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Ep04: Part 2 – Population Health and Health Catalyst with Farhana Nakhooda

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00:03 Tony: Welcome to Digital Health Today, Asia Pacific edition, your go-to podcast to learn about the transformation of healthcare in a region with over 4.5 billion people across more than 40 countries. I’m your host, Tony Estrella.

This is part two of a conversation I had with Farhana Nakhooda. Please check out the first episode, if you haven’t heard it yet for more about her background as a healthcare executive working across Asia Pacific. Welcome back, Farhana.

00:28 Farhana: Thanks a lot, Tony. Great to be back.

00:30 Tony: Now let’s pick up on a conversation regarding population health. To me, the population health technologies come together when we have good systems for inputs, clinical and process analytics, and actionable outputs. And one of the things that stands out to me from your experience is how you’ve worked in partnership with two of the most important stakeholders to bring this population health solution and system to life, governments and hospital systems.

Now, getting started, because you and I both know can sometimes be a challenge, but success can really be rewarding. I’m curious if you could talk about a success story where you’ve seen all the parts come together in the right way, where you brought together the right people, and everyone felt the partnership experience made a difference?

01:11 Farhana: Yeah, absolutely. So one of the very first projects that I felt was a big success was a project that we did in Melbourne, Australia. It was in my first couple of years in IBM. And it was interesting, because I just talked about personalized medicine a bit earlier, and how we were so far ahead of the game.

But what was interesting is that when we went to Melbourne, we worked within a hospital group called Melbourne Health, which included four different hospitals. And when we went to talk to them, and we talked primarily to their clinicians about the fact that, you know, what would be very interesting to do and this was really in, I’m talking almost 2003-ish timeframe, so this was a long time ago, it would be very interesting to be able to look across multiple hospitals at larger populations, to do things like clinical research.

So for example, if I wanted to just say, show me all the patients that are 30 to 35, that have had a particular disease, right, and I want to basically identify that group to do a larger study on them as a clinical researcher. And then eventually, if you were saying, say, cancer, perhaps we also had some of their genetic data. What can we do? And we had a very, very strong CEO of Melbourne health who was looking across these four hospitals, and he said, you know what, I would love to basically be able to do that and start consolidating data. Because hospitals tend to kind of focus on their own patient data. And this concept of data sharing is not very common, and people are sometimes tend to get a little bit protective, but also, there’s security reasons, etc.

So we said, look, I mean, we understand that there are some issues around this. However, if we could create a platform that allows you to actually federate the data, so keep the data where it is, but be able to query the data across the four health systems in an anonymized fashion that would allow you to improve and this would help clinical researchers to publish more papers, etc, this would be fantastic, because you could start understanding more about health care and what creates better health outcomes.

And what we did, which was very interesting is that this was government, of course, so as you said, it’s sometimes a challenge. But what we did is we actually helped them write the business case, to get the funding to do this project. So, we have to give them all the ammunition to basically say, why this would benefit Victoria, why this would benefit Melbourne, and all the various stakeholders that would benefit, meaning the government would basically potentially be able to create new jobs, because this would be a new area of interest for people to start looking at data across larger groups. And then also, it would be great for the doctors themselves and the clinical researchers to publish more papers and get out there in the journals and learn more about the population and ultimately, it would improve patients’ lives. Right? Because you’re studying diseases across a larger community, and a larger population.

And so we ended up getting the funding and we ended up winning that project. And what became really amazing is that that still exists today. It became what’s known now as the “Biogrid”, and it’s still there, and they’ve got so many more hospitals on board. And I still remember honestly, the day that we went in and pitched this idea and it was kind of a wild idea. But the fact that it’s still up and running, I’m very excited for Melbourne and our original team that kind of started this whole project.

04:50 Tony: Oh, that’s exciting, belated congrats, and that’s nice to see this, something has had such longevity. And I guess, it’s also a good lead into what you currently do today: dealing with various similar customer problems. You shared with the once how strong the IBM alumni is and how hard it might be to leave something which is so familiar and impactful. Tell us a bit about why did you decide on making the change to Health Catalyst? What excited you about the opportunity?

05:17 Farhana: Yeah. So I mean, again, I think IBM, like you said, it is, it’s a phenomenal company. I mean, I had 18 fantastic years there, where I think I learned so much. But you know, I’d been there pretty well, since I left medical research, and I thought, well, if I’m going to do something different, it’s time to do it now, otherwise, I’m just going to end up retiring from IBM.

