– QGenda has acquired Shift Admin, an industry-recognized
leader for shift-based specialties including emergency medicine, urgent care,
and hospital medicine.
With the industry-leading scheduling technology for all
specialties across the healthcare delivery system, QGenda’s technology will
ensure care is available for patients when and where it is needed.
QGenda, the leading
innovator in enterprise healthcare workforce management solutions, announced
of Shift Admin, an industry-recognized
leader for shift-based specialties including emergency medicine, urgent care,
and hospital medicine. With the industry-leading scheduling technology for all
specialties across the healthcare delivery system, QGenda’s technology will
serve as the single source of truth for all provider schedules, ensuring care
is available for patients when and where it is needed.
Automated Provider Scheduling for All Specialties
Founded in 2007, Shift Admin offers Automated Schedule
Generation that can generate optimized schedules based on fully customizable
rules and user’s requests. The Shift Admin schedule generator contains a
world-class scheduling algorithm and features a simple but powerful user
interface. Our system is flexible enough to handle even the most complicated
Acquisition Enables Greater Access to Data Insights for
The announcement furthers QGenda’s commitment to advancing
how healthcare organizations manage and schedule their workforce so they can
effectively use providers’ time, reduce burnout and optimize capacity. By
scheduling for all providers and specialties through QGenda, organizations have
greater access to data, details, and insights for thousands of providers
working across the system.
“With care needs fluctuating across states and even within the same area, transparency and flexibility continue to be a large need for healthcare organizations nationwide. QGenda, with the addition of Shift Admin’s shift-based provider scheduling capabilities, is helping healthcare organizations address these priorities. We are partnering with customers to deliver greater visibility into where and when providers are working and optimizing capacity to deliver quality, cohesive care across the entire organization,” stated Greg Benoit, CEO of QGenda.
By adding the leading provider in shift-based scheduling,
QGenda is enhancing capabilities for emergency medicine, hospital medicine, and
urgent care, while building upon its industry-leading scheduling solution for
providers in specialties such as anesthesia, radiology, cardiology, obstetrics
& gynecology, and pathology. The QGenda platform also includes solutions
for on-call scheduling, room management, time tracking, compensation
management, and workforce analytics.
– Today, CVS Health announced Symphony, a medical alert
system designed to keep seniors safe and connected at home.
– Symphony consists of a collection of in-home and wearable devices that offer a new at-home experience by connecting a suite of sensors that can monitor for falls, motion, and room temperature while also providing a 24/7 personal emergency response platform for use when needed.
CVS Health, today announced the release of Symphony medical
alert system to help caregivers monitor the safety and well-being of loved
ones, even from afar. This collection of in-home and wearable devices offers a
new at-home experience by connecting a suite of sensors that can monitor for
falls, motion, and room temperature while also providing a 24/7 personal
emergency response platform for use when needed. Symphony is designed to support
the growing number of seniors choosing to maintain an independent lifestyle at
home, as well as those involved in their care.
Spurred in part by COVID, as you may know, an increasing
number of seniors are choosing to “age in place.” But COVID has also
highlighted major challenges in staying connected to loved ones while socially
isolated. Enter Symphony…a collection of in-home and wearable devices that
are now available in approx. 650 CVSH HUBs and online.
Unlike other systems that require a wearable alert device,
Symphony includes a voice-activated Smart Hub that lets seniors call assigned
caregivers or emergency responders hands-free 24/7. Sensors placed around
the house can monitor motion, temperature, and air quality and alert caregivers
of anything out of the ordinary through a free caregiver smartphone app.
Symphony system also provides alerts for falls or other emergencies and can
assist with facilitating care coordination when needed.
Symphony is the latest example of ways in which CVS Health is supporting seniors at home. Organizations like SilverSneakers® are providing virtual exercise classes to help seniors stay active from the comfort of their homes. And Aetna partnered with the companionship benefit company Papa, Inc., to connect Medicare Advantage members with college-age individuals who can provide remote companionship through the telephone. These are in addition to more traditional services, like virtual care, and SDOH resources like grocery delivery, housekeeping, and others.
Designed to fit a family’s specific needs and adapt to a variety of homes, two easy-to-use Symphony device options are available: the Basic Bundle and Essential Bundle. While both systems come equipped with the Smart Hub and a wearable care button, the Essential Bundle also includes motion sensors and a voice-activated Fall Sensor to automatically detect falls in the bathroom, where the majority of accidents occur. Complementary devices are available for both bundles if desired, including additional motion sensors to extend the range of coverage in larger homes, and entry sensors for use on doors, cabinets, or windows.
Pricing starts at $149.99 for the Symphony Basic Bundle and
$249.99 for the Essential Bundle. A monthly service fee is required, although
no long-term contract is needed to activate. Once activated, each Symphony
bundle can help support safety at home as well as in the event of an emergency.
“We’re committed to helping consumers on their path to better health and new consumer health innovations like Symphony can help give caregivers peace of mind as they monitor a loved one’s safety and well-being through a truly differentiated connected health approach,” said Adam Pellegrini, SVP of Enterprise Virtual Care & Consumer Health at CVS Health.
– DTx and Patient Support leaders, Amalgam Rx, Inc., announce the acquisition of Avhana Health, a privately-held clinical decision support (CDS) company.
Amalgam Rx, Inc., a Wilmington,
DE-based Digital Therapeutics and Patient Support company, announces the acquisition
of Avhana Health, a privately held
clinical decision support (CDS) company, which has deep integrations with the
leading electronic health records (EHR). As part of the acquisition, Amalgam Rx
will expand Avhana’s CDS tools to multiple therapeutic areas and combine them
with other digital solutions to simplify doctors’ workflows.
Founded in 2014, Avhana Health is a clinical decision
support startup used by doctors to support real-time adoption of and adherence
to clinical quality guidelines. Avhana’s SaaS-based CDS tool has been
implemented in more than 150 provider groups and identifies over $120 million a
year in cost savings. Enabling real-time two-way interactions within the EHR, Avhana optimizes
provider workflow beyond simple data integration.
“EHR integration is the Holy Grail for digital health solutions, but it’s not only about data integration; workflow optimization is even more important. Providers, working at the nexus of digital health adoption and scaling, will only adopt tools that are safe, effective, and embedded in their workflow. The combination of Avhana and Amalgam will bring us closer to realizing digital health’s tremendous potential,” said Ryan Sysko, chief executive officer of Amalgam Rx.
Since the onset of the COVID-19 pandemic, hospitals and health systems have pushed forward with innovative technology solutions with great expediency and proficiency. Healthcare organizations were quick to launch telehealth solutions and advance digital health to maintain critical patient relationships and ensure continuity of care. Behind the scenes, hospitals and health systems have been equally adept at advancing technology solutions to support and enhance clinical care delivery. This includes adopting clinical surveillance systems to better predict and prevent an escalation of the coronavirus.
Clinical surveillance systems use real-time and historical patient data to identify emerging clinical patterns, allowing clinicians to intervene in a timely, effective manner. Over time, these clinical surveillance systems have evolved to help healthcare organizations meet their data analytic, surveillance, and regulatory compliance needs. The adaptability of these systems is evidenced by their expanded use during the pandemic. Healthcare organizations quickly pivoted to incorporate COVID-19 updates into their clinical surveillance activities, providing a centralized, global view of COVID-19 cases.
To gain insight into the COVID-19 crisis, critical data points include patient age, where the disease was likely contracted, whether the patient was tested, and how long the patient was in the ICU, among other things. Surveillance is also able to factor in whether patients have pre-existing conditions or problems with blood clotting, for example. This data trail is helping providers create a constantly evolving coronavirus profile and provides key data points for healthcare providers to share with state and local governments and public health agencies. In the clinical setting, the data are being used to better predict respiratory and organ failure associated with the virus, as well as flag COVID-19 patients at risk for developing sepsis.
What’s driving these advancements? Clinical surveillance systems powered by artificial intelligence (AI). By refining the use of AI for clinical surveillance, we can proactively identify an expanding range of acute and chronic health conditions with greater speed and accuracy. This has tremendous implications in the clinical setting beyond the current pandemic. AI-powered clinical surveillance can save lives and reduce costs for conditions that have previously proven resistant to prevention.
Eliminating healthcare-associated infections
Despite ongoing prevention efforts, healthcare-associated infections (HAIs) continue to plague the US healthcare system, costing up to $45 billion a year.According to the Centers for Disease Control and Prevention (CDC), about one in 31 hospitalized patients will have at least one HAI on any given day. AI can analyze millions of data points to predict patients at-risk for HAIs, enabling clinicians to respond more quickly to treat patients before their infection progresses, as well as prevent spread among hospitalized patients.
Building trust in AI
While the benefits are clear, challenges remain to the widespread adoption and use of AI in the clinical setting. Key among them is a lack of trust among clinicians and patients around the efficacy of AI. Many clinicians remain concerned over the validity of the data, as well as uncertainty over the impact of the use of AI on their workflow. Patients, in turn, express concerns over AI’s ability to address their unique needs, while also maintaining patient privacy. Hospitals and health systems must build trust among clinicians and patients around the use of AI by demonstrating its ability to enhance outcomes, as well as the patient experience.
3 keys to building trust in AI
Building trust among clinicians and patients can be achieved through transparency, expanding data access, and fostering focused collaboration.
1. Support transparency
Transparency is essential to the successful adoption of AI in the clinical setting. In healthcare, just giving clinicians a black box that spits out answers isn’t helpful. Clinicians need “explainability,” a visual picture of how and why the AI-enabled tool reached its prediction, as well as evidence that the AI solution is effective. AI surveillance solutions are intended to support clinical decision making, not serve as a replacement.
2. Expand data access
Volume and variety of data are central to AI’s predictive power. The ability to optimize emerging tools depends on comprehensive data access throughout the healthcare ecosystem, no small task as large amounts of essential data remain siloed, unstructured, and proprietary.
3. Foster focused collaboration
Clinicians and data scientists must collaborate in developing AI tools. In isolation, data scientists don’t have the context for interpreting variables they should be considering or excluding in a solution. Conversely, doctors working alone may bias AI by telling it what patterns to look for. The whole point of AI is how great it is at finding patterns we may not even consider. While subject matter expertise should not bias algorithms,
it is critical in structuring the inputs, evaluating the outputs, and effectively incorporating those outputs in clinical workflows. More open collaboration will enable clinicians to make better diagnostic and treatment decisions by leveraging AI’s ability to comb through millions of data points, find patterns, and surface critically relevant information.
AI-enabled clinical surveillance has the potential to deliver next-generation decision-support tools that combine the powerful technology, the prevention focus of public health, and the diagnosis and treatment expertise of clinicians. Surveillance is poised to assume a major role in attaining the quality and cost outcomes our industry has long sought.
John Langton is director of applied data science at Wolters Kluwer, Health, where artificial intelligence is being used to fundamentally change approaches to healthcare. @wkhealth
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 tailorIT, 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.
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.
– 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.
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
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.”
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
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
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
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
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.
This new integrated functionality is expected to be
available to TigerConnect customers in Q1 of 2021.
The combination of Teladoc Health and Livongo creates a
global leader in consumer-centered virtual care. The combined company is
positioned to execute quantified opportunities to drive revenue synergies of
$100 million by the end of the second year following the close, reaching $500
million on a run-rate basis by 2025.
Price: $18.5B in value based on each share of Livongo
will be exchanged for 0.5920x shares of Teladoc Health plus cash consideration
of $11.33 for each Livongo share.
Siemens Healthineers Acquires Varian Medical
On August 2nd, Siemens Healthineers acquired
Varian Medical for $16.4B, with the deal expected to close in 2021. Varian is a
global specialist in the field of cancer care, providing solutions especially
in radiation oncology and related software, including technologies such as
artificial intelligence, machine learning and data analysis. In fiscal year 2019,
the company generated $3.2 billion in revenues with an adjusted operating
margin of about 17%. The company currently has about 10,000 employees
Price: $16.4 billion in an all-cash transaction.
Gainwell to Acquire HMS for $3.4B in Cash
Veritas Capital (“Veritas”)-backed Gainwell Technologies (“Gainwell”),
a leading provider of solutions that are vital to the administration and
operations of health and human services programs, today announced that they
have entered into a definitive agreement whereby Gainwell will acquire HMS, a technology, analytics and engagement
solutions provider helping organizations reduce costs and improve health
Price: $3.4 billion in cash.
Philips Acquires Remote Cardiac Monitoring BioTelemetry for $2.8B
Philips acquires BioTelemetry, a U.S. provider of remote
cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion). With $439M in
revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients
remotely; its portfolio includes wearable heart monitors, AI-based data
analytics, and services.
Price: $2.8B ($72 per share), to be paid in cash upon
Hims & Hers Merges with Oaktree Acquisition Corp to Go Public on NYSE
Telehealth company Hims & Hers and Oaktree Acquisition Corp., a special purpose acquisition company (SPAC) merge to go public on the New York Stock Exchange (NYSE) under the symbol “HIMS.” The merger will enable further investment in growth and new product categories that will accelerate Hims & Hers’ plan to become the digital front door to the healthcare system
Price: The business combination values the combined
company at an enterprise value of approximately $1.6 billion and is expected to
deliver up to $280 million of cash to the combined company through the
contribution of up to $205 million of cash.
SPAC Merges with 2 Telehealth Companies to Form Public
Digital Health Company in $1.35B Deal
Blank check acquisition company GigCapital2 agreed to merge with Cloudbreak Health, LLC, a unified telemedicine and video medical interpretation solutions provider, and UpHealth Holdings, Inc., one of the largest national and international digital healthcare providers to form a combined digital health company.
Price: The merger deal is worth $1.35 billion, including
WellSky Acquires CarePort Health from Allscripts for
Price: $1.35 billion represents a multiple of greater
than 13 times CarePort’s revenue over the trailing 12 months, and approximately
21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12 months.
Waystar Acquires Medicare RCM Company eSolutions
On September 13th, revenue cycle management
provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue
cycle management, workflow automation, and data analytics tools. The
acquisition creates the first unified healthcare payments platform with both
commercial and government payer connectivity, resulting in greater value for
Radiology Partners (RP), a radiology practice in the U.S., announced a definitive agreement to acquire MEDNAX Radiology Solutions, a division of MEDNAX, Inc. for an enterprise value of approximately $885 million. The acquisition is expected to add more than 800 radiologists to RP’s existing practice of 1,600 radiologists. MEDNAX Radiology Solutions consists of more than 300 onsite radiologists, who primarily serve patients in Connecticut, Florida, Nevada, Tennessee, and Texas, and more than 500 teleradiologists, who serve patients in all 50 states.
PointClickCare Acquires Collective Medical
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 acquireCollective Medical, a Salt Lake City, a 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 a lower cost.
Teladoc Health Acquires Virtual Care Platform InTouch
Teladoc Health acquires InTouch Health, the leading provider of enterprise telehealth solutions for hospitals and health systems for $600M. The acquisition establishes Teladoc Health as the only virtual care provider covering the full range of acuity – from critical to chronic to everyday care – through a single solution across all sites of care including home, pharmacy, retail, physician office, ambulance, and more.
Price: $600M consisting of approximately $150 million
in cash and $450 million of Teladoc Health common stock.
AMN Healthcare Acquires VRI Provider Stratus Video
AMN Healthcare Services, Inc. acquires Stratus Video, a leading provider of video remote language interpretation services for the healthcare industry. The acquisition will help AMN Healthcare expand in the virtual workforce, patient care arena, and quality medical interpretation services delivered through a secure communications platform.
CarepathRx Acquires Pharmacy Operations of Chartwell from
CarepathRx, a leader in pharmacy and medication management
solutions for vulnerable and chronically ill patients, announced today a
partnership with UPMC’s Chartwell subsidiary that will expand patient access to
innovative specialty pharmacy and home infusion services. Under the $400M
landmark agreement, CarepathRx will acquire the
management services organization responsible for the operational and strategic
management of Chartwell while UPMC becomes a strategic investor in CarepathRx.
Cerner to Acquire Health Division of Kantar for $375M in
Cerner announces it will acquire Kantar Health, a leading
data, analytics, and real-world evidence and commercial research consultancy
serving the life science and health care industry.
This acquisition is expected to allow Cerner’s Learning
Health Network client consortium and health systems with more opportunities to
directly engage with life sciences for funded research studies. The acquisition
is expected to close during the first half of 2021.
Cerner Sells Off Parts of Healthcare IT Business in
Germany and Spain
Cerner sells off parts of healthcare IT business in Germany and Spain to Germany company CompuGroup Medical, reflecting the company-wide transformation focused on improved operating efficiencies, enhanced client focus, a refined growth strategy, and a sharpened approach to portfolio management.
