3 Steps to Maintain Telehealth’s Momentum Post-Pandemic

In the face of COVID-19, healthcare witnessed how crises can become the long-awaited push for creativity and innovation that the industry needs. When our healthcare infrastructure’s weaknesses were exposed, telehealth helped to stitch them up, with the number of telehealth claims increasing 8,336% nationally from April 2019 to April 2020. Out of need, patients quickly turned to telehealth as a new model of care delivery; clinicians adapted to a new avenue for engaging with patients, policymakers began to improve incentives for its use; and home became our hospital. 

As we continue the fight to control the virus in 2021, the industry is at a pivotal moment in ensuring this year’s telehealth momentum continues post-pandemic. Healthcare organizations should take time now to strategize how best to hardwire telehealth, so it is embedded into care delivery models long-term. In order to achieve this, leaders need to consider their collaboration with other stakeholders, longitudinal integration strategies that go beyond piecemeal solutions and transform the perception of what “home” means in healthcare to meet consumers where they are. 


Step 1: Collaborate to advance technology

If we’ve learned anything from healthcare’s digitization over the years, it’s that technology for technology’s sake is not enough – solving healthcare’s issues is a systems problem, not a disease problem. For telehealth to last, there needs to be a clinical transformation where workflows are rewritten, policies strongly incentivize its use and companies and hospitals partner on outcome-based models that support its scalability. 

In the last six months, we have seen more innovation and adoption in healthcare than we’ve seen in the last decade, with typical innovation timelines of years becoming weeks or days. In many ways, this creativity and open innovation saved the U.S. healthcare system from collapsing and helped us survive the initial surge. We also saw the collaboration of all sorts reach new heights, with organizations, federal agencies, private and public companies from different industries coming together to manage surge capacity while maintaining quality care. Another benefit of these partnerships is the emphasis on long-term policy changes that will empower lasting change and adoption of these innovative approaches. Industry efforts, like ours with the ATA, aim to promote telehealth’s growth and support hospitals, payers, and patients across care settings. The pandemic’s productive collaboration cannot stop here. Instead, we should continue to bring dimensions of policy, clinical experience, and consumer voices to imbed telehealth into our everyday systems. 


Step 2: Determine avenues for seamless data integration across settings

Telehealth’s power is not in its technical claims, but in the power of presenting caregivers with actionable, meaningful patient data so they can make data-driven care decisions with confidence. This is only made possible with interoperable, cloud-based solutions that collect, digest, and analyze data to inform care. With constant transfer of key patient data through connected devices, such as hospital-grade wearables and biosensors, and translating the data into useable insights, remote patient monitoring empowers care teams with the knowledge needed to intervene earlier and keep patients healthy at home. 

Telehealth’s power expands beyond the home, supporting a continuum of care no matter what setting a patient is in. Remote monitoring within the hospital is the crux of minimizing infection risk, handling sudden increases in patient volumes and allocating resources appropriately. These include solutions such as centralized clinical command centers to achieve remote, holistic patient views, or technology that activates scalable patient monitoring for ICU ramp-ups. The solutions we deploy need to be enablers of seamless data transfer – from the ED to ICU, to post-acute and home setting. We now must ensure our informatics backbones mature with these solutions, eliminating gaps in care while ensuring a secure flow of data where and when it’s needed. Deploying cloud-based platforms that bring together the right information across the care continuum will make for a powerful, integrated system that enhances patient and staff safety improves outcomes, and reduces costs.  


Step 3: Transforming what “home” means in healthcare 

2020 has transformed how we view “home.”  Home has become the center of life operations for people across the globe – we work from home, we educate our children at home and we exercise at home. Healthcare is now becoming another cornerstone of the home. With a growing volume of telehealth offerings and household names providing care services, consumer behavior is changing to expect customization, convenience, and instant gratification. The consumer’s voice is loud, and tomorrow’s healthcare will move it from a whisper to a shout – We must be prepared to deliver care when and where patients want to receive it, increasingly let go of healthcare’s brick-and-mortar blueprint, and enable healthcare to match the ease and convenience of other areas of a patient’s life. 

However, just like all these other ‘at-home’ activities that require getting used to or training, we need to support health literacy and engagement for all users. The pandemic has made the inequalities in our health system raw. Even before the pandemic, 5% of the patients account for about half of U.S. healthcare spending. This is a sign that they are not receiving the proactive care and support they need. We have an opportunity to change this equation with virtual care and bridge the digital divide by tailoring solutions to meet each patient’s needs and ensuring equitable availability to all patients.


Transforming telehealth into a standard of care

Technology isn’t the answer to telehealth’s success alone – it is virtualizing care where it is needed most and ensuring it is fully integrated across an institution. Healthcare organizations should reflect on where their greatest challenges and populations are, and look for systematic solutions for telehealth so that virtualization can scale efficiently and build from existing technology and workflows. With productive collaboration across sectors, robust data integration infrastructures, and an evolved perception of how we view healthcare, these tools have the power to influence how patients view and engage with their health, pushing the industry toward more proactive care that will have long-term benefits on outcomes and cost.


About Karsten Russell-Wood

Karsten Russell-Wood, MBA, MPH is the Portfolio Leader for Post-Acute and Home at Philips where he is responsible for Innovation and cross-business platform strategy and portfolio optimization. Prior to joining Philips, Karsten held global product management roles within GE’s healthcare businesses with an orientation to targeted patient populations and continues to be active in venture capital and startups in the digital health space.


Teladoc Health, Dexcom Offers CGM-Powered insights to People with Type 2 Diabetes

Teladoc Health, Dexcom Offers CGM-Powered insights to People with Type 2 Diabetes

What You Should Know:

– Teladoc Health and Dexcom announced an expanded
partnership on a new offering measures the impact of continuous glucose
monitoring and real-time health recommendations for people with Type 2 diabetes
at no cost.


Teladoc Health, Inc., the first and only comprehensive virtual care system, and DexCom, Inc., the leader in real-time continuous glucose monitoring (CGM), today announced that joint Livongo for Diabetes and Dexcom members will now receive CGM-powered insights. In January of 2020, Livongo, which merged with Teladoc Health in October, and Dexcom announced the first phase of their strategic relationship, a data-sharing agreement for Livongo for Diabetes members using Dexcom CGM technology.

Expanded Partnership Details

“We are excited to announce the next phase of our relationship with Teladoc Health, along with launching a commercial pilot demonstrating how Dexcom’s leading CGM combined with Teladoc Health’s data science capabilities enhance the diabetes management experience,” said Matt Dolan, senior vice president and general manager of new markets for Dexcom. “We have received powerful feedback from people with Type 2 diabetes using our technology, and through additional innovative product features, we fully anticipate that we will deliver an even greater impact.”

The expanded partnership includes two developments: 

1. Enhanced product capabilities through CGM-powered
insights, a new set of features and reports that help members more easily
visualize their health information and understand how lifestyle decisions
affect their blood glucose levels. By combining Dexcom CGM data with additional signals from
Teladoc Health, including activity data and food intake, CGM-powered insights offer members a complete health profile and recommendations
that support ongoing diabetes management.

2. A pilot program demonstrating the impact of CGM-powered
insights for people with Type 2 diabetes. Eligible members will receive an
integrated product experience including the Livongo for Diabetes program, Dexcom
CGM technology and CGM-powered insights at no cost. 

“Teladoc Health’s partnership with Dexcom further empowers whole person health through an innovative combination of advanced technology and human expertise,” said Amar Kendale, chief product officer of Teladoc Health. “Our focus is to offer a consumer experience that makes it easy, safe and affordable for people to manage their health with confidence. We are excited about our continued work with Dexcom and new features that enable smarter care, leading to measurable consumer behavior change and better health outcomes.”

Why It Matters

It is estimated that 463 million adults around the world
live with diabetes[1],
a number expected to rise to 700 million by 2045. According to the Centers for
Disease Control and Prevention, regular physical activity, weight management,
and improved blood pressure management are important factors for preventing
diabetes-related complications[2].


Why A Patient-First Strategy for Specialty Rx Pharmacists Is Critical to Optimize Outcomes

 Patient-First Strategy:  Uses Specialty Rx Pharmacists to Maximize Orphan and Rare Disease Management, Optimize Patient Journey and Outcomes
Dr. Brandon Salke, PHARM.D, Pharmacist-in-charge, Optime Care

One of the biggest challenges for biopharmaceutical companies of rare and orphan disease patient populations is optimizing disease management in a way that enhances the patient journey and improves outcomes. As these companies seek innovative solution partners, a patient-first approach that offers specialty Rx pharmacist expertise is critical for securing insurance coverage, coordinating care, ensuring compliance, and, ultimately, minimizing the daily impact of rare and orphan diseases. 

In today’s challenging healthcare environment, biopharma companies need to feel confident that their products are properly and promptly distributed, and reimbursements processed quickly and correctly. The best approach is to partner with a pharmacy, distribution, and patient management organization that offers a patient-first strategy for rare and orphan disorders, as well as personalized care programs designed to maximize the benefit of the therapies prescribed for patients. The goal is to improve the quality of life for both patient and caregiver with a dedicated support system for positive outcomes and long-term well-being.

The right patient-first partner can tailor IT, technology, and data-based upon client needs, combined with a high-touch approach designed to improve patient engagement from clinical trials to commercialization and compliance. 

High Touch Meets Technology

Rare and orphan disease patients require an intense level of support and benefit from high touch service. A care team, including the program manager, care coordinator, pharmacist, nurse, and specialists, should be 100% dedicated to the disease state, patient community, and therapy. This is a critical feature to look for in a patient-first partner. The idea is to balance technology solutions with methods for addressing human needs and variability.  

With a patient-first approach, wholesale distributors, specialty pharmacies, and hub service providers connect seamlessly, instead of operating in siloes. This strategy improves continuity of care, strengthens communication, yields rich data for more informed decision making, and improves the overall patient experience. It manages issues related to collecting data, maintains frequent communication with patients and their families, and ensures compliance and positive outcomes. A patient-first model also hastens time to commercialization and provides continuity of care to avoid lapses in therapy – across the entire life cycle of a product.

Key Components for Effective Patient-First Strategy

A patient-first strategy means that the specialty Rx pharmacist works directly with the patient, from initial consultation, and across the entire patient journey, providing counseling, guidance, and education-based upon individual patient needs. They also develop an individualized care plan based on specific labs and indicators related to patient behavior to help gauge the person’s level of motivation and identify adherence issues that may arise. 

The best patient-first partners enable patients to contact their pharmacist 24/7 and offer annual reassessments that ensure that goals of therapy are on track and every challenge is addressed to improve the patient’s quality of life. These specialty pharmacists also play a critical role on behalf of biopharmaceutical partners, providing ongoing regulatory and operations support and addressing each company’s particular challenges.  

Telehealth

As the COVID-19 pandemic wanes on, it’s also important to find a patient-first partner that offers a fully integrated telehealth option to provide care coordination for patients, customized care plans based on conversations with each patient, medication counseling, education on disease states, and expectations for each drug. 

A customized telehealth option enables essential discussions for addressing patient challenges and needs, a drug’s impact on overall health, assessing the number of touchpoints required each month, follow-up, and staying on top of side effects.

Each touchpoint should have a care plan. For example, a product may require the pharmacist to reach out to the patient after one week to assess response to the drug from a physical and psychological perspective, asking the right questions and making necessary changes, if needed, based on the patient’s daily routine, changes in behavior and so on. 

Capturing information in a standardized way ensures that every pharmacist and patient receives the same assessment based on each drug, which can be compared to overall responses. Information is gathered by an operating system and data aggregator and shared with the manufacturer, who may make alterations to the care plan based on the patient’s story. 

Ideally, one phone call with a patient can begin the process of optimizing medication delivery, insurance reimbursement, compliance, and education based on a plan tailored for each patient’s specific needs.


About Dr. Brandon Salke, PHARM.D

Dr. Brandon Salke serves as the pharmacist-in-charge and General Manager at Optime Care in Earth City, MO. He previously served as a team pharmacist for Dohmen Life Science Services, where he helped launch several new care programs and assisted in the management of clinical trial activities.

He is specialized in specialty pharmaceuticals, particularly ultra-orphan, orphan, and rare disease. Dr. Salke has been involved in all aspects of operations (planning, process integration, project management, etc.) for pharmaceutical manufacturers. This includes clinical trials to commercialization and assisting in commercial launches (and relaunch) of specialty pharmaceuticals.


M&A: TigerConnect Acquires Hospital Middleware Solution Critical Alert

M&A: TigerConnect Acquires Hospital Middleware Solution Critical Alert

What You Should Know:

– TigerConnect has announced an expansion in their suite
through the acquisition of Critical Alert, a leading provider of
enterprise-grade middleware for hospitals and health systems.

– For the hundreds of thousands of nurses that currently
use TigerConnect, these new capabilities will deliver real-time, contextual
information to their mobile device or desktop to allow them to work smarter,
prioritize responses, and efficiently coordinate care, all within the same
reliable TigerConnect platform they use every day for enterprise messaging.


 TigerConnect®,
a care team collaboration solution, today announced the acquisition
of Critical Alert, a Jacksonville,
FL-based leading provider of enterprise-grade middleware for hospitals and
health systems. Critical Alert’s product suite consists of a middleware suite
of products as well as traditional nurse call hardware servicing over 200
hospitals in North America. Financial details of the acquisition were not
disclosed.

Real-Time Care Team Collaboration for Hospitals

Founded in 1983, Cloud-native and mobile-first, Critical
Alert’s middleware solution enables any health system to combine nurse call,
alarm and event management, medical device interoperability, and clinical
workflow analytics.  TigerConnect will integrate Critical
Alert’s middleware stack into its platform to power a wide range of alert types
and alarm management enhancements for TigerConnect’s customers. Critical
Alert’s Nurse Call hardware business will continue to operate under its
namesake as a standalone business unit.  

When combined with Critical Alert’s middleware, TigerConnect dramatically
enhances the value proposition to nursing, IT leadership, and end-users. This ‘dream
suite’ of capabilities comes at a time when nurse burnout is at a record high
and chronic nurse shortages are severely challenging organizations’ ability to
deliver the best quality care.

“We see the Critical Alert acquisition as highly strategic and
a natural evolution of our already-robust collaboration
platform,” said Brad Brooks, CEO and co-founder of TigerConnect. “For the
hundreds of thousands of nurses that currently use TigerConnect, these new
capabilities will deliver real-time, contextual information to their mobile
device or desktop to allow them to work smarter, prioritize responses, and
efficiently coordinate care, all within the same reliable TigerConnect platform
they use every day for enterprise messaging.”

Post-Acquisition Plans

Joining TigerConnect is Critical Alert CEO John
Elms, who will assume the role as TigerConnect Chief Product Officer,
guiding the integration of the two companies’ technologies and leading the
development of all future product offerings. Wil Lukens, currently VP of Sales
for Critical Alert, will assume the role of General Manager of Critical Alert’s
traditional Nurse Call hardware unit. 

“The timing of the deal and the fit of these two companies aligned perfectly,” said John Elms, CEO of Critical Alert. “Two best-in-class, highly complementary solutions coming together to solve some of the chronic challenges—alarm fatigue, response prioritization, resource optimization—that have driven nurse teams to the brink. Together, these unified technologies will make care professionals’ lives easier, not harder, and I couldn’t be more excited to lead the TigerConnect product organization into this next chapter.”

Critical Alert Integration with TigerConnect Plans

TigerConnect’s robust product suite, which includes care
team collaboration (TigerFlow®), on-call scheduling (TigerSchedule®), virtual
care/telemedicine (TigerTouch®), and now virtualized nurse call and
alerts/alarm management (Critical Alert middleware), will help transform
hospitals and healthcare organizations into the real-time health systems of the
future. 

Hardware-free Middleware Forms the Foundation

With a shared cloud-native approach, Critical Alert’s
advanced middleware seamlessly fuses TigerConnect’s care team
collaboration with alarm management and event notifications. Deep
enterprise-level integrations with hospital systems enable the centralization
of clinical workflow management and real-time analytics. Integrating these
systems will have a sizable impact on customer organizations’ productivity and
patient care.

Next Generation Nurse Call

Critical Alert’s nurse call solution brings a modern, badly
needed upgrade to legacy systems, extending both their life and feature-set. A
single mobile- or desktop-enabled user-interface brings vital contextual
information about requests while allowing for centralized answering of nurse
call alerts and management of workflows and assignments. These streamlined
workflows reduce noise and clinical interruptions while improving
responsiveness.

Physiological Monitoring – Less Noise, More Signal

The FDA-cleared offering intelligently routes context-rich
alarm notifications from clinical systems to TigerFlow+. An easy-to-use
workflow builder ensures alerts are prioritized accordingly and are routed to
the appropriate caregiver, suppressing unnecessary noise. The filtering,
mobilization, and escalation of alerts pairs with TigerConnect Teams,
allowing for prompt responses in critical situations.

