Most executive industries in this business are with C-suite types with a strong background in marketing, or a strong background in engineering (and marketing). So I was pleasantly surprised to find that Dell Inc.’s Andrew Litt was the company’s chief medical officer and, to boot, a neuroradiologist of 30-plus years’ experience. He studied New York University’s School of Medicine and eventually became the executive vice-president, vice dean and chief of staff of the university’s Langone Medical Center. He was in Toronto on Monday to speak at the conference of the Ontario Association of Community Care Access Centres and spoke to us before the presentation.
* Litt said health care is “one of the key verticals for Dell,” and one founder Michael Dell is passionate about. From the time Dell purchased Perot Systems five years ago, services has been a focus, and the health care vertical is a large part of that. While the company doesn’t break out revenue by vertical, Litt said about 13,000 of Dell’s 100,000 employees work on the health care file, including more than 300 medical doctors, registered nurses and PhDs. The bulk of Dell’s health care business is in the U.S., though Canada, the U.K. and continental European also rank highly. Litt said there’s something of a boom in Middle East hospital-building, while in developing nations in Africa, focus is on wireless technology because there isn’t much existing wired infrastructure.
* Litt identified a number of key issues in health care wherein IT can help with the goal of improved care for fewer dollars. Collaboration is the first among them. “(There’s) not great collaboration” among the team treating a patient (aside from within the hospital walls. A U.S. senior with one chronic condition will see seven doctors in an average years. They generally don’t have access to each other’s records, so “the patient ends up being the data carrier,” moving records back and fourth among offices. Electronic health records are part of that solution, but standards are vital. Hospitals might have a number of systems, and the 30 or 40 doctors in the area are likely running different systems. Only health care giants like Kaiser Permanente will have a standardized set of tools. “Most places don’t have that,” Litt said.
* Payment methodology and funding are also significant drivers for technology, as health care systems eye a shift from fee-for-service to risk-based funding, wherein metrics judge quality of care. “We don’t want to incent people to give more care,” Litt said. “We want to incent them to provide better care.” Without data on treatments, outcomes, admissions, and myriad other factors, “how am I ever going to provide better care.” — or hold someone financially responsible for that care, Litt asked. Litt said we’ll see an increase in remote monitoring technologies for chronic care patients that send data directly to the hospital. He cites Cancer Care Ontario as one example of a health care organization with a huge trove of data collected over the course of 20 years. “That’s very powerful,” he said.
* We’re moving from a “paternalistic” health care culture to one where the patient wants to be more in control of their care, Littl said. “If you’re used to managing your whole life online, doesn’t it make sense to manage your health?” Litt said. “They need their data to do that.” Personal health monitoring software, like Microsoft’s Health Vault, haven’t taken off, but it’s through no fault of the software — it’s because users don’t want to be bothered to rekey it in. “That will change,” he said.
* Nowhere is safe from the BYOD movement, and health care’s not immune. According to Litt, 62 per cent of the 500,000 doctors in the U.S. use tablet computers. While Dell does make a Windows-based slate, Litt said, the company tends to support mobile devices in a virtual environment, with health-care apps “firewalled” away from other apps that could collect personal data.
* Dell provides cloud-based high performance computing for the Translational Genomics Institute, a network of 13 research hospitals working on treatment for neuroblastoma, a rare cancer that affects children. The goal is to identify genetic fingerprint of individual tumours to determine which combinations from a list of 150 available chemotherapy drugs will be most effective. The data sets involved are so huge, they had to be shared among the researchers by FedExing hard drives back and forth. Litt says the HPC cloud has cut analysis time to five days from three weeks. It’s not only good from a philanthropic perspective, Litt said. “In addition, it’s a great proof-of-concept,” he said. “We are big believers that cloud has a big role to play in health care.”