Predictive analytics: filling the gaps in the patient journey to help personalize care
Predictive analytics: filling the gaps in the patient journey to help personalize care11 March 2020 | 10min
Precision medicine starts with understanding the patient
One of the key opportunities for digital transformation is for predictive analytics to enhance the patient-physician interaction
The next leap for predictive analytics is to look at multi-dimensional, multimodal data – and collaboration is absolutely key
Predictive analytics is transforming healthcare. Generating actionable insights from clinical data may help patients better manage their health, lifestyle and disease risks.
Andrew Wu, cofounder and CEO of Mesh Bio, shares with us his views on the ground-breaking possibilities of predictive analytics in healthcare, what it means for patients, and ways of collaboration to harness its potential.
Understanding the patient first
HT: What does precision medicine mean to you?
Andrew Wu: Precision medicine starts with understanding the patient. This means, where their health state is today, where their health is trending over the next course of treatment. It means delivering the most appropriate care based on the individual’s health status in order to effect improvement. That’s what precision medicine means to us.
HT: What do you think is the most unknown benefit of predictive analytics or that is surprising about predictive analytics?
Andrew Wu: Predictive analytics has the potential to see the bottlenecks in the care delivery across a patient’s journey – what’s working? What’s not working? Not just for the patient but also for the provider. How is a nurse effectively engaging with a patient post-consultation? How is a healthcare professional treating, managing or engaging in the community? This is where predictive analytics has untapped potential to deliver insights for leadership as the patients engage with different delivery professionals across their journey.
HT: What is a problem or bottleneck that predictive analytics has helped solve that you’ve seen in your experience?
Andrew Wu: One of the key areas of improvement is the patient-physician interaction space. We know that healthcare providers are under a lot of pressure to deliver effective care in a short period of time. They also need to convince the patient of the meaningfulness or the value of the intervention program that they’re prescribing. Our focus is to use digital tools and multi-modal data to help physicians prioritize the most meaningful intervention for the individual.
An example of where we’ve been relatively successful thus far, in its early days, is helping doctors prioritize a complex patient case. For instance, when an individual is at elevated risk of cardiovascular disease, what are the major risk contributors ? if it is blood pressure, there would be a variety of interventions that could be meaningful.
The physician then focuses on understanding; Is it diet? Is it a lack of activity? Or considering where the patient is at today, is the best or most effective starting point a therapeutic intervention through targeted medication? Enabling physicians to deliver this kind of personalized care makes the patient feel valued – I’m not just a number or the person in between your previous patient and your next patient.
A holistic approach to care
HT: What do you think is the next big leap for predictive analytics?
Andrew Wu: The next leap for predictive analytics is to look at multi-dimensional, multi-modal data. So, rather than just looking at a computerized tomography (CT) scan or X-ray, how do you combine imaging, laboratory results and other types of information gathered from that patient-physician interaction to provide a holistic picture of the patient’s health and gain further insights. Because it’s not just a shadow on a kidney scan; How does your kidney function? How does your heart and liver function? Assessing the progression of the patient’s disease will help the physician make better decisions on the sort of interventions that make sense and how to mitigate any potential side or adverse effects.
Diseases are getting more complex, and we want to deliver holistic tools that simplify this decision making so that in the 15-20 minutes a patient has with a doctor, they’re getting meaningful insights, meaningful counselling and a very clear message on the interventions, why, and the expected outcome you will get as the patient.
This also increases the patient’s confidence in the system and when you have increased confidence, you get better compliance. Holistic assessment rather than a siloed predictive analytics approach is going to be the next big leap for predictive analytics.
Visionary leaders needed
HT: What do you think is the biggest barrier to what you’ve just described?
Andrew Wu: It’s leadership above all else. It takes visionary leaders at the leading healthcare provider organizations to see the value and convince the various stakeholders across the care organization to commit to working together, rather than shuffling the patient from laboratory testing to counselor or physician to imaging with data sitting separately in different buckets and silos.
Let’s integrate everything together so that holistic solutions can be deployed, and are tailored to the stakeholder, so each stakeholder within the patient’s care delivery journey has this holistic insight. It takes leadership to bring this all together. The onus is upon companies like us to demonstrate and build up compelling use cases, starting from small scale because change management is always challenging.
To underestimate the willpower and the buy in from different stakeholders is frequently the mistake of many companies. We need to demonstrate clear use cases and demonstrate that the patient is more satisfied, medication compliance is increasing, physicians are happier and better able to articulate the care delivery to the patient. Demonstrating all of this is key to getting buy-in from leadership.
HT: What do you think the healthcare leader could do starting today to prepare him or herself or their organization to be ready for these predictive solutions?
Andrew Wu: The big problem is the diversity of needs across the healthcare ecosystem. We talked a lot about the physician’s need, but the nurses may say, “I don’t get enough notes from the physician, so I don’t know how long follow-ups should be”. Or the community nurse practitioner who does home visits gets very sparse information about where the patient is at today and what needs to be managed in the long-term. That’s a picture of the fragmentation, not just in terms of expertise, but also in information that actually drives the delivery experience.
