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in and saying, “Well, we can deliver a big data and AI platform.” That doesn’t actually mean anything, right? Hooker: We have a long history of hype in genetics. They even have their own name for it called genohype — instead of genotype. Remember when the human genome was sequenced and the announcement was made in 2003, there were folks saying, “Oh, in a couple years, we’re all going to have our genomes sequenced? We’re all going to be walking around with our genome on a watch, on a phone?” And here we are, 15 years later, and still maybe one or two million genomes have been sequenced worldwide, the majority of them for research or clinical purposes. It’s taken a long time to get even to where we are in 15 years, and in many ways we aren’t where we thought we would be. In other areas, we’re ahead of where we thought we would be — in cancer and molecular microbiology and things like that. So, it’s a mixed bag. Now, bringing in the AI piece, I think it’s sort of adding onto of a lot of the hype that was already there. Through it all, though, I think that there’s a core group of folks able to work through it and continue to innovate in very pragmatic ways. Stringer: As a scientist, I say prove it to me. And that’s something that I tell people all the time. Here’s a story that I thought was really interesting and sort of proved my point: I’d get asked all the time by investors and other leaders, “What are you doing to bring in new data sources and shouldn’t you be putting together legal information about somebody who has a DUI or something like that?” And it’s like, “Well, our models are pretty good right now. I don’t know how much more accurate you want them to get.” But in the latest Stanford Medical Center magazine, there was a profile of a scientist working with a physician on a predictive model for patients that need to be engaged in palliative care conversations and end-of-life conversations. It’s a really great piece. And you think about Stanford and their access to the EHR and in pulling in data from there. What they ended up pulling in — the data they pulled in to train their model — was just this sort of claims-based data. That’s the data I deal with so I found that very interesting, that I’m sort of challenged all the time about needing to integrate with EHRs and pull in the data from EHRs. And here’s, you know, Stanford — where so much innovation is happening
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— and they’re just using the claims part of this EHR. It’s something for us all to really consider. What are those validation outcomes? How much better we can get with these hype words? Heinley: The proof is in the pudding. Stringer: Yes. Heinley: So let’s bring this back home, to Nashville. I’d like to get your take on the future of the city’s fast-growing, data-driven medical sector. Douglas: I think it’s really exciting to see Nashville. I was born here and moved around a lot and ended up back here. I love this city. It’s exciting to see it shift from — and I mean no disrespect here — the old guard of health care such as HCA, CHS and so on and really get into the smaller, entrepreneurial, tech-focused companies delivering solutions for niche industries within health care. That’s what I get really excited about and when I come to events like these and meet people and hear about what they either are doing or want to do. Hooker: We talk a lot about knowing Nashville is both physically and sometimes is metaphorically situated between Silicon Valley and Washington D.C. and how that gives rise, in my perception and experience, to a very pragmatic innovation. It says, “Yeah, maybe we won’t all be wearing our genomes on a watch six months from now. In Silicon Valley, they might. But how do we really innovate at the real-world challenges of health care? How do we use real-world data to drive decisions and how do we deliver systems that can really reach a lot of different people who are in a lot of different places when it comes to health?”
O’Hara: Using the word pragmatic is how I think about it. We can hold ourselves out as the real world. You know, we’ve got the HCAs and the LifePoints and large companies that manage a lot of hospitals. We know what the reality is on the ground. That can be limiting in a way, too, right? But we’re going to be more about iterative innovations, pragmatic innovations. And that’s sort of what we think about ourselves. But that makes us, I think, inherently less of kind of a moonshot town. We’re not hype-y. We compete against some companies that are in Silicon Valley, that have raised tens of millions of dollars and they’re former Google engineers and former Uber engineers and their take is that health care is really broken. “The people who are doing it today are messed and they don’t understand how to fix it and we’ve got magic pixie dust and we’re good enough to come sprinkle it on you guys in Nashville and fix the messed up stuff that you’ve been doing for a long time.” And there’s some value in that, right? I mean, there’s this notion that, if you ask people what they want, they wanted a faster horse. So there’s that inherent tension that I think we in Nashville have a lot to offer in the regard of understanding how this stuff lives on the ground. But thinking about how to get out of that trap a little bit to take bigger moonshots is also important. Heinley: I saw a lot of heads nodding around the room as you were talking. Elizabeth Ann, anything to add to that? Stringer: I think another important part about moving the technology forward is the money that it takes to do that. When I think about Silicon Valley and the way they’re able to advance and innovate, so much of that is predicated on the money that’s there and the investor community. We have some great investors here in Nashville but we’re nowhere near the size of the capital that we would need here to do the things that they do in Silicon Valley. That does limit us a little bit more. And so there is more of that pragmatic approach. Data inherently is kind of sterile so how do you bring humanity to that? And there’s a connection here in Nashville with having such a large provider community, a hospital community that helps us really understand the health care ecosystem better and allows us to move forward. But it’s not going to look the same as Silicon Valley.
WINTER 2018 | NASHVILLEPOST.COM
Vitals Panel.indd 24
11/15/18 11:43 AM