Category: Caregivers

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The Internet of Medical Things (IoMT) is changing the face of healthcare and has the potential to significantly improve patient access as well as system efficiencies. The adoption of telemedicine, for example, spurred on by the Covid-19 pandemic, has spread rapidly.  Forrester revised its forecasts to predict that virtual care visits in the United States will soar to more than one billion this year—including 900 million visits related to Covid-19 specifically. Likewise, in the United Kingdom, 40% of doctor’s appointments now consist of phone or video calls.

Even before the pandemic, the adoption of IoMT was already growing rapidly, with the market valued at US$44.5 billion in 2018 and predicted to reach US$254 billion in 2026. There are more than 500,000 medical devices on the market, helping to diagnose, monitor, and treat patients – and more and more of these can, and are, becoming connected – not to mention innovations yet to enter the market. The connected medical devices segment specifically is expected to exceed $52 billion by 2022.

The COVID-19 Effect

The COVID-19 pandemic has changed the healthcare landscape more than any other single event in recent memory. The urgent and widespread need for care, coupled with the challenge of physical distancing, has accelerated the creation and adoption of new digital technologies as well as new processes to support their adoption and implementation across healthcare. The MedTech industry is emerging as a key apparatus to combat the virus and provide urgent support.

A simple example demonstrating the potential benefits of IoMT can be seen even within a hospital setting, where monitoring COVID-19 patients is costly in terms of time and PPE (personal protective equipment) consumption, since simply walking into a patient’s room becomes a complex process. IoMT technologies enable medical devices to send data to medical practitioners who can monitor a patient’s condition without having to take readings at the bedside. The same technologies can enable patients who do not require hospitalization to be safely monitored while remaining at home or in a community setting. 

From the patients’ perspective, many are embracing virtual healthcare as an alternative to long waits or having to go to a clinic or hospital altogether. And given the growing number and scope of connected medical devices and services, such as remote patient monitoring, therapy, or even diagnosis, there will be even more options in the future.  

Catalyzed by the pandemic, the IoMT genie is fully out of the bottle, and it is unlikely to go back. 

Increasing Access

This is good news for healthcare and good news for patients and families. Patient access is improving as telehealth, supported by connected devices to enable the collection of health-related data remotely, is helping to lift barriers. This increase in accessibility has the potential to improve the convenience, timeliness, and even safety of access to healthcare services for more people in more places. 

IoMT is lifting geographic barriers that have impeded access to healthcare since its very inception. Individuals with transportation or mobility challenges will no longer need to travel to receive routine care if they can be safely monitored while at home. Historically underserved rural or remote communities can gain access to medical specialists without needing to fly or drive great distances, while services can be delivered more cost-effectively. 

Furthermore, with fewer clinic or hospital-based appointments required for routine monitoring of patients who are otherwise doing well, doctors would be able to concentrate their in-person time and clinic resources on those most in need of care. 

The capacity for specialized medicine enabled by IoMT could also have a dramatic impact. The vast quantities of health data becoming available (with the requisite permissions in place), can enable sophisticated AI-driven health applications that can, for example, predict complications before they occur, better understand the health needs of specific populations, or enable stronger patient engagement and self-care. These models can also equip healthcare practitioners with better sources of information, ultimately leading to better patient outcomes.

Navigating Barriers

That said, while technology capabilities expand, innovation must take into consideration the needs of all the stakeholders within healthcare – from patients and caregivers to healthcare practitioners to administrators and payors/funders. Internet access, infrastructure, and comfort with technology, for example, can pose significant barriers for patients and health practitioners alike. 

One approach is to minimize the technological burden facing end-users. Devices should be user friendly and “ready to go” right out of the box, taking into consideration the circumstances and abilities of the potential range of users (patients and practitioners alike). Relying on the patient’s home Wi-Fi to provide connectivity is not ideal from either a usability or security perspective – not to mention availability and affordability. It is better for medical devices to have a cellular connection that can be immediately and securely connected to the network from any location, while also being remotely manageable to avoid burdening the user with network and setup requirements, or apps to download. 

Another barrier is the concern that both patients and healthcare providers have about security and data privacy risks. According to the 2016 edition of Philips’ Future Health Index, privacy/data security is second only to cost in the list of top barriers to the adoption of connected technology in healthcare across the countries surveyed.  

The Cybersecurity and Infrastructure Security Agency, FBI, and U.S. Department of Health and Human Services have warned of cybercrime threats against hospitals and healthcare providers. The WannaCry ransomware attacks affected tens of thousands of NHS medical tools in England and Scotland. The enthusiasm in rolling out new digital health solutions must not overlook security principles or create systems that rely on ad hoc patches.

One way of meeting the stringent security requirements of healthcare is to ensure that connected medical devices have security literally built into their hardware, following the most recent guidelines set out by the GSMA for IoT security, including the GSMA IoT SAFE specifications. In accordance with this globally relevant approach, connected devices have a specially designed SIM that serves as a mini “crypto safe” inside the device to ensure that only authorized communication can occur.

Similarly, new medical devices and software that are difficult to implement or cannot communicate with other systems such as electronic health/medical records risk being “orphaned” in the system or simply not used.  The latter is a matter of both developing the necessary integrations and ensuring the appropriate access and permissions are managed. More easily said than done, fully integrated systems take time, and some of the pieces may be added incrementally – the key is that the potential to do so is there from the beginning so future resources can be invested in enhancements rather than replacements. 

Early Collaboration is Key

Accessibility and usability must be designed right into IoMT solutions from the outset, and the best way of ensuring that is for developers and healthcare stakeholders to have plenty of interaction long before the product enters the market. Stakeholders are many and healthcare systems are complex, so innovators can look to startup accelerators and other thought leaders to help navigate the territory. The time and effort spent by innovators and healthcare stakeholders in collaborating is a sound investment in the future, ensuring that technology is designed and then applied in meaningful and equitable ways to address the most pressing issues. 

The telehealth genie, powered by IoMT, is indeed out of the bottle and is set to revolutionize healthcare. By ensuring that IoMT technologies are developed and implemented with security, accessibility, and ease of use for all stakeholders as priorities, we can make sure that the full benefits of this new dawn can be enjoyed by all. 

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Heidi Sveistrup, Ph.D. Bio

As the current CEO of the Bruyère Research Institute and VP, Research and Academic Affairs at Bruyère Continuing Care, Heidi Sveistrup, Ph.D. is focusing on increasing the research and innovation supporting pivotal transitions in care; meaningful, enjoyable and doable ways to support people to live where they choose; and creating opportunities to discover and create new approaches to identify, diagnose, treat and support brain health with individuals with memory loss. Fostering new and supporting existing collaborations among researchers, policymakers, practitioners, civil society and industry continues to be a priority.

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Elza Seregelyi Bio

Elza Seregelyi is the Director for the TELUS L-SPARK MedTech Accelerator program, which offers participants pre-commercial access to a secure telehealth platform. L-SPARK is currently working with its first cohort of MedTech companies. Elza has an engineering and entrepreneurship background with extensive experience driving collaborative initiatives.

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What You Should Know:

– 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.

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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.

Bundle Packages

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

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.

Interoperability is a big discussion in health care, with
new regulations requiring interoperability for patient data. Most approaches
follow the typical RESTful API approach that has become the standard method for
data exchange. Yet Health Level Seven (HL7), with its new Fast Healthcare Interoperability
Resources (FHIR) standard for the electronic transfer of health data, is
leading to a rash of implementations that, to date, are not solving core interoperability
issues. 

Data is still insecure, users can’t govern their own health
records, and the need for multiple APIs for different participants with
different rights (human and machine) in the network is adding unneeded
expenditures to an already burdened healthcare system. The way out is not to
add more middleware, but to upgrade the basic tools of interoperability in a
way that finally brings healthcare
technology into the 21st century.  

A Timely Policy 

Doctors, hospitals, pharmacists, insurance providers,
outpatient treatment centers, labs and billing companies are just a few of the
parties that comprise the overcomplicated U.S. healthcare system. 

In digitizing medical files, as required by the 2009 Health
Information Technology for Economic and Clinical Health (HITECH) Act, providers
have adopted whatever solution was most convenient. This has led to the mess of
interoperability
issues that HL7 seeks to remedy with FHIR. 

Existing Electronic Medical Records
(EMR) systems do not easily share data. Best case, patients have to sign
off to share data with two incompatible systems. Worst case, information must
be turned into a physical CD or document to follow the patient between
providers. Data security is also notoriously poor. Hackers prioritized the healthcare sector as their main target in 2019; breach
costs exceeded $17.7 billion.

The New Infrastructure Rush

When common formats, by way of FHIR and HL7, provided
standards and solutions to empower global health data interoperability, the
industry erupted into a flurry of activity. Thousands of healthcare databases
are now being draped in virtual construction tarps and surrounded by digital
scaffolding. 

Building a new, interoperable data ontology for the entire
healthcare system is a massive undertaking. For one, 80% of hospital data is
managed using the cryptic, machine-language HL7 Version 2. Most of the rest
uses the inefficient, dated XML data format. HL7 FHIR promotes the use of more
modern data syntaxes, like JSON and RDF (Turtle). 

