Category: Heart

Among the many evolving technologies in the healthcare industry, there may be none more important or impactful than remote patient monitoring (RPM) hardware and software solutions. This technology is opening up new possibilities in extended healthcare – saving patients money, limiting visits to the doctor’s office, and providing healthcare professionals with powerful tools for diagnosing and treating patients. As these tools continue to mature, software and hardware developers are solving critical challenges to enhance their capabilities and impact.

According to a 2019 report published by the Consumer Technology Association, 88% of healthcare providers have invested in, or are evaluating investments in, RPM technologies and services. Increased demand is driven primarily by the rising age of the baby boomer generation and an increase in chronic disease among the American population.

Medical device manufacturers are helping healthcare providers gather data on patients everywhere they go using wearable technology. These connected health monitoring devices come in the form of smartwatches, wearable heart monitors, blood pressure kits, and more. They’re developed with mobile communication technology that sends data using a patient’s smartphone or directly from the wearable device to software platforms that make the information available to healthcare providers and first responders, notifying them in real-time of accidents and/or healthcare concerns. 

The need to monitor patients outside of a clinical setting, especially during the pandemic, has become extremely important and demanding. We’re witnessing limited capacity in hospitals, significant challenges related to social distancing and other pandemic-related stressors. RPM technology can be a tremendous help in mitigating these issues. 

Despite significant advancements in the art of the possible, RPM is still in its infancy in terms of the potential impact it could have on health and safety. Data security, data accuracy, and systems integration are core challenges that developers of the next generation of innovative RPM devices need to address. This includes overcoming technological and regulatory barriers preventing patient data from being received, making use of machine learning algorithms, and combining real-time data with medical histories. 

Developers of RPM devices must also move beyond model-building and into operationalization for the real potential of technology to be realized and create value for healthcare professionals. Specifically, abstract concepts need to be turned into measurable observations. In its blog “Operationalization of Machine Learning Models,” Open Data Science opines, “Data scientists create beautiful models that no one can understand, and the models don’t usually translate to real business value. If a process is isolated from the enterprise, the insights won’t feed into the overall process.”

To make significant advancements in RPM innovation, software developers must build a digital framework that includes:

– Data storage

– Security

– Middleware

– Machine learning and artificial intelligence

– User interface and user experience 

It begins with a data storage framework that organizes legacy data and real-time data in the cloud and feeds it into the algorithm. Volumes of data can be huge and the types of data can be various, yet they need to be monitored and managed by a single system. 

The next layer of the framework is data security. The challenge is developing a security framework that keeps data confidential for unauthorized users. At the same time, patients must be allowed to establish clear boundaries of ownership over the data, whether that access is given to family members or primary care providers. In the case of an emergency where the patient is incapacitated and unresponsive – the authorized user must be able to quickly access the data to treat the patient.

Next is the middleware, which is software that provides common services and capabilities to applications outside of what’s offered by the operating system. The middleware is customized to meet the needs of the user, in this case, the healthcare provider. 

All of the organized and secure data is then funneled into AI and ML algorithms which will learn and recognize patterns derived from a wide range of data points. There needs to be a high level of trust in the data derived from RPM devices. This is achieved through the collection and proper management of data from large and diverse demographic groups. For example, if AI and ML algorithms are fed significant amounts of data from African American females between the age of 50-65, the algorithm can begin to recognize patterns that lead to more informed diagnoses and patient care plans.

The final piece of framework is the user interface and user experience. One of the most significant challenges to developing a healthcare platform for RPM devices is engineering how the data is presented to a healthcare provider. These professionals don’t have time to learn how to decipher data points on a screen –designers and engineers need to create a user interface that translates patterns in the algorithm into valuable and easy to read information that can improve patient outcomes. 

When it all comes together, the results are rewarding. Let’s take a look at one of the most promising examples of RPM in the real world today. Lark Health, a chronic disease prevention and management company that uses a cognitive behavioral therapy framework, conversational A.I., and connected devices to help people stay healthy and in control of their conditions. Lark’s A.I. is continuously learning how to personalize the experience for the member and communicates via text-message-like interactions to monitor patients remotely, 24/7, while live nurses and health coaches are available when issues need to be escalated such as severe readings or medication changes.

The challenge of getting the most out of RPM technology is not an easy one. It takes high-level expertise in design, software engineering, and data science, as well as knowledge of AI and ML algorithms to learn how to operationalize it. But with the right framework and data, RPM will continue to revolutionize the healthcare industry.

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Roberto Martinez, president, Encora, MexicoRoberto Martinez has been working in the software nearshoring industry for 20+ years. As a senior executive, he is familiar with the needs, obstacles, and challenges faced by small startups as well as big teams. As a leader at Encora, Roberto has helped the company acquire important clients such as OpenTable, Siemens, ZED Connect (Cummins), and others. Roberto has a software engineering background from the prestigious Tecnologico de Monterrey and strategic direction from IPADE.

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What You Should Know:

– Tyto Care announces the launch of its fingertip Pulse
Oximeter device, allowing users to measure their own blood oxygen saturation
level and heart rate from the comfort and safety of home.

– Expanding its clinic-quality remote capabilities, TytoCare users will be able to perform a remote blood oxygen exam, allowing clinicians to better monitor patients with COVID-19 and chronic lung or heart conditions.

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 Tyto Care, a New York City-based all-in-one modular device and examination platform for AI-powered, on-demand, remote medical exams, today announced the release of its FDA-cleared fingertip Pulse Oximeter (SpO2) medical device. The Pulse Oximeter enables TytoCare users to check blood oxygen saturation levels and heart rate, which are crucial for the monitoring of chronic conditions and COVID-19.

Fingertip At-Home Pulse Oximeter Measures Blood Oxygen and Heart Rate

The Pulse Oximeter connects by cable to the TytoCare device.
Users who choose to perform the blood oxygen exam are prompted to place their
finger in the SpO2 device for 15 seconds. Upon completion of the
exam, the blood oxygen and heart rate results appear immediately on the
handheld TytoCare device and the Pulse Oximeter adaptor itself and are also
recorded within the TytoCare platform for review by the clinician and sent to
the patients’ EHR
(Electronic Health Record). If the examination is performed in real-time
during a live telehealth visit, the clinician will see the results immediately
in the TytoCare Clinician Dashboard. Clinicians are able to assess the
reliability of the results recorded by viewing the heart rhythm graph generated
during the exam.     

Why It Matters

This expansion of Tyto Care’s virtual examination solution
is bringing the company even closer to full remote, clinic-level testing
capabilities from the comfort of home. The Pulse Oximeter is a key tool for
monitoring high-risk or infected individuals during the COVID-19 pandemic, as
well as for post-discharge care and home hospitalization. The company’s Pulse
Oximeter device also enables seamless monitoring of patients with chronic lung
and heart conditions, critical during routine times as well.

“We’re excited to announce the release of our Pulse Oximeter, providing patients with more tests that bring the clinic directly to them,” said Dedi Gilad, CEO and Co-Founder of Tyto Care. “The COVID-19 pandemic thrust telehealth into the spotlight, and we are constantly enhancing the TytoCare platform to ensure users have access to the most comprehensive telehealth solution available. The pandemic will eventually be behind us, yet telehealth will remain a key component in the future of healthcare, providing patients with the best possible remote care and clinicians with actionable insights into their patients’ health.”

Availability

The SpO₂ device is available in the
United States and Israel through partnering health systems. In the future, the
device will also be available in Europe, South Africa, and Asia.

The COVID-19 pandemic, which has taken 270,000 American lives to date, has shined a light on another crisis — the U.S. currently has no standardized system for reporting public health data. Health departments all over the country resort to using paper, fax, phone, and email to transmit and receive critical information, and essential healthcare workers are spending precious time retyping data into systems from printed reports and PDFs.

At the heart of this lack of a centralized infrastructure for reporting public health data is the 10th Amendment of the U.S. Constitution, which says, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” Because of this amendment, the federal government — including the CDC — is not able to mandate that states, providers, or public health entities use a centralized reporting mechanism for managing all public health data. Further, the 10^th Amendment also allows states to set up their own IT systems independently of other states and the federal government. The CDC then has to beg for data that sits in bespoke, disparate information systems in each state and territory.

Congress has tried three times in the last fourteen years to fix the issue. In 2006, it passed the Pandemic and All Hazards Preparedness Act (PAHPA), which required the CDC to establish the near-real-time, electronic, nationwide, public health data-sharing capability. Four years later in 2010, the U.S. Government Accountability Office (GAO) reported that not even the most basic planning steps were taken to establish the network. 

Then in 2013, Congress passed the Pandemic and All Hazards Preparedness Reauthorization Act (PAHPRA), which unsuccessfully called for a near real-time interoperable public health data exchange network. Finally, just months before the current pandemic, Congress passed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI), and our need for such a system is now greater than ever.

An Interoperable Public Health Data System

The U.S. Department of Health and Human Services (HHS) needs to lead the creation of a modern public health data approach on behalf of all public health agencies throughout the country, including the CDC. HHS was given $1 Billion for public health data infrastructure modernization in the recently passed CARES Act.

A modern approach to public health data would cost a fraction of that and must consist of three things: the creation of a gateway to link and securely move data between public health entities, the adoption of and adherence to widely accepted health data standards, and the creation of a cloud-based data hub for transparent analysis and reporting of data.

Creation of a Data Gateway

Data must be complete, timely, and accurate. A single federal data gateway would allow for the secure, two-way flow of data between all of the components of the public health ecosystem. The idea is not to create new, custom systems as we have done in the past, but to create a single gateway system at the federal level that stitches all existing data systems together using modern application programming interfaces (APIs). Such a system will allow data to timely flow between jurisdictions and up to the CDC so that we can collectively inform public health decision-making and public policy. 

We should leverage recently adopted interoperability standards to connect data from existing Electronic Health Records (EHR) and insurance claims systems wherever possible to avoid duplicate entry of data by essential workers.

Adoption of a Standardized Data Model

We need to encourage state and local health organizations to use and promote a standardized approach to collecting data at the points of care, testing, and immunization. 

Fortunately, the public health data interoperability challenge can be solved by supporting the private sector’s move to a standardized data model for healthcare data. Congress spent billions of taxpayer dollars over the past several years incentivizing healthcare providers to adopt electronic health record systems and data interoperability standards, most recently as part of the 21^st Century Cures Act, which just saw its regulations go into effect this year. Healthcare providers are busy preparing to accommodate the Cures Act’s updated standards and requirements. The federal government should eat its own dog food by adhering to the same standards when creating the new gateway.

The two main standards to pay attention to are Fast Healthcare Interoperability Resources (FHIR) and the United States Core Data for Interoperability (USCDI). Major IT and EHR companies like Google, Amazon, Microsoft, IBM, Oracle, Salesforce, and Cerner have pledged to support these standards meaning they can immediately begin supporting a new gateway and helping America’s public health system quickly modernize. 

A Cloud-Based Data Hub

Once the data is available, flowing, and standardized, we need a national, cloud-based data hub to begin gaining insights from COVID infection rates, vaccinations, and many other key indicators important to recovering from the pandemic.

Led by HHS with support from OMB and the White House, this new system could be set up within months. There are well-known tools and virtual computing environments that could be put to use right away. A modern data hub would benefit not only the federal government but also the research community and academia, as these organizations play very important roles in helping us further understand and respond to the pandemic.

Most importantly, such a hub would provide transparency and accountability, giving confidence in the data being reported by providing independent reproducibility of conclusions from data analysis.

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About Ed Simcox

Ed Simcox is the chief strategy officer of LifeOmic, the creator of LIFE mobile apps, JupiterOne cloud compliance and security operations software, and the Precision Health Cloud platform in use at major medical and cancer centers. Prior to joining LifeOmic, Ed served as the Chief Technology Officer (CTO) at the U.S. Department of Health and Human Services (HHS), the largest civilian government agency in the world. He led efforts at HHS to effectively leverage data, technology, and innovation to improve the lives of the American people and the performance of the Department’s 29 agencies and offices. While CTO, he also served as Acting Chief Information Officer at HHS, where he oversaw the Department’s IT modernization efforts, IT operations, and cybersecurity

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What You Should Know:

– FCC announces initial 14 pilot project selected for $100M Connected Care Pilot Program that will support connected care service across the country and focus on low-income and veteran patients.

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The Federal Communications
Commission (FCC) today announced an initial set of 14 pilot projects with
over 150 treatment sites in 11 states that have been selected for the Connected
Care Pilot Program.  A total of $26.6 million will be awarded to these
applicants for proposed projects to treat nearly half a million patients in
both urban and rural parts of the country. 

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Connected Care Pilot Program Background

Overall, this Pilot Program will make available up to $100
million over a three-year period for selected pilot projects for qualifying
purchases necessary to provide connected care services, with a particular
emphasis on providing connected care services to low-income and veteran
patients.  

The Pilot
Program will use Universal Service Fund monies to help defray the costs of
connected care services for eligible health care providers, providing support
for 85% of the cost of eligible services and network equipment, which include:

1. patient
broadband Internet access services

2. health care
provider broadband data connections

3. other
connected care information services

4. certain
network equipment

These pilot projects will address a variety of critical
health issues such as high-risk pregnancy, mental health conditions, and opioid
dependency, among others. Here is the list initial list of healthcare providers
that were selected into the Pilot Program:

Banyan Community Health Center, Inc.,
Coral Gables, FL. 
Banyan Community Health Center’s pilot project seeks $911,833 to provide
patient-based Internet-connected remote monitoring, video visits or consults,
and other diagnostics and services to low-income and veteran patients who are
suffering from chronic/long-term conditions, high-risk pregnancy, infectious
disease including COVID-19, mental health conditions, and opioid
dependency.  Banyan Community Health Center plans to serve an estimated
20,847 patients in Miami, Florida, 85% of which are low-income or veteran
patients.

Duke University Health System, Durham,
NC.  Duke
University Health System’s pilot project seeks $1,464,759 to provide remote
patient monitoring and video visits or consults to a large number of low-income
patients suffering from heart failure, cancer, and infectious diseases. 
Duke University Health System’s pilot project plans to serve an estimated
16,000 patients in North Carolina, of which 25% are low-income.

Geisinger, consortium with sites in
Lewiston, PA; Danville, PA; Jersey Shore, PA; Bloomsburg, PA; Coal Township,
PA; and Wilkes-Barre, PA. 
Geisinger’s pilot project seeks $1,739,100 in support to provide connected care
services and remote patient monitoring to low-income patients in rural
communities in Pennsylvania.  Geisinger’s pilot project would serve an
estimated 1,000 patients and would focus on chronic disease management and
high-risk pregnancies, while also treating infectious disease and behavioral
health conditions.  Through its pilot program, Geisinger plans to directly
connect all participating patients, 100% of whom are low-income, with broadband
Internet access service. 

Grady Health System, Atlanta, GA.  Grady Health System’s pilot
project seeks $635,596 to provide Internet connectivity to an estimated 1,896
primarily low-income and high-risk patients who are unable to utilize video
telemedicine services due to lack of a reliable network connection in
Atlanta.  The program will focus on using connected care services such as
patient remote monitoring and video visits/consults to treat vulnerable
patients with conditions such as congestive heart failure, COVID19,
hypertension, diabetes, heart disease, and HIV. 

Intermountain Centers for Human
Development, consortium with sites in Casa Grande, AZ; Nogales, AZ; Coolidge,
AZ; and Eloy, AZ.  Intermountain
Centers for Human Development’s pilot project seeks $237,150 in support to
treat mental health conditions, opioid dependency, and other substance abuse
disorders.  The pilot project plans to serve 3,400 patients in Arizona,
including rural areas, of which 90% are low-income.

MA FQHC Telehealth Consortium,
consortium with 76 sites in Massachusetts.  MA FQHC Telehealth Consortium’s pilot project
seeks $3,121,879 in support to provide mental health and substance abuse
disorder treatment through remote patient monitoring, video visits, and other
remote treatment to patients in Massachusetts, including significant numbers of
veterans and low-income patients.  The pilot project will expand access to
these services by leveraging program funding to increase bandwidth at its
sites, and to provide patients with mobile hotspots.  This project would
serve 75,000 patients through 76 federally qualified health centers in
Massachusetts, including rural areas, with an intended patient population of
61.5% low-income or veteran patients.

Mountain Valley Health Center,
consortium with 7 sites in Northeastern California.  Mountain Valley Health Center’s
pilot project seeks $550,800 in support to provide telehealth capabilities and
in-home monitoring of patients with hypertension and diabetes.  Mountain
Valley’s pilot project plans to serve an estimated 200 patients in rural
Northeastern California, of which at least 24% will be low-income patients and
10% will be veteran patients.

Neighborhood Healthcare – Escondido,
Escondido, CA, Neighborhood Healthcare – Valley Parkway, Escondido, CA,
Neighborhood Healthcare – El Cajon, El Cajon, CA, Neighborhood Healthcare –
Temecula, Temecula, CA, Neighborhood Healthcare – Pauma Valley, Pauma Valley,
CA.  Neighborhood
Healthcare’s pilot project seeks $129,744 to provide patient broadband access
to primarily low-income patients suffering from chronic and long-term
conditions (e.g., diabetes and high blood pressure).  Neighborhood
Healthcare’s collective project plans to serve an estimated 339 patients, 97%
of which are low-income patients, in five sites serving Riverside and San Diego
counties.

OCHIN, Inc., consortium with 15 sites in
Ohio, 16 sites in Oregon, and 13 sites in Washington.  OCHIN’s pilot project seeks
$5,834,620 in support to lead a consortium of 44 providers in Ohio, Oregon, and
Washington, encompassing 8 federally qualified health centers (FQHCs) serving
rural, urban, and tribal communities.  OCHIN’s pilot project will provide
patient broadband Internet access service and wireless connections directly to
an estimated 3,450 low-income patients to access connected care services,
including video visits, patient-based Internet-connected patient monitoring,
and remote treatment and will deliver care to treat high-risk pregnancy,
maternal health conditions, mental health conditions, and chronic and long-term
conditions such as diabetes, hypertension, and heart disease. 

Phoebe Worth Medical Center – Camilla
Clinic, Camilla, GA; Phoebe Physicians Group Inc – PPC of Buena Vista, Buena
Vista, GA; Phoebe Physicians Group – Ellaville Primary Medicine Center,
Ellaville, GA; Phoebe Physicians dba Phoebe Family Medicine & Sports
Medicine, Americus, GA; Phoebe Putney Memorial Hospital, Albany, GA; Phoebe
Putney Memorial Hospital dba Phoebe Family Medicine – Sylvester, Sylvester, GA.  The Phoebe Putney Health System
projects seek $673,200 to provide patient-based Internet-connected remote
monitoring, video visits, and remote treatment for low-income patients
suffering from chronic conditions or mental health conditions.  These projects
plan to serve an estimated 4,007 patients, approximately 1,000 of which will be
low-income patients in six sites serving southwest Georgia. 

Summit Pacific Medical Center, Elma, WA.  Summit Pacific Medical Center’s
pilot program seeks $169,977 in support to provide patient-based
Internet-connected remote monitoring, other monitoring services, video visits,
diagnostic imaging, remote treatment and other services for veterans and
low-income patients suffering from chronic conditions, infectious diseases,
mental health conditions, and opioid dependency.  Summit Pacific Medical
Center’s pilot project would serve an estimated 25 patients in Elma,
Washington, 100% of which would be low-income or veteran patients.

Temple University Hospital,
Philadelphia, PA. 
Temple University Hospital’s pilot project seeks $4,254,250 to provide
patient-based Internet connected remote monitoring and video visits to
patients, including low-income patients, suffering from chronic/long-term
conditions and mental health conditions.  This pilot project plans to
serve an estimated 100,000 patients in Philadelphia, Pennsylvania, 45% of which
are low-income patients. 

University of Mississippi Medical
Center, Jackson, MS. 
The University of Mississippi Medical Center’s (UMMC) pilot project seeks
$2,377,875 in support to provide broadband Internet access service to patients,
enabling remote patient monitoring technologies and ambulatory telehealth
visits to low-income patients suffering from chronic conditions or illnesses
requiring long-term care.  UMMC’s pilot project would impact an estimated
237,120 patients across Mississippi and serve up to 6,000 patients
directly.  Of these patients, UMMC estimates that 52% would be low-income.

University of Virginia Health System,
Charlottesville, VA.  The
University of Virginia (UVA) Health System’s pilot project seeks $4,462,500 in
support to expand the deployment of remote patient monitoring and telehealth
services to an estimated 17,000 patients across Virginia, nearly 30% of whom
will be low-income.  The UVA Health System pilot project will support
patient broadband and information services, including systems to capture,
transmit, and store patient data to allow remote patient monitoring, two-way
video, and patient scheduling. 

A century ago, X-rays transformed medicine forever. For the first time, doctors could see inside the human body, without invasive surgeries. The technology was so revolutionary that in the last 100 years, radiology departments have become a staple of modern hospitals, routinely used across medical disciplines.