Price: EUR 225 million ($247.5M USD)
CompuGroup Medical Acquires eMDs for $240M
CompuGroup Medical (CGM) acquires eMDs, Inc. (eMDs), a
leading provider of healthcare IT with a focus on doctors’ practices in the US,
reaching an attractive size in the biggest healthcare market worldwide. With
this acquisition, the US subsidiary of CGM significantly broadens its position
and will become the top 4 providers in the market for Ambulatory Information
Systems in the US.
Price: $240M (equal to approx. EUR 203 million)
Change Healthcare Buys Back Pharmacy Network
back pharmacy unit eRx Network
(“eRx”), a leading provider of comprehensive, innovative, and secure
data-driven solutions for pharmacies. eRx generated approximately $67M in
annual revenue for the twelve-month period ended February 29, 2020. The
transaction supports Change Healthcare’s commitment to focus on and invest in
core aspects of the business to fuel long-term growth and advance innovation.
Walmart acquires CareZone, a San Francisco, CA-based smartphone
service for managing chronic health conditions for reportedly $200M. By
working with a network of pharmacy partners, CareZone’s concierge services
assist consumers in getting their prescription medications organized and
delivered to their doorstep, making pharmacies more accessible to individuals
and families who may be homebound or reside in rural locations.
Verisk, a data
analytics provider, announced today that it has acquiredFranco Signor, a Medicare Secondary Payer
(MSP) service provider to America’s largest insurance carriers and employers.
As part of the acquisition, Franco Signor will become part of Verisk’s Claims
Partners business, a leading provider of MSP compliance and other analytic
claim services. Claims Partners and Franco Signor will be combining forces to
provide the single best resource for Medicare compliance.
Rubicon Technology Partners Acquires Central Logic
Private equity firm Rubicon Technology Partners acquires
Central Logic, a provider of patient orchestration and tools to accelerate
access to care for healthcare organizations. Rubicon will be aggressively driving Central Logic’s
growth with additional cash investments into the business, with a focus
on product innovation, sales expansion, delivery and customer support, and
the pursuit of acquisition opportunities.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
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.
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.
Communication problems and inadequate information flow are two of the most common root causes of medical errors. The potential for miscommunication and faulty exchange of information in healthcare is substantial.
Consider: patient information is dispersed among multiple providers and payers along the continuum of care. Electronic Health Records (EHRs) and other clinical systems do not capture patient information or format medical documentation in a standardized manner. In an environment with incompatible systems, the easiest way for healthcare organizations to exchange records is to generate those records in a document format. It is not surprising then that many healthcare organizations are still heavily dependent on traditional, paper-based fax, which adds its own challenges to the process. Fax hardware and communication equipment are often unreliable, resulting in document delivery failures and delays.
As a result, an inadequate information flow can cause problems that impact the availability of essential knowledge needed for prescribing decisions, timely and reliable delivery of test results, and coordination of medical orders. The ensuing administrative and medical errors raise healthcare costs and may lead to poor health outcomes, including patient harm and readmissions.
The reality of mundane, manual processes
Document-based information exchange processes are highly inefficient. Staff often print and copy documents, creating a risk of accidental exposure of protected health information and resulting in needless costs. Moreover, documents – whether printed or stored on a workstation or server – still require manual data entry into EHRs and practice management systems. The tasks are tedious, prone to error, and negatively impact workflow, staff efficiency, physicians, and patients, and may lead to the following:
– Patient record errors, including filing or documenting information in the wrong patient file, and data entry errors;
– Poorly documented or lost test results; and
– Gaps in communication during transitions of care from one healthcare provider or setting to another.
In addition to these areas of concern that threaten patient safety, inbound documents often contain a lot of information on clinical, administrative, and financial matters that aren’t necessarily relevant to an intended recipient. That means a recipient must review all pages of the document and separate needed information from extraneous ones, which can further delay processing and patient transitions of care.
Smarter, faster document processing with AI
Healthcare providers need a document exchange and processing strategy that enables fully digital, secure, and efficient communication among numerous, highly customized EHRs, each with its own workflows and document processing preferences.
Such a strategy needs to include moving away from paper to fully digital documents. Healthcare organizations can accomplish this easily and without the need to overhaul the entire existing health IT infrastructure. The two main ways of transitioning from paper to digital are using digital fax instead of traditional fax and document imaging when documents are simply scanned into the system. In many cases, the resulting document format will be a TIFF image; and while it is not machine-readable, it enables paperless filing of clinical documents to the EHR.
Alternatively, converting the document into a readable format, such as a searchable PDF, will allow the healthcare organization to add value in document processing at every subsequent step. Making the document readable enables automatic identification of the type of document, data extraction, including patient name, medical record, date of birth, and physician name, as well as more effective management of the overall lifecycle of the document.
This step requires the utilization of AI and natural language processing techniques. Automatic extraction of data replaces the human labor required to manually index the information, which streamlines the triaging of documents to correct systems, teams, or recipients.
For example, if a digital document is clearly labeled as a discharge summary for John Harrison, a staff member can process it much easier and faster than when she has to open and read it to understand the type of the document and the identity of the patient. By mostly automating the receiving, reading, classifying, and triaging of medical documentation, providers are able to save time and ensure information is received and processed quickly by the right person, which typically means that the patient can be better served.
The COVID-19 pandemic has only driven home the need for seamless, 100%-digital exchange of patient information. If healthcare administrators depend on the physical fax machine to do their jobs, they won’t be able to work remotely. Most people don’t have fax machines at home, and especially fax machines routed to the hospital’s number, to be able to print information and then manually scan and enter that information into the patient’s health record. A fully digital document processing approach enables agility and flexibility necessary in the modern healthcare environment.
Moreover, recent ransomware attacks in the form of malware embedded into email attachments sent to users in hospitals lead to providers blocking inbound email attachments altogether. That means providers could not access their own patient data, let alone data from other institutions. As a result, emergency patients may have to be taken to other hospitals, and surgeries and other procedures delayed. Cloud-based platforms enable users to securely access patient information outside of the hospital’s network.
Small steps lead to big results
It’s essential from both a patient safety perspective and provider efficiency perspective that the exchange and processing of medical documentation be digitized. The benefits of digital document processing are significant, enabling fluid information exchange among all stakeholders.
By transitioning to fully digital document exchange, providers can significantly streamline administrative and clinical processes. The key to realizing the benefits of this approach is to take the first step by moving away from paper and then build on that by harnessing the power of AI to fully support the daily work of clinicians and administrators. Outbound and inbound documents can be prioritized, addressed, processed, and delivered appropriately, facilitating timely information exchange for processing prescriptions, medical orders, billing, reporting, analytics, research, and much more.
About John Harrison
As Chief Commercial Officer at Concord Technologies, John is responsible for the company’s revenue growth and brand development, ensuring Concord continues to create the right products to meet the needs of its customers. John brings more than 25 years of document communication and automation experience to the team. Prior to joining Concord, John held executive management positions at OpenText, Captaris, and Goaldata, overseeing business operations across multiple continents.
– Service commerce platform EverCommerce acquires Dublin,
OH-based Updox, a healthcare communication platform for in-person and virtual
– The acquisition
expands EverCommerce’s health services portfolio and enables the companies to
further their shared goal of simplifying the business of healthcare and
facilitating the growth of healthcare practices.
Today, EverCommerce, a leading service commerce platform, completed the acquisition of Updox, a Dublin, OH-based complete healthcare communication platform for in-person and virtual care. The company will join EverCommerce’s portfolio of health services companies, enabling it to provide customers with faster access to more products, a broader suite of solutions, and more resources.
The acquisition comes on the heels of a breakout year for
virtual care. Digital health is on track to hit over $12 billion in investments
by the end of 2020 – the largest funding year for the sector yet – and over 60
acquisitions through the end of Q3, including other telehealth breakouts like
Teladoc, which recently completed its acquisition of Livongo in a deal valued
at over $18B.
Deliver the Best in Virtual & In-Person Care
Updox provides next-generation virtual care, patient engagement, and office productivity solutions that enable practices to reduce costs and drive revenue. Based on increasing demand for solutions that seamlessly work together to improve practice efficiency and provide an engaging patient experience, Updox has continuously brought new functionality to market. Additional solutions are planned for 2021.
Updox serves more than 560,000 users across healthcare practices, health systems and pharmacies, and more than 210 million patients. Updox has experienced rapid growth and adoption this year, as healthcare providers sought to quickly implement telehealth and other patient engagement solutions that enabled them to acquire new patients, operate more efficiently, and engage their patients as a result of the COVID-19 pandemic. In fact, Updox facilitated over 3.5 million telehealth visits since March and continues to support more than 15,000 visits per day.
The EverCommerce health services portfolio includes a
diverse mix of solutions including cloud-based medical billing, specialty EHR,
practice management, RCM software, lead generation, marketing solutions and
retention services for healthcare practices. With this acquisition,
EverCommerce will advance its mission to provide end-to-end mission-critical
solutions that enable healthcare practices to accelerate growth, streamline
operations and increase patient retention.
“Now more than ever, healthcare providers need a one-stop-shop to acquire new patients, operate more efficiently and engage their patients. They also need one single place to communicate with patients where they are – on their mobile phones,” said Michael Morgan, president of Updox. “We’re thrilled to join the EverCommerce team, which shares our vision for advancing healthcare. We look forward to accelerating innovative solutions that enable healthcare practices to more effectively market to patients, simplify payments, and effectively interact with patients both in and outside the practice.”
– The governor of Virginia announced that the state
will allocate $10 million from the federal CARES Act to
implement a statewide integrated technology platform, Unite Virginia designed
to connect vulnerable Virginians to crucial health and social services.
– Unite Virginia will utilize the Unite Us platform to create
a statewide coordinated care network to help government
agencies, health care providers, and community-based partners ensure
medical care and social services are appropriately delivered to
Virginians, identify gaps in the system to better target resources, supporting
ongoing COVID-19 response/recovery, reduce barriers to care, and advance
Governor Ralph Northam announced that Virginia will allocate
$10M in federal Coronavirus Aid, Relief, and Economic Security (CARES) Act
funding to create Unite Virginia, a statewide technology platform designed to
connect vulnerable Virginians to health and social services. Powered by Unite Us, a technology company that builds coordinated care
networks of health and social service providers, the Commonwealth will
implement an integrated e-referral system that unites government agencies,
health care providers, and community-based partners and supports Virginia’s
response and recovery efforts.
Unite Us Network
Unite Us provides unifying infrastructure between health
care providers and community-based organizations as the foundation for social
care transformation at scale. With networks in more than 40 states, Unite Us is
the statewide technology platform in North Carolina and the company is
developing programs similar to what is planned in Virginia in communities in
Kansas, Minnesota, Missouri, Nebraska, North Dakota, Ohio, Oregon, and South
Dakota. In Virginia, Unite Us already powers networks in the Hampton Roads and
Shenandoah Valley regions. When fully established, this network will be an
integral part of the Commonwealth’s broader public health framework.
This initial funding allocation will cover startup and
implementation costs to operate the e-referral system, which can integrate with
widely used electronic medical record systems in place at hospitals, health
systems, and medical practice groups across Virginia. Establishing those links
will enable health care providers to refer patients to social service
organizations that can provide other supports such as food, transportation assistance,
housing, employment services, and more. In turn, participating organizations
will be able to refer patients and clients to each other.
This interconnected approach also increases the likelihood
that vulnerable Virginians will access support services to manage their health
conditions and the environmental factors that contribute to them. Data insights
gleaned from the integrated technology platform will help state government,
providers, and other partners identify critical needs and better focus efforts
to serve these Virginians.
“The ongoing and widespread impacts of the COVID-19 pandemic underscore the need to unite traditional health care settings and community organizations that address social determinants of health,” said Governor Northam. “This is about connecting people with the supports they need to live healthy lives. Having this critical infrastructure in place will also position our Commonwealth to better respond to and recover from the twin public health and economic crises we face, and advance health equity by ensuring medical care and social services are appropriately delivered to Virginians, reducing barriers to care, and identifying gaps to better our target resources.”
A recent Advisory Board briefing examined the annual Centers for Medicare & Medicaid Services (CMS) Readmission penalties. Of the 3,080 hospitals CMS evaluated, 83% received a penalty for payments to be made in 2021, based on expected outcomes for a wide variety of treated conditions. While CMS indicated that some of these penalties might be waived or delayed due to the impacts of the Covid pandemic on hospital procedure volumes and revenue, they are indicative of a much larger issue.
For too long, patients discharged from the hospital have been handed a stack of papers to fill prescriptions, seek follow-up care, or take other steps in their journey from treatment to recovery. More recently, the patient is given access to an Electronic Health Record (EHR) portal to view their records, and a care coordinator may call in a few days to check-in. These are positive steps, but is it enough? Although some readmissions cannot be avoided due to unforeseen complications, many are due to missed follow-up visits, poor medication adherence, or inadequate post-discharge care.
Probably because communication with outside providers has never worked reliably, almost all hospitals have interpreted ‘care coordination’ to mean staffing a local team to help patients with a call center-style approach. Wouldn’t it be much better if the hospital could directly engage and enable the Primary Care Physician (PCP) to know the current issues and follow-up directly with their patient?
We believe there is still a real opportunity to hold the patient’s hand and do far more to guide them through to recovery while reducing the friction for the entire patient care team.
Strengthening Care Coordination for a Better Tomorrow
Coordinating and collaborating with primary care, outpatient clinics, mental health professionals, public health, or social services plays a crucial role in mitigating readmissions and other bumps along the road to recovery. Real care coordination requires three related communication capabilities:
1. Notification of the PCP or other physicians and caregivers when events such as ED visits or Hospitalization occur.
2. Easy, searchable, medical record sharing allows the PCP to learn important issues without wading through hundreds of administrative paperwork.
3. Secure Messaging allows both clinicians and office staff to ask the other providers questions, clarify issues, and simplify working together.
There are some significant hurdles to improve the flow of patient data, and industry efforts have long been underway to plug the gaps. EHR vendors, Health Information Exchanges (HIEs), and a myriad of vendors and collaboratives have attempted to tackle these issues. In the past few decades, government compliance efforts have helped drive medical record sharing through the Direct Messaging protocol and CCDAs through Meaningful Use/Promoting Interoperability requirements for “electronic referral loops.” Kudos to the CMS for recognizing that notifications need to improve from hospitals to primary care—this is the key driver behind the latest CMS Final Rule (CMS-9115-F) mandating Admission, Discharge, and Transfer (ADT) Event Notifications. (By March 2021, CMS Conditions of Participation (CoPs) will require most hospitals to make a “reasonable effort” to send electronic event notifications to “all” Primary Care Providers (PCPs) or their practice.)
However, to date, the real world falls far short of these ideals: for a host of technical and implementation reasons, the majority of PCPs still don’t receive digital medical records sent by hospitals, and the required notifications are either far too simple, provide no context or relevant encounter data, rarely include patient demographic and contact information, and almost never include a method for bi-directional communications or messaging.
Delivering What the Recipient Needs
PCPs want what doctors call the “bullet” about their patient’s recent hospitalization. They don’t want pages of minutia, much of it repetitively cut and pasted. They don’t want to scan through dozens or hundreds of pages looking for the important things. They don’t want “CYA” legalistic nonsense. Not to mention, they learn very little from information focused on patient education.
An outside practitioner typically doesn’t have access to the hospital EHR, and when they do, it can be too cumbersome or time-consuming to chase down the important details of a recent visit. But for many patients—especially those with serious health issues—the doctor needs the bullet: key items such as the current medication list, what changed, and why.
Let’s look at an example of a patient with Congestive Heart Failure (CHF), which is a condition assessed in the above-mentioned CMS Readmission penalties. For CHF, the “bullet” might include timely and relevant details such as:
– What triggered the decompensation? Was it a simple thing, such as a salty meal? Or missed medication?
– What was the cardiac Ejection Fraction?
– What were the last few BUN and Creatinine levels and the most recent weight?
– Was this left- or right-sided heart failure?
– What medications and doses were prescribed for the patient?
– Is she tending toward too dry or too wet?
– Has she been postural, dizzy, hypotensive?
Ideally, the PCP would receive a quick, readable page that includes the name of the treating physician at the hospital, as well as 3-4 sentences about key concerns and findings. Having the whole hospital record is not important for 90 percent of patients, but receiving the “bullet” and being able to quickly search or request the records for more details, would be ideal.
Similar issues hold true for administrative staff and care coordinators. No one should play “telephone tag” to get chart information, clarify which patients should be seen quickly, or find demographic information about a discharged patient so they can proactively contact them to schedule follow-up.
Building a Sustainable, Long-Term Solution
Having struggled mightily to build effective communications in the past is no excuse for the often simplistic and manual processes we consider care coordination today.
