Business Elevated Podcast (Episode 56)

This podcast series features business and government leaders discussing what it’s like to live and work in the great state of Utah.

This episode includes a conversation between April Young Bennett, industry director of life sciences and healthcare innovation GOED, and Dan Orenstein, general counsel at Health Catalyst.

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Audio

Transcript

Introduction

Welcome to the Business Elevated Podcast, where we discuss what it’s like to live and work in the great state of Utah. Did you know Utah is frequently ranked the best state for business by Forbes? This podcast is a production of the Utah Governor’s Office of Economic Development. Thanks for joining the conversation.

Conversation

April Young Bennett
Dan Orenstein

April Young Bennett: (0:22) Welcome to the Business Elevated podcast. I’m April Young Bennett, industry director of life sciences and healthcare innovation at the Governor’s Office of Economic Development. My guest today is Dan Orenstein, general counsel at Health Catalyst.

Welcome to the show, Dan, how are you?

Dan Orenstein: (0:40) Thank you. Great to be here.

April Young Bennett: (0:43) We are excited to have you here. Can you tell us a little bit about yourself? What’s your background?

Dan Orenstein: (0:49) Happy to do that. My background is in corporate and healthcare law. Prior to coming to Health Catalyst about five years ago, I was with a company called Athena Health in Massachusetts for 10 years – another tech startup that went public and I did something interesting in the health information technology space. I was fortunate to be part of that and then to be able to leverage that experience at Health Catalyst. Before that, I’d been in private practice in Washington D.C., and Boston.

April Young Bennett: (1:22) Can you tell us a little bit about Health Catalyst?

Dan Orenstein: (1:25)  I’d love to. Health Catalyst is a leading provider of data and analytics, technology, and services to healthcare organizations. Our mission is to make sure all healthcare decisions are data-informed and to enable massive measurable data-informed health care improvement. And I’ll talk a little bit in a minute about how we do that.

But a couple of things to note. Research estimates that 30% of U.S. healthcare spending is wasteful, implying more than a trillion dollars of waste among the $3.6 trillion of spending in healthcare. We’re hoping to be a part of reducing the waste and improving outcomes in clinical, financial, and operational areas.

Currently, we have over 250 hospitals that we serve as clients and 3,000 clinics comprising 70 million patients. And we have over 1.000 employees, including about half in the Salt Lake area.

April Young Bennett: (2:35) Wonderful to talk to somebody who comes from a thriving Utah company. Can you tell us a little bit more about Health Catalyst’s roots in Utah?

Dan Orenstein: (2:43) Absolutely. We are Utah bred, born, and developed. It starts with our co-founders Tom Burton and Steve Barlow who came out of the Intermountain Healthcare quality program. They were already involved with others at the program which is one of the nationally recognized quality improvement programs in the country. And they’d started getting inquiries and feelers to do that work elsewhere. In 2008, they decided to break out on their own and form Health Catalyst to bring some of those methodologies to other healthcare providers and systems, mostly hospitals. They started doing that with some of our early clients.

Since then, in 2011, we got our first round of venture capital funding. And one of the funders requirements was we remain Salt Lake or Utah-based because of some of the advantages of being in Utah. So that’s kinda how we formed and wound up with clients all over the country. But our headquarters in Utah.

April Young Bennett: (4:01) Can you talk about some of those pros and cons of building a company from the startup phase in Utah?

Dan Orenstein: (4:07)  I think our early investors wanted us to stay in Utah and not go to Silicon Valley. Some of our largest investors were based back east. Some of Utah’s advantages are a very talented and stable labor force, a technology cluster where you have experienced workers. 

And now there’s a little bit of a health information technology cluster in Utah as well. So that’s great. You want to have that ecosystem of peers. It’s healthy for everybody in the industry. So that’s been a real benefit. Lower cost of living and maybe less competition are also advantages. It was very hot and overheated in Silicon Valley for a while, which was another possibility they were considering. 

In terms of the cons, like anywhere there’s a tight job market for people with technology experiences, the health information technology world is a little bit small. So that can be a little bit of a challenge. As a newly public company, there aren’t a ton of publicly traded companies in Utah. At this point, an ecosystem is still developing, and we’re hoping it develops a lot more in the future.

