The following is a conversation between Jay Komarneni, Founder and Chair of the Human Diagnosis Project and Denver Frederick, Host of The Business of Giving on AM 970 The Answer.
Denver: And this evening’s semi-finalist is the Human Diagnosis Project, also referred to as Human Dx. And here to tell us about it is their President and CEO, Jay Komarneni. Good evening, Jay, and welcome to The Business of Giving!
Jay: Denver, thanks so much for having me!
Denver: Congratulations on being named as one of the semi-finalists of the 100&Change competition. Give us an overview of the Human Diagnosis Project and what you hope to achieve.
Jay: Absolutely! Thanks. Denver, I think what the Human Diagnosis Project exists to do is to answer the essential question of human health and well-being which is: When you or someone you love isn’t well, what should be done? This is a question that every single person on the planet struggles with many times during their lifetime, and our goal is really to help answer this question for all and forever.
Denver: What was the impetus for you to start this, Jay? And were there any platforms that inspired your model?
Jay: The story of the Human Diagnosis Project actually starts with the day I was born. I actually was born with a congenital heart defect and was able to get access to the best care and the best specialists when I was a teenager and had to have my heart defect corrected with open heart surgery. If I didn’t grow up in a family of physicians in one of the richest countries on earth, I wouldn’t have had access to that insight. We really believe as a team that everyone in the world should have access to the world’s collective medical insight in order to get better answers to those questions.
Denver: And this is not really just a “safety net” for those people who need to go to an emergency room. A lot of this is focused around specialty care. Would that be correct?
Jay: The proposal that we had put together for MacArthur in conjunction with the American Medical Association, the American College of Physicians, the American Board of Medical Specialties, and the American Board of Internal Medicine is specifically to use the Human Diagnosis Project to improve specialty care for the nation’s underserved. That being said, the system that we’re building ultimately can help every single person on the planet with both primary care and specialty care. As you may know, a billion people on earth lack access to even basic health care, and a hundred million people are put into poverty as a function of their health care cost. So this is a much bigger problem than just the problem we seek to serve here in the US, but we think that this is a tremendous opportunity to help begin building the system, and using it to help the people who need it the most.
If you can actually provide them insight through a system like Human Dx, you can actually ensure that only the people who really need care are the ones that are getting care. So that when they’re paying for it, they really need it. And then you’re actually freeing up specialty capacity to help the patients who really need help.
Denver: Let me see how this might work. Let’s say I’m an attending physician, and I come across a challenging case, and I’m not exactly sure what it is or what I’m looking at, but I’m a bit concerned. What would I do?
Jay: The way that this works typically is one of three things happens when you’re a primary care physician and you’re trying to get a better answer to your case: (1) you actually do what’s called a curbside consult, so you ask other physicians what they think– who you know and are done in person; (2) is you do something called an electronic consult where you actually ask someone through your existing electronic health record or system; or (3) you do a referral. So the issue becomes that when you’re uninsured, you’re really making a choice between two tough places; you’re deciding whether or not to delay necessary care… and potentially get sicker, or potentially pay for care that may not be needed and go into poverty as a function of your costs. There are 10 million people in this country who are in poverty because of their medical costs.
So, imagine that you’re making that decision. Well, as a primary care physician who’s helping people in the Safety Net, 90% of those Safety Net centers cannot get access to specialists. If you can actually provide them insight through a system like Human Dx, you can actually ensure that only the people who really need care are the ones that are getting care. So that when they’re paying for it, they really need it. And then you’re actually freeing up specialty capacity to help the patients who really need help. So the opportunity here– and the way that Human Dx works to solve this problem– is when a primary care physician goes to the system, they basically can encode and organize the major details of the case, post it to the system, and then have other specialists pontificate on that case. Then they can get insight much faster than they otherwise would’ve been able to by doing a traditional referral or e-consult.
Denver: How many of these cases can be addressed through electronic consults?
Jay: Well, I think what’s exciting is that the literature shows anywhere from 30% to 50%. (more…)