“The stories are heartbreaking,” DeMoro says, telling of an instance where a woman having a heart attack was prepared to die rather than call an ambulance because she was afraid that, if she went to the hospital, she would lose her home and her son would have no place to live. DeMoro says the woman's son called an ambulance.
DeMoro contends that the biggest influence in healthcare today is information technology. She says healthcare CEOs have become “captivated” by IT and worries that technology is replacing human judgment and the human touch. “All the hospitals worship it, and they're trying to provide healthcare without human beings,” she says. “Nurses are now monitoring the monitor instead of monitoring the patient.”
Making her third and highest appearance on the list is Judith Faulkner, founder and CEO of Verona, Wis.-based Epic Systems, the nation's leading vendor of electronic health-record systems. At No. 22, Faulkner was the highest IT professional on the list, and she says the biggest influence on her is the feedback her customers provide.
As Faulkner rises in influence, she's finding herself—rather than her company—in the spotlight, which she says is not always pleasant.
“I'm frequently referred to as 'media shy,' so to me, publicity is something I prefer to avoid—not because it's good or bad—but because I prefer to be someone who's not in the public eye,” Faulkner says, adding that inaccurate articles—such as a recent London Daily Mail story—do little to change her mind. “Doctor read it and believe it.”
The Daily Mail story described her as a “Harley-Davidson-riding friend of President Barack Obama.”
“I don't know (Obama),” she says. “And, by that, I don't mean I'm an enemy, but I met him once and that was for a few seconds—and I don't own a Harley.”
Dr. Carolyn Clancy, director of HHS' Agency for Project Japan Testing and Quality, holds the No. 32 spot in her 10th appearance on the list. And she says she's excited about the work AHRQ is doing in using technology to advance healthcare quality and patient safety—even if the fiscal 2013 Republican budget calls for eliminating funding for her agency.
“We're very optimistic,” Clancy says, adding that it's because she's hearing a common message across healthcare industry sectors. “They want to dramatically accelerate high-quality care, but they need good information, and that's what AHRQ does.”
Of particular interest is the $475 million AHRQ received from the American Recovery and Reinvestment Act, which was used to develop a health “data infrastructure” that Clancy says created a platform for future studies.
“We recognize that that the Recovery Act was a one-time investment and we would never have the opportunity again,” she says, adding that the investment helped create a scientific foundation for “transitioning from people running around looking for paper charts to getting feedback in real time for doing the right thing.”
One technological innovation that Clancy highlighted was at a California hospital where the patient population speaks 21 languages. In addressing readmission challenges, Clancy says the hospital developed a system where patients are provided a password-protected recording in their own language and can listen to their discharge instructions over and over.
“It's hard not to feel optimism,” Clancy says.
Dr. Eric Topol, chief academic officer for Scripps Health, San Diego, and director of the Scripps Translational Science Institute, feels the same optimism. Topol, making his second appearance on the list, holding the No. 64 spot after landing at No. 69 last year, says genomic medicine is making “remarkable” progress in fighting cancer and Alzheimer's disease. He also notes advances in telephone technology that can diagnose a child's ear infection, help to regulate a patient's high blood pressure medication or calibrate a new prescription for their eyeglasses.
Topol, who this year was named to the No. 1 spot in the , says he ed some Australian college students who developed StethnoCloud, a telephone attachment that can help remotely diagnose pneumonia. He says that, in their reply, the students told him they were inspired by his book The Creative Destruction of Medicine.
Despite all the attention focused on the Affordable Care Act, Topol says the politics are “in a separate orbit from what we're talking about.”
“The hope is that, through continued, relentless effort, we will be able to get that public demand and get that consumer-driven revolution,” Topol says. “This is highly threatening to the medical community, but highly empowering to the public.”