Let’s use innovative capabilities to get high-quality notifications and transitions of care to all PCPs, not continue with multi-step processes that yield empty, cryptic data. The clinician needs clinically dense, salient summaries of hospital care, with the ability to quickly get answers—as easy as a Google search—for the two or three most important questions, without waiting for a scheduled phone call with the hospitalist. X-Rays, Lab results, EKGs, and other tests should also be available for easy review, not just the report. After all, if the PCP needs to order a new chest x-ray or EKG how can they compare it with the last one if they don’t have access to it?
Clerical staff needs demographic information at their fingertips to “take the baton” and ensure quick and appropriate appointment scheduling. They need to be able to retrieve more information from the sender, ask questions, and never use a telephone. Additionally, both the doctor and the office staff should be able to fire off a short note and get an answer to anyone in the extended care team.
That is proper care coordination. And that is where we hope the industry is collectively headed in 2021.
About Peter Tippett MD, PhD: Founder and CEO, careMESH
Dr. Peter S. Tippett is a physician, scientist, business leader and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
About Catherine Thomas: Co-Founder and VP, Customer Engagement, careMESH
Catherine Thomas is Co-Founder & VP of Customer Engagement for careMESH, and a seasoned marketing executive with extensive experience in healthcare, telecommunications and the Federal Government sectors. As co-founder of careMESH, she brings 20+ years in Strategic Marketing and Planning; Communications & Change Management; Analyst & Media Relations; Channel Strategy & Development; and Staff & Project Leadership.
– Kyruus is acquiring HealthSparq from Cambia Health
Solutions, a family of more than 20 companies working to make healthcare more
economically sustainable and efficient for people and their families.
– HealthSparq is a healthcare guidance and transparency
technology company serving the health plan market.
– With the acquisition, the combined entity now serves
more than 60 health systems and 100 health plan brands nationwide.
Kyruus, the leader in
provider search and scheduling solutions for health systems, today announced it
is acquiring HealthSparq from Cambia Health Solutions, a family of
more than 20 companies working to make healthcare more economically sustainable
and efficient for people and their families. HealthSparq is a trailblazing
healthcare guidance and transparency technology company serving health plans.
As part of Cambia, HealthSparq has grown to serve more than
80 million health plan members nationwide through its digital solutions. Cambia
will have an ownership stake and a seat on the Kyruus Board of Directors. HealthSparq
will become part of Kyruus, accelerating a groundbreaking platform to connect
payer and provider organizations and enabling people to find and schedule with
the right providers seamlessly across access channels.
Acquisition Will Transform Care Navigation Through Novel
Healthcare remains incredibly siloed, making it difficult
for people to find and schedule care that meets their unique clinical,
financial, and personal needs. Kyruus’ acquisition of HealthSparq expands the
company’s mission to make healthcare work better for everyone by connecting
people to the care they need, whether they search on a health system website or
health plan website. This will also accelerate payer-provider collaboration to
further streamline patient access and boost provider data accuracy.
Post-Acquisition Plans & Impact
Together, Kyruus and HealthSparq serve more than 60 health
systems and 100 health plan brands nationwide. The companies have already
started working together in select markets to enhance health plan directories
with provider-verified data and enable online scheduling from health plan websites.
Combining operations will accelerate the integration of their platforms,
enabling health plans to link personalized insurance benefit and cost
information with rich provider data, while allowing health systems to tap into
health plan websites as a new patient engagement source. Over time, the unified
platform will facilitate increasingly sophisticated patient routing and
matching across channels – all while giving people the convenience of online
scheduling wherever they look for care.
The HealthSparq team will transition to Kyruus and continue
to execute on HealthSparq’s full breadth of solutions for health plans. Mark
Menton, CEO of HealthSparq, will join the Kyruus executive team and serve as
General Manager of the health plan business unit.
Scheduling an appointment shouldn’t be complicated. Yet too often, patients are left to figure out their next move alone, with just a single phone number to call.
Frustrated and confused, patients may drop out of the scheduling process entirely or miss the appointments they’ve already booked. Missed appointments can lead to critical gaps in care, poor health outcomes and possible readmissions, and they are also unnecessarily costly for providers.
But what if you could make scheduling easy? Minimizing the burden on patients could close more gaps in care, improve the patient experience and reduce call center workload at the same time. Automated, targeted outreach campaigns can help you do exactly this.
Using a simple text message or voice message, you can prompt patients to book their next appointment right there and then. Here’s how:
5 ways automated patient outreach can help close gaps in care
1. Quicker and easier for patients to book care
An automated solution can send targeted text messages (SMS) or interactive voice calls (IVR) to patients to remind them to book an appointment. By providing a self-scheduling link in the message, patients can book their appointment immediately. Patients are often more likely to schedule when they’re given a reminder plus a booking link, compared to a reminder message alone. There’s less risk of appointments being forgotten, sealing any potential care gaps from the start.
2. More appointments booked
Automation also means you can contact and schedule more patients than if your call center was contacting each person individually. One large Medicaid managed care plan saw a 140% increase in their scheduling rates since using
Patient Schedule. They’re able to match patients to the right provider first time, protecting calendars from errant bookings and eliminating the dreaded three-way calls between member, provider and payer.
3. More patients showing up to appointments
When automated patient outreach is paired with digital scheduling, patients are far more likely to show up to appointments. The Iowa Clinic found that when patients book online, they’re not only more likely to show up, but they feel more engaged and eager to follow their care plan. Their patient show rates are as high as 97% for appointments scheduled online. If those patients are also more engaged, that’s a good sign that care gaps can be minimized too.
4. Better coordination of transport services
One obstacle to attending non-emergency appointments that is often overlooked is the lack of access to reliable transportation. With automated scheduling software, this can be easily fixed. Once a member has booked an appointment, data analytics can flag up a potential need for transportation, so the member can be sent an automated text reminder to book transport. And if they need to reschedule for some reason, the transportation booking will auto-update too. Patients (and staff) no longer need to wrangle two separate systems for booking appointments and transportation.
5. Better management of wait lists and reduced call times
Another way to close gaps in care is to give patients the option to book an earlier appointment, if a slot becomes available. Seeing their doctor sooner can mean quicker treatment and reduce the chance of a patient disengaging with their care plan because of a long wait.
With automated outreach, you can send an automatic message to offer an earlier appointment, and then cancel the old booking (and offer it to others) at the same time. This enables better wait list management and can reduce call time for staff by an average of 50%.
Automated patient outreach is a win-win. It’s far more convenient for patients, and drives down costs for providers and payers. Learn more about how automated appointment reminders and digital patient scheduling can help your organization improve the patient experience and close costly gaps in care.
– San Francisco-based digital health startup Pair Team
emerges out of stealth with $2.7M in seed funding backed by Kleiner Perkins,
Craft Ventures, & YC.
– Pair Team provides both a remote team and AI that automates workflows, provides infrastructure & improves medical practices — efficiencies and billing as you’d expect, but all driving toward value-based, quality patient care.
– Pair’s wrap-around technology tripled the rate of annual wellness visits and increased revenue by 15% for clinics in 2020.
Pair Team (“Pair”) announced today it has
emerged out of stealth and has raised $2.7 million in seed funding backed by Kleiner Perkins, Craft Ventures, and YCombinator, along with other prominent
funds. Pair is an end-to-end operations platform for value-based primary care,
backed by Pair’s own care team. For patients, Pair provides a digital front door
and helps them navigate healthcare.
Automate Primary Care Operations Infrastructure
Founded in 2019 by Neil Batlivala and Cassie Choi, RN after experiencing how critical a high functioning administrative team is to provide high-quality primary care by building out operations together at leading tech-enabled practices of Forward and Circle Medical. The majority of healthcare is local and fragmented, and no solutions were built to enable existing clinics. Pair came out of that need and provides a simple yet comprehensive solution that covers the front, mid, and back-office. Their automation, along with a human-in-the-loop approach provides end-to-end operations of patient outreach, scheduling, e-forms, care gap reports, record requests, referrals, lab coordination, etc., to offload the traditional job functions of the front desk and medical assistants.
“Primary care is systematically and chronically under-resourced. Pair ensures patients receive the very best practices in health care — from annual checkups, follow-ups after hospital discharge, and preventative care screenings,” commented Neil Batlivala, CEO and co-founder of Pair Team. “We not only monitor patient data, but we go further to operationalize it with automation and our care team.”
Pair provides a revenue-sharing model to the share cost of operations with primary care providers. The platform monitors health plan and system data to trigger automated workflows that engage patients to schedule clinically impactful visits, surface care recommendations to clinicians, and manage follow-up care coordination. Their bolt-on model allows them to work as an extension of your care team within existing processes and accelerate quality programs in days, not months. For practices, this drastically improves care quality and visit efficiency. For plans, this aligns day-to-day operations with a total cost of care.
Helping Medicaid Populations Navigate Their Healthcare
Pair helps Medicaid populations navigate their healthcare with follow-ups, preventive cancer screening, and those recommendations on current (and ever-changing) Medicaid requirements. The company starts with existing processes and accelerates quality programs in days, not months.
Despite COVID and patient’s avoidance of medical offices and care, Pair’s wrap-around operations technology and care team tripled the rate of preventative care visits and are on track to increase clinical revenue by 15% by end of the year through quality incentives alone. To date, Pair manages care for thousands of Medicaid patients in southern California and has closed hundreds of care gaps with their remote care team.
PointClickCare Technologies, a provider of cloud-based technology for long-term and post-acute care facilities, will spend between $500 million and $1 billion to purchase care coordination platform Collective Medical.
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.
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
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
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
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.
Wolters Kluwer, Health launches new Alexa skill, Emmi Care Plan to keep patients
engaged with their care team at home following discharge from the hospital.
–Using a natural dialogue that automatically adjusts to patient responses, customers can engage with the skill on Alexa-enabled devices simply by saying, “Alexa, ask Emmi Care Plan” to complete periodic health assessments, reminders, and additional education.
To keep health consumers engaged with their providers
while recovering at home, Wolters Kluwer, Health is
launching Emmi® Care Plan, a new Alexa healthcare skill that
restores the patient-provider dialogue after discharge simply by using the
Every day, patients who are discharged from hospitals return
home to face the often-daunting journey of a successful recovery. For their
care providers, the stream of valuable patient information essential for
quality care decreases to the occasional phone call once patients leave the
How Emmi Care Plan Works
Emmi Care Plan empowers patients to play a proactive role in their health, whether they are in recovery at home or are managing chronic conditions. Using a natural dialogue that automatically adjusts to patient responses, customers can engage with the skill on Alexa-enabled devices simply by saying, “Alexa, ask Emmi Care Plan” to complete periodic health assessments, reminders, and additional education.
How are you feeling today? Have you used a rescue inhaler? Have you smoked or been around someone smoking today? Are you taking your medications?
Jason Burum adds, “For providers, the Emmi Care Plan skill adds a new layer of interaction to stay connected to consumers using the Alexa-enabled devices that are already an integral part of their day-to-day activities.” As clinicians engage with patients over time, they will gain new insights on their care journey at home. When risks for a change in the patient’s condition are identified, their care team is notified for follow-up.
Integration with Health System & Clinical Workflows
The new skill is part of Wolters Kluwer’s EmmiTransition solution which
keeps patients connected to their care teams post-discharge
through empathetic voice design, interactive phone calls and now, Alexa-based
interactions. EmmiTransition can be seamlessly integrated in a healthcare
system’s IT and
clinical workflows. Patients can access the Alexa skill through
participating healthcare providers by using an Alexa-enabled
smart speaker or device.
The new skill focuses on chronic conditions
like COPD, and targets health challenges that not only incur high costs
for patients and hospitals, but also exact a high toll on a patient’s
quality of life. By giving the care team access to connect with patients via Alexa-enabled
devices, they have visibility to a more longitudinal stream of patient
condition information. As a result, they can tailor and optimize care plans
in real-time, with an aim to improve engagement and outcomes.
Early feedback from test users has been overwhelmingly
positive, saying the skill “made them feel heard, cared for, and
offered encouragement.” Other feedback included “easy to answer the questions,”
“the skill was efficient and well-planned,” and they liked “not
having to speak to a human.”
As if 2020 couldn’t be
any more challenging for healthcare providers, new federal rules on
interoperability and patient access, granting patients direct access to their healthcare
data, begin taking effect this November and continue into 2022. These rules,
while ultimately beneficial to patients, bring an additional level of
operational complexity to many revenue-stressed healthcare organizations.
If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For example, consider the huge increase in 2020 in virtual care visits, projected to be more than 1 billion by year’s end, and with an estimated 90% related to Covid-19. Many of these new virtual health patients will move through different care networks, using different health plans, and seeking remote access to their health records. These are precisely the type of patients’ interoperability is meant to help.
What should healthcare providers be doing now to ensure they’re not only compliant with new interoperability rules, but also applying them as optimally as possible to benefit their patients and organizations? In this article, we review the upcoming rules and suggest five key steps providers can take to ensure their interoperability implementations proceed as smoothly as possible.
What’s Ahead with
After several years of discussion on interoperability standards, the Office of the National Coordinator (ONC) for Healthcare IT and the Centers for Medicare & Medicaid Services (CMS) issued their final rules on interoperability in the spring of 2020. The new rules, covering both health systems and health plans, are intended to ensure that patients can electronically access their healthcare information regardless of health system or type of electronic health records (EHR) and covering all CMS-regulated plan types, including Medicare Advantage, CHIP, and the Federally Facilitated Exchanges.
Starting Nov. 2, 2020, healthcare systems must begin complying with interoperability rules preventing information blocking, which means not interfering with patients’ access to or use of their electronic health information. Providers must also attest they are acting “in good faith” regarding preventing information blocking, with any non-compliance flagged on the National Plan and Provider Enumeration System. By May 1, 2021, hospitals, psychiatric hospitals, and critical access hospitals with an EHR must send notification of their patients’ admission, discharge, and transfer (ADT) events to providers.
Interoperability will replace the current fragmented and error-prone ways of exchanging vital healthcare information. Near-term benefits of interoperability include improved care coordination and patient experience, greater patient safety, and stronger patient privacy and security. Longer-term benefits include higher provider productivity, reduced healthcare costs, and more accurate public health data.
For providers, the good
news about interoperability is that they’ve had years to think about and
implement many of its fundamental tenets, based on their work meeting
meaningful use requirements. That’s borne out in a 2019 HIMSS survey of
healthcare organizations which found nearly 75% of respondents past the
“foundational” level of interoperability – “foundational” defined as allowing
data exchange from one IT
system to another, but without data interpretation.
Five Steps for
While healthcare systems
will achieve significant interoperability gains through technology investments,
they should not consider technology as the ultimate sole key to
interoperability success. If anything, financial and political considerations
may be far more important to your organization’s interoperability success. Here
are five critical non-technology factors to consider:
1. Determine your “master”
All pertinent stakeholders in your organization should be on the same page about your interoperability strategy, resources, and timing. Know up-front that those implementing interoperability may not have previously worked with patient-centric analytics, partners, or departments in your organization. Plan your resources and timing accordingly. Your strategy should focus on the value-add of interoperability internally, such as access to additional data points on your patients, and externally, such as how you describe the upcoming benefits of interoperability to your patients.
2. Convey your vision, expectations
and expected return
An interoperability implementation is
a massive change management initiative, which requires continuous, top-down
leadership and championship, and proper expectation-setting. Communicate where
your organization currently stands regarding its interoperability capabilities,
and where you wish to have it go. Convey how the organization plans to get to
its future desired state. And perhaps most importantly, share the likely return
on investment in this effort. Be as specific as possible. For example, if you
believe interoperability gains will ultimately enable a 5% decrease in your
hospital readmissions, state that.
3. Examine workflows and identify
specific use cases
Every type of ADT event in your
organization, and its corresponding workflows and system interactions, should
be under review. Consider all types of clinical use cases, the types of data to
be exchanged, and those involved in providing patient care. This will help
determine your optimal approach to data-sharing and how your organization can
strategically use the additional data you receive from other health
4. Rigorously prep your data
Standardized data collection and reporting
which produces quality data is the heart and soul of successful
interoperability. Be sure your organization’s data is clean and meaningful, and
will ultimately be understandable and useful to your patients.
5. Think big-picture differentiation
There’s nothing in the ONC and CMS
interoperability rules that says you need to stop at mere rules compliance.
Consider your pursuit of interoperability as a singular opportunity to be a
patient-centric leader in your market. Let everyone relevant know of the
success you’ve achieved.
offers a chance for healthcare systems to achieve multiple operational gains,
when handled well, it is ultimately a patient-centric endeavor. Always keep the
needs and interests of your patients at the core when facilitating access to
their personal health data. It’s the ultimate smart long-term interoperability
– With $4.5 million in funding from
Kleiner Perkins and Define Ventures, and backed by Redesign Health, MedArrive
is poised to bridge the virtual care gap and make affordable at-home care the
– Co-founded by the former head of Uber Health, MedArrive enables healthcare providers to seamlessly extend care services into the home, unlocking access to high-quality healthcare for more people at a fraction of the cost.