Smart Bed Alarms for Enhanced Patient Safety

Integrations with popular smart bed systems provide remote
monitoring of bed status details, informing nurses whether they should walk or
run to a patient’s room. Staff can review and adjust bed compliance settings
from their mobile device and receive fall prevention notifications if safe-bed
configuration is compromised.

Real-time Location System (RTLS) Measures What Matters

The integration of RTLS with a deployed nurse call
application greatly enhances the data available to clinical leadership. The
combined TigerConnect/Critical Alert offering enables real-time tracking
of staff location (presence) and time spent on tasks, providing deeper insights
into resource planning, workflow effectiveness and ongoing process improvement
initiatives.

Advanced Analytics for Deeper Workflow Insights

A better understanding of patient behavior and workflows
helps reveal areas for optimization that can lead to improved patient care and
staff efficacy. The new combined platform capabilities centralize the
collection and tracking of patient event data and nurse task efficiency,
turning insights into action. Advanced analytics also allow for identifying,
documenting, and benchmarking responsiveness, compliance, resource allocation,
and patient throughput across the health system. 

Availability

This new integrated functionality is expected to be
available to TigerConnect customers in Q1 of 2021.

12 Telehealth & Virtual Care Predictions and Trends for 2021 Roundup

Dr. Paul Hain, Chief Medical Officer of GoHealth

Telehealth is Here to Stay in 2021

Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows patients, especially high-risk populations like seniors, to connect with their doctors in a safe and efficient way. Telehealth is valuable for many types of visits, mostly clearly ones that involve mental health or physical health issues that do not require a physical exam or procedure. It’s an efficient modality for both the member and provider.

With the growing popularity of telehealth services, we may see permanent changes in regulatory standards. Flexible regulatory standards, such as being able to use platforms like FaceTime or Skype, would lower the barrier to entry for providers to offer telehealth and also encourage adoption, especially among seniors. Second, it’s likely we’ll see an emergence of providers with aligned incentives around value, such as in many Medicare Advantage plans, trying very hard to encourage utilization with their members so that they get the right care at the right time. In theory, the shift towards value-based care will allow better care and lower costs than the traditional fee for service model. If we are able to evolve regulatory and payment environments, providers have an opportunity to grow these types of services into 2021 to improve patient wellness and health outcomes.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Dr. Salvatore Viscomi, Chief Medical Officer, GoodCell

2021 will be the year of patient controlled-health

The COVID-19 pandemic brought the realities of a global-scale health event – and our general lack of preparedness to address it – to the forefront. People are now laser-focused on how they can protect themselves and their families against the next inevitable threat. On top of this, social distancing and isolation accelerated the development and use of digital health tools, from wellness trackers to telehealth and virtual care, most of which can be accessed from the comfort of our homes. The convergence of these two forces is poised to make 2021 the year for patient-controlled health, whereby health decisions are not dictated by – but rather made in consultation with – a healthcare provider, leveraging insights and data pulled from a variety of health technology tools at people’s fingertips.


Bullshit Metrics: Is Patient Engagement Real?

Anish Sebastian, CEO of Babyscripts

Beyond telemedicine

Telemedicine was the finger in the dyke at the beginning of pandemic panic, with healthcare providers grabbing whatever came to hand — encouraged by relaxed HIPAA regulations — to keep the dam from breaking. But as the dust settles, telemedicine is emerging as the commodity that it is, and value-add services are going to be the differentiating factors in an increasingly competitive marketplace. Offerings like remote patient monitoring and asynchronous communication, initially considered as “nice-to-haves,” are becoming standard offerings as healthcare providers see their value for continuous care beyond Covid.


Rise of the "Internet of Healthy Things"

Daniel Kivatinos, COO and Co-Founder of DrChrono

Telehealth visits are going to supersede in-person visits as time goes on.

Because of COVID-19, the world changed and Medicare and Medicaid, as well as other insurers, started paying out for telehealth visits. Telemedicine will continue to grow at a very quick rate, and verticals like mental health (psychology and psychiatry) and primary care fit perfectly into the telemedicine model, for tasks like administering prescription refills (ePrescribing) and ordering labs. Hyperlocal medical care will also move towards more of a telemedicine care team experience. Patients that are homebound families with young children or people that just recently had surgery can now get instant care when they need it. Location is less relevant because patients can see a provider from anywhere.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Dennis McLaughlin VP of Omni Operations + Product at ibi

Virtual Healthcare is Here to Stay (House Calls are Back)

This new normal however is going to put significant pressure on the data support and servicing requirements to do it effectively. As more services are offered to patients outside of established clinical locations, it also means there will be more opportunity to collect data and a higher degree of dependence on interoperability. Providers are going to have to up their game from just providing and recording facts to passing on critical insight back into these interactions to maximize the benefits to the patient.


Sarahjane Sacchetti, CEO at Cleo

Virtual care (of all types) will become a lasting form of care: The vastly accelerated and broadened use of virtual care spurred by the pandemic will become permanent. Although it started with one-off check-ins or virtual mental health coaching, 2021 will see the continued rise in the use and efficacy of virtual care services once thought to be in-person only such as maternity, postpartum, pediatric, and even tutoring. Employers are taking notice of this shift with 32% indicating that expanded virtual health services are a top priority, and this number will quickly rise as employers look to offer flexible and convenient benefits in support of employees and to drive productivity.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Omri Shor, CEO of Medisafe

Digital expansion: The pandemic has accelerated patient technology adoption, and innovation remains front-and-center for healthcare in 2021. Expect to see areas of telemedicine and digital health monitoring expand in new and novel ways, with increased uses in remote monitoring and behavioral health. CMS has approved telehealth for a number of new specialties and digital health tools continue to gain adoption among healthcare companies, drug makers, providers, and patients. 

Digital health companions will continue to become an important tool to monitor patients, provide support, and track behaviors – while remaining socially distant due to the pandemic.  Look for crossover between medical care, drug monitoring, and health and wellness – Apple 

Watch has already previewed this potential with heart rate and blood oxygen monitoring. Data output from devices will enable support to become more personalized and triggered by user behavior. 


Kelli Bravo, Vice President, Healthcare and Life Sciences, Pegasystems

The COVID-19 pandemic has not only changed and disrupted our lives, it has wreaked havoc on the entire healthcare industry at a scale we’ve never seen before. And it continues to alter almost every part of life across the globe. The way we access and receive healthcare has also changed as a result of social distancing requirements, patient concerns, provider availability, mobile capabilities, and newly implemented procedures at hospitals and healthcare facilities.

For example, hospitals and providers are postponing elective procedures again to help health systems prepare and reserve ICU beds amid the latest COVID-19 resurgence. While level of care is always important, in some areas, the inability to access a healthcare provider is equally concerning. And these challenges may become even more commonplace in the post-COVID-19 era. One significant transformation to help with the hurdle is telehealth, which went from a very small part of the care offering before the health crisis to one that is now a much more accepted way to access care.
As the rise in virtual health continues to serve consumers and provide a personalized and responsive care experience, healthcare consumers expect support services and care that are also fast and personalized – with digital apps, instant claims settlements, transparency, and advocacy. And to better help serve healthcare consumers, the industry has an opportunity to align with digital transformation that offers a personalized and responsive experience.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Brooke LeVasseur, CEO of AristaMD

Issues pertaining to the COVID-19 pandemic will continue to be front-and-center in 2021. Every available digital tool in the box will have to be employed to ensure patients with non-COVID related issues are not forgotten as we try to free up in-person space and resources for those who cannot get care in any other setting. Virtual front doors, patient/physician video and eConsults, which connect providers to collaborate electronically, will be part of a broadening continuum of care – ultimately aimed at optimizing every valuable resource we have.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Bret Larsen, CEO and Co-Founder, eVisit

By the end of 2021, virtual care paths will be fairly ubiquitous across the continuum of care, from urgent care and EDs to specialty care, all to serve patients where they are – at home and on mobile devices. This will be made possible through virtualized end-to-end processes that integrate every step in patient care from scheduling, waiting rooms, intake and patient queuing, to interpretation services, referral management, e-prescribe, billing and analytics, and more.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Laura Kreofsky, Vice President for Advisory & Telehealth for Pivot Point Consulting

2020 has been the year of rapid telehealth adoption and advancement due to the COVID pandemic. According to CDC reports, telehealth utilization spiked as much as 154% in late March compared to the same period in 2019. While usage has moderated, it’s clear telehealth is now an instrumental part of healthcare delivery. As provider organizations plan for telehealth in 2021 and beyond, we are going to have to expect and deliver a secure, scalable infrastructure, a streamlined patient experience and an approach that maximizes provider efficiency, all while seeing much-needed vendor consolidation.


12 Telehealth & Virtual Care Predictions and Trends for 2021

Jeff Lew, SVP of Product Management, Nextech

Earlier this year, CMS enacted new rules to provide practices with the flexibility they need to use telehealth solutions in response to COVID-19, during which patients also needed an alternative to simply visiting the office. This was the impetus to the accelerated acceptance of telehealth as a means to both give and receive care. Specialty practices, in particular, are seeing successful and positive patient experiences due to telehealth visits. Dermatology practices specifically standout and I expect the strong adoption will continue to grow and certainly be the “new normal.” In addition, innovative practices that have embraced this omni-channel approach to delivering care are also establishing this as a “new normal” by selectively using telehealth visits for certain types of encounters, such as post-op visits or triaging patients. This gives patients a choice and the added convenience that comes with it and, in some cases, increases patient volume for the practice.


Patient-First Model: High Tech Meets High Touch for Individuals with Rare Disorders

Patient-First Model: High Tech Meets High Touch to Optimize Data, Inform Health Care Decisions, Enhance Population Health Management for Individuals with Rare Disorders
Donovan Quill, President and CEO, Optime Care

Industry experts state that orphan drugs will be a major trend to watch in the years ahead, accounting for almost 40% of the Food and Drug Administration approvals this year. This market has become more competitive in the past few years, increasing the potential for reduced costs and broader patient accessibility. Currently, these products are often expensive because they target specific conditions and cost on average $147,000 or more per year, making commercialization optimization particularly critical for success. 

At the same time precision medicine—a disease treatment and prevention approach that takes into account individual variability in genes, environment, and lifestyle for each person—is emerging as a trend for population health management. This approach utilizes advances in new technologies and data to unlock information and better target health care efforts within populations.

This is important because personalized medicine has the capacity to detect the onset of disease at its earliest stages, pre-empt the progression of the disease and increase the efficiency of the health care system by improving quality, accessibility, and affordability.

These factors lay the groundwork for specialty pharmaceutical companies that are developing and commercializing personalized drugs for orphan and ultra-orphan diseases to pursue productive collaboration and meaningful partnership with a specialty pharmacy, distribution, and patient management service provider. This relationship offers manufacturers a patient-first model to align with market trends and optimize the opportunity, maximize therapeutic opportunities for personalized medicines, and help to contain costs of specialty pharmacy for orphan and rare disorders. This approach leads to a more precise way of predicting the prognosis of genetic diseases, helping physicians to better determine which medical treatments and procedures will work best for each patient.

Furthermore, and of concern to specialty pharmaceutical providers, is the opportunity to leverage a patient-first strategy in streamlining patient enrollment in clinical trials. This model also maximizes interaction with patients for adherence and compliance, hastens time to commercialization, and provides continuity of care to avoid lapses in therapy — during and after clinical trials through commercialization and beyond for the whole life cycle of a product. Concurrently, the patient-first approach also provides exceptional support to caregivers, healthcare providers, and biopharma partners.


Integrating Data with Human Interaction

When it comes to personalized medicine for the rare orphan market, tailoring IT, technology, and data solutions based upon client needs—and a high-touch approach—can improve patient engagement from clinical trials to commercialization and compliance. 

Rare and orphan disease patients require an intense level of support and benefit from high touch service. A care team, including the program manager, care coordinator, pharmacist, nurse, and specialists, should be 100% dedicated to the disease state, patient community, and therapy. This is a critical feature to look for when seeking a specialty pharmacy, distribution, and patient management provider. The key to effective care is to balance technology solutions with methods for addressing human needs and variability.  

With a patient-first approach, wholesale distributors, specialty pharmacies, and hub service providers connect seamlessly, instead of operating independently. The continuity across the entire patient journey strengthens communication, yields rich data for more informed decision making, and improves the overall patient experience. This focus addresses all variables around collecting data while maintaining frequent communication with patients and their families to ensure compliance and positive outcomes. 

As genome science becomes part of the standard of routine care, the vast amount of genetic data will allow the medicine to become more precise and more personal. In fact, the growing understanding of how large sets of genes may contribute to disease helps to identify patients at risk from common diseases like diabetes, heart conditions, and cancer. In turn, this enables doctors to personalize their therapy decisions and allows individuals to better calculate their risks and potentially take pre-emptive action. 

What’s more, the increase in other forms of data about individuals—such as molecular information from medical tests, electronic health records, or digital data recorded by sensors—makes it possible to more easily capture a wealth of personal health information, as does the rise of artificial intelligence and cloud computing to analyze this data. 


Telehealth in the Age of Pandemics

During the COVID-19 pandemic, and beyond, it has become imperative that any specialty pharmacy, distribution, and patient management provider must offer a fully integrated telehealth option to provide care coordination for patients, customized care plans based on conversations with each patient, medication counseling, education on disease states and expectations for each drug. 

A customized telehealth option enables essential discussions for understanding patient needs, a drug’s impact on overall health, assessing the number of touchpoints required each month, follow-up, and staying on top of side effects.

Each touchpoint has a care plan. For instance, a product may require the pharmacist to reach out to the patient after one week to assess response to the drug from a physical and psychological perspective, asking the right questions and making necessary changes, if needed, based on the patient’s daily routine, changes in behavior and so on. 

This approach captures relevant information in a standardized way so that every pharmacist and patient is receiving the same assessment based on each drug, which can be compared to overall responses. Information is gathered by an operating system and data aggregator and shared with the manufacturer, who may make alterations to the care plan based on the story of the patient journey created for them. 

Just as important, patients know that help is a phone call away and trust the information and guidance that pharmacists provide.


About Donovan Quill, President and CEO, Optime Care 

Donovan Quill is the President and CEO of Optime Care, a nationally recognized pharmacy, distribution, and patient management organization that creates the trusted path to a fulfilled life for patients with rare and orphan disorders. Donovan entered the world of healthcare after a successful coaching career and teaching at the collegiate level. His personal mission was to help patients who suffer from an orphan disorder that has affected his entire family (Alpha-1 Antitrypsin Deficiency). Donovan became a Patient Advocate for Centric Health Resources and traveled the country raising awareness, improving detection, and providing education to patients and healthcare providers.


Human API CEO Talks Data Privacy Concerns in Employee Wellness Programs

Human API CEO Talks Data Privacy Concerns in Employee Wellness Programs
Andrei Pop, Founder, and CEO of Human API,

A recent BBC article discusses the rise in employee health
tracking via wearable devices and highlights a number of concerns around data
privacy. To try and prevent health tracking schemes from crossing ethical
lines, and eroding trust between employee and employer, some industry figures
believe that organizations need to work with third-party vendors who specialize
in managing wellbeing data. These vendors would hold the data independently
under strict privacy rules, and work with employees directly to change their
lifestyles.

We recently spoke with Pop, Founder, and CEO of Human API to understand how a user-controlled data platform can address privacy concerns surrounding employee wellness programs. Human API delivers a user-controlled health data ecosystem that gives users full control of which enterprises, insurers, and researchers they want to share their data with to learn more about. The company works alongside a number of organizations such as Omada Health and Thrive Global helping them create wellness programs for their employees while keeping their personal data secure.

HITC: In response to the COVID-19 pandemic, how are
employers investing in employee wellness?

Pop: We have seen a number of different initiatives
across the board. Some of the more obvious include offering access to
mindfulness tools, online workouts, fitness apps, or online counseling services
for key issues such as mental health, financial distress, or relationship
difficulties. Others are more inventive, such as tools that encourage employees
to take breaks or ensure they are working in a safe environment at home.

We believe that one of the most important lessons and
reminders for employers during COVID-19 is that employees are the most valuable
assets for any business. Companies that treat their employees as such and
invest in making their teams feel supported throughout the crisis will thrive
in the long run. 

After all, recent studies show that 80% of employees at companies with
developed health and wellness programs feel engaged in their workplace and cared
for by their employers. Modern employees — especially Millennials — are
motivated to join businesses that are committed to their improvement and
progression. While one year ago, this may have meant salary increases and
promotions, through the lens of COVID-19 this also means improving employees’
health and well-being.

Our customers like Thrive Global are actively working with
their employer customers to build additional well-being programs and products
on top of their software platform, to support employee resilience, well-being,
and productivity.