Secondly, databases have no notion of the new FHIR schema.
Armies of developers must build frameworks and middleware to facilitate interoperability.
This is why Big Tech incumbents including Google Cloud Healthcare, Amazon AWS
and Microsoft for Healthcare are jumping into the fray with their own
solutions. 

The outcome, once HL7’s 22 resources are fully normative, will
be seamless information sharing, electronic notifications, and collaboration
between every player in the giant web of patients, providers, labs, and
middlemen. But it will come at a steep cost in the current traditionally RESTful
API-based manner that is being broadly pursued. 

The Problem with APIs

The new scaffolding is expensive, takes data control away
from patients, and is not inherently secure. The number of unique APIs required
to support the access, rights and disparate user base in the healthcare network
are the reason. 

Interoperability requires a common syntax and “language” to
enable databases to talk to each other. The average traditional API costs up to
$30,000 to build, plus half that cost to manage annually. That is not to
mention the cost to integrate and secure each API. A small healthcare
organization with only 10 APIs faces costs of $450,000 annually for basic API
services. 

When you consider that most big healthcare organizations will
need to connect thousands of APIs, HL7’s interoperability schema really is the
best way forward. The traditional API tooling to manage the interoperability of
the well-framed data structures, however, is the problem. 

Moreover, the patient, the rightful owner of their own
health record, still doesn’t have the ability to govern their own data. Because
change only happens in the database itself, the manager of the database, not
the patient, controls the data within. 

In the best case, this puts an additional burden on patients
to give explicit permission every time health records move between providers.
In the worst case, a provider sees an entire medical history without a
patient’s consent–your podiatrist seeing your psychiatric records, for
example.

Finally, each API enables one data store to talk to the
next, opening opportunities for bad actors to make changes to databases from
the outside. The firewalls that protect databases and networks are penetrable,
and user profiles are sometimes created outside of the database itself, making
it possible to expose, steal and change data from outside the database. 

In that light, HL7 is paving the wrong road with good
intentions. But there is another way. 

Semantic Standards and Blockchain to the Rescue

If you eliminate data APIs, secure interoperability, with
data governance fully in the hands of the patient, becomes possible. Healthcare
data silos will be replaced with a dynamic, trusted and shared data network
with privacy and security directly baked in. The solution involves adding
semantic standards for full interoperability, blockchain for data governance
and data-centric security. 

Semantic standards, such as RDF formatting and SPARQL
queries, let users quickly and easily gain answers from multiple databases and
other data stores at once. Relational databases, the ones currently in use in healthcare,
are all formatted differently, and need API middleware to talk to one another.
Accurate answers are not guaranteed. Semantic standards, on the other hand,
create a common language between all databases. Instead of untangling the
mismatched definitions and formatting inevitable with relational databases,
doctors’ offices, for example, could easily pull in pertinent patient records,
insurance coverage, and the latest research on diseases.

Patients, for their part, would use blockchain to regain control
of their data. Patients would be able to turn on aspects of their data to
specific caregivers, instead of relinquishing control to database business
managers, as is currently the case. Your podiatrist, in other words, will not
be able to see your psychiatric records unless you choose to share them. 

The data ledger, which lives on the blockchain, will contain
instructions as to who can update (writer new records on) the ledger, who can
read it, and who can make changes. All changes are controlled by private-key
encryption that is in the hands of the patient; only those with authorization
can see select histories of health data (or, as in the case of an ER doctor,
entire histories, with permission). 

Data security is controlled in the data layer itself,
instead of through middleware such as a firewall. Data can be shared without
API, thanks to those semantic standards, and data are natively embedded with
security in the blockchain. Compliance, governance, security and data
management all become easier. Data cannot be stolen or manipulated by an
outside party, the way it commonly is by healthcare hackers today. 

The interoperability conundrum, in other words, is solved.
Fewer APIs means fewer security vulnerabilities; a common, semantic standard
eliminates confusion and minimizes mistakes. Blockchain puts patients in
control of who sees what parts of their health records. Eliminating the need
for API middleware also saves tens of thousands of dollars, at a minimum.

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About Brian Platz 

Brian is the Co-CEO and Co-Chairman of Fluree, PBC, a decentralized app platform that aims to remodel how business applications are built. Before establishing Fluree, Brian was the co-founder of SilkRoad technology which expanded to over 2,000 customers and 500 employees in 12 international offices.

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As we re-examine the healthcare system in the wake of the pandemic, we are continually identifying opportunities to rebuild parts of the system to new and improved specifications. One critical facet is digital health, where we continue to struggle with what should really be table stakes: the ability to integrate data from disparate organizations and systems into a unified view of the whole person and take action.

During the height of the pandemic, telehealth made it possible to deliver care that was personal yet socially responsible. As a direct benefit, the use of digital health tools on both the clinical and consumer side picked up a tremendous and timely head of steam. But what will become of these innovations once we make our eventual return to normal?

Today, many healthcare consumers can talk to a therapist or a counselor through text, monitor glucose levels through a diabetes app and meet with their primary care provider over videoconference. The challenge is that a lot of this patient data is still landlocked in electronic medical record (EMR) systems that do not communicate or coordinate with one another or with payer systems or consumer apps.

The sustainability and applicability of digital health tools are still often questioned despite reports that investors had poured a staggering $5.4 billion into the digital health industry just by June of this year (Rock Health). The key to success is to seamlessly connect these tools with legacy systems and siloed access points to create a truly integrated healthcare continuum. Jumping between systems, each holding only its own limited slice of patient data, and then trying to take action on this data, is neither scalable nor sustainable.

Healthcare consumers have long looked at the seamless nature of apps in other areas of life and asked for a similar level of accessibility and on-demand, high-quality information from the healthcare system. Accenture found in its 2020 Digital Health Consumer Survey that although consumers are interested in virtual services, a cumbersome digital experience turns them off. Additionally, the survey found that concerns over privacy, security, and trust remain, along with difficulty integrating new tools and services into day-to-day clinical workflows.

The good news is that the Office of the National Coordinator (ONC) has made several major data exchange rulings this year that will push providers and payer organizations to update legacy systems to make consumer health data more assessable and sharable across all parties, all for the benefit of the patient.

The Stage is Set: Healthcare Leaders Must Act, Now

The incredible investments in the industry, increasing consumer demand, and data sharing regulation show that healthcare connectivity and interoperability have never been more essential. To ensure that the digital health transformation and remote healthcare delivery models progress optimally beyond the current environment, we must support healthcare organizations in evolving their infrastructure and software capabilities to support this kind of strategy. This is where health tech has a critical role to play in building flexible pipes to connect the full spectrum of repositories and players, including doctors, specialists, nurses, care managers, health coaches, caregivers, and, of course, the healthcare consumer.

What does this look like in practice? Imagine if an unusually high heart rate warning was triggered by a patient’s smartwatch, which then alerted the patient’s care manager to check-in. With a comprehensive view of that patient, the care manager calls the patient to assess if they are okay and learns the patient ran out of their prescription which helps lower the heart rate. Knowing that patient does not have access to a car and is afraid to take public transportation due to COVID-19, the care manager then sets up a prescription delivery straight to that patient’s doorstep.

Through this process, digital health tools, patient data, and social determinants of health all came together to equip that care manager to deliver personalized care to the patient. Sound like sci-fi? This innovative approach can actually be a reality for organizations that manage large populations. The key is educating more healthcare leaders about the benefits of a comprehensive healthcare platform that improves health outcomes, lowers costs and increases member satisfaction. 

This all starts with a platform that coordinates and aggregates the siloes of data and tools (clinical and digital) into a central hub. that allows providers to oversee the access points, plans, and processes in a patient’s healthcare journey without the task of building or maintaining the system themselves. This can be a game-changer in the way we assess and treat patients and help the industry to fully realize the dream of truly comprehensive, coordinated care.

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About Adam Sabloff

Adam Sabloff is the founder and CEO of VirtualHealth, provider of HELIOS, the leading SaaS care management platform, serving more than 9 million members across the U.S. Prior to VirtualHealth, Sabloff served as VP of Development and Chief Marketing Officer for Midtown Equities, a $7 billion real estate, media and aviation conglomerate, where he also oversaw its technology subsidiary, Midtown Technologies.

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

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

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

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

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

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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. 

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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.

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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.

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What You Should Know:

– The American Medical Association (AMA) announced the addition of three Current Procedural Terminology (CPT) codes for AstraZeneca’s COVID-19 vaccine.

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The American Medical Association (AMA) today announced that
the Current Procedural Terminology (CPT®) code set is
being updated by the CPT Editorial Panel to include immunization and
administration codes that are unique to the COVID-19 vaccine under development
by AstraZeneca and University of Oxford.

The new CPT codes will be effective for use on the condition
that the AstraZeneca vaccine receives approval or emergency use authorizations
from the Food and Drug Administration (FDA). The AMA is publishing the new CPT
codes now to ensure electronic systems across the U.S. health care
system are updated and prepared for the prospect of FDA approval or
authorization for the AstraZeneca vaccine.