– MedArrive’s fully integrated care management platform allows providers and payors to bridge the virtual care gap by marrying physician-led telemedicine with hands-on care from EMS professionals.
MedArrive, a new health ITstartup has emerged from stealth with the official launch of a new care management platform that enables healthcare providers and payors to extend services into the home, scaling access to high-quality healthcare and meaningfully reducing costs for providers and their patients. Co-founded by Dan Trigub (former head of Uber Health) and Inna Plumb, MedArrive bridges the virtual care gap by integrating physician-led telemedicine with hands-on care from a network of trusted EMS professionals, improving patient outcomes while empowering an underutilized segment of healthcare workers.
Backed by healthcare innovation platform and venture studio Redesign Health, MedArrive has
raised $4.5 million in seed funding, co-led by Kleiner Perkins and Define Ventures. As part of the seed funding,
Annie Case, Principal at Kleiner Perkins, and Lynne Chou O’Keefe, Founder and
Managing Partner at Define Ventures, will both join the MedArrive Board
In-Person, At Home, On-Demand
MedArrive taps into a capable workforce of EMS professionals (e.g., EMTs and paramedics) so they can leverage the full scope of their training, earn supplemental income, and diversify their day-to-day responsibilities. At the same time, patients using MedArrive are able to access trusted medical expertise from the safety of their homes and within their existing health systems, ultimately resulting in better patient outcomes, a better-utilized healthcare workforce, and significant cost savings for patients and providers alike.
More Than 20k Trusted EMTs & Paramedics Nationwide
Today, MedArrive partners can tap into a dense network of more than 20k trusted EMTs and paramedics ready to be deployed across the country, with equal representation in rural and urban markets. This will be particularly critical for our partners looking to distribute flu vaccines and, when available, a COVID-19 vaccine without overwhelming health systems. Additional services include chronic condition management, transitional care, readmission prevention, urgent care, palliative care, and more. MedArrive provides the most extensive coverage for providers and payors looking to expand their impact and scale care into the home to meet the diverse needs of their patients.
This injection of capital will enable MedArrive to continue
building their innovative platform, growing their team of industry experts, and
driving the expansion of key healthcare provider partnerships across the
country. With an initial focus on the Florida market, the team expects to
expand quickly and effectively over the coming months.
“Now more than ever, as we continue battling a global pandemic, patients deserve healthcare that is accessible, affordable, and safe,” said Dan Trigub, co-founder and CEO of MedArrive. “The current pandemic has placed additional stress on our already flawed health system – patients are avoiding clinics, delaying preventative and critical care, and facing financial strain. By working alongside communities of EMS professionals, providers, and payors to bring high quality care into the home at a fraction of the cost of alternatives, MedArrive’s integrated solution is putting patients back at the center of care.”
When doctors know their patients have been to the hospital, they can act fast to provide needed support. Widespread use of hospital event notifications is associated with all kinds of health benefits, including a 10 percent decrease in readmissions for Medicare beneficiaries. These event notifications are one of the simplest, easiest (most-bipartisan!), and most impactful changes we can make to improve patient outcomes in U.S. healthcare.
To this goal, the Centers for Medicare and Medicaid Services (CMS) released new regulations in March that will require hospitals to share event notifications with community providers when a patient is admitted, discharged, or transferred (ADT). Hospitals have to comply by May 2021 if they want to keep getting paid by Medicare and Medicaid.
This policy will improve care, reduce costs, and save lives. It’s also simple and straightforward. CMS explains, “Lack of seamless data exchange in healthcare has historically detracted from patient care, leading to poor health outcomes, and higher costs.” ADT notifications close these gaps and many healthcare organizations have been using them for years, vastly improving care for patients.
Take the Utah Health Information Network (UHIN) which has utilized ADT notifications to reduce costs and readmissions for over a decade. According to the former UHIN President and CEO, Teresa Rivera,
“This level of care coordination quite literally saves both lives and money.” She continues, “This secure and cost-effective method provides the patient’s entire medical team, regardless of where they work, with the important information they need to coordinate care. That coordination is important to reducing readmission rates, and helps health care professionals provide a better experience to patients.”
ADT notifications are a standard set of messages that most electronic health record (EHR) systems can generate with minimal set-up. In fact, in a 2019 letter from the National Association of ACOs in support of CMS’ proposal to require hospitals participating in Medicare and Medicaid to send event notifications, they expressed that new standards efforts are not needed for the successful implementation.
The authors wrote, “In numerous conversations with HIEs, other intermediaries and providers, we were unable to find a single example where a hospital was unable to send an ADT notification today due to lack of standards.”
But you wouldn’t know it if you listened to the misconceptions that are currently being spread to hospitals about this requirement. Here are five myths that I’ve encountered just this month:
Myth 1: The ADT notification policies are strict and difficult to comply with. Not true. CMS listened to feedback that Meaningful Use requirements were too regimented and promoted a “check the box” not “get it done” mentality. CMS purposely worked to keep these ADT requirements broad and non-prescriptive. Hospitals don’t need to comply with any specific technical standard. The CMS regulations released in March are final.
Myth 2: You have to connect to a nationwide network. Wrong. Hospitals can choose from a wide variety of regional and statewide health information exchange (HIE) partners. The policy requires “reasonable effort” to send notifications to providers in your community. An intermediary can be used to comply with the rule as long as it “connects to a wide range of recipients.” Unlike what some nationwide companies are saying, the regulations do not mandate out-of-state alerts.
Myth 3: The policy creates a big technical burden for hospitals. More than 99 percent of hospitals have EHR systems in place today, and most of those can produce standard ADT transactions with relatively minimal effort. While the time to activate ADT notifications varies, it can usually be done in as little as a day by a hospital IT team.
Myth 4: The timing isn’t right. It’s happening too fast. A global pandemic is exactly the moment when we need this kind of data sharing in our communities. With COVID-19, it is even more crucial that care teams are alerted promptly when a patient is seen in the emergency department or discharged from the hospital so that they can reach out and provide support. Regardless, CMS has given an additional six months of enforcement discretion for hospitals, pushing back the deadline to May 2021.
Myth 5: There’s no funding available for this work. Wrong again. In California and several other states, hospitals can take advantage of public funding to connect to regional HIEs that provide ADT notification services. There’s $50 million in funding available just in California.
This new policy is an exciting step forward for patients and providers. It gives primary care and post-acute providers crucial, needed information to improve patient care. Hospitals can meet the requirements with minimal burden using existing technologies. Patients will have a more seamless experience when they are at their most vulnerable.
In healthcare, it’s easy to assume that great impact requires great complexity. But time and again the opposite is true. So let’s bust the myths, get it done, and keep it simple.
About Claudia Williams
Claudia Williams is the CEO of Manifest MedEx. Previously the senior advisor for health technology and innovation at the White House, Claudia helped lead President Obama’s Precision Medicine Initiative. Before joining the White House, Claudia was director of health information exchange at HHS and was director of health policy and public affairs at the Markle Foundation.
– Northwell Health announced that its Northwell Direct unit, which works with large employers, will be offering Conversa HealthCheck to screen employees, customers, students, and visitors.
– HealthCheck is a quick, chat-based electronic screening
for symptoms and signs of exposure to COVID-19. If cleared, users receive a
digital “badge” that allows entry to a facility. If not cleared, they
are given additional information on staying home and steps for testing and
– Employers use aggregated, de-identified results to
determine workforce needs and make decisions about reopening or temporarily
Direct today announced that it is partnering with Conversa Health to offer the COVID-19
HealthCheck, a screening chat tool for coronavirus disease 2019 (COVID-19). The
tool is easy to use, efficient and confidential, and allows retailers, schools,
hotels, sporting and entertainment venues and other employers to create and
maintain a safe environment for employees, customers, students and visitors.
The rollout marks the first introduction of the COVID-19
HealthCheck to the tri-state region. In use more than 125,000 times every
workday, HealthCheck has proven to help businesses, universities, health
systems and other venues across the country.
COVID-19 HealthCheck: How It Works
Employees use the HealthCheck from home before each workday,
clicking on a secure link on their phone, tablet or computer to engage in a
simple, conversational automated chat that checks for possible exposure to the
new coronavirus and potential symptoms of infection. The chat takes about a
minute and a half, and after completion, employees who are cleared for the day
receive a digital “badge” that they can display for entry to the workplace. If
they are not cleared, they are instructed to stay home and are given guidance
on the appropriate steps to take for testing and care. The process is similar
when colleges and universities provide the HealthCheck for use by faculty and
Aggregated, De-identified Results of Workforce Daily
Employers who roll out the HealthCheck are notified of the
aggregated and de-identified results of their workforce’s daily screens,
providing information that can help them manage their business, adjust staffing
and make decisions about reopening or temporarily closing specific worksites.
The HealthCheck is continually updated to reflect the latest coronavirus
guidelines from the CDC and other scientific organizations.
Northwell Direct COVID-19 Solutions
Northwell Direct clients can use the HealthCheck solution on
its own or as part of a portfolio of tools built to help curb the spread of
COVID-19. For example, if a client uses Northwell Direct’s clinical concierge
service, employees whose responses raise any concerns will be guided to connect
with that service, which includes a 24/7 nurse line and an extensive care
Northwell Direct can also provide diagnostic (PCR) and
antibody testing for COVID-19 and
return-to-work assessments. Overall, Northwell Direct offers a holistic
approach that leverages the knowledge of Northwell Health’s experts in
infectious disease, occupational health, workforce safety, behavioral health
As businesses throughout New York and the country confront rising caseloads in their area, the first job of every employer is to ensure a safe and healthy workplace,” said Nick Stefanizzi, CEO of Northwell Direct, a Northwell Health company that provides customizable health care solutions to employers in the tri-state area. “Conversa’s COVID-19 HealthCheck is a fast, easy, evidence-based way to clear people for work or put them on a path to care – without compromising privacy or creating bottlenecks.”
Senior isolation is a health risk that affects at least a quarter of seniors over 65. It has become recognized over the past decade as a risk factor for poor aging outcomes including cognitive decline, depression, anxiety, Alzheimer’s disease, obesity, hypertension, heart disease, impaired immune function, and even death.
Physical limitations, lack of transportation, and inadequate health literacy, among other social determinants of health (SDOH), further impair access to medical and mental health treatment and preventive care for older adults. These factors combine to increase the impact of chronic comorbidities and acute issues in our nation’s senior population.
COVID-19 exacerbates the negative impacts of social isolation. The consequent need for social distancing and reduced use of the healthcare system due to the risk of potential SARS-CoV-2 exposure are both important factors for seniors. Without timely medical attention, a minor illness or injury quickly deteriorates into a life-threatening situation. And without case management, chronic medical conditions worsen.
Among Medicare beneficiaries alone, social isolation is the source of $6.7 billion in additional healthcare costs annually. Preventing and addressing loneliness and social isolation are critically important goals for healthcare systems, communities, and national policy.
Organizations across the healthcare spectrum are taking a more holistic view of patients and the approaches used to connect the most vulnerable populations to the healthcare and community resources they need. To support that effort, technology is now available to facilitate analysis of the socioeconomic and environmental circumstances that adversely affect patient health and mitigate the negative impacts of social isolation.
Addressing Chronic Health Issues and SDOH
When we think about addressing chronic health issues and SDOH in older adults, it is usually after the fact, not focused on prevention. By the time a person has reached 65 years of age, they may already be suffering from the long-term effects of chronic diseases such as diabetes, hypertension or heart disease. Access points to healthcare for older adults are often in the setting of post-acute care with limited attention to SDOH. The focus is almost wholly limited to the treatment and management of complications versus preventive measures.
Preventive outreach for older adults begins by focusing on health disparities and targeting patients at the highest risk. Attention must shift to care quality, utilization, and health outcomes through better care coordination and stronger data analytics. Population health management technology is the vehicle to drive this change.
Bimodal Outreach: Prevention and Follow-Up Interventions
Preventive care includes the identification of high-risk individuals. Once identified, essential steps of contact, outreach, assessment, determination, referral, and follow-up must occur. Actions are performed seamlessly within an organization’s workflows, with automated interventions and triggered alerts. And to establish a true community health record, available healthcare and community resources must be integrated to support these actions.
Social Support and Outreach through Technology
Though older adults are moving toward more digitally connected lives, many still face unique barriers to using and adopting new technologies. So how can we use technology to address the issues?
Provide education and trainingto improve health literacy and access, knowledge of care resources, and access points. Many hospitals and health systems offer day programs that teach seniors how to use a smartphone or tablet to access information and engage in preventive services. For example, connecting home monitoring devices such as digital blood pressure reading helps to keep people out of the ED.
Use population health and data analyticsto identify high-risk patients. Determining which patients are at higher risk requires stratification at specific levels. According to the Centers for Disease Control and Prevention, COVID-19 hospitalizations rise with age, from approximately 12 per 100,000 people among those 65 to 74 years old, to 17 per 100,000 for those over 85. And those who recover often have difficulty returning to the same level of physical and mental ability. Predictive analytics tools can target various risk factors including:
– Recent ED visits or hospitalizations
– Presence of multiple chronic conditions
– Food insecurity, housing instability, lack of transportation, and other SDOH
– Frailty indices such as fall risk
With the capability to identify the top 10% or the top 1% of patients at highest risk, care management becomes more efficient and effective using integrated care coordination platforms to assist staff in conducting outreach and assessments. Efforts to support care coordination workflows are essential, especially with staffing cutbacks, COVID restrictions, and related factors.
Optimal Use of Care Coordination Tools
Training and education of the healthcare workforce is necessary to maximize the utility of care coordination tools. Users must understand all the capabilities and how to make the most of them. Care coordination technology simplifies workflows, allowing care managers to:
– Risk-stratify patient populations, identify gaps in care, and develop customized care coordination strategies by taking a holistic view of patient care.
– Target high-cost, high-risk patients for intervention and ensure that each patient receives the right level of care, at the right time and in the right setting.
– Emphasize prevention, patient self-management, continuity of care and communication between primary care providers, specialists and patients.
This approach helps to identify the resources needed to create community connections that older adults require. Data alone is insufficient. The most effective solution requires a combination of data analytics to identify patients at highest risk, business intelligence to generate interventions and alerts, and care management workflows to support outreach and interventions.
About Dr. Jenifer Leaf Jaeger
Dr. Jenifer Leaf Jaeger serves as the Senior Medical Director for HealthEC, a Best in KLAS population health and data analytics company. Jenifer provides clinical oversight to HealthEC’s population health management programs, now with a major focus on COVID-19. She functions at the intersection of healthcare policy, clinical care, and data analytics, translating knowledge into actionable insights for healthcare organizations to improve patient care and health outcomes at a reduced cost.
Prior to HealthEC, Jenifer served as Director, Infectious Disease Bureau and Population Health for the Boston Public Health Commission. She has previously held executive-level and advisory positions at the Massachusetts Department of Public Health, New York City Department of Health and Mental Hygiene, Centers for Disease Control and Prevention, as well as academic positions at Harvard Medical School, Boston University School of Medicine, and the Warren Alpert Medical School of Brown University.
Signify Health, a leading provider of technology-enabled healthcare solutions designed to keep people healthy and happy at home has acquiredPatientBlox, an Atlanta-based technology company with deep expertise in applying distributed ledger technology in healthcare. The acquisition accelerates Signify’s prospective provider payment capabilities for episodes of care, supporting the company’s commitment to advance value-based care through novel payment and risk arrangements. Financial details of the acquisition were not disclosed.
Acquisition Will Accelerate Prospective Episode of Care
The addition of blockchain technology enables a further shift away from traditional fee-for-service models. By making payments to providers at the start of the episode, providers are incentivized to drive care redesign because there is shared measurement and accountability at every step of the process, which results in improved care coordination, outcomes, and cost savings.
An episode of care is a healthcare event — a condition or a treatment — that is marked by a sequence of interactions between a patient and providers. The blockchain can capture each of those interactions and the patient’s care milestones that trigger payments. The PatientBlox platform is designed to manage these transactions without relying on fee-for-service claims.
PatientBlox Integration Offers Payers/Providers Array of Payment Options
As part of the acquisition, Signify will integrate the
PatientBlox technology into its already robust and scalable value-based care
platform, which supports $6B in healthcare spend annually associated with
the federal government’s bundled payment program, BPCI-A, and episodes of care
payment programs by health plans and employers.
The proprietary PatientBlox technology is built-for-purpose and highly-secure, enabling functionality that facilitates contract and payment administration under a prospective payment model. Under its expanded platform, Signify will offer payers and providers a diverse array of payment options to meet them where they are in their value-based care journey.
