Hospitals hit back on drug pricing, but will they knock out the problem? – Ernst Berndt

From The Conversation

MIT Sloan Professor Ernst Berndt

MIT Sloan Professor Ernst Berndt

Drug manufacturing and pricing vaulted into the news several years ago when a privately held company raised the price of a drug used for infections from US$13.50 to $750 for one pill.

After an outcry from hospitals, the company later relented, dropping its price by a small margin. Still, this single dramatic increase shed light on the once obscure arena of older generic drugs that continue to be in short supply and whose prices occasionally skyrocket.

Frustrated with these shortages and alarmed by the potential for price gouging, a coalition of hospitals has recently struck back. Four not-for-profit, religiously affiliated hospital systems and the U.S. Veterans’ Administration announced their intent to form a company that would manufacture generic drugs, thereby helping to mitigate or eliminate shortages and prevent future massive price spikes for rarely used generic drugs.

I’m an economist who has studied the health care industry, including the U.S. generic industry, and I see a few regulatory and business hurdles to this approach.

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Defending hospitals against life-threatening cyberattacks – Mohammad S. Jalali

Mohammad Jalali, MIT Sloan Research Scientist

From The Conversation

Like any large company, a modern hospital has hundreds – even thousands – of workers using countless computers, smartphones and other electronic devices that are vulnerable to security breaches, data thefts and ransomware attacks. But hospitals are unlike other companies in two important ways. They keep medical records, which are among the most sensitive data about people. And many hospital electronics help keep patients alive, monitoring vital signs, administering medications, and even breathing and pumping blood for those in the most dire conditions.

A 2013 data breach at the University of Washington Medicine medical group compromised about 90,000 patients’ records and resulted in a US$750,000 fine from federal regulators. In 2015, the UCLA Health system, which includes a number of hospitals, revealed that attackers accessed a part of its network that handled information for 4.5 million patients. Cyberattacks can interrupt medical devices, close emergency rooms and cancel surgeries. The WannaCry attack, for instance, disrupted a third of the UK’s National Health Service organizations, resulting in canceled appointments and operations. These sorts of problems are a growing threat in the health care industry.

Protecting hospitals’ computer networks is crucial to preserving patient privacy – and even life itself. Yet recent research shows that the health care industry lags behind other industries in securing its data.

I’m a systems scientist at MIT Sloan School of Management, interested in understanding complex socio-technical systems such as cybersecurity in health care. A former student, Jessica Kaiser, and I interviewed hospital officials in charge of cybersecurity and industry experts, to identify how hospitals manage cybersecurity issues. We found that despite widespread concern about lack of funding for cybersecurity, two surprising factors more directly determine whether a hospital is well protected against a cyberattack: the number and varied range of electronic devices in use and how employees’ roles line up with cybersecurity efforts. Read More »

Reimagining Chile’s healthcare system: Harnessing the power of strategic analytics and Big Data to keep patients healthier for less money – Rafael Epstein, Marcelo Larraguibel, Lee Ullman

Lee Ullmann, Director of the MIT Sloan Latin America Office

Lee Ullmann, Director of the MIT Sloan Latin America Office

From El Mercurio

Economic growth, urbanization, and rising affluence are having a profound impact on the health of Latin Americans. Very little of it is positive, especially in Chile.

While life expectancy has increased faster in Chile than in most OECD countries and income per person has quadrupled over the last quarter-century, great disparities continue to exist between the country’s public and private healthcare systems. Healthcare costs are skyrocketing and many of the country’s public hospitals—especially those in rural areas—face a shortage of general practitioners and family physicians.

The modern Chilean diet—comprised largely of ultra-processed foods and sugary drinks—is taking a toll. One third of Chilean children are overweight or obese; one quarter of Chilean adults are in those categories. Chronic diseases, like diabetes, are increasingly prevalent. Stress-related disorders and mental illnesses are also on the rise, as are rates of alcoholism, tobacco use, and certain types of cancer. Over the last decade suicide has been one of the top 10 causes of death in Chilean men.

Today’s statistics are bleak, but we have hope for the tomorrow. Technological innovations and discoveries, powered by Big Data, hold enormous opportunities for Chile and Latin America overall. To explore this further, we are hosting a conference next month in Santiago—“Strategic Analytics: Changing the Future of Healthcare”—that aims to highlight the many ways in which data and analytics promise to transform the provision of healthcare. The conference is expected to draw hundreds of researchers and leaders from academia, health care, government, and industry.

Our agenda is ambitious. By combining MIT’s expertise in analyzing massive amounts of data and optimizing complex systems with Universidad de Chile’s path-breaking medical research and Virtus Partners’ strategic and operational insights, we aim to unravel the complicated underlying problems that plague the healthcare system.