Growing List
of CPT Codes to Support COVID-19 Vaccines

The AstraZeneca vaccine joins two other COVID-19 vaccines that were previously issued unique CPT codes to report vaccine-specific immunizations once FDA approval or authorization has been granted. On Nov. 10, the AMA announced that COVID-19 vaccines developed by Pfizer and Moderna had been issued unique CPT codes to clinically distinguish each vaccine for better tracking, reporting, and analysis that supports data-driven planning and allocation

AstraZeneca COVID-19 Vaccine CPT Codes Overview

The new
Category I CPT code and long descriptor for the AstraZeneca vaccine are:

91302: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative-free, 5×10¹⁰ viral particles/0.5mL dosage, for intramuscular use

In addition to the new vaccine-specific product CPT code, the AstraZeneca vaccine has been issued vaccine administration CPT codes that are distinct to its two-dose immunization schedule. These CPT codes report the actual work of administering the vaccine, in addition to all necessary counseling provided to patients or caregivers and updating the electronic record.

For quick reference, the new vaccine administration CPT codes and long descriptors for the AstraZeneca vaccine are:

0021A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative-free, 5×10¹⁰ viral particles/0.5mL dosage; first dose 

0022A: second dose

In addition to the long descriptors, short and medium descriptors for all the new vaccine-specific CPT codes can be accessed on the AMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SAR-CoV-2 virus and the COVID-19 disease.

“A mass vaccination effort with the first available COVID-19 vaccines presents enormous logistical challenges,” said AMA President Susan R. Bailey, M.D. “The ability to correlate each COVID-19 vaccine with its own unique CPT code provides analytical and tracking advantages that ensures optimal vaccine distribution and administration, especially for patients who will need to complete the two-dose immunization schedule.”

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

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

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

Preventive fall detection

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

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

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

Keeping elders in their homes longer

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

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

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

How the sensors work

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

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

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

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About Ajay Rane

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

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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. 

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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.

What You Should Know:

– Highmark Health signs six-year strategic partnership agreement
with Google Cloud to transform the health experience for patients and
caregivers through the development of Highmark Health’s new Living Health
Model

– The Living Health model is designed to eliminate
the fragmentation in health care by re-engineering the healthcare delivery
model with a more coordinated, personalized, technology-enabled experience.

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Highmark Health and Google Cloud today announced a six-year strategic partnership to build and maintain the innovation engine behind Highmark’s Living Health model. The agreement includes the development of the Living Health Dynamic Platform, which will be designed to help overcome the complexities and fragmentation within the healthcare industry.

Re-engineering The Healthcare Delivery Model

Highmark’s Living Health model is designed to eliminate the fragmentation in health care by re-engineering the healthcare delivery model with a more coordinated, personalized, technology-enabled experience. In addition to offering seamless, simpler, and smarter interactions with patients, the Living Health model is designed to free clinicians from time-consuming administrative tasks while providing them with timely data and actionable information about each patient. Living Health is not just focused on improving the patient-clinician relationship, it is about changing the way health care delivery operates.

“The Living Health model is about improving each person’s health and quality of life, every day,” commented Dr. Tony Farah, executive vice president and chief medical and clinical transformation officer of Highmark Health. “The traditional health care system is too fragmented and for the most part reactive. The Living Health model takes the information and preferences that a person provides us, applies the analytics developed with Google Cloud, and creates a proactive, dynamic, and readily accessible health plan and support team that fits an individual’s unique needs.”

Living Health Model
Powered by Google Cloud

Highmark Health will lead the collaboration to build its
Living Health Dynamic Platform on Google Cloud. Key elements of the agreement
include:

– The construction of a highly secure and scalable platform
built on Google Cloud

– The application of Google Cloud’s advanced analytic and
artificial intelligence capabilities to supercharge Highmark Health’s existing
clinical and technology capabilities

– The engagement of a highly skilled professional services
team that will collaborate to drive rapid innovation

– The use of Google Cloud’s healthcare-specific solutions, including the Google Cloud Healthcare API, to enable rapid innovation, interoperability, and a seamless Living Health experience.

Highmark Health will control access and use of its patient
data using rigorous long-standing organizational privacy controls and
governance, which will be enhanced through the creation of a joint Highmark
Health-Google Cloud Data Ethics and Privacy Review Board to ensure that uses of
data are consistent with prescribed ethical principles, guidance, and customer
expectations of privacy.

Why It Matters

The strategic partnership reflects Highmark Health’s vision for a remarkable health experience by moving care and disease management of clinical conditions beyond traditional care settings through an engaging digital experience. By providing the insights needed to enable timely interventions, people will be empowered to proactively manage their health. For example, specific outcomes could include proactive intervention based on timely and individual patient data; digital disease management; easily accessible, personalized health plans; and centralized scheduling and management of care teams.

Economic Impact of Partnership

Approximately 125 new jobs are being created at Highmark Health to support the development of the Living Health Dynamic Platform, specifically in the areas of application development, cloud-based computing architectures, analytics, and user experience design.  

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

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

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

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

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

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

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

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

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

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About Stuart Karten

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

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A global health crisis has thrust us into a scenario in which lives quite literally depend on the ability to virtually connect. Telehealth has rapidly emerged as a vital tool, enabling continuity of care, allowing vulnerable individuals to access their physician from home, and freeing up resources for providers to treat the most critical patients. The acceptance of telehealth and expansion of covered services for the senior population demonstrate that this technology will endure long after COVID-19 subsides. 

Prior to the pandemic, just 11% of Americans utilized telehealth compared to 46% so far this year, and virtual healthcare interactions are expected to top 1 billion by year’s end. While the technology has been a life-saver for many, usage depends heavily on the availability of audio-video capabilities, internet access, and technological prowess – potentially leaving vulnerable patients behind.

Seniors Face Physical, Technical and Socioeconomic Barriers to Telehealth

Despite telehealth’s surge, there is growing concern that the rapid shift to digitally delivered care is leaving seniors behind. Telehealth is not inherently accessible for all and with many practices transitioning appointments online, it threatens to cut older adults off from receiving crucial medical care. This is a significant concern, considering older adults account for one-quarter of physician office visits in the United States and often manage multiple conditions and medications, and have a higher rate of disability. This puts an already vulnerable population at a higher risk of severe complications from COVID-19.

Research published recently in JAMA Internal Medicine found that more than a third of adults over age 65 face potential difficulties accessing their doctor through telehealth. Obstacles include familiarity using mobile devices, troubleshooting technical issues that arise, managing hearing or vision impairments, and dealing with cognitive issues like dementia. Many of these difficulties stem from the natural aging process; it is imperative for provider organizations employing telehealth and telehealth vendors to improve offerings that consider vision, hearing, and speaking loss for this population. 

While barriers associated with aging are a key factor within the senior population, perhaps the greatest challenges in accessing telehealth are socioeconomic. The rapid shift to digital delivery of care may have left marginalized populations without access to the technological tools needed to access care digitally, such as high-speed internet, a smartphone or a computer.

According to the JAMA study, low-income individuals living in remote or rural locations faced the greatest challenges in accessing telehealth. A second JAMA study, also released this summer indicated that “the proportion of Medicare beneficiaries with digital access was lower among those who were 85 or older, were widowed, had a high school education or less, were Black or Hispanic, received Medicaid, or had a disability.”

These socioeconomic factors are systemic issues that existed prior to the pandemic, and the crisis-driven acceleration of telehealth has magnified these pre-existing challenges and widened racial and class-based disparities. Recent initiatives at the federal level, such as the FCC’s rural telehealth expansion task force, are a step in the right direction, though more sustained action is needed to address additional socioeconomic challenges that are deeply rooted within the healthcare system.   

Fortunately, Telehealth Hurdles Can Be Overcome

Recognizing that telehealth isn’t a “one-size fits all” solution is the first step towards addressing the barriers that disproportionately impact seniors and work is needed on multiple levels. Telemedicine consults are impossible without access to the internet, so the first step is to provide and expand access to broadband and internet-connected devices. With more than 15% of the country’s population living in rural areas, expanding broadband access for these individuals is especially crucial. In addition, older adults in community-based living environments need greater access to public wi-fi networks. 

Access to mobile and other internet-connected devices is also essential. Products designed with large fonts and icons, closed captioning, and easy set-up procedures may be easier for older adults to use. For example, GrandPad is a tablet designed specifically for seniors and has an intuitive interface that includes basic video calling, enabling seniors to virtually connect with their caregivers.

To address affordability, the Centers for Medicaid and Medicare Services (CMS) allowed for mid-year benefit changes in 2020 to allow for payment or provision of mobile devices for telehealth. Many Medicare Advantage organizations are enhancing plans’ provisions of telehealth coverage and devices for 2021.

In addition to increasing access to broadband and internet-connected devices, providing seniors with proper educational resources is another crucial step. Even if older adults are open to using technology for telehealth visits, many will need additional training. Healthcare organizations may want to connect older patients with community-based technology training programs. Some programs take a multi-generational approach, pairing younger instructors with older students.

For example, Papa is an on-demand service that pairs older adults with younger ‘Papa Pals’ who provide companionship and assistance with tasks such as setting up a new smartphone or tablet. 

From a socioeconomic perspective, careful consideration is needed to address the concerns that telehealth may reinforce systemic biases and widen health disparities. Providers may be less conscious of systemic bias toward patients based on race, ethnicity, or educational status.

In turn, providers must address implicit bias head-on, such as offering workplace training and incorporating evidence-based tools to adequately measure and address health disparities. This includes pushing for policies that enable widespread broadband access funding to better connect communities in need. 

