After a career working at well-known companies like Geisinger and Google Health and currently serving as the President and CEO of Cerner, Dr. David Feinberg shares his unique technology lens regarding healthcare. Dr. Feinberg discusses the influence technology can have in improving patient and clinician experiences with host Bill Russell.
Dr. David Feinberg is driven toward making care better for everyone. Working a significant portion of his career in technology, he believes it is a potential tool and platform for this to happen.
His focus is to eliminate the waiting room. This includes the anxiety of access, communicating in ways patients understand, and making care accessible overall.
Inertia, or forces, keep the healthcare industry from reducing waiting room times and the overall connection with patients. However, the opportunity presented itself for an eliminated waiting room during the pandemic.
A new curve appeared in telemedicine where people realized a fundamental problem with the current health system. Dr. Feinberg explained that the present system is built around providers instead of consumers. When the system favors providers, more patients are within a waiting room, so a doctor's time is not wasted.
On the other hand, from a consumer standpoint, a system provides care 24/7, and information is accessible to patients.
During the pandemic, Dr. Feinberg was leading Google Health's efforts. From impressions, the team learned that people were looking for information on the virus early on. From that, they sought to provide accurate information that was not authoritative yet understandable. This effort could have a dramatic effect in saving lives, he explained.
In partnership with Apple, his team worked to create exposure notifications that took off worldwide. This brought a dramatic decrease in mortality. During a health crisis such as this, it became clear that access to information as consumers was integral.
With 15% of the 20 billion Google daily searches being health-related, the search engine proved to be a pivotal resource for the country navigating the pandemic.
Since his time at UCLA, Dr. Feinberg has worked toward patient satisfaction, where he helped the health system adopt this focus. Previously a place where two out of three patients would not recommend UCLA to a friend, after focusing on patient experience, the system shifted from the 28th to the 99th percentile.
The system flipped patient opinion by adopting the mission of healing humankind one patient at a time by alleviating suffering, promoting health, and delivering acts of kindness.
Dr. Feinberg took this experience with Geisinger and helped the system adopt its original money-back guarantee on specific procedures. The system holds care pathways where reinfection rates are calculated and having the surgery again is covered.
Proven Care is a no money-back guarantee on any part of a patient's experience with no questions. Through an app, patients can leave feedback about their experience and will be reached out to make anything right by staff.
"It was incredibly worth it to be able to refund money to people who we didn't do right by and learn where we did right. But we also were learning where we're doing really well," he said.
According to Dr. Feinberg, healthcare accounts for 20% of overall health. The other 80% revolves around a patient's zip code and genetic code.
In his work with Cerner, he sees how healthcare is delivered worldwide. For example, doctors can prescribe opera in Sweden because they combine social and medical care.
"If you're in a value-based situation where you're responsible for the outcomes of patients, you start thinking about the things that drive better outcomes. Things that drive better outcomes are not just making sure they don't get an infection during surgery, but figuring out how you can avoid surgery altogether," Dr. Feinberg said.
Transitioning to a value-based mentality means that health systems no longer should treat a patient's immediate physical need but also ensure they don't return soon. This is where considering other influencers of health outcomes like transportation, food, and loneliness is essential.
Acknowledging the need for people to access healthy, nutritious food and transportation are essential factors Dr. Feinberg wants the United States to implement.
By ensuring people have these necessities regardless of their background, he believes the healthcare costs in America would decrease by 50% overnight.
"It would be the biggest boom we've ever had in our economy because a lot of that would then go to wages, and everything would get better," he said.
Half of the disorders physicians treat are lifestyle disorders due to patients not readily having these needs met.
Cerner's primary focus is improving usability for clinicians. There is a need to dramatically reduce the time nurses spend looking for supplies or at their terminals.
Dr. Feinberg and his team pose the question of how technology can be used to help clinicians complete important tasks at the bedside as opposed to at a terminal. Improving product usability is Cerner's top job.
"I don't want to go incremental. I want to go leapfrog and really change how we do it," he said.
During the pandemic, clinicians struggled to find patient charts because they were physical copies locked in offices. Cerner has digitized records and is now working to make them usable for non-clinical needs.
He explained that disparate data sets need to be given back to people so they can make actionable decisions. By collecting larger pieces of data, clinicians gain insight into helping patients.
Responding to recent headlines that healthcare is too hard for big tech, Dr. Feinberg believes that Google is a healthcare company in many ways. For example, a large percentage of patients take time to research on Google before going to the ER or starting a new medicine. Google is also moving records to the cloud-like other health systems like Oracle, Microsoft, and AWS.
"Healthcare to me, fundamentally, is people caring for people, and technology is a tool," he said.
While tech companies try solving health through apps, it does not work on their own. More than this, it is about connecting with people, communities, and families, according to Dr. Feinberg.
Tech companies mess up when they see health as only a technology problem and negate it as a human problem.