“We combined our team’s healthcare, fintech, and supply chain experience with machine-learning and Distributed Ledger Technology (DLT) to build the PatientBlox platform for administration and management of prospective bundles,” said PatientBlox Co-Founder and CEO Rahul Sharma. “Our DLT based platform enables collaboration between Healthcare Payers and Providers and provides real time data synchronization across entities thus enabling rapid scaling of prospective bundled payment programs. We are excited to work with Kyle and the Signify team and are proud to have the novel technology developed by the PatientBlox team be part of Signify’s leading platform, which is already driving real change in the healthcare industry.”
– Upfront Healthcare has raised $11.5 million in its Series B with new investor Baird Capital co-leading the round with existing investor LRVHealth (venture capital arm for 22 health systems, payers, and vendors).
– Upfront’s Enterprise Care Traffic Control Platform is
the multi-channel patient communication hub that activates every patient to get
the care they need at the appropriate clinical service throughout their care
Founded in 2016, Upfront has built a foundational platform designed to grow with health system clients and their ever-changing needs. Upfront provides extensible patient solutions that continuously guide and motivate all patients to complete necessary care at the most appropriate site or with the most applicable service. Upfront engages patients across multiple channels, presenting personalized, curated content, and culturally relevant information. Under the hood, Upfront is powered by a library of data connectors, integrated machine learning capabilities, and an enterprise orchestration engine.
Upfront’s automated patient navigation and engagement platform use advanced analytics, strategic prioritization, and effective engagement to convert actions without adding care managers, access managers, or administrative staff. Upfront’s unique approach to patient engagement eliminates the cumbersome App download process and does not require patients to remember a username and password. This approach removes barriers to adoption and delivers a convenient and easy to use experience. The company’s dynamic, responsively designed microsites are secure, HIPAA compliant, and compatible with any device.
COVID-19 Pandemic Underscores Need for Care Traffic
Patient confusion, frustration, and distrust peaked over the last twelve months with the expansion of health system sites of care and services and the COVID-19 pandemic. As a result, the demand for Care Traffic Control solutions that can transform a fragmented collection of services into a coherent, well-designed ecosystem drove rapid growth, doubling Upfront’s revenue year over year.
In addition, health systems accelerated their digital health
strategies to engage patients and regain trust, increasing the adoption of
Upfront at existing clients more than 10x. The additional funds will support
the implementation of these evolving health system and patient needs,
accelerate the product roadmap, and expand sales and marketing.
“We set out more than four years ago to help patients navigate the complexities of the healthcare system by delivering a cohesive and frictionless experience, and we have made great progress toward that goal,” said Albert, Upfront’s CEO. “We are excited to partner with leading investor Baird Capital and eager to work together to continue to invest in our platform to make a larger impact for patients and providers.”
Removing common and costly workflow barriers from provider
medaptus’ clinical workforce and workflow solutions empowers healthcare delivery entities to achieve their desired patient, clinical and financial outcomes. medaptus has applied information technology to solve problems that are common and costly to healthcare organizations that include single-specialty groups, acute care hospitals, hospital medicine teams, ambulatory care settings, and cancer centers. The company’s information technology solutions enable better revenue capture and integrity, hospital medicine workflows that make sense, and computer-assisted coding for infusion services coding processes.
Volaris Group Background
Volaris has a successful track record of acquiring,
strengthening, and growing vertical market software companies. The medaptus
acquisition expands the company’s footprint in the healthcare information
technology space. Financial details of the acquisition were not disclosed.
Volaris acquires, strengthens, and grows vertical market technology companies. As an operating group of Constellation Software Inc., Volaris is all about strengthening businesses within the markets they compete in and enabling them to grow – whether that growth comes through organic measures such as new initiatives and product development, day-to-day business, or through complementary acquisitions.
“We are delighted to welcome medaptus to our team. The company complements our current healthcare portfolio, adding new customers and unique automation capabilities to the mix. medaptus software solutions address a number of important issues in healthcare and the company’s outstanding track record and service quality reputation provide an excellent opportunity for future growth and innovation,” said Michael Melville, Group Leader at Volaris Group.
– Central Logic has acquired Omaha-based Ensocare, which
automates the referral process for patients from hospital to post-acute care
(PAC) when they are being discharged.
– This acquisition means that Central Logic’s technology
solution will now expand its reach across the care continuum, from acute to
post-acute care—into, through and out of the health system. This combined
capability is key to increasing patient satisfaction while also increasing
patient census by ensuring beds are available when they are needed by new
the leading healthcare access and orchestration company, announced today that
it has acquired
Omaha-based Ensocare, which automates
the inpatient referral process to post-acute care (PAC). Central Logic’s health
system technology solution currently focuses on referrals and transfers into a
health system by uniting all available provider, facility and transportation
resources. Financial details of the acquisition were not disclosed.
Making Care Transition More Efficient
About 40% of Medicare beneficiaries are discharged from the hospital to post-acute facilities. With a
large aging population, U.S. health systems face growing pressures to improve
care access and streamline transitions of care to optimize patient outcomes,
increase operating margins, and control costs.
Founded in 1999, Ensocare provides hospitals and post-acute care
providers software and proactive support to manage patient transitions of care,
improve efficiency in the referral management process and streamline
communication between healthcare organizations. Backed by live, 24/7 customer
support and tapping into the nation’s largest no-cost post-acute care network,
we’ll help you lower costs, enhance patient satisfaction and increase
profitability by automating workflows and eliminating inefficient systems.
Acquisition Expands Central Logic’s Solutions to Post-Acute
The acquisition of Ensocare expands Central Logic’s solution
to include successful transitions out of hospitals to post-acute care
settings—including skilled nursing and rehabilitation facilities, long-term
acute care centers, and even the home—by tapping into Ensocare’s active,
curated network of more than 50,000 PAC providers nationwide. Placement
confirmations are secured on average within 30 minutes.
In light of the Ensocare
acquisition, Central Logic becomes the only solution in the market that
provides region-wide acute care transfer, transport and post-acute care
transfer capabilities in one platform, enabling health systems to more
cohesively operate as one.
Private Equity firm Rubicon Technology partners, a leading
private equity firm based in Boulder, Colo., made a strategic majority investment in Central Logic in June,
with a commitment to accelerating growth. Two weeks before Rubicon’s majority
investment in Central Logic, the PE firm announced a new $1.25 billion fund that exceeded the fund target
of $850 million in less than 6 months. The Ensocare acquisition marks the first
major milestone in Central Logic’s growth trajectory that Rubicon committed to
when making its strategic majority investment in the company earlier this year.
Central Logic’s technology will now span 800 hospitals and
health systems, covering 150,000 providers and more than 5 million
patients—representing 14% of U.S. annual inpatient visits. he company now
employs 125 team members and will continue to operate Ensocare’s Omaha, Neb.,
location, as well as existing Central Logic offices in St. Paul, Minn., and
“This strategic acquisition means that our solutions will now span the care continuum from acute to post-acute care, which will improve transitions into, through and out of the health system, creating true ‘systemness’ for our clients,” said Angie Franks, CEO of Central Logic. “By operating as one, health systems can offer a more seamless experience for their patients across all acuity levels while enabling providers to stay connected and strengthening the relationships with PAC providers in their communities.”
Our fully integrated solution will provide visibility and access to data that ensures hospital beds are freed in a timely manner when inpatient care is no longer necessary. This decreases length of stay and increases throughput,” Franks said. “Further, this kind of efficient orchestration and navigation creates bed availability and access for incoming patients, creates more time for clinicians to operate at the top of their license and elevates revenue capture and reduction of system leakage.”
Central Logic’s existing solutions already deliver 10x ROI to health system clients in the first year, and Franks says that clients that expand their engagement to include the acute to post-acute orchestration and access solution will see even greater results. “This is more important now than ever as health systems across the country implement the necessary controls and programs to rebuild operating margin deficits due to COVID-19,” Franks added.
– The latest report from Chilmark Research examines the
new approaches and tools for utilizing community resources that can address
social determinants of health, giving providers the ability to extend care
beyond the confines of the clinic.
– This research indicates that the next two years will largely bring an expansion of product capabilities with slow and steady growth in implementation as the market better defines key variables and sets standards for performance.
COVID-19 has dramatically increased the overall population’s need for community resource engagement in traditional healthcare settings. The steady march to value-based care (VBC) continually amplifies interest in solutions that contribute to utilization management strategies. Vendors are rising to meet this need by connecting community-based organizations to various healthcare partners so that both may benefit from the coordination of service provision.
The latest Chilmark Research report, Addressing SDoH: IT Solutions to Engage Community Resources, evaluates these solutions, identifying the strengths and weaknesses of options in the market and predicting how the market will develop in the future. Research in this report is based on interviews with executive leadership teams of solutions vendors, executives from the major EHR companies, and extensive secondary research.
Vendors discussed in the report include aunt bertha, Cerner, Epic, HealthEC, Healthify, NowPow, Signify Health, Solera, Unite US, Xealth
Leveraging Community Partners Is Key
to Addressing SDoH
are some of the best resources providers can
utilize to address the social factors impacting patients’ health status, but
this is a new need for HCOs, which under fee-for-service (FFS) tried to keep
all care within the clinic to maximize revenues. Data management and liquidity
make effective integration with external partners a key barrier to
implementation, while legal and internal engagement issues continue to slow
Predicted 10-Year SDoH Adoption Trajectory
This research indicates that the next two years will largely bring an expansion of product capabilities with slow and steady growth in implementation as the market better defines key variables and sets standards for performance. Within five years, a public option for insurance will dramatically increase the rate of solutions adoption, culminating in >80% adoption in provider locations by 2030.
The report provides a roadmap and
predicts key inflection points for the greater adoption of these solutions, and which social determinants have historically been
the best predictors of increased health services utilization. It includes brief
profiles of key vendors providing this functionality, and how they plan to
impact community health.
“This has been a major challenge to healthcare systems, and people now get that we need to address [SDoH] better. The pandemic has proven to be an additional, critical driver for continued expansion of VBC, which requires understanding all of the factors that can influence a member’s health status,” according to report co-author Jody Ranck. “We see an opportunity here from the pandemic, that it has basically shown us where the failures are in the system today, and that going forward we need to do more to engage resources beyond the clinic.”
the leader in technology-enabled behavioral health integration, is now
available to healthcare providers through Epic’s App
Orchard marketplace. NeuroFlow combines provider workflow augmentation
solutions, clinical care dashboards, and a patient-facing application to create
a clinical feedback loop centered around behavioral health.
– Patient generated data including validated assessment
scores, mood and sleep ratings, and journal responses are fed into NeuroFlow’s
provider-facing web platform, which leverages a combination of machine learning
and natural language processing (NLP) from patient journal entries to risk
stratify patients and enhance care coordination efforts.
– The NeuroFlow integration with Epic will
help organizations accelerate their efforts toward integrated care by
facilitating reimbursement for collaborative care codes and optimizing value-based contracts.
– The launch is an encouraging development for health
systems seeking to practice any of a range of collaborative care models, a
clinical approach integrating both the physical and mental health of
patients. Hospitals and health systems using Epic can deploy NeuroFlow to
streamline clinical workflows and scale existing initiatives for measuring and
treating patients’ mental health symptoms.
– RxVantage has acquired onPoint Oncology to provide cancer care teams with on-demand access to educational resources, reimbursement data, and analytics.
– The acquisition of onPoint Oncology builds on
RxVantage’s rapidly expanding digital offerings for providers. In April,
RxVantage launched Virtual Meetings to help providers reestablish access to
life science experts amidst the disruptions caused by COVID-19.
leading digital platform connecting healthcare providers to educational
resources and experts from life science companies, today announced the acquisition
of onPoint Oncology,
the leader in oncology reimbursement data and analytics.
The partnership ensures that care teams will have access to
onPoint’s unique revenue cycle
data and reimbursement insights as well as one-click access to educational
resources and expertise from any life science company, all through the free RxVantage digital platform.
The acquisition of onPoint Oncology builds on RxVantage’s
rapidly expanding digital offerings for providers. In April, RxVantage launched
Virtual Meetings to help providers reestablish access to life science experts
amidst the disruptions caused by COVID-19.
onPoint will operate as a wholly-owned subsidiary of
RxVantage. As part of the acquisition, industry veterans Tracy Lewis and Bobbi
Buell will join RxVantage leadership team. Financial details of the acquisition
were not disclosed.
Founded in 2007, RxVantage’s mission is to ensure that every
provider has the most relevant information and data on medications and medical
technologies, in order to deliver the best care to every patient. More than
6,000 medical practices across the US utilize RxVantage to connect and engage
with over 50,000 experts from life science companies.
– 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.”
The Centers for Medicare and Medicaid Innovation (CMMI) created the Direct Contracting Model to expand opportunities for more diverse providers and healthcare organizations to participate in value-based care arrangements for Medicare fee-for-service (FFS) beneficiaries.
The goal of the new model is to create the next generation of risk-sharing arrangements to improve outcomes for patients, lower costs, and ensure high-quality care. In developing the Direct Contracting model and associated payment options, CMMI decided to build on lessons learned from accountable care initiatives, in particular, the Next-Generation ACO (NGACO) Model, as well as Medicare Advantage and other innovative private payers. The new model specifically aims to attract providers new to Medicare FFS and Innovation Center models: “the payment model options appeal to a broad range of physician practices and other organizations because they are expected to reduce burden, support a focus on beneficiaries with complex, chronic conditions, and encourage participation from organizations that have not typically participated in Medicare FFS or CMS Innovation Center models.”
High risk equals high reward for the new Direct Contracting Entities (DCE). The payment model options that participants can choose from aim to (1) increase risk-sharing arrangements through capitated and partially capitated population-based payments, (2) include providers and organization new to Medicare FFS, (3) increase access and empower beneficiaries in their care, and (4) decrease provider burden by emphasizing only core quality metrics and making certain care delivery waivers available. Importantly, the model offers options for new entrant DCEs, meaning DCEs that have no or limited experience with Medicare FFS beneficiaries and associated Medicare risk-based contracts, as well as high needs DCEs that will focus specifically on high cost, high acuity beneficiaries.
The Direct Contracting model begins with an optional six-month implementation period on October 1, 2020, which is intended to support organizations that need additional time to align beneficiaries and optimize their care coordination and management functions. In light of COVID-19’s overwhelming impact on healthcare this year, CMMI announced the first Direct Contracting Model performance year will start April 1, 2021—a three-month delay from the original start date, with five performance years to follow. The second cohort of Direct Contracting participants will begin in January 2022.
The Innovation Center will initially test two risk-sharing options:
Professional – includes a 50% shared savings/shared losses provisions and Primary Care Capitation, a capitated, risk-adjusted monthly payment for enhanced primary care services that’s equal to seven percent of the total cost of care benchmark for enhanced primary care services
Global – is 100% full risk option with either Primary Care Capitation or Total Care Capitation, which is a capitated, risk-adjusted monthly payment for all services provided by Direct Contracting Participants and preferred providers.
CMS may test a third option, the Geographic Option, in the future, which would also be a 100% risk arrangement offering an opportunity for participants to assume the total cost of care risk for Medicare FFS beneficiaries in a defined region.
Achieving Success in the Direct Contracting Model:
Similar to existing accountable care models, critical elements to achieve success in the Direct Contracting model include a focus on workflows, systems, and partnerships that support care coordination activities, including connections to needed healthcare and wrap-around services, as well as supporting providers in attaining quality benchmarks while managing overall utilization. Underlying these capabilities is access to real-time actionable information to drive timely interventions and coordination activities.
Real-time information through admission, discharge, and transfer (ADT) event notifications for Emergency Department, hospital, or post-acute encounters enable care coordination teams to deploy workflows and resources to more easily and quickly support patients. Knowing when and where patients are receiving care and understanding the clinical context for their care allows providers and care teams to more seamlessly work together to provide the right care at the right time without unnecessary or duplicative interventions. It also allows care teams to identify patients at high risk for complications, including readmissions and can prompt time-sensitive outreach and connection to additional resources.
Having access to real-time information can not only improve patient outcomes and quality but will also help to maximize payment incentives for Direct Contracting participants. Coordinated care consistently leads to shorter lengths of stay, which not only has positive quality implications for patients but also financial benefits for Direct Contracting Entities.
In addition, healthcare organizations can use real-time information to continuously strengthen and refine care network partnerships and collaborations.
To effectively manage Medicare FFS patients within the Direct Contracting Model, participants will need to coordinate with other providers across care settings and deploy timely interventions that support patients’ health and well-being. Real-time information, through ADT data, will provide participants with a new level of clinical intelligence to successfully prioritize and deploy care coordination services and ensure seamless transitions of care for patients while also creating optimal opportunities to achieve shared savings.