Today, new technology is once again radically reshaping medicine: artificial intelligence (AI). Like the X-ray before it, AI gives clinicians the ability to see the unseen and has transformative applications across medical disciplines. As its impact grows clear, it’s time for health systems to establish departments dedicated to clinical AI, much as they did for radiology 100 years ago.

Radiology, in fact, was one of the earliest use cases for AI in medicine today. Machine learning algorithms trained on medical images can learn to detect tumors and other malignancies that are, in many cases, too subtle for even a trained radiologist to perceive. That’s not to suggest that AI will replace radiologists, but rather that it can be a powerful tool for aiding them in the detection of potential illness — much like an X-ray or a CT scan. 

AI’s potential is not limited to radiology, however. Depending on the data it is trained on, AI can predict a wide range of medical outcomes, from sepsis and heart failure to depression and opioid abuse. As more of patients’ medical data is stored in the EHR, and as these EHR systems become more interconnected across health systems, AI will only become more sensitive and accurate at predicting a patient’s risk of deteriorating.

However, AI is even more powerful as a predictive tool when it looks beyond the clinical data in the EHR. In fact, research suggests that clinical care factors contribute to only 16% of health outcomes. The other 84% are determined by socioeconomic factors, health behaviors, and the physical environment. To account for these external factors, clinical AI needs external data. 

Fortunately, data on social determinants of health (SDOH) is widely available. Government agencies including the Census Bureau, EPA, HUD, DOT and USDA keep detailed data on relevant risk factors at the level of individual US Census tracts. For example, this data can show which patients may have difficulty accessing transportation to their appointments, which patients live in a food desert, or which patients are exposed to high levels of air pollution. 

These external risk factors can be connected to individual patients using only their address. With a more comprehensive picture of patient risk, Clinical AI can make more accurate predictions of patient outcomes. In fact, a recent study found that a machine learning model could accurately predict inpatient and emergency department utilization using only SDOH data.

Doctors rarely have insight on these external forces. More often than not, physicians are with patients for under 15 minutes at a time, and patients may not realize their external circumstances are relevant to their health. But, like medical imaging, AI has the power to make the invisible visible for doctors, surfacing external risk factors they would otherwise miss. 

But AI can do more than predict risk. With a complete view of patient risk factors, prescriptive AI tools can recommend interventions that address these risk factors, tapping the latest clinical research. This sets AI apart from traditional predictive analytics, which leaves clinicians with the burden of determining how to reduce a patient’s risk. Ultimately, the doctor is still responsible for setting the care plan, but AI can suggest actions they may not otherwise have considered.

By reducing the cognitive load on clinicians, AI can address another major problem in healthcare: burnout. Among professions, physicians have one of the highest suicide rates, and by 2025, the U.S. The Department of Health and Human Services predicts that there will be a shortage of nearly 90,000 physicians across the nation, driven by burnout. The problem is real, and the pandemic has only worsened its impact. 

Implementing clinical AI can play an essential role in reducing burnout within hospitals. Studies show burnout is largely attributed to bureaucratic tasks and EHRs combined, and that physicians spend twice as much time on EHRs and desk work than with patients. Clinical AI can ease the burden of these administrative tasks so physicians can spend more time face-to-face with their patients.

For all its promise, it’s important to recognize that AI is as complex a tool as any radiological instrument. Healthcare organizations can’t just install the software and expect results. There are several implementation considerations that, if poorly executed, can doom AI’s success. This is where clinical AI departments can and should play a role. 

The first area where clinical AI departments should focus on is the data. AI is only as good as the data that goes into it. Ultimately, the data used to train machine learning models should be relevant and representative of the patient population it serves. Failing to do so can limit AI’s accuracy and usefulness, or worse, introduce bias. Any bias in the training data, including pre-existing disparities in health outcomes, will be reflected in the output of the AI. 

Every hospital’s use of clinical AI will be different, and hospitals will need to deeply consider their patient population and make sure that they have the resources to tailor vendor solutions accordingly. Without the right resources and organizational strategies, clinical AI adoption will come with the same frustration and disillusionment that has come to be associated with EHRs. 

Misconceptions about AI are a common hurdle that can foster resistance and misuse. No matter what science fiction tells us, AI will never replace a clinician’s judgment. Rather, AI should be seen as a clinical decision support tool, much like radiology or laboratory tests. For a successful AI implementation, it’s important to have internal champions who can build trust and train staff on proper use. Clinical AI departments can play an outsized role in leading this cultural shift.  

Finally, coordination is the bedrock of quality care, and AI is no exception. Clinical AI departments can foster collaboration across departments to action AI insights and treat the whole patient. Doing so can promote a shift from reactive to preventive care, mobilizing ambulatory, and community health resources to prevent avoidable hospitalizations.

With the promise of new vaccines, the end of the pandemic is in sight. Hospitals will soon face a historic opportunity to reshape their practices to recover from the pandemic’s financial devastation and deliver better care in the future. Clinical AI will be a powerful tool through this transition, helping hospitals to get ahead of avoidable utilization, streamline workflows, and improve the quality of care. 

A century ago, few would have guessed that X-rays would be the basis for an essential department within hospitals. Today, AI is leading a new revolution in medicine, and hospitals would be remiss to be left behind.

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About  John Frownfelter, MD, FACP

John is an internist and physician executive in Health Information Technology and is currently leading Jvion’s clinical strategy as their Chief Medical Information Officer. With 20 years’ leadership experience he has a broad range of expertise in systems management, care transformation and health information systems. Dr. Frownfelter has held a number of medical and medical informatics leadership positions over nearly two decades, highlighted by his role as Chief Medical Information Officer for Inpatient services at Henry Ford Health System and Chief Medical Information Officer for UnityPoint Health where he led clinical IT strategy and launched the analytics programs. 

Since 2015, Dr. Frownfelter has been bringing his expertise to healthcare through health IT advising to both industry and health systems. His work with Jvion has enhanced their clinical offering and their implementation effectiveness. Dr. Frownfelter has also held professorships at St. George’s University and Wayne State schools of medicine, and the University of Detroit Mercy Physician Assistant School. Dr. Frownfelter received his MD from Wayne State University School of Medicine.

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What You Should Know:

– Central Logic acquires Acuity Link to power the company’s
Intelligent Transport capabilities, speeding time to care in the best setting.

– In addition, the company rolls out a new interoperable Bed Visibility capability that offers a real-time snapshot into available beds across the enterprise for improved access and enhanced revenue capture.

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Central
Logic, a St. Paul, MN-based healthcare access and orchestration company,
has acquired Acuity Link, a leading
provider of transportation communications and logistics management software.
Acuity Link’s technology powers Central Logic’s new Intelligent Transport capability, which was announced
today along with the company’s real-time Bed Visibility platform.

The addition of Intelligent Transport and Bed Visibility to
Central Logic’s industry-leading platform solidifies the company’s leadership
in healthcare access and orchestration, by providing best-in-class technology
tools focused on elevating health system operations that support greater
clinician effectiveness, better outcomes and increased revenue capture.

“This strategic acquisition—which follows our recent acquisition of Ensocare—further demonstrates that Central Logic delivers the most comprehensive access and orchestration solution and services in the industry, with a focus on enabling health systems to ‘operate as one’ by providing innovative technologies that bring disparate processes, information and locations together,” said Angie Franks, CEO of Central Logic.

Acquisition Automates the Transport Request and Tracking Process 

Transportation coordination related to patient transfers and
other transitions of care is still a highly manual, inefficient process at many
health systems. Health system access center agents, who manage patient
transfers, discharges and other transitions of care, often need to call multiple
transportation companies and must record key milestones manually.

Central Logic recognized this challenge facing its health
system clients and sought to address it by forming a strategic relationship
with Acuity Link in 2019 to co-develop the Intelligent Transport coordination
and communication tool.

“The acquisition of Acuity Link advances our focus on holistically addressing our clients’ strategic business goals around revenue capture, care delivery, and the infrastructure required to excel in both value-based care and fee-for-service environments,” Franks said. “This is one more validation of our commitment to meeting the full access and orchestration vision of the health systems with whom we partner.”

Intelligent Transport is a vendor-agnostic solution that
automatically considers all types of patient transportation modes, acuity
levels, healthcare settings and even the health system’s contracting
obligations. Intelligent Transport’s proprietary algorithms suggest the most
efficient, clinically appropriate and cost-effective means of transport—from
aircraft to ride-share—and arranges transportation in just seconds. In many
cases, patients are delivered to the care setting 75% faster than through
manual workflows.

This faster end-to-end transport process decreases bed cycle
times and expedites bed availability with timely transport to, from and between
sites of care. Intelligent Transport’s algorithms ensure contract compliance,
with access center agents easily able to adhere to the health system’s policies
around vendor rights and obligations.

Intelligent Transport also offers real-time geo-tracking of
transport status so access centers always know where the patient is in their
journey and can work proactively with all pertinent information at their
fingertips.

Bed Visibility Offers Real-Time, Enterprise-Wide
Perspective

Central Logic’s new Bed Visibility capability addresses
another critical component of successful patient transfers and transitions of
care: The ability to know quickly and easily where the right type of bed,
specialist care and other important resources are available within the health
system, so patients can receive the level of care they need more quickly.

Central Logic’s Bed Visibility solution retrieves
information seamlessly within the platform and displays all necessary data
points—including average wait times, emergency department pre-admits, and
availability by service line and facility—in a single, easy-to-understand view.

Without Bed Visibility, the health system’s EHR or bed
management tools require agents in access centers to open various applications
and click through multiple screens to view the information—wasting precious
time that can affect clinical outcomes. Further, the inefficiency and waiting
that often occur can be frustrating, and the failure to quickly identify an
appropriate bed is a leading cause of patient leakage to competitors.

With automated, real-time visibility into that information
via Bed Visibility, a hospital’s access center can increase satisfaction—and
future referrals—from referring providers, while also decreasing leakage and
improving keepage.

“Bed Visibility, when supported by our full platform, can help health systems realize an improved patient census, especially within their specialty centers such as those focused on heart and vascular, neurology or orthopedics,” Franks said. “Every patient that is successfully referred, transferred and admitted brings an average of nearly $11,000 in revenue to the health system, which could result in millions of dollars annually to the bottom line with just 100 additional transfers per month, for a total of 1200 per year.”

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What You Should Know:

– COVID-19 care deferrals lead to three major boomerang
conditions that payers and providers must proactively address in 2021,
according to a newly released report by Prealize.

– COVID-19’s hidden victims—those who avoided or deferred
care during the pandemic—will increasingly return to the healthcare system, and
many will be diagnosed with new conditions at more advanced stages. Healthcare
leaders must act now to keep this boomerang from driving worse outcomes and
higher costs.

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Prealize, an artificial
intelligence (AI)-enabled predictive analytics company, today announced the
publication of a new report that explores key medical conditions payers and
providers should proactively address in 2021. Healthcare utilization for
preventive care, chronic care, and emergent care significantly decreased in
2020 due to the COVID-19
pandemic, which will result in an influx of newly diagnosed and later stage
conditions in 2021. Prealize’s
2021 State of Health Market Report: Bracing for Impact identifies the
top at-risk conditions based on Prealize’s claims analysis and predictive
analytics capabilities.

Report Background & Methodology

Many procedures and diagnoses fell significantly in 2020,
with several dropping nearly 50% below 2019 levels between March and June. Total
healthcare utilization fell 23% between March and August 2020, compared to the
same time period in 2019.

To explore the full scope of healthcare utilization and
procedural declines in 2020, and assess how those declines will impact
patients’ health and payers’ pocketbooks in 2021, Prealize Health conducted an
analysis of claims data from nearly 600,000 patients between March 2020 and
August 2020.

Prealize identified the three predicted conditions likely to
see the largest increase in healthcare utilization in 2021:

1. Cardiac diagnoses will increase by 18% for ischemic
heart disease and 14% for congestive heart failure

These increases will be driven by 2020 healthcare
utilization declines, for example, patients deferring family medicine and
internal medicine visits. These visits, which help flag cardiac problems and
prevent them from escalating, declined 24% between March and August of 2020.

“Cardiac illnesses are some of the most serious and
potentially fatal, so delays in diagnosis can lead to significant adverse
outcomes,” said Gordon Norman, MD, Prealize’s Chief Medical Officer.
“Without early recognition and appropriate intervention, rates of patient
hospitalization and death are likely to increase, as will associated costs of
care.”

2. Cancer diagnoses will increase by 23%

Similar to cardiac screening trends, significant declines in
2020 cancer screenings will be a key driver of this increase, with 46% fewer
colonoscopies and 32% fewer mammograms performed between March and August 2020
than during that same time period in 2019.

“Cancer doesn’t stop developing or progressing because
there’s a pandemic,” said Ronald A. Paulus, MD, President and CEO at RAPMD
Strategic Advisors, Immediate Past President and CEO of Mission Health, and one
of the medical experts interviewed for the report. “In 2021, when patients
who deferred care ultimately receive their diagnoses, their cancer sadly may be
more advanced. In addition, an increase in newly diagnosed patients may make it
harder for some patients to access care and specialists—particularly for those
patients who are insured by Medicaid or lack insurance altogether.”

3. Fractures will increase by 112%

This finding, based on combined analysis of osteoporosis
risk and fall risk, is particularly troubling for the elderly patient
population.

A key driver of increased fractures in 2021 is the number of
postponed elective orthopedic procedures in 2020, such as hip and knee
replacements. These procedural delays are likely to decrease mobility, and
therefore, increase risk of fractures from falls.

“In elderly patients, fractures are very serious events
that too often lead to decreased overall mobility and quality of life,”
said Norman. “As a result, patients may suffer from physical follow-on
events like pulmonary embolisms, and behavioral health concerns like increased
social isolation.”

Why It Matters

“These predictions are daunting, but the key is that providers and payers take action now to mitigate their effects,” said Prealize CEO Linda T. Hand. “It’s going to be critical to gain insight into populations to understand their risk at an individual level, build trust, and treat their conditions as early as possible to improve outcomes. The COVID-19 pandemic has challenged every aspect of our healthcare system, but the way to get ahead of these challenges in 2021 will be to proactively identify and address patients most at risk. We’re going to see proactive care become an important driver for success next year, as providers and payers seek to mitigate unnecessary and expensive procedures that result from 2020’s decreased medical utilization. The right predictive analytics partner will be critical to providers and payers being able to take the right course of action.”

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Electronic medical records (EMRs) are widely expected to serve as a cornerstone technology that drives the delivery of modern patient care. 

But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a category of information used differently than traditional clinical knowledge, but the volume of data generated through molecular testing alone also requires informatics and management of a higher magnitude than previously required.

The EMR is designed to reflect a snapshot (or collection of snapshots) in time: clinical summaries, annotated lab and test results, operation notes, etc. These are mostly stored as isolated documents, loosely coupled with the rest of the patient chart. They need to remain available for reference over time, in some instances, so providers can chart and contextualize ongoing trends and chronic conditions. However, these views are anchored in time and represent limited actionable value during clinical decision-making months, years, and decades later.

Genomic information, on the other hand, represents a patient’s life signature. DNA rarely changes over the course of an individual’s lifetime. This means the results from germline testing – a patient’s molecular profile – conducted early in life are relevant, meaningful, and actionable during clinical decision making far into the future. They can also deliver insights exposing heritable proclivities that may be life-changing or life-saving for family members as well.

This recognition in and of itself alerts healthcare leaders that they need to adopt an advanced, more sophisticated strategy for data governance, management, and sharing than the approach traditionally applied to other clinical information systems, such as EMRs. 

To be successful, healthcare organizations need an accelerator external to the EMR that is built on a data model unique to the management of molecular knowledge so test results and genomic insights can be used and shared across clinical specialties and care settings, as well as overtime. In addition, the rise of precision medicine requires an agile informatics platform that enables the cross-pollination of genomic data with clinical insights and ever-advancing discoveries in genomic science.

Consider these examples of how EMRs fall short of expectations for optimal use of genomic intelligence:

1. Studies have found that, despite ubiquitous availability of molecular tests, providers consistently fail to identify patients most at risk for heritable diseases. The Journal of the American Medical Informatics Association (JAMIA) recently released research showing that half the women meeting national guidelines for genetic screening are not getting the tests they need to determine their breast and ovarian cancer risk. 

The reason? “The full story of a patient’s risk for heritable cancer within their record often does not exist in a single location,” says the JAMIA article. “It is fragmented across entries created by many authors, over many years, in many locations and formats, and commonly from many different institutions in which women have received care over their lifetimes.” In other words, no matter which EMRs they use, health systems routinely miss opportunities to improve care for patients they see. To achieve greater success, providers need tools that exceed EMR functionality and span multiple clinical systems.

2. Shortly after birth, Alexander develops a seizure disorder. The neonatologist orders a germline test to help her arrive at a precise diagnosis and begin targeted treatment. This approach is successful and Alexander thrives. In addition to genomic variants identifying the cause of his seizure disorder, the test results also contain information about other heritable risk factors, including cardiovascular disease.

Decades later, in the 70s, Alexander sees his primary care provider (PCP) with a rapid heartbeat and shortness of breath. After doing routine lab work, the PCP diagnoses congestive heart failure (CHF). If, however, the PCP had access to Alexander’s genomic test results – which remain as relevant and accurate as when he was an infant – the PCP would have noted a variation that indicated the CHF was due to dilated cardiomyopathy, requiring a different treatment regime.

It is vital that health leaders immediately begin to plan an informatics strategy that accommodates genetic and genomic data while empowering providers to leverage these insights at the point of care as they make routine, yet critical, clinical decisions. As they evaluate their approach, they would do well to ask the following questions:

– Which providers in my organization are already ordering genomic tests on their patients? How are test results being stored and managed – and can they be easily shared with and accessed by others in the health system?

– As the volume of genetic and genomic testing accelerates – and it will – how will we manage the volume of data generated? How will we apply consistent governance to the ordering process? How can we ensure results will be consumed as discrete data so our organization can optimize its value now and in the future?

– What steps do we need to take so our precision medicine strategy remains current with changing science? Which informatics tools deliver access to up-to-date knowledge bases and clinical guidelines to ensure optimal medical decisions are made?

The advent of precision medicine represents a new standard of care for healthcare providers from coast to coast. Genetic and genomic information supplies a new data set that can be used to arrive at more accurate diagnoses sooner and more effective treatment faster. This, in turn, supports better outcomes, higher patient (and provider) satisfaction, and competitive differentiation for the health system adopting precision medicine first in its market.

But to capture this value, healthcare leaders must look beyond their legacy EMRs, recognizing that they were not developed nor do they have the capacity to properly handle the upcoming data revolution. Instead, industry innovators are looking for platforms agnostic to individual EMRs and integrated with molecular labs to address the next-generation demands of precision medicine.

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About Assaf Halevy

Assaf Halevy is the founder and CEO of 2bPrecise, LLC, leading an international team dedicated to bridging the final mile between the science of genomics and making that data useful at the point of care. He joined Allscripts as senior vice president of products and business development in 2013 when the company acquired Israel-based dbMotion. An initial inventor and co-founder of dbMotion, Halevy helped develop the leading clinical integration and population health management platforms in the industry today.

With 13 patents pending in the areas of actionable clinical integration, interoperability, and precision medicine, Halevy leverages his industry expertise by evaluating strategic alliances and partnerships for U.S. and international markets. Halevy was invited to participate in several U.S. government activities and contribute to an HHS privacy committee task force. In 2016, he was part of a small selective group of executives invited to the White House by Vice President Joe Biden to discuss the future of interoperability.

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What You Should Know:

– Conversa Health’s COVID-19 programs now include patient monitoring pre- and post-vaccination, education on vaccines, and appointment reminders.

– Healthcare workers at UCHealth in Colorado are
receiving 24/7 monitoring of vital signs two days before and seven days after
receiving their vaccinations courtesy of Conversa Health.

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Conversa Health, a Portland, OR-based automated virtual care and triage platform, has expanded its suite of COVID-19 programs with tools to help the vaccine effort. As part of its expansion, Conversa has partnered with BioIntelliSense to monitor healthcare workers at UCHealth in Colorado before and after receiving COVID-19 vaccinations. UCHealth physicians, nurses, and other front-line staff members wear BioIntelliSense’s BioButton medical device two days before and seven days after vaccination. The BioButton continuously monitors temperature, respiratory rate and heart rate at rest. Conversa collects information from the BioButton and integrates the vital signs data with insights from a daily interactive vaccination health survey developed by Conversa.

“Automated vaccine monitoring for our frontline healthcare workers is an important step toward scaling the program for the larger population, particularly vulnerable patient populations and seniors in long-term care environments,” said Dr. Richard Zane, UCHealth chief innovation officer and professor and chair of emergency medicine at the University of Colorado School of Medicine. “We are working closely with partners like Conversa and BioIntelliSense to navigate the ever-changing healthcare landscape and transform the way patients receive care.”

Vaccine education, tracking and screening

Conversa also is assisting health systems across the country
with the challenge of vaccinating millions of patients. This effort begins with
educating patients on the safety and efficacy of the vaccines. Patients want to
know when they will be eligible to receive vaccines and what their experience
will be like, including potential side effects. And patients need an easy way
to set up vaccine appointments and get reminders to follow through on their
visits. Health systems also want to monitor potential side effects, both to
ensure patients get needed follow-up care and to report any side effects to the
Centers for Disease Control and Prevention.

