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October 23: Today on the Conference channel, it’s an Interview in Action live from HLTH with Joe Gagnon, CEO and Board Member at 1upHealth, Inc. Trying to synthesize sprawling healthcare data to make it usable and beneficial to patients is a vast mountain to climb — but that's exactly what Joe is up to. In this interview Joe explores 1upHealth's ambitious attempt to construct a multi-use general-purpose data platform capable of handling anything from claims to clinical data while focusing on the industry adoption of FHIR data standards. What's in store for AI and machine learning when quality data takes center stage? How can 1upHealth's API revolutionize patient access to medical data?

Unlock the full potential of AI in Healthcare with experts David Baker, Lee Milligan, and Reid Stephan on Nov 2nd, 1 PM ET. Learn to navigate budget constraints and enhance operational efficiency in healthcare IT. Don’t miss out on affordable, scalable AI solutions and practical tips for success. Register Here: https://thisweekhealth.com/practical-ai-in-healthcare/

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Welcome to This Week Health Conference. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a set of channels and events dedicated to leveraging the power of community to propel healthcare forward. Today we have an interview in action from the Fall Conferences on the West Coast.

Here we go.

All right, here we are from the Health Conference, Health 2023. We're out here in Vegas. And today we are joined by Joe Gagnon with OneUp Health, CEO of OneUp Health. Yes. Looking forward to this conversation. We're going to cover a lot of different things. But for those people listening who aren't familiar with OneUp Health, give us an idea of the data platform and what you guys are doing.

Yeah. So,

over the past sort of three and a half years, what we've done is A multi use, sort of general purpose data platform for the industry to be able to consume anything from claims to clinical data. Use the FHIR data standard to platform that data in the cloud and then make that data accessible to any use case, downstream process, analytic, containerize that data, basically enable patient access.

Both FHIR, ACCESS, and

COMPETE. So, if I'm building, if I'm with a health system, and I want to bring all this data together, claims, clinical data, and whatnot, and I want to build an app, or I want to include it in one of my apps I'm going to be able to essentially have... The ability to tap into that through APIs and what not and deliver that back out to the

consumer.

Yeah. Yeah, so that's what we really started off building. The first API for patient access actually five years ago. And it's evolved into a set of APIs that can enable any of the authorized, of course, right? It's got to be authorized patient access or under TPO. As long as you have the authority to get access to that data, you leverage our API, you put that behind the scenes.

And then it pulls the data in the format that your application can compute on.

So, I mean, a lot of these apps are just going to use OAuth or SAML or something, and they're going to authenticate against, you know, MyChart or some other... That's right. But once they do that, now we can start to...

Aggregate a lot of information. A lot of people rely on just the pie chart functionality. Yeah, and this allows them to expand it to a lot of different data sets.

Yeah, I think that so it starts with a simple use case like that where someone's trying to build their own record So to speak, but really the benefits in healthcare are against risk, quality, care, right?

Those things are where real money flows. I mean, think about real time quality measures that FHIR. Think about an ACO relationship or risk based relationship using 90 day old data. We can help you get that to

real time so you can really understand that relationship.

And then, one day, enable... Care manager with real time data combining sort of even gaps in care being closed because now I see from the claim whether that prescription was actually filled even though that doctor wrote the script that may not have happened and that data does not come together today.

That 90 day old data, to some, might sound like a crazy use case. Yeah. I hear it often. Yeah. Like, it's, you have these care managers or population health management companies who are making decisions on data that is 90 days is

kind, actually. Yeah. in our lives is next to real time data. And so what we're doing is decided that let's move away from proprietary data models. Let's not have this be just one. Like, so let's leverage the cloud. Let's leverage things like JSON, which is just a data format in the cloud, right? Let's leverage the open internet with security to make this work.

Interoperability has not succeeded because we tried to do conversions, actually, rather than platforming FHIR, which the industry has finally adopted. Which actually makes it possible for us to communicate. It's almost like the dollar is a standard currency, FHIR is a standard currency for data exchange

and changes how we can work together.

But it's not the only way that you exchange data. No. There's probably a FHIR is bulk FHIR. Because I think that... When you have a trusted partnership in a, in an ACO model or some other... We're going to be able to transmit that political data, the claims data, back and forth and create an accurate picture of what's going on in that population or in that.

And hopefully drive better outcomes. I would think are we seeing more adoption yet, or is it still pretty slow?

It's early, but what we're starting to show, right, is that in a specific relationship, because I have a... Health plan, an ACO partner, health system. They're starting to share data and starting to look at how different it is, so we're doing the before and after comparison.

It's like tech enabled re engineering. You bring technology to re engineer a process. So the design of the ACO concept is great, but if the data doesn't move effectively, then you don't get to a good outcome. So, I think we have some behavioral changes to work through. We have some industry trust that has to be built.

But overall, what's good is that we will have a utility that any business can use to operate better. And that's what we've needed forever, right? And this doesn't obviate the need for all the tech that's on this floor. It all should use our platform to move data in between all the different

stakeholders.

I want to talk to you a little bit about AI it's either in their name or it's just hovering over that whole floor right now. Um, AI requires accurate data. That's right. Like, it's great that we have these these transformers that can now make these great summaries, but it makes summaries of quality data. Yeah. I would assume. At this point that, that's one of the, that's one of the bigger use cases is how are we going to get this data into these models in an effective way so that we can train these models and then start to create the use cases to solve some of the problems that's

a great question.

So, we actually did a lot of research on AI, and actually, one of our teammates left and started an AI company to build transformer models for care planning. But, I think we've got to sort of step back a little and think that first we've got to build quality data. We have to trust that data is of quality, and we know that today, every time we push data into a system, we probably have not really measured its quality.