This recognition that healthier, happier employees are proven to be more
creative, productive, and less transient, is driving this increased interest in
wellness initiatives. We believe it will continue to do so well after a vaccine
has solved the immediate threat from COVID-19. Employee well-being is going to
be table stakes in the future for employers who want to attract and retain the
best talent. 

HITC: Has the remote workforce revolution increased
interest in these programs from employers?

Pop: We think about this question a lot since we’re a
virtual-first company by design. Remote working is a trend that has been
accelerated by years due to the pandemic, and our customers are actively
building new wellness solutions to empower employers to take better care of
their people. Wearable devices are now front and center as a way to support
employee wellness, and programs are rapidly emerging to help people stay active
and healthy during these trying times.

Increased interest in wellness solutions to problems
associated with ‘stay at home’ measures — such as a strain on mental health —
is clearly represented in funding data from 2020. A recent report from CB Insights shows that
although wellness applications for general fitness and sleep saw fewer deals
and dollars than they did in the first half of 2019, there has been a spike in
funding for mental health-focused wellness startups. 

During the pandemic, which has been described as a ‘mental
health crisis,’ downloads of consumer meditation and mindfulness apps like Calm
and Headspace have increased significantly. 

We’re also seeing a lot of movement in the enterprise space.
A couple of examples include Spring Health, a service that helps companies
offer their workers mental health benefits, which recently raised $76 million, and MindLabs,
which recently raised $1.8M for its mobile app combining live videos from
mental health professionals leading meditation and mindfulness sessions, with
an EEG headband that measures heart and respiration rates to show how
successful sessions are in reducing stress. 

HITC: What role will user-controlled data platforms play
in working with these enterprises?

Pop: User-controlled data platforms will facilitate
the secure transaction and exchange of fragmented health data to power wellness
solutions, programs, and products, and ultimately accelerate the pace of
innovation for enterprises. Platforms like ours have a vested interest in
earning and keeping user trust, and are able to offer an extra layer of
security and privacy (peace of mind) to end-users. We believe our approach to
enabling data sharing will continue to increase adoption and user participation
in wellness programs and solutions. As we’ve seen in other industries,
companies Uber, and other modern transaction layers that enable trusted
transactions opened the market to new innovations and new consumer behaviors.
Our platform is helping drive enterprise and consumer behavior in a similar way
by accelerating the rise of a consumer health ecosystem that empowers people to
be proactive participants in their own health and well-being. 

HITC: How can employees control their data to solve the
trust issue?

Pop: Through our platform, employees can connect and
disconnect a data source any time they want. They are in full control of which
companies have access to their health data, and we’ll never sell any
identifiable employee health data. Our security policy and protocols are designed
in the best interest of employees (end consumers) to maximize trust,
engagement, and participation. 

HITC: What challenges and trends do you see heading into
2021 and beyond for the user-controlled health data ecosystem?

Pop: Trust remains a big issue, but we find that
people are beginning to be more comfortable with sharing their data while
they’re at home. I believe the biggest challenge to the rise of a new consumer
health ecosystem is how fast industries and enterprises can adapt and innovate.
This is new terrain that companies are learning to navigate and master. We’re
seeing the emergence of a new wellness paradigm to respond to the pandemic, and
we’re excited to help accelerate the trend of empowering consumers to take
control of their own health. As more health data sources come online, our
consumer health data platform will help enable more innovative products and
solutions. There’s a global opportunity and historic moment here to capitalize
on by leveraging the power of wearable technology and health data to transform
consumer well-being.

How The Internet of Things (IoT) Can Be Used to Monitor The Elderly

How the IoT Can Be Used to Monitor the Elderly
Ajay Rane, VP of Global Ecosystem Development, Sigfox

Shelter-in-place orders related to the COVID-19 pandemic have exaggerated the social exclusion and loneliness of many elderly and vulnerable individuals, thereby increasing their chances of experiencing critical health complications. This trend—combined with societal shifts including reduced inter-generational living, greater geographical mobility, and less cohesive communities—has placed the elderly at heightened risk of being isolated and, consequently, in harm’s way.

Fortunately for senior citizens quarantined or living alone, technology can help detect and alert caregivers, healthcare professionals or family members to elderly persons’ changes in behavior—which can prevent serious issues. 

Of the solutions available, the IoT is uniquely positioned to enable caregivers to support the well-being of those at risk when others cannot be at their side. By tracking key health indicators such as dehydration and malnutrition and behavioral changes like decreased mobility, IoT-enabled monitors reduce emergency hospital admissions and allow elders to stay in their homes longer safely. 

Preventive fall detection

Falling, which becomes more prevalent with age, is the second leading cause of accidental or unintentional injury deaths worldwide. Therefore, actions for preventing falls must be taken both at home and in care facilities. Recording incidents, identifying risk factors (individual and environmental), and highlighting the preventive and corrective measures are critical steps in fall prevention, prediction, and detection. And they can all be accomplished with the IoT.

With conventional fall-detection technologies, a person must wear or carry the device and press a button upon falling. If the person is unwell but does not fall, nothing is reported, which is why it is important to monitor discomfort by other means, such as an algorithm that detects a change in the patient’s general wellbeing. 

Using IoT sensors for this purpose, healthcare providers are able to track progress over longer periods of time (days or months) and determine whether an individual’s health is deteriorating, thereby placing them at future risk of falling. With this knowledge, caregivers can intervene and provide increased care before any injury occurs.

Keeping elders in their homes longer

When used in conjunction with tele-assistance services, IoT solutions can also help reassure families their loved ones are safe living on their own by transmitting critical information indicative of deteriorating health so that early warning signs don’t go unnoticed.

Companies such as SeniorAdom and Vitalbase have already developed remote assistance solutions based on IoT technology, including various motion detection sensors, geolocation pendants, and wrist bands. These solutions are designed to automatically detect any potential behavioral changes due to a fall, physical weakness, or cognitive deterioration (e.g., Alzheimer’s disease).

These innovative solutions make it possible to better protect elderly populations by anticipating risks and acting quickly in the event of an emergency. With a self-learning algorithm and an intelligent box wirelessly connected to sensors installed in the home, SeniorAdom can detect a potentially critical or abnormal situation and warn caregivers or relatives. SeniorAdom’s motion sensors and door open/close sensors learn the daily activities of the monitored individual to “get smart” on their everyday habits. As a result, the sensors can detect and send alerts about any changes in activities, which might indicate a problem. 

How the sensors work

Operating on a 0G network—which is optimized to frequently transmit small amounts of information over a large distance—IoT-enabled sensors detect conditions and movement from connected devices, and never pick up personal information. Additionally, these devices consume minimal energy on a 0G network and therefore support communications at a very low cost. This means families can receive effective care without a hefty price tag. 

Devices that run on other networks, like cellular, can also use a 0G network as a backup to ensure device users have constant supervision and those vulnerable individuals are able to communicate their health needs immediately. For example, Vitalbase’s Vibby OAK, an automatic fall detector worn on the wrist or neck, connects to a cellular mobile device but uses a 0G network when there is no primary connectivity, either because the user is not near a phone, or there’s no cellular network connectivity. At healthcare facilities, the device can interface with all existing nurse call systems to alert medical staff when an issue arises. 

By optimizing automatic and intuitive fall-detection devices with the IoT, older adults can live more independently and maintain autonomy. The ability to remotely monitor seniors, receive alerts in case of emergencies, predict issues based on early warning signs, and intervene proactively offers peace of mind to both healthcare providers and families of senior citizens.


About Ajay Rane

Ajay Rane is the VP of Global Ecosystem Development at Sigfox, the initiator of the 0G network and the world’s leading IoT (Internet of Things) service provider. Its global network, available in 60 countries with 1 billion people covered, allows billions of devices to connect to the Internet, in a straightforward way, while consuming as little energy as possible. 


COVID-19 Exposed The True Vulnerability of Healthcare Infrastructure

How COVID-19 Exposed The True Vulnerability of Healthcare Infrastructure
Martyn Crew, Director of Solutions Marketing at Gigamon

In 2019, 41 million patient records breached in 572 reported incidents at an average cost of $1.8 million per breach. These statistics are far from surprising with healthcare records selling for a reported average of $45 on the dark web. Unfortunately, the year 2020 aggravated these issues as COVID-19 exposed the true vulnerability of the healthcare infrastructure. Organizations not only had to manage the medical and financial impacts of the pandemic but also the security risks inherent in the work-from-home (WFH) model and the increasingly sophisticated attacks of cybercriminals intent on exploiting these vulnerabilities. In this article, we’ll dive into some of these growing threats.

The Bare Minimum of EDR

Although most organizations have now provided WFH employees with secure computers using endpoint detection and response (EDR) solutions or mandated the use of virtual private networks (VPNs), this does not fully solve the security problem.

These solutions may protect the user and network from future attacks, but if network infiltration has already occurred, threats in the form of advanced persistent threats (APTs) may be lying dormant for weeks, months, or maybe even years, on an apparently secure network. To respond to these threats, a network detection and response (NDR) capability is required. This capability looks for activity or patterns of behavior from users or network servers that indicate attacks may be in progress may have taken place or may be developing.

Ideally, EDR and NDR need to be integrated and used together to provide end-to-end network visibility and security.

Exploited Fears

Cybercriminals and other bad actors were quick to exploit the COVID-19 pandemic with, for example, phishing attacks. These exploited the fears of healthcare consumers and healthcare workers who, in the early days of WFH, were often accessing corporate networks on secured mobile phones and personal computers from their home networks.

This led to a variety of security issues; for example, Mirai botnet–type attacks that exploited WFH practices to infect healthcare organizations’ networks or dropper-based attacks that loaded malware to steal users’ credentials and ultimately lead to ransomware attacks. While these attacks still continue, most healthcare organizations have taken the measures necessary to secure their networks and their patient and organizations’ data.

A Spike in State-Sponsored Attacks

Beyond threats from financially motivated cybercriminals looms the threat from highly sophisticated and well-resourced state-sponsored attackers. As widely reported in the media, there has been a spike in state-sponsored security attacks on lab and research facilities working on COVID-19 treatments. For example, the Wall Street Journal cited U.S. officials as suggesting that Chinese and Iranian hackers are targeting universities and pharmaceutical and other healthcare firms that are working to find a vaccine for COVID-19, in an attempt to disrupt this research and slow its development.

In addition to direct attacks on research institutions, software vendors that develop the tools used by these institutions are also at risk. Security is becoming a “supply chain” issue that touches not only all of the network users and assets but also all the precursors to these assets, including the network carriers and software vendors on which network users rely.

Lack of Trust

Who can you trust in this expanded threat environment? To take proper precautions, nobody. As healthcare consumers and the workforce want or need to operate on an “access anywhere, anytime” model, adopting what’s called a Zero Trust security architecture not only makes sense, it is close to an imperative for healthcare organizations.

Zero Trust means that, because the network is under constant attack from a huge array of external and internal threats, all users, devices, applications, and resources on the network must be treated as being hostile. These users and devices need to be rigorously and continuously authenticated, while patient, research, and other data and network assets need to be protected at a much granular level than traditional perimeter-based security models allow.

The Rise of IoMT Devices

Healthcare organizations must also find new, more cost-effective ways to deliver high-quality healthcare to their increasingly tech-savvy consumers – and the use of Internet of Medical Things (IoMT) devices is critical to this process. IoMT devices, ranging from simple telehealth and remote patient monitoring to surgical robots and augmented reality technologies, can reduce operating costs and increase the quality of patient care.

COVID-19 has accelerated the adoption of IoMT technology, a process that will further accelerate with the availability of 5G networks over the coming one to three years. Many of the simpler IoMT devices don’t support traditional security models, so their adoption poses significant new threats unless healthcare institutions act to enhance security by, for example, ensuring that their network detection and response tools are ready for this challenge.

Looking ahead, it’s clear that the world is evolving towards a new normal, which will pose more threats and concerns for the healthcare industry. Recognizing this and preparing for the threats discussed, will create a better game plan for what’s to come and allow for necessary growth within healthcare infrastructure. 


About Matyn Crew
Martyn Crew is Director of Solutions Marketing at Gigamon. He brings a 30-year background in all aspects of enterprise IT to his role where he focuses on a number of initiatives and products including Gigamon’s Application Visibility and Intelligence solutions.


Medical Device Design: 4 Ways Designers Can Create Medical Devices That Work for Everyone

Karten Design: Design Must Play a Larger Role in Healthcare
Stuart Karten, Founder/President, Karten Design

Medical device design has been going through sweeping
changes over the last decade.  Ten years ago,
medical device companies weren’t concerned with delivering consumer-level
design: Devices that are both attractive and intuitively easy to use by a wide
variety of users.  Then the Affordable Care
Act
was passed, and adherence and healthy behavior change became a
regulatory requirement.  

Our firm, which has been a long-time proponent of the
“consumerization” of medical product design, saw a steady uptick in business
based on our ability to deliver product experiences that a consumer expects
while also meeting regulatory requirements of the FDA.  And yet we still had to do a fair amount of
convincing to engineering teams about the importance of design that not only
works for physicians, but also makes life easier for caregivers and
patients. 

Our goal has always been to make design a priority for and
deliver great experiences to every voice in the ecosystem.  As tragic as COVID-19 has
been for millions of people, it has accelerated the consumerization of medical
device design:  the pandemic has
radically changed medical products for the better, forever. 

In the last six months, we have had many traditional device
companies and startups approach us to design COVID-19 testing products.  They want clinically effective medical
devices that are as easy to use as at-home pregnancy tests.  Companies are also coming to us with
non-COVID medical device ideas, and even the conversations around those
products have changed:  there is a
realization that medical devices must address a multi-layered audience. 

While all medical products must integrate the emotional,
physical and cognitive needs of the health consumer to create a holistic
experience, to really achieve consumer-level design companies need to go well
beyond human factors and useability studies and truly push the design
boundaries.  Medical device companies
that can’t integrate these four elements into their medical products are not
making scalable products, and will underachieve in today’s marketplace:

1. Improve Convenience:  Consumers today are accustomed to
convenience. We expect the world to operate at the speed of a Google search,
with the customizability of meal planning on sites like Plated or Blue Apron,
and the responsiveness of booking a ride on Uber. Healthcare rarely works this
way so a medical device must integrate it into the design.  In the medical world, the laws of consumer
design also apply:  with Axonics
Modulation Technology system, we
transformed
an innovative technology into a complete ecosystem of physical
and digital products that improve the experience and work hard in the background
to return normal daily lives to people suffering from incontinence.

2. Aim to Delight: 
Creating delight can transform an experience and build relationships
that keep customers engaged with your brand. 
Most medical solution providers look at users in terms of physical and
cognitive usability. But this is only the beginning. We believe there are four
additional dimensions that will help companies develop a qualitative
understanding of health consumers and their motivations—emotional, social,
contextual, and developmental. Exploring these dimensions at the front end of
the product development process will reveal what patients need and desire from
a health experience and enable companies to respond with meaningful innovation
that gains adoption and changes health outcomes.  We use these motivations to create delight in
the medical device.

3. Provide Personalized Experiences: Personalization
is a growing trend in the consumer product world, and it needs to become one in
healthcare. Those at the forefront are using data to make predictions that
anticipate customers’ needs and desires. Entertainment platforms, like Netflix,
make recommendations that introduce users to new content based on their
previous consumption. Virgin America’s in-flight screens address their
passengers by name and provide personalized information about their itinerary,
in addition to personalized dining and entertainment recommendations. In
healthcare, targeted, personal experiences can be a tipping point to meaningful
behavior change. Information has the power to engage health consumers in
moments where their decisions have a direct impact on their health and
wellbeing. With a majority of people carrying or wearing smart devices, it’s
possible to have continuous data about their location. This data can be used to
generate relevant, real-time recommendations. 
With COVID-19 or any future pandemic, real-time information can save
countless lives.

4. Be Emotional: 
The goal of consumer-driven product innovation is to create an emotional
connection between users and brands—a delightful experience or perception that
keeps people coming back. This is an important goal in healthcare as well, as
more complex factors start to influence choice, and continued engagement plays
a growing role in health outcomes. Although the medical product development
process is more burdened by engineering, technology, and regulation, medical
solution providers can adopt some best practices from consumer companies to
help their products connect. Consumer giants apply numerous resources toward
developing a deep understanding of their user. To capture health consumers’
interest and loyalty, it’s necessary for medical device makers to develop a
knowledge that goes deeper than a medical record or hospital survey. This
holistic understanding of consumers and their health journeys will breed
empathy—something that only comes from first-hand emotional transactions—and
help companies uncover many opportunities for meaningful innovation and
differentiation.


About Stuart Karten

Stuart Karten is the principal of Karten Design, a
product innovation consultancy creating positive experiences between people and
products specializing in health technology. 


