The Future of Healthcare With Dr. Joseph Menzin of Boston Health Economics

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Joseph Menzin, Ph.D. Joseph Menzin, Ph.D. is the CEO of Boston Health Economics (BHE), a health analytics research firm that he founded in 1996. He has more than 30 years of experience in the fields of outcomes research, […]

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As a part of my interview series with leaders in healthcare, I had the pleasure to interview Joseph Menzin, Ph.D.

Joseph Menzin, Ph.D. is the CEO of Boston Health Economics (BHE), a health analytics research firm that he founded in 1996. He has more than 30 years of experience in the fields of outcomes research, epidemiology, and informatics. Dr. Menzin spearheaded the development and launch of BHE’s flagship analytics platform. He spends most of his time helping to grow BHE and leading its research activities. Dr. Menzin has a bachelor’s degree in Economics from the University of Rochester and earned his doctorate in Economics from Boston University.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

While enrolled as a Ph.D. student in economics, I lived with a group of medical students. Those students subscribed to American Medical News, a newspaper that discussed interesting developments in medicine, which really piqued my interest in the medical field. While initially I wasn’t sure where to focus, I learned that my Ph.D. program at BU was one of the first where you could specialize in Health Economics, which I then decided to do — I haven’t looked back since.

Fast forward a few years and, in 1996, I founded Boston Health Economics (BHE), which started as a research consultancy serving life science companies. At the time, the healthcare analytics field looked very different than it does today — it was a lot of time-consuming programming and intensive analysis on relatively slow computers, and we simply didn’t have access to the technology available today. We spent a lot of time helping our clients painstakingly parse huge amounts of data, and eventually, we decided there had to be a better way. Today, BHE is first and foremost a healthcare analytics company, and the software solutions we’ve built have transformed how life sciences companies and other organizations approach data analysis.

Can you share the most interesting story that happened to you since you began leading your company?

For me, one of the most interesting things about BHE is the huge role my eldest son, Jordan, has played in our success. Jordan is BHE’s Chief Technology Officer and has been instrumental in the design and development of our core product, the Instant Health Data (IHD) SaaS solution. About a dozen years ago, we had started building custom software for our clients, and established a really solid foundation in health IT. I remember that Jordan asked, during one of our tennis games, “Why don’t we turn this into a stand-alone solution so that all our clients can run their own analyses?” The IHD platform was born and has allowed BHE to grow from a research consultancy into the leading health technology company that it is today. And the rest, as they say, is history.

We have a great dynamic, and I feel that we both bring very different, but important, talents to the table. We also have support via a great leadership team now that we are a fast-growing company. Like any partnership, there needs to be a division of labor. I have focused the most on the business development and research side, while Jordan has handled all things related to the IHD product.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

When I first started out on my own, I had a lot to figure out. One of the things I learned pretty quickly, was that I needed better organization when it came to billing. I would send out invoices without invoice numbers and had several projects with short names, but no project numbers. It turned out that not having a numbering system made it difficult to track payments and organize project materials. Fortunately, my wife Roberta is organized and helped me with a system — she went on to become BHE’s Business Manager for many years. My key lesson is to ask for help, even when your wife needs to bail you out.

What do you think makes your company stand out? Can you share a story?

BHE is incredibly focused on quality and customer service. We ultimately became a tech-focused SaaS company on the heels of two decades as a professional services business. The care, consideration and trust that we built with our customers has become our mantra on the tech side as well. Our customers know that they can count on us, and that our product and services are second to none in our field.

Our IHD platform has become the clear leader in the field of real-world data (RWD), which is the kind of information collected during the routine practice of medical care — think health insurance claims, electronic health records and health surveys, among other sources. Currently, more than two dozen life science companies and research organizations are using IHD for healthcare data analytics, and this SaaS solution has been used for analytics in over 100 abstracts and manuscripts. Our customers run several thousand analyses every year and use the platform to respond to regulatory inquiries in the U.S., Europe, Russia, China and Australia, among other countries.