“With millions of people needing to be vaccinated, we cannot have a manual, paper process to track who received a vaccine and who experienced side effects,” said Dr. Nick Patel, chief digital officer at Prisma Health, an 18-hospital system serving South Carolina. “We have to automate this process to track information accurately and at scale. With Conversa, we will be able to do that for the 1.2 million patients that Prisma Health serves annually. Digital tracking also allows us to provide vaccinated individuals with a digital badge for entering an airplane, a public building or an entertainment venue. That will be a key to allowing life to return to something close to pre-COVID normal.”

Dr. Paul Hain, Chief Medical Officer of GoHealth

Telehealth is Here to Stay in 2021

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

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

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Dr. Salvatore Viscomi, Chief Medical Officer, GoodCell

2021 will be the year of patient controlled-health

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

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Anish Sebastian, CEO of Babyscripts

Beyond telemedicine

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

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Daniel Kivatinos, COO and Co-Founder of DrChrono

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

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

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Dennis McLaughlin VP of Omni Operations + Product at ibi

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

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

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Sarahjane Sacchetti, CEO at Cleo

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

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Omri Shor, CEO of Medisafe

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

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

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

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

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

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

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Brooke LeVasseur, CEO of AristaMD

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

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Bret Larsen, CEO and Co-Founder, eVisit

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

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

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

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Jeff Lew, SVP of Product Management, Nextech

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

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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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Teladoc Health and Livongo Merge

The combination of Teladoc Health and Livongo creates a
global leader in consumer-centered virtual care. The combined company is
positioned to execute quantified opportunities to drive revenue synergies of
$100 million by the end of the second year following the close, reaching $500
million on a run-rate basis by 2025.

Price: $18.5B in value based on each share of Livongo
will be exchanged for 0.5920x shares of Teladoc Health plus cash consideration
of $11.33 for each Livongo share.

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Siemens Healthineers Acquires Varian Medical

On August 2nd, Siemens Healthineers acquired
Varian Medical for $16.4B, with the deal expected to close in 2021. Varian is a
global specialist in the field of cancer care, providing solutions especially
in radiation oncology and related software, including technologies such as
artificial intelligence, machine learning and data analysis. In fiscal year 2019,
the company generated $3.2 billion in revenues with an adjusted operating
margin of about 17%. The company currently has about 10,000 employees
worldwide.

Price: $16.4 billion in an all-cash transaction.

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Gainwell to Acquire HMS for $3.4B in Cash

Veritas Capital (“Veritas”)-backed Gainwell Technologies (“Gainwell”),
a leading provider of solutions that are vital to the administration and
operations of health and human services programs, today announced that they
have entered into a definitive agreement whereby Gainwell will acquire HMS, a technology, analytics and engagement
solutions provider helping organizations reduce costs and improve health
outcomes.

Price: $3.4 billion in cash.

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Philips Acquires Remote Cardiac Monitoring BioTelemetry for $2.8B

Philips acquires BioTelemetry, a U.S. provider of remote
cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion). With $439M in
revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients
remotely; its portfolio includes wearable heart monitors, AI-based data
analytics, and services.

Price: $2.8B ($72 per share), to be paid in cash upon
completion.

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Hims & Hers Merges with Oaktree Acquisition Corp to Go Public on NYSE

Telehealth company Hims & Hers and Oaktree Acquisition Corp., a special purpose acquisition company (SPAC) merge to go public on the New York Stock Exchange (NYSE) under the symbol “HIMS.” The merger will enable further investment in growth and new product categories that will accelerate Hims & Hers’ plan to become the digital front door to the healthcare system

Price: The business combination values the combined
company at an enterprise value of approximately $1.6 billion and is expected to
deliver up to $280 million of cash to the combined company through the
contribution of up to $205 million of cash.

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SPAC Merges with 2 Telehealth Companies to Form Public
Digital Health Company in $1.35B Deal

Blank check acquisition company GigCapital2 agreed to merge with Cloudbreak Health, LLC, a unified telemedicine and video medical interpretation solutions provider, and UpHealth Holdings, Inc., one of the largest national and international digital healthcare providers to form a combined digital health company. 

Price: The merger deal is worth $1.35 billion, including
debt.

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WellSky Acquires CarePort Health from Allscripts for
$1.35B

WellSky, global health, and community care technology company, announced today that it has entered into a definitive agreement with Allscripts to acquire CarePort Health (“CarePort”), a Boston, MA-based care coordination software company that connects acute and post-acute providers and payers.

Price: $1.35 billion represents a multiple of greater
than 13 times CarePort’s revenue over the trailing 12 months, and approximately
21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12 months.

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Waystar Acquires Medicare RCM Company eSolutions

On September 13^th, revenue cycle management
provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue
cycle management, workflow automation, and data analytics tools. The
acquisition creates the first unified healthcare payments platform with both
commercial and government payer connectivity, resulting in greater value for
providers.

Price: $1.3 billion valuation

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Radiology Partners Acquires MEDNAX Radiology Solutions

Radiology Partners (RP), a radiology practice in the U.S., announced a definitive agreement to acquire MEDNAX Radiology Solutions, a division of MEDNAX, Inc. for an enterprise value of approximately $885 million. The acquisition is expected to add more than 800 radiologists to RP’s existing practice of 1,600 radiologists. MEDNAX Radiology Solutions consists of more than 300 onsite radiologists, who primarily serve patients in Connecticut, Florida, Nevada, Tennessee, and Texas, and more than 500 teleradiologists, who serve patients in all 50 states.

Price: $885M

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PointClickCare Acquires Collective Medical

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

Price: $650M

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Teladoc Health Acquires Virtual Care Platform InTouch
Health

Teladoc Health acquires InTouch Health, the leading provider of enterprise telehealth solutions for hospitals and health systems for $600M. The acquisition establishes Teladoc Health as the only virtual care provider covering the full range of acuity – from critical to chronic to everyday care – through a single solution across all sites of care including home, pharmacy, retail, physician office, ambulance, and more.

Price: $600M consisting of approximately $150 million
in cash and $450 million of Teladoc Health common stock.

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AMN Healthcare Acquires VRI Provider Stratus Video

AMN Healthcare Services, Inc. acquires Stratus Video, a leading provider of video remote language interpretation services for the healthcare industry. The acquisition will help AMN Healthcare expand in the virtual workforce, patient care arena, and quality medical interpretation services delivered through a secure communications platform.

Price: $475M

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CarepathRx Acquires Pharmacy Operations of Chartwell from
UPMC

CarepathRx, a leader in pharmacy and medication management
solutions for vulnerable and chronically ill patients, announced today a
partnership with UPMC’s Chartwell subsidiary that will expand patient access to
innovative specialty pharmacy and home infusion services. Under the $400M
landmark agreement, CarepathRx will acquire the
management services organization responsible for the operational and strategic
management of Chartwell while UPMC becomes a strategic investor in CarepathRx. 

Price: $400M

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Cerner to Acquire Health Division of Kantar for $375M in
Cash

Cerner announces it will acquire Kantar Health, a leading
data, analytics, and real-world evidence and commercial research consultancy
serving the life science and health care industry.

This acquisition is expected to allow Cerner’s Learning
Health Network client consortium and health systems with more opportunities to
directly engage with life sciences for funded research studies. The acquisition
is expected to close during the first half of 2021.

Price: $375M

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Cerner Sells Off Parts of Healthcare IT Business in
Germany and Spain

Cerner sells off parts of healthcare IT business in Germany and Spain to Germany company CompuGroup Medical, reflecting the company-wide transformation focused on improved operating efficiencies, enhanced client focus, a refined growth strategy, and a sharpened approach to portfolio management.

Price: EUR 225 million ($247.5M USD)

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CompuGroup Medical Acquires eMDs for $240M

CompuGroup Medical (CGM) acquires eMDs, Inc. (eMDs), a
leading provider of healthcare IT with a focus on doctors’ practices in the US,
reaching an attractive size in the biggest healthcare market worldwide. With
this acquisition, the US subsidiary of CGM significantly broadens its position
and will become the top 4 providers in the market for Ambulatory Information
Systems in the US.

Price: $240M (equal to approx. EUR 203 million)

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Change Healthcare Buys Back Pharmacy Network

Change
Healthcare buys
back pharmacy unit eRx Network
(“eRx”), a leading provider of comprehensive, innovative, and secure
data-driven solutions for pharmacies. eRx generated approximately $67M in
annual revenue for the twelve-month period ended February 29, 2020. The
transaction supports Change Healthcare’s commitment to focus on and invest in
core aspects of the business to fuel long-term growth and advance innovation.

Price: $212.9M plus cash on the balance sheet.

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Walmart Acquires Medication Management Platform CareZone

Walmart acquires CareZone, a San Francisco, CA-based smartphone
service for managing chronic health conditions for reportedly $200M. By
working with a network of pharmacy partners, CareZone’s concierge services
assist consumers in getting their prescription medications organized and
delivered to their doorstep, making pharmacies more accessible to individuals
and families who may be homebound or reside in rural locations.

Price: $200M

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Verisk Acquires MSP Compliance Provider Franco Signor

Verisk, a data
analytics provider, announced today that it has acquired Franco Signor, a Medicare Secondary Payer
(MSP) service provider to America’s largest insurance carriers and employers.
As part of the acquisition, Franco Signor will become part of Verisk’s Claims
Partners business, a leading provider of MSP compliance and other analytic
claim services. Claims Partners and Franco Signor will be combining forces to
provide the single best resource for Medicare compliance. 

Price: $160M

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Rubicon Technology Partners Acquires Central Logic

Private equity firm Rubicon Technology Partners acquires
Central Logic, a provider of patient orchestration and tools to accelerate
access to care for healthcare organizations. Rubicon will be aggressively driving Central Logic’s
growth with additional cash investments into the business, with a focus
on product innovation, sales expansion, delivery and customer support, and
the pursuit of acquisition opportunities.

Price: $110M – $125 million, according to sources

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• 

• 

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:

– Philips acquires BioTelemetry, a U.S. provider of
remote cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion).

– With $439M in revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients remotely; its portfolio includes wearable heart monitors, AI-based data analytics, and services.

– BioTelemetry business is expected to deliver double-digit growth and improve its Adjusted EBITA margin to over 20% by 2025; the acquisition will be sales growth and adjusted EBITA margin accretive for Philips in 2021.

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Philips, today
announced it has entered in an agreement to acquire
BioTelemetry, Inc., a U.S.-based provider
of remote cardiac diagnostics and monitoring for $2.8B ($72 per share), to be
paid in cash upon completion.

 USD 72.00 per share, to be paid in cash upon
completion. The board of directors of BioTelemetry has approved the transaction
and recommends the offer to its shareholders. The transaction is expected to be
completed in the first quarter of 2021.

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BioTelemetry Background

Founded in 1995, BioTelemetry primarily focuses on the diagnosis and monitoring of heart rhythm disorders, representing 85% of its sales. BioTelemetry’s clinically validated offering includes wearable heart monitors (e.g. a mobile cardiac outpatient telemetry patch and extended Holter monitor) that detect and transmit abnormal heart rhythms wirelessly, AI-based data analytics, and services.

With over 30,000 unique
referring physicians per month, BioTelemetry provides services for over one
million patients per year. Additionally, BioTelemetry has a clinical research
business that provides testing services for clinical trials. The total
addressable market is USD 3+ billion, growing high-single-digits driven by an
increasing prevalence of chronic diseases, and the adoption of remote
monitoring and outcome-oriented models.

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Acquisition Strengthens Philips’ Cardiac Care Portfolio

The acquisition of BioTelemetry is a strong fit with Philips’ cardiac care portfolio, and its strategy to transform the delivery of care along the health continuum with integrated solutions. The combination of Philips’ leading patient monitoring position in the hospital with BioTelemetry’s leading cardiac diagnostics and monitoring position outside the hospital, will result in a global leader in patient care management solutions for the hospital and the home for cardiac and other patients. Philips’ current portfolio includes real-time patient monitoring, therapeutic devices, telehealth, and informatics. Moreover, Philips has an advanced and secure cloud-based Philips HealthSuite digital platform optimized for the delivery of healthcare across care settings. Every year, Philips’ integrated solutions monitor around 300 million patients in hospitals, as well as around 10 million sleep and respiratory care patients in their own homes.

“The acquisition of BioTelemetry fits perfectly with our strategy to be a leading provider of patient care management solutions for the hospital and the home,” said Frans van Houten, CEO of Royal Philips. “BioTelemetry’s leadership in the large and fast growing ambulatory cardiac diagnostics and monitoring market complements our leading position in the hospital. Leveraging our collective expertise, we will be in an optimal position to improve patient care across care settings for multiple diseases and medical conditions.”

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Post-Acquisition Plans

Upon completion of the transaction, BioTelemetry and its
approximately 1,900 employees will become part of Philips’ Connected Care
business segment. The acquisition is projected to be sales growth and adjusted
EBITA margin accretive for Philips in 2021. Philips targets significant
synergies driven by cross-selling opportunities (especially in the U.S.),
geographical expansion, and portfolio innovation synergies, such as Philips’
Health Suite digital platform. Additionally, Philips will drive operational
performance improvements through its proven productivity programs. The
BioTelemetry business is expected to grow double-digits and to improve its
Adjusted EBITA margin to more than 20% by 2025.

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What You Should Know:

– Elation Health, which provides an easy-to-use and
affordable clinical technology platform for more than 7 million independent primary
care clinicians serving 14M+ patients – including an EHR raises $40M in Series
C funding from Al Gore’s sustainable investment firm, Generation Investment
Management.

– Elation’s API-enabled platform also allows
organizations to transform the patient and provider experience and implement
their own models of data-driven, value-based care.

– Company will surpass a milestone this year of
delivering more than 20 million in-office and virtual visits through their
provider network.

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Elation
Health, a clinical-first technology company powering the future of
independent primary care, today announced a Series C financing round of $40
million led by Al Gore’s Generation Investment
Management, a firm that invests in sustainable businesses accelerating the
transition to a more healthy, fair, safe, and low-carbon society. The round
also included participation from existing investors, including Threshold Ventures and Kapor Capital.

Clinical-First Commitment to Independent Primary Care

Independent primary care is one of the few areas in healthcare where upfront investment leads to significant savings in the long term. For every dollar spent on primary care, studies suggest that as much as $13 in downstream healthcare costs are avoided. Increased spending on primary care is also associated with fewer emergency department visits and reduced total hospitalizations and specialty interventions for chronic conditions such as diabetes, high blood pressure, and congestive heart failure

Elation Health was founded in 2010 after siblings Kyna and
Conan Fong struggled to help their father transition his solo primary care
practice from paper charts to a digital system. Born from that experience,
today Elation Health powers the largest network for independent primary care,
with 14,000 independent clinicians caring for seven million patients. The
company offers an EHR
solution, enterprise APIs, revenue cycle services, patient engagement app, and
access to interoperability partners.

The company surpassed a milestone this year of delivering more than 20 million in-office and virtual visits through its provider network. In addition to serving small practices, Elation has partnered with primary care innovators such as Crossover Health and Cityblock Health to provide the underlying clinical platform for technology-enabled, team-based care.

Helping Intendent Practices Shift to Virtual Care Amid The
COVID-19 Pandemic

In 2020, Elation Health’s customer base of independent
practices has faced significant business challenges as primary care shifts to
virtual settings and the pace of insurance and government policy change has
accelerated. The company has responded by expanding its role as a critical
technology partner — including adding HIPAA-compliant telehealth to its core
offering, deepening support for Medicare and Medicaid quality programs, and
delivering new patient engagement capabilities for patients to schedule
appointments and interact with practices. Elation’s API-enabled platform also
allows organizations to transform the patient and provider experience and
implement their own models of data-driven, value-based care.

Expansion Plans

In the year ahead, Elation Health will continue to invest in
its core platform, while adding new capabilities to support business operations
for independent primary care. The company has plans to develop solutions in
billing and payment collection, patient population management, interoperability,
and quality reporting — ensuring practices have the tools to drive high-quality
patient outcomes and business success.

What You Should Know:

– Amazon today announced the launch of Amazon HealthLake,
a new HIPAA-eligible service enables healthcare organizations to store, tag,
index, standardize, query, and apply machine learning to analyze data at
petabyte scale in the cloud.

– Cerner, Ciox Health, Konica Minolta Precision Medicine,
and Orion Health among customers using Amazon HealthLake.

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Today at AWS re:Invent, Amazon
Web Services, Inc. (AWS), an Amazon.com company today announced Amazon HealthLake, a
HIPAA-eligible service for healthcare and life sciences organizations. Current
Amazon HealthLake customers include Cerner, Ciox Health, Konica Minolta
Precision Medicine, and Orion Health.

Health data is frequently incomplete and inconsistent, and is often unstructured, with the information contained in clinical notes, laboratory reports, insurance claims, medical images, recorded conversations, and time-series data (for example, heart ECG or brain EEG traces) across disparate formats and systems. Every healthcare provider, payer, and life sciences company is trying to solve the problem of structuring the data because if they do, they can make better patient support decisions, design better clinical trials, and operate more efficiently.

Store, transform, query, and analyze health data in
minutes

Amazon HealthLake aggregates an organization’s complete data across various silos and disparate formats into a centralized AWS data lake and automatically normalizes this information using machine learning. The service identifies each piece of clinical information, tags, and indexes events in a timeline view with standardized labels so it can be easily searched, and structures all of the data into the Fast Healthcare Interoperability Resources (FHIR) industry-standard format for a complete view of the health of individual patients and entire populations.

Benefits for Healthcare Organizations

As a result, Amazon HealthLake makes it easier for customers to query, perform analytics, and run machine learning to derive meaningful value from the newly normalized data. Organizations such as healthcare systems, pharmaceutical companies, clinical researchers, health insurers, and more can use Amazon HealthLake to help spot trends and anomalies in health data so they can make much more precise predictions about the progression of the disease, the efficacy of clinical trials, the accuracy of insurance premiums, and many other applications.

How It Works

Amazon HealthLake offers medical providers, health insurers,
and pharmaceutical companies a service that brings together and makes sense of
all their patient data, so healthcare organizations can make more precise
predictions about the health of patients and populations. The new
HIPAA-eligible service enables organizations to store, tag, index, standardize,
query, and apply machine learning to analyze data at petabyte scale in the
cloud.

Amazon HealthLake allows organizations to easily copy health
data from on-premises systems to a secure data lake in the cloud and normalize
every patient record across disparate formats automatically. Upon ingestion,
Amazon HealthLake uses machine learning trained to understand medical
terminology to identify and tag each piece of clinical information, index
events into a timeline view, and enrich the data with standardized labels
(e.g., medications, conditions, diagnoses, procedures, etc.) so all this
information can be easily searched.

For example, organizations can quickly and accurately find
answers to their questions like, “How has the use of cholesterol-lowering
medications helped our patients with high blood pressure last year?” To do this,
customers can create a list of patients by selecting “High Cholesterol” from a
standard list of medical conditions, “Oral Drugs” from a menu of treatments,
and blood pressure values from the “Blood Pressure” structured field – and then
they can further refine the list by choosing attributes like time frame,
gender, and age. Because Amazon HealthLake also automatically structures all of
a healthcare organization’s data into the FHIR industry format, the information
can be easily and securely shared between health systems and with third-party
applications, enabling providers to collaborate more effectively and allowing
patients unfettered access to their medical information.

“There has been an explosion of digitized health data in recent years with the advent of electronic medical records, but organizations are telling us that unlocking the value from this information using technology like machine learning is still challenging and riddled with barriers,” said Swami Sivasubramanian, Vice President of Amazon Machine Learning for AWS. “With Amazon HealthLake, healthcare organizations can reduce the time it takes to transform health data in the cloud from weeks to minutes so that it can be analyzed securely, even at petabyte scale. This completely reinvents what’s possible with healthcare and brings us that much closer to everyone’s goal of providing patients with more personalized and predictive treatment for individuals and across entire populations.”

What
You Should Know:

–
Highmark, one of the largest Blues plans, has chosen Lark Health for its
chronic disease prevention and management platform.

–
Members will have access to Lark’s 24/7 AI-based coaching and programs to
manage diabetes, hypertension, and prevent chronic conditions.

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Highmark Inc., America’s fourth-largest overall Blue Cross Blue Shield-affiliated organization, announced a growing collaboration with Lark Health, virtual chronic disease prevention and management platform giving select Highmark members access to Lark’s 24/7 health coaching to prevent and manage conditions like hypertension and diabetes and to stay healthy through weight management and stress reduction programs.  

Costly Impact of Chronic Diseases

Chronic conditions are widespread and costly, and Lark’s
programs are aimed at providing personalized health coaching to address them at
scale. Six in 10 U.S. adults have a chronic disease, while 4 in 10 have two or
more. Diabetes affects an estimated 30 million Americans, and is a risk factor
for complications such as neuropathy, hypertension, stroke, heart disease, and
kidney disease. Diabetes costs the nation an estimated $327 billion annually in
direct medical costs and indirect costs, such as lost productivity. Nearly 1 in
3 adults have hypertension, which is an underlying cause of over 1,000 deaths
each day in the U.S. Hypertension costs the country over $48 billion each year.
Nearly 2 out of 3 individuals with diabetes also have hypertension.