Health plans can support expanded access to care through benefit design, reducing costs for plan members. To match members and patients with the right resources and assistance, health plans and providers should launch outreach campaigns that are segmented by demographic group. Outreach initiatives could include assessments to determine each person’s ability and comfort level with telehealth. 

The Path Forward 

Without question, telehealth is playing a central role in delivering care during the current pandemic, and many of its long-touted benefits have been accentuated by the current demand. Telehealth, along with other digital monitoring technologies, have the potential to address several barriers to care for seniors and other vulnerable populations for whom access to in-person care may not be viable, such as those based in remote locations or with mobility issues.

In the post-pandemic era, telehealth can provide greater access and convenience, but if not implemented carefully, the permanent expansion of telehealth may worsen health disparities. Careful consideration and collaboration will be essential in embracing the value of telehealth while mitigating its inherent risks. 

If implemented correctly, telehealth can provide continued access to care for our vulnerable aging population and can significantly improve care as well. Enhancing the ability to connect with healthcare providers anytime, anywhere can give seniors the freedom to gracefully age in place.

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About Anne Davis

Anne Davis is the Director of Quality Programs & Medicare Strategy at HMS, a healthcare technology, analytics, and engagement solutions company, where she’s focused on the company’s Population Health Management product portfolio.

What You Should Know:

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

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

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

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

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

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

What You Should Know:

– Nuance Communications, Inc. and one of the country’s
largest health systems, Providence, announced a strategic collaboration,
supported by Microsoft, dedicated to creating better patient experiences and ease
clinician burden.

– The collaboration centers around Providence harnessing
Nuance’s AI-powered solutions to securely and automatically capture
patient-clinician conversations.

– As part of the expanded partnership, Nuance and
Providence will jointly innovate to create technologies that improve health
system efficiency by reducing digital friction.

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Nuance® Communications, Inc. and Providence, one of the largest health systems in the
country, today announced a strategic collaboration to improve both the patient
and caregiver experience. As part of this collaboration, Providence will
build on the long-term relationship with Nuance to deploy Nuance’s cloud
solutions across its 51-hospital, seven-state system. Together, Providence and
Nuance will also develop integrated clinical intelligence and enhanced revenue cycle
solutions.

Enhancing the Clinician-Patient Experience

In partnership with Nuance, Providence will focus on the clinician-patient experience by harnessing a comprehensive voice-enabled platform that through patient consent uses ambient sensing technology to securely and privately listen to clinician-patient conversations while offering workflow and knowledge automation to complement the electronic health record (EHR). This technology is key to enabling physicians to focus on patient care and spend less time on the increasing administrative tasks that contribute to physician dissatisfaction and burnout.

“Our partnership with Nuance is helping Providence make it easier for our doctors and nurses to do the hard work of documenting the cutting-edge care they provide day in and day out,” said Amy Compton-Phillips, M.D., executive vice president and chief clinical officer at Providence. “The tools we’re developing let our caregivers focus on their patients instead of their keyboards, and that will go a long way in bringing joy back to practicing medicine.”

Providence to Expand Deployment of Nuance Dragon Medical
One

To further improve healthcare experiences for both providers
and patients, Providence will build on its deployment of Nuance Dragon
Medical One with the Dragon Ambient eXperience (DAX). Innovated by Nuance and
Microsoft, Nuance DAX combines Nuance’s conversational AI technology with
Microsoft Azure to securely capture and contextualize every word of the patient
encounter – automatically documenting patient care without taking the
physician’s attention off the patient.

Providence and Nuance to Jointly Create Digital Health
Solutions

As part of the expanded partnership, Nuance and Providence
will jointly innovate to create technologies that improve health system
efficiency by reducing digital friction. This journey will begin with the
deployment of CDE One for Clinical Documentation Integrity workflow management,
Computer-Assisted Physician Documentation (CAPD), and Surgical CAPD, which
focus on accurate clinician documentation of patient care. Providence will also
adopt Nuance’s cloud-based PowerScribe One radiology reporting solution to
achieve new levels of efficiency, accuracy, quality, and performance.

Why It Matters

By removing manual note-taking, Providence enables deeper
patient engagement and reduces burdensome paperwork for its clinicians. In
addition to better patient outcomes and provider experiences, this
collaboration also serves as a model for the deep partnerships needed to
transform healthcare.

What You Should Know:

– The American Medical Association (AMA) published an
update to the Current Procedural Terminology (CPT®) code set that includes new
vaccine-specific codes to report immunizations for the novel coronavirus
(SARS-CoV-2).

– The new Category I CPT codes and long descriptors for the vaccine products 91300 and 91301 for better tracking, reporting, and analysis that supports data-driven planning and allocation.

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The American Medical Association (AMA) today published an update to the Current Procedural Terminology (CPT^®) code set that includes new
vaccine-specific codes to
report immunizations for the novel coronavirus (SARS-CoV-2).

New Category CPT Codes

The new Category I CPT codes and long descriptors
for the vaccine products are:

91300: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use

91301: Severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike
protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use

In accordance with the new vaccine-specific product CPT codes, the CPT Editorial Panel has worked with the Centers for Medicare & Medicaid Services to create new vaccine administration codes that are both distinct to each coronavirus vaccine and the specific dose in the required schedule.  This level of specificity is a first for vaccine CPT codes, but offers the ability to track each vaccine dose, even when the vaccine product is not reported (e.g. when the vaccine may be given to the patient for free). These CPT codes report the actual work of administering the vaccine, in addition to all necessary counseling provided to patients or caregivers and updating the electronic record.

Admin CPT Codes & Long Descriptors

For quick reference, the new vaccine administration CPT codes and
long descriptors are:

0001A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose

0002A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose

0011A: Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 100 mcg/0.5mL dosage; first dose

0012A: Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 100 mcg/0.5mL dosage; second dose

Availability

All the new vaccine-specific CPT codes published in today’s update will be available for use and effective upon each new coronavirus vaccine receiving Emergency Use Authorization or approval from the Food and Drug Administration. In addition to the long descriptors, short and medium descriptors for the new vaccine-specific CPT codes can be accessed on the AMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SAR-CoV-2 virus and the COVID-19 disease.

What You
Should Know:

– The HHS and
the American Society of Nephrology announces the launch of the COVID-19
Kindey Care Challenge.

– The $300k
challenge aims to identify and share these frontline solutions so all
communities can benefit. Winners will receive $20,000 each in recognition of
their solutions.

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The U.S. Department of Health and Human Services (HHS)
and the American Society of Nephrology (ASN) launched the KidneyX COVID-19 Kidney
Care Challenge . The $300,000 challenge invites eligible entities
or individuals to submit demonstrated solutions that reduce the transmission of
coronavirus among people living with kidney disease and/or reduce the risk of
kidney damage among people who contract the virus.

Challenge
Overview

The COVID-19 Kidney Care
Challenge seeks to identify replicable solutions from providers, staff,
patients, and caregivers and share them across healthcare communities. KidneyX
is particularly interested in demonstrated solutions that consider the patient
experience and could be implemented without requiring significant effort,
expertise, money, or other resources.

These solutions may be
applied in a range of settings — such as dialysis centers, clinics, hospitals, homes,
and transport. Solutions may address, but are not limited to:

– Data collection and
dissemination.

– Patient management and
monitoring.

– Education, training, and
communication.

– Supply chain and
resource management.

– Care setting logistics.

KidneyX is particularly
interested in solutions that consider the patient experience and could be
implemented without requiring significant time, expertise, money, or other
resources. Solutions that reduce the impact of the COVID-19
pandemic on communities facing existing health disparities are encouraged.

Why It Matters

The 37 million Americans living with kidney disease are at increased risk of severe illness from COVID-19. And acute kidney injury — sudden loss of kidney function — affects 20-40% of COVID-19 patients admitted to intensive care. The pandemic is exacerbating existing health disparities and social determinants of health, as kidney disease disproportionately affects low-income communities and people of African American, Asian, Hispanic, Latin American, Native American, or Pacific Islander descent. Individuals and organizations on the front lines have responded by quickly developing or adapting solutions for safely delivering kidney care during the pandemic.

“COVID-19’s heavy impact will be felt for decades to come, drastically intensifying inequities within the American healthcare system,” said KidneyX Steering Committee Chair Dr. John Sedor. “The COVID-19 Kidney Care Challenge, alongside KidneyX’s ongoing work, offers us a way to potentially improve outcomes for patients in the near term — as well as help set innovation roadmaps for the health challenges of the future.”

Evaluation Criteria

The judging panel will
assign up to five points for each of the criteria below, for a maximum of 20
points.

Impact: The confidence in the solution to reduce
SARS-CoV-2 transmission among people with kidney disease and/or reduce the risk
of kidney injury/disease among people who contract COVID-19.

Feasibility: The ease with which the solution could be
implemented, considering factors such as time, expertise, money, or other
resources required.

Adaptability: The extent to which the solution could be
adapted for other people or used in other care settings and/or geographies.

Ingenuity: The degree to which the submission offers a new
solution, demonstrates an improvement on an existing solution, or applies an
existing solution in new ways.

Entrants are invited to submit their solutions via an online
submission form. The submission form asks entrants to provide an overview
of the solution; available data to demonstrate the solution has, or could have,
a positive impact; and additional information to assess how the solution may be
implemented in other settings.

