/" target="_blank">www.healthequityconsortium.org</a>.  We value our partners, especially Microsoft, whose vision and tech leadership were fundamental to the launch of HEC. If you want to know more about Microsoft’s solutions, please visit <a href="https://www.microsoft.com/en-us/industry/health/microsoft-cloud-for-healthcare" target="_blank">Microsoft Cloud for Healthcare | Microsoft.</a>

Closing Gaps in Community-based Health Equity

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VP & Head of Vision for the Healthcare and Public Sector

The 1920s was a time of big ideas, boundless energy, large personalities, and gigantic dreams. This exuberant, freewheeling, and tumultuous decade earned its own nickname, the Roaring 20s. Its byproducts launched America into the modern era.  The 1920s also became the decade when American medical education, research and clinical care standardized, professionalized, and modernized. The decade witnessed breakthrough discoveries (penicillin, insulin, vitamins), dramatically reduced communicable diseases, improved diagnostics and expansion of public health. These developments put the U.S. on the path to becoming the global leader in medical research, education and clinical care.  Weary from WWI and the 1918-19 pandemic, America began the 1920s with a profound sense of uncertainty and loss. This weariness gave way to a titanic wave of creativity, innovation, cultural upheaval and status-quo-busting dynamism. By the decade’s end, it was hard to recognize or even remember its humble start.  A century later, COVID-19 pandemic brought America to a standstill. Addressing this viral threat challenged long-established cultural norms, raised fundamental questions regarding societal equity and justice, and fed political and social polarization even as new technologies fundamentally redefined work, entertainment, and human connection. Even before COVID and for the first time in history, the rate of societal innovation was occurring at a pace beyond human beings’ natural ability to absorb and adapt. The pandemic has increased societal anxiety associated with disrupting norms. Weaving digital technologies into the fabric of daily life to ease adaptation, reduce stress and promote well-being is the challenge of our times.  COVID also has exposed weaknesses in healthcare&#39;s supply chain and public health infrastructure, the health risks associated with unchecked chronic disease, and profound disparities in access to healthcare services. The result was needless death and suffering. Frontline healthcare professionals have battled COVID for over two years. Their heroism and selflessness have inspired the nation. Unfortunately, they often have labored with inadequate resources and suffered from high stress/burnout levels. Going forward, health companies must take better care of their workers and give them more tools to manage their own health as well as patients’ health. The elimination of elective surgeries in March 2020 and relaxed regulatory barriers accelerated the adoption of digital and virtual technologies. In the process, healthcare’s ecosystem pivoted to become more decentralized, consumer-oriented, and cost-effective. Hospital-at-home care proliferated.  Concurrently, breakthroughs in vaccine development and genomic underpinnings of health suggest medicine is on the precipice of systematic improvements in diagnoses, treatments and personalized wellness. Health tech venture investment in 2021 was almost double 2020’s level (<a href="https://rockhealth.com/insights/2021-year-end-digital-health-funding-seismic-shifts-beneath-the-surface/" target="_blank">$29.1</a> vs. <a href="https://rockhealth.com/insights/2020-market-insights-report-chasing-a-new-equilibrium/" target="_blank">$14.9</a> billion), which in turn was double 2019’s investment (<a href="https://rockhealth.com/insights/in-2019-digital-health-celebrated-six-ipos-as-venture-investment-edged-off-record-highs/" target="_blank">$7.4 billion</a>). Many new virtual care, augmented intelligence, care management and consumer health companies have gained market share and clout. Despite these innovations and advances, healthcare still largely operates in the same ways it did during the 1920s with hospital-centric care delivery, fee-for-service payment, and fragmented service provision. Changing consumer expectations, new competitors, value-based payment models and pro-market regulatory reforms place enormous economic pressure on status-quo business models. For many incumbent healthcare companies, there is a natural desire to return to pre-pandemic business practices. This would be a mistake. American society will not continue to pay premium prices for healthcare services that deliver suboptimal outcomes and do little to prevent the spread of chronic disease.  Relative to other industries, healthcare has been slower to adapt disruptive digital technologies that reshape supply-demand dynamics by empowering consumers. Given this reality, healthcare incumbents will experience disruptive change at an accelerated pace during the coming decade.  Addressing this digital imperative is a massive challenge for health companies. Big challenges require big solutions. Work environments and strategic positioning must adapt. Successful healthcare leaders will differentiate their organizations by pursuing value-based, consumer-friendly service delivery at scale.  New business models are emerging to challenge status-quo practices and give consumers what they need, want and desire. 1920s-like turbulence will eliminate many legacy businesses. Companies that promote well-being through high-value service provision will become market leaders.  This is an exciting and perilous time for healthcare. The industry will change more in the next ten years than it has in the last hundred. 2030 Healthcare will bear little resemblance to 2020 Healthcare. Welcome to Healthcare&#39;s Roaring 2020s! David W. Johnson is CEO of 4sight Health. Matt Bragstad is VP &amp; Head of Vision for the Healthcare and Public Sector of Infor.  Dig deeper on this topic <a href="https://www.4sighthealth.com/the-roaring-20s-then-now-insights-on-healthcares-post-pandemic-future/" target="_blank">here</a>. Opt in for 4sight Health commentaries <a href="https://www.4sighthealth.com/insights/" target="_blank">here</a>.

Healthcare's Roaring 2020s

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Chief Scientist

In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates. About Acacia Parks: As Chief Scientist at Happify Health, Acacia’s research focuses on digital methods for managing and treating depression and anxiety, as well as chronic health conditions. Her passion lies at the intersection of research and regulatory strategy for digital therapeutics. She received her B.A. in Psychology from Reed College, and her Ph.D. in Psychology from the University of Pennsylvania, where her graduate research helped build the foundation for research on bringing mental health interventions to the general public. Prior to joining Happify Health, Acacia was an Associate Professor of Psychology at Hiram College.

COVID-19 Discussion with Acacia Parks

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