In AAO Lecture, AMA CEO Discusses How the Organization Is Addressing Areas of Innovation

In a symposium during the American Academy of Ophthalmology annual meeting in Chicago, James Madara, MD, CEO and executive vice president of the American Medical Association (AMA), delivered a lecture with the goal of thinking about the future of medicine. Madara highlighted 3 areas in which medicine can progress into the mid-21st century using the AMA strategic framework as a backbone and highlighted innovations that are currently being implemented to help push these areas forward.

The 3 areas that Madara highlighted are what he called “precompetitive needs.” “What I mean by that are needs that, if not fulfilled, there will be no health system that will work very well regardless of what it turns out to be mid-century,” said Madara. “To find these precompetitive needs and fill them, one needs innovation.”

Madara highlighted the component view of the AMA, which comprises the House of Delegates, members, practice/business tools, research and education, and advocacy. He pinpointed practice/business tools, research and education, and advocacy as the innovation ecosystem of the AMA. The research and education area of the AMA has 3 strategic arcs that make up the strategic framework of the AMA: chronic disease, professional development, and removing obstacles to physician interaction. There are also 3 accelerators that overlap all 3 of the arcs in innovation, equity, and advocacy.

The strategic framework of the AMA was designed in 2011 after executives were able to sort future projects according to feasibility and desirability.

The chronic disease arc aims to lead the charge to confront public health crises and also eliminate health inequities. The professional development arc aims to drive the future of medicine through reimagining training, education, and lifelong learning and promoting innovation to address the big issues in health care. The removing obstacles arc aims to clear away the barriers that interfere with patient care, such as making the patient-physician relationship more valued and using technology as an asset.

“These are precompetitive, and the chronic disease consumes greater than 85% of our $4 trillion spent and it’s increasing,” said Madera. “If we don’t get a handle on chronic disease, no health system’s going to work very well.”

Madera said that the AMA began to address the professional development arc by creating a consortium of medical schools, with 37 schools in total. These schools created products that are widely distributed, including a competency-based education and integration of health system science into a medical school. Recently, 11 sites began “reimagining residency” to offer a smoother transition from medical school to residency.

The AMA also created the AMA Education Hub, with 15 associations in the federation currently using the platform to deliver education, including the CDC and Stanford. Madara said that the AMA has developed a program currently in the pilot phase called “Reconnect,” which is an artificial intelligence (AI)–driven tool that can interrogate electronic health records (EHRs) and create an educational direction based on the physician’s real-life panel.

The AMA has also made progress in the chronic disease arc with tools developed for hypertension. A tool that is AI based can also search EHRs to identify hypertension control and potential therapies that can be used. Madara noted findings that the use of the tool increases the percentage of patients with controlled blood pressure.

The removing obstacles arc, Madara continued, has been addressed with the AMA Recovery Plan for American Physicians. This proposed roadmap focuses on Medicare payment reform, fixing prior authorization, fighting scope creep, reducing physician burnout, and supporting telehealth.

“Just this week [we had] success in California with the governor vetoing a bill that would have been bad for ophthalmology. We were happy to help that,” said Madara.

Accelerators for these arcs include innovation, where Madara said that the AMA has made moves. An innovation ecosystem exists within the organization to develop environmental intelligence, low-to-moderate technology solutions for the strategic arcs, and problem definition at the right site. Madara also mentioned the AMA’s work with MATTER, a health care accelerator featuring an interactive lab.

Health2047 is the AMA’s innovation shop that uses the technology of Silicon Valley to yield deep tech solutions. Health2047 has so far launched 9 companies that promote the art and science of medicine while advancing the betterment of public health.

“All of these companies relate to the strategic framework of the AMA. So, you can think of these as the commercial translation of the AMA’s strategic framework,” said Madara.

Madara concluded that health care would not be successful in the mid-century regardless of form if all of the physicians were trained for the 20th century rather than the current century, if chronic disease and its increasing burden was not addressed, and if physicians did not have their patients return to them while removing any administrative obstacles.

“These are things that need to be addressed and this is why the strategic framework is viewed by us in the organization as something that addresses the needs of the mid-century health care system by focusing on precompetitive needs on one hand and focusing the innovation at the right place where the question should be asked, and that is the physician-patient interface,” said Madara.