About Vanessa Kuhn, Ph.D
Vanessa Kuhn, Ph.D., is the Director of Policy at PatientPing, a care collaboration platform that provides real-time visibility into patient care events across the continuum. PatinetPing works with hospitals, post-acutes, health plans, ACO’s and beyond, the platform connects providers across the nation to improve patient and organizational outcomes.
– Doctor On Demand and CareLinx, one of the largest professional networks for in-home care, have announced a collaboration to bring in-home virtual care services to CareLinx clients.
– At a time when seniors have been encouraged to stay home to avoid exposure to COVID, Doctor On Demand’s partnership with CareLinx will vastly improve their opportunity to receive comprehensive healthcare while remaining safe.
After being the first and only telemedicine provider to roll out medical care for Medicare Part B beneficiaries, Doctor On Demand is doubling down on their efforts to support seniors in their homes. Doctor On Demand, the nation’s leading virtual care provider, and CareLinx, a nationwide, professional network for in-home care, today announced a partnership to bring in-home virtual care services to CareLinx clients.
Supporting High-Risk Patients at Home
The partnership aims to expand CareLinx’s in-home care offerings and improve health outcomes for their clients, geriatric and high-risk patients who need support at home. Today, CareLinx tech-enabled caregivers have digital care plans on their smartphones — enabling quality delivery of everyday care services such as bathing and meal prep, as well as direct communication to a patient’s family.
Doctor On Demand will augment these existing services by connecting CareLinx clients with virtual care providers in real-time. CareLinx caregivers will support the Doctor On Demand registration process and assist with in-home follow-ups and care coordination recommended by Doctor On Demand’s board-certified physicians as well.
CareLinx Clients Receive Access to Virtual Visits, Powered by Doctor on Demand
Eligible CareLinx clients will receive initial visits with board-certified physicians through Doctor On Demand at no cost. These virtual visits can be used to treat a spectrum of health issues, including diagnosis and testing of COVID-19, typical ailments like infections, rashes, cold and flu, and ongoing chronic diseases like asthma, diabetes, high blood pressure, and thyroid issues. Doctor On Demand physicians can also fill prescriptions and order lab work, and patients can see the same physician time and time again, building a trusted, personal relationship via video.
Why It Matters
“Now more than ever, finding high-quality, in-home care is pivotal during a time when seniors and high-risk patients are being encouraged to stay at home to minimize risk and exposure to COVID-19. Our partnership with Doctor On Demand enables CareLinx to continue equipping caregivers with digital tools and technologies to make caregiving easier, more transparent, and higher quality,” said Sherwin Sheik, CEO, CareLinx. “Additionally, this partnership is helping to supplement in-home activities of daily living with a telehealth option for our clients, who may not otherwise realize they have the option to see a provider virtually for medical ailments. Combined with the in-home care they are receiving, these services can help provide an expanded continuum of care to help them stay healthy and safe where they want to be — at home.”
of widely available, easy-to-use systems that automate tasks, such as
scheduling follow-up calls, developing and distributing targeted
communications, and properly responding to questions, makes managing ongoing
relationships difficult, especially for patients with complex medical
conditions. To eliminate such communication barriers, the solution uses
powerful analytics to provide a 360-degree view of patients along with their
utilization trends to easily stratify the most vulnerable patients. With these
views in place, providers can take suitable steps and group patients based on
shared conditions or goals for improved medical management and care delivery.
2-Way Communication at Population & Individual Levels
Built on top of Innovaccer’s proprietary FHIR-enabled Data Activation Platform, the solution enables HIPAA-compliant, two-way communication channels to engage patients at both the population and individual levels. The solution enables care teams to easily manage appointments, monitor patient ratings, and feedback, and conduct one-click appointment booking and prescription renewals. With the solution, the care teams can create patient cohorts based on disease, region, and various other parameters to send bulk outreach emails. It simplifies the process of connecting healthcare teams with patients to provide administrative and clinical support.
“Patient-centricity is the essence of healthcare, and artificial intelligence has always been viewed as the answer to achieving individualized, consumer-oriented healthcare,” says Abhinav Shashank, CEO at Innovaccer. “With our patient relationship management solution, we will resolve the complexity that prevents healthcare organizations from building strong patient relationships. Our goal is to enable healthcare teams to care as one for their patients.”
Clinicians in healthcare settings typically have information coming at them from all directions, at all times, and often with little distinction as to the level of urgency. It makes for inefficiency and confusion for today’s busy doctor.
In today’s hospital setting, that disjointed communication creates dissonance and distraction. Even though the world has gravitated to the ubiquitous use of smartphones, that’s not the dominant form of connection for physicians. The vast majority of hospitals still depend on paging systems to quickly reach doctors as they circulate through a facility and even outside it.
In fact, a study published in the Journal of Hospital Medicine in 2017 found that hospitals provided pagers to 80 percent of hospital-based clinicians, and more than half of all physicians in the survey reported that they received patient care-related communication most commonly by pager. Other information sources reported in the study included unsecured standard text messaging (53 percent of clinicians), and 27 percent used a secure messaging application.
While paging systems seem like a throwback form of technology, they have a history of providing reliable connections between clinicians in hospital settings. They operate on a frequency that is less prone to interference, and they travel significantly farther than messages traveling on cellular networks or Wi-Fi. That means pager signals reach hospital areas that are likely to have bad reception, such as radiology departments or basements. In addition, pager signals are not susceptible to surges in demand or network overload situations, which may occur during emergencies.
However, many hospitals are taking steps to resolve some of these issues. For example, a variety of technologies, such as repeaters, range extenders, or boosters, can improve coverage to challenge areas for both Wi-Fi and cellular networks.
Even so, pagers – a technology that was patented in 1949 and first used in New York City’s Jewish Hospital – are now a duplicative device that does not match the capability of the smartphones that physicians rely on. Many report that it’s frustrating to have to carry a separate paging device that does not fully meet their communication needs.
Pagers don’t work like physicians need them to. For example, it’s frustrating to receive a page, then return the call as requested, only to find that the doctor or nurse who initiated the page is no longer on duty or otherwise inaccessible. That typically requires a message to voicemail or further calls to find out how to reach the other clinician. Communication that could be handled in two minutes with a smartphone could take as much as half an hour to complete with a pager-based system. And that interferes with other work that a clinician should be accomplishing during hospital rounds.
Here’s one real-life example from a surgeon at a major Boston-area hospital. The doctor needed to reach a radiology technologist after regular work hours to get post-surgery X-ray images of a patient uploaded to another EHR system. The physician eventually calls the technologist’s pager number, but there are no instructions for how to ensure the message was left or even if the page went through. The physician calls a nurse to have her call the technologist’s page number on his behalf, but still has no assurance that the call went through. Finally, the technologist returned the call after 35 minutes and multiple phone calls.
Paging systems also have security shortcomings. Many pagers are not fully secure, exposing messages sent over a system to anyone who can tap into the frequency being used. As a result, many pagers and pager messaging systems are not HIPAA compliant, exposing hospitals to potential liability or even hacking or service attacks that could impact communications.
To improve efficiency and security, healthcare organizations need to look to gravitate toward an all-encompassing medical communications system that captures all pager-like messages and seamlessly incorporates them into a collaboration platform that does not rely on store-and-forward functionality.
Over recent years, clinicians have come to accept and widely use smartphones as a form factor, and their multi-tasking capability also enables clinicians to do more than one task – for example, communicate via text messages, consult an electronic health records system and engage in verbal communication with one or more clinicians.
While the utility of the pager network remains and pager systems are likely to stay in use for the foreseeable future, it is important for healthcare systems to keep the technology but get away from the pager form factor. Transforming the system won’t get rid of pagers completely but will enable physicians to get pager messages in a different way, connecting the current highly accessible pager network directly to a medical professional’s smartphone.
Such a strategy combines the ease of use and convenience of a smartphone with the advantages of a pager network.
About Fred Lizza
Fred Lizza is CEO of Statum Systems , a developer of advanced mobile collaboration platforms geared to caregivers. He was previously CEO of StrategicClaim, an insurance claims platform, and Freestyle Solutions, an e-commerce leader. Fred earned his MBA from Harvard University.
– Banner Health, one of the country’s largest non-profit healthcare systems, has partnered with Innovaccer for its digital transformation.
– Banner Health will leverage the platform to create unified patient records that drive comprehensive, preventive, and whole-person care solutions for patients across the care continuum.
one of the country’s largest non-profit healthcare systems, has partnered with Innovaccer, Inc., a leading healthcare
technology company, to leverage its FHIR-enabled Data Activation
Platform to realize digital transformation in their care delivery. The
partnership will consolidate their health data and several vendors and
transform the way they manage healthcare data to drive actionable insights and
their population health management strategy for more than one million lives.
Creating Unified Patient Records to Drive Whole-Person
Care Across Care Continuum
As an integral part of their digital transformation journey, Banner Health will leverage the platform to create unified patient records that drive comprehensive, preventive, and whole-person care solutions for patients across the care continuum. The health system will integrate clinical and payer data distributed across its multiple practices, hospitals, and systems. The platform supports FHIR APIs and complies with the latest FHIR v4.0.1 version to ensure seamless data exchange across the network.
Digital First Approach to Banner Health Network
As a part of the “digital-first” approach and to gain a more
comprehensive view of its network, Banner Health will leverage InGraph,
Innovaccer’s solution that generates insights using analyses with population
stratification, advanced analytics and customizable dashboards.
With the platform’s point-of-care alerts and digitally
connected ecosystem, Banner Health will engage its network providers with
real-time updates on care gaps, coding gaps, and other relevant information for
a comprehensive view of their patients. Combined with Innovaccer’s referral
management solution, these insights will enable them to conduct value-based
referrals and reduce network leakage.
Banner providers will be able to assign the appropriate care
management pathways for particular patient populations designed in
collaboration with Innovaccer. The digitally connected environment provided by
the platform will enable the organization to personalize healthcare experiences
for their patients with outreach and virtual patient engagement
“Banner Health’s mission is to ‘make health care easier, so that life can be better.’ Technology plays a critical role in our efforts to create a robust population health management strategy. In our partnership with Innovaccer, we are confident in our path forward. Their comprehensive set of solutions is exactly what our population health management program needs,” says Julie F. Smith, VP of Clinical Applications at Banner Health.
– HP launches patient-first print technologies to help healthcare
workers stay safe and spend more time caring for patients.
– Innovations co-developed with healthcare professionals
include industry’s first sterilizable printers, exclusive EMR-compliant
workflow solutions, and services to improve patient safety and privacy.
Today, HP Inc.
officially launched new print solutions for the healthcare industry. Based on
deep customer insights and co-developed with healthcare providers, associations
and partners, HP Healthcare Print Solutions address the most pressing issues
facing the healthcare industry today including patient wellness and safety,
care coordination, mobility, privacy and security.
Reducing the Risk of Virus Transmission and Healthcare-Associated Infections
HP’s new Healthcare Edition MFP keyboards and touch-enabled
control panels are designed to be disinfected regularly, withstanding up to
10,000X industry-standard germicidal wipes, helping to reduce the risk of
health-care associated infections (HAIs) and viral pathogen transmission.
HP has further enhanced the disinfection capabilities of high-touch areas of
the printer with removable covers/drapes that can be sterilized daily in an
autoclave up to 134 ºC. HP is also collaborating with Clorox Healthcare to
offer a guide detailing infection prevention best practices and other
In order to enhance support of infection prevention
policies, HP has also broadened disinfection capabilities of HP Personal System
devices to include HP Engage Go3 and HP Elite products such as HP EliteDesks,
HP EliteOne (display panel only), ZBook Mobile Workstations and Z Series
Desktop Workstations, HP Elite and Z Displays (Z, S, E and P series, Display
Panel Only) and HP Education Notebooks (keyboards only) .
The U.S. Centers for
Disease Control (CDC) estimates that healthcare-associated infections
(HAIs) are responsible for 1.7
million infections and 99,000 associated deaths each year. Infections and
viruses add further strains to healthcare organizations’ ability to provide
safe, quality care to patients. Influenza alone accounts for an US$11B economic
annual burden. Studies show commonly used technologies, like printers and
mobile devices, are often highly contaminated with pathogenic bacteria and
viral pathogens. Most IT and IoT devices were not designed to be regularly
cleaned by hospital-grade disinfectant wipes. Repeated use has shown to damage
the integrity of the plastic and, ultimately, the device itself.
Minimizing Contact with Common Points of Transmission
HP’s unique global Managed Print Services (MPS) program with
Zebra Technologies provides the HP Advance mobile app on Zebra’s TC52-HC
handheld touch computer to enable care providers to minimize contact with
common points of infection transmission at the point of care. Providers can
walk up to any HP Healthcare Edition MFP, authenticate with the TC52-HC mobile
computer and release critical patient documents without having to touch the
Reducing the Risk of Electromagnetic Interference (EMI)
Patient and clinical worker mobile and IoT devices add to a
very congested radio spectrum that can interfere via electromagnetic
interference (EMI) with life-saving medical devices. The new HP Health
Solutions portfolio of IoT hand-held devices and IoT print devices are EN/IEC
60601-1-2 certified for EMI safety. The EN/IEC 60601-1-2 certification
ensures these devices can be used within the patient sphere and shared patient
areas without risk of EMI to sensitive patients and surrounding medical
Helping Ensure Positive Patient ID
Patient identification errors are common and can lead to
serious reportable events that harm not only the patient’s health, but also the
clinical standing of the healthcare facility where such an error occurred. Together,
HP and Zebra solutions empower clinicians to better manage positive patient
identification through integrated color patient ID wristbands, trackable
specimen labels printed on-demand with Radio Frequency Identification (RFID)
location services and point of care identification solutions for patients.
Digitizing Processes for Faster, More Efficient Care
HP Healthcare Edition MFPs include the HP Workpath Biscom for Healthcare app fully integrated
with EPIC and Cerner. This
enables the entire clinical team to digitally transmit and receive patient
information and high-resolution color imaging like MRIs or directly input data
into the electronic
medical record (EMR) system right from an app on the printer. As a
result, care providers can make timely critical decisions to improve the
experience of patients and the entire care team and give back face time with
68% of physician respondents reported feeling burned out at
the moment, largely because of paperwork, regulatory demands and electronic
health record (EHR) documentation. Important pieces of healthcare data can fall
through the cracks, frustrating patients who don’t understand why a specialist
can’t see last week’s diagnostic test result or why they were not offered a
diabetic-friendly hospital menu while staying as an inpatient, for
Protecting Patient Privacy and Security
As the implementation of technology advances, so too are the
security threats against healthcare systems. To help healthcare
organizations defend against emerging threats, HP provides the world’s most
secure PCs16 and printing solutions to protect patient privacy and sensitive
information. The new Healthcare portfolio also offers Basic Print Cloud
Services delivered through a service, HP Print Security Advisory Services and
HP Security Manager that provides patient data protection to all HP devices,
with the added protection of PrintSecure on Zebra wristband printers.
HP Healthcare Print Solutions are now available for direct
MPS customers in North America with plans to roll out across Europe and Asia in
The agreed sale price of $1.35 billion represents a multiple
of greater than 13 times CarePort’s revenue over the trailing 12 months, and
approximately 21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12
months. CarePort is included in Allscripts Data, Analytics and Care Coordination
reporting segment and represents approximately 6% of Allscripts consolidated
revenues. Reference should be made to the Allscripts quarterly earnings reports
and supplemental financial data for a reconciliation of non-GAAP Adjusted
EBITDA. William Blair and J.P. Morgan Securities, LLC acted as financial
advisors to Allscripts in connection with the sale of CarePort.
Acquisition Enhances Care Coordination Across Acute,
As part of the acquisition, WellSky and CarePort will facilitate effective patient care transitions across the continuum — driving better outcomes for patients, providers, and payers. With the addition of CarePort, WellSky is uniquely positioned to manage the acute care discharge process, track patients across post-acute care settings, apply patient and population-level analytics, and support EMR-based care protocols.
CarePort’s EHR-agnostic suite of solutions connects the
discharge process with post-discharge care coordination — allowing providers
and payers to track and manage patients throughout their care journey. By
providing end-to-end visibility across the continuum, WellSky and CarePort can
improve outcomes, lower costs, and increase patient satisfaction.
“As part of the WellSky team, we will be able to accelerate our mission to connect providers across the continuum. Both of our organizations are aligned in our dedication to proactively bridging gaps in care. Together, we have the technology, analytics, and network to ensure that patients receive seamless care,” said Dr. Lissy Hu, CEO of CarePort. “Joining WellSky means that we can increase vital connections between acute, post-acute, and community care providers to make a meaningful difference in the lives of more patients in more places.”