PointClickCare Acquires Collective Medical for $650M to Create to Largest Combined Acute and Post-Acute Care Network

PointClickCare Acquires Collective Medical for $650M to Create to Largest Combined Acute and Post-Acute Care Network

What
You Should Know:


PointClickCare announces its intent to acquire Collective Medical to create the
largest combined acute and post-acute care network in North America for $650M.


Collective Medical’s platform connects more than 1,300 hospitals, thousands of
ambulatory practices and long-term post-acute care (LTPAC) providers, as well
as accountable care organizations (ACOs) and every national health plan in the
country, across a 39-state network.

– With the acquisition of Collective Medical, PointClickCare will solidify its position as a high-growth, cloud-based SaaS leader, serving a large, diversified customer base across the acute, ambulatory, post-acute, and payer spectrum.


PointClickCare
Technologies
, a leader in senior care technology with a network of more
than 21,000 skilled nursing facilities, senior living communities, and home
health agencies, today announced its intent to acquire
Collective Medical, a Salt Lake
City, UT-based leading network-enabled platform for real-time cross-continuum
care coordination for $650M. Together, PointClickCare and Collective Medical
will provide diverse care teams across the continuum of acute, ambulatory, and
post-acute care with point-of-care access to deep, real-time patient insights
at any stage of a patient’s healthcare journey, enabling better decision making
and improved clinical outcomes at lower cost.

The acquisition follows a partnership, created between the
companies in August 2019, which streamlined the integration of Collective
Medical’s solution for care transitions with PointClickCare’s leading
cloud-based software platform. Hundreds of PointClickCare customers are already
leveraging this connection to the Collective platform to coordinate seamless
care transitions and influence decisions at the point of care.

COVID-19 Underscores Barriers to Care Coordination

Currently, hospitals, ACOs and health plans
lack the data and tools to effectively coordinate with LTPAC providers and
other disparate points of care – an issue spotlighted further by the COVID-19 pandemic.
And despite the healthcare system’s ongoing move to value-based payment
models
, barriers to care coordination
persist, especially for seniors and other complex patient populations. Through
this acquisition, the company will be uniquely positioned to address these
challenges.

PointClickCare supports a network of more than 21,000
skilled nursing facilities, senior living communities and home health agencies.
In the United States, 97 percent of all hospitals discharge patients to skilled
nursing facilities using PointClickCare. Founded in 2005, Collective Medical’s
platform connects more than 1,300 hospitals, thousands of ambulatory practices
and long-term post-acute care (LTPAC) providers, as well as accountable care
organizations (ACOs) and every national health plan in the country, across a
39-state network.

These providers come together via the Collective platform to
support patients suffering from a variety of complex conditions, including
substance use disorder, mental and behavioral health issues, and other care
needs requiring multiple interventions and transitions across disparate care
settings. The combination of PointClickCare and Collective Medical will enable
care to be more seamlessly delivered for the most complex (high-cost,
high-needs) patients, including the rapidly growing aging population.

The acquisition will connect care teams, post-acute
providers, hospitals and health plans with better data about their patients,
ultimately reducing administrative burdens and bringing down the high costs of
complex care. Providers and health plans will be empowered as they work to
solve the complexities around the senior patient population by leveraging
increased information across diagnoses groups and unprecedented access to drive
behavior change at the point of care.

Acquisition Establishes PointClickCare As Leader in Acute and Post-Acute
Care Network

With the acquisition of Collective Medical, PointClickCare
will solidify its position as a high growth, cloud-based SaaS leader, serving a
large, diversified customer base across the acute, ambulatory, post-acute, and
payer spectrum. As the shift to value-based care fuels growing market demand
for intelligence and collaboration tools, the company will be best positioned
to provide the most fully integrated set of real-time care coordination tools
across the entire continuum of care, powered by the largest network of its kind
in the U.S.

“The healthcare ecosystem is a mix of disconnected providers, systems, plans, processes and data. Healthcare costs and risk are on the rise, while patient care and provider-to-provider coordination are inconsistent. Our mission is to improve the lives of seniors, and we believe the best way to meaningfully advance this goal is by connecting disparate points of care,” says Mike Wessinger, founder and chief executive officer of PointClickCare Technologies. “Collective Medical offers the right fit of people and technology and together we will initiate a new era of data-enriched collaboration across the continuum that radically transforms how data and people are empowered to liberate health.”

The acquisition is subject to receiving regulatory
approvals, including from The Committee on Foreign Investment in the United
States (CFIUS), and other customary closing conditions, and is expected to be
completed by the end of December 2020.

UCB Taps Medisafe to Develop Branded Digital Drug Companions for Antiepileptic Medications

UCB Taps Medisafe to Develop Branded Digital Drug Companions for Antiepileptic Medications

What You Should Know:

– UCB has selected Medisafe to develop branded digital
drug companions for antiepileptic medications, marking the company’s official
entry into the digital therapeutics space.

– The initial collaboration will primarily be focused on their antiepileptic medications, but they are exploring its use for additional brands. 


Medisafe,
a leading digital
therapeutics
company specializing in digital companions, has been selected
by UCB to develop branded digital drug
companions for its antiepileptic medications, with greater capabilities to
expand across additional brands. The digital companions streamline support for
patients to access financial assistance, patient diaries, and doctor discussion
guides throughout their treatment journey.

UCB is launching both digital companions in November in
support of National Epilepsy Awareness Month and the more than 3.4 million
patients in the US who live with the neurological condition. 1 in 26 people in
the US will develop epilepsy at some point in their lives and UCB wants to make
managing medication therapies easier through new digital companions from Medisafe. UCB
is a leader in antiepileptic medications commonly used to treat epilepsy and
the new digital experience for users will deliver condition-specific
content to help support patients through any medication challenges. To
date, nearly 7MM users rely on Medisafe’s digital therapeutics platform,
which applies real-world evidence to build connected medication management
programs and influence patients’ behavior on therapy. 

The collaboration will raise awareness and drive engagement
with a content-rich digital experience for patients to gain support and
community throughout the course of their treatment. The Medisafe app
is available to Android and iPhone users through both the Google play and Apple
app stores. Patients can experience the antiepileptic medication resource
centers within the Medisafe app, unlocking a world of advanced
patient support and guidance as a result of this collaboration. 

“At UCB, we focus on fostering collaborations that deliver a purposeful impact to people living with epilepsy. As part of our ongoing digitalization efforts, the Medisafe app will allow us to continue supporting patients with new, innovative ways of navigating their health,” said Anita Moser, Head of Assets and Optimization for U.S. Neurology, UCB. “During the COVID crisis, the ability to support patients digitally is more important than ever, and we are pleased to deliver personalized and immediate support directly to epilepsy patients and their caregivers.”

How COVID-19 Has Revealed Healthcare’s Blockchain Use Cases

How COVID-19 Has Revealed Healthcare’s Blockchain Use Cases
Brett Furst, President at HHS Technology Group

Blockchain technology has somewhat infamously been described as “a solution in search of a problem,” but as the healthcare industry responds to the demands of the pandemic, several valuable use cases have surfaced that could benefit from employing the emerging technology.  

Due in large part due to its ability to promote trust, transparency, and privacy, blockchain has emerged as today’s best technology-based option for accomplishing the important objective of delivering real-time access to critical information that is presented in a consistent format from trusted sources.

False positives, duplicate records, and privacy issues make it very difficult to derive actionable intelligence with confidence from the current data-sharing infrastructure that exists in the healthcare industry. Further, lack of trust represents another challenge that hinders the formation of greater transparency, as much of the healthcare industry remains reluctant to pervasively share data due to privacy and competitive barriers.  

By design, blockchain allows for competing organizations to come together to share data about their patients in a completely auditable way, while maintaining their competitive independence and privacy concerns. It is these fundamental qualities that have helped blockchain emerge as a viable solution for a number of critical healthcare functions whose importance has grown during the COVID-19 pandemic, such as contact tracing, provider credentialing, and patient records-sharing.

Blockchain: The basics
Before delving into the specifics of what blockchain can do for healthcare during the pandemic, it is important to establish a general understanding of blockchain’s basics. By no means is it necessary for most healthcare executives to develop a deep knowledge of the technology, but familiarity with its essential elements will enable business leaders to speak roughly the same language as healthcare technology experts as blockchain continues to gain prominence.

Blockchain is a distributed ledger technology that enables users to share trusted and verified information in a decentralized manner. Combined with security and cryptography technology, blockchain can protect the privacy of users who contribute data while also sharing the provenance of the data, enhancing trust.

Blockchain technology provides a safe, effective way to accurately document, maintain, store, and move data – from health records to financial transactions. With blockchain, people can directly engage with others to receive services, transfer money, and perform other common daily tasks we do in business today.

Blockchain use cases
The biggest benefits offered by blockchain are associated with greater trust and privacy due to the technology’s ability to enable better data accuracy and verification. At its most basic level, blockchain changes ownership and control of data from one centralized source to multiple sources that contribute data. Following are three COVID-19-related use cases for blockchain in healthcare.

Contact tracing: To follow the potential transmission of the novel coronavirus, many governments have embarked upon contact tracing, in which infected individuals are asked to list all other people they’ve come into contact with over a certain period of time. Decentralization of data helps facilitate critical healthcare operations such as contact tracing because the process is reliant on using granular, sensitive data to inform public health officials of who may be at risk of exposure based on their movements and contacts. In contract tracing, maintaining individuals’ privacy is critical. Earlier this year, blockchain platform Nodle launched a contact-tracing app called “Coalition,” which emphasized user privacy.

Patient-record sharing: Another valuable use case for blockchain as it relates to COVID-19 is the aggregation of patient records during a crisis or disaster to create a “light” electronic health records system, which disparate groups of providers can use to share patient records while treating unfamiliar patients during the pandemic or other crises and natural disasters. Such a platform will allow providers to work with patients who may not have access to their usual provider, but still receive the full range of needed services and prescriptions. The main concept of the solution is that patients’ electronic health records follow them wherever they go. In other words, regardless of where the patient stays during a disaster, there is always access to their personal medical information and they are able to receive required medical services. This patient data can be delivered through a blockchain digital wallet, providing access, security, and integrity of data.

Provider credentialing: Provider credentialing — which is the process of verifying providers’ skills, training and education — is an often-tedious, time-consuming process for both providers and payers that can lead to delays in care that contribute to poor health outcomes. By using blockchain for the process, providers can maintain control of their own data and give health systems, payers and other authorities access to their credentials as they like. Earlier this year, five organizations announced plans to use a new blockchain credentialing system from ProCredEx with the aim of using distributed ledger technology to reduce time and costs associated with the traditional approach to credentialing. 

The right technology at the right time
It is important to note that blockchain technology requires a cultural and paradigm shift toward broader collaboration across traditionally disparate and potentially competitive entities. The technology facilitates a framework that allows organizations to contribute to joint efforts without risking their intellectual property or proprietary information. However, it will still require an intentional change in behavior to successfully work across different business interests toward a common goal. Nonetheless, to surmount the challenges posed by healthcare’s manual, time-consuming processes for contact tracing, patient record-sharing, and provider credentialing, blockchain represents the right technology at the right time. 


About Brett Furst

A senior executive with nearly three decades of experience in selling and managing technology solutions within the manufacturing, CPG, and healthcare industries, Brett Furst serves as president of HHS Technology Group, a software and solutions company serving the needs of commercial enterprises and government agencies.


Change Healthcare Unveils Social Determinants of Health Analytics Solution

Change Healthcare Acquires Credentialing Tech Docufill to Improve Administrative Efficiency

What You Should Know:

– Change Healthcare launches national data resource on
social determinants of health (SDoH) for doctors, insurers and life sciences
organizations to better understand the connection between where a person lives
and how they live their life to the care a patient receives and their health
outcome.

– 80% of U.S. health outcomes are tied to a patient’s
social and economic situation, ranging from food, housing, and transportation
insecurity to ethnicity.


Change Healthcare, today announced the launch of Social Determinants of Health (SDoH) Analytics solution that will serve as an innovative national data resource that connects the circumstances of people’s lives to the care they receive. The SDoH Analytics solution is designed for health systems, insurers, and life sciences organizations to explore how geodemographic factors affect patient outcomes.


Understanding Social Determinants of Health

SDoH includes factors such as socioeconomic status, education, demographics, employment, health behaviors, social support networks, and access to healthcare. Individuals who experience challenges in any of these areas can face significant risks to their overall health.

“All the work I do—for Mayo Clinic, the COVID-19 Healthcare Coalition, and The Fight Is In Us— is predicated on equity,” said John Halamka, president, Mayo Clinic Platform. “The only way we can eliminate racism and disparities in care is to better understand the challenges. Creating a national data resource on the social determinants of health is an impactful first step.”

The SDoH Portrait Analysis includes financial attributes, education
attributes, housing attributes, ethnicity, and health behavior attributes.

3 Ways Healthcare Organizations Can Leverage SDoH
Analytics

Healthcare organizations can now use SDoH Analytics to
assess, select, and implement effective programs to help reduce costs and
improve patient outcomes. Organizations can choose one of three ways to use
SDOH Analytics:

1. Receive customized reports identifying SDoH factors that
impact emergency room, inpatient, and outpatient visits across diverse
population health segments.

2. Append existing systems with SDoH data to close
information gaps and help optimize both patient engagement and outcomes.

3. Leverage a secure, hosted environment with ongoing
compliance monitoring for the development of unique data analytics, models, or
algorithms.

Why It Matters

Scientific research has shown that 80% of health outcomes
are SDoH-related. Barriers such as food and housing availability,
transportation insecurity, and education inequity must be addressed to reduce
health disparities and improve outcomes. Change Healthcare’s SDoH Analytics
links deidentified claims with factors such as financial stability, education
level, ethnicity, housing status, and household characteristics to reveal the
correlations between SDoH, clinical care, and patient outcomes. The resulting
dataset is de-identified in accordance with HIPAA privacy regulations.

“Health systems, insurers, and scientists can now use SDoH Analytics to make a direct connection between life’s circumstances and health outcomes,” said Tim Suther, senior vice president of Data Solutions at Change Healthcare. “This helps optimize healthcare utilization, member engagement, and employer wellness programs. Medical affairs and research are transformed. And most importantly, patient outcomes improve. SDoH Analytics makes these data-driven insights affordable and actionable.”

4 Ways to Combat Hidden Costs Associated with Delayed Patient Care During COVID-19

Matt Dickson, VP, Product, Strategy, and Communication Solutions at Stericycle
Matt Dickson, VP, Product, Strategy, and Communication Solutions at Stericycle

COVID-19 terms such as quarantine, flatten the curve, social distance, and personal protective equipment (PPE) have dominated headlines in recent months, but what hasn’t been discussed in length are the hidden costs of COVID-19 as it relates to patient adherence.  

The coronavirus pandemic has amplified this long-standing issue in healthcare as patients are delaying routine preventative and ongoing care for ailments such as mental health and chronic disease. Emergency care is also suffering at alarming rates. Studies show a 42 percent decline in emergency department visits, measuring the volume of 2.1 million visits per week between March and April 2019 to 1.2 million visits per week between March and April 2020. Patients are not seeking the treatment they need – and at what cost?

When the SARS outbreak occurred in 2002, particularly in Taiwan, there was a marked reduction in inpatient care and utilization as well as ambulatory care. Chronic-care hospitalizations for long-term conditions like diabetes plummeted during the SARS crisis but skyrocketed afterward. Similar to the 2002 epidemic, people are currently not venturing en masse to emergency rooms or hospitals, but if history repeats itself, hospital and ER visits will happen at an influx and create a new strain on the healthcare system.

So, if patients aren’t going to the ER or visiting their doctors regularly, where have they gone? They are staying at home. According to reports from the Kaiser Family Foundation, 28 percent of Americans polled said they or a family member delayed medical care due to the pandemic, and 11 percent indicated that their condition worsened as a result of the delayed care. Of note, 70 percent of consumers are concerned or very concerned about contracting COVID-19 when visiting healthcare facilities to receive care unrelated to the virus. There is a growing concern that patients will either see a relapse in their illness or will experience new complications when the pandemic subsides. 

Rather than brace for a tidal wave of patients, healthcare systems should proactively take steps (or act now) to drive patient access, action, and adherence.

1. Identify Who Needs to Care The Most 

Healthcare providers should consider risk stratifying patients. High-risk people, such as an 80-year-old male with comorbidities and recent cardiac bypass surgery, may require a hands-on and frequent outreach effort. A 20-year-old female, however, who comes in annually for her physical but is healthy, may not require that level of engagement. Understanding which patients are at risk for the potential for chronic conditions to become acute or patients who have a hard time staying on their care plan may need prioritized attention and a more thorough engagement effort. 

