Remarkable Leadership: Meet Dr. Ashis Barad, Chief Digital Officer, AHN

• By:  Bill Toland
• Posted:  November 10, 2022
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When Ashis Barad, MD, thinks about the future of medicine, he envisions an environment without walls, without friction between provider and insurer — and, in some ways, without patients.

“One of the things we have to do much better is get in front of people before they are ill,” says Dr. Barad, Allegheny Health Network’s chief digital officer. “If we engage them earlier, caring for people upstream, the hope is that you can turn ‘sick care’ into ‘health care,’ and that you can be proactive and prescriptive well in advance of them ever becoming a patient.”

The word “patient,” he explains, has an implicitly negative connotation, suggesting that a consumer of health services must already be sick or injured before they interact with a care provider.

“There needs to be a shift in our relationship with the patient,” he adds. “I don’t love the word ‘patient’ anymore — I don’t love ‘consumer,’ either, because it has an air of retail about it. But because so much of our Living Health strategy is a virtual and digital health strategy, ‘consumer’ is a better fit in many ways.”

Of course, hospitals will always have patients — and patients will always get sick, despite the best efforts of providers. How we engage those patients, guide them through their care journeys, and ensure that they receive outstanding, equitable, high-value care is the industry’s defining challenge for the 21st century.

Trust and transparency

Bill Toland: You talk a lot about moving care upstream and getting in front of problems. That seems to align perfectly with the organization’s vision of a world where everyone embraces health. But as care providers, how do we realistically reach more people before they get sick or develop a chronic condition — and what is your role in that?

Dr. Ashis Barad: From a digital health perspective, we really have to know our patients much better and anticipate their health needs much better. We have a wealth of data, but so much of it is retrospective — how do we make it predictive? How do we build health technology that knows us?

I think patients may be hesitant about that level of insight — but on the other hand, why shouldn’t your health provider know you at least as well as Amazon does?

Bill Toland: Right. But do you really want your health care app interacting with your favorite delivery app and reminding you not to order that pizza?

Dr. Ashis Barad: That's the concern. But if we're really going to do this, and do it right, we have to have that level of transparency. And to do that, you need to earn and keep the trust.

I do think there is still a lot of trust and goodwill in our care teams — our doctors, our nurses, our navigators — that they will do what’s right for you and advocate for you. That may not extend to the health care industry as a whole. But I think providers have that trust — more so than, say, Amazon, or some digital health startups.

Now is the time to really show people why they should trust us and how that makes their lives better and healthier.

Bill Toland: The last few years have certainly tested that trust, haven’t they? Digital tools are wonderful, but that same online infrastructure can seed a lot of mistrust and misinformation.

Dr. Ashis Barad: Sure. Trust is evolving. But I think people are slowly becoming more sophisticated, and certainly people who are growing up in the digital world are getting really savvy as to what to trust and what not to trust. Regardless, I don’t think the digital space is inherently bad or good — there will always be bad actors and good ones. Our role as caregivers is to position ourselves among the good ones, so people will trust us, connect to us, and ultimately allow the level of information transparency that’s necessary for us to positively impact their wellness.

This is our moment to build on that trust, develop that loyalty, so that we can be something more than caregivers. What we need to be is the trusted orchestrator of care for the communities we serve.

Bill Toland: What does that look like to you?

Dr. Ashis Barad: It means we are looking out for your best interest at all times — and that sometimes may not even be at our own system, you know?

But regardless, we're going to make sure that you're taken care of, in a personal way, and that we are full partners in your journey — wellness, sickness, and everything in between. Right now, many people don’t view us as life partners — they kind of view us as contractors they call when they need something fixed. I think that's why some people start their health care journey on Google, TikTok, Facebook and within their peer groups, rather than with their doctors.

“Eyes on the stars”

Bill Toland: How do you get fellow caregivers to think that far ahead when so many providers — AHN included — are dealing with unprecedented operational and workforce challenges? It’s like the line from “Apollo 13”: “All right, there's 1,000 things that have to happen in order. We are on number eight.”

Dr. Ashis Barad: Here’s another line. I'm a Teddy Roosevelt fan, and he said something like, “Keep your eyes on the stars, and your feet on the ground.” I think about that line a lot.

And I think the fact that I'm a practicing doctor here — using the tools, seeing the burnout, seeing the staff shortages — is key to all this stuff that I'm doing as chief digital officer. The demand placed on our front-line, everyday providers is not sustainable. That was me two years ago — feeling all those pressures, feeling burnt out, feeling like the system wasn't really empathizing with caregivers. And feeling like the system wasn’t giving clinicians a strong voice when it came to how to best utilize these developing technologies.

Bill Toland: Is that one of the reasons you came here?

Dr. Ashis Barad: That’s part of it. But the bigger part is that I’m excited about Living Health, and being part of a blended health organization.