And it just so happened that a good friend of mine had actually posted on Facebook about a billion dollar unicorn that was going for IPO. And I started looking into this company. And when I understood what Health Catalyst does, and what Health Catalyst does is they’re a data driven outcome-improvement company. So what they do is they take data from health systems, clinical, administrative, operational data, they integrate that data into their platform. So they have something called the data operating system and they use that data to basically identify opportunities to improve access, cut cost, or improve quality, and if you’re a private hospital, even increase revenue.

And I looked at this, and I just thought, you know, I have met healthcare clients all over Asia Pacific for the last 18 years, and this solution is missing in Asia Pacific. I mean, most hospitals were looking at using data for maybe some clinical research projects, which are very niche, or really for an internal or external reporting purposes. Right? So just pure reporting. But I hadn’t seen any hospital really using data in this respect, which was really to identify real opportunities to save lives and improve outcomes from an enterprise wide perspective. And so it wasn’t an easy decision by any means.

But when I heard more and more about Health Catalysts, and I met their team, and honestly, it is probably one of the most mission-driven companies I’ve ever seen. And if you have an opportunity to look at Glassdoor on Health Catalysts, you should, because it is quite phenomenal. Because the people, they’re all come from health care. They’re all true believers in improving lives and improving outcomes. And that was always been my passion, my whole life. From the time I could speak, according to my parents, I was talking about going into health care. And to me, this company is a healthcare company, right, that’s what their focus is, is improving lives. And so I joined them, basically, because I wanted a new challenge, a new opportunity and I really felt like this was a niche area that was completely missing in the market in Asia.

08:00 Tony: Well, that’s a fantastic story. And I have to agree with you, having met many of your colleagues from around the world that is a fantastic group of people. And for those of you not familiar with Health Catalyst, I think one of the things that stands out as a company is how, when it comes time for compensating individuals for their performance, everyone’s incentives are aligned to improving health outcomes for your customers. And that’s when everybody wins is at the corporate level, at the partnership level, and at the individual level. And I think that’s special because everybody really believes that that’s the right way to approach working in this particular area of healthcare. And so it’s wonderful to see.

And, you know, one of the things about Asia Pacific is, it has its challenges when it comes to data. And I’m a big believer in the population health approach. And as you and I have talked about, given my background, I think that there’s many stakeholders that can be part of this broader view of population health that expands on what’s happened in health systems, in hospitals, and takes it to other types of stakeholders, whether that gets insurers involved, or employers. And talk a bit about the data challenge in Asia Pacific. You’ve seen many health systems. So where are we today as a region? That’s a big question. And then maybe point to one place where data is really coming together in a good way.

09:22 Farhana: Yeah. So again, you know, if you look at data across Asia Pacific, right, as you rightly said at the beginning, you’re really looking at multiple markets. Right? I mean, you said that when you think of Asia Pacific, you think of Southeast Asia, Australia, New Zealand, etc. So when I look at data, and I kind of compare maturity levels across the region, the first place I’d start is let’s go with the most advanced which would be the developed markets. Right?

So if I take say Singapore, Australia, New Zealand, Japan and even Korea, they’ve gone down the digitization path already. They’ve already put in place medical record systems. They have back-end ERP systems, billing systems, lab systems. And so that’s a big step, right, because they’re already generating data. But where the challenge in lies is, then what are they doing with that data? And is the data usable?

And so some of the challenges that they have in places is looking at things like data governance, or data stewardship, and ensuring that first of all, is the data collection being done the same across, right? Because once you start aggregating data, you need to be comparing apples to apples. And if everybody is pulling in data in a different way, you need to actually be able to pull that data and standardize it in order to use it. And so data quality becomes a challenge and issue, but it’s addressable. Absolutely.

And again, when you look at those markets, a lot of the data is really being used primarily for things like clinical research, which would be niche projects, let’s say, a clinician and his team is working on, or maybe a small group or collaborators are working on, or they’re using the data for internal reporting, or external reporting. But again, you don’t see people really using it, as I said, as a way to aggregate data across the whole organization and use it to improve insights. So that’s the develop markets.

Now, when you go developing, you really still have hospitals that are purely manual today. A lot of them are still doing paper base, right? And so yeah, one of their challenges is if I went to say, a hospital in Indonesia, and I said, hey, we’d like to collect your data and start analyzing it, they’d be my guest, here’s my paper records, and you’re welcome to use it. So that’s a very different problem altogether.

But again, what’s changing things, which is exciting is there’s a lot of digital health companies, as you know, right, that are starting to quickly, you know, help these hospitals leapfrog and go into a digital platform very quickly, where over time, these things will become digital. But again, in the developing markets, I think, we always talk about the fact that, even with basic billing data, and the one thing that’s kind of interesting is that every hospital in Asia, I would say, would at least have their billing digital just because they need to get paid. And so that’s always the starting point, is that even if you have billing data, we can already start to identify opportunities for improvement. But it takes time.