For example, patients with a history of mental health issues may lack motivation or momentum to seek care. Their disposition to be disengaged may require greater input to push past their disengagement.  

Especially important is the ability to educate and guide patients to the appropriate venue of care (ER, telehealth visit, in-person primary care visit, or urgent care) based on their self-reported symptoms.  Allowing patients to self-triage while scheduling appointments helps them make more informed decisions about their care while reducing the burden on over-utilized emergency departments.

2. Capture The Attention of The Intended Audience and Induce Action

Once you’ve identified who needs care the most, how do you break through the “information clutter” to ensure healthcare messages resonate with the intended audience? The more data points, the better. It is important to understand the age of the patient, their preferred communication channel, and the intended message for the recipient, but effective communication exceeds those three data points. Consider factors like the presence of mental health conditions, comorbidities, or health literacies. Then, think beyond the patient’s channel of choice and select the appropriate channel of communication (text, phone call, email, paid social media advertisement, etc.), that will most likely induce action. As an organization, also consider running A/B tests to detect and analyze behavior. As you collect more data, determine what exactly is inducing patient action. 

Of note, don’t underestimate the power of repetition. Patients may need to be reminded of the intended action a few times in a few different ways before moving forward with seeking the care they need. Repetition is also shown to decrease no-show rates, a critical metric. Proactive, prescriptive, and tailored communication will help increase engagement. Moving past the channel of choice and toward the channel of action is key.

3. Engage Patients Through Personalized and Tailored Communication 

In addition to identifying the right communication channel, it’s also important to ensure you deliver an effective message.  Communication with patients should be relevant to their particular medical needs while paying close attention to where each person is in their healthcare journey. Connecting with patients on both an emotional and rational level is also important. For example, sending a positive communication via phone, email, or text to lay the foundation for the interaction shows interest in the patient’s wellbeing. 

A “Hey, here’s why you need to come in” note makes a connection in a direct and personalized way. At the same time, and in a very pointed manner, sharing ways providers and health systems are keeping patients safe (e.g., telehealth, virtual waiting rooms, separate entrances, and mandating masks), also provides comfort to skittish patients. Additionally, consider all demographic information when tailoring communications. And don’t forget to analyze if changes in content impact no-show rates. Low overall literacy may impact health literacy and may require simpler and more positive words to positively impact adherence. 

It may sound daunting, especially for individual health systems, to personalize patient communication efforts, but the use of today’s data tools and technological advancements can relieve the burden and streamline efforts for an effective communication approach. 

4. Use Technology to Your Advantage (With Caution)

Once you have developed your communication strategy, don’t stop there.  Consider all aspects of the patient journey to drive action.  A virtual waiting room strategy, for example, can help ease patient concerns and encourage them to resume their care. Health systems can help patients make reservations, space out their arrival times, and safeguard social distancing measures—all while alleviating patient fears. Ideally, the patient would be able to seamlessly book an appointment and receive a specific arrival time, allowing ER staff to prepare for the patient’s arrival while minimizing onsite wait time.

When implemented properly, telehealth visits can also improve continuity of care, enhance provider efficiency, attract and retain patients who are seeking convenience, as well as appeal to those who would prefer not to travel to their healthcare facility for their visit. Providers need to determine which appointments can successfully be resolved virtually. Additionally, some patients might not have the means for a successful telehealth visit due to a lack of internet access, a language barrier, or a safe space to talk freely.

To ensure all patients receive quality care, health systems should make plans to serve patients who lack the technology or bandwidth to participate in video visits in an alternative manner. For example, monitor patients remotely by asking them to self-report basic information such as blood sugar levels, weight, and medication compliance via short message service (SMS). This gives providers the ability to continuously monitor their patients while enhancing patient safety, increasing positive outcomes, and enabling real-time escalation whenever clinical intervention is needed.

It is important we ensure all patients stay on track with their health, despite uncertain and fearful times. Health systems can enhance patient adherence and induce action through the implementation of tools that increase patient engagement and alleviate the impending strain on the healthcare system. 


About Matt Dickson

Matt Dickson is Vice President of Product, Strategy, and General Manager of Stericycle Communication Solutions, a patient engagement platform that seamlessly combines both voice and digital channels to provide the modern experience healthcare consumers want while solving complex challenges to patient access, action, and adherence. . He is a versatile leader with strong operational management experience and expertise providing IT, product, and process solutions in the healthcare industry for nearly 25 years. Find him on LinkedIn.

Aptar Pharma Acquires the Assets of Respiratory Startup Cohero Health

Aptar Pharma Acquires the Assets of Cohero Health

What You Should Know:

– Apstar Pharma acquires the assets of respiratory health company Cohero Health to expands its digital portfolio with a focus on respiratory disease management.

– Cohero Health develops digital tools and technologies to improve respiratory care, reduce avoidable costs, and optimize medication utilization.


AptarGroup, Inc., a global leader in consumer dispensing, active packaging, drug delivery solutions, and services, announces that it has acquired all operating assets and the proprietary portfolio of Cohero Health, Inc. (“Cohero Health”), a digital therapeutics company transforming respiratory disease management for asthma and chronic obstructive pulmonary disorder (COPD). Financial details of the acquisition were not disclosed.

Start breathing smarter

Founded in 2013, New York-based Cohero Health develops innovative digital tools and technologies to improve respiratory care, reduce avoidable costs, and optimize medication utilization. With this transaction, Aptar Pharma acquires Cohero Health’s turnkey digital health platform and device assets including:

· BreatheSmart Connect digital health platform – care coordination and HIPAA-compliant SaaS cloud service which captures and securely stores data from Cohero Health’s devices and BreatheSmart® software for remote monitoring and patient communications to help manage patient therapy;

· BreatheSmart® App – designed for patient habit creating and behavior change, driving appropriate medication utilization. Provides real-time tracking of medication adherence and lung function, along with reminders, educational materials, and symptom/trigger recording;

·
HeroTracker® Sensors
– Bluetooth enabled medication smart inhaler sensors
designed for both control and rescue medications. Attaches to respiratory
medications to automatically record time and date of doses taken

· mSpirometer™ and cSpirometer™lung function diagnostic sensors – enable comprehensive pulmonary lung function testing in a handheld wireless device.

Acquisition Expands Aptar’s Digital Portfolio

“Cohero Health further strengthens and expands Aptar’s digital portfolio, in this case, with a focus in respiratory disease management,” commented Sai Shankar, Aptar Pharma’s Vice President, Global Digital Healthcare Systems. “Aptar has made previous investments in digital respiratory company Sonmol in China and digital health company Navia Life Care in India. With this strategic bolt on, Aptar now has global capabilities to deploy digital respiratory health, utilizing either the Cohero or Aptar device portfolio/platform. The investment will also facilitate Aptar’s ability to provide diagnostic solutions in respiratory and a significant number of other disease categories.”

Ontrak Acquires Science-Backed, Behavior Change Platform LifeDojo

Ontrak Acquires Science-Backed, Behavior Change Platform LifeDojo

What You Should Know:

– Ontrak acquires LifeDojo Inc, a San Francisco, CA-based
comprehensive, science-backed behavior change platform.

– The acquisition broadens Ontrak’s addressable market
and footprint to lower acuity populations enabling new interventions and remote
patient monitoring.


Ontrak, Inc., a
leading AI-powered
and telehealth-enabled,
virtualized healthcare company, today announced that it has acquired
LifeDojo Inc, a comprehensive, science-backed behavior change platform.
Financial details of the acquisition were not disclosed.

Behavior Change Platform for Consumers and Employers

Founded in 2013, LifeDojo is a platform that makes
transformative life changes possible for members in over 16 countries.
Supported by decades of public health research, the LifeDojo approach to
member-centric behavior change delivers lasting health improvement outcomes,
high enrollment, and better engagement than traditional programs. Clients
include Fortune 500 companies and high-tech, high-growth organizations who use
LifeDojo’s 32 behavior change modules.

COVID-19 Spawns Mental Health Surge

The Journal of the American Medical Association (JAMA) this month reported accumulating evidence of a “second wave” mental health surge that will present monumental challenges for an already greatly strained mental health system and individuals at high risk for mental health disorders such as anxiety, depression, and post-traumatic stress. A June 2020 survey from the Centers for Disease Control and Prevention of 5,412 US adults found that 40.9% of respondents reported “at least one adverse mental or behavioral health condition,” including depression, anxiety, posttraumatic stress, and substance abuse, with rates that were three to four times the rates one year ago.

4 Ways LifeDojo Acquisition Advances Ontrak’s Growth
Strategy

With the coronavirus pandemic rapidly increasing demand for
“telemental” health solutions, the acquisition of LifeDojo is expected to
advance the Ontrak growth strategy in four ways:

First, the acquisition adds a technology-first,
digital business deployed by blue chip customers in the employer space.

Second, LifeDojo enhances Ontrak’s market-leading
behavioral health engagement capabilities for new and existing customers, with
the addition of the LifeDojo digital tools that drive member value and lower
cost. The combination of behavioral health coaching and digital app-based
solutions meets accelerated payer demand for a comprehensive suite of
behavioral health services and solutions.

Third, the LifeDojo platform increases the company’s
addressable market by enabling the creation of lower cost, digital
interventions across behavioral health and chronic disease populations.

Fourth, LifeDojo’s member-facing apps enable remote
patient monitoring capabilities, initially focused on member reported data,
that will feed Ontrak AI capabilities and further personalize Ontrak’s
evidence-based coaching.

“As a public company and leader in virtualized healthcare, Ontrak is uniquely positioned to attract companies, products and technologies that expand our value proposition and footprint with health plan and employer partners. We will endeavor to make additional strategic purchases that expand our addressable market and maximize customer value. LifeDojo and these other intended acquisitions can possibly expand our total addressable $33.7 billion market by up to 100%,” said Mr. Terren Peizer, Chairman and CEO of Ontrak.

Were We Mentally Ready for COVID-19? Why It’s Time to Take Behavioral Health Seriously

Were We Mentally Ready for COVID-19? Why It’s Time to Take Behavioral Health Seriously
Dr. Jacob Lazarovic M.D., IMCS Group

As you read this, over 200,000 American deaths have been attributed to the virus. The influx of cases continues, while state and local economies are experiencing hardship, children are shuttered in their homes learning remotely, grown children are moving back home and the “new normal” disrupts nearly all of life’s plans. 

Yet, these issues don’t reveal all the traumas that Americans are experiencing 10 months into the pandemic. The pandemic’s impact continues to be swift and brutal, showing little sign of slowing down. Loneliness and isolation are gripping many American adults, as the nation settles in for a long fall/winter.

Growing evidence supports the notion that this virus is spread through aerosols, that is, person-to-person transmission by means of inhalation of infectious particles. With the onset of colder weather and the approaching holiday season, conditions are rife for spreading the virus. Flu season is imminent and COVID-19 cases are increasing.

While the safest choice is to isolate until the widespread availability of a vaccine arrives (within the next 6-12 months), this is an unwelcome option for some already suffering from “pandemic fatigue” and not really an option at all for others (like those who work outside the home).

Either way, America’s mental health is at risk. According to the CDC, reports of mental health conditions (anxiety, trauma, substance abuse, suicide) have considerably increased during the pandemic with more than 40% of American adults reporting mental health struggles. Frontline healthcare workers are particularly affected, and over 71% have experienced psychiatric symptoms, including depression, anxiety, insomnia, and distress. Even run-of-the-mill loneliness and isolation contribute to substance misuse and disorders, which, by the way, contribute to an increased risk for COVID-19.


Key Ways Mental Health Providers Can Help  

Because mental health threats are now part and parcel of living amid the COVID-19 pandemic, it is important to routinely gauge the health of those close to you, (and this is paramount for those recovering from COVID-19, frontline workers, and first responders.) Consider consulting a mental health provider if you notice any of these characteristics in yourself or someone you know:

– Displaying frequent, uncharacteristic anger, anxiety, irritation; 

– Withdrawing from friends and family;

– Ignoring personal hygiene;

– Engaging in high-risk activities, such as heavy drinking, illicit drug use, or self-destructive behavior;

– Exhibiting feelings of overwhelming sadness, hopelessness, grief, or worthlessness 

Nearly every American is impacted mentally, financially, and emotionally by the pandemic, and even the fortunate few who aren’t already personally affected are feeling the stress of an uncertain future. Mental health providers aim to improve coping skills, relationships, and self-care regimens to reduce anxiety, depression, or other mental illness. From generalized anxiety to neuropsychology related to recovery from COVID-19, behavioral health specialists are equipped to help in a myriad of ways such as these: 

1. Building resilience by introducing coping and stress tolerance activities, such as mindfulness and meditation, or a simple shift in perspective 

2. Shoring up social connections and relationships to serve as a layer of protection and diffusion from life stress

3. Ensuring self-care activities, such as adequate sleep, diet, exercise, and more to sustain mood and self-esteem

4. Delivering grief and loss counseling for those who have suffered acute human losses during the crisis

5. Counseling for substance abuse and addiction

6. Initiating a short intervention using cognitive behavioral therapy techniques

Those with pre-existing mental health issues, including depression, PTSD, social anxiety, agoraphobia, generalized anxiety and major depression, may benefit from an increased intensity in treatment, by frequency or duration.

For survivors of COVID-19 who have had significant cardiac and respiratory complications including prolonged periods of dyspnea (shortness of breath), hypoxemia (decreased blood oxygen levels), and hypoxia (decreased oxygenation of organs), neurocognitive screening and ongoing monitoring of mental status will be helpful.


Advances in Telemedicine 

Recent advances in computer-administered neurocognitive testing have allowed

clinicians to administer psychological and neurocognitive assessment instruments by telemedicine, and there are now many more neurocognitive assessment batteries available to aid in the detection and quantification of neuropsychological functional deficits.

Historically, psychologists, psychiatrists, and L.C.S.W.s have not done virtual sessions with patients, but COVID is changing that, and increasingly insurers are receptive to this practice. The technology, capability, and compliance aspects of virtual appointments were available prior to 2020, but COVID has brought “distance meeting” into the American vernacular. Medical doctors now treat patients via telehealth in numerous instances, and mental health patients can be treated using similar meeting applications.

Telebehavioral health could not be more timely. In the fight against isolation, virtual technology allows human beings to check on one another and meaningfully connect, at the same time allowing people seeking mental health services to receive treatment safely without risking infection from a devastating disease.  

Even as the pandemic presents a common threat like none other we have faced in recent years, it also offers us the opportunity to reach out and check on one another. Everyone is affected in some way by COVID-19, be it the disease itself or simply disruption to our routines and mass anxiety. It’s definitely time to take mental health seriously. Our technology ensures that we do not have to be alone in isolation, and relief may be just a call away. Through mutual understanding and effort, we can focus on the unifying experience of overcoming this crisis.


About Dr. Lazarovic

Dr. Lazarovic, M.D., F.A.A.F.P., has nearly 40 years of medical administration/managed care experience, including 18 years as Chief Medical Officer at Broadspire/CRAWFORD, a global third-party administrator of workers’ compensation, disability, auto and medical product liability claims. Experienced in clinical guidelines, medical cost control and strategic planning, Dr. Lazarovic has conducted and published original research and analytics and presented at multiple industry conferences. Dr. Lazarovic is currently the CMO responsible for the development of advanced, evidence-based clinical applications at MyAbilities Technologies, a medical software and services company in the workers’ compensation and disability sector.  


Press Ganey Acquires Doctor.com, Acquires Majority Stake in Binary Fountain

Press Ganey Acquires Doctor.com, Acquires Majority Stake in Binary Fountain

What You Should Know:

– Press Ganey advances the healthcare consumerism movement with acquisitions of Doctor.com and a majority stake in Binary Fountain.

– Expanded technology platform enables industry-leading
management of providers’ online brand and seamless Web-wide patient acquisition
and loyalty strategies.


Press Ganey today
announced the expansion of its market-leading health care consumerism platform
with the acquisitions
of Doctor.com and a majority equity stake
in Binary Fountain. These acquisitions create the largest health care
consumerism platform in the industry that offers an unmatched opportunity for
health systems and providers to drive digital patient acquisition, retention,
and reputation management strategies that will deliver new levels of growth and
loyalty.


Set Up Your Virtual Practice in 5 Minutes or Less with
Doctor.com’s Turnkey Solution

Founded in 2013, Doctor.com provides the critical
infrastructure and integrations necessary to enable modern digital experiences
for patients. Doctor.com clients benefit from best-in-class provider data,
robust physician and patient engagement tools, and seamless integrations with
the most prominent health care directories, search engines, social media
platforms, and EHR/PM systems. As a result, thousands of clients, including
200+ leading hospitals and health systems, 30,000+ private practices, and
leading brands in the life sciences industry, have been empowered by Doctor.com
to enhance their digital presence and credibility, increase patient trust, and
grow their business.


