IQVIA研究论坛2020

“The historical evidence belies the notion that a public option will simply be a small addendum to our healthcare coverage options. If you look at Medicare history, you will see that Congress has bowed to pressure and increased provider reimbursement rates. Medicare Part B was designed to be self-sustaining, but within a year after it was passed, Congress began to pass legislation to shield beneficiaries from the true costs. A public option will likely be a pretty popular program and Congress will face tremendous pressure to offset some of the beneficiary costs. We have estimated that over 10-30 years a politically stylized popular public option would add $800 billion to the Federal deficit and result in either significant tax increases or massive spending cuts and become the third largest federal spending program, behind Medicare and Social Security.”Lanhee Chen，Ph.D

“It is true that Congress sometimes has increased provider reimbursement rates, but other times they have cut them. At the end of the day we know that Medicare payments are far below commercial insurance rates. I can’t imagine that Congress will be as generous in payments to providers when it comes to the public option as private insurers have been in their negotiations. At the same time, I don’t know how many people will actually enroll in a public option – that will depend on design details that the Biden campaign has not provided yet.”雪利酒粉，博士

“The initial wave of infections in Germany hit younger people who were infected during carnival festivities and skiing vacations. This was different compared to Northern Italy, where the first wave of infections mainly hit the elderly population. The lockdown in Germany was initiated relatively early. Germany has a higher number of ICU beds than other European countries. The country also has a large network of testing laboratories, which enabled Germany to provide a testing capacity up to 500,000 tests per week early in the pandemic. Finally, in Germany there is a large, decentralized system of primary care practitioners (about 30,000). They own their practice, they are active and did not wait for national experts and political authorities to give directions for how respond to a pandemic.”Dr. Wolfgang Rathmann

“There is more often a misdiagnosis with a rare disease than with a common disease because people are trained to look for what’s common, not what’s rare. Misdiagnosis is therefore less typical for common diseases. But you can train the algorithm to pick up patterns in almost any population. The data may be different in a common vs. a rare disease. The approach may be similar, but the underlying data you would put in to train the model might be slightly different. As an example, for common cardiovascular diseases, it could be data fed in from wearables; for example, a wristwatch that picks up your heart rate as opposed to coding for a rare disease that may not have as many visits to the hospital. So the technique is the same, but the underlying data different.”艾伦·劳里（Allan Lawrie）博士

“在本届会议上，询问阿德勒·米尔斯坦（Adler-Milstein）有关技术能力生成患者健康数据并增加患者获得护理和提供者和付款人愿意加强和查看这些技术如何提高患者的访问和愿意的原因的原因。必威官方在线必威手机APPcan improve patient outcomes and reduce their costs: “The reasons are multifaceted, but one of the key reasons is about control. I don’t think providers and payers believe their ability to change patient behavior is strong. This is still a very hard nut to crack as behavior change is difficult to implement at scale – even with today’s technologies. It is why the focus of providers and payers in risk-based models is more on internal organizational changes before turning to the patient. There is no killer app, or anything close.”Julia Adler-Milstein, Ph.D.

“与人类生成的数据合作提出的挑战与IQVIA通常在我们的注册表和试验中使用患者数据的方式有很大不同。我们通常通过临床网站招募，而不是通过社交媒体类型的宣传来识别参与者。在这里，我们将直接向人们邀请他们加入。这是一种以患者为中心的志愿者，与我们通常与药品客户一起招募和评估参与者的方式不同。但是最大的好处是，这几乎是实时的。IQVIA合作的大多数现实世界注册表都无法及时访问策展数据。”Matthew Reynolds, Ph.D.

“The speed of innovation with AI/ML has prompted whether AI/ML will replace doctors. The answer is no, at least for the foreseeable future. Contrary to common belief, doctors are not resisting ML. If ML alleviates the burden of very simple and repetitive tasks, such as reading retinal scans, ophthalmologists are quite happy, as it enables them to perform more procedures and make more money. This is also a reason for caution when ML is being promoted with the promise it will reduce costs.”Isaac Kohane, Ph.D.

“像任何临床访问一样，急诊科的访问只是及时的快照。我喜欢急诊医学的一件事是，即使在短时间内，我们也有机会了解整个患者。在我们的研究工作中，至关重要的是，我们至关重要的是要确定首先将患者带到那里的结构性决定因素，以及离开后会变得更好的障碍。因此（在患者同意下），我们进行基线评估，进行自我报告调查，在入学时查看社交媒体和电子健康记录，然后我们纵向跟踪患者。必威手机APP我们将开始一项新的研究，在其中注册急诊科的青少年，并关注六个月，查看社交媒体数据，情绪的每日自我报告，孤独和暴力暴露以及医疗数据，以尝试发展更好的干预措施。因此，即使在急性护理环境的快照中，也有机会让人们参与纵向数字数据收集。”Dr. Megan Ranney

“Some practices have employed their own pharmacists to help them. In other areas, groups of pharmacists are helping the GPs with their medication management. Pharmacists have told us that having a tool like SMASH is really helpful, because it depersonalizes their feedback. Instead of creating the perception among the GPs that they have done something wrong, and therefore create a lot of pushback, the pharmacists could now point to the dashboard and say that the patient is at risk due to hazardous prescribing. So the pharmacists feel that the care record has helped them build a better relationship with the GPs. The other thing we found is that GPs tend to be very competitive and sharing data between practices has been shown to be an effective tool to drive down hazardous prescribing.”理查德·威廉姆斯

“我们意识到这一挑战。一种方法是确保我们在每个国家都有良好的智能，以支持对数据的解释。此外，我们在苏格兰正在处理的一件事是将医院开处方数据与初级保健处方以及其他来源结合起来，以便我们拥有全面的患者药物暴露旅程。因此，从系统的角度来看，我们的挑战较少，因为我们从患者的角度来看。这是我们超越前进国家之间的结构差异的方式之一。”马里恩·本尼（Marion Bennie）