Expansion of 2-Year Collaboration

Highmark’s vision is to deliver tech-enabled
and consumer-friendly solutions that meet members where they are and allow them
to more easily manage their health with highly personalized coaching. Since
beginning the two-year collaboration, member enrollment in Lark has been
increasing year-over-year.

Highmark’s employer group customers in Pennsylvania, Delaware, and West Virginia, as well as commercial National group customers, are able to access Lark’s unlimited 24/7 personal counseling in real-time through an easy-to-use, text message-like modality.

Lark and Highmark have worked together throughout the collaboration to identify and reach out to individuals at risk of developing chronic conditions, increasing awareness of the virtual care offerings through social media advertising, direct mail, email, and text campaigns.

Virtual Care Platform that Addresses Health Plans’ Costliest
Challenges

Powered by conversational AI, the platform seamlessly addresses the whole person, with counseling for diabetes, cardiovascular disease, prediabetes, smoking cessation, stress, anxiety, and weight management, and it incorporates smart connected devices, like scales, that sync with the program to help remotely monitor conditions. When an emergent situation or complex question arises, Lark escalates the concern to a live interaction telephonically or provides a recommended next step.

“Preventing and managing chronic conditions is time-consuming, costly, and inconvenient. We need solutions that are scalable and meet people where they are, especially for individuals who might have comorbid conditions,” said Lark CEO and co-founder Julia Hu. “We are thrilled that Highmark members are choosing and embracing Lark to help them stay healthy, and we look forward to continuing our work with Highmark to offer engaging health coaching to more people.”

As if 2020 couldn’t be
any more challenging for healthcare providers, new federal rules on
interoperability and patient access, granting patients direct access to their healthcare
data, begin taking effect this November and continue into 2022. These rules,
while ultimately beneficial to patients, bring an additional level of
operational complexity to many revenue-stressed healthcare organizations. 

If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For example, consider the huge increase in 2020 in virtual care visits, projected to be more than 1 billion by year’s end, and with an estimated 90% related to Covid-19. Many of these new virtual health patients will move through different care networks, using different health plans, and seeking remote access to their health records. These are precisely the type of patients’ interoperability is meant to help. 

What should healthcare providers be doing now to ensure they’re not only compliant with new interoperability rules, but also applying them as optimally as possible to benefit their patients and organizations? In this article, we review the upcoming rules and suggest five key steps providers can take to ensure their interoperability implementations proceed as smoothly as possible.  

What’s Ahead with
Interoperability? 

After several years of discussion on interoperability standards, the Office of the National Coordinator (ONC) for Healthcare IT and the Centers for Medicare & Medicaid Services (CMS) issued their final rules on interoperability in the spring of 2020. The new rules, covering both health systems and health plans, are intended to ensure that patients can electronically access their healthcare information regardless of health system or type of electronic health records (EHR) and covering all CMS-regulated plan types, including Medicare Advantage, CHIP, and the Federally Facilitated Exchanges. 

Starting Nov. 2, 2020, healthcare systems must begin complying with interoperability rules preventing information blocking, which means not interfering with patients’ access to or use of their electronic health information. Providers must also attest they are acting “in good faith” regarding preventing information blocking, with any non-compliance flagged on the National Plan and Provider Enumeration System. By May 1, 2021, hospitals, psychiatric hospitals, and critical access hospitals with an EHR must send notification of their patients’ admission, discharge, and transfer (ADT) events to providers. 

Interoperability will replace the current fragmented and error-prone ways of exchanging vital healthcare information. Near-term benefits of interoperability include improved care coordination and patient experience, greater patient safety, and stronger patient privacy and security. Longer-term benefits include higher provider productivity, reduced healthcare costs, and more accurate public health data.  

For providers, the good
news about interoperability is that they’ve had years to think about and
implement many of its fundamental tenets, based on their work meeting
meaningful use requirements. That’s borne out in a 2019 HIMSS survey of
healthcare organizations which found nearly 75% of respondents past the
“foundational” level of interoperability – “foundational” defined as allowing
data exchange from one IT
system to another, but without data interpretation.  

Five Steps for
Interoperability Excellence 

While healthcare systems
will achieve significant interoperability gains through technology investments,
they should not consider technology as the ultimate sole key to
interoperability success. If anything, financial and political considerations
may be far more important to your organization’s interoperability success. Here
are five critical non-technology factors to consider: 

1. Determine your “master”
interoperability strategy

All pertinent stakeholders in your organization should be on the same page about your interoperability strategy, resources, and timing. Know up-front that those implementing interoperability may not have previously worked with patient-centric analytics, partners, or departments in your organization. Plan your resources and timing accordingly. Your strategy should focus on the value-add of interoperability internally, such as access to additional data points on your patients, and externally, such as how you describe the upcoming benefits of interoperability to your patients.

2. Convey your vision, expectations
and expected return

An interoperability implementation is
a massive change management initiative, which requires continuous, top-down
leadership and championship, and proper expectation-setting. Communicate where
your organization currently stands regarding its interoperability capabilities,
and where you wish to have it go. Convey how the organization plans to get to
its future desired state. And perhaps most importantly, share the likely return
on investment in this effort. Be as specific as possible. For example, if you
believe interoperability gains will ultimately enable a 5% decrease in your
hospital readmissions, state that.

3. Examine workflows and identify
specific use cases

Every type of ADT event in your
organization, and its corresponding workflows and system interactions, should
be under review. Consider all types of clinical use cases, the types of data to
be exchanged, and those involved in providing patient care. This will help
determine your optimal approach to data-sharing and how your organization can
strategically use the additional data you receive from other health
systems. 

4. Rigorously prep your data

Standardized data collection and reporting
which produces quality data is the heart and soul of successful
interoperability. Be sure your organization’s data is clean and meaningful, and
will ultimately be understandable and useful to your patients. 

5. Think big-picture differentiation

There’s nothing in the ONC and CMS
interoperability rules that says you need to stop at mere rules compliance.
Consider your pursuit of interoperability as a singular opportunity to be a
patient-centric leader in your market. Let everyone relevant know of the
success you’ve achieved. 

While interoperability
offers a chance for healthcare systems to achieve multiple operational gains,
when handled well, it is ultimately a patient-centric endeavor. Always keep the
needs and interests of your patients at the core when facilitating access to
their personal health data. It’s the ultimate smart long-term interoperability
strategy. 

---

Shanti Wilson is
a consultant with Freed Associates,
a California-based healthcare management consulting firm. 

The dominant presence of COVID-19 has not meant the absence of cancer, ear infections, heart attacks, chronic pain, or other illnesses that need attention and care. Physicians have continued treatment for all types of maladies, and physician training has continued as well. But this treatment and this training look much different these days. Despite the challenges that came with major COVID shutdowns and changing requirements, the healthcare system and patients have been both creative and resilient in finding robust “temporary” solutions to these challenges. It is now looking like some of these COVID-era transitional steps will be preserved and play a lasting role in the future of medical education and telemedicine. What must be sacrificed to reap the benefits of these new protocols?

The rapid adoption of technology and virtual engagement tools has been both impressive and interesting to watch – Zoom meetings between medical association boards of directors, FaceTime calls between isolated patients and their family members at home, telehealth phone appointments with family practice physicians, or virtual medical conferences through Webex – the increasing reliance on these tools has pushed boundaries and exposed both opportunities and challenges with technology use for the future of healthcare.

As COVID-19 has significantly accelerated the feasibility and acceptance of telehealth care by physicians, patients, and payors, we now see healthcare systems navigating in real-time the complex issues with cybersecurity and patient privacy. Due to waivers, everyday technologies can be utilized right now, including FaceTime, Skype, Facebook Messenger video chat, Google Hangouts, and Zoom, but new regulatory guidance may be needed to develop safe, secure, and patient-friendly telehealth applications for the future. Cyber-security, already an important priority in the healthcare information space, is going to become that much more essential as doctor’s offices and clinics implement even more telehealth protocols faster than they ever would have normally planned or budgeted for.

These changes in practice and patient care have also impacted how controlled substances are prescribed. The Drug Enforcement Agency has modified policies to allow for the remote prescribing of controlled substances during the pandemic. Online counseling, informed consent, and follow-up with patients can be done in a virtual setting. Pill counts can be done in a video call and patients can still have their questions answered regarding their pain therapy, although it is likely that after the crisis, prescribing certain controlled substances may return to in-person visits.   It is important that the regulatory climate continues to evolve at the pace needed to address the changing needs and realities of telehealth in the time of COVID.

While we have all become more comfortable on telehealth platforms, there continues to be an important role for in-person visits. Patients may appreciate the convenience of telemedicine; however, they must understand that it can limit a physician’s ability to perform a thorough examination and possibly reduce the chances of a physician detecting an unexpected complication or condition. 

Moving forward, I expect there will be much greater reliance on telehealth strategies even post-COVID, but it will always have to be balanced with old-fashioned office visits.

Residency training has also experienced a profound shift this year. Conventional teaching approaches have either been cut back or have been canceled due to COVID risks, and reduced access to personal protective equipment (PPE) has limited the amount of time spent with patients being cared for during residency and fellowship programs. But we can’t stop training for the next generation of physicians or providing quality Continuing Medical Education (CME) for practicing physicians. E-learning techniques, such as webinars and online skills training, certainly play a role – and these may offer ways to actually enhance cross-departmental or multidisciplinary collaborative educational sessions. E-learning may be more cost-effective and easier to participate in than traveling to conferences or symposia, but the hands-on learning and deep discussions that can occur in breakout sessions or clinical training modules will need to be replaced somehow. And there must be careful vetting of online content in order to avoid a proliferation of commercially biased information, plagiarized materials, or simply false information. As we all adjust to new settings and styles for learning, there must be purposeful strategies to ensure online lectures are still supported with opportunities for learning from direct patient contact and collegial support.

Despite these concerns and challenges, new models for CME activities actually pose a great opportunity for increased access, cost-effectiveness, and practicality for busy clinicians.

Even before the first case of COVID-19 was diagnosed, technological innovation had already begun to change education, healthcare, and even social relationships. The COVID-19 crisis has simply accelerated the drive and interest in these new tools. But while the technological tools and platforms to a large extent existed years before COVID-19, they have never been used as purposefully, as rapidly, or with such intentionality as they are being used now.

I am sure the shift toward technology and virtual engagement in medicine will not go away when we finally get past the COVID-19 crisis. There will likely be lasting changes with the reliance on distance-medicine techniques for both patient care and physician training. But we must keep a close eye on regulatory frameworks that need to be updated, and make extra efforts to build and maintain patient-physician relationships.

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About Shalini Shah, MD

Shalini Shah, MD is Vice-Chair and Associate Professor, Department of Anesthesiology & Perioperative Care, and Enterprise Director of Pain Services, UC Irvine Health.  Dr. Shah completed her residency in Anesthesiology from NYP-Cornell University and a combined fellowship in Adult and Pediatric Chronic Pain at Brigham and Women’s Hospital, Beth Israel Deaconess and Children’s Hospital of Boston, Harvard Medical School. 

Senior isolation is a health risk that affects at least a quarter of seniors over 65. It has become recognized over the past decade as a risk factor for poor aging outcomes including cognitive decline, depression, anxiety, Alzheimer’s disease, obesity, hypertension, heart disease, impaired immune function, and even death.

Physical limitations, lack of transportation, and inadequate health literacy, among other social determinants of health (SDOH), further impair access to medical and mental health treatment and preventive care for older adults. These factors combine to increase the impact of chronic comorbidities and acute issues in our nation’s senior population.

COVID-19 exacerbates the negative impacts of social isolation. The consequent need for social distancing and reduced use of the healthcare system due to the risk of potential SARS-CoV-2 exposure are both important factors for seniors. Without timely medical attention, a minor illness or injury quickly deteriorates into a life-threatening situation. And without case management, chronic medical conditions worsen. 

Among Medicare beneficiaries alone, social isolation is the source of $6.7 billion in additional healthcare costs annually. Preventing and addressing loneliness and social isolation are critically important goals for healthcare systems, communities, and national policy.

Organizations across the healthcare spectrum are taking a more holistic view of patients and the approaches used to connect the most vulnerable populations to the healthcare and community resources they need. To support that effort, technology is now available to facilitate analysis of the socioeconomic and environmental circumstances that adversely affect patient health and mitigate the negative impacts of social isolation. 

Addressing Chronic Health Issues and SDOH 

When we think about addressing chronic health issues and SDOH in older adults, it is usually after the fact, not focused on prevention. By the time a person has reached 65 years of age, they may already be suffering from the long-term effects of chronic diseases such as diabetes, hypertension or heart disease. Access points to healthcare for older adults are often in the setting of post-acute care with limited attention to SDOH. The focus is almost wholly limited to the treatment and management of complications versus preventive measures.  

Preventive outreach for older adults begins by focusing on health disparities and targeting patients at the highest risk. Attention must shift to care quality, utilization, and health outcomes through better care coordination and stronger data analytics. Population health management technology is the vehicle to drive this change. 

Bimodal Outreach: Prevention and Follow-Up Interventions

Preventive care includes the identification of high-risk individuals. Once identified, essential steps of contact, outreach, assessment, determination, referral, and follow-up must occur. Actions are performed seamlessly within an organization’s workflows, with automated interventions and triggered alerts. And to establish a true community health record, available healthcare and community resources must be integrated to support these actions. 

Social Support and Outreach through Technology 

Though older adults are moving toward more digitally connected lives, many still face unique barriers to using and adopting new technologies. So how can we use technology to address the issues?

Provide education and training to improve health literacy and access, knowledge of care resources, and access points. Many hospitals and health systems offer day programs that teach seniors how to use a smartphone or tablet to access information and engage in preventive services. For example, connecting home monitoring devices such as digital blood pressure reading helps to keep people out of the ED. 

Use population health and data analytics to identify high-risk patients. Determining which patients are at higher risk requires stratification at specific levels. According to the Centers for Disease Control and Prevention, COVID-19 hospitalizations rise with age, from approximately 12 per 100,000 people among those 65 to 74 years old, to 17 per 100,000 for those over 85. And those who recover often have difficulty returning to the same level of physical and mental ability. Predictive analytics tools can target various risk factors including:

– Recent ED visits or hospitalizations

– Presence of multiple chronic conditions

– Depression 

– Food insecurity, housing instability, lack of transportation, and other SDOH 

– Frailty indices such as fall risk

With the capability to identify the top 10% or the top 1% of patients at highest risk, care management becomes more efficient and effective using integrated care coordination platforms to assist staff in conducting outreach and assessments. Efforts to support care coordination workflows are essential, especially with staffing cutbacks, COVID restrictions, and related factors. 

Optimal Use of Care Coordination Tools

Training and education of the healthcare workforce is necessary to maximize the utility of care coordination tools. Users must understand all the capabilities and how to make the most of them. Care coordination technology simplifies workflows, allowing care managers to: 

– Risk-stratify patient populations, identify gaps in care, and develop customized care coordination strategies by taking a holistic view of patient care. 

– Target high-cost, high-risk patients for intervention and ensure that each patient receives the right level of care, at the right time and in the right setting.

– Emphasize prevention, patient self-management, continuity of care and communication between primary care providers, specialists and patients.

This approach helps to identify the resources needed to create community connections that older adults require. Data alone is insufficient. The most effective solution requires a combination of data analytics to identify patients at highest risk, business intelligence to generate interventions and alerts, and care management workflows to support outreach and interventions. 

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About Dr. Jenifer Leaf Jaeger 

Dr. Jenifer Leaf Jaeger serves as the Senior Medical Director for HealthEC, a Best in KLAS population health and data analytics company. Jenifer provides clinical oversight to HealthEC’s population health management programs, now with a major focus on COVID-19. She functions at the intersection of healthcare policy, clinical care, and data analytics, translating knowledge into actionable insights for healthcare organizations to improve patient care and health outcomes at a reduced cost.

Prior to HealthEC, Jenifer served as Director, Infectious Disease Bureau and Population Health for the Boston Public Health Commission. She has previously held executive-level and advisory positions at the Massachusetts Department of Public Health, New York City Department of Health and Mental Hygiene, Centers for Disease Control and Prevention, as well as academic positions at Harvard Medical School, Boston University School of Medicine, and the Warren Alpert Medical School of Brown University.

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What You Should Know:

– AliveCor announced they received FDA clearance of new
algorithms for use with their personal EKG devices, KardiaMobile and
KardiaMobile 6L. These additional determinations will be available via a
software upgrade for the Kardia devices in 2021.

– The additional FDA-cleared algorithms double the number
of heart rhythm disturbances that AliveCor’s Kardia devices can detect,
broadening the number of patients who are able to use their remote monitoring
devices.

---

AliveCor, an AI-based
personal ECG technology and provider of enterprise cardiology solutions, today
announced that the US FDA had given clearance to the company’s next generation
of interpretive ECG algorithms. AliveCor’s KardiaMobile and KardiaMobile 6L
devices, along with the Kardia app, allow users to take a 30-second ECG and
receive instant determinations of multiple cardiac conditions.

Why It Matters

This new FDA clearance positions AliveCor to deliver
AI-based remote cardiological services for the vast majority of cases when
cardiac patients are not in front of their doctor. AliveCor’s goal is to help
cardiologists efficiently provide the best possible 24/7 service to their
patients.

New Generation of AI-Powered Remote Cardiology

This new FDA 510(K) clearance provides detail and fidelity
unlike any previously seen in personal ECG devices including:

– A “Sinus Rhythm with Premature Ventricular
Contractions (PVCs)” determination if two or more ventricular ectopic
beats are detected. PVCs are a common occurrence where extra heartbeats
originate in the bottom chamber of the heart and occur sooner than the next
expected regular heartbeat. After the PVC beat, a pause usually occurs, which
causes the next normal heartbeat to be more forceful. When one feels the heart
“skip a beat,” it is this more forceful beat that is felt.

– A “Sinus Rhythm with Supraventricular Ectopy
(SVE)” determination if narrow-complex ectopy, such as premature atrial
contractions (PACs), are detected. PACs are similar to PVCs, but these beats
originate in the top chamber of the heart, however not in the heart’s natural
pacemaker, the Sinus Node.

– A “Sinus Rhythm with Wide QRS,” determination
for QRS intervals of 120ms or longer. 
Wide QRS indicates that the activation of the bottom chamber of the
heart is taking longer than expected. This could indicate a bundle branch block
in which there is a delay in the passage of heart’s electrical signals along
the bottom of the heart.

– A reduced number of “Unclassified” readings,
thereby giving users more reliable insight into their heart rhythms.

– Improved sensitivity and specificity on the company’s
“Normal” and “Atrial Fibrillation” algorithms, giving users
fewer false positives, fewer false negatives, and even greater confidence in
Kardia determinations.

– New visualizations, including average beat, PVC
identification, and a tachogram.

“Kardia AI V2 is the most sophisticated AI ever brought to personal ECG,” said AliveCor CEO Priya Abani. “This suite of algorithms and visualizations will provide the platform for delivery of new consumer and professional service offerings beyond AFib, by allowing a much wider range of cardiac conditions to be determined on a personal ECG device.”

Availability

Today, KardiaMobile and KardiaMobile 6L are the most
clinically validated personal ECG devices in the world, and provide instant
detection of Normal Sinus Rhythm, Atrial Fibrillation, Bradycardia, and
Tachycardia. The new determinations and services will be available in 2021.

What You Should Know:

– Bill & Melinda Gates Foundation awards Caption
Health a $4.5M grant to support the development of an AI-guided lung ultrasound
system.

– The grant from the Bill & Melinda Gates Foundation
will be leveraged to create new AI technology that allows medical professionals
without prior ultrasound experience to perform lung ultrasounds, expanding
access to quality medical care.

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Caption Health, a leading medical
artificial intelligence (AI) company, today announced that it has received
a grant from the Bill & Melinda
Gates Foundation in the amount of $4.95 million to support the development
of innovative AI technology for lung ultrasound. The grant was awarded to
Caption Health by the foundation due to the need to further develop solutions
that enable timely and accurate diagnosis of pneumonia, the leading killer of
children under 5, in resource-limited settings with a shortage of highly
trained physicians. 

Caption Health already has the first and only FDA cleared AI
platform that enables medical professionals without prior ultrasound experience
to perform cardiac ultrasound exams (Caption
AI). Like cardiac ultrasound, performing lung ultrasound requires a high
level of clinical skill and specific expertise, which has limited its broad
adoption. With this grant, Caption Health will be able to expand its
first-in-class AI technology to lung ultrasound, providing healthcare workers with
real-time guidance to acquire diagnostic-quality images for each lung zone and
automated interpretation to detect key lung pathologies.