April Young Bennett: (5:34) It’s great that we have your company here being part of that growth that we’re experiencing in Utah. We talk a lot about how it’s one of the largest life science growing sectors in the United States. It’s exciting to see that growth happening.

We’re in the middle of a health crisis right now with this pandemic. Can you tell us a little bit about how Health Catalyst helped Utah hospitals and businesses during the COVID-19 pandemic?

Dan Orenstein: (6:04) Yes, I think we’ve done as much as we can, given our capabilities. When the pandemic hit, we looked at the tools we’re using to help health and hospital systems and asked ourselves how can we quickly pivot this technology to help with the pandemic? Some of the highlights are using our data and analytics to work on enhanced case detection for COVID-19 to reduce transmission and manage capacity and supplies.

Let me give a couple of examples to make it a little more tangible. One of the big challenges at the beginning of the pandemic was capacity planning. How do you plan for staffing for PPE supplies that are running short? And how do you manage that in an effective way? So this also illustrates how we do it.

We took the publicly available University of Pennsylvania capacity prediction tool and enhanced it. This is the publicly available tool. And then, we plugged it into our data platform. Now, rather than someone in a health system having to manually enter the data and create a prediction for capacity, every single day or multiple times a day, the data is stored from that system. And we source it from clinical, financial, and operational sources, including the electronic health record. And we automatically feed it real-time into that tool giving an ongoing real-time forecast of staffing needs.

A lot of our clients adopted that. We were also able to use some of the technology and algorithms we developed with some of our systems for predicting when a COVID-19 case would develop or become more severe. So looking at different data indicators from the same data platform and planning algorithms to predict when the case would progress we could suggest early clinical interventions to our clients.

So those are a couple of examples of tools that our clients use during the pandemic. And we’re hoping that some of that continues. Those tools will be useful to prepare for future public health emergencies as well. And also for managing vaccine distribution and tracking patients who need a second dose of the vaccine or other follow-up in connection with the massive effort that’s kicking off right now.

April Young Bennett: (8:59) I like how you talk about how we can use these tools going forward in the future. One of Utah’s goals is not just to go back to normal, but rather to go back to better than normal. Learn from what we’re experiencing right now, and have an even stronger health system as we go forward. 

What are some things you think we’ve learned from this pandemic that will help us to have a stronger healthcare system as we move forward into the future?

Dan Orenstein: (9:24) There’ve been a lot of lessons learned and some of them have come out of the problems that we’ve experienced and among them is preparation. Supply chain management is a big issue. I think we’re caught flat-footed at the beginning. In the future, we’ll have a better national and state system to prepare for making sure medical, and other critical supplies are available in an emergency. And from our perspective, which is the data perspective, we look at how it goes and what could be better.

The ability to have some national patient matching strategy to match patients across systems as they’ve moved from one environment to another in the health healthcare system The ability to match electronic health record lab and pharmacy data across different systems. We’re making a lot of progress on that. The data mappings don’t work perfectly right now, that could be improved. 

The last one I’ll mention is reporting. I think the state of Utah is making a big effort to consolidate health care and COVID reporting. That can all be improved. I think most observers have said that our public health infrastructure needs reinforcement.

And you can see that as part of Biden’s plan going forward to hire 100.000 more public health workers. Also, the data systems that support the public health infrastructure with various policy changes to enable better, faster sharing of data. I think something will come out of this and put us on a better footing in the future.

April Young Bennett: (11:21) That data is so important. One of the great things about living in this time is we can take our human efforts and amplify them.

Let’s talk about the Biden administration. Do you want to talk about some of their healthcare priorities and how that will affect the business of healthcare?

Dan Orenstein: (11:43) Sure. What a time to take over the federal government. There were a lot of challenges with the pandemic, among other challenges. The COVID-19 pandemic is going to be a top priority for the Biden administration. And that involves vaccine distribution.

