Interview with Marc Lassaux
Interviewer: So how did you get into the area of applied technology that you’re currently in?
Lassaux: I went to school for a degree in IT and over the years worked in several fields related to IT. I was a consultant prior to working for QHN, Quality Health Network, and that gave me some really good experience in understanding overall systems and how they interact with people and the best ways for people to utilize technology.
I started at QHN in 2006 on the health information technology side of things and have loved it and been involved basically ever since. We’re really trying to understand the problems that can be helped in the healthcare space with technology. We work to figure out the right ways to apply technology to try and move the needle on better outcomes for patients and people and work to lower costs and lower the hits on the system overall.
You can’t just take it from a technology perspective though. You need to look at it from a people and process perspective first and foremost to understand those needs and then look at how you apply technology to make something better happen.
Interviewer: And then kind of diverging away from that a little bit, how are you personally affected by the issues of aging? What made you want to get involved in this frailty project?
Lassaux: I became interested after talking to Dr. Page and seeing his passion for this project and frailty overall and him describing to me the often unnecessary services that are provided to folks who might not want those services or might not understand the benefits versus costs of doing those services. I don’t mean costs financially, but costs from a personal and quality of life perspective.
It is important to think about the quality of life and people’s happiness and to help them understand that they have choices and that unneeded services might make things worse. I think about my parents who are starting to age and at some point in the future are going to need more help thinking through things like frailty. It would be good to have an indicator of what might or might not help.
The project shows a way to open a discussion, a realistic discussion with not only care providers, but with family. Having this type of information can help make more informed decisions about what will really help, what won’t, and what would reduce quality of time spent with loved ones and friends. Given all of that I was excited to help.
Pat asked me if I could help architect an overall solution and a way to approach this to try and pilot what this could look like. Could we gather and move data required to do this? Could we provide data back to the caretakers so they could work with families to help make these decisions? I’m was interested for all of those reasons and to help solve those types of questions.
Interviewer: And then, so you answered this a little bit., but just on a broader scope, how do you see this effort of bringing supportive data to providers? How do you see that overcoming errors in the decision making and overall just improve collaboration with doctors to help the patient’s care?
Lassaux: Well, I think it opens up the lines of communication. And so from that perspective, improved collaboration is important. It’s collaboration amongst them with their peers and amongst the family and the caretakers that are working with the providers and working with the patients.
I think it just helps them make better and more informed decisions and that is extremely important for providers. They really have a limited amount of time that they can spend with a patient. So having good data at the point of care while they’re with that person helps them maximize their decision making and I would say they can work at the top of their license.
They’re not out scouring, searching for data trying to bring all of that together. They’re spending more time using the high-quality data that they have to help make more informed decisions more quickly.
Interviewer: And then in your opinion, what motivates providers to change their workflow to get out of that comfort zone and make some changes, knowing that this could improve patient care? Or even if they don’t know that it’ll improve patient care, if it’s just a theory, what motivates providers to make that change?
Lassaux: I’ll use an example of another program that I worked on in the past. I’ll just tell you that story real quick without using names.
There was a doctor that we were working with and we were doing a new program that took clinical data from the practice, took clinical data from the health information exchange, and took claims data from the payer. It combined all of that data and then ran a process, an algorithm, against that data that created a score of a patient’s risk of having heart attack or stroke over the next five years.
We were talking to providers about this program and the data, and about the risks and they were a little bit skeptical to start with, as they should be, right? They were asking questions like “how do I trust the data”, “how can I know it is real”?
As part of the program we provided a few doctors an example list of their patients risk of heart attack or stroke in descending order. One of the doctors involved in the program looked at it and he recognized the number one highest risk patient on the list had a stroke the previous day and was in the hospital. The doctor said, “I looked at that list, I recognize that patient. He was number one on the list and now he’s in the hospital” and then he said, “I’ve got to call patient number two…”
That’s the power of this work, to engage with providers and find the wins that will make a difference and help. They adopted the solution and started working with us to improve it.
Interviewer: Hopefully we continue to improve that way without being super skeptical and then waiting for problems to actually arise. So the next question is, what motivates providers to change from silos of care to collaborative care? What allows them to want to trust working with people not necessarily inside of their bubble?
Lassaux: Providers understanding that they share the care of the person, of the patient with many other organizations in the community and that they all have a part and a stake in really high-quality care for that person. Having a clear understanding of who can provide what services in a community is important and critical.
We have to be proactive thinking as a community and as healthcare leaders in communities, about the services needed, who can reasonably provide those services, where they need to come from, and what type of supports are needed to provide those services. We need to agree to work together through easy to use collaborative processes and technology.
Interviewer: How does this effort overlap with QHN’s CRN? And then within that, if you could quickly define and describe what QHN is and what CRN is.
Lassaux: QHN, Quality Health Network, is a community based nonprofit organization that is dedicated to helping providers of care in our communities and in our region have better quality outcomes for patients. Our mission is really to facilitate the availability of information so that they can provide high quality care.
QHN started out in 2004 working with physical health data: moving data, facilitating the availability of information on the physical health side of care. QHN then worked on sharing behavioral health information with appropriate security and consent. When you combine behavioral health with physical health information providers get a better, more robust picture of the needs of a person or a patient and can better address those needs.
We know that social needs like housing, transportation, hunger and others are often a bigger driver of health than physical or behavioral health so we are now working to exchange social needs data. This is where CRN comes in- when you combine the three large domains of information, then you really create what can be thought of as a community resource network. CRN works to tie the
physical health needs together with the behavioral health needs, together with the social health needs to provide information and drive whole person health.
CRN will allow organizations that are involved in the care of a person to understand who else they share the care of that person with, what are the person’s needs, who’s going to do what next, and how do they most effectively communicate.
Interviewer: Is there anything that these questions didn’t cover that you also want to go over?
Lassaux: So we piloted this frailty program, we’ve demonstrated that we can move data from post-acute long-term care and from the ambulatory settings, between those care settings to calculate the risk scores and that’s been valuable.
To move forward, we need to understand how this fits into larger programs that are dealing with frail patient populations and how we fit these lessons learned into those larger scale programs. It gets a little bit challenging just because of the variety and shear number of different programs and activities that healthcare providers are really working on at any given time.
There’s a lot of new technology, there’s a lot of new measurement, and there’s a lot of new programs that providers have to work on. So getting tools like this into the process can be difficult, but we’ve got to keep trying and going for it. We need to work to align this to programs where it can be helpful. It can make a difference.