Why It Matters

The COVID-19 crisis radically disrupted the health care
industry and altered consumer behavior. The result was massive growth in
telehealth services, with Press Ganey administering more than 15 million
telemedicine surveys year to date. Coupled with more than 71% of patients
seeking physician reviews online and 70,000 health-related Google searches each
minute, these fundamental shifts have escalated the need for health care
providers to enhance and streamline the online healthcare customer experience.

“This acquisition is game-changing for the industry. By pairing data and insights from Press Ganey’s 472 million consumer surveys a year with next-generation technology, health care organizations can finally unite their patient experience and patient acquisition efforts within one powerful platform. This unified solution drives performance improvement, accelerates transparency initiatives, and improves the patient experience,” said Andrei Zimiles, co-founder and CEO, Doctor.com. “As patients continue to ‘shop’ for care in increasingly competitive digital channels, this groundbreaking new platform from three pioneers in the consumerism space gives health care organizations the edge they’ve been looking for.”

Financial details of the acquisition were not disclosed.

AWS, PHDA Collaborate to Develop Breast Cancer Screening and Depression Machine Learning Models

AWS, PHDA Collaborate to Develop Breast Cancer Screening and Depression Machine Learning Models

What You Should Know:

– Amazon Web Services (AWS) and the Pittsburgh Health Data Alliance (PHDA) announce a collaboration to produce more accurate machine learning models for breast cancer screening and depression.

– In work funded through the PHDA-AWS collaboration, a research team led by Shandong Wu, an associate professor at the University of Pittsburgh Department of Radiology, is using deep-learning systems to analyze mammograms in order to predict the short‐term risk of developing breast cancer. 

– A team of experts in computer vision, deep learning,
bioinformatics, and breast cancer imaging, including researchers from the
University of Pittsburgh Medical Center (UPMC), the University of Pittsburgh,
and Carnegie Mellon University (CMU), are working together to develop a more
personalized approach for patients undergoing breast cancer screening.


Last August, the Pittsburgh Health Data Alliance (PHDA)
and Amazon Web Services (AWS)
announced a new collaboration to advance innovation in areas such as cancer
diagnostics, precision medicine, electronic health records,
and medical imaging. One year later: AWS collaboration with Pittsburgh Health
Data Alliance begins to pay dividends with new machine learning innovation.

Researchers from the University of Pittsburgh Medical Center
(UPMC), the University of Pittsburgh, and Carnegie Mellon University (CMU),
who were already supported by the PHDA,  received additional support
from  Amazon Research Awards to use machine learning
techniques to study breast cancer risk, identify depression markers, and
understand what drives tumor growth, among other projects.


Accurate Machine Learning Models for Breast Cancer Screening
and Depression

In work funded through the PHDA-AWS collaboration, a
research team led by Shandong Wu, an associate professor in the University of
Pittsburgh Department of Radiology, is using deep-learning systems to analyze
mammograms in order to predict the short‐term risk of developing breast
cancer.  A team of experts in computer vision, deep learning,
bioinformatics, and breast cancer imaging are working together to develop a
more personalized approach for patients undergoing breast cancer screening.

Wu and his colleagues collected 452 de-identified normal
screening mammogram images from 226 patients, half of whom later developed
breast cancer and half of whom did not. Leveraging AWS tools, such as
Amazon SageMaker,
they used two different machine learning models to analyze the images for
characteristics that could help predict breast cancer risk. As they reported in
the American Association of Physicists in Medicine, both
models consistently outperformed the simple measure of breast density, which
today is the primary imaging marker for breast cancer risk,  The team’s
models demonstrated between 33% and 35% improvement over these existing
models, based on metrics that incorporate sensitivity and specificity.


Why It Matters

“This preliminary work demonstrates the feasibility and promise of applying deep-learning methodologies for in-depth interpretation of mammogram images to enhance breast cancer risk assessment,” said Dr. Wu. “Identifying additional risk factors for breast cancer, including those that can lead to a more personalized approach to screening, may help patients and providers take more appropriate preventive measures to reduce the likelihood of developing the disease or catching it early on when interventions are most effective. “


Tools that could provide more accurate predictions from screening images could be used to guide clinical decision making related to the frequency of follow-up imaging and other forms of preventative monitoring. This could reduce unnecessary imaging examinations or clinical procedures, decreasing patients’ anxiety resulting from inaccurate risk assessments, and cutting costs.

Moving forward, researchers at the University of Pittsburgh
and UPMC will pursue studies with more training samples and longitudinal
imaging data to further evaluate the models. They also plan to combine deep
learning with known clinical risk factors to improve upon the ability to
diagnose and treat breast cancer earlier.


Second Project to Develop Biomarkers for Depression

In a second project, Louis-Philippe Morency, associate
professor of computer science at CMU, and Eva Szigethy, a clinical researcher
at UPMC and professor of psychiatry, medicine, and pediatrics at the University
of Pittsburgh, are developing sensing technologies that can automatically measure
subtle changes in individuals’ behavior — such as facial expressions and use of
language — that can act as biomarkers for depression.

These biomarkers will later be compared with the results of
traditional clinical assessments, allowing investigators to evaluate the
performance of their technology and make improvements where necessary. This
machine learning technology is intended to complement the ability of a
clinician to make decisions about diagnosis and treatment.  The team is working with a gastrointestinal-disorder
clinic at UPMC, due to the high rate of depression observed in patients with
functional gastrointestinal disorders.

This work involves training machine learning models on tens
of thousands of examples across multiple modalities, including language (the
spoken word), acoustic (prosody), and visual (facial expressions). The
computational load is heavy, but by running experiments in parallel on multiple
GPUS AWS services have allowed the researchers to train their models in a few
days instead of weeks.

A quick and objective marker of depression could help
clinicians more efficiently assess patients at baseline, identify patients who
would otherwise go undiagnosed, and more accurately measure patients’ responses
to interventions. The team presented a paper on the work, “Integrating
Multimodal Information in Large Pretrained Transformers”, at the July 2020
meeting of the Association for Computational Linguistics.


“Depression is a disease that affects more than 17 million adults in the United States, with up to two-thirds of all depression cases are left undiagnosed and therefore untreated,” said Dr. Morency. “New insights to increase the accuracy, efficiency, and adoption of depression screening have the potential to impact millions of patients, their families, and the healthcare system as a whole.”


The research projects on breast cancer and depression
represent just the tip of the iceberg when it comes to the research and
insights the collaboration across PHDA and AWS will ultimately deliver to
improve patient care. Teams of researchers, health-care professionals, and
machine learning experts across the PHDA continue to make progress on key
research topics, from the risk of aneurysms and predicting how cancer cells
progress, to improving the complex electronic-health-records
system
.


Digital Behavioral Health: Addressing The COVID-19 Behavioral Health Crisis

digital behavioral health and addressing the COVID-19 behavioral health crisis
Victor Siclovan, Director of Medicaid Transformation Project at AVIA

Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these pernicious trends on overall mental health will take time. However, precedents like the Great Recession suggest that these trends are likely to worsen the conditions driving suicide and substance-related deaths, the “deaths of despair” that claimed 158,000 lives in 2017 and contributed to a three-year decline in US life expectancy among adults of all racial groups.

Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 2018 data showed that only 43% of adults with mental health needs, 10% of individuals with SUD, and 7% of individuals with co-occurring conditions were able to receive services for all necessary conditions. 

The treatment gap is staggering, and COVID-19 is exacerbating it: an estimated 45% of adults report the pandemic has negatively impacted their mental health, to say nothing of the disruption of essential in-person care and services. In a similar vein, a recent CDC report has highlighted the staggering and “disproportionately worse mental health outcomes, [including] increased substance use, and elevated suicidal ideation” experienced by “younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.”

Consistent with the CDC report’s findings, the crisis can be felt most acutely by the very workforce that must deal with COVID-19 itself. Hospitals, health systems, and clinical practices – together with other first responders – comprise the essential front line. They bear the burden of their employees’ stress and illness, and must also cope with the many patients who present with a range of mental illnesses and substance use disorder (SUD).

But providers don’t have to face this burden alone: numerous behavioral health-focused digital solutions can support providers in meeting their most urgent needs in the era of COVID-19. Many of these solutions have made select services available for free or at a discount to healthcare providers in recognition of the immense need and challenging financial circumstances. Some solutions also help systems take advantage of favorable, albeit time-sensitive, conditions, enabling them to lay the foundation for broader behavioral health initiatives in the long term. Several of these solutions are described below, in the context of three key focus areas for health systems.

Focus Area 1: Supporting the Frontline Workforce 

Health system leaders need to keep their workforces healthy, focused, and productive during this period of extreme stress, anxiety, and trauma. Providing easily accessible behavioral health resources for the healthcare workforce is therefore of paramount importance.

Health systems should consider providing immediate, free access to behavioral health services to employees and their families and consider further extending that access to first responders, other healthcare workers, and other essential services workers in the community.

Many digital product companies are granting temporary access to their services and are expanding their offerings to include new, COVID-19-specific modules, resources, and/or guidance at no cost. 

Fortunately, the market is rife with solutions that have demonstrated effectiveness and an ability to scale. However, many of these rapidly-scalable solutions are oriented toward low-acuity behavioral health conditions, so it is important that health systems consider the unique needs of their populations in determining which solution(s) to adopt.

The following are several solutions to consider:

Online CBT solutions. These tools are being used to expand access to lower-acuity behavioral health services, targeting both frontline workers and the general population. MyStrength, SilverCloud and others have deployed COVID-19-specific programming.

Text-based peer support groups. Organizations are using Marigold Health to address loneliness and social isolation in group-based chat settings, one-on-one interactions between individuals and peer staff, and broader community applications.

Focus Area 2: Maintaining Continuity of Care 

As the pandemic continues to ripple across the country, parts of the delivery system remain overwhelmingly focused on containing and treating COVID-19. This can and has led to the disruption of care and services, of particular significance to individuals with chronic conditions (e.g., serious mental illness (SMI) and SUD), who require longitudinal care and support. Standing up interventions — digital and otherwise — to ensure continuity of care will be critical to preventing exacerbations in patients’ conditions that could drive increased rates of ED visits and admissions at a time when hospital capacity can be in short supply.

In the absence of in-person care, many digital solutions are hosting virtual recovery meetings and providing access to virtual peer support groups. Additionally, shifts in federal and state policies are easing restrictions around critical services, including medication-assisted treatment (e.g., buprenorphine can now be prescribed via telephone), that can mitigate risky behavior and ensure ongoing access to treatment. 

The use of paraprofessionals has also emerged as a promising extension of the historically undersupplied behavioral health treatment infrastructure. Capitalizing on the rapid expansion of virtual care, providers should consider leveraging digital solutions to scale programs that use peers, community health workers (CHWs), care managers, health coaches, and other paraprofessionals, to reduce inappropriate hospital utilization and ensure patients are navigated to the appropriate services.

The following are several solutions to consider:

Medication-assisted therapy (MAT) via telemedicine. These solutions provide access to professionals who can prescribe and administer MAT medications, provide addiction counseling, and conduct behavioral therapy (e.g., CBT, motivational interviewing) digitally. Solution companies providing these critical services include Eleanor Health, PursueCare, and Workit Health.

Behavioral health integration. Providing screening, therapy, and psychiatric consultations in a variety of care settings — especially primary care — will help address the increased demand. Historically, providers have had difficulty scaling such solutions due to challenging reimbursement, administrative burden, and stigma, among other concerns. Solutions like Valera Health and Concert Health were created to address these challenges and have seen success in scaling collaborative care programs.

Recovery management tools for individuals with SUD. WEConnect Health and DynamiCare Health are both offering free daily online recovery support groups.

Focus Area 3: Leveraging New Opportunities to Close the Treatment Gap

As has been widely documented, the pandemic has spurred unprecedented adoption of telehealth services, aided by new funding opportunities (offered through the CARES Act and similar channels) and the widespread easing of telehealth requirements, including the allowance of reimbursement for audio-only services and temporarily eased provider licensure requirements.

Tele-behavioral health services are no exception; the aforesaid trends ensure that what was one of the few high-growth areas in digital behavioral health before the pandemic will remain so for the foreseeable future. This is unquestionably a positive development, but there is still much work to be done to close the treatment gap. Critically, a meaningful portion of this work is beyond the reach of the virtual infrastructure that has been established to date. For example, there remains a dearth of solutions that have successfully scaled treatment models for individuals with acute illnesses, like SMI or dual BH-SUD diagnoses.

Health system leaders should continue to keep their ears to the ground for new opportunities to expand their virtual treatment infrastructure, paying particular attention to synergistic opportunities to build on investments in newly-developed assets (like workforce-focused solutions) to round out the continuum of behavioral health services. 

COVID-19 has all but guaranteed that behavioral health will remain a major focus of efforts to improve healthcare delivery. Therefore, health systems that approach today’s necessary investments in behavioral health with a long-term focus will emerge from the pandemic response well ahead of their peers, having built healthier communities along the way.


About Victor Siclovan

Victor Siclovan is a Director on the Medicaid Transformation Project at AVIA where he leads work in behavioral health, chronic care, substance use disorder, and Medicaid population health strategy. Prior to AVIA, Victor spent nearly 10 years at Oliver Wyman helping large healthcare organizations navigate the transition to value-based care. He holds a BA in Economics from Northwestern.


Why Hasn’t A More Holistic Approach to Patient Care Become The Norm?

Why Holistic Healthcare Is Worth the Cost

When food production technology made it possible, wheat flour processors started to eliminate the tough exterior (bran) and nutrient-rich core (germ) of the kernel to get at the large, starchy part (the endosperm) only. The bread produced from this process is white and fluffy, and it makes great PB&Js and takes forever to grow mold, but it is almost totally lacking nutritional value.

Nutrition experts eventually pointed this out, of course, after which commercial bakers tried fortifying their bread by adding back essential nutrients stripped out by processing. It didn’t work. While white bread from refined flour is still available, nutrition experts strongly recommend whole grain products as the healthier alternative.

Opposition to this reductionist approach to nutrition is perhaps best captured by the idea of the sum being the whole of its parts: If inputs are lacking, the end result will fall short also.

Each human being is also a sum of parts, and the reductionist approach to healthcare is essential when it comes to advancing many aspects of medicine and healthcare.

“Historically, the invention of the microscope, the defining of Koch’s four infectious disease postulates, the unraveling of the human genome, and even intelligent computers are salient examples of the dramatic benefits of biomedical reductionism,” explained Dr. George Lundberg.

These successes, however, may have convinced many in both the medical community and society at large that reductionism is a necessary, if not sufficient, approach. The numbers say otherwise.

“Classical medical care interventions contribute only about 10 percent to reducing premature deaths compared to other elements such as genetic predisposition, social factors, and individual health behaviors,” Lundberg goes on to say. “Most contemporary medical researchers have concluded that the chronic degenerative diseases of modern Western humans have multiple contributory causes, thus not lending themselves to the single agent-single outcome model.”

Paging Dr. House. It turns out your particular form of genius just isn’t frequently that useful.

And nowhere is the single agent-single outcome model arguably less effective than in behavioral health and chronic disease management. What many in medicine and healthcare now realize is that a vicious cycle of alternating physical and mental ailments are the norm with both chronic illness and long-term mental health challenges.

“Depression and chronic physical illness are in a reciprocal relationship with one another: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses,” says Professor David Goldberg of the Institute of Psychiatry in London.

It’s an unsurprisingly intuitive conclusion to reach. A man with depression lacks the desire to eat well, exercise, often practice necessary daily hygiene. As his untreated depression deepens, his physical health declines as well. A woman with chronic, untreated pain feels like it will never end and her life is over. Faced with a seemingly unmanageable challenge, she falls into a funk that eventually metastasizes into full-blown depression.

A reductionist approach to these scenarios might be to encourage more exercise or prescribe antidepressants. While both are necessary, neither will likely be sufficient.

So why hasn’t a more holistic approach to patient care become the norm? In a nutshell, because it’s expensive. Chronic illnesses, generally, are the most expensive component of healthcare.

According to a New England Journal of Medicine study, patients “with three or more chronic conditions (43 percent of Medicare beneficiaries) account for more than 80 percent of Medicare health care costs.”

For this expensive, highly at-risk group, holistic care is what actually works.

The NEJM articles conclude that “an intervention involving proactive follow-up by nurse care managers working closely with physicians, integrating the management of medical and psychological illnesses, and using individualized treatment regimens guided by treat-to-target principles improved both medical outcomes and depression in depressed patients with diabetes, coronary heart disease, or both.”

Of course, the regimen included in the NEJM study is expensive—perhaps more so than what qualifies as holistic care now.

But it requires a certain type of twisted logic to argue for holding down costs by rationing care inputs—by reductively treating only just the most obvious health concerns—when this approach invariably leads to readmissions, more office visits, more disability payments, more days of work missed.