And some of that is continuing the efforts of Operation Warp Speed that started under the last administration and enhancing that and keeping that moving forward. The distribution effort is a huge logistical effort. It’s a data effort. And it’s just applying effort. I think they’re going to put a lot of priority into that. And then you might wonder what’s left. If it’s all COVID-19 all the time, what about other healthcare priorities like Medicaid expansion and the Affordable Care Act public option? 

If it’s okay, I will comment on a few of those. So things the administration is going to face is a Congress where there is a majority in the House of Representatives but a very slim Democrat majority in the Senate. With the tie-breaking vote with Kamala Harris, it’s 50-50. That means things like public option and Medicare; you hear a lot about big democratic priorities. There aren’t likely to be big policy shifts or accomplishments in those areas because there needs to be a supermajority in the Senate to pass sweeping policy changes like that. I think we’re going to see more incremental steps. One of them that’s worth mentioning is Medicaid expansion. What can be done within the framework of the existing Affordable Care Act?

The Medicaid expansion that occurred in several states in 2020. Utah expanded its Medicaid program under the Affordable Care Act. The administration is going to be looking to push that in other states as well. And things like expanding subsidies and tax credits to increase coverage, particularly for underserved populations under the Affordable Care Act. Those things are probably going to fall second to the COVID recovery efforts in the near term.

April Young Bennett: (14:13) In Utah, Gov. Cox announced his priorities for the first 500 days. And health security is one of those top priorities, along with addressing the COVID-19 pandemic. He’s also talked a lot about health data, quality data, and healthcare costs data. How could we have more transparency in healthcare and have all of us understand the data and what’s going on. 

Let’s talk a little bit more about Health Catalyst. Tell us about some of the projects or collaborations that you’re most proud of.

Dan Orenstein: (14:53) There are so many, but let me start with talking about some work we’ve done in Utah with Intermountain. After our founding, Intermountain became a client of Health Catalyst. And so we’ve done some great improvement work with them. Because the methodology came out of Intermountain it’s been a great relationship.

So what it is, in a nutshell, is looking at clinical processes almost like they are manufacturing processes and trying to reduce the variations that occur from episode to episode. If you can reduce the variation, you can improve quality across all different care episodes. We’ve done work with Intermountain on increasing and improving their lab transmission and lab outreach. That’s been a really valuable relationship. We also mentioned a couple of great projects that we’ve worked on during our IPO process.

So one of our early clients is a line of health in Minnesota and we’ve achieved results with Allina that we’ve duplicated across a lot of different clients. And one of them I mentioned was predictive analytics, and that’s a huge problem for hospitals is sepsis mortality and morbidity.

We can use our data from our platform and analytics tools to predict when a patient may be progressing into septic shock and suggest early interventions. We’ve been able to reduce septic mortality by 30% at Allina and that’s a result we’ve achieved in many other places. We’ve been able to use similar methods to reduce opioid prescription rates and reduce readmission rates for heart failure and several other conditions.

So those are some examples of the improvement collaborations that we’ve accomplished with some of our clients.

April Young Bennett: (17:05) It’s wonderful to see using health data to save lives in that way and make people’s lives better.

Dan Orenstein: (17:10) It does feel good. It’s nice to have that mission orientation. It’s good going to work knowing that you can make a difference in that way.

April Young Bennett: (17:22) All right. I think we’re about done. Is there anything else you’d like to tell us about Health Catalyst before we close?

Dan Orenstein: (17:27) I appreciate the opportunity to talk about these things. The only other thing I would mention is that I think you mentioned something about growing our technology. We’re in a growth phase, and one of the things about our technology is that it can be used in many different ways.

So the data kind of leads you where you want it to go. And we’ve been successful in adding a lot of tools, including a tool that deals with hospital chargemaster systems. That tool deals with getting analytics insights back into electronic health records.

Hopefully, we’re looking forward to having, as the Utah community of analytics and artificial intelligence develops, bringing some of those capabilities into healthcare.

April Young Bennett: (18:32) That’s very exciting. Thank you so much for being here.

Dan Orenstein: (18:35) Thank you very much.

Conclusion

Thanks for listening to the Business Elevated podcast, a production of the Utah Governor’s Office of Economic Development. Listen to other episodes where you get your podcasts or at business.utah.gov.