Connected Health: Epic president talks patient engagement

BOSTON—“Analytics at the point of care is a fun, fun area,” said Carl Dvorak, president of Epic, speaking at Partners HealthCare’s 10th Annual Connected Health Symposium.

“We have great repositories of information to analyze which gives incredible insight in how patients experience rehabilitation.”

The biggest thing that needs to change, Dvorak said, is accountability of the patient. “We hear a lot of talk about accountability for providers and I meet a lot of providers who are sick of it. We have to find a way to engage patients at a deeper level and make sure it’s clear what they need to do. It’s incredibly important when providers are at risk financially for that patient.”

Dvorak said apps are good but they sit in siloes outside the health management construct. The ability to bring all the data together and whip it up in the blender would produce an impressive drink, he said.

Dvorak said Epic is working on genograms and genomics and patient engagement with regard to family members. “The genomic process is an important part of the process to understand phenotypic information of patients.” A patient can report parents’ and siblings’ health experiences with 50 to 60 percent accuracy but grandparents comes down to 30 percent accuracy.

Today though, all the generations have some kind of EHR and even more people will have fairly comprehensive records within the next five years. “We’re creating the infrastructure to allow relatives to donate their medical history. That will go a long way to simplify the genomic annotation process, and what an impressive database of research information that’s going to provide.”

These efforts also can help with research recruitment. “We can do a lot more through patient engagement and direct them to research that matters to them specifically. We can promote trials that are uniquely appropriate to a patient.” One big challenge, however, is keeping those signed up for a trial on the schedule. Many patients fall off because they didn’t know the schedule. New tools provide reminders and alerts to keep trial participants on the protocol.

Dvorak said Epic has developed MyChartBedside that offers inpatients education, information about their care team, schedules and more while an outpatient module offers patients a recovery companion to help monitor rehab.

Speaking of monitoring, Dvorak said consumer devices can serve as a hub to collect biomonitoring data and not just stream it to a clinician’s inbox but to sophisticated algorithms watching for negative trends. “In theory, this was available in the early 2000s but it was expensive and clunky and had a lot of infrastructure needs.”  

Wifi, Fitbits and other consumer-grade products now allow opportunities “we couldn’t cost-justify before,” Dvorak said. He also said that a lot of conference speakers disparage healthcare but he thinks “what people do in healthcare is extraordinary and amazing. Core vendors will be very active in this area but smart core vendors recognize the larger potential.”

Dvorak said it’s exciting to be a vendor in this space and compared patient engagement to the last mile of a marathon. “The obvious question is, what will you mile time be?”