Nashville's Tech, Innovation Improving Care Across the Country

With access to a connected network of business leaders and access to capital, Nashville companies are making health care better throughout the nation—one app, electronic health record and clinical trial at a time.

Less than five years ago, Nashville-based Heritage Group, along with 10 of the nation's leading healthcare companies, formed the Heritage Healthcare Innovation Fund, a $167 million strategic initiative to build businesses that improve the delivery of healthcare. Combined with Nashville's professional diversity, the region's companies have the resources to generate productive, and disruptive, innovation in healthcare.

“What's unique about Nashville is the healthcare talent pool that we have, particularly within providers and payers,” said Stuart McWhorter, CEO of the Nashville Entrepreneur Center. “The family tree developed by Nashville Health Care Council depicts the level of talent that exists in Nashville.”

The ongoing research and development from institutions like Vanderbilt University, Meharry Medical College and Hospital Corporation of America are providing Nashville companies with the data they need to revolutionize healthcare.

For instance, Sarah Cannon Research Institute, which is focused on advancing therapies for patients, is one of the world's leading clinical research organizations conducting community based clinical trials in oncology, cardiology and orthopedics through affiliations with a network of more than 1,000 physicians across the United States and United Kingdom.

SCRI has led more than 170 'first-in-human' clinical trials since its inception in 1993, and has been a clinical trial leader in approximately 80 percent of approved cancer therapies in the past 10 years. The research operation is an arm of Sarah Cannon, the global cancer enterprise of HCA that offers patients access to world-class cancer services through 75 centers across the United States and United Kingdom.

“A learning healthcare system is one that commits to using the data that is a natural byproduct of the care we provide, to continuously inform and improve all future care,” said Jonathan Perlin, chief medical officer of HCA, the largest for-profit healthcare operator in the world.

With 25 million care episodes taking place at its more than 160 hospitals every year, HCA has more than enough data to mine. HCA is leveraging its large swath of clinical information through an initiative called, “The Partnership for Advancing Clinical Excellence.” The initiative will manage research partnerships between HCA and other institutions such as the Harvard Pilgrim Health Care Institute, Centers for Disease Control and Institute of Medicine.

As an example, HCA partnered with several organizations to discover best practices related to reducing the rate of hospital-acquired infection MRSA. The study found that a certain approach known as universal decolonization reduced MRSA by 37%, as well as all blood stream infections of intensive care unit patients by 44%.

“Having a large health system allowed us to advance knowledge quickly, contribute to the literature and science, and improve healthcare,” Perlin said. “That's really the goal of the initiative.”

Companies that sprouted in Nashville a while ago are still innovating as national powerhouses.

TeamHealth, for instance, founded in 1979, is now one of the largest providers of hospital-based clinical outsourcing with 21 regional offices and over 13,000 affiliated healthcare professionals. It was recently named among Fortune's Most Admired Companies. TeamHealth is tapping its reach and breadth to help hospitals and health systems achieve efficiencies in three key areas: integration, alternative payments and telemedicine.

With integration, the company discovered a care coordination pattern between emergency docs, hospitalists and anesthesiologists to expedite patient care. Now, a Medicare patient who arrives with a hip fracture is sent to surgery 12 hours faster than usual, which undoubtedly helps toward reducing mortality.

“Any company that staffs emergency medicine, hospital medicine and anesthesia simultaneously could arguably develop the same processes,” said Miles Snowden, chief medical officer for TeamHealth. “However, we are one of the very few who does all of those lines of work. So while there's nothing proprietary about the ability to coordinate, the ability to own all of those staffing contracts in the same hospital is fairly unique.”

With alternative payments, TeamHealth's participation in CMS's bundled payments program has helped drive innovation toward creating new processes in areas such as patient discharge. For example, following discharged patients to a nursing home just as if they were in the hospital for a period of time, and sending in care coordinators to the home as an extension of hospital physicians.

Looking forward, the organization is partnering with Seattle-based Carena to launch a telemedicine initiative that allows advanced practice clinicians to provide care in communicates where no care would otherwise be available—usually rural or remote, Snowden said. “In the past, location has required us to say 'no' to providing access to care in communities where we couldn't hire a physician. Now we can,” Snowden said.