Interviews

At the American College of Cardiology 66th Scientific Session, Eric Peterson, MD, professor of medicine in the division of cardiology at Duke University School of Medicine, presented study findings that showed patients discontinued rivaroxaban less frequently than other anticoagulation agents. These results are important, he said, because regardless of what a clinician prescribes, “it’s the drugs that patients take that make the difference.”

The increased emphasis that the Affordable Care Act and Medicare accountable care organizations (ACOs) placed on prevention is important in reducing the high cost of older patients, especially as the baby boomer generation reached retirement age, explained Mariétou Ouayogodé, PhD, post-doctoral fellow at The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth.

Jonathan Hirsch, founder and president of Syapse, was working to earn a PhD at Stanford when he noticed that physicians needed better software systems in order to successfully implement precision medicine. He then dropped out of graduate school to found Syapse, a health IT company that provides physician-friendly software.

When caring for patients with diabetes, it’s important for providers to take into account the patient’s culture and how it can affect communication styles and treatment preferences, according to Heather Zacker, MS, senior director of Care Alliances of Joslin Innovation at Joslin Diabetes Center.

Advances in technology has had a profound impact on the National Library of Medicine and allows the use of virtual reality to deliver information in new ways to patients, explained Patricia Flatley Brennan, RN, PhD, director of the National Library of Medicine.

The cost of oncology care has increased significantly in recent years, leading employers to worry about how they can provide consistent benefits for employees with cancer and their family members, according to Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

Patients with obesity often face severe stigmatization from healthcare providers, which can discourage them from seeking help, according to Fatima Cody Stanford, MD, MPH, MPA, FAAP, FTOS, of Harvard Medical School and Massachusetts General Hospital. She explained that the “dismal” obesity education in medical schools can lead physicians to judge obese patients unfairly.

Years of experience as an oncology nurse practitioner have underscored the importance of evidence-based resources for both patients and clinicians, says Carrie Stricker, PhD, RN, AOCN, chief clinical officer and co-founder of Carevive.

When discussing value in oncology, the outcomes that matter are those that are important to the patient, said Stuart Goldberg, MD, chief medical officer, Cancer Outcomes Tracking and Analysis, John Theurer Cancer Center. He also discussed how the use of data to stratify patients is important for providing value-based cancer care.

Convenient care clinics like MinuteClinic allow patients without regular primary care to become more informed about their health and medications, according to Kristene Diggins, FAANP, CNE, NEA‐BC, DNP, MBA, manager of professional practice at MinuteClinic.

As healthcare increasingly rewards quality and value in care delivery, Aetna hopes that 75% of its payments will be value-based by 2020, according to Harold L. Paz, MD, MS, executive vice president and chief medical officer at Aetna.

Despite the number of available drugs for treating rheumatoid arthritis, many patients still have untreated symptoms, according to Grace C. Wright, MD, PhD, clinical associate professor of medicine and attending rheumatologist at New York University Langone Medical Center. Treatments could be tailored more efficiently if tests helped to predict which individual patients are most likely to respond to a medication.

Insurers can engage the practices they work with by building a sense of trust and open communication with the providers, according to Kim Eason, manager at Horizon Blue Cross Blue Shield of NJ.

Hospitals don't always adequately prepare patients for the reality of cancer treatment and all the ways it might affect someone's life, explained Melissa Thompson, MBA, healthcare strategist, patient, and self-advocate.

Contrary to concerns that telemedicine could be overused, some programs are seeing lower involvement than expected, according to Anne Schmidt, MD, associate medical director at Blue Cross and Blue Shield of Alabama.

The Oncology Care Model (OCM) can challenge providers who are overwhelmed by the wide scope of data involved, according to Barry Russo, CEO of The Center for Cancer & Blood Disorders. He explained the importance of educating staff, physicians, and patients to help ease the journey towards any new model.

Genomic-based solutions can help identify which cancer patients will respond better to treatment based on biomarkers, said David Fabrizio of Foundation Medicine, Inc.

Recent advances in insulin formulations and innovative drug classes have made it easier than ever to manage diabetic patients’ glucose levels, according to Yehuda Handelsman, MD, FACP, FACE, FNLA, medical director and principal investigator at the Metabolic Institute of America.

Precision medicine has demonstrated clinical utility and cost-effectiveness, which is why many believe this approach will be key to value-based cancer care in the future, said Jonathan Hirsch, founder and president of Syapse.

The Network for Excellence in Health Innovation finds potential areas of innovation and then tries to eliminate the obstacles to those ideas so its members can achieve the triple aim, according to Susan Dentzer, president and CEO of The Network for Excellence in Health Innovation.

Joseph Alvarnas, MD, of the City of Hope and editor-in-chief of Evidence-Based Oncology, admits that he was once “oblivious” to his patients’ concerns about the cost of cancer treatment. However, it is important for clinicians to empathize with these fears and understand how they can factor into a patient’s care choices.

As founder and CEO of The Samfund, Samantha Watson has found that most cancer patients prioritize their physical health over their financial stability, leaving them lagging behind their peers economically or even facing bankruptcy.

Investing in Project ECHO allowed Health Share to offer continuing education for providers, and many of them now say they enjoy participating in the program, said Christine Bernsten, senior manager of delivery systems transformation for Health Share of Oregon.

The introduction of value-based payment models means that the goals of providing optimal patient care have become aligned for the clinician and the insurer, leading to more cooperation and support, said Roy Beveridge, MD, chief medical officer of Humana. This represents a shift from the more adversarial relationship between physicians and payers that existed under fee-for-service models.

Carevive recognizes the importance of including patient-reported outcomes into the care planning process, so they have developed surveys that will provide patients with the resources to address those concerns, according to Carrie Stricker, PhD, RN, AOCN, chief clinical officer and co-founder of Carevive.

The spread of HIV has stabilized in some areas of the world, but continues to rise in others, said Thomas C. Quinn, MD, director of the Johns Hopkins Center for Global Health.

Surrogate endpoints could eventually add to or replace clinical endpoints in determining a cancer treatment’s effectiveness, according to Pam Mangat, MS, associate director TAPUR study at the American Society of Clinical Oncology. She also said that a deeper understanding of a patient’s genetic makeup and tumor biology in conjunction with new technologies will drive improvements in oncology care.

Through the use of workshops and other productions, the Texas Business Group on Health educates employers on how they can maximize value through oncology care innovations like precision medicine, according to Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health.