So you asked me the question about, you know, could you name one country or one organization that has really got the data equation right? And I think, I have to give a lot of kudos to Singapore, in terms of a country that has really put a lot of effort in digitizing their systems, and ensuring that the data is basically being collected and aggregated, because I think they’re going down this journey of data driven outcome improvement, but all the fundamentals are there. I mean, they have government support. The government is actually very focused on leveraging data to improve outcomes. I mean, that’s one of their biggest focus areas. In fact, the idea of democratization of data is something good.

But as you’re aware, there have been cyber breaches across the region, and there’s a lot of fear about those kinds of things. So they have to go about it as Singapore does very cautiously, which I totally respect, right. So they’re basically going down this path and they’re certainly taking the right steps towards, moving towards a data driven approach to improvement of health. But as I said, I think they’re going to do it at a pace that’s comfortable, that gives not only themselves confidence, but the public and patients confidence that it’s all being done in a very secure way that’s not going to compromise anybody as well, moving forward.

13:51 Tony: It’s truly special to see how much initiative has been taken to be proactive about putting data systems in place, because it’s been a really big decision. Right? It’s expensive. You’re changing behavior of people who may not want to go down that path. And it’s exciting also to see that it’s happening, not just at the hospital level, speaking about Singapore specifically, but it’s starting to take place that general practitioners and trying to get other stakeholders to really be plugged into that same sense of having a digital repository that can be used in a data and privacy safe way to help across stakeholders. So that’s transition that we’re seeing.

So you know, I think we’re coming up on time here for the conversation about what’s happening with Health Catalyst. Curious to get your views as to the next two to four years, what does it look like for you to see in this mission based environment that you’re in for Health Catalyst to have made a difference? What’s your views for these next couple of years?

14:53 Farhana: Yeah. So I think my dream is that in the next four or five years onwards, that at least in the more developed markets and slowly in the developing markets, that every decision that’s made in healthcare is done with data, right, is done with a data-driven approach. Because if you think about it, I would much rather go to a hospital where I know that doctors have data to leverage to make better decisions, right.

And to me, my vision, and what I would love to see is a lot of healthcare systems leveraging their data to improve their outcomes and cutting costs significantly so that it does a number of things. One, is it makes sure that patients don’t have to keep paying more and more and more. And the higher the government GDP spent on health care increases, that comes down to citizens, right? And the better the outcome are for patients, the better everybody is, right, the quality of life improves, etc. So to me, the value equation is very simple. It’s really about improving quality, at a lower cost and getting a better care outcomes and improving access as well.

So my real mission and vision over the next two to four years is to start down this path. I don’t expect that we’re going to hit every single hospital out there, but at least if we can get to a lot of the big markets that can actually use this kind of data-driven outcome improvement work to improve and save lives, I mean, to me, that would be phenomenal. Because, I mean, the beauty about this business is it’s a win-win. Yes, it’s a business. And, of course, we’re a company and we have a commercial business.

But the reality is that honestly, for the amount of money that’s being spent on this, the returns are just so much higher, right? I mean, some of our customers like Aligner Healthcare, they’re the size of Singapore, and we’re saving them 125 million US dollars a year in data-driven outcome improvement. Right? Now, you can imagine taking that to other countries and saying, well, Indonesia is moving to universal health care, and Vietnam is moving to universal health care. So they’re all needing to do more, get better outcomes at a fixed budget. And I would love to be able to help these markets achieve those goals, and ultimately help improve the lives of all these citizens and patients.

17:23 Tony: Wow, that’s admirable and fantastic. I can’t wait for the day to come where we’re seeing that in action across multiple countries. Thank you so much, Farhana, for taking the time to speak with us today. And look forward to speaking with you again sometime in the future.

17:38 Farhana: Yeah, thank you so much, Tony. And thank you so much for this opportunity. This was a great conversation. And yeah, I’m excited as well to see the outcomes of what we can achieve.

17:47 Tony: And that’s a wrap on this episode. Farhana’s LinkedIn information is in the show notes. Before I go, here’s how you our audience can support us. Please share this podcast with others. And if you subscribe, you’ll get updates on new episodes and other content. You can also get in touch with me on twitter at EstrellaVino, using the spelling of my last name or email at [email protected] if you have any questions, suggestions or ideas for future episodes.

And finally, please visit our website at digitalhealthtoday.com. We’re on our second home at healthpodcastnetwork.com to hear other episodes from our podcasting team including Dan Kendall, and Eugene Borukhovich. This show was researched and written by Taliossa and produced along with Mission Based Media. The sound and music was by Ivan Yurich. And until next time, I’m Tony Estrella, and thank you for listening.

 

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