We are very fortunate to be based in Singapore, partly because of this awareness that chronic diseases are going to pose a huge burden to our healthcare systems, and we’ve been fortunate enough to have great leadership that recognizes this problem and has galvanized entire healthcare systems to make the change.
Rather than me saying what could be, it’s actually happening in Singapore, where we have the privilege of having tertiary healthcare integrated with community care and primary care as well. We have what we call a polyclinic, which is essentially primary care where an individual with a disease can be picked up early and then triaged to move into the tertiary care system to receive specialized care, or if it’s an acute case, into hospital.
Post discharge, they move into community care where they see a physician before they are discharged back home. Because these systems are all integrated under one roof in the physical sense, there is an opportunity to really change this journey and streamline the delivery processes.
Recognizing that we had this opportunity, health systems in Singapore have started innovation teams that are outside of these three care settings. They investigate how a patient care journey looks like coming in through primary care and then going into specialist care then going back into community care and going back home. How do follow-ups happen at the tertiary versus primary care level? Maybe you go and see the specialist once every six months, but you see a primary care professional once every three months to get your medication.
The opportunity is that these innovation teams can look across the care journey, identify key failures or bottlenecks within the system, and the vision is potentially integrating these data silos into a seamless care delivery system, so to speak. It’s why start-ups like ours have been engaging with a number of these integrated healthcare systems to deliver our predictive analytics solutions all the way across the paradigm, from primary care to specialist and eventually into community and long term care.
A focus on innovation
HT: I’m very intrigued by this concept of innovation teams. Who championed these and who is on the team?
Andrew Wu: Singapore is a very mandate driven society and it’s not just healthcare systems. Even our Ministry of Health has an Office of Healthcare Transformation that drives policy – like what is the data policy or what are the ethics around analytics solutions. So, even at the ministry level, the government level, there are innovative teams. There are also innovation teams at each care delivery organization. These could involve Chief Medical information Officers (CMIO), practicing physicians with a particular specialty, or oncologists or surgeons.
One of the organizations that we work with, the Chief of Data and Strategy is an anesthesiologist, which isn’t that obvious, but anesthesiologists deal with multivariate analysis all the time. When the patient is in the operating theater, they have to look at all these different variables and are always adjusting. They understand the need for a holistic assessment of the patient in order to quickly derive the next most meaningful adjustment or action to care for the patient, and in this case maintaining the patient’s state whilst they are undergoing the procedure.
HT: Do these innovation teams then bring in start-ups or industry partners to say, “Here are the gaps in our patient journeys, how can you help us close the gaps?’ Is there a formal process where they ask you to help them solve these problems?
Andrew Wu: I love that you asked this question. As I mentioned earlier, these innovation teams sit outside of the organization, so they’re not colored by vested interest so to speak. But, they have the mandate to look across the organizations to identify these bottlenecks or challenges.
One modality that we’ve been fortunate to have in Singapore is a digital platform for healthcare providers to put out innovation calls to address opportunities for transformation in care delivery. This is what our provider professionals are seeing as real challenges to delivering more effective and efficient care. Anyone with a great idea, either internally or externally, can propose a solution that addresses the pain point.
These innovation platforms then draw in start-ups or sometimes a scientist and a clinician that partner to develop a solution together. Mesh Bio has been able to go through this platform to partner with health systems to develop and deploy digital solutions that address their key care delivery challenges.
Collaboration for transformation
HT: This is an incredibly fresh way of solving problems. How important do you think this collaboration model is to the transformation of healthcare? What are the benefits and challenges of this model? Should it be something that gets imitated elsewhere?
Andrew Wu: Collaboration is absolutely key. It’s through this kind of convergence and insights that a more meaningful and well-rounded solution can be derived as compared to looking at the primary care professional who only wants things in this way, but software could do this. The main challenge is speaking the same language.
Physicians work in a particular way, and when you run a clinical laboratory, you’re very much process focused. It’s essentially getting the sample, pushing it through the machine, curating the insights, and pushing out the reports as efficiently as possible. But the physician is very much case driven. Every case is its own case – how do I draw in my wealth of insights and experience, and from the latest advances in medical knowledge to very quickly determine the needs of the patient.
Speaking the same language is the main challenge. Setting a common vision and partnership frameworks or commandments of mutual respect, such as in Startup Creasphere, and mutually trying to achieve the objective of transforming healthcare, that’s a very strong basis for engagement.
Mesh Bio successfully participated in Startup Creasphere, a leading digital health accelerator that strives to transform healthcare together with startups.
Dr. Andrew Wu is the cofounder and CEO of Mesh Bio, a digital health startup providing analytics solutions based on computational biology and AI, for chronic disease diagnosis and management. He was previously Chief Operating Officer of Clearbridge Biomedics (now known as Biolidics) where he developed innovative cancer diagnostics technology in the field of liquid biopsy. He was also Chief Product Officer of Clearbridge Health. Both companies are now listed on CATALIST on the Singapore Exchange. Andrew holds a Bachelors and PhD in Biochemical Engineering from University College London.