With WellSky’s deep experience in post-acute care and
CarePort’s suite of care coordination solutions, this combination is a natural
fit. CarePort clients will gain access to a broader network of post-acute
providers and can leverage WellSky’s powerful predictive analytics suite, and
leading value-based care technologies. This combination of capabilities will
enable health systems, payers, and post-acute providers to more effectively
collaborate in a data-driven way and enhance patient outcomes.
“Together with CarePort, WellSky will establish new, meaningful connections between historically disparate settings of care. We have the exciting opportunity to bring care coordination to more providers in service of delivering more informed, personalized care,” said Bill Miller, CEO of WellSky. “Through this agreement, we’re ensuring our clients have the intelligent technology they need to do right by their patients, collaborate with payers, and succeed in value-based care models. It’s WellSky’s mission to realize care’s potential, and this moves us that much closer to achieving it.”
– Humana Inc. and Fresenius Medical Care North America
(FMCNA) today announced an agreement to broaden their collaboration toward
improving the health of eligible Humana Medicare Advantage members
agreement between Humana and Fresenius Medical Care North America goes into
effect Jan. 1, 2021.
Humana Inc. and leading renal care company Fresenius Medical Care North America (FMCNA) announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage and commercial members with chronic kidney disease (CKD) and end-stage renal disease (ESRD) through more coordinated, holistic care.
The expanded partnership is in keeping with the goals
outlined in the 21st Century Cures Act, which enables people with ESRD to
enroll in Medicare Advantage Plans, and with federal initiatives that call for earlier diagnosis and
treatment of kidney disease; a reduction in the number of Americans developing
ESRD; and support for patient treatment options such as home dialysis or kidney
transplant as applicable.
The agreement between
Humana and Fresenius Medical Care North America goes into effect Jan. 1, 2021,
and encompasses the following:
Expanded Availability of Care Coordination Services:
FMCNA currently provides specialized care coordination services for Humana
members with CKD in three states: Iowa, Kentucky, and North Carolina. The
agreement expands the availability of these services to eligible Humana members
in an additional 39 states, with the goals of improving quality of life and
health outcomes, increasing access to care and minimizing care gaps, slowing
disease progression and lowering hospitalization rates, and reducing the cost
FMCNA’s care coordination services include early detection of CKD to slow
disease progression; medication reviews and regimen adherence guidance;
behavioral health screenings; nutritional counseling; strategies for managing
multiple comorbidities; education about – and support for – home dialysis
treatment when applicable and beneficial to the patient; transplant education;
and palliative care.
FMCNA partners with InterWell Health, a physician-led population health
management company working to improve clinical outcomes and lower medical costs
through its network of over 1,100 nephrologists across the country.
Transitional Care Units: These units are
designed to help people recently diagnosed with kidney failure learn about
treatment options available to them – including transplant and home dialysis –
and be more empowered in managing their own care. Transitional Care Units may be either a space within a
dialysis center or a standalone facility, offering comprehensive, hands-on
education from dedicated staff that is individualized for each patient. This
includes the importance of renal nutrition, medication adherence, and vascular
access care; assisting patients transitioning between modalities (e.g., from
in-center dialysis to home dialysis); and supporting individuals returning to
dialysis from transplant. The agreement is intended to locate Transitional Care
Units in select areas where Humana has significant Medicare Advantage
Value-Based Agreement: The expanded
collaboration also improves upon the parties’ existing clinic network contract,
which provides eligible Humana Medicare Advantage and commercial members with
ESRD access to dialysis at more than 2,600 centers of Fresenius Kidney Care, the dialysis services division of
Fresenius Medical Care North America. By implementing a value-based payment
model for in-center and home dialysis services and at Transitional Care Units,
as well as for CKD care coordination services, compensation will be based on
meeting agreed-upon quality improvement and patient outcome goals, and reducing
overall costs to the system.
Individuals with CKD have kidneys that do not filter blood
properly, which causes waste and fluid levels that can be dangerously high. CKD
and ESRD affect a wide spectrum of the population but the degree of impact is
not uniform. For example, kidney failure rates among Black Americans are about
three times that of white Americans. In total, approximately 15% of American
adults, or about 37 million people, have CKD, but many are unaware of their
condition. CKD management is complex, and failure to appropriately manage the
condition may cause considerable symptoms and worsening health outcomes,
This agreement represents an evolution of our work with
Humana and leverages our over 10 years of industry leadership in value-based
care,” said Bill Valle, Fresenius Medical Care North America’s Chief Executive
Officer. “Our scale, integrated nephrology network, and standardized clinical
interventions and protocols uniquely position us to predictably and
consistently improve health outcomes and reduce overall costs. We welcome this
opportunity to offer more coordinated, holistic care to Humana’s members, with
a keen focus on education, comorbidity management, early detection, and
treatment options, including home dialysis. This approach also helps eliminate
barriers to keep renal disease treatment uninterrupted for at-risk
– Curation Health raises an undisclosed Series A round of funding to accelerate the adoption of its advanced clinical decision support platform.
– Curation Health provides an advanced clinical decision
support platform for providers and health plans that aids in managing risk
contracts and improving quality performance.
Curation Health, an Annapolis, MD-based advanced clinical decision support platform for value-based care, today announced the completion of Series A financing round for an undisclosed amount led by Deerfield Management Company, including participation from existing investor WindRose Health Investors.
Founded in 2018 by a team of healthcare veterans and clinicians, Curation Health helps providers and health plans effectively navigate the transition from fee-for-service to value-based care. The company’s advanced clinical decision support platform for value-based care drives more accurate risk adjustment and improved quality program performance by curating relevant insights from disparate sources and delivering them in real-time to clinicians and care teams. With Curation Health, clinicians enjoy a streamlined, comprehensive clinical documentation process that enables better clinical and financial outcomes while simultaneously reducing clinical administrative burdens on providers.
Helping Clients Battle Challenges of COVID-19
Curation Health’s solutions are proving especially helpful
to clients as COVID-19 intensifies several long-standing challenges: clinician
burnout and frustration with administrative tasks, difficulty identifying
highest-risk patients, and multiple standards and workflows that prevent
efficiencies across teams. To provide even more robust client assistance during
this time of need, Curation Health has continued to focus on expanding their
integration partnerships with leading electronic health record vendors (EHRs)
and introduced an array of platform enhancements over the last six months,
– 20 percent expansion of the platform’s clinical rule set
to identify additional performance opportunities hidden within patient records
and provider information systems;
– Deployment of an accelerated implementation program,
enabling provider adoption of the platform and workflows in as few as 30 days;
– Multiple new features and functionality that further
expedite point-of-care clinical documentation and engage physicians in
compliance and workflow best practices
In just the last six months, Curation Health has also
experienced 125% customer growth as providers and health plans have continued
to prioritize risk management and quality amid COVID-19. New provider and
health plan customers have been compelled by Curation Health’s track record of
helping health plans and providers identify and address undiagnosed and
unmanaged chronic clinical conditions in as many as 1 out of 3 patients, while
also eliminating up to 10 minutes of provider time per patient on unnecessary
clinical administrative tasks. Curation Health will use this latest funding for
strategic hires to support continued customer growth, as well as expansion of
services to clients that rely on the company’s platform to successfully manage
risk contracts and improve quality.
“Our team at Curation is focused on helping customers drive more accurate and compliant risk adjustment and quality performance by enabling efficient pre-visit reviews, integrated point-of-care guidance, and post-visit documentation workflows. This latest infusion of funding will be used to further empower our customers’ value-based care teams with even stronger tools and support,” said Kevin Coloton, founder and CEO of Curation Health.
The impact of the coronavirus crisis is shining a bright light on many of the challenges facing the U.S. healthcare system.
So much more than a lack of primary care physicians and hospital beds, the all-hands-on-deck approach to combating the spread of COVID-19 has forced patients fearful of engaging with the healthcare system for needs unrelated to the virus to put elective procedures, routine care and timely treatment for chronic or critical conditions on the back burner.
Compounding these issues, fears surrounding visiting the doctor’s office have forced primary care facilities to lay off or furlough clinicians and staff, deferring or skipping clinician salaries in some cases. When it comes to epidemic illness, primary care professionals serve as the first line of defense, preventing patients from flooding emergency rooms and hospitals when they don’t actually need to be there. However, in spite of the need for access to affordable primary care, many primary care practices will not survive the pandemic.
Despite new CDC guidance showing people with underlying medical conditions like diabetes or hypertension are at increased risk for severe illness from COVID-19, most regular wellness check-ups, cancer screenings, and nonemergency procedures have been put on hold. While COVID-19 is responsible for more than 140,000 deaths in the U.S. alone, experts predict this delay in care for chronically ill patients has resulted in a “silent” death-toll — and one that continues to climb as the world waits for a vaccine.
In the meantime, what can hospitals and clinics in the U.S. do to better serve chronic care patients and ensure no one else falls through the cracks during the pandemic?
Healthcare generates a lot of data for patient records. It’s crucial that hospitals and medical clinics have the ability to analyze that data to identify and categorize vulnerable patients who are either:
– high-risk due to potential coronavirus-related complications or
– require regular check-ups because of care related to chronic illness, mental health, or addiction.
Facing the aforementioned barriers to primary care and treatments, many chronic and crisis care patients are exponentially more vulnerable to the impact of the virus. Even if these patients do not contract COVID-19, the regression that can happen when a condition is not properly managed can be equally dangerous.
Data analysis that allows healthcare providers to stratify patient population risk and engage patients based on care needs provides caretakers the information they need to create personalized treatment plans that ensure the needs of chronic and crisis care patients are not neglected.
Safe and Continuous Outreach
Healthcare clinics that traditionally rely on in-office visits are now scrambling to provide access to their patients through telemedicine and virtual visits while navigating the challenging new landscape of billing codes and payment rules for these services. Previously derided as less than effective medicine, telemedicine, and virtual visits have become necessary to reduce staff exposure, preserve personal protective equipment (PPE) and minimize the impact of patient surges on facilities.
Because systems have had to adjust the way they triage, evaluate and care for patients through the use of methods that do not depend on in-person services, telehealth, and virtual care services are helping provide necessary care to at-risk patients while minimizing the transmission risk of the virus that causes COVID-19 to healthcare personnel and other patients.
From phone calls and telemedicine appointments to apps, surveys, and regular check-ins, advances in technology empower hospitals and clinics to prioritize relationships that build the foundation enabling continuity of care, even using a new channel to communicate. Through proactive communication with patients about helpful resources and the option for virtual visits, providers can see significant success in their commitment to continued engagement with — and care for — patients.
Dedicated Patient Advocacy
Good patient-provider relationships foster better communication, which drives improved health and wellness. As such, it’s important that hospitals and clinics have ongoing and dedicated patient advocates to reach out to high-risk and chronic care patients.
By serving as the link between a patient’s care provider and the real world, patient advocates strive to ensure that patients have access to the care and resources they need. Whether that involves access to prescriptions, medical supplies, food, financial assistance, mental health programs, or workforce navigation, care coordination needs to extend beyond simple community referrals.
In the face of a global pandemic, patients often face complicated decisions concerning their health and overwhelming obstacles to receiving care. Ongoing, dedicated patient advocacy offers guidance that helps patients navigate the complicated health system, ensuring they get the care and support they need throughout the continuing COVID-19 outbreak.
Despite efforts to safely reopen businesses and get employees back to work, the virus itself has not gone away. With practitioners fearing the spread of the disease, patients afraid to keep their in-person appointments and clinicians being redirected to emergency rooms or coronavirus test sites, primary care doctors are seeing their patients far less frequently, and patients are struggling to effectively maintain their health.
That strain on the primary care system will continue. However, by moving to value-based care models, such as advanced primary care, that leverage data, and analytics to identify and categorize vulnerable patients, facilitate safe and continuous outreach to these patients through telemedicine and other virtual means and have dedicated patient advocates reaching out to high-risk and chronic care patients, hospitals and clinics can continuously serve their most vulnerable patients throughout the duration of the coronavirus crisis.
About Dr. Kayur Patel
Dr. Kayur Patel serves as Chief Medical Officer of Proactive MD. A practicing physician with extensive experience in internal and emergency medicine, his specialty lies in bringing physicians and hospital leadership together in order to convert healthcare challenges into opportunities for growth. He is a nationally-recognized authority and a national speaker on the subject of quality in healthcare.
– The U.S. Department of Veterans Affairs (VA) announced
its first go-live of the VA Electronic Health Record Modernization (EHRM)
program – launching the new Centralized Scheduling Solution (CSS) at the VA
Central Ohio Healthcare System in Columbus, OH to make medical visits more
efficient for care providers and Veterans.
– CSS streamlines patient scheduling by coordinating clinician availability and resources in a single system, allowing VA schedulers to identify and secure any resources needed in real-time as they make appointments, and enables Veterans to schedule and cancel their appointments online, making it easier to manage their medical appointments.
The U.S. Department of Veterans Affairs (VA) launched a new
appointment scheduling tool Aug. 21 at the VA Central Ohio Healthcare System to
make medical visits more efficient for care providers and Veterans. The launch
marks the VA’s first go-live of the VA
Electronic Health Record Modernization (EHRM) program.
A critical component of VA’s Electronic Health Record
Modernization (EHRM) effort, the Centralized Scheduling Solution (CSS) will be
implemented at all VA health facilities to expedite patient-care coordination
throughout the department.
VA’s current scheduling solutions require VA staff to log in to multiple software applications to coordinate calendars, clinicians, rooms, and equipment. This process requires time-intensive manual data entry and workarounds to finalize appointments. CSS streamlines patient scheduling by coordinating clinician availability and resources in a single system, allowing VA schedulers to identify and secure any resources needed in real-time as they make appointments, and enables Veterans to schedule and cancel their appointments online, making it easier to manage their medical appointments.
Cerner is leveraging
innovation to ensure VA providers have the data and information needed to
improve health outcomes for Veterans. In preparation for CSS go-live, Cerner
successfully migrated and tested demographic information for 60,000 Veterans
who receive care at the VA Central Ohio Healthcare System. CSS is a capability
that will be included in VA’s new electronic health record (EHR). Following the
CSS go-live in Columbus, VA will begin implementing the full EHR at
Mann-Grandstaff VA Medical Center in Spokane, Washington this fall.
Why It Matters
This is a critical milestone in the project, bringing us one step closer to providing Service members and Veterans a lifetime of seamless care.
“VA has delivered an enhanced scheduling system that will benefit Veterans and health care providers,” said Acting VA Deputy Secretary Pamela Powers, who has oversight of VA’s EHRM program. “This is another successful launch of a major milestone in the EHRM effort and will optimize Veterans’ access to health care by improving appointment scheduling. CSS also provides an efficient and transparent method of identifying and eliminating double bookings, flagging canceled appointments and maximizing provider time spent with patients.”
– Today Vocera Communications acquires EASE Applications,
a provider of a secure communication platform and mobile application that
delivers updates, messages to patients’ loved ones, during surgeries and at
– The Orlando-based EASE offers a cloud-based service
that is built to improve the patient experience by enabling friends and family
members to receive timely updates about the progress of loved ones in the
hospitals. Care team members can send a patient’s loved ones HIPAA-compliant
texts, photos, and video updates putting them at ease and saving valuable time.
Inc., a provider of clinical communication and workflow solutions,
today announced that it has acquired EASE (Electronic Access to Surgical
Events), based in Orlando, FL. EASE offers a cloud-based communication
platform and mobile application built to improve the patient
experience by enabling friends and family members to receive timely updates
about the progress of their loved one in the hospital. The EASE app
enables nurses and other care team members to send HIPAA-compliant texts,
photos, and video updates to patients’ loved ones, putting them at ease and
saving valuable time.
Patients can add friends and family members to their distribution list; and with a simple tap, caregivers can keep them informed and ease their concerns. Messages, pictures, and videos sent disappear 60 seconds after being viewed, and nothing is saved on the mobile device, providing an additional layer of security and privacy. The application also provides secure two-way video conferencing between patients’ families and care teams. Additionally, EASE enables care team members to customize in-app surveys, offering a quick way to track and improve patient engagement and satisfaction in real-time, and giving feedback and support for the caregivers.
Return on Investment
With more than 1.6 million sent messages, the EASE
application has demonstrated improved patient and family satisfaction and
reduced the number of phone calls from loved ones to the hospital. In one study
with approximately 2,500 family members, 98% said that EASE reduced their
anxiety, and 81% reported that the availability of EASE would influence their
choice of hospital. Additionally, patient satisfaction scores increased by an
average of 6% for patients who used EASE compared to patients who did not use
Issuance of Restricted Stock Units
As part of the onboarding process, Vocera will issue
restricted stock units totaling approximately 60,000 shares of Vocera common
stock to approximately eleven employees of EASE. These restricted stock units
will vest over three years after the closing and will be made from an
inducement plan adopted by the company’s board of directors pursuant to the
inducement exemption provided under the NYSE listing rules.