Challenge Timeline

Round 1 of the challenge
is now accepting solutions until December 4, 2020. Round 2 will be open to
eligible entrants from Round 1, as well as new eligible entrants who did not
enter the first round; the second round will accept solutions from December 9,
2020 to January 20, 2021. The judging panel will recommend winners from both
rounds to receive $20,000 each in recognition of their solutions.

What You Should Know: 

– 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. 

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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.”

What You Should Know:

– Stryker launches the industry’s first and only completely wireless hospital bed, ProCuity that can connect seamlessly to any nurse call system for every acuity level.

– ProCuity Bed Series designed to enhance patient and
caregiver safety for all acuity levels, reduce in-hospital falls

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Stryker, one of the
world’s leading medical technology companies, today announced the global launch
of the industry’s first and only completely wireless hospital bed, ProCuity.
This intelligent bed was designed to help reduce in-hospital patient falls at
all acuity levels, improve nurse workflow efficiencies and safety, as well as
help lower hospital costs. It is the only bed on the market today that can
connect seamlessly to nurse call systems without the use of cables or wires. 

Why It Matters

Up to one million patients experience a fall while being
treated in a hospital annually pre-coronavirus. The number of hospitalizations
since COVID-19 has increased resulting in a higher number of patient falls and
a challenging work environment for hospital staff. New Stryker research found
an overwhelming majority (97%) of nurses report having encountered a patient
having difficulty getting out of a hospital bed, with three quarters (75%) of
nurses report having encountered a situation where a patient has hurt
themselves

One Bed All Acuity Levels

Set at an industry-low height of 11.5
inches*, ProCuity is ergonomically designed with the latest
technologies to promote safe patient handling and help reduce fall-related
injuries, including intuitive patient positioning and bed alarms as well as
ergonomic side rails. Helping to address nurse call cable connectivity issues
prevalent in hospitals today, ProCuity can be equipped with fully
wireless features. Additionally, the bed’s easy-to-use touchscreens and other
key components make the job of caregivers easier and more efficient, while
providing for more enhanced patient experience.  

Other key features of the Procuity include:

Completely Wireless: ProCuity’s Secure®
Connect™ wireless solution makes it the only bed on the market that can connect
without cables to nurse call systems. Additionally,
with iBed Wireless, all bed data, including bed configuration
and exit alarm activity, are wirelessly compatible
with facilities’ hospital information systems (HIS). To help give
caregivers increased visibility to safe bed configuration and bed exit
alarm activity, ProCuity can also integrate with Stryker’s
optional patient-centric clinical dashboard, iBed Vision. 

Ergonomic Side Rails: Three-position Secure® Assist
side rails allow for easier patient entry and exit as well as nurse-patient
interaction. By working in a “clocking motion,” the side rails stay tightly
close to the bed, thus avoiding unnecessary interference with any real estate
next to the bed. 

Intuitive Patient and Bed Monitoring Systems: ProCuity’s exclusive
Adaptive Bed Alarm uses load cell technology to sense a patient’s weight and
will alert nurses if a patient is out of position or has left the bed.
With ProCuity’s iBed™ Watch system, all operational aspects of
the bed, from side rail positioning, head of bed angle and height, are
monitored to ensure that it is always in a safe position for the patient.
Caregivers are alerted immediately if any components are out of
position.   

Zoom Motorized Drive: To help caregivers move
patients safely and more
efficiently, ProCuity Z and ZM models come
complete with Zoom® Motorized Drive, a motorcycle throttle-like touch handle
that deploys the central fifth wheel. It also comes with one-touch electric
brakes.

Standard, Customizable Platform: From MedSurg
units to the ICU, the ProCuity bed series is designed to meet all
patient acuity levels. This helps make standardization across hospitals easier
while reducing hospital costs associated with renting specialty beds and the
need for bed transfers and extra staff.   

Enhanced Patient Experience: To provide greater
flexibility for taller patients, ProCuity has an integrated bed
extender, which allows the bed to stretch an additional 12 inches in length. It
also comes with a USB port and holder to allow patients to charge and store
personal electronic devices like phones. 

Guarantee Program: Through Stryker’s Financial
Guarantee program, the company promises customers will see a 50% reduction in
bed-related falls occurring on Stryker
beds utilizing iBed Wireless technology**. 

Global Launch: ProCuity is being launched
globally in over 70 countries, with a market focus in North America, Latin
America, Europe, the Middle East, Australia/New Zealand, and Asia. In the U.S.,
units will ship in January 2021. 

“Patient safety is at the foundation of everything we do at Stryker. With rising acuity rates leading to increased bed demand, coupled with the continuing challenge of in-hospital falls, we needed to find a solution to further enhance our response to some of today’s most pressing healthcare challenges,” said Jessica Mathieson, VP/GM of Acute Care, Stryker. “Leveraging our long history in innovation, ProCuity is the culmination of years of extensive research and feedback from nurses and other healthcare professionals to create what is truly a ‘brilliance in a bed’ solution. It was designed to improve patient outcomes and assist caregivers for years to come.” 

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.

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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.

The Palo Alto-based startup provides tools to support family caregivers, and uses predictive analytics to help them develop personalized action plans.

What You Should Know:

– Intermountain Healthcare collaborates with Vynca, a national leader in advance care planning solutions to prioritize and digitize advance care planning.

– The
collaboration enables integrated digital completion workflows and establishes a
single, centralized source of truth with built-in error prevention – enabling
the Intermountain Healthcare team to honor patients’ end-of-life
wishes, avoid unwanted healthcare utilization and reduce trauma for
families, caregivers and clinicians when faced with hard decisions in a medical
crisis.

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 Vynca, a national leader
in advance care planning solutions, today announced a partnership with Intermountain Healthcare, a
not-for-profit health system, to ensure advance care planning documents are
easily and reliably accessible to clinicians, patients and their caregivers
across the care continuum. The collaboration
enables integrated digital completion workflows and establishes a single,
centralized source of truth with built-in error prevention – enabling the Intermountain Healthcare team
to honor patients’ end-of-life wishes, avoid unwanted healthcare utilization
and reduce trauma for families, caregivers and clinicians when faced with hard
decisions in a medical crisis.

Why It Matters

Intermountain has
been at the leading edge of healthcare systems
identifying evidence-based innovations to achieve the Triple Aim – improving
experience of care, health of populations and
reducing per capita costs. As such, they recognized that improving
end-of-life care quality and reducing
unwanted healthcare interventions required a
new solution with the digital data capabilities to define and track
success. Intermountain is able to transform the
process of advance care planning by integrating Vynca’s
end-to-end solution with the health system’s existing clinical workflow and
their Cerner electronic
health record (EHR), who is also a Vynca partner. The collaboration enables customized outreach to
patients, shared decision making to digitally complete documents and ensures
documents are available to clinicians, patients and their selected caregivers.

“We are grateful to collaborate with an innovative health system like Intermountain to support providers and patients through the advance care planning process,” said Ryan Van Wert, MD, CEO and co-founder, Vynca. “Vynca’s solutions and services are designed to guide and empower individuals and providers to engage in these important conversations. Through shared decision making and document accessibility, patients can feel confident that their care preferences will be known across the care continuum.”

Integration
with Cerner EHR

A
lack of clarity in patient wishes, combined with concerns over document
accuracy and integrity and breakdowns in transitions of care have
historically led to low clinical confidence in advance care planning documents, as
well as patient safety concerns and unwanted healthcare utilization.
By integrating Vynca’s digital technology solutions
throughout the entire system, Intermountain gains
the ability to increase advance care planning conversations and documentation, access forms at
the point of care, decrease hospital mortality and
readmission rates and improve patient and family care satisfaction. 

“Vynca’s software solution provides an effective digital storage and retrieval system for advance care planning documents that integrates into our Cerner EHR,” said Mary Helen Stricklin, MSN, RNC, Intermountain’s system nursing director for palliative care. “Caregivers at various points of care are able to quickly glance to see if a patient has stated preferences for end-of-life care or life-support, so they can know, share and honor those preferences. The Vynca software also allows caregivers to complete electronic Provider Order of Life Sustaining Treatment (POLST) forms stating end-of-life wishes. Vynca provides for these forms to be signed electronically by the patient and provider with an immediate availability in their medical record. If patient wishes change, new documents are easy to create, and previous documents can also be viewed in their record.” 

Intermountain receives
business intelligence and reporting information on when, where and if advance care forms were
accessed at the point of care before critical
clinical decisions were made – delivering insights into utilization, success
and value from implementing a digitized advance care planning program. Vynca enables providers and patients to not just view
documents, but also continue discussions across all care settings.

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

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

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

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

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

Focus Area 1: Supporting the Frontline Workforce 

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

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

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

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

The following are several solutions to consider:

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

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

Focus Area 2: Maintaining Continuity of Care 

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

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

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

The following are several solutions to consider:

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

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

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

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

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

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

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

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

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About Victor Siclovan

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

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What You Should Know:

– physIQ has been selected by the National Institute of Health (NIH) to develop an innovative AI-based COVID-19 digital biomarker solution to address the COVID-19 pandemic.