Why It Matters

“Ultrasound can be challenging for clinicians without prior experience because it requires skill in both obtaining and interpreting images. Caption Health is the leader in developing artificial intelligence that combines image acquisition and interpretation to enable clinicians to perform ultrasound regardless of skill level,” said emergency medicine physician Dr. Chris Moore, Associate Professor of Emergency Medicine, Chief of the Section of Emergency Ultrasound, and Director of the Emergency Ultrasound Fellowship at Yale. “Expanding this AI to lung ultrasound and putting it in the hands of clinicians could have profound implications for the diagnosis and treatment of pneumonia, a leading cause of death in our youngest global citizens, as well as for COVID-19 and other lung conditions.”

Lung ultrasound enables the detection of a range of
pulmonary pathologies such as pneumonia and other consolidations, pulmonary
edema, pleural effusions and pneumothorax. Furthermore, it is non-invasive,
portable and does not expose recipients to harmful radiation. As the cost of
miniaturizing ultrasound hardware decreases, Caption Health’s AI technology
solves the remaining challenge currently limiting ultrasound’s widespread use:
enabling clinicians without lengthy specialized training to acquire and interpret
diagnostic-quality ultrasound images. 

As COVID-19 cases rise, lung ultrasound is playing a
critical role in the triage and monitoring of these patients. When patients
arrive in the Emergency Department with suspicion of COVID-19, lung ultrasound
can be used for early detection of pulmonary involvement, offering higher sensitivity than chest x-rays. For those who are
diagnosed with COVID-19, lung ultrasound can be used to grade the degree of
pulmonary involvement, and to monitor changes over time. Caption Health’s AI
technology will expand access to this powerful diagnostic tool by enabling
medical professionals without prior experience in lung ultrasound to perform
these exams, and could eventually lead to lung ultrasound becoming a routine
part of point-of-care assessments.

 “Pulmonary health and cardiovascular health are closely intertwined,” said cardiologist Dr. Randolph Martin, FACC, FASE, FESC, Chief Medical Officer of Caption Health. “Abnormalities or disease states in the lungs can directly cause prominent abnormalities of cardiac function, just as disease states in the heart can lead to marked abnormalities in the lungs. By taking our unique methodology for developing breakthrough AI for cardiac imaging and applying it to lungs, we will continue to broaden the impact we can have in helping with the management of patients with conditions affecting these two vital systems.”

Future Research Plans

Having demonstrated extensive clinical validation for its
cardiac ultrasound technology, including a multi-center prospective clinical
study and numerous published abstracts, Caption Health intends to seek similar
validation for its AI lung ultrasound technology to demonstrate the ability of
the technology to equip non-specialists to perform lung ultrasound exams.

What You Should Know:

– Cardiopulmonary digital health company Eko raises $65M
in Series C funding to close the gap between virtual and in-person heart and
lung care.

– The latest round of funding will enable Eko to expand
in-clinic use of its platform of telehealth and AI algorithms for disease
screening and to launch a monitoring program for cardiopulmonary patients at
home.

Eko, a
cardiopulmonary digital
health company,
today announced $65 million in Series C funding led by Highland Capital
Partners and Questa Capital, with participation from Artis Ventures, DigiTx
Partners, NTTVC, 3M Ventures, and other new and existing investors. The new
funding will be used to expand in-clinic use of the company’s platform of telehealth
and AI
algorithms for disease screening, and to launch a monitoring program for
cardiopulmonary patients at home.

Eko was founded in 2013 to improve heart and lung care for
patients through advanced sensors, digital technology, and novel AI algorithms.
The company reinvented the stethoscope and introduced the first combined
handheld digital stethoscope and electrocardiogram (ECG). Eko’s FDA-cleared AI
analysis algorithms help detect heart rhythm abnormalities and structural heart
disease. Eko seeks to make AI analysis the standard for every physical exam. The
company recently launched Eko AI and Eko Telehealth to combat the needs of the COVID-19
pandemic.

Eko Telehealth delivers:

– AI-powered and FDA-cleared identification of heart murmurs
and atrial fibrillation (AFib), assisting providers in the detection and
monitoring of heart disease during virtual visits

– Lung and heart sound live-streaming for a thorough virtual
examination

– Single-lead ECG live-streaming, enabling providers to
assess for rhythm abnormalities

– Embedded HIPAA-compliant video conferencing, or can work
alongside the video conferencing platform a health system has in place

Symptoms of valvular heart disease and AFib often go
undiagnosed during routine physical exams. With the development of Eko’s AI
screening algorithms, clinicians are able to harness state-of-the-art machine
learning to detect heart disease at the earliest point of care regardless if
the patient visit is in-person or remote.

“We are thrilled that our new investors have joined our journey and our existing investors have reaffirmed their support for Eko,” said Connor Landgraf, CEO and co-founder at Eko. “The explosion in demand for virtual cardiac and pulmonary care has driven Eko’s rapid expansion at thousands of hospitals and healthcare facilities, and we are excited for how this funding will accelerate the growth of our cardiopulmonary platform.”

While most of the public’s attention is focused on the horse race for an approved COVID-19 vaccine, another major hurdle lies just around the corner: the distribution of hundreds of millions of vaccine doses. In today’s highly complex and disconnected health data landscape, technologies like AI, Machine Learning, and robotic process automation (RPA) will be essential to making sure that the highest-risk patients receive the vaccine first.  

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Why identifying at-risk patients is incredibly difficult 

Once a vaccine is approved, it will take months or years to produce and distribute enough doses for the U.S.’ 330 million residents. Hospital systems, primary care physicians (PCPs), and provider networks will inevitably need to prioritize administration to at-risk patients, potentially focusing on those with underlying conditions and comorbidities. That will require an unimaginable amount of work by healthcare employees to identify patient cohorts, understand each patient’s individual priority level, and communicate pre- and post-visit instructions. The volume of coordination required between healthcare systems and the pressing need to get the vaccine to high risks groups makes the situation uniquely different than other nationally distributed vaccinations, like the flu. 

One key challenge is that there’s no existing infrastructure to facilitate this process – all of the data necessary to do so is locked away in disparate information silos. Many states have legacy information systems or rely on fax for information sharing, which will substantially hamper efforts to identify at-risk patients. Consider, in contrast, the data available in the U.S. regarding earthquake risk– you can simply open up a federal geological map and see whether you’re in a seismic hazard zone. All the information is in one place and can be sorted through quickly, but that’s just not the case with our healthcare system due to its fragmentation as well as HIPAA and patient privacy laws. 

There are several multidimensional barriers that make it nearly impossible for healthcare workers employed by providers and state healthcare organizations to compile patient cohorts manually: 

– Providers will need to follow CDC guidelines on prioritization factors, which based on current guidelines for those with increased risk could potentially include specific conditions, ethnicities, age groups, pregnancy, geographies, living situations (such as multigenerational homes), and disabilities. Identifying patients with these factors will require intelligent analysis of patient profiles from existing electronic health record data (EHR) used by a multitude of providers. 

– Some hospital networks use multiple EHR and care management systems that have a limited ability to share and correlate data. These information silos will prevent providers from viewing all information about patient population health data. 

– Data on out-of-network care that could require prioritization, like an emergency room visit, is often locked away in payer data systems and is difficult to access by hospital systems and PCPs. That means payer data systems must be analyzed as well to effectively prioritize patients. 

– All information must be shared and analyzed in accordance with HIPAA laws, and the mountain of scheduling communications and pre- and post-visit guidance shared with patients must also follow federal guidelines.  

– Patients with certain conditions, like heart disease, may need additional procedures or tests (such as a blood pressure reading) before the vaccine can be administered safely. Guidelines for each patient must be identified and clearly communicated to their care team. 

– Providers may not have the capacity to distribute vaccines to all of their priority patients, so providers will need to coordinate care and potentially send patients to third-party sites like Walgreens, Costco, etc.

All of these factors create a situation in which it’s extremely difficult – and time-consuming – for healthcare workers to roll out the vaccine to at-risk patients at scale. If the entire process to analyze, identify, and administer the vaccine takes only two hours per patient in the U.S., that’s 660 million hours of healthcare workers’ time. A combination of analytics, AI, and machine learning could be a solution that’s leveraged by healthcare workers and chief medical officers in identifying the priority of patients supplemented with CDC norms.

How RPA can automate administration to high-risk patients 

Technology is uniquely poised to enable health workers to get vaccines into the hands of those who need them most far faster than would be possible using humans alone. Robotic process automation (RPA) in the form of artificial intelligence-powered digital health workers can substantially reduce the time spent prioritizing and communicating with at-risk patients. These digital health workers can intelligently analyze patient records and send communications 24 hours a day, reducing the time needed per patient from hours to minutes. 

Consider, a hypothetical situation in which the CDC prioritizes certain risk profiles, which would put patients with diabetes among those likely to receive the vaccine first. In this scenario, RPA offers significant benefits in the form of its ability to: 

Analyze EHR and population health data: 

Thousands of intelligent digital health workers could prepare patient data for analysis and then separate patients into different cohorts based on hemoglobin levels. These digital health workers could then intelligently review documents to cross-reference hemoglobin levels with other CDC prioritization factors (like recent emergency room admittance or additional pre-existing or chronic conditions ), COVID-19 testing and antibody tests data to identify those most at risk, then identify a local provider with appointment availability.

Automate patient engagement, communications and scheduling: 

After patients with diabetes are identified and prioritized, communications will be essential to quickly schedule those at most risk and prepare them for their appointments, including making them feel comfortable and informed. For example, digital health workers could communicate with diabetes patients about the protocol they should follow before and after their appointment – should they eat before the visit, what they should expect during their visit, and is it safe for them to return to work after. It’s also highly likely that widespread vaccine administration will require a far greater amount of information than with other health communications, given that one in three Americans say they would be unwilling to be vaccinated if a vaccine were available today. At scale, communications and scheduling will take potentially millions of hours in total, and all of that time takes healthcare employees away from actually providing care. 

While the timeline for approval of a COVID-19 vaccine is unclear, now is the time for hospitals to prepare their technology and operations for the rollout. By adopting RPA, state healthcare organizations and providers can set themselves up for success and ensure that the patients most critically in need of a vaccine receive it first.  

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 About Ram Sathia

Ram Sathia is Vice President of Intelligent Automation at PK. Ram has nearly 20 years of experience helping clients condense time-to-market, improve quality, and drive efficiency through transformative RPA, AI, machine learning, DevOps, and automation.

What You Should Know:

– Cardiac patients and their cardiologists are
experiencing a high number of false positives with remote patient monitoring
devices as a result of signal artifact providing inaccurate data, which can
lead to many complications—other than medical, such as unnecessary tests and
increased medical costs.

– Ambulatory cardiac monitoring provider InfoBionic has devised a way to decrease false positives and increase efficiency.

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Remote cardiac monitoring’s false positives—especially on atrial fibrillation (Afib)—hurt everyone, from the patient to the boss who will have to go without an employee when he or she has to go in for unnecessary tests. An estimated 12.1 million people in the United States will have Afib by 2030; Afib increases the risk of stroke, heart failure, and death, and is one of the few cardiac conditions that continue to rise.⁽¹⁾ “We must give the clinician more effective diagnoses, while at the same time increasing confidence in our healthcare technology systems with respect to the accuracy of the same patient data,” expressed Stuart Long, CEO of InfoBionic, a provider of ambulatory cardiac monitoring services.

Impact of Remote
Patient Monitoring on Afib

Afib is a “fluttering feeling that can point to a quivering heart muscle, a notable skipped beat as the mark of a palpitation, and a racing heart rate that sparks other discomforts.” ⁽²⁾ With the rise of remote patient monitoring (RPM) as an effective and economical modality to treat and monitor patients, false positives continue to rise to generate a lack of confidence in the accurate clinical data captured through RPM. False positives can overwhelm the clinician and result in the increased use of resources and downstream costs, and false negatives could have detrimental clinical consequences.⁽³⁾ 

Without a reliable RPM supported by powerful AI solutions, healthcare payers experience higher costs. Heart disease takes an economic toll, as well, costing the nation’s healthcare system $214 billion per year and consuming $138 billion in lost productivity on the job. ⁽⁴⁾ The cascading effect of false positives run the gamut of the human experience—from the physical and emotional health of the patient to the added out-of-pocket expenses of unnecessary and avoidable tests.

The increased risks of hospital readmissions at a time when healthcare systems are overtaxed and understaffed adds another factor of what could have been an unneeded situation. “InfoBionic AI has all but eliminated the need for physicians to deal with false positives. In fact, 100% of Atrial Fibrillation events longer than 30 seconds are detected accurately (true positive) by InfoBionic’s AI system⁽⁶⁾,” said Long.

By
leveraging cloud computing with continuous arrhythmia monitoring to create a
reliable platform with accurate data collection, an ambulatory cardiac monitor,
such as the MoMe^® Kardia device, optimizes AI solutions,
allowing for consistency in the treatment. Integrated sensor measures have been
shown to predict heart failure and might have the potential to
empower patients to participate in their own care.⁽⁵⁾ Offering
24-hour monitoring through RPM technology that reduces false positives leads to
the patient becoming more comfortable with the RPM service, which increases the
likelihood the patient will adopt the practice of self-care well into the
future. Cardiac patients with pulmonary or electrolyte problems may need
continuous cardiac monitoring to screen for arrhythmias.

“A primary feature of our MoMe^® Kardia is its ability to leverage technology in a way that makes physicians feel more confident via analysis precision that verifies detected cardiac episodes through the algorithm,” said Long. Another distinct advantage is the ability to provide 6 lead analysis instead of the 1 or 2 leads provided by other systems. This affords the physician a much better view of each heartbeat, thereby increasing physician confidence in the accuracy of diagnosis.

The
AI
provides valuable clinical statistics that guide treatment with the best
patient outcomes. As the leading provider to collect every heartbeat and
transmit it to the cloud in near real time, explains Long, InfoBionic’s AI
algorithms are informed by over 15 million hours of electrocardiogram (ECG)
collected from the entire patient population. With full disclosure transmission
that allows AI algorithms to run on powerful servers in the cloud, the system
utilizes much more intensive processing than could be accomplished on other
patient-worn devices. Multiple patented algorithms are run concurrently on the
ECG stream, each with superior performance on a variety of clinical conditions.

What You Should Know:

– Mayo Clinic announced a collaboration with Vocalis
Health to to research and develop new voice-based tools for screening, detecting
and monitoring patient health, beginning with a study to identify vocal
biomarkers to detect pulmonary hypertension (PH).

– The clinical validation study will utilize Vocalis
Health’s proprietary software, which can operate on any connected voice
platform (mobile, computer, tablet, etc.) to analyze patients’ health based on
voice recordings.

– Following this initial phase, researchers will work to
identify vocal biomarkers targeting additional diseases, symptoms and
conditions.

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Mayo Clinic and Vocalis Health, Inc., a company
pioneering AI-based
vocal biomarkers for use in healthcare, today announced a collaboration to
research and develop new voice-based tools for screening, detecting and
monitoring patient health. The collaboration will begin with a study to
identify vocal biomarkers for pulmonary hypertension (PH) which could help
physicians detect and treat PH in their patients.

Impact of Pulmonary Hypertension

Pulmonary hypertension is a severe condition causing high blood pressure in the lungs, but
as the symptoms are similar to other heart and lung conditions, it is often not
detected in routine physical exams. While traditional blood tests can sometimes
detect pulmonary hypertension, it frequently goes undiagnosed. This
strategic collaboration aims to provide an
alternative and highly scalable method to check patients for PH, using only a recording of the patient’s voice, to understand their health and the progression of the disease. 

Study Establishes Relationship Between Certain Vocal Biomarkers
& Pulmonary Hypertension

In a previous trial with Vocalis Health, the Mayo research
team established a relationship between certain vocal characteristics and PH.
In this new collaboration, Mayo will conduct a prospective clinical validation
study to further develop PH vocal biomarkers. The clinical validation study
will utilize Vocalis Health’s proprietary software, which can operate on any
connected voice platform (mobile, computer, tablet, etc.) to analyze patients’
health based on voice recordings. Following this initial phase, researchers
will work to identify vocal biomarkers targeting additional diseases, symptoms
and conditions.

Vocalis Health Background

Vocalis Health is an AI healthtech company pioneering the
development of vocal biomarkers – where health-related information is derived
from analysis of people’s voice recordings – to screen, detect, monitor and
predict health symptoms, conditions and diseases.  Vocalis Health is currently focused on
screening users for COVID-19 and on monitoring patients with chronic diseases
such as COPD.

“We have seen the clinical benefits of voice analysis for patient screening throughout the COVID-19 pandemic, and this collaboration presents an opportunity for us to continue broadening our research, beginning with pulmonary hypertension,” said Tal Wenderow, CEO of Vocalis Health. “Voice analysis has the potential to help physicians make more informed decisions about their patients in a non-invasive, cost-effective manner. We believe this technology could have important clinical implications for telemedicine and remote patient monitoring in the very near future. We are excited to work with Mayo Clinic and have already started planning clinical trials for additional indications.”

What You Should Know:

– Northwestern Memorial Hospital is the first in the
nation to deploy FDA-cleared AI-guided ultrasound by Caption Health, including
measurement of ejection fraction – the most widely used measurement to assess
cardiac function.

– Caption Health’s AI-guided cardiac ultrasound enables clinicians – including those without experience – to accurately perform diagnostic-quality exams — accelerating the availability of information and saving lives.

– Caption AI has been shown to produce assessments
similar to those of experienced sonographers in work presented to the American
Society of Anesthesiologists.

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Northwestern Memorial
Hospital is the first hospital in the United States to purchase Caption Health’s
artificial
intelligence (AI) technology for ultrasound, Caption AI. The FDA cleared, AI-guided
ultrasound system enables healthcare providers to acquire and interpret quality
ultrasound images of the human heart, increasing access to timely and accurate
cardiac assessments at the point of care.

Performing an ultrasound exam is a complex skill that takes years to master. Caption AI enables clinicians—including those without prior ultrasound experience—to quickly and accurately perform diagnostic-quality ultrasound exams by providing expert turn-by-turn guidance, automated quality assessment, and intelligent interpretation capabilities. The systems are currently in the hospital’s emergency department, medical intensive care unit, cardio-oncology clinic, and in use by the hospital medicine group.

Democratize the Echocardiogram

Point-of-care ultrasound (POCUS) has a number of benefits. Increased usage of POCUS contributes to more timely and accurate diagnoses, more accurate monitoring, and has been shown to lead to changes in patient management in 47% of cases for critically ill patients. POCUS also allows patients to avoid additional visits to receive imaging, as well as providing real-time results that can be recorded into a patient’s electronic medical record.

“Through our partnership with Caption Health, we are looking to democratize the echocardiogram, a stalwart tool in the diagnosis and treatment of heart disease,” said Patrick McCarthy, MD, chief of cardiac surgery and executive director of the Northwestern Medicine Bluhm Cardiovascular Institute, a group involved in the early development of the technology. “Our ultimate goal is to improve cardiovascular health wherever we need to, and Caption AI is increasing access throughout the hospital to quality diagnostic images.” 

How Caption Health Works

Caption AI emulates the expertise of a sonographer by providing real-time guidance on how to position and manipulate the transducer, or ultrasound wand, on a patient’s body. The software shows clinicians in real-time how close they are to acquiring a quality ultrasound image, and automatically records the image when it reaches the diagnostic-quality threshold. Caption AI also automatically calculates ejection fraction, or the percentage of blood leaving the heart when it contracts, which is the most widely used measurement to assess cardiac function.

“Northwestern Medicine has been a tremendous partner in helping us develop and validate Caption AI. We are thrilled that they are bringing Caption AI into key clinical settings as our first customer,” said Charles Cadieu, chief executive officer and co-founder of Caption Health. “The clinical, economic and operational advantages of using AI-guided ultrasound are clear. Most important, this solution increases access to a safe and effective diagnostic tool that can be life-saving for patients.”

What You Should Know:

– FDA awards AppliedVR Breakthrough Device designation for
treating treatment-resistant fibromyalgia and chronic intractable lower back
pain

– AppliedVR’s EaseVRx program helps patients learn self-management skills grounded in evidence-based cognitive-behavioral therapy (CBT) principles and other behavioral methods.

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AppliedVR,
a pioneer advancing the next generation of digital medicine, today announced
its EaseVRx product received Breakthrough Device designation from the U.S. Food
and Drug Administration (FDA) for treating treatment-resistant fibromyalgia and
chronic intractable lower back pain. EaseVRx is now one of the first virtual
reality (VR) digital therapeutics to get breakthrough designation to treat
conditions related to chronic pain.

What is the FDA Breakthrough Device Program?

The FDA Breakthrough Device Program helps patients receive more timely access to breakthrough technologies that could provide more effective treatment or diagnosis for life-threatening or irreversibly debilitating diseases or conditions. 

Clinical Trial Results/Outcomes

AppliedVR achieved this milestone after successfully
completing the first randomized controlled trial (RCT), evaluating VR-based
therapy for self-management of chronic pain at home. The RCT, which was
published in JMIR-FR,
found that a self-administered, skills-based VR treatment program for treating
chronic pain was feasible, scalable and was effective at improving on multiple
chronic pain outcomes – each of which met or exceeded the 30-percent threshold
to be clinically meaningful. On average, participants noted:

– Pain intensity reduced 30 percent;

– Pain-related activity interference reduced 37 percent;

– Pain-related mood interference reduced 50 percent;

– Pain-related sleep interference reduced 40 percent; and

– Pain-related stress interference reduced 49 percent.

