Value, Innovation, and Radiology

WASHINGTON, D.C. – May 18, 2016: The American College of Radiology invited Adam C. Powell, Ph.D. to discuss the relationship between value, innovation, and radiology as a part of a broader panel of lectures on markets, value, and commoditization. During the lecture, Dr. Powell discussed the answers to five questions:

  • What is healthcare innovation?
  • What is value?
  • How does healthcare innovation impact value?
  • How do we search for value?
  • How do quality measures impact the search for value?

In summary, the answers to the questions were as follows.

What is healthcare innovation?

Healthcare innovation is “Something new, or perceived new by the population experiencing the innovation, that has the potential to drive change and redefine healthcare’s economic and/or social potential.” (Weberg D. Innovation in healthcare: a concept analysis.   Nurs Adm Q. 2009;33(3):227-37.)

What is value?

Value is outcomes / cost

How does healthcare innovation impact value?

New technologies may shift the production possibilities frontier. In doing so, they may be superior to prior technologies on multiple dimensions. Our feelings about value are relative and context-based. The adoption of innovations by others may change our beliefs about what constitutes value.

How do we search for value?

We explore options until we feel we find one which we feel provides sufficient value. We perform a bounded search, in that we do not consider every option in the universe of options, as doing so would likely be too costly. Instead, we search until we find something which seems good enough. This form of search (bounded rationality) was proposed by Cyert and March (1963).

How do quality measures impact the search for value?

Quality measures facilitate social comparisons and comparisons between present and past performance. Both forms of comparisons have the potential to increase aspirations. As the gap between present performance and aspired performance increases, satisfaction declines. Decreased satisfaction leads to the search for new solutions with the potential to boost performance. This can lead to the adoption of innovations.

Evaluating mHealth Apps

BOSTON– February 10, 2016: Are mHealth app ratings actually useful? A study authored by Adam C. Powell, Ph.D., John B. Torous, MD, and colleagues examined the interrater reliability of 22 measures commonly used to evaluate the quality of mobile health apps for depression and smoking cessation. Six raters assigned ratings to a pool of 20 apps, and then the level of agreement between the ratings was calculated using Krippendorff’s alpha. Surprisingly, the six raters had rather poor agreement on 21 of the 22 measures which were examined. There was rather high disagreement over basic issues, like whether the apps were easy to use, stated their advertising policies, and had performance issues. However, the raters had strong agreement about the level of interactiveness and feedback within the apps. These findings suggest that mHealth app reviews should be used cautiously, especially if they rely upon measures which have not been validated.

To learn more about which measures of mHealth app quality have high interrater reliability, download the full text of the study at http://mhealth.jmir.org/2016/1/e15/

Automating Medicine

CHICAGO– January 25, 2016: After the develop of artificial intelligence systems such as Watson, the future of radiology and other data-driven fields of medicine have been drawn into question. In a discussion held by the American College of Radiology, Adam C. Powell, Ph.D., explored whether or not radiology and other fields of medicine are likely to be automated. The discussion was hosted by Saurabh “Harry” Jha, MBBS, and also featured Matthew Hawkins, MD and patient advocate Andrew DeLaO. A recording of the discussion is available on the official blog of the Journal of the American College of Radiology. See: http://jacrblog.org/radiologists-pick-your-replacement-watson-or-pigeons

Establishing the Evidence

BOSTON– April 2, 2015: Payer+Provider helps organizations assess the value that healthcare innovations deliver by relying upon published researched findings. While assisting clients in evaluating the value delivered by wellness applications, it was noticed that there was often little evidence to support value. To explore the strength of evidence behind mHealth apps with more rigor, John B. Torous, MD, and Adam C. Powell, Ph.D., performed a comprehensive review of the evidence base on apps for managing depression and bipolar disorder. They found that there was a paucity of papers examining either type of intervention. To read their findings, see http://www.sciencedirect.com/science/article/pii/S2214782915000135

Lecture on Valuing Information

BOSTON– March 3, 2015: Adam C. Powell, Ph.D., President of Payer+Provider Syndicate and Adjunct of Health Informatics at Northeastern University, will speak at the annual meeting of the American College of Radiology on May 20th in order to discuss the value of information. Building upon a recent talk at the Radiological Society of North America conference, Dr. Powell’s speech, Valuing Information: A Perspective from Behavioral Economics, will demonstrate how organizations  can assess the financial value of the information that diagnostics produce. He will be presenting alongside Drs. Saurabh Jha and Richard Abramson. In 2014, Drs. Jha and Powell co-authored, A (Gentle) Introduction to Behavioral Economics, an article introducing the subject to radiologists.