– Early detection of COVID-19 decompensation in patients
is complicated by infrequent and non-specific clinical data. The first-in-kind
tool will collect and analyzes continuous physiologic data could provide early
clinical indicators of COVID-19 decompensation.

The National Cancer
Institute (NCI) and the National
Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (NIH), have
awarded physIQ a contract to develop an
AI-based COVID-19 Decompensation Index (CDI) Digital Biomarker to address the
rapid decline of high-risk COVID-19 patients.

Why It Matters

Today, high-risk COVID-19
patients and their providers are finding out too late that in the disease
continuum they are getting sicker and need urgent care. The new early warning
system under development could allow providers to intervene sooner when a
COVID-19 patient is clinically surveilled from home and begins to worsen.
Rather than relying on point measurements, such as temperature and SpO2, that
are known to be lagging or insensitive indicators of COVID-19 decompensation,
continuous multi-parameter vital signs will be used to establish a targeted
biomarker for COVID-19.

Despite the technological advances and attention paid to COVID-19, the healthcare community is still monitoring patient vitals the very same way as we did in the 1800s,” said Steven Steinhubl MD, Director of Digital Medicine at Scripps Translational Science Institute (STSI) and a physIQ advisor. “With the advances in digital technology, AI and wearable biosensors, we can deliver personalized medicine remotely giving caregivers new tools to proactively address this pandemic. For that reason alone, this decision by the NIH has the potential to have a monumental impact on our healthcare system and how we manage COVID-19 patients.”

COVID-19 Decompensation Index (CDI) Digital Biomarker Development

PhysIQ will develop and validate a CDI algorithm that builds off existing wearable biosensor-derived analytics generated by physIQ’s pinpointIQTM end-to-end cloud platform for continuous monitoring of physiology. The data will be gathered through a clinical study of COVID-19 positive patients in collaboration with the University of Illinois Hospital and Health Sciences System (UI Health) and build upon work already in-place for monitoring COVID-19 patients convalescing at home.

In the development phase of this project, physIQ and its clinical partner will monitor participants who are confirmed COVID-19 positive, whether recovering at home or following discharge from the hospital. During the validation phase, physIQ will evaluate lead time to event statistics, decompensation severity assessments, and the ability for CDI to predict decompensation severity.

“The application of the CDI may provide a universal indicator of decompensation,” said Karen Larimer PhD, ACNP-BC, study PI and physIQ’s Director of Clinical Development. “Application of this technology could detect COVID-19 decompensation and prevent hospitalization or morbidity events in both scenarios.”

The study is designed to capture data from a large, diverse
population to investigate CDI performance differences among subgroups based on
sex/gender and racial/ethnic characteristics. This project will not only enable
the development and validation of the CDI, it will also collect rich clinical
data correlative with outcomes and symptomology related to COVID-19 infection.

This index will build on physIQ’s prior FDA-cleared, AI-based multivariate change index (MCI) that has amassed more than 1.5 million hours of physiologic data, supporting the development of this targeted digital biomarker for COVID-19. This will enable new research and further insight into using digital health to advance the public health response.

What You Should Know:

– 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
other times.

– 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.

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Vocera Communications,
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
the application.

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.

What You Should Know:

– Today, Allergy Amulet announces $3.3M in seed funding
to launch the world’s smallest and fastest consumer food allergen sensor and
empower the allergy community by alleviating fears about what’s in their food.

– Allergy Amulet’s novel technology can improve the
quality of life for the millions of people living with food allergies or
intolerances by testing for common allergenic ingredients in seconds. The portable
device is made to fit every lifestyle — it’s small enough to fit on a
keychain, a necklace, or in a pocket. 

– Every 3 minutes, a food allergy sends someone to the
ER. For the 32 million Americans and between 220-520 million people globally
who live with food allergies, the potentially fatal disease is a constant
threat. 

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Allergy Amulet, a Madison, WI-based company empowering the
food allergy community by alleviating fears about what’s in their food, today
announces $3.3 million in seed funding led by TitletownTech, a joint venture between Microsoft and the
Green Bay Packers.

Every 3 Minutes, a Food Allergy Sends Someone to the ER

Food allergies affect 32 million Americans and between 220
to 520 million people globally—that’s one in 13 children and one in 10 adults.
They can be fatal, even after ingesting only trace amounts of a known allergen.
The company has developed the world’s smallest and fastest consumer food allergen
sensor, which is capable of testing foods for common allergenic ingredients in
seconds. The patented technology fits on a keychain, a necklace, a wristband,
or in a pocket, and doubles as a medical alert system, making it easier and
safer to manage food allergies and intolerances. 

Simple + Fast Detection

Allergy Amulet helps: 

Individuals with food allergies: It makes testing for food allergens
easy, giving people additional assurances that their food is safe. 

Parents with children who have food allergies: It gives
parents another tool to manage their children’s allergies, and helps children
live a normal childhood, maintain independence, and safely attend sleepovers
and birthday parties (or just school) with friends. 

Businesses: It gives restaurant owners, schools, childcare
providers, summer camps, and hotels the power of extra precaution to save them
time, money, and worry. 

How It Works

The Allergy Amulet is a fast and portable food allergen and
ingredient sensor, designed to fit every lifestyle. Its first-of-its-kind
detection platform pairs molecularly imprinted polymer (MIP) technology with a
conductive electrochemical platform to detect target allergenic ingredients.
The Amulet consists of two parts: a USB-sized reader (the “Amulet”) and a test
strip that houses the proprietary sensor chips. The case also accommodates
epinephrine and antihistamines, giving users a complete allergy care management
platform. 

For consumers, testing for food allergens is made possible
in four simple steps:

Step 1:  Users collect a sample of the food with
the test strip, and turn the top of the tester to grind the sample.

Step 2: A chip slides out from the test strip and is
inserted into the reader. 

Step 3: Test results appear on the reader within
seconds, indicating the presence or absence of the target allergen.  

Step 4: Optional: store test results in the mobile
app, connect and share results with the food allergy community, or hold down a
button on the reader to alert your emergency contacts.

The Team 

The Allergy Amulet team has deep connections to the
communities they serve — Barnes has managed life-threatening food allergies
since childhood, and experienced a near-fatal anaphylactic event as a teenager.
After meeting her Co-founder and Scientific Advisor, Dr. Joseph BelBruno, a
Dartmouth chemistry professor emeritus with life-threatening food allergies,
the two worked to make Allergy Amulet a reality.  

The company holds one issued U.S. patent with multiple
applications, and its waitlist has thousands of individuals signed up to
participate in an early beta release, scheduled to kickoff later this
year. 

Expansion Plans

This infusion of new capital will be used to manufacture beta units, help to launch pre-orders, expand product offerings to cover more allergens, grow the company’s world-class team, add additional restaurant and company partners to its roster, and educate consumers on the benefits of additional food allergen management tools. In addition to Titletown, its seed financing includes participation from Great North Labs, Colle Capital, Great Oaks VC, DeepWork Capital, Dipalo Ventures, and Bulldog Innovation Group.

“The current standard of care — avoiding certain foods,
injecting epinephrine to treat reactions, and visiting the emergency room —
can take a serious emotional, financial, and physical toll on individuals,
caregivers, and families,” said Abigail Barnes, Co-founder and CEO of Allergy Amulet.
“Our hope is to help individuals more safely engage in the activities that
bring them joy, whether that means going to a restaurant with friends and
family or eating a cupcake at a party.”

Availability

Allergy Amulet is slated for pre-sales Fall of 2020 and
launch Fall of 2021.   

What You Should Know:

– Philips announced the launch of Virtual Care Station, a
telehealth environment delivering virtual care services to patients in
convenient neighborhood locations, such as retail settings, libraries, town
halls and universities.

– Using proven Philips technology developed for the ATLAS
program (Accessing Telehealth through Local Area Stations), which was created
to serve healthcare needs of U.S. Veterans, Virtual Care Station provides all
patients, including those in underserved rural or urban areas, with a low-cost,
community-based option to improve patient outcomes while minimizing infection
exposure.

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Philips, today announced the launch of Virtual Care Station, a telehealth environment that delivers virtual care services in convenient neighborhood locations such as retail settings, libraries, town halls, and universities. The pod-based solution connects provider and insurance networks, allowing health providers and patients to have a local, community-based choice for care.

Whether in underserved rural or urban areas, Virtual Care
Station helps deliver on the Quadruple Aim by giving patients access to virtual
face-to-face care, and is designed to help improve clinical outcomes, lower
costs and increase patient and staff satisfaction. Virtual Care Station is
based on Philips technology developed for the ATLAS program (Accessing
Telehealth through Local Area Stations), which was created to serve the
healthcare needs of U.S. veterans.

Why It Matters

With the COVID-19 pandemic came a boom in the telehealth
industry, serving as a viable way to reduce staff and patient exposure to
infection, preserve PPE and lessen the impact of patient surges. However, at-home
telehealth isn’t always an option for those without reliable internet access,
or private areas to have sensitive clinical conversations.

