My wife and I recently came across a box of photos from 20 years ago—We had a great laugh about my “high style” of the time during the founding of HealthCore. But it drove the point home that our mission never went out of style—In fact it is more relevant today than ever.
In 1996, as clinical pharmacists within a group practice owned by Blue Cross Blue Shield of Delaware, my co-founder, Mark Cziraky and I, along with our clinical pharmacy team, provided decision support services to sixteen surrounding physicians and four nurse practitioners within that practice. Together we worked to make the best decisions for the patient and to maximize the patient’s understanding and buy-in to what we were doing. Using the literature as our primary source, we usually knew which treatments ‘on average’ were safe and effective, but not necessarily if they would work or be safe in the patient in front of us. The patient we were treating seemed different than those that were studied in trials, making it difficult for us to determine which option would be best.
Twenty years later, physicians are still grappling with these same issues as conclusive, broadly applicable evidence exists for relatively few treatments. Consider cardiovascular treatments where only a little over 10% of recommendations within guidelines are based on sufficient evidence (from multiple, large-scale studies) to support the recommendation. This dearth of relevant evidence exists in nearly all disease-based treatment guidelines. However, zoom out of point-of-care relationships between patients and providers and you’ll find that only a small portion of all stakeholders – regulators, product innovators, payers – understand the magnitude of this issue.
For precise decisions you need evidence of the safety and effectiveness of bio-medical products, treatments, and procedures relevant across the diverse patient populations and variable care settings found in the real-world. This is the problem we sought to solve in 1996 and remains or mission to this day now as a part of Anthem, one of the largest stakeholders in the US.
Today, as a clinical outcomes research company, we provide clarity that empowers decision makers to act with precision to improve the quality, safety, and affordability in healthcare.