To truly understand the landscape of health data and analytics, consider that current estimates suggest there are about 2,300 exabytes of health data in the industry, which is an unimaginable amount of information. There really isn’t much to compare an exabyte to, but some experts have said that just five exabytes would be equal to all the words ever spoken by mankind. So “a lot” is a huge understatement.

One of the biggest differentiators of the IHD platform is that it works with complex data and greatly reduces the amount of upfront time analysts need to spend preparing it. In fact, research and business analysts using IHD can usually get results in hours or days for work that still takes weeks or even months with other tools out there. There’s no doubt in my mind that undiscovered findings lie hidden in this data, and if we could quickly parse all of it using newer techniques like machine-learning, we’d uncover new ways to better understand human health and wellbeing with the goal of improving care for everyone.

I also firmly believe that healthcare analytics teams need to be able to understand data and manipulate it at scale regardless of where they sit in any organization, be it life science companies, health systems, payers, universities, health technology organizations, or regulatory authorities.

What advice would you give to other healthcare leaders to help their team to thrive?

Know your market and know your team. In many instances, leaders flounder because they think they know the direction that the company needs to take to find new customers and new sales, but they miss the mark. This may be the result of a lack of focus, flawed advice, faulty market research, or latching on to the newest trends that can be short-lived. It is important to find a direction and stay on course, or you may not get the commitment you need from your team. You also have to build a diverse team that trusts you’ll provide them with the leeway to provide input on strategy and also let them implement. People from all different backgrounds bring a fresh perspective to key strategic discussions.

I’m also a huge proponent of hiring leaders who can roll up their sleeves and get down in the weeds with employees. It can be hard to find someone who is both a skilled manager and isn’t afraid to do the day-to-day work, but these types of player-coaches are absolutely critical for success.

My advice overall: Don’t settle. A passionate, intelligent, and driven employee is worth the wait.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

  1. A major issue with the U.S. healthcare system is how fragmented it is. There’s not a lot of incentive for medical professionals to coordinate care, so patients can spend a lot of time going to different doctors and receiving repetitive tests to find out what’s wrong with them. Not only is that time-consuming and inefficient, but it’s also extremely expensive.
  2. Social determinants of health also play a big role. Our population is diverse, with wide disparities in income and social circumstances. This can lead to barriers in receiving appropriate medical care. Moreover, relatively high rates of poverty, obesity, homelessness, gun violence, and substance abuse all can reduce the effectiveness of medical care. We need to expand our definition of healthcare to focus on keeping people healthy through things like providing adequate housing, exercise and nutritional counseling, mental health services and more.
  3. Finally, lack of access to care remains an issue. Even among those who have insurance, the quality of different insurance plans varies dramatically, and high costs can prevent people from receiving the care they need.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

  1. Better leverage of analytics for evidence-based decision-making. Healthcare has fallen behind many other industries with regard to the use of data to support decision-making. With better data sources and more powerful analytics, we should be able to increase the speed at which we gather insights and better inform strategies to improve medical care. For example, if patient outcomes data was more easily accessible, physicians would be empowered to design individualized treatment plans based on results from patients with similar health profiles. As we develop a deeper understanding of our health on a genetic level, we can use data to further specialize treatment plans on a per patient basis.
  2. Reduce barriers to accessing healthcare. A number of Americans face barriers to accessing care. More attention needs to be paid to the underlying causes, whether those are gaps in insurance coverage, high out-of-pocket costs, or other factors. It is pivotal to provide people with adequate access to care. As an example, research has shown that lowering copayments for medications used to combat chronic diseases can improve outcomes.
  3. Take advantage of efficiencies. Offering telehealth and virtual care more widely could improve access to care for some conditions and also reduce costs. This is especially important for patients who live in rural areas and have a difficult time getting to a doctor’s office, along with the many patients today who don’t have a primary care physician. The COVID-19 pandemic, which has necessitated fewer in-person medical encounters, has provided an important test of the benefits of telehealth services.
  4. Embrace shared decision-making. A greater commitment to shared decision-making between health professionals and patients can help ensure medical care is provided in an optimal way. Collecting data on patient-centered outcomes would be valuable for supporting these efforts, along with robust analytics. With more evidence on the outcomes of various care strategies, patients and their clinicians can work together to weigh key decisions, such as the risk versus benefit of various surgical procedures or the effectiveness versus side effects of drug therapies.
  5. Recognize that health outcomes are not just about medical care. Lastly, we must take more steps as an industry toward addressing social determinants of health (SDoH). Social determinants play a pivotal role in the overall health and outcomes of a patient, and at times could matter more than the actual medical care received. For example, how is a patient supposed to successfully manage their diabetes long-term if they don’t have access to healthy foods, don’t understand the importance of dietary restrictions, or can’t afford their medications? In order to truly improve the health of the U.S patient population, healthcare must extend past the walls of a hospital or care setting.

