‘We’re on the cusp of miracle cures’

From: POLITICO Future Pulse - Thursday Feb 09,2023 07:01 pm
The ideas and innovators shaping health care
Feb 09, 2023 View in browser
 
Future Pulse

By Ben Leonard, Ruth Reader, Carmen Paun and Erin Schumaker

WASHINGTON WATCH

David Schweikert is pictured. | AP

Rep. David Schweikert (R-Ariz.) sees innovation as the key to driving down health care costs. | J. Scott Applewhite/AP Photo

Rep. David Schweikert (R-Ariz.) is concerned about how health care spending is driving the increase in the national debt.

And as co-chair of the Telehealth Caucus and chair of the Ways and Means Oversight Subcommittee, he’s well positioned to draw attention to those concerns.

Schweikert thinks technology and innovation can help bring down costs. But he’s worried that Washington’s tendency to protect entrenched interests could get in the way.

Ben caught up with Schweikert in his Capitol Hill office to discuss how technology can become a bigger part of health care delivery and his plans as subcommittee chair.

This interview has been edited for length and clarity.

What are you most excited about in health care right now? 

It’s the possibility that we would align policy with cures and the financing and disruption — it could have major effects on future debt.

We’re on the cusp of miracle cures — a potential cure for diabetes with stem cells.

A few years ago, there were hearings about how liver transplant hospitals were going to have to be built because of hepatitis C. Then all of a sudden, a drug comes out and it’s outrageously expensive. But then another competitor came out and crashed the price. The solution was the ability to get that into the population quickly. How do you adopt that as a model?

You have said you want to do oversight on Medicare. What might that look like?

Right now, we send durable medical equipment providers to drop off oxygen tanks. [Those providers] are very good, professional and really expensive. Why couldn’t that oxygen tank have been tossed in the back of a Lyft and dropped off for $12? How do I add technology and modern practices to disrupt that cost?

What’s next for telehealth after passing extensions in the omnibus? 

Updating the definition of what telehealth is. Imagine if I have a smartwatch, and it’s watching my temperature and heart rhythm, and it gives me an avatar that looks like whoever my favorite television doctor is.

I have a conversation with the avatar saying, “Can you analyze the data coming off my body? What’s wrong with me?”

Do you allow it to write the script?

Just starting to think of that as the future of telehealth is a revolution.

Do you think people will like that? 

People will love it. Telehealth was one of the most lobbied-against policies on Capitol Hill for years and years. “Grandma won’t be able to work FaceTime,” they’d say. Turns out Grandma knew how to work FaceTime.

What can Congress do to accelerate that? 

Stop being afraid of it. Because when you start to talk about how my doctor could be an avatar, you now have an army of lobbyists who are going to come and be really cranky with you.

DEA says it’s coming out with a rule on virtual prescribing soon. Is there something you’d like to see from that?

I really wish DEA, FDA, CMS and those on the policymaking side would sit around the table and understand each party’s concern. CMS is concerned about billing fraud. DEA is concerned about prescription abuse. FDA is concerned about efficacy and misuse. Republicans, Democrats and interested parties need to sit around a table and say: “Here’s the problem. What do we do to fix it?”

 

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This is where we explore the ideas and innovators shaping health care.

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FORWARD THINKING

LOS ANGELES - 1988: Hank Gathers #44 of the Loyola Marymount Lions drives the ball during a game in Los Angeles, California. Hank Gathers was one of the nation's top college basketball players in the late 1980's and early 1990's before collapsing and dying of a heart attack during a West Coast Conference Tournament game against Portland at the end of his senior season. Hank Gathers uses a left hand dribble during a home game (Photo by Getty Images)

Hank Gathers was a top college player before he collapsed on the court in 1990. | Getty Images

About 1 in 300 kids has an undetected heart issue that leaves them vulnerable to sudden cardiac arrest.

That’s one of the top causes of death in youth athletes.

The problem often goes undetected because electrocardiograms, or ECGs, aren’t typically used in athletes’ physicals. Nonprofit Who We Play For is trying to expand and improve heart screening by using artificial intelligence created by Amazon Web Services to pore over ECG data.

Who We Play For’s founder, Evan Ernst, told Ben that the AI correctly flags pediatric ECGs as normal or abnormal 94 percent of the time.

“Our dream is to make ECGs the standard of care for kids, especially athletes, but all kids, and that can’t happen right now in America because of the variability amongst [ECG] readers,” Ernst said.

Reading ECGs is difficult even for doctors, whose interpretations vary. Ernst hopes AI can provide more certain results.

The biggest challenge, said Rowland Illing, chief medical officer at Amazon Web Services, isn’t a lack of data but how to translate that data into something actionable.

 

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WORKFORCE

AW Medical’s doctors represent a range of cultures and ethnicities and have experience treating a Medicaid population.

HHS is looking into the root causes of physician burnout. | AP Photo/Evan Vucci

Concerned about doctors who say they’re overwhelmed with data, the Department of Health and Human Services is trying to evaluate the root causes of their burnout.

Between 2017 and 2021, hospitals increased their ability to research how their doctors use their electronic health records systems, according to a recent study from the HHS Office of the National Coordinator for Health IT published in the American Journal of Managed Care.

More than two-thirds of hospitals had data on the time clinicians took to document patient information in 2021. But the study also found that smaller hospitals lag behind medium and large ones, and rural hospitals are behind urban ones.

What’s next? Small electronic records developers have begun to offer auditing capabilities more frequently, which could alleviate those discrepancies.

“If these trends continue, gaps in access between lower-resourced and greater-resourced hospitals should narrow, enabling more hospitals to engage in data-driven provider burden reduction initiatives,” wrote the researchers, Chelsea Richwine and Vaishali Patel of HHS.

 

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