Andrew Sorenson: [
00:00:00] Too many families are dealing with struggles related to the cost of health care. And so for me, my personal why is trying to find ways to pull low value care out of the system. And I think that that's the way that I can maximize the contribution that I'm making to society.
Speaker2: [
00:00:18] Welcome back to a fireside chat with Jill Merck Research looking at health care I.T. with a lens to the future.
John Moore III: [
00:00:28] So I'm joined today by Andrew Sorenson, who is the chief analytics officer of Castell Health. Could you tell me a little bit more about what that means and what you do with pesto?
Andrew Sorenson: [
00:00:36] Yeah, so Castell Health is a population health services organization that was founded by Intermountain Health Care in 2019. And as the chief analytics officer, I helped think through all of our product strategy related to technology and analytics products and find ways to deliver insights to care teams so that they can provide really high quality care to the patients that we serve.
John Moore III: [
00:01:03] Fantastic. So can you tell me a little bit more about some of the projects that you've worked on specifically in any of the unique things that you've had to troubleshoot or work through to actually make these insights accessible and digestible for year end users.
Andrew Sorenson: [
00:01:17] Yeah, absolutely. There's been huge gains and progress made in the technology and analytics space over the last five years. And in fact, I'd say that in a lot of ways, our ability to produce insights and to process data has outpaced our customers ability to think through the requests that they have for us at times. And so an important part of the way that we partner with our customers is to really understand the problems that they're trying to solve and then take what we know about how we can manage data and then deliver something to them that we hope outpaces what they've looked for. And so one example of that is this algorithm that we've created called the ensemble outreach model. And essentially what we do is we bring data together using a number of vendor partners like Arcadia. And then we build a model that helps care teams understand who would be the most important patients to reach out to to ensure that we're delivering really affordable and high quality care.
John Moore III: [
00:02:14] So when you talk about affordable care, are you referring to kind of the shift towards value based care and doing cost containment and identifying gaps that can be addressed around performance and bad actors on the physician side, bad practices? Is that something
Andrew Sorenson: [
00:02:28] You're referring to? Absolutely. We should hire you to to talk about it. That's a really good understanding.
John Moore III: [
00:02:33] So that's what we write about here at Hallmark. So I've got a pretty good sense of what what you guys tend to do. But there's so many nuances and flavors of it that I'm trying to tease out what it is unique.
Andrew Sorenson: [
00:02:41] Sure. So here are some things that I would say are pretty unique about Castell. A number of organizations exist similar to us, but as far as I know, those organizations really serve a pretty narrow population, either a very small number of people or a very narrow set of the health care industry. By contrast, Castell provides value based care services that support commercial populations, Medicare Advantage populations, as well as populations that are in CMS based programs such as MSSP and direct contracting. So we have a very broad footprint, and we serve about nine hundred thousand members, which is orders of magnitude larger than most organizations that would consider themselves our competitors.
John Moore III: [
00:03:29] So I know that you were one of the speakers here at Hemmes this year. Could you tell me a little bit about what you presented on and what some of the findings are that you were sharing with the rest of the community?
Andrew Sorenson: [
00:03:36] Yeah, we've had a number of great opportunities to present at HIMSS. It's been a really great experience here. A couple of the things that we've presented on is the journey that we went through over about a 10 year period, taking the things that we learned at Intermountain Health Care to help deliver insights and better experiences for the care teams that serve our patients. So we talked about a number of the lessons that we've learned throughout that process. We're also talking about the way that we make investments in our data supply chain, both through our own hardware as well as in partnerships with companies like Arcadia and Collective Medical, for example, to really make sure that we're condensing and combining all of the data available to us so that rather than having care teams worry about all of the different reports that they need to look at, they get a very seamless experience where they're consuming insights at the right place, at the right time.
John Moore III: [
00:04:33] That is such a key, getting the insights at the right place at the right time. So are you serving this up within an EHR or do you have a standalone reporting service that you're using on your end to tease out these insights and kind of provide them to the end user?
Andrew Sorenson: [
00:04:45] It depends on the product that we're talking about. Most of our products are delivered outside of the EMR, but we want to make it a very frictionless process. And so we think a lot about human centered design and how we can deliver products again at the right place and at the right time, and usually depending on the consumer that you're talking about, that may be just adjacent to the EMR at the point of care for a more administrative employee. Sometimes their workflow is their inbox. And so we found that their preference is to get those insights delivered to them in their inbox. But we work really closely to understand what exactly it is that they want to know and and when the setting is. That those insights would be most valuable to them.
John Moore III: [
00:05:31] So enough of the kind of primary stuff, so one of the other questions I've been asking everybody, while I'm here, sure, is whether or not they have an opinion on the impact of the executive. That big executive order that Biden just put out there around anti-competitive behavior and technology, health care and the American economy in general. So as you've probably seen, there was a Health Affairs article recently, as well as another group that published on the impact of consolidation within the health care industry has had in Intermountain. Being such a big health care player. I don't know what you've seen, but what do you think this executive order will have as far as an impact in the M&A activity that we've been seeing over the last few years in health care? That's just gone completely gangbusters? Yeah. Do you think it will have an impact that some people are talking about and that a Biden apparently is hoping it does? Or do you think it will fall flat without teeth behind it?
Andrew Sorenson: [
00:06:17] Yeah. Not really. My area of expertize, but I can tell you that Castell's mission aligns very closely to Intermountain, which is to help people live the healthiest lives possible. And as Intermountain looks for new markets to enter really the objective in finding partners or growth opportunities, it's really to drive that mission to help people live the healthiest lives possible and to drive greater affordability and quality in those communities.