EaseVRX Program Background

AppliedVR’s EaseVRx program helps patients learn self-management skills grounded in evidence-based cognitive-behavioral therapy (CBT) principles and other behavioral methods. The program was designed by AppliedVR, in partnership with the top pain experts and researchers, to improve self-regulation of cognitive, emotional, and physiological responses to stress and pain. AppliedVR has already been shown to be an effective treatment for acute pain in hospital settings. 

Why Virtual Reality Is An Effective Approach for Pain
Management

Lower back pain is one of the most common
chronic conditions that people face worldwide and represents one of the top
reasons why people miss work. Additionally, it’s an extremely
costly problem for insurers, especially as they look to cut costs related to back surgery. Recent research indicated that, when combined with neck pain,
lower back pain costs nearly $77 billion to private insurance, $45 billion to
public insurance, and $12 billion in out-of-pocket costs for patients.

Chronic pain more broadly also is a difficult and costly
problem that has contributed to many other major health problems in the U.S.,
including the opioid epidemic. A previous Johns Hopkins study in the Journal of
Pain found that chronic pain can cumulatively cost as high as $635 billion a year — more than the annual costs of
cancer, heart disease and diabetes — and lower back pain has been one of the most common reasons for prescribing opioids.
Cognitive behavioral therapies like VR are now seen by many providers as an
effective alternative or complement to pharmacological interventions that can
support their larger treatment tool belts.

“Since 1980, the American Chronic Pain Association has advocated a multidisciplinary approach to pain management—using a combination of medical and behavioral techniques to address pain,” said Penny Cowan, founder and CEO of the American Chronic Pain Association. “Virtual reality has the potential to be an important resource in this approach, helping people with pain to think differently about their conditions and learn strategies to reduce suffering and improve quality of life.”

Future Clinical Trials

AppliedVR is currently engaged in many other trials,
including feasibility studies with multiple well-known payers and with the
University of California at San Francisco (UCSF) to study how digital therapeutic platforms, including
virtual and augmented reality, can be used to improve care access for
underserved populations. AppliedVR also is advancing two clinical trials with
Geisinger and Cleveland Clinic to study VR as an opioid-sparing tool for acute
and chronic pain – specifically the company’s RelieVRx and EaseVRx platforms.
The National Institute on Drug Abuse (NIDA), part of the National Institutes of
Health (NIH), recently awarded $2.9 million grants to fund the trials.

What You Should Know:

– Today, Blue Cross and Blue Shield of North Carolina partners
with Carrot Inc. and Virta Health to help address two of the largest ongoing
health issues facing Americans today – smoking and type 2 diabetes.

– Virta and Carrot’s programs will be available to
individual under-65 members and fully insured group members beginning November
2020.

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Blue Cross and Blue Shield of North Carolina (Blue Cross NC), today announced it is teaming up with Carrot Inc. and Virta Health to launch no-cost virtual programs to help members quit smoking and reverse type 2 diabetes. Virta and Carrot’s programs will be available to individual under-65 members and fully insured group members beginning November 2020 at no cost. They support Blue Cross NC’s commitment to make health care better, simpler and more affordable by providing members easy access to care through digital technology. 

“We resolve to make whole person care a priority, and that means we have to think beyond treating conditions, and work to prevent and reverse them,” said Von Nguyen, vice president of clinical operations and innovations at Blue Cross NC. “We are excited to team up with Carrot and Virta and bring their innovative, life-changing programs directly to the homes of our members and address some of North Carolina’s most pressing health issues.”

Carrot’s Clinically-Proven Program Empowers People to
Quit Smoking 

In addition to being the leading cause of preventable death in the U.S., smoking remains a tremendous burden on our nation’s health care system. According to the Centers for Disease Control and Prevention, more than 16 million Americans are living with a disease caused by smoking, and for every person who dies because of smoking, at least 30 people live with a serious, smoking-related illness such as diabetes, COPD, heart disease, or cancer. Smoking-related illness costs the State of North Carolina over $13 billion every year.  

Carrot’s clinically-proven, app-based program Pivot, combines innovative technology, human-centered design, and behavioral science to empower people to quit smoking and remain non-smokers. In a recent clinical study 42 percent of participants achieved a successful quit over the course of the study, and seven months after the onset of the study, 86 percent of those who quit were smoke-free.

Pivot’s digital solution includes text-based access to
trained tobacco experts, a first-of-its-kind personal breath sensor to track
progress, nicotine therapy products, and access to Pivot’s online community for
collective wisdom and inspiration.  

“Carrot is excited to collaborate with Blue Cross NC to ease the burden smoking has long placed on the state of North Carolina and the American health care system,” said David S. Utley, M.D., CEO of Carrot Inc. “Quitting smoking is hard – every year, millions try to stop smoking. We’re proud to bring Pivot to the hundreds of thousands of Blue Cross NC members who want to live life tobacco free and help them prevent or reverse the severity of chronic conditions like diabetes, heart disease and COPD.”

Diabetes Reversal with Virta Health
More than 3.7 million people in North Carolina—nearly half of the adult
population—have either prediabetes or type 2 diabetes.  According to the
CDC, diabetes increases the risk for severe illness for those with COVID-19.

Virta Health, the leader in type 2 diabetes reversal, uses an innovative virtual care model that helps patients achieve normal blood sugar while eliminating the need for diabetes-specific medications. Patients receive near-real-time access to board-certified physicians and health coaches who provide expert, individualized guidance on nutrition and behavioral change through the Virta app. Virta also serves as a partner to Primary Care Providers, integrating its specialized diabetes reversal treatment into existing care plans.

In Virta’s peer-reviewed clinical outcomes, at one year 94
percent of participants reduced or eliminated the need for insulin. The
majority of patients eliminated all diabetes-specific prescriptions while
achieving normal blood sugar. Results also include 12 percent (30lbs) weight
loss, and improvement in over 20 markers of cardiovascular health, including
blood pressure.

“This is a massive opportunity to change the direction of health of an entire state, save lives, and significantly reduce healthcare spend along the way,” said Sami Inkinen, Virta Health co-founder and CEO. “Our collaboration with Blue Cross NC provides strong optimism that we can solve the type 2 diabetes crisis our nation is facing.” 

What You Should Know:

–  Butterfly
Network launched its next-gen ultrasound product, the new Butterfly iQ+
featuring the world’s only Ultrasound-on Chip™ technology and announced a
landmark collaboration with the American College of Cardiology (ACC).

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Butterfly Network,
Inc., today announced the launch of its next-gen ultrasound product, the
new Butterfly iQ+, the world’s only single-probe, whole-body
ultrasound system that connects to a mobile device and features an integrated
telemedicine platform. Butterfly iQ+ offers new capabilities, such as
faster frame rates, Needle VizTMtechnology, a longer battery life and
industry-leading durability. 

Ultrasound reinvented again

Butterfly iQ+ features an optimized manufacturing
process in partnership with TSMC, the largest and most advanced dedicated IC
foundry in the world. TSMC’s MEMS (microelectromechanical systems)
manufacturing technology enables the ultrasound transducer to seamlessly integrate
with CMOS (complementary metal-oxide semiconductor) technology. In addition,
TSMC possesses manufacturing capacity that can scale to realize Butterfly’s
vision of making an ultrasound device as ubiquitous as the stethoscope for the
world’s 40 million healthcare providers.

Butterfly’s innovative product has been shown to be a
particularly useful tool during the global COVID-19 pandemic due to its lung imaging
capabilities, portability and ease of cleaning, as infection control has become
increasingly important. Butterfly iQ+ brings a suite of new
capabilities that make it even easier to make fast decisions at the bedside. 

Faster, sharp imaging

With patented on-chip digital micro-beamforming enabling 15%
faster frame rates and 60% faster pulse repetition frequency, healthcare
providers can see image details in the heart, lungs and bladder with optimized
clarity. High-performance shallow imaging capabilities help support fast,
confident interventional decision-making, while deep imaging capabilities in
the lung and deep cardiac presets allow for sharp details. The Butterfly iQ+ can
help healthcare providers save time in their diagnosis and treatment of
patients, improving overall patient outcomes.

State-of-the-art technology for new levels of control

The cutting-edge Needle VizTM technology available
on Butterfly iQ+ can provide healthcare professionals with an
enhanced ability to see a needle—improving confidence for central line
placements, regional nerve blocks and other guided procedures. Additionally, in
just four seconds, clinicians can calculate bladder volume automatically using
the AI-based Auto Bladder Volume tool, allowing faster decisions at the
bedside. 

More power and durability 

The Butterfly iQ+ extends battery life by 20%
and scanning time by 100% to help healthcare providers get through their shift.
With its durable, anodized aluminum body and replaceable compression- and
stomp-tested cable, the Butterfly iQ+ offers military-grade
durability to withstand tough shifts, and has been tested to withstand an
industry-leading 4-foot drop. This next-generation device has gone through
rigorous testing to ensure shock resistance and protection from dust and water
damage. 

Pricing & Availability

Putting ultrasound on a chip, Butterfly was able
to define a new precedent of affordability by providing a whole-body ultrasound
device at $1,999, plus membership. Today, as it reinvents ultrasound
again, Butterfly iQ+ will be available for the same affordable
price. 

“Two years ago, Butterfly introduced the world’s first handheld, single-probe, whole-body ultrasound system. Since then, the device has been used by tens of thousands of medical professionals across the globe with significant clinical, economic and societal impact,” said Laurent Faracci, Butterfly Network’s Chief Executive Officer. “We have collaborated with the Butterfly community of users to define our innovation path. The first result in that journey is the new Butterfly iQ+, a big step forward for point-of-care ultrasound, with our most advanced chip ever and a number of amazing innovations and improvements that our talented team and partners developed.”

The COVID-19 pandemic is not just a medical crisis.  Since the highly contagious disease hit American shores in early 2020, the virus has dramatically changed all sectors of society, negatively impacting everything from food supply chains and sporting events to the nation’s mental and behavioral health.

For some people, work-from-home plans and limited access to entertainment are manageable obstacles.  For others, the shuttered schools, lost wages, and social isolation spell disaster – especially for individuals already living with socioeconomic challenges.

The social determinants of health have always been important for understanding why some populations are more susceptible to increased rates of chronic conditions, reduced healthcare access, and shorter lifespans.  COVID-19 is throwing the issue into high relief.

Now more than ever, healthcare providers need to gain full visibility into their populations and the non-clinical challenges they face in order to help individuals maintain their health and keep their communities as safe as possible during the ongoing pandemic.

Exploring correlations between socioeconomic circumstances and COVID-19 vulnerability

Clinicians and researchers have worked quickly to identify patterns in the spread of COVID-19.  Early results have emphasized the danger posed by advanced age and preexisting chronic conditions such as obesity, diabetes, and heart disease. 

Further, data from the Johns Hopkins University and American Community Survey indicates that the infection rate in predominantly black counties is three times higher than in mostly white counties. The death rate is six-fold higher.

Data from the Centers for Medicare and Medicaid Services (CMS) confirms the trend: black Medicare beneficiaries are hospitalized at a rate of 465 per 100,000 compared to just 123 per 100,000 white beneficiaries. Hispanic Medicare beneficiaries had 258 hospitalizations per 100,000, more than double the white population’s hospitalization rate.

Researchers suggest that the social determinants of health may be largely responsible for these disconnects in infection and mortality rates.  Racial, ethnic, and economic factors are strongly correlated with increased health concerns, including longstanding disparities in access to care, higher rates of underlying chronic conditions, and differences in health literacy and patient education.

Leveraging data-driven tools to identify vulnerable patients

Healthcare providers will need to take a proactive role in identifying which of their patients may be at enhanced risk of contracting the virus and experiencing worse outcomes from the disease.  

They will also need to ensure that person gets adequate treatment and participate in contact tracing efforts after a positive test.  Lastly, providers will have to ensure their public health reporting data is accurate to inform local and regional efforts to contain the disease.

The process begins by developing confidence in the identity of each individual under the provider’s care.  Healthcare organizations often struggle with unifying multiple electronic health record (EHR) systems and other health IT infrastructure, resulting in medical records that are incomplete, inaccurately duplicated, or incorrectly merged.

Access to current and complete medical histories is key for highlighting at-risk patients.  An enterprise master patient index (EMPI) can provide the underlying technical foundation for initiating this type of population health management.  

EMPIs help organizations create and manage reliable unique patient identifiers to ensure that records are always associated with the correct individual as they move throughout the healthcare system.

When paired with claims data feeds, health information exchange (HIE) results, and interoperability connections with other healthcare partners, EMPIs can bring a patient’s complete healthcare status into focus.

This approach ensures that providers stay informed about past and present clinical issues and service utilization rates.  It can also support a deeper dive into the social determinants of health.

Combining EHR data with standardized data about socioeconomic needs can help providers develop more comprehensive and detailed portraits about their patients’ holistic health status.  

By including this information in EHRs and population health management tools, providers can develop condition-specific registries to guide outreach activities.  Providers can deploy improved care management strategies, close gaps in care, and connect individuals with the resources they need to stay healthy.

Healthcare organizations can acquire socio-economic data about their communities in a variety of ways, including integrating public data sources into their population health management tools and collecting individualized data using standardized questionnaires.

Once providers start to understand their patients’ non-clinical challenges, including the ability to avoid situations that may expose them to COVID-19, they can begin to prioritize patients for outreach and develop personalized care plans.

Conducting effective outreach and interventions for high-needs patients

COVID-19 has taken a staggering economic toll on many families, including those who may have been financially secure before the pandemic.  Routine healthcare, prescription medications, and even some urgent healthcare needs are often the first to fall by the wayside when finances get tight. 

Healthcare providers have gotten creative about staying connected to patients through telehealth, drive-in consults, and other contactless strategies.  But they must also ensure that their vulnerable patients are aware of these options – and that they are taking advantage of them.

Contacting a large number of patients can be challenging since phone numbers, emails, and home addresses change frequently and are prone to data entry errors during intake. Organizations with EMPIs can leverage their tools to ensure contact information is up to date, accurate, and associated with the correct individual.

Care managers should prioritize outreach to patients with complex medical histories and known clinical risks for vulnerability to COVID-19.  These conversations are a prime opportunity to collect social determinants of health information or refresh existing data profiles.

Looking to the future of healthcare in a COVID-19 world

Combining technology-driven strategies with targeted outreach will be essential for healthcare organizations aiming to provide holistic support for their populations during – and after – the COVID-19 pandemic.

By developing certainty about patient identities and synthesizing that information with data about the social determinants of health, providers can efficiently and effectively connect with their patients to offer much-needed resources.

Taking a proactive approach to addressing the social determinants of health during the outbreak will help providers maintain relationships with high-needs patients while building new connections with those facing unanticipated challenges.

With a combination of population health management strategies and innovative technology tools, healthcare providers and public health officials can begin to view the social determinants of health as a fundamental component of the fight against COVID-19. 

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Andy Aroditis, is CEO of NextGate, the global leader in healthcare enterprise identification.

What You Should Know:

– Tyto
Care and Amwell® announced an expanded partnership, allowing
the companies to develop new integrations to enhance virtual care offerings for
providers.

– By pairing Tyto Care’s TytoHome device and platform
with Amwell’s platform, the two companies will together provide patients
and providers with augmented virtual care experiences and
broadly enrich the capabilities and satisfaction with healthcare organizations’
virtual care applications.

---

Telehealth
provider Amwell, today
announced it is expanding its partnership with Tyto Care, the
healthcare industry’s first all-in-one modular device and examination platform
for AI-powered, on-demand, remote medical exams. Together the companies will
introduce exclusive integrations and newly designed workflows and tools to
enhance the ability for providers using the Amwell platform to examine and
diagnose patients virtually. Additionally, Amwell will become a reseller of Tyto Care’s
integrated devices.   

Tyto Care Background

Tyto Care seamlessly connects people to clinicians to provide
the best virtual home examination and diagnosis solutions. Its solutions are
designed to enable a comprehensive medical exam from any location and include a
hand-held, all-in-one tool for examining the heart, lungs, skin, ears, throat,
abdomen, and body temperature; a complete telehealth platform for sharing exam
data, conducting live video exams, and scheduling visits; a cloud-based data
repository with analytics; and built-in guidance technology and machine
learning algorithms to ensure accuracy and ease of use for patients and
insights for healthcare providers.

Conduct Exams and Diagnoses

By pairing the TytoHome handheld examination
device – which enables on-demand examinations of the heart, lungs, abdomen,
skin, throat, ears, heart rate, and body temperature – with Amwell’s telehealth
platform, providers can guide patients through
virtual health examinations and together gain real-time insight into a
patient’s health data and status directly in the visit. For patients and
providers, this will augment the virtual care experience and more broadly
enrich the capabilities and overall satisfaction associated with healthcare
organizations’ virtual care applications. This enriched workflow will be available to
thousands of Amwell hospitals, health systems, health plans
and employer clients who collectively serve millions of patients.  

“As COVID-19 wages on and more patients and providers adopt telehealth, it’s critical that we accelerate the depth of care that can be provided in the home – to keep patients and providers safe,” said Roy Schoenberg, President and Co-CEO, Amwell. “Our latest integration with Tyto Care will allow providers to clinically come closer than ever before to patients during telehealth encounters, allowing them to see, interact, examine and deliver care in ways that growingly resemble in-person care.”

Offering More Holistic Care for Patients

“Our longstanding partnership with Amwell exemplifies our shared goal of providing deeply integrated telehealth solutions that put health in the hands of consumers, creating a more impactful and seamless healthcare experience for both patients and providers,” said Dedi Gilad, CEO and Co-Founder, Tyto Care. “The integration with TytoHome will enable Amwell to offer more holistic care for patients, especially for urgent and primary care needs, as well as help to enable better adherence to treatment plans. We look forward to continuing our work together as we realize the full potential of clinic-quality, at-home care in this new era of telehealth.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What You Should Know:

– Validic launches the newest version of its remote
patient monitoring (RPM) offerings, Validic Impact: Rapid Deployment.

– This new standalone version of Validic Impact requires
no EHR integration and can be used as a fully standalone solution.

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Validic, a Durham,
NC-based provider of health data platforms and solutions for scaling remote
patient monitoring (RPM), has announced the release of a major update to its
remote patient monitoring solution, Validic
Impact. This new release offers the ability to deploy an end-to-end
technology solution for chronic and acute condition monitoring, rapidly.

Validic Impact: Rapid Deployment Features

Validic
Impact: Rapid Deployment offers providers a standalone, web-based
application to manage device-driven RPM programs. The solution is designed for
scale and offered with an ease of use that allows provider groups to quickly
purchase and launch.

Validic’s RPM solutions offer the alerting, visualization
and analytics capabilities needed to engage and manage patients from their
home. The Validic Impact solutions can support the management of acute and
chronic conditions, such diabetes, hypertension, heart failure, and COVID-19
(coronavirus). This new version of Validic Impact requires no EHR integration
and can be used as a fully standalone solution.

– Set up and launch rapidly – with no technology
integration and minimal configuration requirements, providers can deploy
comprehensive RPM programs rapidly.

– Create protocol templates – standardize
templates for the conditions you want to manage with default programmed alerts,
consent language, etc.

– Enroll patients quickly – invite a patient to
a program within seconds – enabling them to consent and connect their device(s)
from any browser.

– Personalize and monitor – easily adjust and
personalize goals and alerts for each patient; automate outreach to patients
who are not submitting readings, trending in the wrong direction, or flag
readings of concern for timely interventions.

Validic’s RPM model allows physicians to tap into the
devices their patients already own and use. The solution can integrate over 480
consumer and clinical health devices via Validic’s core health data
platform. In addition to supporting a bring-your-own-device (BYOD), Validic
Impact also supports kitted device fulfillment and 24/7 device support through
strategic relationships with device logistics companies.

Why It Matters

“COVID-19 was a call to action for healthcare,” Drew Schiller, CEO of Validic said. “Our platform-first RPM approach enhances virtual visit offerings. Right now, that means quickly replacing clinical data usually gathered during in-person visits, such as weight and blood pressure, with home health data.”

Schiller added, “Beyond improving the quality of care delivered through telehealth, RPM will continue to serve as a staple of virtual care and extend in-person care offerings.”

The coronavirus pandemic has affected every aspect of our lives, from how we work to how we get our health care. The crisis has put the creativity of many small businesses to the test after being forced to move operations online once social distancing became the norm. As economies reopen, many aspects of our life that changed in response to the virus will likely return to the way they were.

However,  we have the opportunity to emerge stronger from this crisis if the salient shortcomings from our economic system are addressed. Regarding health care, the virus has exposed deep flaws in the way services are provided and has shown us how businesses and people can be better prepared when the next pandemic hits.

