John Halamka

ANALYSIS JOHN HALAMKA, MD, LAUNCHES MAYO CLINIC'S 'DIGITAL DATA BUSINESS' BY MANDY ROTH | JANUARY 07, 2020 Mayo Clinic TOPICS Telemedicine Innovation Data Analytics Business Strategy Technology The physician and innovator shares his vision as the new president of the Mayo Clinic Platform. KEY TAKEAWAYSHalamka will help Mayo Clinic expand from an empathetic care business to also a digital data business.The Platform Halamka is developing will create convenience and access for patients, and focus on using technology to deliver in-home care.Machine learning is poised to have one of the greatest impacts on healthcare delivery, says Halamka. In an industry demanding change, one of healthcare's leading innovators is undergoing a personal transformation to accelerate innovation on a grander scale. On January 1, John Halamka, MD, assumed a new position as president of the Mayo Clinic Platform, which the Rochester, Minnesota, healthcare system says is a coordinated portfolio approach to create new platform ventures to take advantage of emerging technologies such as artificial intelligence, connected healthcare devices, and natural language processing. Halamka is an emergency room physician and technology expert, who developed his first healthcare application 40 years ago at age 17 and later helped launch a technology startup in the basement of a Palo Alto, California, home. He leaves behind a 20-year career as chief information officer at Beth Israel Deaconess Medical Center, most recently serving as executive director of the Health Technology and Exploration Center for Beth Israel Lahey Health in Boston. He also was the International Healthcare Innovation Professor at Harvard Medical School, has served two U.S. presidential administrations, and consulted with governments around the world, planning their healthcare information technology strategies. Halamka spent much of December 2019 "volunteering" at the Rochester, Minnesota–based Mayo Clinic, meeting with stakeholders and immersing himself in the ethos of one of the world's leading healthcare organizations. He plans to commute to Minnesota weekly from his Massachusetts home, where he operates Unity Farm Sanctuary, which he established with his wife, for rescued farm animals. GET THE LATEST ON HEALTHCARE LEADERSHIP IN YOUR INBOX. Enter your email Halamka completed his undergraduate studies at Stanford University, where he received degrees in medical microbiology and public policy, with a focus on technology issues. He went to medical school at the University of California, San Francisco, and simultaneously pursued graduate work in bioengineering at the University of California, Berkeley, focusing on technology issues in medicine. He completed his residency at Harbor–UCLA Medical Center, Los Angeles, in the department of emergency medicine. Halamka then joined the faculty of Harvard Medical School in Boston and completed a post-doctoral fellowship in medical informatics at Harvard and Massachusetts Institute of Technology. HealthLeaders caught up with Halamka recently. In part one of this interview series, he tells us about his career journey and what he hopes to accomplish at the helm of the Mayo Clinic Platform. In part two, Halamka shares broader perspectives about the industry, as well as the roles players like Google, Epic, and Cerner perform in the greater landscape. His comments have been lightly edited for clarity and brevity. HealthLeaders: Why was Mayo Clinic a good choice for you? John Halamka, MD: When I look at the 40 years that I've been in this industry … I've often looked at "when is there a perfect storm for innovation?" That perfect storm usually occurs when there's alignment of government policy, of academic progress, and industry innovation. Then there's also a culture, motivation, urgency to change, and visionary leadership. Mayo has a culture right now with Gianrico Farrugia, MD, the new CEO and president, that says in 2025 hospitals are not only going to be in the empathetic care businesses, they're [also] going to be digital data businesses. [Mayo Clinic will be] using data of the past to figure out how to deliver care appropriately in the future and [will] take data that is being generated from the things you wear, the things in your home, and interpret them in novel ways. [Farrugia's] view really is that we need to transform as a healthcare industry, and [the organization is] willing to invest in it. So I thought, hmm, Mayo—an $18 billion organization with 86,000 employees, and an urgency to do digital transformation—has a perfect storm opportunity. That would be the reason I'm trying this new adventure. HL: Do you feel it's necessary to have a stage like Mayo Clinic to do that? Halamka: You need a platform by which you can convene people and that may mean third-party companies, academics, or government leaders. So the Mayo brand is a very powerful way to bring people together. When I look at the places in this country where they could actually pull this off, it's probably one of the few. (Courtesy Mayo Clinic News Network) HL: What do you want to accomplish at Mayo, and what factors will lead to your success? Halamka: [As a patient, provider, or healthcare navigator for your family] ask yourself, "what aren't you getting today?" I could argue that in most healthcare environments you aren't getting convenience, access, and evidence—all the things that a patient would want. So might we take the assets that Mayo Clinic has—which includes data, expertise, and molecules like genomes and pathology—and through a technology platform, make them available to patients in novel ways? That's what I've been asked to lead. What do I mean by novel ways? Maybe some of the care that you're going to receive when you're sick isn't in the brick-and-mortar hospital; it's actually in your home. That's okay and safe because we now have the capacity to monitor you in your home closely. In fact … how much medical expertise is usually in the brick-and-mortar facility at three in the morning on a Sunday? You've got your interns; you've got your residents. You may not have the specialty experts there, but if you're talking about a digital telemetry service where you're being monitored in your home 24/7—continually staffed by experts and machine learning, and all the rest—you actually might get more attentive care in your home. HL: What innovations do you think are going to have the greatest impacts on healthcare? Halamka: I have a new book* coming out that reflects on the impact of machine learning on healthcare practice. Why do I think machine learning is here, practical, and ready for prime time? Machine learning is pattern recognition. As a clinician, I was trained to recognize patterns. … The challenge is that there is more medical literature published every day than a human can read in a lifetime. [Machine learning] is not replacing humans, but [offers] tools that augment human decision-making by saying, "Hey, doctor, for the patient in front of you, 83% of patients like that in the past had this disease." That's powerful. … The power of using these tools helps us scale the human experience far beyond the learning apprenticeship of any one person. HL: Let's time travel. We've gone 10 years into the future. What were you able to successfully accomplish at Mayo; how would things be different? Halamka: Prognosticating the future is always challenging. But imagine this, my daughter who's 26 told me, "Dad, my husband and I just moved to the Washington, D.C., area and we were hungry. So we picked up the phone and we got GrubHub. We needed a ride, so we picked up the phone and we took a Lyft. I also got a new doctor who wants me to fax my medical history." Shouldn't my daughter say, "Dad, I picked up my phone and Mayo Clinic was there. I got the teleconsultation, the prescription, the advice that I needed. No fax machine was involved." [Ten years in the future] we've moved to an app economy. We've moved to an on-demand economy where, whether it's using a service on my phone or even just passively having the monitors that I'm wearing connected to my clinician, it feels like I have continuous care. It's not as we have today—extraordinarily disconnected and episodic care. HL: What are the greatest obstacles and challenges that the healthcare industry has to overcome to achieve the vision that you have for Mayo? Halamka: That's an easy question to answer. It isn't technology; technology is good enough. It's fear of change. I'm a clinician, so clinicians aren't the earliest adopters of emerging technologies and for lots of reasons. They're concerned about safety, and risk, and reputation. In moving an organization forward, you have to permit risk-taking, but within guardrails. You can't have patient harm. Change management is always the hardest task. *Reinventing Clinical Decision Support: Data Analytics, Artificial Intelligence, and Diagnostic Reasoning, coauthored by Halamka and Paul Cerrato, MA, is published by CRC Press. “MAYO CLINIC HAS A PERFECT STORM FOR OPPORTUNITY.”JOHN HALAMKA, MD, PRESIDENT, MAYO CLINIC PLATFORM Mandy Roth is the innovations editor at HealthLeaders.