CRF President Calls for Adaptability in the Face of Innovation, Health Care Reform

San Francisco, CA—The United States is currently at an intersection of innovation, payment and regulatory reform, and the only way to create a value-based health care system is to change with the times, according to CRF president and CEO, Jack L. Lewin, MD. During his Keynote Address Wednesday morning at TCT 2013, Lewin explained the five critical trends currently shaping innovation, and the impact they will have on the future of interventional cardiology.

“Innovation is not [facing] decline in the future of the United States, but …. we have to think differently about how to bring products to market, how to treat patients and, in cardiology and interventional cardiology, [how to] manage people over time,” Lewin said.

The first of these trends is the progression of science, Lewin noted, citing developments such as progenitor heart cells and robotic surgery, as well as future inventions like MRI machines the size of cell phones and flash drives containing personal genetic code.

“This is an amazing time,” he said. “Science is going faster than ever; the National Academy of Sciences says we’re going to double medical knowledge between now and 2022, and it may even go faster than that because of the information age and the move to global scientific progression that’s going on.”

Second among the trends is information technology and big data, or the use of extremely large datasets for analysis. Technology-based breakthroughs set to transform the economy and the field of cardiology include the use of the internet as a “cloud,” allowing rapid change in information; smart engineering and manufacturing; and the wireless revolution’s potential to transform health care, Lewin said. Additionally, big data, analytics and research will promote the use of patient databases based on information from the government and insurers. 

The third trend is the change in politics and public scrutiny of health care quality and costs, according to Lewin. Health care costs, specifically Medicare and Medicaid, are currently the primary driver of federal spending and are increasingly responsible for destabilizing the US economy, he said. 

Regulatory expansion is also part of the innovative process, and is the fourth critical trend. The US Food and Drug Administration (FDA) in particular will be an important part of the equation with the implementation of innovative trial designs and a faster drug and device approval process, Lewin said. 

The fifth and final trend, which Lewin said will greatly influence innovation, is health reform and its payment components. In payment reform, according to Lewin, a percentage of costs accrued in the post-acute space of a procedure like PCI could be spared if cardiologists took responsibility for patients who re-enter the hospital in the 90 days following the procedure. Doing so would not only benefit patient care outcomes and regulatory agencies, but also improve the reimbursement process, he said. The unstable financial climate of the US health care system is an important issue, but to reach a point of sustainability requires adaptability, Lewin said. In the future, big data will change the ways in which drugs and devices are researched, developed and marketed and how their performance is quantified. 

“This is going to be a time in which payment reform, health reform and regulatory reform come together to create a new environment for innovation,” Lewin said. “There’s going to be an increase in global research — that’s great — but the United States isn’t going to see a decline in innovation leadership if we’re willing to change with these times and become part of the process of creating a value-based health care system, so let’s take on the challenge.”

Disclosures:

Lewin reports no relevant conflicts of interest.