Laura Crawford, M.I.S.
Advisor, Global Patient Outcomes and Real World Evidence
Eli Lilly and Company
Q&A with Laura Crawford, M.I.S.
What are the most pressing challenges facing us in healthcare today?
I believe the top two most pressing challenges are these:
1. Geographic and economic disparities in access to quality care.
2. Inadequate impact of innovation due to interoperability barriers: it is still true that it takes an average of 17 years for a medical innovation to become regular practice in care. All stakeholders -- patients, providers, payers, research – will win if we improve knowledge transfer in our health ecosystem.
What are the steps needed to transition to precision medicine?
We need to increase the medical knowledge base by evolving the clinical trial model to become more patient-centered. We need faster recruitment, better flow and impact of trial evidence for individual patients, and we need for clinical trials to become a clinical care option.
Precision medicine is in large part about accurately applying population health insights to individual health decisions. We need technical and cultural interoperability so that we can access intelligently filtered, contemporaneous, relevant evidence at the point of health decision.
Because most of our health behaviors take place outside the healthcare delivery system, we need to be able to easily connect patient-generated and other real world data to clinical data so that we can make decisions based on the whole data story of each individual patient.
Where do you see the future of healthcare?
I believe the future of healthcare is a rapid learning health system where research insights flow more efficiently to the point of health decision and our experiences, preferences, and values as patients better inform research so that the health ecosystem can become more patient-centered, learning from real experience. Research and practice will evolve to be more patient-centered and data and insights will flow efficiently and appropriately between them.
In this learning health system, our complete medical histories will be readily available -- wherever and whenever needed. We will begin to use data from our health behaviors that take place outside of delivery and research as part of our input to shared decision-making. Patients will have nimble and flexible control of our own data. The world’s best medical evidence will be available and intelligently filtered at the point of decision, translating population insights to the individual patient.
In the U.S., the Office of the National Coordinator for Health IT has an operational learning health system as its pinnacle goal for 2024; building of this network of networks is beginning!
What role does a group like eHealth Initiative play in supporting executives and companies like you/yours?
eHI's strength lies in its broad range of stakeholders from all across the health ecosystem. I don't know another venue where stakeholders -- integrated health systems, patient advocacy groups, informatics groups, provider organizations and societies, payers, health information exchanges, electronic medical record vendors, research institutions, and others -- can talk with each other about how health IT systems can help improve patient outcomes. This allows us to understand each other's needs and priorities and move together more effectively and efficiently to make health IT enable improved patient outcomes.
It may surprise people to know that…
Lilly has a sincere mission to improve patient outcomes: all stakeholders -- patients, providers, payers, research -- win if patients have the information and care that is best for them.
Laura is a medical informaticist who spent the first half of her career on the delivery side of healthcare where she was shaped by serving the information and evidence needs of patients, their families, and healthcare providers. She has spent the second half of her career in health research, working now as an advisor in Eli Lilly and Company's Global Patient Outcomes and Real World Evidence group.
Her passion is improving the flow of data, information, and evidence between research and practice. Believing that improving this flow is a win-win for patients, providers, payers, and the research sector, she develops informatics strategies and solutions to help enable a rapid learning ecosystem so that health-related decision-making is improved at the point of care and research is better informed by practice.