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

I’m a firm believer in using data to identify problems and then having the healthcare experts propose the appropriate solutions.

On the government level, policy leaders and decision-makers should continue to find the right balance between access, quality of care, and costs. We’re heading in the right direction, but we must more proactively use data to inform policy decisions, especially with regard to identifying programs and services that work and imitating / re-creating these programs in areas with similar populations and environments. If more healthcare databases were easily accessible and industry stakeholders were encouraged to share best practices, healthcare professionals, data scientists and analytics teams could successfully design more innovative programs, therapies and devices.

At the community level, leaders must identify local population healthcare and other social needs and match those to the appropriate resources. This might include expanding public transportation, providing additional resources to mitigate food insecurity, or offering programs like mental health counselling.

It’s also important for pharmaceutical companies, device manufacturers, healthcare providers and other industry stakeholders to make their own commitment toward applying data analytics. More and more healthcare organizations are employing data scientists and analytics teams to process healthcare data, but often they lack the time and resources to generate the results that will have a real impact on device or drug outcomes.

At the individual level, we must take our healthcare into our own hands and be our own advocates. However, health literacy is important to teach as well. For example, patients who are newly diagnosed with diabetes may need help understanding self-management of their blood glucose levels. Similarly, with high deductible health plans, patients have to be good consumers and ask about prices for visits and tests.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

While as a society we recognize that mental health plays a huge role in our overall wellbeing, we continue to treat patients in a vacuum. All aspects of health, including mental health, are interconnected and should be approached holistically. When it comes to mental health specifically, we cannot disentangle the relationships among factors such as depression, substance abuse, poverty, and physical health conditions. We must not only improve access to mental health care and health care in general, but simultaneously improve communication between care teams, creating a safety net around patients when they are in need. We also need to provide more education to reduce or eliminate the stigma surrounding mental health and substance abuse so that patients can receive appropriate treatment.

How would you define an “excellent healthcare provider”?

An “excellent healthcare provider” would have compassion, excellent clinical expertise, and be armed with the latest insights into evidence-based care.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Tell me and I forget, teach me and I may remember, involve me and I learn,” by Benjamin Franklin. This quote speaks to me for many reasons, but primarily because the message fits right into our story and mission at BHE around working with clients to make analytics assessible and scalable across their entire organization.

Are you working on any exciting new projects now? How do you think that will help people?

We’re always working on new projects at BHE and thinking about ways to upgrade or enhance our platform and the data analytics capabilities we provide. Right now, we’re working with many of our clients to help scale their in-house analytics capabilities so they can more rapidly make data-informed decisions. We’re always leveraging user feedback and our dedicated customer support team to further optimize our solutions and ensure our customers can find the answers they need to be successful.

We’re also rolling out a data science module that will allow users to apply sophisticated machine learning techniques to projects built in our existing analytics platform. We want to help companies do more with the data they already have and unlock potential new insights.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I really enjoyed Atul Gwande’s The Checklist Manifesto. His simple, practical way to approach complex problems was inspiring, along with his fortitude of pushing for real change in the medical community — something that could only be accomplished by a peer.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.

The main movement I would advocate for is political reform. If we can find ways for voters to get politicians to work together for the common good, rather than petty special interests, we’d all be better off. In healthcare that is quite challenging. Perhaps we can all think of encouraging people of real character to run for political office.

How can our readers follow you on social media?

Or Twitter @bheanalytics

Thank you so much for these insights! This was so inspiring!

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