Of course many countries—including the US—face healthcare challenges. Our hope is that this conference inspires engineers, medical professionals, economists, and technologists from all over the world to see the benefits of working together to improve human health. Our goal is simple: to keep patients healthier for less money.

Progress is afoot. At MIT, researchers have devised algorithms that boost treatment for certain diseases, including diabetes, using a combination of machine learning and electronic medical records. At a time when 1.7 million Chileans, or about 12.3% of the population, have diabetes, this research has important implications.

The dawn of telemedicine—which enables doctors to monitor patients from afar—also holds promise, particularly for patients who live in remote areas. (Chile is a long and skinny country, and about 10% of the population lives in rural areas.) Researchers at the Universidad de Chile’s Medical Informatics and Telemedicine Center are using sensors and other devices to monitor patients’ blood pressure, heart rate, weight, and blood sugar levels from great distances. Technologists at the MIT Media Lab are finding new ways to apply emotion technology and wearable devices to help sufferers with autism, anxiety, and epilepsy manage their symptoms.

Researchers are also finding new ways to contain medical costs. Using Big Data to measure returns of healthcare spending, economists are able to help hospitals uncover best practices and align incentives to improve the quality of the care they provide. This has special relevance to Chile. The country’s Fondo Nacional de Salud (FONASA) struggles with overwhelming management challenges and increasing costs. Meanwhile, access to high-quality technology and healthcare services is still limited to the wealthy.

The promise of Big Data is immense, but so, too, are its perils. Many questions remain: How do we ensure that patient data stays both confidential and secure? How do we safeguard against Big Data applications creating even more disparities between the rich and poor, and instead use it to build a more equitable healthcare system for all? And how should governments cope with managing the high costs of aging populations?

These are big challenges and nothing will be solved overnight. Our hope is that the conference will point to new ideas and solutions that improve patient health for generations to come.

Read the original blog post at El Mercurio.

Lee Ullmann is the Director of the MIT Sloan Latin America Office.

Rafael Epstein is the Provost of Universidad de Chile.

Marcelo Larraguibel is the Founder of Virtus Partners, the management consultancy, and an Advisory Council Member of the MIT Sloan Latin America Office (MSLAO).

Using big data to manage medical expectations — Cynthia Rudin

MIT Sloan Asst. Prof. Cynthia Rudin

From The Health Care Blog 

For all the advances in both medicine and technology, patients still face a bewildering array of advice and information when trying to weigh the possible consequences of certain medical treatments. But a hands-on, data-driven tool I have developed with some colleagues can now help patients obtain personalized predictions for their recovery from surgery. This tool can help patients better manage their expectations about their speed of recovery and long-term effects of the procedure.

People need to be able to fully understand the possible effects of a medical procedure in a realistic and clear way. Seeking to develop a model for recovery curves, we developed a Bayesian modeling approach to recovery curve prediction in order to forecast sexual function levels after prostatectomy, based on the experiences of 300 UCLA clinic patients both before radical prostatectomy surgery and during the four years immediately following surgery. The resulting interactive tool is designed to be used before the patient has a prostatectomy in order to help the patient manage expectations. A central predicted recovery curve shows the patient’s average sexual function over time after the surgery. The tool also displays a range of lighter-colored curves illustrating the broader range of possible outcomes.

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Why we can’t fix our healthcare system — Ayesha Khalid

From TEDx

This talk was given at a local TEDx event, produced independently of the TED Conferences. Ayesha Khalid, surgeon at Harvard Medical School and recent MBA from the MIT Sloan Fellows Program, is at the intersection of disruptive innovation in healthcare and the digital health experience. Ayesha previously pioneered groundbreaking research in sinus disease including muco-ciliary clearance and outcomes following surgery. She is now a passionate believer that disruptive innovation in healthcare requires collaboration, not competition. Using a systems thinking approach, Ayesha wants us to suspend our belief that adding more process to our healthcare system will add back “health” and “care” to a broken system. Instead, this compelling talk provides an imaginative way to approach the redesign of our health care system to one that promotes “health” and works “systematically” for the patient.

A sinus surgeon at Harvard Medical School and recent MBA graduate from MIT, Ayesha Khalid is a healthcare innovation enthusiast involved with entrepreneurial ventures at the intersection of healthcare innovation and digital technologies. She has pioneered groundbreaking research techniques in inflammation and sinus disease and is working to create different funding paradigms to accelerate clinical research.

For more information, see this op-ed about Dr. Khalid’s approach to reshaping the healthcare system in Huffington Post UK.

Ayesha Khalid is a surgeon at Harvard Medical School and recent MBA graduate from the MIT Sloan Fellows Program.