Mount Sinai CEO Kenneth L. Davis, MD: Our Ability to Access Information in Real Time to Prevent Disease is Drawing Closer
Health care systems and genomics projects have generated massive patient data sets for years now, and the ability of the medical field to access and use this “Big Data” to improve health and cut costs is now on the horizon, predicts Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System in New York City. Physicians will have these new capabilities within two decades, preventing disease to dramatically “bend the cost curve” in medicine, Dr. Davis said.
He made his remarks as part of the Aspen Ideas Festival, held in Aspen, Colorado, from June 25 to July 4. Presented by the Aspen Institute and The Atlantic, the festival is a unique global exchange of ideas that gathers leading thinkers to discuss vital issues.
"The mapping of the human genome has given us the ability to see trends quickly, and combining that with the electronic medical record, we can see patterns in genes, or systems of genes, related to disease risk and treatment choices that we have never been able to see before," said Dr. Davis. "We are in a brave new world where new tests, apps and devices can predict illness before it happens,” and in real time, often before a patient leaves the doctor’s office.
"While we are currently able to identify high-risk patients using Mount Sinai supercomputers, I envision a future where hospital technicians in a central control room monitor and identify patients in danger of a medical crisis that we would prevent in real time using low-energy chips and the right mathematics," said Dr. Davis.
During the festival, the Supreme Court upheld the Affordable Care Act’s subsidies for individual health insurance in states with a federal exchange. On that topic, Dr. Davis told audiences: "The ruling stabilizes insurance markets and ensures health coverage for millions of Americans. Since the enactment of health care reform, our health system has worked to adapt to the changing health care landscape, shifting away from the fee-for-service model, moving toward population health management, and streamlining services to reduce readmissions. The decision enables us to move forward in providing comprehensive, accessible care to our communities."
During a panel on "Providing a Social Safety Net," Dr. Davis pointed out that the United States, as compared to other countries, spends a disproportionate amount on its health care system, and much less on its social safety net. "What we see in health care, especially in the communities that Mount Sinai serves, is how frayed the social safety net is. Through government-funded, preventable admission programs, we have trained case managers to help manage patients at risk in the communities we serve. Our interventions have been so effective that the number of emergency visits for these high-risk patients has been dramatically reduced. But we need to reinvest in these programs to sustain them. "
Dr. Davis also said that reducing obesity and increasing physical activity is critical to improving health and reducing the cost of chronic disease in communities. "In the neighborhood we serve of East Harlem, 25 percent of kids in Head Start are obese and 40 percent are overweight. We are nearing a health catastrophe and we need to make sure we are creating enough spaces where children can play," said Dr. Davis during a panel on "Physical Literacy.” "Perhaps we can make federal education dollars contingent on physical education programs in schools."
During a conversation on the 21st Century Cures Act, which calls for the appropriation of National Institutes of Health (NIH) funding for biomedical research, Dr. Davis said he favored longer market exclusivity (patent protection) to incentivize pharmaceutical companies to invest in compounds that treat chronic diseases like Alzheimer's disease.
In a panel on "The Power and Importance of Failure in Business," Dr. Davis said that Mount Sinai is now a robust health system with a renowned medical school and seven hospital campuses. However, in early 2000, the Mount Sinai Medical Center – at the time comprising two hospitals and the medical school – was reeling after a failed merger with NYU Medical Center and the inability to adapt to the Balanced Budget Act. In 2003, Dr. Davis took on the role of Dean of the Medical School after serving as Chairman of Mount Sinai's Department of Psychiatry for 16 years. Six weeks later, he was asked to take over as CEO. "I witnessed a series of failures in management. Our financials were in a tailspin. However, I was able to put in a leadership team that was focused on data and solving problems. We also shared the same values of collaboration and transparency. We were able to turn around our financial situation."
Other Mount Sinai panelists included Brian Koll, MD, Executive Director for Infection Prevention and Control for the Mount Sinai Health System and Professor of Medicine for the Icahn School of Medicine at Mount Sinai, and Eric Nestler, MD, PhD, Nash Family Professor of Neuroscience and Director, Friedman Brain Institute, Icahn School of Medicine.
Addressing lessons learned during the recent U.S. Ebola crisis, Dr. Koll said that not enough respect was given to the virus when it first arrived in the United States. “We didn’t really understand the transmission of the disease, and were not ready for the volume of fluids and issues regarding fluid replacements in patients sick with Ebola. We learned that staffing needed to be adjusted and many more nurses than usual were needed to treat a single patient with Ebola, and had to make sure the health workers wearing personal protective gear felt comfortable and safe in the gear chosen."
Dr. Nestler spoke on a panel titled "What the Science Tells Us About Beating Addiction." "We know that addiction is a complex disorder with strong psychological and social factors, but at its core is a biological process. Over the past two decades, we have learned a great deal about that process and how drugs of abuse change the brain to cause addiction. In fact, we have been able to identify the initial targets in the brain that drugs of abuse bind to, how those drugs affect the nerve cells that express those targets and how those nerve cells change over time during the course of repeated exposure to cause behavioral abnormalities that we call drug addition," said Dr. Nestler.
For a summary of Mount Sinai’s participation at Aspen, please go to this link.
About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.
The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals."