A decade ago, doctors Tom Frieden and Farzad Mostashari wrote a commentary for a leading medical journal entitled, “Health Care as If Health Mattered.” The essay, published in JAMA (sorry—it’s behind a paywall), had a simple, if obvious, premise: “Health care must be restructured to make maximizing health the organizing principle.”
As simple and obvious as that might seem, however, that’s not how health care today is structured. Our system is a try-to-fix-it-if-broken one, not a try-to-keep-bodies-healthy model.
Dr. Frieden and Dr. Mostashari, at the time of their commentary, were then the New York City Health Commissioner and Assistant Commissioner, respectively—where they had led pioneering efforts to reduce smoking and rid the city’s restaurants of artificial trans fats, among other initiatives. One can argue, of course, whether or not such peremptory municipal injunctions are appropriate, but the idea behind them was the try-to-keep-bodies-healthy approach. Get people to quit smoking and you reduce the risk of them developing cancer, heart disease, cerebrovascular disease, COPD, and those wet, hacking coughs on the subway. Push restaurants and other food suppliers to stop serving junk laced with industrial-strength trans unsaturated fatty acids—“solid fats produced artificially by heating liquid vegetable oils in the presence of metal catalysts and hydrogen”—and you might actually reduce the incidence of coronary heart disease and diabetes in a wide swath of citizens.
In their JAMA commentary, the duo suggested three “synergistic changes” to transform the health paradigm: (1) change the payment structure overall to offer “substantial rewards for disease prevention and effective management of chronic disease”; (2) develop an “information system oriented toward prevention”; and (3) change care management so that it supports the above.
Importantly, all these things have to be done together, they argued, for such a new model to work. (“Pay-for-performance initiatives have been hampered by lack of reliable information on quality of care and outcomes,” for instance.)
Back in 2008, Frieden, who would later go on to run the CDC during the Obama administration, and Mostashari, who would become National Coordinator for Health IT, had high hopes for information systems, such as electronic health records. “EHRs have the potential to enable valid clinical quality measurement, high-quality preventive care, and better management of chronic conditions such as hypertension and hypercholesterolemia,” they wrote.
I think it’s fair to say they haven’t lived up to that potential. But who knows, maybe if we can truly reorient the entire U.S. health system toward a prevention, preemption, and maintenance model, EHRs will find their right mission and achieve it.
The day’s news is below.
|Clifton Leaf, Editor in Chief, FORTUNE|
Modified mosquitoes credited with plummeting Dengue rates in Australia. Scientists have used a novel genetic modification technique that’s being credited with plunging Dengue fever rates in the Australian city of Townsville. The researchers released about 4 million of the pathogen-carrying Aedes aegypti mosquitoes infected with Wolbachia bacteria—bacteria that prevent the skeeters from transmitting viruses like Zika and Dengue. (Nature)
Capsule raises $50 million in Series B. Online pharmacy Capsule has raised $50 million Series B funding round led by Thrive Capital and Glade Brook Capital with participation from existing investors. Capsule has set out to challenge traditional pharmacies such as CVS and Walgreens and is aiming to expand nationwide, just as Amazon gets into the drug distribution business.
President Trump will say something about drug prices next week. President Donald Trump on Tuesday told a group of business leaders that his administration will be “announcing something next week which is going to get [drug prices] down really substantially.” It’s unclear what the administration has planned, although its recently released blueprint on drug prices has been criticized as largely being soft on drug makers, although it does take aim at middlemen such as insurers and pharmacy benefits managers (PBMs). (Reuters)
Rep. Chris Collins indicted for insider trading on a biotech. New York Congressman Chris Collins (R) has been indicted for insider trading involving a tiny Australian biotech called Innate Immunotherapeutics. Collins had also convinced several of his fellow members of Congress—including former Representative and Health and Human Services Secretary Tom Price—to invest in the company, which then had a catastrophic clinical trial failure. The indictment issued Wednesday alleges that Collins called his son immediately after learning new of the failure and that his son then sold shares, avoiding more than $768,000 in losses. Collins’ son and the father of his son’s fiancée will also be facing charges, though Collins’ spokesperson has promised a “vigorous defense” to clear the Congressman’s name. In the mean time, House Speaker Paul Ryan announced that Collins would no longer be serving on the powerful House Energy and Commerce Committee as the matter is resolved and will face an internal ethics investigation. (Fortune)
THE BIG PICTURE
WHO: Health workers being vaccinated against Ebola. The World Health Organization (WHO) announced Wednesday that a vaccination campaign for health workers has begun in the Democratic Republic of Congo, which is facing yet another Ebola outbreak. The experimental vaccine has been developed by Merck and previously deployed in Ebola-afflicted regions; what makes the current outbreak even more difficult to cope with is it’s happening in a particularly volatile and violence-riddled region of the country. (Reuters)
A Cryptocurrency Bloodbath: Bitcoin, Ethereum, and More Plunge, by Chris Morris
Trump Administration Announces Tariffs on $16 Billion in Chinese Imports, by Hallie Detrick
The HALO Shirt Promises to Reduce Concussions in Football Players, by Don Reisinger
|Produced by Sy Mukherjee|