Indeed, a reductive approach to accounting—silos of financial impact across the continuity of a life lived—hides the fact that specific healthcare costs are not alone the measure of how chronic illness detracts from both individual life satisfaction and broader societal efficiencies.

The key, then, is to make holistic health both the norm and affordable. How can that be done? By creating initiatives designed to achieve a core set of goals:

Incentivize primary care: In the last two decades, the number of primary care providers (PCPs) available to patients in the United States has decreased by about 2 percent. This may not sound like a lot, but the decline comes as the population has increased, naturally, which means fewer patients have a PCP. As healthcare shifts to pay for performance, not services, the PCP is the natural quarterback of patient care. The country needs many more PCPs, not fewer, and the federal government has an opportunity to use loan forgiveness incentives and other tools to nudge medical school students in that direction.

Embrace technology: Arguably, holistic care only became possible with the digital age. Chronic disease management requires frequent measurement of patient vitals, which is very expensive without wearables and similar digital age technologies. Now, patients can regularly provide data with no clinical intervention, that data can automatically upload to an electronic health record, and that EHR can alert the clinician when results are alarming.

Make poor choices expensive: Perhaps only because smoking has become so socially unacceptable can the cost of cigarettes be so high ($7.16 per pack in Chicago with all taxes) without creating significant protests. But the data is clear that higher costs equal fewer smokers. The same types of behavioral economics programs can also apply to fast food, soda, etc. Yes, people will get upset and complain about the nanny state, but absent some attempt to change behavior, we may want to consider changing the name to the United States of Diabetes.

Reward smart choices: Healthy people use healthcare and insurance less often, which drives down costs. Duh. Combining technology and incentives (avoiding diabetes), Utah’s Intermountain Healthcare engaged almost 1,500 pre-diabetic employees in a program through Omada Health that collectively yielded 9,162 pounds lost. Omada billed Intermountain based on the level of success, and without speaking to specific numbers, Intermountain felt the cost of the program was a wise investment when compared with the costs of diabetes treatment.

These four bullets are probably just the most obvious suggestions, of course. They don’t account for the complexities of the American healthcare system focused on payment models, the profit motive, or what to do with the uninsured, homeless, and devastatingly mentally ill.

But the benefits of holistic thinking when reductionism is inadequate applies to both individual care and the healthcare system as a whole. Public health, for example, takes a holistic approach to communities by looking at how housing, transportation, and education impact general overall health. Where this approach is done well, the benefits are obvious.

Reductionist isolation will always be necessary when identifying specific genes or determining which natural elements are effective in treating disease. But it’s wise to always bring the right tools for the job.

4 Areas Driving AI Adoption in Hospital Operations and Patient Safety

4 Reasons Why Now Is the Time for Hospitals to Embrace AI
Renee Yao, Global Healthcare AI Startups Lead at NVIDIA

COVID-19 has put a tremendous burden on hospitals, and the clinicians, nurses, and medical staff who make them run. 

Many hospitals have suffered financially as they did not anticipate the severity of the disease. The extended duration of patient stays in ICUs, the need for more isolated rooms and beds, and the need for better supplies to reduce infections have all added costs. Some hospitals did not have adequate staff to check-in patients, take their temperature, monitor them regularly, or quickly recruit nurses and doctors to help.

AI can greatly improve hospital efficiency, improve patient satisfaction, and help keep costs from ballooning. Autonomous robots can help with surgeries and deliver items to patient’s rooms. Smart video sensors can determine if patients are wearing masks or monitor their temperature. Conversational tools can help to directly input patient information right into medical records or help to explain surgical procedures or side effects.

Here are four key areas where artificial intelligence (AI) is getting traction in hospital operations and enhancing patient safety:

1- Patient Screening

We’ve become familiar with devices in and around our homes that use AI for image and speech recognition, such as speakers that listen to our commands to play our favorite songs. This same technology can be used in hospitals to screen patients, monitor them, help them understand procedures, and help them get supplies.

Screening is an important step in identifying patients who may need medical care or isolation to stop the spread of COVID-19. Temporal thermometers are widely used to measure temperatures via the temporal artery in the forehead, but medical staff has to screen patients one by one. 

Temperature screening applications powered by AI can automate and dramatically speed up this process, scanning over 100 patients a minute. These systems free up staff, who can perform other functions, and then notify them of patients who have a fever, so they can be isolated. Patients without a fever can check-in for their appointments instead of waiting in line to be scanned. 

AI systems can also perform other screening functions, such as helping monitor if patients are wearing masks and keeping six feet apart. They can even check staff to ensure they are wearing proper safety equipment before interacting with patients.  

2. Virtual Nurse Assistant 

Hospitals are dynamic environments. Patients have questions that can crop up or evolve as circumstances change. Staff have many patients and tasks to attend to and regularly change shifts. 

Sensor fusion technology combines video and voice data to allow nurses to monitor patients remotely. AI can automatically observe a patient’s behavior, determining whether they are at risk of a fall or are in distress. Conversational AI, such as automatic speech recognition, text-to-speech, and natural language processing, can help understand what patients need, answer their questions, and then take appropriate action, whether it’s replying with an answer or alerting staff.

Furthermore, the information recorded from patients in conversational AI tools can be directly inputted into patients’ medical records, reducing the documentation burden for nurses and medical staff.

3. Surgery Optimization 

Surgery can be risky and less invasive procedures are optimal for patients to speed up recovery, reduce blood loss, and reduce pain. AI can help surgeons monitor blood flow, anatomy, and physiology in real-time. 

Connected sensors can help optimize the operating room. Everything from patient flow, time, instrument use, and staffing can be captured. Using machine learning algorithms and real-time data, AI can reduce hospital costs and allow clinicians to focus on safe patient throughput.

But it’s not just the overall operations. AI will allow surgeons to better prepare for upcoming procedures with access to simulations beforehand. They will also be able to augment procedures as they happen, incorporating AI models in real-time, allowing them to identify missing or unexpected steps.

Contactless control will allow surgeons to utilize gestures and voice commands to easily access relevant patient information like medical images, before making a critical next move. AI can also be of assistance following procedures. It can, for example, automatically document key information like equipment and supplies used, as well as staff times. 

4. Telehealth

During COVID-19, telehealth has helped patients access their clinicians when they cannot physically go to the office. Patients’ adoption of telehealth has soared, from 11% usage in 2019 in the US to 46% usage in 2020. Clinicians have rapidly scaled offerings and are seeing 50 to 175 times the number of patients via telehealth than they did before. Pre-COVID-19, the total annual revenue of US telehealth was an estimated $3 billion, with the largest vendors focused on the “virtual urgent care” segment. With the acceleration of consumer and provider adoption of telehealth, up to $250 billion of current US healthcare spend could potentially be virtualized.

Examples of the role of AI in the delivery of health care remotely include the use of tele-assessment, telediagnosis, tele-interactions, and telemonitoring.

AI-enabled self-triage tools allow patients to go through diagnostic assessments and receive real-time care recommendations. This allows less sick patients to avoid crowded hospitals. After the virtual visit, AI can improve documentation and reimbursement processes.

Rapidly developing real-time secure and scalable AI intelligence is fundamental to transforming our hospitals so that they are safe, more efficient, and meet the needs of patients and medical staff. 


About Renee Yao

Renee Yao leads global healthcare AI startups at NVIDIA, managing 1000+ healthcare startups in digital health, medical instrument, medical imaging, genomics, and drug discovery segments. Most Recently, she is responsible for Clara Guardian, a smart hospital ecosystem of AI solutions for hospital public safety and patient monitoring.


Brightline Raises $20M for Virtual Pediatric Behavioral Health Platform

Brightline Raises $20M for Virtual Pediatric Behavioral Health Platform

What You Should Know:

– Brightline raises $20 million to bring its virtual behavioral
healthcare platform to kids and families across California and beyond.

– Brightline delivers integrated care through innovative
technology, virtual behavioral health services, and a collaborative care team
focused on supporting children across developmental stages and their families.


Brightline, a
Palo Alto, CA-based provider of technology-enabled pediatric behavioral healthcare,
announced it has raised $20M in Series A funding led by Threshold Ventures and
previous investor Oak HC/FT. Leading healthcare organizations Blue Shield of
California, Blue Cross Blue Shield of Massachusetts, and Boston Children’s
Hospital joined the round, as well as SemperVirens VC, Rock Health, and City
Light Capital. In addition, the company announced the expansion of its telehealth
services to children and families across the State of California, with
additional states coming soon.

Science-Backed Treatment

Founded in 2019, Brightline is reinventing behavioral health
care for children and families. Brightline’s treatment programs are grounded in
proven clinical methods and designed to track progress and move children
forward in their care. Their virtual behavioral health services available now
include:

● Behavior therapy with child and adolescent psychologists
and clinical social workers

● Psychiatry evaluation and medication support, in
combination with therapy

● Speech-language therapy

● Coaching support and training for parents

● Free clinician-led classes for parents

● Digital treatment programs families can use between
appointments

● Mobile app to make it all easier

Recent Traction

The round follows exciting news earlier this summer about
Brightline’s decision to launch four months ahead of schedule to bring urgently
needed telehealth services (including behavior therapy, psychiatry,
speech-language therapy, coaching support, and more) to families feeling the
overwhelming impact of a global pandemic on their kids. Brightline plans to use
the funds primarily to enhance its technology and innovations, expand
telehealth capabilities and treatment programs, and grow the team to support
children and families across the country.

We need behavioral health and developmental support for kids and their families more than ever,” said Naomi Allen, Brightline CEO and co-founder. “Bringing strong new investors and strategic partners into the Brightline family allows us to continue innovating on our breakthrough model of integrated clinical teams, coaching support for parents, and care through telehealth and our mobile app for families when they need it most. We’re thrilled to have an exceptional Series A investment to continue building a brighter future for families.”

5 Critical Considerations for Patient Privacy in Telehealth

5 Critical Considerations for Patient Privacy in Telehealth
Sachin Nayyar, CEO at Securonix

The COVID-19 pandemic has had a tremendous ripple effect across all industries, with one of the most impacted being healthcare. Providers have had to quickly adapt to supporting patients ‘virtually’ in a secure manner, while simultaneously developing procedures to support accurate reporting to government organizations. These changes have placed added pressure on security and privacy professionals, as they struggle to keep up with urgent demand.

Mature healthcare organizations already have stringent policies and procedures in place to remain compliant with government regulatory requirements (i.e., HIPAA, HITECH Act, etc.) and protect patients’ privacy. However, with the new focus on telehealth, unprecedented patient growth, and strict regulations on reporting, the key threats healthcare security and privacy teams need to be able to detect are also evolving: 

  • Unauthorized access to patient data by employees
  • Patient data snooping (by employees, family members, co-workers, etc.)
  • Compromised records (unusual access patters – new locations, multi-location access, etc.)
  • Failed logins and download spikes 
  • Terminated or dormant user accounts being used to gain access
  • Accessing discharged patient records or deceased patient records

Identifying these threats and uncovering suspicious patterns or activities, however, is no easy feat. Most security monitoring solutions cannot integrate with and consume electronic medical records (EMR) in a usable format. As a result, these solutions have limited out of the box content, leaving a majority of threat detection engineering to the security operations teams, which are already overwhelmed. Legacy security tools are no longer cutting it, as they use rule-based security event monitoring methods that do not account for the need to protect patient data privacy required by regulations such as HIPAA, HITRUST, and GDPR. They also lack the ability to protect patient data from insider threats, advanced persistent threats, or targeted cyberattacks.

Successfully monitoring patient data privacy must focus on two key entities: the employees accessing records and the patients whose records are being accessed. Organizations need to be able to visualize and correlate events across these entities and throughout the IT infrastructure and EMR applications to detect suspicious patterns while adhering to reporting and compliance mandates.

Monitoring EMR applications is crucial to detect and prevent suspicious activity that may lead to data compromise. However, this can be a cumbersome process. Given that nearly all EMR records contain patient data information, organizations must maintain the confidentiality of this data while enabling security monitoring. Unfortunately, most traditional SIEMs do not provide solutions to this problem. As a result, organizations are forced to intermix sensitive patient data with other IT data, risking compliance violations.

To achieve these goals in the near term, there are five crucial areas where healthcare security and privacy teams need to focus attention:

1. Remote Access Protocol: Like all other industries, healthcare organizations must now grant remote access to a large percentage of their workforce. As they migrate workers to remote access these organizations must address logistical challenges such as ensuring IT support can keep up with requests and implementing multi-factor authentication. 

2. Security Training: Organizations must make sure that their employees are abreast of the unique challenges that accompany working remotely and associated security best practices (i.e., security hygiene, secure internet connections, strong vs. weak passwords, signs of phishing attacks, etc.)

3. Critical App Exposure: Typically, critical applications containing electronic health records are not exposed to the internet without very rigid security controls. However, with the need to share and access more information via apps, strict security is more critical than ever before. 

4. Use of Personal Devices: Many organizations do not issue corporate devices to all their employees. Therefore, there is a greater security risk as workers are being permitted to use their personal devices to access critical systems.

5. User Monitoring and Detection: Identity activity patterns are vastly different as employees adapt to the new normal. As a result, prospective attack vectors have changed drastically. Monitoring and detecting new patterns of human and non-human identities must happen quickly in order to adapt to the new reality and detect attacks.

With the entire world experiencing unprecedented changes, we must learn to adapt quickly and strategically. New threat patterns will emerge, but it is crucial to remain vigilant about all activity and access occurring across IT infrastructure. Stringent regulations and ethical codes of conduct also mean that organizations need to be more vigilant about protecting patient data privacy than ever before. 

The constantly evolving data landscape makes it hard to differentiate new and normal, from malicious and threatening. Healthcare organizations need to assess their security posture, ensuring that they have proper tools in place to accurately analyze and correlate events across the IT infrastructure and electronic records. Only with access to this full picture will they be able to detect any suspicious patterns and ultimately protect patient data.


About Sachin:

Sachin Nayyar is the CEO of Securonix, a company redefining Next-Gen SIEM using the power of big data and machine learning. drives the vision and overall business strategy for Securonix. Built on an open Hadoop platform, Securonix Next-Gen SIEM provides unlimited scalability and log management, behavior analytics-based advanced threat detection, and automated incident response on a single platform.

Prior to Securonix, Nayyar served as the founder & CEO of VAAU where he led the company from conception to acquisition by Sun Microsystems. Following the acquisition by Sun, Sachin served as the Chief Identity Strategist for Sun Microsystems where he led the vision and strategy for the Sun security portfolio. Sachin is a renowned thought leader in areas of risk, regulations, compliance, identity/access, and governance and speaks frequently at professional conferences and seminars.

Sharecare Launches Digital COVID-19 Return-to-Work Solution for Employers

Sharecare Launches Digital COVID-19 Return-to-Work Solution for Employers

What You Should Know:

– Sharecare launches its offering for employers: [email protected],  a virtual solution for COVID-19 that’s integrated with its app-based digital health platform for managing consumer health and well-being.

– The offering is designed for employers – organizations
of any kind – to support their workforces as they return to work when the time
is right (and whether they’re working virtually or remotely).

– The solution features digital health pass, daily screener, telehealth integration, access to testing, and employee readiness surveying capabilities.


Sharecare, the digital health
company that helps people manage all their health in one place, announced [email protected],
Sharecare’s comprehensive COVID-19
readiness solution. Integrated into Sharecare’s robust health management and
engagement platform, [email protected] empowers U.S. employers to address the
evolving emotional, educational, clinical and operational challenges introduced
by the pandemic, while equipping their employees with tools and resources to
stay safe and build resilience, whether continuing to work remotely or
returning to the physical workplace.

[email protected] Areas of Focus

Sharecare Launches Digital COVID-19 Return-to-Work Solution for Employers

Through
[email protected], these tools, programs and content, among other new features,
are now available to Sharecare’s enterprise partners. Sharecare’s new COVID-19
readiness solution covers three distinct areas of focus to support U.S.
employers throughout the pandemic and beyond, including:

Assessment & Triage: Empowers employers with a real-time perspective on the overall health and safety of their workforce; while providing employees with a simple and convenient way to track their health status on a daily basis and gain confidence that their colleagues are doing the same. Components include:

  • Readiness survey: Developed in partnership with Dr. Sandro
    Galea, dean of the Boston University School of Public Health; assesses
    employees’ willingness to resume activities and what will make them feel safe
    at work.

    • Daily screener & digital health pass: Securely monitor an employee’s health;
      employer receives reporting status and test results for each employee as well
      as aggregated data.

      • Daily screener: Clinically validated. Provides
        employees with a personalized COVID-19 report to view daily entries and monitor
        progress; locate nearby testing sites by state and county; and see lab results
        from employer-ordered COVID-19 tests.
      • Health pass: Secure QR code-powered
        certification within the Sharecare app, validating each employee’s health
        status as part of an organization’s return to work protocol.1
    • Telehealth integrationEnables employers to seamlessly integrate Sharecare’s
      HIPAA-compliant telehealth solution or other third-party telehealth
      solutions.