– Cerner announces a commitment to help expand COVID-19 testing at Historically Black Colleges and Universities (HBCUs) across the U.S through a partnership with Testing for America.
– As part of the partnership, Cerner will serve as the national technology partner for a return to school effort led by the Thurgood Marshall College Fund (TMCF) and The United Negro College Fund (UNCF). The strategic initiative aims to support HBCUs in their COVID-19 testing of students, faculty, and staff to help safely reopen campuses.
– Cerner recognizes the COVID-19 pandemic underscores the need for people of all races, colors, and socio-economic backgrounds to have access to quality health care and is proud to partner in this important initiative.
Cerner Corporation® announced it will serve as the technology partner in partnership with non-profit Testing for America and others, including the Thurgood Marshall College Fund (TMCF) and The United Negro College Fund (UNCF), to support Historically Black Colleges and Universities’ (HBCUs) efforts to offer rapid, consistent and affordable COVID-19 testing for students, faculty, and staff. Testing for America and its collaborators are helping these academic institutions develop comprehensive reopening safety strategies and linking them to lab partners and other support in the hopes of helping them safety return to classes.
Why It Matters
The effort to support HBCUs comes as communities of color
around the nation are disproportionately impacted by the economic and health
effects of the novel coronavirus. Testing of everyone on campus is one tool in
an overall safety plan to help identify and contain the virus, often spread by
asymptomatic carriers, and to help the campuses of HBCUs, which will serve a
vital role in our nation’s recovery.
Cerner’s interoperable technology can be employed to make sure each COVID-19 test result is reported directly to the student, faculty, and staff member, as well as their physicians, for better, seamless medical care coordination and guidance and to all required public health agencies.
Importance of HBCUs Talent Infrastructure
This country’s HBCUs are a vital part of our national talent infrastructure. Our 101 HBCUs are responsible for 23% of all black college graduates, 60% of engineers, and 70% of doctors. Notably, they also have just one-eighth of the endowment of their non-HBCU counterparts. Cerner recognizes the COVID-19 pandemic underscores the need for people of all races, colors, and socio-economic backgrounds to have access to quality health care and is proud to partner in this important initiative.
“The nationwide effort to provide access to COVID-19 testing
holds the promise to be a key pillar of the safe return to campus for these
essential institutions. We are excited to have Cerner’s technology help scale
this important initiative.”
“Robust testing protocols will help give the university community more confidence in coming back and will support our comprehensive approach to reopening,” said Tony Allen, president, Delaware State University. “We want to ensure that the kind of space so many of our students call home is perceived as a safe one, so that they can continue their education without pause.”
– Lumeon, the leader in care pathway orchestration
announced it has raised $30M in Series D funding to extend the reach of its
Care Pathway Management (CPM) platform.
– The platform empowers providers to improve care
quality, deliver better outcomes, reduce costs, and ultimately develop and
scale new models of care delivery – particularly important right now as
COVID-19 accelerates the technology-driven transformation of healthcare.
Lumeon, a Boston, MA-based provider of care pathway orchestration, today
announced that it has closed $30M in Series D funding led by new investors
Optum Ventures and Endeavour Vision, with participation from current investors
LSP, MTIP, IPF Partners, Gilde and Amadeus Capital Partners. The investment
will enable the company to extend the reach of its Care Pathway Management
(CPM) platform, which helps healthcare providers automate their patient care coordination
to improve care quality, deliver better outcomes and reduce costs.
Why Care Pathways?
With proven ability to reduce unwarranted
variation and lower the overall cost of care delivery, care pathways are
an increasingly attractive proposition for healthcare providers.
The challenge, however, has always been to take paper-based pathways off the
page and into operational reality. This means being able to direct tasks and
coordinate care across clinicians, ward managers, nurses, patient educators –
the entire team responsible for successful care delivery – even the patient
Deliver Engaging Virtual Care Journeys
Founded in 2005, Lumeon’s platform connects
the care journey across the care continuum, operationalizing care plans beyond
the four walls of your hospital. Lumeon’s CPM platform
uses real-time data to dynamically guide patients and care teams along their
care journeys. By automating, orchestrating and virtualizing care delivery
across care settings, Lumeon’s solutions allow health systems to operate with
predictability and efficiency, delivering optimal care to each patient while
substantially lowering costs for healthcare providers.
Lumeon’s CPM platform
integrates with all electronic health record (EHR) systems in addition to
incorporating required clinical and administrative data from point solutions
and devices, addressing the fragmented nature of healthcare technology and the
challenge of interoperability. By extending beyond the confines of a healthcare
provider’s EHR, Lumeon’s configurable solutions maximize current investments as
organizations evolve their care delivery models.
“While the markets for data analytics, clinical decision support and patient engagement are well established, what is missing today is the ability to effectively connect them to solve the problem of personalizing care delivery in a scalable way,” said Lumeon Founder and CEO Robbie Hughes. “The ‘last mile’ that turns the insight into action is the hardest part for health systems, and is the core of the Lumeon proposition.”
– Blue Shield of CA and kidney care provider Cricket
Health announced a partnership to offer a personalized, virtual,
multidisciplinary care available for members with kidney disease or kidney
failure at no extra cost
– By offering remote care, via phone or virtually online,
Cricket Health’s approach to kidney care is designed to keep Blue Shield
members living with kidney disease healthy at home, and out of clinics or
hospitals whenever possible.
Health insurer Blue Shield of
California and kidney care provider Cricket
Health today announced a new innovative, personalized and comprehensive
care coordination program for members who have late-stage chronic kidney
disease or end-stage renal disease at no additional cost to them.
As part of the long-term collaboration, Cricket Health will offer a multidisciplinary care team that includes nurses, pharmacists, social workers, dieticians, and trained patient mentors to provide an evidence-based approach to help patients better manage chronic kidney disease and end-stage renal disease.
How It Works
The team, available online and by phone, work closely with the participating member’s medical providers including primary care physicians, nephrologists, and other specialists to ensure that, as much as possible, the patient remains healthy, at home, and out of the hospital. The program is especially relevant in today’s COVID-19 environment and is available to members enrolled in Blue Shield’s fully insured Preferred Provider Organization (PPO) benefit plans.
Blue Shield’s claims data and Cricket’s advanced data analytics capabilities are used to identify members with or at risk for chronic kidney disease, and Cricket invites them to participate in the program. Once enrolled, Cricket Health will deploy a multidisciplinary care team and virtual programs with the goal of slowing the progression of the disease, reducing health complications, and avoiding emergency room visits or hospitalizations.
By intervening well before kidney failure, Cricket Health can deliver an evidence-based, personalized kidney care plan for each patient that improves health outcomes. For members whose kidney disease does progress, Cricket Health will help them understand their treatment options — such as in-center dialysis or transplant — and empower them to make their preferred choice.
Why It Matters
This offering comes at a critical time, as those living
with chronic kidney disease or end-stage renal disease have
an elevated risk of complications from COVID-19. By offering remote care, via
phone or virtually online, Cricket Health’s approach to kidney care is designed
to keep Blue Shield members living with kidney disease healthy
at home, and out of clinics or hospitals whenever possible.
This innovative kidney care is the latest example of Blue Shield of
California’s Health Reimagined initiative to transform the
healthcare system for individuals, families and communities, and also address
health inequities often found among minority communities. Kidney disease
impacts communities of color disproportionately and Blue Shield’s
collaboration with Cricket Health seeks to expand access to quality kidney
“We recognize that for too long, the healthcare system in the U.S. has fallen short of providing patients who suffer from kidney disease – an estimated 37 million Americans – with the highest quality health care at an affordable cost,” said Seth Glickman, M.D., chief health officer, Blue Shield of California. ”By working with Cricket Health, we can reimagine kidney care and expand health care options for members with late-stage chronic kidney disease and end-stage renal disease so they can live the healthiest lives possible.”
As COVID-19 continues to impact the country, providers across the continuum face new challenges delivering care and ensuring safety for their patients and themselves. During this period, sharing real-time information about patients’ care encounters across provider types and care settings matter more than ever. In particular, hospitals sharing admission, discharge, and transfer (ADT) events with COVID-19 patients’ community-based providers is critical to ensure the best treatment course and safer more seamless care transitions for infected and recovering patients.
Real-time ADT-based notifications include information about a patient’s current care encounter, demographic details, information about the provider or institution sending the notification, and, as permissible, clinical information. This data enables providers across the continuum to make informed and coordinated decisions about their patients’ treatment and care transition plans. Even before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) recognized the importance of such ADT notifications in supporting patient care and finalized a new Condition of Participation (CoP) as part of the recently published Interoperability and Patient Access Final Rule (85 FR 25510). The CoP requires hospitals to share electronic patient event notifications, or e-notifications, with other community providers, such as primary care physicians (PCPs) and post-acute care providers, to facilitate better care coordination and improve patient outcomes.
The necessity and benefit of these e-notifications has come into stark relief as providers and the healthcare system more broadly fight COVID-19. ADT-based e-notifications are an accessible and easy way to help enable better safety for COVID-19 patients and their providers while also ensuring efficient use and appropriate allocation of scarce resources. For example, ADT-based e-notifications can:
Enhance Safety for PatientsProtecting patient safety and providing appropriate treatment is especially urgent during a crisis like COVID-19 when resources are limited and staff is stretched. E-notifications allow hospitals that treat COVID-19 patients to more rapidly get in touch with a patient’s other providers and obtain important medical histories to help guide treatment and clinical decision-making. Traditional exchange of data facilitated by phone calls, faxes, or labor-intensive data searches can introduce treatment delays, unnecessary or harmful interventions, and frustrations for providers. The faster information can be exchanged and a patient’s history is known by the hospital care team, the easier it is to effectively and safely treat the patient with the most appropriate interventions.
Enhance Safety for Providers: Hospital e-notifications are especially important for post-acute and other community-based providers that will continue treatment for COVID-19 patients discharged from the hospital. Because e-notifications provide context about the patient’s most recent encounter, including diagnoses where permissible, they help guide the continuation of care. Receiving e-notifications from hospitals allows such providers to appropriately prepare staff and put safety measures in place prior to treating COVID-19 patients. In particular, Skilled Nursing Facilities need time to properly and safely intake infected patients while Home Health Agencies need to prepare and equip their nurses for visits to homes of infected patients.
Open Hospital Beds for the Sickest Patients: Through real-time e-notifications, hospitals are able to more easily and quickly communicate and share information with COVID-19 patients’ other community-based providers who will care for recovering patients after they are discharged from the hospital. This exchange of information allows hospital care teams to more seamlessly and quickly transition recovering COVID-19 patients to the next level of care, which opens scarce hospital beds for the sickest patients.
Improve Care for COVID-19 Patients:Real-time e-notifications from hospitals allow PCPs and care coordinators to know when their patients have inpatient or ED events. In particular, discharge notifications can trigger critical follow-up services, including telehealth-based visits, to ensure COVID-19 patients recover safely and fully after they leave the hospital. Engaging COVID-19 patients after a hospitalization can help prevent readmissions and keep patients healthy in their homes. At the same time, PCPs are able to support the financial viability of their practices by being able to provide and bill for Transitional Care Management Services and ensure patient engagement in ongoing preventive and other clinical care.
Bolster Public Health Response:Aggregated and de-identified ADT-based notifications offer wide-ranging and powerful real-time data for local, state, and federal public health officials to detect emerging COVID-19 hotspots and intense ED, hospital, ICU strain. Real-time data about the hospital and ED utilization can help public health officials direct and allocate scarce resources to the highest need areas quickly.
These are just some examples of how ADT-based e-notifications can play an important part in helping healthcare organizations effectively, efficiently, and safely deliver care for their patients during the ongoing pandemic – and beyond.
About Jay Desai, CEO & Co-Founder, PatientPing
Jay started PatientPing in 2013 with one goal in mind: to connect providers everywhere to seamlessly coordinate patient care. Prior to founding PatientPing, Jay worked at the CMS Innovation Center (CMMI) where he helped develop ACOs, bundled payments, and other payment initiatives. Jay’s passion lies at the intersection of technology, policy, and community building. He has an MBA in healthcare management from Wharton and a BA from the University of Michigan.
– 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
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.
– GYANT raises $13.6M in Series A funding for AI-enabled digital front door solutions to drive meaningful patient-doctor engagement.
– The investment will enable GYANT to scale up its product development to meet rapidly increasing market demand and support its exponential customer growth.
– Current customers include Intermountain Healthcare, OSF
Healthcare, Adventist Health, Health First, Integris, etc.
GYANT, a San Francisco, CA-based care navigation company, today announced the close of a $13.6 million Series A financing round led by Wing Venture Capital. Wing VC is joined by Intermountain Ventures and existing investors Grazia Equity, Alpana Ventures, Techstars Ventures and Plug and Play Ventures. The financing will enable GYANT to continue providing best in class support and services for its fast-growing and high-profile customer base. In addition, GYANT will advance technology and interoperability to deliver the most user-friendly and personalized digital care navigation assistant on the market.
Connecting Patients & Managing Relationships
Patient expectations for a convenient and seamless healthcare experience continue to grow. As a result, health systems face an increasing need for digital health tools that improve patient experiences while optimizing workflow and reducing costs. Founded in 2016, GYANT has built the virtual front door to help health systems improve care utilization, cut costs through automation, and improve the patient experience. GYANT’s Front Door appears on a hospital system’s website or mobile app to chat with patients and guide them to the care and digital health tools they need, 24-7. GYANT is customizable to any organization’s branding, EHR, digital tools, and clinical endpoints.
GYANT ties together all of the digital tools a health system needs in a single interface, creating a seamless patient experience — increasing engagement, trust, and loyalty at each stage of the healthcare journey. GYANT’s unique combination of deep intelligence, physician oversight, and a human-driven, empathetic approach allows health systems to solve for traditional complex care issues, ensuring that patients receive the right care, anytime and anywhere.
GYANT’S AI-Driven Platform Increased Hospital’s Patient
Contact Rate by 39%
Cleveland Clinic first started working with GYANT to
virtualize patient outreach in 2018 to complement their existing post-discharge
call program. The combination of Cleveland Clinic’s care management processes
and GYANT’s AI-driven patient engagement platform has since fueled a 39 percent
increase in the hospital’s patient contact rate.
GYANT’s platform combined with live clinical engagement
helps patients stay in touch with their providers, while also offering a more
efficient patient and caregiver experience. This process allows more patients
to receive the support and resources they need following their hospital stay
and are escalated to a Cleveland Clinic caregiver should they require
Demand for GYANT’s AI-enabled Front Door solution
skyrocketed this year, and was further accelerated
by COVID-19. The pandemic forced rapid,
widespread adoption of digital access. The digital health market is valued
at over $106 billion and expected
to grow significantly as providers innovate to meet the demands of
healthcare consumerization. Delivering on this need, GYANT’s financing follows
a period of remarkable growth, having expanded from 3 customers in July 2019 to
24 customers in July 2020 including Intermountain Healthcare, Geisinger, OSF
Healthcare, Adventist Health, Health First, Integris, etc.
“We are thrilled by the support of ambitious, successful investors who see the disruptive potential of AI in healthcare,” said Stefan Behrens, co-founder and chief executive officer, GYANT. “The need for digital access and care navigation has never been greater, especially with healthcare inequities and disparities in the spotlight today. This is the time for GYANT to continue growing and realize our vision of personalized patient experiences with digital navigation to the right, best possible care.”
Curavi Health, CarePointe, U.S. Health Systems announced a merger agreement to form Arkos Health. Arkos Health will provide virtual care solutions and health insights to vulnerable populations across the United States. These three entities will become wholly-owned subsidiaries of Arkos Health, and the executive leadership teams will be merged. UPMC will continue to own a financial stake in Arkos Health, while remaining both a customer and service provider.
CarePointe, founded in 2015 and headquartered in Las Vegas,
and USHS, founded in 2018 and based in Tempe, Arizona, together will provide a
technology-enabled care coordination solution for Arkos Health’s provider and
payer partners. Currently providing services to more than 110,000 seniors, they
serve at-risk and value-based organizations by driving down costs and improving
quality of care.
Curavi was spun out from leading health care provider and
insurer UPMC in 2016 and provides clinical care in post-acute and
long-term care settings via its telemedicine and software solution, which was
designed specifically for those facilities. Its physicians have performed
approximately 60,000 consults to date, maintaining a 94% treat-in-place rate
and reducing potentially harmful transfers to hospital emergency
“With Arkos Health, providers and payers can effectively deliver quality care to frail seniors through a customized mobile and virtual platform using performance-based business models,” said Amish Purohit, M.D., chief executive officer of USHS. “Curavi, CarePointe and USHS have all demonstrated an ability to improve clinical outcomes while reducing costs, and together we will continue to elevate our clients’ experiences by providing differentiated care.”