So, first part is... We're going to build a platform that brings data to a level of quality you could measure, in the accuracy, in the currency of that data. Once we have that, then we can use that as an input into an LLM. We want to actually start by using some machine learning on the front end to help interpolate that data and make more sense of it.

And then we can use that data collectively once it's been cleaned and it's high quality and it's aggregated at a mass scale to then feed into the LLMs that others can leverage. So we don't really have an intention to be an AI platform, but you need good quality, robust and comprehensive data to do that and we're starting on that.

Journey now,

We'll get back to our show in just a minute. Having a child with cancer is one of the most painful and difficult situations a family can face. In 2023, to celebrate five years of This Week Health, we have partnered with Alex's Lemonade Stand all year long with a goal of raising 50, 000 from our community.

We've already achieved that goal and we've exceeded that goal by 5, 000, so we're up over 55, 000 for the year. We want to blow through that number. We ask you to join us. Hit our website in the top right hand column. You're going to see a logo for the lemonade stand. Go ahead and click on that to give today.

We believe in the generosity of our community and we thank you in advance. Now back to our show. 📍  because I think one of the things as CIOs, we somehow lose sight of, I'm not sure how we lose sight of this, but we think like all the data is in the EHR, and it's only a small percentage of the data. And actually if you're looking at really health outcomes in general, a very fractional percent of what actually leads to health is in the EHR.

And so, We're going to have to aggregate a lot of different datasets over time to get that whole person profile in order to deliver better care.

Yeah, this idea of the LPR, Longitudinal Patient Record, right? But that requires, like, so, imagine most of us, we've changed health plans probably... three or four times in the past five or ten years, right?

So, you might have Humana and United and a Cigna who have our history. Payer to payer which CMS is sponsoring, will allow us to get historical payer data together. Then I can go get that data. From the different medical records that you're a part of, and either at the health plan level or personally, you can start to assemble that data so you actually really do have a historical view.

And as you change status in your life, you want to have that history, because without that, we're either retesting, we're making incomplete decisions, we're costing out in a different way than we want to. So, it isn't about replacing the medical record. But it's a patient history that's really important to many of the decisions we need to

make.

So much, and it's not like we're serial changers of health plans, but we change jobs. Yeah. It's like we didn't have a choice. No. That we just changed. And eventually we're all going to have to change because we're going to go to Medicare and we didn't start on Medicare. Oh

my gosh, and that's a huge issue, right?

So when someone, they call it, ages into Medicare from a commercial plan, none of that data moves forward. Right, and so you're almost a brand new patient to whoever, if you're in an MA plan or even just a Medicare generally, and so there's this Big potential for a gap that gets created because you don't have the history.

Yeah,

at a time in your life where...

It matters more than ever. Yeah, no, I think that we know that the predominance of our cost of healthcare goes up as we age. So we can do that transition better by making the data move

easier. Boy, we'll get better outcomes. So, in the last couple minutes here, I just started my health journey.

I'm Let's say I restarted my health journal. Yeah, there you go. I've let myself go and a personal trainer. I'm monitoring some different things, blood glucose and to try to be healthier and I've been able to lose 26 pounds. Congrats! So, which is great. But you are at the peak here.

So you've, give me the marathon. So you ran, how many

marathons in? Oh, I did six marathons in six days on six continents. The marathon is 26... 26. 2 miles, so yeah, and I flew 37, 000 miles that week, and I ran 157 miles, and actually only slept 14 hours. I was on these overnight flights every day. But what was interesting about it was everyone thought that was a big deal, but I had sort of worked up 15 years of my life to be ready for that, and I think what I've found personally, which you'll find on your journey, is that your system, who you are, is actually capable of way more than we ask of it every day.

And I keep on upping the gain every year, and I find that I'm capable. So my big challenge this year, Bill, was to do 100, 000 push ups and to run 3, 000 miles.

In the year. In the

year. So I'm doing 300 push ups a day, every day. Keeping myself accountable to sort of a goal, but it's also, the diet.

It's the mindset. It's not carrying stress. It's having great relationships. It's actually just reframing how we think about the intersection of biology and lifestyle. And if you want to live a long, happy, and vital life. You have to actually make good lifestyle choices because our biology doesn't work in our favor and we can't change that but we can work with it and I've found that I've uncovered power in myself and I just went to, you know, when when I was a kid I went to school in the Bronx.

I didn't come up from anything really that fancy but I felt that through the choices I've made I've changed the potential of what I could do. So today, you know, I can go out and do an adventure race, I could do an ultra marathon, I can ride 100 miles on my bike, I can do whatever you ask me to do because I'm Built the power along the way.

You can start with just one mile and one

pushup. That's all you have to do. You don't have any sensors or anything on you, or do you

not? Yeah, no, I do not. My watch does do some things for me. I think that the sensors are not as accurate as we would like them to be. So I do track what I do every day.

I've written down my activity for the past 21 years, so I can tell you what I've done every day for that. I haven't actually, I've exercised every day for the past 11 years, at least an hour a day. I haven't taken a day off. I keep this as part of the sort of like, eat well, sleep well.

Seven days a week. Seven days a week. Exercise, I write every day. I actually try and take ownership over myself I'm never a victim, and it really makes

a difference and I would love to measure more, by the way.

Whether it's inside tracking around a blood test or a better device that could monitor, if I have data feeding back to me, I'll know why my performance is what it is.

It's really a good thing for us. Joe, I appreciate the conversation. Bill, thank you very much. Thank you.

Another great interview. I want to thank everybody who spent time with us at the conference. I love hearing from people on the front lines. It is phenomenal that you shared your wisdom and experience with the community and we greatly appreciate it. We also want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders.

They are CDW, Rubrik, Sectra, and Trellix. Thanks for listening. That's all for now.

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