Testing & Tracking: Provides a decision framework to ensure a safe, confident return to work for an employer and their employees. Features include:

  • COVID-19 testingSearchable database of all available sanctioned and credible
    testing options. Sharecare, in conjunction with testing and diagnostic service
    providers, guides employees through the process to understand if they need to
    get tested, which test is appropriate, where to get tested, and their results,
    which are privately available to them within the Sharecare app.

    • Contact tracing: Uses low-emission Bluetooth readings between
      mobile phones over time to approximate the proximity and duration of an
      encounter between Sharecare app users who opt-in.2 Privately
      notifies individuals who may have been exposed to someone with COVID-19.
    • Reporting and analytics: Status and risks for each employee, including
      results of positive COVID-19 tests and exposure events. Additional dashboards
      can be segmented by geography, worksite locations, and segmentation tactics
      applicable to the organization; as well as real-time and actionable reporting
      analytics providing clients with insights on population outcomes.

Build & maximize
resilience
: Tools and resources to foster resilience
by addressing the emotional, physical and financial challenges that many
employees encounter during the pandemic and as they return to work, including:

  • Interactive map: Measures and monitors the progression of
    COVID-19 cases and mobility data across the country, down to a county-by-county
    basis.

    • Anxiety management: From its voice-based stress tracker to the
      award-winning relaxation and mindfulness videos, Sharecare has multiple tools
      to help people manage stress. Most recently, Sharecare acquired a digital
      therapeutics company founded by renowned neuroscientist Dr. Jud Brewer and
      whose suite of apps, including Unwinding Anxiety, are clinically proven to
      positively affect long-term behavior change.
    • Financial protection: Sharecare provides employees direct access to
      SmartDollar, an online program designed to help them get on a budget, save for
      emergencies, pay off debt, and start investing so they can retire with
      confidence.

Integration with Sharecare’s Existing Digital Health Platform

Sharecare
has integrated these capabilities into its comprehensive digital platform
currently available to 30 million covered lives. By offering an even more
robust solution, Sharecare is ideally positioned not only to support the health
and well-being of its client partners and their employees in the face of the
pandemic but also to enable them to return to work safely when the time is
right. 

“Although the ultimate goal of enabling employees to safely return to the workplace is clear, the path for getting there is less certain for many organizations – and that’s further complicated by the daily information overload that is often complex and contradictory,” said Jeff Arnold, founder, chairman and CEO of Sharecare. “A successful return-to-work strategy requires more than just a particular testing protocol; we have to create a new culture of well-being that can adapt and evolve over time while empowering each individual to build resilience and foster longevity. We are committed to helping everyone stay safe against the threat of the pandemic, while equipping our government, employer and health plan partners to work toward recovery as a key component of their comprehensive well-being strategies.”

Cohere Health Launches with $10M to Increase Transparency Across Care Journey

Cohere Health Launches with $10M to Increase Transparency Across Care Journey

What You Should Know:

– Boston-based health IT start-up Cohere Health announced the official launch of its company with a $10 million Series A funding round led by Flare Capital Partners.

– The company’s patient journey-focused platform improves the notoriously difficult prior authorization process and replaces an existing patchwork of legacy, siloed processes, and antiquated technologies that contribute to the enormous administrative burden for physicians and health plans.

– The end goal is transparent, high-value care alignment across the entire patient care journey, to improve the quality of care delivered, the lower total cost of care, and transform the patient and physician experience.


Cohere Health, a
Boston, MA-based health
IT
startup,
today announced its company launch, with the mission of aligning the
relationship between physicians and health plans around the care journey in a
way that is appropriate for each patient. Cohere Health’s launch is
flanked by the news of its recent $10 million Series A funding round led by Flare Capital Partners, with Define Ventures as an investor and partner
as well as participation from an additional leading national strategic partner.

Every Health Journey Should Be A Win-Win-Win

Confusion and complexity shouldn’t define a patient’s journey. Patients deserve clearer paths to health, more transparency, and fewer bumps on the way. Assessing every transaction without any context creates an undue burden for physicians and health plans alike. Administrative complexity should never stand in the way of patient care.

Led by Co-Founder and CEO Siva Namasivayam, Cohere Health aims to improve the quality of care delivered, the lower total cost of care, and transform the patient and physician experience. Cohere’s patient journey platform, CohereNext replaces the existing patchwork of legacy, siloed processes, and antiquated technologies that contribute to enormous administrative burden for physicians and health plans. It further facilitates the transition from fee-based services to value-based arrangements by providing an evolutionary path that can support all payment arrangements while reducing unnecessary variation in clinical outcomes.

Benefits of Care Journey Recommendations

Cohere leverages care journey recommendations to fundamentally change the healthcare system through:

Evidence-based care paths: increase transparency and trust among patients and their physicians.

Advanced analytics and rules: help identify high-value care and, ultimately, improved outcomes

Payments and incentives: incentivize physicians by ensuring that behavior leading to optimal patient outcomes also benefits practice economics

Proven Leadership Team

Cohere Health has assembled an impressive team of proven
leaders, including Gary Gottlieb, MD, former CEO of Partners Healthcare (now
MassGeneral Brigham) as Chairperson of the Board of Directors. “As a physician,
it’s clear to me that the administrative complexity of the current system gets
in the way of delivering the care that patients deserve, that physicians want
to provide, and that health plans want for their members,” Gottlieb said. “If
we’re going to realize the promise of value-based care, we need an approach
that is based on all available evidence, shared expectations and transparency.”

Siva Namasivayam, CEO of Cohere Health, explained: “The current system is resource-intensive, unwieldy and creates a frustrating experience for patients, physicians and health plans. There’s no reason it should be so miserable for everyone involved. We have the evidence-based clinical algorithms, human-centered design and innovative technology to improve the system dramatically.” Namasivayam, who has more than 20 years of experience working on transformational healthcare businesses, was previously the CEO/Founder of SCIO Health Analytics.

4 Ways Healthcare Organizations Can Establish Partnerships to Drive Innovation

Nebraska Medicine’s experience points to four ways healthcare organizations can establish partnerships with vendors that drive innovation and performance excellence.

With public and private healthcare spending significantly outpacing that of other countries, U.S. hospitals face intense pressure to find new ways to capture greater value. More and more, organizations are finding that partnerships with existing vendors can help unlock next-level performance gains in a transformative environment.

Take Nebraska Medicine, for example. In the early 2000s, the health system created multidisciplinary committees to boost revenue integrity and adopted new revenue cycle management processes that strengthened performance—with strong results. But best practices alone are no longer enough to fuel revenue cycle gains at a time of decreased reimbursement, rising out-of-pocket costs, and staffing issues. “You’ve got to be able to get to the data,” says Jana Danielson, Executive Director, Revenue Cycle for Nebraska Medicine—a $1.8 billion academic medical center with two hospitals, ~450 revenue cycle staff, 913,000 hospital billing claims, and 1.6 million physician billing claims per year. 

“Without real-time access to data and data analytics, revenue cycle teams risk making decisions based on emotions, not facts,” Danielson says. “Our partnership with a vendor enables our revenue cycle team to more effectively use data to identify our pain points and empower team members to take the right steps for improvement.”  

Nebraska Medicine’s experience points to four ways healthcare organizations can establish partnerships with vendors that drive innovation and performance excellence.

1. Look for a partner that will challenge your assumptions around performance

The right partner will dig deeper, not only tracking key performance indicators (KPIs) but also taking a hard look at how these KPIs were calculated. 

For example, in revenue cycle management, there are many ways to track clean claim rates, a measure that reflects the quality of claim data that is collected and reported. Some organizations consider a clean claim rate to be the percentage of claims accepted by the payer on the first pass. Others calculate it as the percentage of claims that pass through the organization’s billing department without manual intervention before being submitted to the payer. Depending on how this metric is calculated, sometimes a percentage that seems to indicate above-average performance in comparison with peers may not reflect breakdowns in processes that have occurred before a claim is submitted.

At first glance, Nebraska Medicine’s clean claim rate in 2017 was strong: 

95.87 percent for a physician billing and 87.59 percent for hospital billing. However, using claims analytics, the health system uncovered a hidden challenge. Some billers were bypassing the claim edits. In those instances, claims were being submitted before corrections were made. The result: a lower-than-expected clean claim rate. 

Nebraska Medicine’s revenue cycle leaders worked with the organization’s vendor to tackle this challenge. The revenue cycle department developed scorecards by individual employees that showed their performance against key metrics, including their rate of bypassed edits, and reiterated expectations for revenue cycle processes. Within three months, the number of bypassed edits significantly decreased. Today, Nebraska Medicine’s clean claims rate averages 93.78 percent—well above the industry standard—for more than 900,000 hospital claims per year.

EXHIBIT ONE:

At Nebraska Medicine, Reduction in Bypassed Claim Edits Drives High Clean Claims Rate 

2. Make sure the vendor has both product knowledge and operational expertise

Many vendors make the business case for partnership based on the quality of their product or system, such as a 99 percent clean claim rate or a 3 percent denial rate. Some back up their product expertise by regularly working with clients to optimize their use of a technology or service—and it’s a solid step toward a true partnership.

But the best vendors also commit to understanding the context in which their products or services are used in your organization. They examine your team’s work processes and draw upon their operational expertise to make suggestions for improvement, even when the modifications they propose fall outside their paid relationship with your organization.

Consider that 90 percent of patients expect out-of-pocket estimates before care is delivered—not surprising, given the rise in high deductibles and patients’ expected contribution toward their healthcare costs. Providing a patient financial “concierge” at the point of contact not only helps patients better understand their out-of-pocket obligation but also bolsters an organization’s ability to:

– Collect copays upfront

– Explore barriers to payment and patient-tailored solutions

– Increase point-of-service collections and revenue

The right vendor will offer both tried-and-true and out-of-the-box suggestions to drive increased efficiency and revenue, regardless of whether this boosts the vendor’s bottom line.

3. Ask bold questions—and expect thoughtful responses

We’re at the tip of the iceberg when it comes to using artificial intelligence (AI) in healthcare. AI offers a massive set of capabilities for innovation and improvement in healthcare, including in revenue cycle. For example, the use of machine learning has the potential to elevate revenue cycle performance by predicting:

– When a claim will be paid—and how much—down to the hour of remittance

– The probability that a claim will be denied payment—and why

– Whether a patient encounter will require prior authorization before the date of service

– Whether new edits need to be incorporated into existing workflows based on payer responses and denials

But is now the right time for your organization to invest in AI for revenue cycle, or are there other, more foundational competencies your team should hone first? The best vendors keep a pulse on the industry’s newest innovations and partner with you in determining the right approach for your organization. They also help make the business case for innovation to senior leaders, when appropriate.

As Nebraska Medicine examines opportunities to leverage AI in revenue cycle, it has worked with a claims analytics vendor to assess how payer behavior affects revenue, both in the short term and long term. At a time when the nation’s biggest health plans vary greatly in their time to payment, instant access to payment trends by individual payers empowers Nebraska Medicine to have more candid conversations with payers around performance. It also strengthens Nebraska Medicine’s contract negotiating power.

“We want to make sure we’re not at the bottom of the pile when it comes to our relationships with payers,” Danielson says. “If we are, we need to be able to dive into the specific issues that need to be fixed to improve performance.”

4. View your vendor as a strategic ally

Sometimes, you don’t know what you need until you see it. Other times, the pain points you’re sure to require dedicated focus turn out to be pebble-sized problems, not boulders. The key to finding a true partner in innovation is to actively seek a vendor that demonstrates not just a superior level of service, but also a strong willingness to listen to clients and share candid feedback.  

For example, senior leaders at Nebraska Medicine once asked revenue cycle leaders to uncover what they viewed as “skyrocketing denials rate.” Danielson partnered with the health system’s claims analytics vendor to drill down, by payer, into first-pass denial rates, partial denial rates, and more to provide a complete picture of denials status. These efforts showed one payer’s clean claim rate was 10 points lower than that of its peers.

However, the payer did not account for significant patient volume, translating to a small impact on revenue cycle performance. Nebraska Medicine determined it could make a bigger difference in lowering denial rates by focusing on the organization’s largest payer—avoiding a complete overhaul to the revenue cycle team’s payer relations approach.

Creating an Innovation Mindset

The bar for revenue cycle performance is rising, especially with continued dips in reimbursement rates, an uptick in challenges to claim payment, and an environment where consumers are the new payer. Moving past the traditional mindset of what a vendor relationship should look like toward an innovation mindset enables leaders to more fully benefit from a vendor’s subject matter expertise and accelerates gains in performance.


About Eric NilssonEric Nilsson joined The SSI Group, LLC (SSI) as the Chief Technology Officer to lead SSI’s long-term technology vision. He brings nearly 30 years of experience in the software industry with the last 10 in healthcare technology. Prior to joining SSI, he served as the chief technology officer at Nextech and Surgical Information Systems (SIS), where he focused on SaaS, on-premise EMR and practice management solutions as well as inpatient and ambulatory surgery providers from large hospital networks to surgery centers.

COVID-19 Has Permanently Shifted Patient Behavior Towards Virtual Care

Report: How COVID-19 Has Permanently Changed Patient Behavior Towards Virtual Care

What You Should Know:

– The COVID-19 crisis has significantly impacted the
patient care paradigm, and the ripple effects have altered patient behaviors
and expectations, requiring a significant change in how life sciences companies
engage with and support patients

– Accenture surveyed 2700 patients about changes in care
during COVID-19 and found a major shift to virtual care, which patients
embraced.

– Virtual care is here to stay and can be an integral
part of the patient experience with health care providers and as part of
clinical trials.

– With 70% of patients deferring or canceling treatment, virtual tools were widely adopted as an essential lifeline for continuing care.


The COVID-19 pandemic has permanently shifted patient behavior towards virtual care, according to a new survey from Accenture. The Accenture COVID-19 Patient Survey conducted in May across China, France, Germany, Japan, the U.K., and the U.S. asked 2,700 oncology, cardiology, or immunology patients globally how patient care has changed during COVID-19. The survey revealed patients have embraced virtual care and communications at very high rates as a result of COVID-19 and nine out of 10 reported the quality of care was as good or better than before.

Patients Chose to Defer and Change their Care

As restrictions came into effect, patients faced difficult choices about whether and how to continue their treatments. Many healthcare providers canceled appointments, and transportation options were shut down. Patients were afraid to risk exposure to COVID-19 by going to their healthcare providers for regular treatment, and many (70%) deferred or canceled at least some elements of their treatment.
 
But nearly half of all surveyed patients also started getting some treatment at home instead of going to their healthcare provider’s office and they began using virtual tools such as video conference calls, online chat, and apps. 1 out of 5 patients switched to a different therapy due to COVID-19, while nearly half considered making a change. Patients were concerned about how treatment might affect their risk of COVID-19, and about the method and timing required for specific treatments.

Sixty-three percent of those who used video conferencing
said it was very good or excellent, an impressive response given 70% were using
video conferencing for treatment for the first time. By using technology to
support communication and care, healthcare providers were largely able to
maintain or even improve on the patient experience.

Other key findings of the survey include:

Trust in the Healthcare Ecosystem Increased

 Forty-seven percent of respondents said they received better, more personalized responses; 41% said quicker responses and 40% said it was more convenient to access through new communications channels.
 
In addition, the overall trust in the healthcare system has increased. Sixty percent of patients surveyed said their trust in healthcare providers has increased, and 45% said their trust in pharmaceutical and medical device companies has increased.

Virtual care helped keep some clinical trials going

Worryingly, many clinical trials were disrupted by COVID-19.
Seventy-seven percent of patients said their clinical trials were suspended or
delayed, which could have a knock-on effect on the speed in which new
treatments come to market.
 
However, for trials that continued, the use of virtual care was critical for
consultations, treatment, and monitoring. Consider that 61% of patients whose
trials continued used some form of virtual communication or care.

Using virtual technologies as a regular part of the clinical trial process would not only improve resilience to disruptions but would help to improve the patient experience.
 
Patients said they want to be consulted more, but they are currently far from the center of the clinical trial design process. As decisions were being made on how to modify clinical trials due to COVID-19, only 14% of surveyed patients were asked about what changes would work for them. This held true across all therapeutic areas and geographies.
 
“Increasing virtual communication and treatment options offers multiple benefits for clinical trials, as one-third of all patients in trials reported that even before COVID-19, they had difficulty making appointments or physically getting to clinics for treatment,” said Michel. “Patients want more video conferencing and fewer clinic visits, which would make clinical trials more convenient and accessible.”

For more information, the full report is available for
download here.