Built with insights from patients, physicians and
caregivers, and designed to emulate traditional face-to-face visits, the
Virtual Care Station pod-based solution promises:

– Camera, lighting and speakers designed for enhanced
patient assessments

– Spacious layouts to accommodate the needs of patients in
wheelchairs or with service dogs

– Supplemental in-home virtual telehealth check-ins to track
patients between visits, allowing clinicians the opportunity to manage health
escalations

“By expanding our telehealth solution, we hope to give providers an option to engage in population health and support patients closer to home in lower cost settings that can lead to the potential for more follow-up visits, and the opportunity for clinicians to identify at-risk patients earlier and manage health escalations,” said Vitor Rocha, Chief Market Leader for Philips North America.  “Not only does it mean the convenience of shorter drive times for patients, it could mean better health outcomes and a safer environment for providers as people benefit from getting the quality care they need in the right place at the right time.”

What You Should Know:

– Magellan Health launches a pilot program for a group of
providers that will begin using video games as therapy for children with autism
and other behavioral health conditions. 

– As part of the pilot program, patients will be given
access to the video platform developed by Mightier, a digital health company
born out of Boston Children’s’ Hospital and Harvard. 

– The games include a wearable heart rate monitor &
tablet loaded with 25 different games, each designed to help children learn how
to regulate their emotional reactions and manage stress, anxiety through deep
breathing, etc.

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Magellan Health,
Inc., one of the nation’s leaders in behavioral health, today
announced a collaboration between Magellan Healthcare (Magellan), the
behavioral and specialty healthcare segment of the company, and Neuromotion,
Inc., developer of Mightier, an
in-home digital platform that empowers children to learn lifelong emotional
skills through play, to make Mightier available to certain Magellan members in
a pilot program.

“Children are increasingly being diagnosed with behavioral
health disorders and the impact is felt by the entire family,” said Matthew
Miller, senior vice president, behavioral health, Magellan Healthcare. “We are
proud to launch this pilot with Mightier as a cost effective,
outcomes-based treatment. By teaching children how to navigate daily challenges
through visual technology they learn how to cope and properly manage their
stress in a meaningful and fun way.”

Pilot Program Details

Developed at Boston Children’s Hospital and Harvard Medical
School, the Mightier program pairs video games with clinically validated
emotion calming skills to help kids learn through play. In addition to the
video game platform, caregivers are supported with a personalized dashboard to
track progress, access to the Mightier Parent community, and 1-1 coaching with
a licensed, master’s level clinician to tailor the program to
their individual family needs.

Over the last three years, Mightier has reached more than
25,000 families worldwide, with thousands of new families being added every
month. Over 75 percent of families report improvement made possible by an
unwavering commitment to building an engaging experience supported by clinical
expertise.

By combining Magellan’s market-leading clinical experience and network of providers specializing in autism with Mightier’s innovative technology, children and families participating in the pilot will receive high-quality care focused on positive outcomes.

Jason Kahn, PhD, Mightier’s Chief Scientific Officer says the collaboration will set the stage to positively impact families and improve outcomes for children with ASD. “Mightier is a new tool that supports the increasing diagnoses of autism and other behavioral health disorders. Our solution meets kids and families where they are: at home. The pandemic amplifies this need even further, we need new ways to support kids and families. Our digital program can play a significant role by providing evidenced-based, personalized interventions from the comfort of home.”

“The numbers don’t lie,” is a famous old adage and quite appropriate with regard to the rapid rise and deployment of telehealth solutions in the medical community. It may have taken a global pandemic for society to recognize and investigate the rewards of its adoption, but statistics reveal that telehealth’s moment has indeed come. And it certainly seems like it’s here to stay.

How did we come so far, so fast? By undertaking forward-thinking policies and bold action, the health care industry nimbly and quickly adopted this technology to mitigate the immediate threat of COVID-19’s lethal contagiousness.

As it pertains to effectiveness, the federal government’s overwhelming response to shore up commerce, industry, and unforeseen unemployment levels has been met with mixed reviews. But the designated programs specific to the healthcare industry have been an undeniable success. Thanks to a sudden and massive infusion of funding and support for telehealth medicine, initiated by federal and state governments, the health care industry is witnessing a historic sea-change in its processes, procedures, and practices. The widespread, rapid adoption of telehealth solutions is the prime example.

Beyond the impact of funding, now in the hundreds of millions of dollars, the utilization of telehealth also benefited from additional measures which simultaneously boosted its appeal for trial and adoption. For the first time, health care providers were permitted to use telehealth to treat Medicare patients, opening the door for insurance companies and state governments to follow suit.

Subsequently, many of the nation’s largest private insurance providers then took it a step further—waiving copays for patient consultations via telehealth. For both the insured and uninsured, the elimination of out-of-pocket costs is likely to increase consumer trial and adoption of virtual physician visits. The bold and swift decisions to relax certain restrictions and requirements within the traditional health care model has created fertile ground for telehealth’s trial and adoption.

The use of telehealth as a practical solution has been available for some time, but its adoption by consumers faced difficulty, as many perceived virtual visits would not measure up to the value of in-person doctor appointments. But recent research and surveys on telehealth’s usage reveal this barrier may be crumbling. In April, Sage Growth Partner (SGP) and Black Book Market Research collaborated on a survey revealing that, prior to COVID-19, only a quarter of respondents had used telehealth. But amidst the backdrop of our current pandemic, nearly 60% of those surveyed say they are now likely to consider telehealth in addressing their personal health care needs. Additionally, other studies have concluded that after an initial trial of telehealth, a majority of consumers expressed high levels of satisfaction with their experience—and a strong likelihood of follow-up use.

Yet only viewing the benefits of telehealth through the narrow lens of a physician-patient consultation is to overlook its full value proposition across the health care industry as a whole. What are some other examples of how telehealth is changing the health care landscape for the better? Here are a few ways in which its adoption and use are improving our models of caregiving:

Protecting our Collective Health

Amidst the COVID-19 pandemic, an obvious benefit is the option to seek care remotely while maintaining isolation through the practice of social distancing. There are no crowded waiting rooms or hospital hallways to deal with, thereby lessening the risk of exposure and infection to patients and caregivers alike.

Meeting the Caregiver Demand 

In some areas of the U.S., a steep demand for health advisors has spiked, due to postponement of elective surgeries and the need for ongoing treatment of patients with chronic health care conditions. Pack Health, Birmingham, Al. chronic care coaching provider utilizes certified Health Advisors to help patients get access to care options while helping them develop self-management skills to gradually improve their conditions. With a surge of over 50,000 new patients, the company rapidly transformed its onboard training program to a telehealth platform to meet the demand for new hires. In doing so, Pack Health was able to scale up staffing much faster and cheaper than ever before.

Impact on Rural Health Care

According to the consultants at Guidehouse, one in four rural hospitals are deemed high-risk for closing—and this was reported before the pandemic. Through the use of telehealth platforms, a large portion of the rural United States can now receive access to clinical care services and at-home monitoring services. In effect, telehealth can become a new tool to help alleviate rural America’s serious deficit of accessing critical care. 

Impact on Mental Health Care

The rise in telehealth adoption is also having a positive effect for patients who require access to mental health services. Even before the pandemic, many people with various mental health needs chose not to seek treatment due to perceived social stigmas. Using telehealth as a solution, they can now obtain access to providers, care, therapy, and treatment in the privacy of their homes. Likewise, those patients already under the care of mental health professionals are able to keep routine appointments, in spite of COVID-19’s disruption.

As for telehealth’s future, it is certain to benefit in multiple ways from its current trial by fire. Perhaps there is no better proving ground for assessing its total value proposition than during a global health crisis that shows no sign of relenting. Being at the right place at the right time can be an invaluable proving ground and the future of the telehealth industry appears to be positioned for staggering growth. In April, Global Market Insights, market research, and consulting company released a report predicting the telemedicine market will reach $175.5B by the year 2026. 

Furthermore, healthcare providers need to think of telehealth as only one component of comprehensive care. Patients need to have several different touchpoints throughout the healthcare continuum to ensure the best quality of care. Examples of these touchpoints include advanced biometric wearables, real-time data collection, and advanced analytics to provide actionable data for patients and care teams.

As technology continues to drive the rapid pace of improvements in digitalization, platforms, high-speed broadband access, and mobile devices, the widespread adoption of telehealth and telemedicine solutions will become even more commonplace. As a result, the ever-increasing capacity to improve our traditional health care delivery models may indeed be forever changed for the better.

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About Ernie Ianace

Ernie Ianace is the Executive Vice President of Sales and Marketing at VitalTech® Affiliates, LLC. Based in Plano, TX, VitalTech is a rapidly growing provider of fully integrated digital health solutions and smart biomedical wearables that provide real-time monitoring for patient wellness and safety.  The company’s connected care platform, VitalCare®, enables health systems, skilled nursing facilities, home health providers, physicians, and senior living facilities to streamline workflows while improving health outcomes, increasing patient safety, and lowering the cost of care.

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Prior to the outbreak of COVID-19, the healthcare industry in the United States was in the midst of an intense refocusing on patient-centered care. This evolution was defined by a number of innovations, policies, and even federal reimbursement programs that prioritized emphasis on and impact on the patient experience. It led to changes in everything from the quality of hospital food, valet parking, and room amenities to fundamentally reimagined standards of care for even mundane procedures like blood draws.

The rapid spread of coronavirus and the consequences of the resulting pandemic on health systems around the country are significantly reframing this dynamic. An all-in focus on treating COVID-19 patients sidelined elective procedures, routine care, and caused many patients to avoid or defer timely treatment for conditions like heart attacks and strokes. The result is that our country’s health system is just now emerging from “on pause” with truncated timelines and “build the plane as you fly it” mentalities for how to restart and even contemplate a new abnormal.