1. The way companies insure their workers will change 

One trend we will likely see occurring is the decentralization of healthcare. Before the pandemic, there had been growing signs of American businesses becoming tired of a rigged system where costs to keep employees insured often spiraled out of control. One example of this dissatisfaction was the partnership between Amazon, JP Morgan, and Berkshire Hathaway, who more than 2 years ago announced the formation of their own joint venture to provide healthcare coverage to their employees. 

The pandemic is going to introduce a long term change in healthcare and especially the relationship between companies and healthcare providers. More companies will make the switch to self-funded insurance and assume the healthcare expenses of their employees while being reimbursed for claims that exceed a certain amount through stop-loss insurance. Businesses will also start to hire their own physicians to offer services to their employees directly to reduce their dependence on the healthcare system.

Given our early struggle to increase our virus testing capabilities, companies may take steps to avoid waiting for the federal or local governments to step in during a pandemic.  Businesses may start partnering with local labs to design their own diagnostic tools and serological tests which would allow them to react more quickly and successfully to an outbreak. Businesses will value knowing which of their employees have been exposed, how many might be immune, and which might be more susceptible to infection based on parameters such as BMI or blood pressure readings.  

2. Businesses and people will take charge of their own health

Although the United States spends close to 20% of its GDP on healthcare, diseases that put people at higher risk for severe COVID-19 illness, including obesity, diabetes, and heart disease, are still prevalent in the population. 

This crisis exposed the need for businesses to help employees maintain a healthy lifestyle in order to protect themselves and their jobs. Businesses may start promoting behaviors proven to strengthen the immune system and improve overall health, including taking active breaks at work to increase physical activity or encouraging healthy eating by offering healthy food choices. Companies may also start to offer testing equipment in office locations to help employees keep track of their health. Businesses may start investing in mini-physiology lab stations that include equipment to measure blood pressure, lung function, and heart health. They may also invest in blood tests that measure important biomarkers that allow employees to make better health choices that reduce their risk of disease.

3. Telehealth solutions will become widely available 

The pandemic has amplified the need for a technology-driven transformation of healthcare. Companies can invest in built-in telemedicine capabilities so that employees have an easy way to get online care when they need it.  The regulatory barriers that have delayed widespread use of telehealth should start to disappear. Hospitals can benefit from offering these services and implementing them now will better equip them for future crises. Doctors can remotely provide care to vulnerable patients so they don’t have to be exposed by going to a hospital, and physicians and nurses who have to quarantine themselves can still see patients through telehealth means so that hospitals don’t have to face staff shortages when they believe they might have been exposed. 

4. Artificial Intelligence will change everything

The use of AI in healthcare will combine with the trends described above to completely disrupt healthcare, especially in terms of corporate wellness. Skyrocketing costs and disillusionment with the governmental response to COVID-19 will convince organizations of all sizes to take more direct responsibility for the health and wellness of their employees. Cloud-based systems can aggregate everything from electronic medical records to whole-genome sequences. Fitness trackers and other inexpensive devices can add real-time physiologic data that can be tracked over time.

All this data would be overwhelming for human physicians, but it’s perfect for AI-based systems. For example, an AI can continuously calculate the probabilities of dozens of diseases for each employee and generate automatic recommendations when a probability exceeds a certain threshold. Such systems can also give employees personalized advice to help them reduce such probabilities and return to a healthy state. The advice can range from lifestyle changes (nutrition, exercise, etc.) to supplements or further testing. These AI-based systems will grow in sophistication over time to rival – and even exceed – the capabilities of human physicians.

Summary

The American healthcare system was clearly dysfunctional even before COVID-19. However, the pandemic has put the flaws into sharp relief and will almost certainly push companies and other organizations to seek better solutions. Those solutions will leverage many recent developments including:

• Cloud platforms with nearly limitless storage and compute capacity
• Engaging mobile apps
• Direct-to-consumer molecular and genetic testing
• Fitness trackers and other medical devices
• Artificial intelligence

Together, these trends will usher in lasting change that will transform the healthcare landscape for all businesses.

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About Dr. Don Brown

Don is a serial software entrepreneur (founder of 4 companies), life-long learner (4 degrees: a bachelor’s in physics, a master’s in computer science +  biotechnology and an MD) and philanthropist (donated  $30 million for the establishment of the Brown Immunotherapy Center at the Indiana University School of Medicine).  Prior to LifeOmic, Don founded Software Artistry which became the first software company in Indiana ever to go public and was later acquired by IBM for $200 million. Don then founded and served as CEO of Interactive Intelligence which went public and was acquired by Genesys Telecommunications Laboratories in 2016 for $1.4 billion.

What You Should Know:

The FDA and Syapse announce research collaboration expansion
to address urgent public health challenges including supporting FDA’s goal of
rapid understanding of COVID-19.

As part of the research, Syapse is partnering with FDA’s
Oncology Center of Excellence to investigate methods to derive RWD from
multiple sources including electronic health records, registries and molecular
data

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Syapse, a real-world
evidence company accelerating the delivery of precision medicine through the
Syapse Learning Health NetworkTM, and the U.S.
Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) have
expanded an existing multi-year Research Collaboration Agreement (RCA) focused
on the use of real-world data (RWD) to support clinical and regulatory
decision-making.

Research Collaboration Details

Through a multi-year collaboration, Syapse is partnering with
FDA’s Oncology Center of Excellence to:

– Investigate methods to derive RWD from multiple sources
including electronic health records, registries and molecular data;

– Enhance understanding of how patients respond to therapies
outside of clinical trials to improve care and outcomes; and

– Understand the impact of COVID-19 on
cancer care.

Based on their collaboration efforts, Syapse and
the FDA have highlighted results from rapid analyses of real-world
data involving cancer patients with COVID-19. Recently, the FDA’s OCE
and Syapse presented data at a virtual medical meeting of an analysis
of more than 200,000 health records of people living with cancer across two
major health systems. Data suggest that patients with cancer who also had
COVID-19, compared to those who did not have COVID-19, are more likely to have
other health conditions such as kidney failure, obesity and heart disease, in
addition to increased rates of hospitalization and invasive mechanical
ventilation, along with 16 times greater risk of death. Syapse and
its Learning Health Network collaborators presented these findings at the AACR
Virtual Meeting on COVID-19 and Cancer on July 22, 2020. The full presentation
can be found on the Syapse website.

Thomas Brown, MD, Syapse’s chief medical officer, stated, “Understanding how a patient’s medical history influences their treatment outcomes in a real-world setting is critical for clinicians, researchers and regulatory agencies to appropriately weigh the risk-benefit profile of a drug for a given patient.”

Syapse’s global network of healthcare providers shares
real-world data to support clinical decisions and foster collaborations among
participants. Healthcare providers, including doctors and nurses, share and
learn which cancer treatments produced better real-world outcomes in clinically
and molecularly similar patients. 

It wasn’t that long ago that people went to the bank on a Friday to cash their paper paychecks. Maybe they’d put some in checking and take some out in cash. They’d go to the grocery store over the weekend and maybe write one of those checks. Everyone always had to have a pen with them.

It wasn’t that long ago that people would call the ticket agent and discuss flight options for vacation. They’d send a paper ticket in the mail. When it was time to go, people would carry that ticket with them through the airport and onto the plane. (Of course, people could also keep their shoes on and could bring as much shampoo as their heart desired).

It wasn’t that long ago that if someone needed surgery, they’d have to call to schedule it. The hospital would call again the day before to tell them what time to come. People would travel there, fill out a bunch of paperwork, and be wheeled around to several different areas and talk to several different people. Eventually, they’d wake up post-surgery in a hallway with a bunch of other people and hopefully a family member. They’d wheel the person to their room where they’d have a small TV for entertainment, a dry erase board with some names on it and maybe the room number, and a stack of papers on the bedside table – cafeteria menus, instructions, important phone numbers and the like.

Oh wait – that time is now.

Better, more convenient systems are a no brainer for industries like banking and travel, but the hospital experience is still rife with paper handouts, basic cable packages, and manual dry erase boards with markers that don’t work half the time. Patients shouldn’t settle for that, and in this era when COVID-19 has led healthcare to embrace lots of other conveniences (like telehealth for remote doctors’ appointments), they won’t settle for it anymore.

Imagine a new kind of hospital room. While nobody should take a patient’s TV away, there’s so much more that can be done with patient TV. Most people have smart TVs in their homes that serve as a complete hub for their entertainment. Add a smartphone to the mix, and people can do nearly anything from their couch. A hospital bed should be no different.

Since EMRs became mandatory years ago, hospitals have relied on them as the source of truth for patient records and information. But EMRs paired with additional technology can do so much more. Now, hospitals can pull information from the EMR to personalize the patient experience. Imagine a hospital room TV greeting you by name with soothing music and welcoming imagery. Imagine the pillow speaker handset transforming into a smart TV remote where you can peruse movies on demand, live TV, or Netflix. Take it a step further – imagine that TV can talk to your EMR, so you can watch educational content just for you based on your condition, so you can learn about your care, treatment, and how to recover when you go home. 

Imagine adding more systems. Integrate dietary systems (in concert with the EMR) to let patients order their meals without sifting through paper and dialing phone numbers – as they do at home when they’re using DoorDash. Imagine letting patients dim the lights, request a blanket, or turn the thermostat up if they’re cold, without climbing out of bed and risking a fall. Imagine letting patients use their phones to input important information for the care team to know, or to video chat with a “visitor,” even during a pandemic when in-person visits aren’t allowed – even if the person on the other end doesn’t have a Zoom account or an iPhone for FaceTime.

Imagine never seeing a dry erase board in a patient room again. Instead, a digital display automatically updates with all the patient’s latest information, based on what’s in the EMR. 

Imagine up-to-the-minute precautions displayed instantly and digitally outside each patient’s room so care teams know what PPE they need before they go in.

Technology exists to do all these things. The early adopters are already seeing increased patient satisfaction scores that seem to consistently climb. Beyond that, especially now when nurse retention and preventing care team burnout are paramount, these technologies alleviate the burden on them. Streamlining, digitizing, and virtualizing all aspects of care and a patient’s time in the hospital benefits staff, too. When nurses don’t have to search all over to find markers that work or run back and forth to the printer to get pages of hand-outs for patients, they can spend more quality face time with patients and operate at top of license. 

When patient education is delivered in the right way, at the right time to the bedside, you’re not just saving printer paper – you’re giving patients the tools to succeed at home and avoid costly readmissions. It’s time to reimagine healthcare, and there’s no better time than now when the window to adopt new technology is wide open.

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About Jeff Fallon

Jeff Fallon brings over 30 years of experience in healthcare technology, medical devices, pharmaceuticals, and diagnostics to eVideon as their Chief Executive Officer. Prior to joining eVideon, he helped distinguished organizations such as Johnson & Johnson and patient experience technology companies forge innovative strategic relationships and strategies.

What You Should Know:

– Eko today announced a global collaboration with
AstraZeneca to accelerate the development of digital health tools for the
earlier screening of cardiovascular diseases, including heart failure. 

– Through the collaboration, AstraZeneca and Eko will explore accelerating the development of Eko algorithms, enhancing clinical trials with Eko technology, and potentially building new heart failure detection solutions.

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Eko, a digital health company building AI-powered screening and telehealth solutions to fight cardiovascular disease, today announced with AstraZeneca to accelerate the development of digital health tools for the earlier screening of cardiovascular diseases, including heart failure. Through the collaboration, AstraZeneca and Eko will explore accelerating the development of Eko algorithms, enhancing clinical trials with Eko technology, and potentially building new heart failure detection solutions.

Why It Matters

Heart failure is one of the leading causes of morbidity and
mortality, affecting approximately 64 million people worldwide. Heart failure
happens when the heart cannot pump enough blood into the body and is most
commonly detected by echocardiogram imaging tests that are not normally
conducted during a physical exam. Because of the limited access to
echocardiography or other diagnostic tests, heart failure is frequently
diagnosed late, making life-prolonging treatment more challenging. Heart
failure remains as fatal as some of the most common cancers and is the leading
cause of hospitalization for those over the age of 65, representing a
significant clinical and economic burden.

Eko’s AI-Powered telehealth platform for virtual pulmonary
and cardiac exams, providing clinicians within-person level exam capabilities
during video visits. The platform is already deployed by more than 200 health
systems for telehealth, the platform goes beyond standard video conferencing to
facilitate stethoscope audio, ECG live-streaming, and FDA-cleared
identification of atrial fibrillation (AFib) and heart murmurs.

“Eko was founded to provide a better way to understand our heart and lung health and to improve cardiopulmonary care for patients through digital technology and novel algorithms,” said Connor Landgraf, CEO and co-founder of Eko. “Eko’s collaboration with AstraZeneca will allow us to expand the capability of our technology, generate real-world data, and explore disease management solutions while leveraging AstraZeneca’s global expertise and existing relationships across the treatment continuum for heart failure.”

Shots:

• The P-III EMPEROR Trial involves assessing of Jardiance (10 mg) vs PBO in two studies EMPEROR-Reduced [NCT03057977, N=3,730] & EMPEROR-Preserved [NCT03057951, N=5,990] in patients with HFrEF & HFpEF respectively
• The EMPEROR-Reduced study meets its 1EPs in reducing the risk for the composite of cardiovascular death or hospitalization due to heart failure while the overall safety profile was similar. Additionally, the full data of the stay will be presented at ESC 2020 on Aug 29, 2020, with expected regulatory submissions are planned in 2020
• Jardiance is a prescribed drug administered along with diet and exercise to lower blood sugar in and helps in reduction of CV death in adults with T2D

Click here to read full press release/ article | Ref: Eli Lilly | Image: Pharma World

What You Should Know:

– Caption Health AI is awarded FDA 510(k) clearance for
its innovative point-of-care ejection fraction evaluation.

– Latest AI ultrasound tool makes it even easier to
automatically assess ejection fraction, a key indicator of cardiac function, at
the bedside–including on the front lines of the COVID-19 pandemic.

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Caption Health, a Brisbane,
CA-based leader in medical AI technology, today announced it has received FDA
510(k) clearance for an updated version of Caption Interpretation™, which
enables clinicians to obtain quick, easy and accurate measurements of cardiac
ejection fraction (EF) at the point of care.

Impact of Left Ventricular Ejection Fraction

Left ventricular ejection fraction is one of the most widely
used cardiac measurements and is a key measurement in the assessment of cardiac
function across a spectrum of cardiovascular conditions. Cardiovascular
diseases kill nearly 700,000 Americans annually, according to the Centers for
Disease Control and Prevention; furthermore, considering EF as a new vital sign
may shed light on determining cardiac involvement in the progression of COVID-19. A
recent global survey published in European Heart Journal – Cardiovascular Imaging reported
that cardiac abnormalities were observed in half of all COVID-19 patients
undergoing ultrasound of the heart, and clinical management was changed in
one-third of patients based on imaging.

How Caption Interpretation Works

Caption Interpretation applies end-to-end deep learning to
automatically select the best clips from ultrasound exams, perform quality
assurance and produce an accurate EF measurement. The technology incorporates
three ultrasound views into its fully automated ejection fraction calculation:
apical 4-chamber (AP4), apical 2-chamber (AP2) and the readily-obtained
parasternal long-axis (PLAX) view—an industry first. While ejection fraction is
commonly measured using the more challenging apical views, the PLAX view is often
easier to acquire at the point of care in situations where patients may not be
able to turn on their sides, such as intensive care units, anesthesia
preoperative settings and emergency rooms. This software provides unprecedented
access for healthcare providers to bring specialized ultrasound techniques to
the bedside.

“Developing artificial intelligence that mimics an expert physician’s eye with comparable accuracy to automatically calculate EF—including from the PLAX view, which has never been done before—is a major breakthrough,” said Roberto M. Lang, MD, FASE, FACC, FESC, FAHA, FRCP, Professor of  Medicine and Radiology and Director of Noninvasive Cardiac Imaging Laboratories at the University of Chicago Medicine and past president of the American Society of Echocardiography. “Whether you are assessing cardiac function rapidly, or looking to monitor changes in EF in patients with heart failure, Caption Interpretation produces a very reliable assessment.”

Caption Interpretation Benefits

At the point of care, a less precise visual assessment of EF
is frequently performed in lieu of a quantitative measurement due to resource
and time constraints. Using Caption Interpretation in these settings provides
the best of both worlds: it is as easy as performing a visual assessment, but
with comparable performance to an expert quantitative measurement.

Caption Interpretation was trained on millions of image
frames to correctly estimate ejection fraction, emulating the way an expert
cardiologist learns by evaluating EF as part of their clinical practice. While
virtually all commercially available EF measurement software works by tracing
endocardial borders, Caption Interpretation analyzes every pixel and frame in a
given clip to produce highly accurate EF measurements.

Caption Health broke new ground in 2018 when it received the
first FDA clearance for a fully automated EF assessment software. Two years
later, Caption Interpretation remains the only fully automated EF tool
available to providers, and, with today’s clearance, continues to be the pacesetter
in ultrasound interpretation.

“We are pleased to have received FDA clearance for our latest AI imaging advancement—our third so far this year,” said Randolph P.  Martin, MD, FACC, FASE, FESC, Chief Medical Officer of Caption Health, Emeritus Professor of Cardiology at Emory University School of Medicine, and past president of the American Society of Echocardiography. “An accurate EF measurement is an indispensable tool in a cardiac functional assessment, and this update to Caption Interpretation makes it easier for time-constrained clinicians to incorporate it into their practice.”

Recent Traction/Milestones

Caption Interpretation works in tandem with Caption
Guidance, cleared by the FDA earlier this year, as part of the Caption AI platform. Caption Guidance
emulates the expertise of a sonographer by providing over 90 types of real-time
instructions and feedback. These visual prompts direct users to make specific
transducer movements to optimize and capture a diagnostic-quality image. In
contrast, use of other ultrasound systems requires years of expertise to
recognize anatomical structures and make fine movements, limiting access to
clinicians with specialized training.

The company recently closed
its Series B funding round with $53 million to further develop and
commercialize this revolutionary ultrasound technology that expands patient
access to high-quality and essential care.

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.”

What You Should Know:

– The National Institutes of Health (NIH) has granted next-generation
cardiac AI company Eko an award totaling $2.7 million to support continued
collaborative work with Northwestern Medicine Bluhm Cardiovascular Institute

– The grant will focus on validating algorithms and help
more accurately screen for heart murmurs and valvular heart disease during
routine office visits with Northwestern Medicine.

– By incorporating data from tens of thousands of heart
patterns into Eko sensors and algorithms, clinicians will have
cardiologist-level precision in detecting subtle abnormalities from normal
sounds.

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Eko, a digital health company
building AI-powered screening
and telehealth solutions to
fight cardiovascular disease, today announced it has been awarded a $2.7
million Small Business Innovation Research (SBIR) grant by the National
Institutes of Health (NIH). The grant will fund the continued collaborative
work with Northwestern Medicine Bluhm Cardiovascular Institute to validate
algorithms that help providers screen for pathologic heart murmurs and valvular
heart disease during routine office visits.

Eko and Northwestern first announced their collaboration in
March 2019 to provide a simpler, lower-cost way for clinicians to identify
patients with heart disease without the use of screening tools such as
echocardiograms which are typically only available at specialty clinics. By
incorporating data from tens of thousands of heart patterns into the
stethoscope and its algorithms, clinicians will have cardiologist-level
precision in detecting subtle abnormalities from normal sounds.

“Cardiovascular disease is the leading cause of death in the U.S., and valvular heart disease often goes undetected because of the challenge of hearing murmurs with traditional stethoscopes, particularly in noisy or busy environments. A highly accurate clinical decision support algorithm that is able to detect and classify valvular heart disease will help improve accuracy of diagnosis and the detection of potential cardiac abnormalities at the earliest possible time, allowing for timely intervention,” said James D. Thomas, MD, director of the Center for Heart Valve Disease at Northwestern Medicine and the clinical study’s principal investigator. “Our work with Eko aspires to extend the auscultatory expertise of cardiologists to more general practitioners to better serve our patient community, playing a pivotal role in growing the future of cardiovascular medicine.”

Recent FDA Clearance and Telehealth Platform Launch

This recognition comes on the heels of several key company
milestones, including the clearance
of Eko’s cardiac AI algorithms by the U.S. Food and Drug Administration and the
launch
of Eko’s AI-powered telehealth
platform. Eko’s ECG-based deep learning algorithm, developed on a large
clinical dataset in collaboration with the Mayo Clinic, can help efficiently
identify signs of possible heart failure in patients.

Eko’s AI-Powered telehealth platform for virtual pulmonary and cardiac exams, providing clinicians within-person level exam capabilities during video visits. The platform is already deployed by more than 200 health systems for telehealth, the platform goes beyond standard video conferencing to facilitate stethoscope audio, ECG live-streaming, and FDA-cleared identification of atrial fibrillation (AFib) and heart murmurs.

What You Should Know:

– Microsoft released the public preview of Azure IoT
Connector for FHIR (Fast Healthcare Interoperability Resources), the latest
update to the Microsoft Cloud for Healthcare.

– The Azure IoT Connector for FHIR makes it easy for
health developers to set up a pipeline to manage protected health information
(PHI) from IoT devices and enable care teams to view patient data in context
with clinical records in FHIR.

