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Envisioning the Future of an Intelligent HealthScience System
The Synergy II Forum, hosted by ACRES and the National Academy of Medicine (NAM), brought together a diverse and distinguished group of leaders and innovators to tackle the ambitious challenge of envisioning a future health and science system. This event was the third and most ambitious in a series of 'systems-thinking' exercises convened by the Alliance for Clinical Research Excellence and Safety (ACRES) since its founding in 2012.
Synergy II was held on December 12-13, 2022, at the National Academies of Sciences, Engineering and Medicine in Washington, DC in the National Academy of Sciences Building.
The event was co-sponsored by MITRE Corporation and the Milken Institute's FasterCures.
An event illustrator captured the proceedings of Synergy II
Host: National Academy of Sciences
Healthcare Leaders & Innovators
The forum convened a select group of 60 leaders and innovators from across various sectors. Attendees included influential figures from:
Healthcare: Providers, clinical leaders, chief medical officers, public health experts, and those focused on patient experience and outcomes.
Business and Industry: Leaders from biopharmaceutical companies, technology firms, and those involved in clinical research and innovation.
Government and Policy: Representatives from federal agencies like the FDA and CMS, and experts in health policy and reform.
Technology and Academia: Professors and researchers from institutions like MIT and Harvard, specializing in areas such as artificial intelligence, system dynamics, and biomedical innovation.
Patient Groups and Advocacy: Individuals committed to patient-centered care and addressing health equity.
Notable participants included Greg Koski (President and Founder of ACRES), Michael McGinnis (Leonard D. Schaeffer Executive Director of the National Academy of Medicine), Esther Krofah (Executive Director for Health at the Milken Institute's FasterCures), Kimberly Warren (MITRE Vice-President), and Dr. Rob Califf (Commissioner, US Food and Drug Administration).
Proceedings
Synergy II was a two-day working meeting applying systems-thinking and systems engineering principles to envision a new, integrated approach to health and science. The event aimed to create a truly enterprise-wide system that leverages data, analytics & AI to achieve unprecedented levels of quality, safety, efficiency, and effectiveness in health and science.
Day One: Building a Foundation for an Intelligent HealthScience System
The forum began with an official opening and welcome by leaders from ACRES and NAM.
Keynote remarks were delivered by Dr. Freda Lewis-Hall, former Chief Patient Officer at Pfizer.
Session 1, "A Walk Through Wonderland: Systems and Systems Thinking," introduced a conceptual framework and lexicon for systems thinking, discussing complexity and how systems work, with an emphasis on connectivity, interoperability, feedback, and analytics.
Session 2, "Systems at Work (or Not) – Firsthand Experiences," included case studies and discussions on where systems thinking has been tried in health and science, identifying successes, failures, and challenges.
Participants were then divided into four multi-disciplinary breakout groups focused on different "worldviews" or domains: People, Processes, Policies, and Technology. These groups began to holistically envision an Intelligent HealthScience System (IHSS) from their respective domain's perspective.
The day concluded with presentations of results from the breakout sessions and reflections on the day's discussions, setting the stage for envisioning exercises on Day Two.
A social gathering in the evening facilitated networking and included informal remarks from partner organizations and FDA Commissioner Dr. Rob Califf.
Reception at the NAS Great Hall
Working Groups
Participants were then divided into four multi-disciplinary breakout groups focused on different "worldviews" or domains: People, Processes, Policies, and Technology. These groups began to holistically envision an Intelligent HealthScience System (IHSS) from their respective domain's perspective.
Mod: Eric Heckler
Mary Tobin
Kedar Mate
Deborah Weymouth
Yuri Quintana
Ayodola Anise
Gary Gottlieb
Rachel Ziegler
Gigi Hirsch
Jeff Sherman
Erin Holve
Mod: Stacey Chang
Marty Kohn
Pam Duffy
Geoffrey Ling
Richard Braatz
Jason Paragas
Lee Fleischer
Nancy Leveson
Scott Lowry
John Sterman
Craig Lipset
Mod: Becky Kush
Susan Winckler
Esther Krofah
Stephen Ondra
Kristin Schneeman
Jonathan Perlin
Hilary Marston
Kim Warren
Bernard Munos
Michael Brown
David Harrington
Mod: Ashish Cowlagi
Sara Gerke
Doug McNair
Matt Whalen
Briana Pistone
Brian Anderson
Ken Thorpe
Mike Rea
Stephen Friend
Michael Seid
Priti Lakhani
Day Two: Creating a Blueprint for an Intelligent HealthScience System
Session 4, "Eyes on the Prize: Envisioning an Intelligent HealthScience System," involved a facilitated group discussion among visionary leaders to begin drafting a roadmap for the future, covering challenges, solutions, and immediate action items.
Breakout Session 2 tasked the same groups with outlining an agenda for future work toward achieving an IHSS, identifying three top priorities: what the next steps should be, how they can be realized, and who should carry the responsibility.
The event concluded with presentations from these breakout groups, a keynote address from Dr. Victor Dzau (President, National Academy of Medicine), and a closing group discussion to chart a course for the future.
"We believe that bringing together government, non-profits, academia, and industry can achieve data-driven innovation in healthcare, public and population health, and real benefit for patients. We are honored to be a partner in making this event happen".
Kimberly Warren, MITRE Vice-President.Key Outcomes
The Synergy II Forum aimed to address the long-standing fragmentation and inefficiency in the US health and science landscape, acknowledging that despite significant resources, the system often fails to provide optimal care. It sought to move beyond the limitations of current "learning health system" models, which have had mixed results, by developing a truly integrated system.
The main outcome was the envisioning and drafting of a blueprint for an "Intelligent HealthScience System" (IHSS). Such a system is designed to combine human ingenuity with advanced technologies like machine learning and artificial intelligence to provide optimal precision care at a personalized level efficiently and equitably.
The participants achieved consensus on several "table stakes" – minimal requirements and guiding principles – for developing an IHSS:
Target the Neediest First: Implement designs that prioritize those most in need, including victims of structural inequity and systemic abuse, inviting them into system design and implementation.
Design and Align New Incentives: Address imbalances of power and clarify public and private interests, leading with economically workable payment and service models focused on optimal outcomes for all. This includes fostering equity, inclusion, empathy, and person-centeredness.
Engage and Empower Patients: Bring individuals to the table in culturally competent ways, enabling them to be resources for their own care and the development of precision-driven data. The paradigm must apply to all players in health.
Leverage Technology and Data Standards: Create a learning health system that includes public health, research, and healthcare. This requires incentivizing the adoption of global data standards across the U.S. for semantic interoperability and robust, trustworthy tools for data processing, analysis, and AI, with proper regulatory guardrails and oversight.
Create a truly Integrated System: The goal is universal health coverage, where healthcare is seen as a social justice and human right. Decisions should be based on clinician recommendations, patient input, and solid evidence, ensuring integration of specialist treatment plans.
The forum concluded with a vision that is broad-based, building upon current state-of-the-art thinking around Learning Health Systems and grounded in the four key themes of People, Processes, Policy, and Technology. The report will offer a pathway to achieve a next-generation adaptive "sentient" health system that spans personalized research and care. The path forward involves establishing a 'convening authority' – a collaboration of trusted third-party partners committed to innovation and addressing the relationships and interactions among these four perspectives, moving beyond existing silos.
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