
Patients should have final say and control over their health data, HHS said Tuesday.

Atul Grover, MD, PhD, the executive vice president for the Association of American Medical Colleges, sat down with Representative Lauren Underwood, D-Illinois, for a conversation about her healthcare-related efforts during her first year in Congress representing people from a suburban rural district 2 hours from Chicago.

The evolution of data in healthcare in combination with policy advancements demonstrates how far the field has come but also brings up new challenges.

From a value-based medicine perspective, we think there's no greater value in the healthcare system than improving survival for cancer patients and reducing the costs of treating late stage cancer; we believe the GRAIL test could be the test case for how to make this transition, said Joshua Ofman, MD, MSHS, chief of Corporate Strategy and External Affairs at GRAIL Inc.

CKDintercept, the primary care initiative of the National Kidney Foundation, involves multiple strategies aimed at improving the quality of kidney care, explained Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.

Physical disabilities may make it difficult for patients with chronic kidney disease to follow provider recommendations and achieve a good therapeutic alliance, which can lead to increased burden of illness, according to Cynthia Delgado, MD, associate professor of medicine at the San Francisco Veterans Affairs Medical Center and University of California San Francisco Medical Center.

The GUARD-AF trial will allow us to look at both the benefits and the risks of screening for atrial fibrillation and the reduction of stroke, said Roland Chen, MD, MS, vice president and head of clinical development for innovative medicines at Bristol-Myers Squibb.

Pathways are not trying to restrict or take control of treating the patient from the physician, it’s actually trying to enhance that for the physician and take the guesswork of how to do that out of it, said Rani Khetarpal, MBA, vice president of Oncology Value-Based Partnerships at New Century Health.

We are really excited about the progress we have seen in the EXPLORER-HCM trial, and after the results are published in the first half of 2020, we will quickly begin conversations to seek FDA approval of mavacamten, said Jay Edelberg, MD, PhD, senior vice president of Clinical Development at MyoKardia.

Blue Cross Blue Shield utilizes data to drive insights into what works and what doesn't work in cancer care, as well as, delineating trends through our collaboration with provider specialties and organizations across the US, said Jennifer Atkins, MBA, vice president of Network Solutions at Blue Cross Blue Shield.

Results of the PIONEER-OLE study has shown promising results of mavacamten for patients with obstructive HCM that will be further evaluated in our pivotal phase 3 EXPLORER-HCM trial, said Jay Edelberg, MD, PhD, senior vice president of Clinical Development at MyoKardia.

At the end of the day, the focus should be on improving the efficiency of our healthcare system and bringing cost-effective care to patients, said Jane Barlow, MD, MPH, MBA, EVP and Chief Clinical Officer for Real Endpoints.

There are multiple ways in which people with diabetes can develop heart failure, which is why heightened awareness through the initiative Diabetes Can Break Your Heart is warranted, said Javed Butler, MD, MPH, MBA, professor of physiology and chairman for the Department of Medicine at the University of Mississippi.

Recent findings have shown that aerobic exercise improves microvascular function and coronary artery function in patients with kidney disease, but further research is needed on the relationship between exercise and kidney function, said Danielle Kirkman, PhD, assistant professor at Virginia Commonwealth University.

The patient's voice is important in analyzing and evaluating the effectiveness of care, as well as in assessing the value of new treatments, said Stephen Edge, MD, FACS, FASCO, vice president of Healthcare Outcomes and Policy at Roswell Park Cancer Institute.

Through the risk-based, capitated model it has implemented, New Century Health promotes the ability to control drug costs without jeopardizing care for the patient, said Rani Khetarpal, MBA, vice president of Oncology Value-Based Partnerships at New Century Health.

The phase 2 ESCaPE-CMD study results exhibited a significant improvement in coronary flow reserve for patients with CMD, said C. Noel Bairey Merz, MD, FACC, FAHA, director of the Barbra Streisand Women's Heart Center.

Future research should examine the effects of exercise on slowing the progression of kidney disease, among other important questions, according to Danielle Kirkman, PhD, assistant professor at Virginia Commonwealth University.

An increasing emphasis on prevention is shifting the mindset around pediatric nephrology, and findings from ongoing studies will further expand the evidence base, said Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

A major upcoming challenge in healthcare will be determining how to pay for specialty drugs and medical advancements like cellular therapies, said Bret Jackson, president of the Economic Alliance for Michigan.

Better blood pressure measurement techniques, electronic health record alerts, and simpler clinical practice guidelines can all help primary care clinicians identify hypertension in children, said Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Including an exercise physiologist or physical therapist on a multidisciplinary nephrology care team can make it easier to include exercise as part of routine care for chronic kidney disease (CKD), said Danielle Kirkman, PhD, assistant professor at Virginia Commonwealth University.

Implementing screening for chronic kidney disease (CKD) in the primary care setting can help identify patients who may benefit from upstream interventions and medications to reduce their risk of kidney failure, said Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.

Correctly diagnosing hypertension in children is crucial for identifying other underlying conditions and allowing for earlier treatment and better outcomes, explained Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

There are new technologies that allow for genetic counseling services through which the provider does not even need to get that involved in the process, said Banu Arun, MD, medical oncologist, Department of Breast Medical Oncology, Division of Cancer Medicine, MD Anderson Cancer Center.

Listening to patient concerns and issues and communicating with them can really help providers keep patients with breast cancer adherent to their hormonal therapies, said Erica Mayer, MD, MPH, assistant professor, medicine, Harvard Medical School.

Two abstracts on liquid biopsy tests revealed the potential of analyzing circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) in promoting heightened decision-making by clinicians for patients with early-stage and metastatic breast cancer.

In phase 3 trial results presented at the San Antonio Breast Cancer Symposium in San Antonio, Texas, oral paclitaxel with encequidar, the first orally administered paclitaxel, was shown to exhibit superior confirmed response and survival with less neuropathy for patients with metastatic breast cancer compared with intravenous (IV) paclitaxel.

Rita Nanda, MD, associate professor, medicine, The University of Chicago Medicine, outlines the design of the I-SPY2 clinical trial and what the results have been so far.

Ensuring that prognostic or predictive tests to help make decisions regarding radiation therapy are accurate and clinically validated remains a challenge, said Corey Speers, MD, PhD, assistant professor, radiation oncology, University of Michigan.

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