John Moore III: [
00:06:44] Ok, great. So that's I mean, that's what we feel, too. We think that the future of health care, especially in America, is some kind of a capitation value based model. We think it's the only way to really work on containing costs and maintaining performance, you know, maintaining the quality of care that we do have access to in this system and keeping people from going to bad actors having them understand that, you know, some of these hospitals won't be the care that they want or need. So I've also heard, though, a lot of these provider groups are still pretty resistant to the overall concept of value based care because they love the fee for service model. And there's a direct incentive there. And I've also heard that on some of these nationalized health care systems, there isn't that incentive to go beyond just the bare minimum of clients that they need to see her patients that a doctor needs to see. So do you think we'll reach an equilibrium or a good balance around PBC? Do you think this is just the first stone kind of topic cast around pushing towards a more comprehensive capitation model? What are your thoughts on the future of VBC in America?
Andrew Sorenson: [
00:07:41] So I think a lot of large health systems are experiencing a chicken and the egg problem, right? They need to make investments in order to be successful and value based care. But they also don't have a large number of value based care contracts. If they intrude into those contracts without making the investments that they need to, then they may experience pretty poor performance in those contracts in the short run. And I actually think that Castell is really well positioned to remedy that issue because of the scale that we have relative to our competitors and because of the experience that we had at Intermountain Health Care and managing that transition to volume from volume to value, we have a core set of tools that can help those organizations really seamlessly make that transition. And so rather than making that investment themselves, we've already made the majority of those investments and we're eager to partner with organizations in that situation.
John Moore III: [
00:08:35] It's something I've been asking everyone because I know my reasons for being in this industry and what drew me into health care. But I've also heard across, you know, my whole time being in the health care community. This isn't normal. It, you know, people aren't driven by the normal ity. Let's build a startup and make a bunch of money kind of drive. People are motivated by much more personal reasons. So if I'd love to hear what got you into health care, what motivates you to really try to change the system from what it operates as today?
Andrew Sorenson: [
00:09:02] Yeah, I think I decided really early in my life that it was important to me to do something that was going to make a difference in the world and it was really going to leave a mark. And so I think in my mid-twenties, I realized that the best opportunity for me to do that was in health care analytics. I think I realized I was really passionate about health care and was pretty good at analytics and analytics strategy. And too many families are dealing with struggles related to the cost of health care. And I know that data is a key part of transitioning towards lower value delivery systems. And so for me, my personal y is trying to find ways to pull low value care out of the system. And I think that that's the way that I can maximize the contribution that I'm making to society.
John Moore III: [
00:09:53] That's wonderful. I love hearing that. But I mean, obviously, first of all, we had to get all the data to begin with. So do you think that the High Tech Act is really what kind of enabled what your vision for how to help health care kind of came to be? Or were you able to do this before everybody started implementing EHR and digitizing records?
Andrew Sorenson: [
00:10:09] Yeah, I think the increase in the amount of data that we have definitely created the right circumstances in which we could create really high value analytics. I think where we're seeing a real opportunity is to turn all of that data into insights. It's like. We live in an oil rich country, but you can't put crude oil into your car. And so I see a key part of my role as not only helping in that enrichment process, but then working with the right vendors who have significant experience in doing the same thing. And so companies like Arcadia are helping us really catapult and make significant progress very quickly in pulling data from lots of different sources, some of which we didn't have a lot of experience with to begin with and to move that along really quickly.
John Moore III: [
00:10:54] Do you have any thoughts on the social determinants of health data and how that could actually be incorporated into the way that we provide care? Or is this something that because of how doctors are trained to be more focused on acute incidents or chronic diseases, it's going to be harder to get these social determinants integrated into actual care provision? Do you think that this is really a doctor or a care providers responsibility to help patients and individuals find those resources? Or is this something that's more of a social programs responsibility? A lot of people are talking about in healthcare right now. I'm trying to push it into the health care system as a responsibility for them because it's so directly affects health. But again, it's not the symptoms, it's not the disease necessarily so sure. So how do we start incorporating that into care provision?
Andrew Sorenson: [
00:11:34] Yeah, that's a great question. I don't know that we know the answer yet. The way that I've envisioned this potentially playing out is that as we put value based care models in place, we're going to create the incentives for providers, for health systems and other actors in the industry that create an incentive for people to be interested in the overall wellness of a population. And it seems that the connection between the social determinants of health and health care spending are pretty well documented. And I envision that we're going to see an increasing demand for insights related to the social determinants from health care teams over time. And so I want to be ready as that pull really comes to be to not only provide that data in a way that's meaningful to providers, but to have also made the decisions about which of those data elements are going to be most valuable. Because I think that that's still a really open question, and we're doing a lot of work on that within Castell and are putting some exciting strategies in place to help people with their social needs that are not traditionally within what a health care provider would conceive as her or his role.
John Moore III: [
00:12:45] Ok, so real quick, what are three words that you would use to describe this year's HIMSS?
Andrew Sorenson: [
00:12:50] Quiet, cozy and exciting.
John Moore III: [
00:12:54] Wonderful. And finally, how do people find out more or get in touch with you?
Andrew Sorenson: [
00:12:59] They can go to Castell Healthcare, or they can find me personally on LinkedIn. My name is Andrew Sorenson.
John Moore III: [
00:13:05] All right. Thanks a lot, Andrew. Great talking to you, and I look forward to staying in touch.
Andrew Sorenson: [
00:13:08] Hey, me too. Thank you.