I think the claims data that we have access to is what’s missing from most provider organizations. It’s what makes Living Health possible. We have provider data, we have payer data, and we have our Google relationship to help analyze the data and give it value and insight. The next step in that is wisdom to help our members and patients. The power of Google analytics on top of our whole data ecosystem is really the secret sauce — I truly believe it could be the most powerful thing in American health care. I don't think anybody has this level of data, and this level of blending, right now.

Bill Toland: What kind of insights are we looking for in this mountain of data?

Dr. Ashis Barad: Most providers have a system of record — years of patient care data. What we are doing with Living Health is building a system of actionable insight on top of that data.

The doctor might have only 10 minutes with you, but in those 10 minutes, we can call upon our system to say, “Bill, I see that based on your genomics, your family history, your diet, what part of town you live in, your existing medical conditions, your BMI, your psychographics and everything else, there's a 30% chance of you developing diabetes next year.”

So when people ask me, “What is Living Health?,” that’s part of the answer — leveraging the data to an unprecedented degree, to deliver personalized, precision medicine. That’s the moonshot.

The other part, as I mentioned, is building the engagement — the apps, the trust, the interaction — so that we can meet people upstream.

Bill Toland: Getting back to Amazon and similar platforms and apps — right now, they probably know more about our behaviors than our health systems do, correct?

Dr. Ashis Barad: For sure. Much of that just has to do with the volume of interactions. Think how often you interact with Amazon. But in health care, on average, a person has 2.1 interactions with their providers per year. Obviously you have some really high-volume users, but that’s counterbalanced with a whole cohort of people who don’t interact with their provider or engage in their health in a meaningful way. So in building this system of the future, we need the digital tools and a digital experience where people are willingly interacting with us weekly or daily.

Breaking down silos

Bill Toland: “Willingly interact” seems to be the key phrase. No one wants to be interacting with 17 different health care apps. Expecting people to check an AHN app, a MyChart app, an insurance app, and various digital health solution apps, might be a lot to ask if we want patients to have a simplified experience.

Dr. Ashis Barad: That’s very true. Amazon is a good analogy for that. Amazon, from an architecture standpoint, is probably 2,000 apps. And so we have to build an Amazon-like experience for our consumers, surfacing all of the information they need, when they need it — all in one place and all in one platform. We can't build a carousel of apps. Health care’s already very fractured — very siloed, historically. If we take the same silo approach in the digital space, then we've actually made things worse.

The digital tool that is tracking your blood sugar needs to be the same one that calls up the schedule and finds you the next three available appointments for the endocrinologist. And it’s the same tool that connects you with your dietician to review what you’ve been eating.

It needs to be ahead of your problem — otherwise, our next interaction with you will be in an emergency room for severe edema or ketoacidosis.

Bill Toland: But it also has to be more than just Amazon, right? Medicine will never be fully digital.

Dr. Ashis Barad: Of course, the human touch is still very important in medicine. Health care is still local. You go to see the person you know and trust, right?

The trick is getting the digital side to interact seamlessly with the physical side. Target is a great example, from a consumer standpoint — the digital experience is good, and it works in concert with the physical store very well. Health care can be the same way — in person when you need it to be, bricks and mortar when you need it to be, but with an intelligent virtual and digital piece that can anticipate our needs and provide that connected experience, rather than two separate experiences.

Bill Toland: Where does cost of care fit into all of this? If you’re buying airline tickets, you might choose the airline with the better app and the more convenient digital experience, even if it costs a few dollars more. But if you’re a self-insured company, or an individual buying a health policy, aren’t you shopping on price?

Dr. Ashis Barad: It's a great question. Cost can mean different things to different people. For a company, they may care more about the end-of-year price tag. In my view, getting upstream, ahead of problems — before they deteriorate into costly chronic conditions — is where effective digital tools can really impact systemic cost.

For an individual, cost may matter to some people more than others. Right now, we don’t even give people enough information to allow them to make truly educated decisions about the cost of their care. “If you go this route, it’s this cost. If you go this other route, it’s that cost.” That layer is very much missing in health care. It's not yet retail-grade for most health care providers.

Bill Toland: You mentioned personalized medicine earlier. What’s your role in creating that?

Dr. Ashis Barad: For health care to be truly personalized, it has to make sense of all the data we’re sitting on, and it has to create optimal care scenarios — not for someone who is “kind of” like you, but for someone who is almost exactly like you. A lot of medicine today is recommended courses of action, based on a study of 10,000 people who may or may not look like you, or eat like you, or have your medical history.

If I’m a 57-year-old Indian woman with breast cancer, I don’t want to know the standard course of treatment — I want to know the optimal course of treatment for other 57-year-old Indian women with the specific type of breast cancer. Surfacing that information for the clinician allows them to make better recommendations, and giving the patient that information allows them to make a guided choice.

Bill Toland: And are we close?

Dr. Ashis Barad: We’re getting there — that’s what Living Health is, and that’s why I’m here.