As we peer ahead to imagine what the future might look like, it’s clear that patient experience as we knew it just earlier this year will cease to exist. Instead, it will be replaced by the dual and interrelated realities of patient and practitioner demands. These two groups harbor pandemic-driven negative perceptions, fears, and concerns about our healthcare infrastructure that have the potential to impair the practice of even the most basic medical care.

Routine Care Avoidance

These fears from a patient perspective were brought home to me twice in the past few weeks. Since I was diagnosed with Crohn’s disease as a teenager some 30-years ago, I have had regular visits with my physician. Normally, I am a “people person” who prefers face-to-face interactions with those in my personal and professional lives. But last month, I conducted my first-ever telehealth appointment for a routine check-up because I refused to set foot in a hospital.

It simply makes sense to handle the routine at a remove – why expose me and my subpar immune system unnecessarily? I was pleasantly surprised by the experience itself. At a time when we’re all meeting over Zoom, having my regular check-up “at a distance” felt natural and informative – and it was just about the only way I’d ever consider engaging with the hospital…at least for now.

Amidst this all, my three-year-old terrified my wife and me when he developed a 105-degree fever. We are no strangers to childhood fevers, but this was a frightening scenario made all the more so because of the growing prevalence of COVID-19 at the time. After much consultation, handwringing, and debate, we decided to treat him at home instead of risk exposure in the hospital.

I’m relieved to say that everything turned out fine and it was a short-lived spike, but it’s a telling insight into the mindset of patients today – including those of us who work in the healthcare industry. Even a minor fever normally sends most parents rushing to their child’s doctor’s office or emergency room. To incorrectly assume that a hospital was a greater risk to my child then self-treating a 105-degree fever speaks to the irrational fear and misinformed decision-making this pandemic has fostered and its power to keep us all out of the healthcare system.

Practitioner Skepticism and Resentment

This same basic risk-reward computation will also surely play out for our healthcare workers. We’ve already seen nurses and physicians critique their employers for what they feel is inadequate protection or faulty leadership and priorities during this outbreak. While many have remained on the job out of a sense of duty to their patients, the growing doubt and resentment will certainly linger long after the pandemic has (hopefully) subsided.

As we learn to live with the virus and we begin to see electives and routine care once again allowed, it’s easy to envision a range of workers from transport and cafeteria staff to nurses and aides deciding to stay away from the job until they feel reasonable expectations about safety, prevention, and compensation are being met. And the number of clinicians and healthcare staffers who will either retire or seek employment in alternative industries, could, unfortunately, become significant.

Planning for the Hospital of Tomorrow

Health system leaders must begin planning now for this new reality. Conversations have certainly already begun about the hospital of the future and what changes lie in store for standards of care, physical infrastructure and layout, budgets, workplace safety, and practitioner well-being, and innovation paths.

But, top-down decisions based on historical trends or projections absent real input from patients and practitioners at this moment will lead to a long-term undermining of confidence in the system. There is simply no modern precedent for this sudden and dramatic shift in expectations, and Patient Advisory Councils alone won’t cut it.

The reality is that the lists of “nice to haves” and “need to have” for patients and practitioners will become increasingly polarized, with the latter defining the table stakes they will require before returning to the hospital. These demands will then become the financial lens through which health systems and leaders must make future decisions about standards of care, innovations, and investments.

If they have not already, providers will soon realize they are no longer in the driver’s seat when it comes to care decisions and that employee and consumer trust in them has been severely compromised. They must begin to take strong and decisive action to meet patient and practitioner demands or people will not walk back through their doors. Over the coming months, no decision about a hospital or its operation will be made without first asking how it not only satisfies patient and practitioner demands but also reassures and delights both stakeholders.

So how must health systems think about and plan for this eventuality?

Protection & Safety

Outbreaks of antibiotic-resistant bugs or Ebola have always made patients and even practitioners queasy about entering the hospital, but these were often short-lived episodes. Now, health leaders must double down on promises to keep patients and practitioners safe in the face of an invisible but persistent virus that has changed our trust in the system.

This response could take the form of deliberate decisions on hospital infrastructure and layout, bringing changes to the very physical plant that supports our medical care. The concept of “social design” looks at how everything within a hospital’s walls contributes to the level and quality of care it can deliver. From the placement of beds to ventilation systems to the flow of staff into and out of a nursing station, leaders must revisit these basic assumptions post-COVID. And a new onus exists for administrators to communicate these decisions and capabilities to patients and potential patients in their encachment area.

Systems will also likely maintain existing social distancing guidelines, perhaps even taking them a step further with wayfinding in the halls and waiting rooms using explicit signage and direction. Enforcement of these protocols will be essential. And of course, systems must stock and deploy adequate stores of PPE…easier said than done.

New infection standards will also emerge. Consider the fast boil of Kinnos, an upstart founded amidst the Ebola crisis with a new technology that enforces real-time quality control and compliance every single time a surface is disinfected.

Transformative Care

We have already seen the dramatic remaking of care in the midst of COVID-19. The boon in telehealth is just one example that will certainly continue to grow and expand. But there will certainly be more changes on the horizon, perhaps new robotic technologies for arms-length treatment protocols and remote or personal health monitoring from home, as a result of this outbreak. But it will all be focused on transforming how patients and practitioners engage with health systems across the country – while both reassuring and delighting.

Community Engagement

Finally, recent events remind us that we are all members of the community, and hospitals have an integral seat at the table as facilitators of population health. Systems and leadership cannot rely on philanthropy and good corporate citizenship, they must actively engage on the issues that matter most to their staff and patients – as these stakeholders are members of the extended community.

From food drives to financial education to emerging health policies, hospitals must become more deeply entrenched alongside those in their communities. The early and immediate signs are promising, as our hospitals are our extended homes. I’m cautiously optimistic, and appreciative of all that our caregivers and administrators are doing to keep us healthy.

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About Eric Stone

Eric M. Stone is the Co-Founder and Chief Executive Officer at Velano Vascular. A patient advocate and serial healthcare entrepreneur, Stone is a National Trustee of the Crohn’s and Colitis Foundation. Prior to Velano, he served as the Vice President of Sales and Marketing of Molecular Health, and earlier in his career launched a series of pioneering conventional cardiology devices for Abbott while based in Brussels, Belgium, and California.

Stone was a founding member of Model N’s Life marketing with Trilogy Software and has since co-founded social sector programs at Harvard and Wharton. He served for a decade on Harvard University’s Alumni Association (HAA) Board of Directors and is a past and current Director and Advisor to multiple healthcare upstarts. Stone received an MBA from The Wharton School, a Master’s from Harvard University, and a BA from the University of Pennsylvania.

What You Should Know:

– Allscripts and Microsoft sign a five-year partnership extension to support Allscripts’ cloud-based Sunrise electronic health record and drive co-innovation.

– The alliance will enable Allscripts to harness the power of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams, and Power BI, creating a more seamless and highly productive user experience.

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Today Allscripts and
Microsoft Corp. announced the
extension of their long-standing strategic alliance to enable the expanded
development and delivery of cloud-based health IT solutions.
The five-year extension will support Allscripts’ cloud-based Sunrise electronic health record
(EHR), making Microsoft the cloud provider for the solution and opening up
co-innovation opportunities to help transform healthcare with smarter, more
scalable technology. The alliance will enable Allscripts to harness the power
of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams
and Power BI, creating a more seamless and highly productive user experience.

Partnership Impact for Cloud-based Sunrise EHR

Sunrise is an integrated EHR that connects all aspects of
care, including acute, ambulatory, surgical, pharmacy, radiology and laboratory
services including an integrated revenue cycle and patient administration
system. Cloud-based Sunrise will offer many added benefits beyond the
on-premise version that will improve organizational effectiveness, solution
interoperability, clinician ease of use and an improved patient experience.
Client benefits include a subscription model delivering faster implementations
and lower annual upgrade costs, helping organizations leverage the software
without increasing burdens on their internal IT resources.

The cloud-based Sunrise solution will provide enhanced
security, scalability and flexibility, as well as the opportunity to add new
capabilities quickly as business needs and the cloud evolve. The cloud-based
solution will also include expanded analytics and insights functionality that
can quickly engage with the Internet of Things. Finally, the cloud-based
Sunrise solution will include a marketplace that enables healthcare apps and
third parties to easily integrate with a hospital EHR. Allscripts clients will
begin to see these updates by the end of 2020.

Why It Matters

“The COVID-19 pandemic will forever change how healthcare is
delivered, and provider organizations around the world must ensure they are
powered by innovative, interoperable, comprehensive and lower-cost IT solutions
that meet the demands of our new normal,” said Allscripts chief executive
officer Paul Black. “Healthcare delivery is no longer defined by location —
providers need to have the capability to reach patients where they are to truly
deliver the care they require. Cloud solutions, mobile options, telehealth
functionality — these are the foundational tools for not just the future of
healthcare, but the present. Collaborating with Microsoft, the leader in the
public cloud sector, we will efficiently deliver the tools caregivers need to
improve the clinical outcomes of their patients and operational performance of
their organizations.”