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This week, Microsoft released the preview of Azure
IoT Connector for FHIR—a fully managed feature of the Azure API for FHIR.
The connector empowers health teams with the technology for a scalable
end-to-end pipeline to ingest, transform, and manage Protected Health
Information (PHI) data from devices using the security of FHIR APIs.

Telehealth
and remote monitoring. It’s long been talked about in the delivery of
healthcare, and while some areas of health have created targeted use cases in
the last few years, the availability of scalable telehealth platforms that can
span multiple devices and schemas has been a barrier. Yet in a matter of
months, COVID-19 has accelerated the discussion. There is an urgent need for
care teams to find secure and scalable ways to deliver remote monitoring
platforms and to extend their services to patients in the home environment.

Unlike other services that can use generic video services
and data transfer in virtual settings, telehealth visits and remote monitoring
in healthcare require data pipelines that can securely manage Protected Health
Information (PHI). To be truly effective, they must also be designed for
interoperability with existing health software like electronic medical record
platforms. When it comes to remote monitoring scenarios, privacy, security, and
trusted data exchanges are must-haves. Microsoft is actively investing in
FHIR-based health technology like the Azure IoT Connector for FHIR to ensure
health customers have an ecosystem they trust.

Azure IoT Connector for FHIR Key Features

With the Azure IoT Connector for FHIR available as a feature
on Microsoft’s cloud-based FHIR service, it’s now quick and easy for health
developers to set up an ingestion pipeline, designed for security to manage PHI
from IoT devices. The Azure IoT Connector for FHIR focuses on biometric data at
the ingestion layer, which means it can connect at the device-to-cloud or cloud-to-cloud
workstreams. Health data can be sent to Event Hub, Azure IoT Hub, or Azure IoT
Central, and is converted to FHIR resources, which enables care teams to view
patient data captured from IoT devices in context with clinical records in
FHIR.

Key features of the Azure IoT Connector for FHIR include:

– Conversion of biometric data (such as blood glucose, heart
rate, or pulse ox) from connected devices into FHIR resources.

– Scalability and real-time data processing.

– Seamless integration with Azure IoT solutions and Azure
Stream Analytics.

– Role-based Access Control (RBAC) allows for managing
access to device data at scale in Azure API for FHIR.

– Audit log tracking for data flow.

– Helps with compliance in the cloud: ISO 27001:2013 certified supports HIPAA and GDPR, and built on the HITRUST certified Azure platform.

Microsoft customers are already ushering in the next generation of healthcare

Some of the healthcare organizations who are embracing the technology include:

– Humana will accelerate remote monitoring programs for
patients living with chronic conditions at its senior-focused primary care
subsidiary, Conviva Care Centers.

– Sensoria is enabling secure data exchange from its Motus
Smart remote patient monitoring device, allowing clinicians to see real-time
data and proactively reach out to patients to manage care.

– Centene is managing personal biometric data and will
explore near-real-time monitoring and alerting as part of its overall priority
on improving the health of its members.

What You Should Know:

– Digital surgery pioneer Activ Surgical raises $15M in funding led by ARTIS Ventures to accelerate U.S. commercialization and European expansion efforts for its ActiveEdge platform, which enables existing surgical systems, from scopes to robots, to visualize, characterize and track tissue, in real-time beyond today’s human capability. 

– ActivSight, is an easy-to-adapt, connected imaging module that seamlessly attaches to today’s laparoscopic and arthroscopic systems so outcomes can be improved immediately, providing real-time, on-demand insights, integrated into standard monitors.

– The company is aiming for FDA clearance in Q4 this year
and already has eight hospital systems in the US signed up for pilot programs.

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Activ Surgical™, a Boston, MA-based digital surgery pioneer, today announced the close of a $15 million venture round led by ARTIS Ventures, a venture firm focused on pioneering investments at the intersection of life sciences and computer sciences. LRVHealth, the “Inside Healthcare” venture capital platform, joined the round, along with participation from existing investors DNS Capital, GreatPoint Ventures (GPV), Tao Capital Partners, and Rising Tide VC. To date, Activ Surgical has raised a total of $32 million.

ActivSight: Reveal Game-Changing Visual Data During Surgery

Founded in 2017, Activ Surgical is building a
hardware-agnostic platform to enable autonomous and collaborative surgery
through the integration of computer vision, artificial intelligence and
robotics. The company’s first product in the portfolio, ActivSight, is an
easy-to-adapt, connected imaging module that seamlessly attaches to today’s
laparoscopic and arthroscopic systems so outcomes can be improved immediately,
providing real-time, on demand insights, integrated into standard
monitors. The company’s second product currently in development,
ActivInsight will transform massive amounts of surgical data into intelligent,
real-time guidance for surgeons over the next 12 months.

Preventable medical errors are the third leading cause of
death after heart attack and cancer, with preventable surgical errors costing
U.S. health care $36B+ and 400k+ deaths every year. Activ Surgical’s
patent-protected surgical software platform reduces unintended and preventable
surgical complications by enhancing a surgeon’s intra-operative decision
making. In 2018, Activ Surgical completed the world’s first fully autonomous
minimally invasive robotic surgery of soft tissue.

Expansion Plans

Activ Surgical will use proceeds of the latest financing round to accelerate U.S. commercialization and European expansion efforts for itsActivEdge™ platform, which enables existing surgical systems, from scopes to robots, to visualize, characterize and track tissue, in real-time beyond today’s human capability. The company is aiming for FDA clearance in Q4 this year and already has eight hospital systems in the US signed up for pilot programs.

“Activ Surgical is poised to play a leading role in the democratization of surgical care, extending insights from experienced surgeons to surgical systems all over the globe, and ensuring world-class care for all, regardless of location,” said Todd Usen, CEO, Activ Surgical. “We welcome the guidance and support from our new and current investors and Board members as we accelerate our efforts to commercialize our first product, ActivSight. 2020 will be pivotal for our business with committed pilot projects with major hospital systems slated to launch by the end of this year.”

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.

A clinician’s mission is to deliver the best possible care to his or her patients. However, when technology gets in the way of the workflow, clinicians are obligated to spend valuable time making sure data inputs are accurate and complete across disparate systems. Nowhere is this more prevalent than with electronic medical records (EMRs).

Dr. Peter Greene, MD, CMIO, with Johns Hopkins, said, “Efficiency is really at the heart of what troubles us most. Clinicians really want the EMR to make their work easier. Current EMRs take up too much of their time and pull them away from face-to-face time with patients and care teams.”

Dr. Greene’s reflections embody the concerns that the design of the EMR system in critical workflows does not put the patient first. To address this, EMR developers are devoting significant effort into making the EMR design work on behalf of the clinician and patient. Many are finding the greatest room for improvement is in implementing touchscreen technology into the workstation on wheels (WoW) or on in-room wall mounts. Such technology allows clinicians to quickly access key sections of the EMR and input important data like physical exam findings and medication type and dosage. 

Transform Healthcare With Touch Technology 

EMR developers are recognizing that touchscreens significantly enhance the clinician’s experience and patient interaction. From the chief medical officer to the clinicians and medical staff, everyone is familiar with touchscreen technology in their daily lives via their mobile devices. Bringing this technology to clinicians’ and nurses’ workflows frees them from needing to use a keyboard and mouse in favor of a more intuitive and dynamic display. This allows them to more quickly and easily access medical records, view medical images, prescribe medication and document care, and improve their efficiency by up to 20%. 

It’s faster and easier to clean touchscreen displays too, especially when comparing them to a traditional keyboard and mouse. With a solid piece of glass and a seamless surface, the touchscreen is easily cleaned with wipes commonly available is patient settings. Whether it’s COVID-19, common influenza, or another infectious disease, implementing a streamlined touchscreen solution can help protect patients.  

Build a Unified Architecture for Clinicians

Many modern touchscreen-based workflows are built on a mobile architecture like Android. As healthcare organizations invest in streamlined solutions for clinicians, there’s often a gap that occurs when the mobile operating system doesn’t link seamlessly with the desktop architecture. Without a unified platform connecting every touchpoint, organizations lose precious time continually replacing outdated platforms and hardware. Making the decision to invest in a unified architecture will streamline the entire ecosystem, shorten future deployment time, and enable flexibility across the organization. 

The first step for CIOs, CMIOs, CNIOs, and health systems to achieve this is to create a proof of concept that brings together key leaders within the clinical staff to showcase inclusion of touch technology at the desktop level, coupled with mobile devices for a variety of clinical applications. Next, they can deploy a trial built on a flexible, scalable architecture to help the organization better envision the investment they are making before committing more money. 

In this trial, they can demonstrate how the EMR improves key workflows as clinicians more easily enter data and health information while taking care of their patients. From this demonstration, CIOs and health systems can receive feedback from clinicians to share with the EMR engineering team to help them better understand how they can improve the design of their UI/UX to get the most out of the unified desktop and mobile experience. 

From trial and iteration to solution deployment, the objective remains the same – to create an infrastructure that scales to the demands of the environment while leaving the user satisfied. The outcome of patient care is always first and foremost in the minds of clinicians, so the technology should enable them to focus on care and deliver on that ultimate goal.

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About Jeff Fountaine

As director of the healthcare vertical market for Elo, Jeff Fountaine develops and delivers solutions that enhance provider experiences and patient engagement in the healthcare and medical market. With 15 years of experience, he addresses critical workflow challenges for clinicians while ensuring positive patient outcomes through the use of technology.

What You Should Know:

– Philips integrates the BioIntelliSense FDA-cleared
BioSticker™ sensor as part of its remote patient monitoring solutions for
patients outside the hospital.

– Multi-parameter sensors aid monitoring across multiple chronic conditions with medical-grade vital signs for physicians to remotely track core symptoms, including COVID-19.

– Healthcare Highways is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S.

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Philips, today announced it has formed a strategic collaboration with BioIntelliSense, a continuous health monitoring, and clinical intelligence company, to integrate its BioSticker™ medical device into Philips’ remote patient monitoring (RPM) offering to help monitor at-risk patients from the hospital into the home.  With the addition of multi-parameter sensors, Philips’ solutions can enhance how clinicians monitor patient populations living with chronic conditions – including diabetes, cancer, congestive heart failure and more –  in their homes with passive monitoring of key vital signs, physiological biometrics, and symptomatic events via a discreet wearable patch for monitoring up to 30 days.

COVID-19 Pandemic Underscores Need for Remote Patient Monitoring

Remote patient monitoring and telehealth-enabled clinical programs offer care teams a sustainable and scalable way to manage patient populations with chronic or complex conditions at home and plays a key role in supporting care for COVID-19 patients who do not require hospitalization. By regularly transmitting patient data that can provide critical insights into a patient’s condition, the collaboration will empower care teams in the U.S. with a more holistic patient view and the ability to intervene earlier before adverse events occur.  With single-use sensors and patient-owned technology supporting remote monitoring, care teams can also help reduce the need for clinicians and patients to interact in person.

“With more patients interacting with their doctors from home and more hospitals developing strategies to virtually engage with their patients, remote patient monitoring is now, more than ever, an essential tool,” said Roy Jakobs, Chief Business Leader Connected Care, member of the Executive Committee at Royal Philips. “Building on Philips’ global leadership in patient monitoring, which includes an extensive suite of advanced monitoring solutions, platforms, and sensors, this is the latest example of our capability to allow more seamless, cloud-based data collection across multiple settings from the home to the hospital and back into the home. Patient data, coupled with our clinically differentiated and leading AI-powered technology, quantifies the data into relevant actionable insights to help detect deterioration trends and support care interventions – all while outside the walls of the hospital.”

Wireless, Secure Data Transfer of Key Vital Signs

The
BioSticker is a single-use, FDA-cleared 510k class II wearable medical device
to enable at-home continuous passive monitoring with minute level data across a
broad set of vital signs, physiological biometrics and symptomatic events (skin
temperature, resting heart rate, resting respiratory rate, body position,
activity levels, cough frequency) on a single device for thirty-days. Symptoms,
including those directly associated with COVID-19 such as temperature and
respiratory rate, can be remotely monitored in confirmed cases of Coronavirus
and also for those patients not sick enough to be hospitalized, or those
suspected of having COVID-19.

In
addition to COVID-19, the BioSticker device will help transform the way
clinicians monitor and manage patients living with chronic conditions from the
home. 

“Multi-parameter
sensors are the natural next phase for remote monitoring, especially at a time
when more patients are engaging with their physicians from home,” said James
Mault, MD, Founder and Chief Executive Officer of BioIntelliSense. “Clinicians
need medical grade monitoring and algorithmic clinical insights for COVID-19
exposure, symptoms and management. Accelerated by the COVID-19 crisis, the
practice of medicine has been irreversibly enlightened as to the safety and
efficacy of virtual care. Philips is a demonstrated leader in remote patient
monitoring, and we look forward to BioIntelliSense’s technology  playing
an integral role in simplifying and enhancing outcomes for patients and their
doctors.”

Healthcare Highways first to leverage BioSticker as a part of
Philips’ RPM solutions

Healthcare Highways, a provider of health plans, high-performance provider networks, pharmacy benefit management, population health management, and benefit plan administration, is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S. Out of the seven programs that will be deployed with Healthcare Highways, one will focus specifically on monitoring patients with COVID-19. The remaining six will focus on conditions across the acuity spectrum, including patients with congestive heart failure, hypertension, diabetes, total joint replacement, cancer and asthma. The program will help Healthcare Highways improve insights to patient health status across its provider network.

“Healthcare Highways was built on the idea of delivering measurable value and access to quality care to our members. We work in partnership with our providers to innovate on the care model, and look at Remote Patient Monitoring as the next frontier of how providers will connect with patients,” said Creagh Milford, DO, MPH, Chief Medical Officer of Healthcare Highways and Chief Executive Officer of HighCare Health. “COVID-19 has underscored the need for proactive care management. Resources are strained and by integrating an RPM program with biosensor technology, we’ll be able to drive further value for our unique member base, providers and employers to establish a new way of care delivery.”

The loss of lives and livelihoods from COVID-19 is almost too much to comprehend. And yet, slowly, conversations are emerging about the positives percolating from the pandemic. 

It’s human nature to want to look for the positives in even the worst of situations, and I’ve noticed that in both my personal and my professional circles of late, people are talking about the things they hope we don’t lose when things go back to “normal.”  

Chief among them, especially in my healthcare technology circles, is a level of humanity that our previously faster-paced lives, ways, and organizations had perhaps too often and too easily dismissed. Humans on the frontline of care delivery, for example. The effects of social isolation on healthy people, much less those who are sick. The struggle and juggle of modern work-life balance. Inequalities in healthcare access and delivery. 

We’ve long talked about technology’s ability to make some of these things easier, to close some of these gaps, but now we know just how possible they are when people, politics, and policy unite in the face of a pandemic. We now know just how quickly even the largest and slowest-moving of health systems can change course and even course-correct. 

Until now, it’s been far easier to talk about the promise of technology, telemedicine, and remote workforce scenarios than it was to actually deploy them. Because before, to deploy such solutions also meant loss; loss of control, loss of normalcy, loss of humanity. Until now.

Now, the very things that once seemed to threaten us are bringing us and our organizations closer together. They’re also shining a light on the hard facts about the real value (indeed, the necessity) of such soft skills as empathy, communication, and human insight; skills that have never been more important nor more obvious in the deployment of technology, applications, and people to deliver care. 

Amid the COVID-19 recovery that we all hope is near, here are three things from which I hope we never recover: 

 1. Virtual Care Support and Delivery 

Whether telemedicine, telehealth, or the remote workforce, we’ve not merely crossed the chasm but bridged it, and I predict we’re here to stay.

Prior to COVID-19, less than 10% of healthcare visits were conducted with telehealth and/or telemedicine. That number is now estimated at 40% to 50%, and it’s unlikely that the cat gets put back in the bag, nor should it. 

Key enablers of this long-overdue trend have been changing reimbursement policies, the relaxing of regulations governing patient data, and the ability of doctors to treat patients across state lines and platforms thanks to various state and federal licensure waivers. 

Necessity, too, has relaxed the barriers to working remotely, which until now was relatively unheard of for large health systems with equally large corporate and back-office staff and campuses. 

Back in my CIO days, I too was a believer in the importance of physical office presence. I wanted to see the 50-plus people on my service desk. It provided a comfort level that people were doing their jobs and doing them at the levels that I and our patients expected. 

Being on the consulting side, though, I’ve completely changed my mind. The flexibility of being able to work remotely is a phenomenal perk, and I dare say that the thousands now working from home would agree with me that you actually find yourself working more hours, not fewer, than in an office environment. 

Countless IT Service and Support Desks, one of which I serve on the advisory board, has been working remotely throughout the pandemic, and they’re doing yeoman’s work in the face of huge increases in IT support for health systems across the country deploying more and new solutions for patients, physicians and staff alike. 

For context, telehealth-related calls for one organization at which I serve on the advisory board have jumped 29% during COVID, accounting for more than 30% of calls compared to just 1% pre-COVID. EMR-related calls jumped 54% for one health system client, mostly due to telehealth appointments being conducted through patient portals such as MyChart. We also saw monthly call volume for that same client nearly triple during COVID, with more than 11,500 calls in April alone. 

Overall, we saw a jump in average call duration of more than 60% for telehealth-related calls.

This is likely another trend that continues along with more and more teams working remotely, especially with tech giants like Facebook and Google once again setting precedent. Both recently announced they would let employees continue to work from home for the rest of the year. If that kind of flexibility holds, we’ll likely see unprecedented movement among the tech workforce who may now be freer to pick their employer without the prospect of having to pick up their lives and move. 

This means pay, flexibility, and, yes, communication, become increasingly important in recruiting and retaining the best tech development and support teams. 

2. Communication with Feeling and Facts

To be fair, communications were probably pretty good in most health systems prior to COVID-19, but it was likely more periodic and in the form of an email from HR rather than the constant communications with teams like we’re seeing now.

Every employer in the healthcare arena should continue to focus on employee and stakeholder communication as we see this pandemic through, and indeed well beyond it. According to research from McKinsey & Company, “The overwhelming effects of a crisis strip leadership back to its most fundamental element: making a positive difference in people’s lives. By turning inward to cultivate awareness, vulnerability, empathy, and compassion, and then turning outward to comfort and address the concerns of stakeholders, leaders can exhibit individual care, build resilience, and position their organizations to positively reimagine a postcrisis future.”

Most people are hungry for solid, factual information, and the more that can be disseminated to the organization the better. In fact, the latest Edelman Trust Barometer found that people have increasingly lost faith in traditional authority figures and institutions and have shifted their trust to the relationships within their control, most notably their employers. 

The more we can learn from some of the best practices coming from these times of crisis and upheaval and continue to keep connected with our teams, the better. 

When we demonstrate to our people and our patients that we understand their struggles and needs and that we trust them enough to share real, factual, meaningful information… as well as to work remotely and get the job done and done well… that’s when everyone wins. 

3. Empathic HIT

There has been a dramatic shift in mentality about how and where people do their jobs as well as how and where they receive care. I’ve been heartened by the increased show of heart as we all navigate these uncharted waters. 

I believe this uptick in empathy may, in fact, be COVID-19’s most meaningful consequence, and I believe empathic HIT has newfound intrinsic value. Here’s why. 

Remember that dramatic increase in call volume and call duration that I mentioned earlier? Yeah, well guess why these calls are lasting longer. The Continuous Improvement Manager who supervises IT Support Desk teams at one organization I’m involved with tells me it’s because their people are focusing as much on the humans on the other end of the line and their holistic needs as they are on the reason they called in the first place. 

Recently, one of the supervisor’s agents received a call from an elderly patient in her 80s whose husband had just passed away. To access his life insurance policy and cover funeral expenses, she needed to gather all sorts of health information, but she couldn’t access his medical records. Adding to her stress, she wasn’t particularly tech-savvy. The agent helping her knew the patient was already traumatized to have lost her husband, and she knew it had to be heightened by the pandemic, so she was determined to help ease some of her stress. Instead of transferring her to another department – billing, medical records, insurance – the Support Desk agent stayed on the line with her for two and a half hours, helping her through every phone conversation with all of the right people to ensure she received everything she needed.

While a lengthy phone call may sound like a relatively simple task for some, it meant the world to the human on the other end. These are the kinds of soft skills that make technology work for us. Empathic HIT Support understands that it’s not just a numbers game or getting to the next call. Rather, it’s about being a voice of comfort and reason and being curious enough to ask the questions that lead to the right answers, connecting people with technology in ways that lead to access to care and healing. 

I’ve been both proud and impressed with how our healthcare providers have responded to the challenges we’ve been presented these past few weeks and months. We’ve probably grossly over-engineered as many solutions as we’ve simplified, but that’s ok. Healthcare people, in general, don’t wait for solutions, they usually create them. They’re creative people who want to do good for their patients and their people.

About Randy Carpenter

Randy Carpenter is currently the Senior Vice President of the Executive Advisory Board at HCTec. He has over 30 years of experience in all aspects of Healthcare Information Technology (HIT) and has held various leadership roles for healthcare and pharmaceutical services organizations throughout his career.