– Shields Health Solutions and Excelera announce a major
specialty pharmacy merger that will form a combined company that consults with
700+ hospitals in 43 states, including Mass General Brigham, Yale New Haven,
Intermountain Healthcare and Henry Ford.
– The network of hospitals is designed to improve patient
care through an infrastructure that helps with things like acquiring prior
authorization for specialty drugs and staying adherent to them. It can also
lower costs for patients by negotiating lower rates from manufacturers with the
leverage of insights from 1 million+ patients in those hospitals.
Shields Health Solutions (Shields), the leading health
system specialty pharmacy integrator, has joined
forces with ExceleraRx
Corp. (Excelera), a healthcare company that empowers integrated delivery
networks, health systems, and academic medical centers to provide personalized,
integrated care for patients with complex and chronic conditions focused on
improving patient care.
Merger Reflects Growing Need for On-Site, Integrated
Serving 60+ health systems and academic medical centers, the
combined organization addresses 700+ hospitals that account for the opportunity
of $30B in specialty pharmacy revenue. The use of specialty medications to
treat complex patients – those with multiple, chronic illnesses or rare, hard
to treat diseases that require close monitoring and support – is increasing an
average of 17 percent per year, and health systems across the U.S. have been
building on-site, integrated specialty pharmacies to provide comprehensive,
streamlined care for this growing population to improve outcomes. Since 2015,
the prevalence of health system-owned specialty pharmacies in large hospitals has doubled, with nearly 90 percent of large
hospitals operating a specialty pharmacy in 2019.
“On-site, integrated specialty pharmacy is the future
of complex patient care and we look forward to combining forces with Excelera
to make our impact even greater. As we have shown, this model materially
improves clinical outcomes for patients and reduces total medical expenses for
covered patients,” said Lee Cooper, CEO, Shields. “Together, our
network of more than 60 of the country’s top health systems, representing
nearly 30% of non-profit healthcare systems based on net patient service revenues,
creates an unparalleled industry-first that will enable unprecedented best
practice sharing and ultimately lead to improved outcomes for complex
Benefits of On-Site, Integrated Specialty Pharmacies for
Shields and Excelera offer programs for health systems to
build, operationalize and optimize integrated specialty pharmacies, as well as
help manufacturers and payors access critical patient and drug performance
insights. With a more personalized, high-touch approach to patient care,
Shields and Excelera have found that hospital-owned specialty pharmacies
dramatically simplify medication and care management for patients and can:
– Reduce medication co-payments from hundreds, sometimes
thousands of dollars, to an average co-pay of $10
– Streamline time-to-therapy, typically from several weeks
to an average of two days
– Decrease physician administrative paperwork by thousands
– Improve medication adherence rates to over 90 percent, on
Financial details of the acquisition were not disclosed.
One of the biggest challenges for biopharmaceutical companies of rare and orphan disease patient populations is optimizing disease management in a way that enhances the patient journey and improves outcomes. As these companies seek innovative solution partners, a patient-first approach that offers specialty Rx pharmacist expertise is critical for securing insurance coverage, coordinating care, ensuring compliance, and, ultimately, minimizing the daily impact of rare and orphan diseases.
In today’s challenging healthcare environment, biopharma companies need to feel confident that their products are properly and promptly distributed, and reimbursements processed quickly and correctly. The best approach is to partner with a pharmacy, distribution, and patient management organization that offers a patient-first strategy for rare and orphan disorders, as well as personalized care programs designed to maximize the benefit of the therapies prescribed for patients. The goal is to improve the quality of life for both patient and caregiver with a dedicated support system for positive outcomes and long-term well-being.
The right patient-first partner can tailorIT, technology, and data-based upon client needs, combined with a high-touch approach designed to improve patient engagement from clinical trials to commercialization and compliance.
High Touch Meets Technology
Rare and orphan disease patients require an intense level of support and benefit from high touch service. A care team, including the program manager, care coordinator, pharmacist, nurse, and specialists, should be 100% dedicated to the disease state, patient community, and therapy. This is a critical feature to look for in a patient-first partner. The idea is to balance technology solutions with methods for addressing human needs and variability.
With a patient-first approach, wholesale distributors, specialty pharmacies, and hub service providers connect seamlessly, instead of operating in siloes. This strategy improves continuity of care, strengthens communication, yields rich data for more informed decision making, and improves the overall patient experience. It manages issues related to collecting data, maintains frequent communication with patients and their families, and ensures compliance and positive outcomes. A patient-first model also hastens time to commercialization and provides continuity of care to avoid lapses in therapy – across the entire life cycle of a product.
Key Components for Effective Patient-First Strategy
A patient-first strategy means that the specialty Rx pharmacist works directly with the patient, from initial consultation, and across the entire patient journey, providing counseling, guidance, and education-based upon individual patient needs. They also develop an individualized care plan based on specific labs and indicators related to patient behavior to help gauge the person’s level of motivation and identify adherence issues that may arise.
The best patient-first partners enable patients to contact their pharmacist 24/7 and offer annual reassessments that ensure that goals of therapy are on track and every challenge is addressed to improve the patient’s quality of life. These specialty pharmacists also play a critical role on behalf of biopharmaceutical partners, providing ongoing regulatory and operations support and addressing each company’s particular challenges.
As the COVID-19 pandemic wanes on, it’s also important to find a patient-first partner that offers a fully integrated telehealth option to provide care coordination for patients, customized care plans based on conversations with each patient, medication counseling, education on disease states, and expectations for each drug.
A customized telehealth option enables essential discussions for addressing patient challenges and needs, a drug’s impact on overall health, assessing the number of touchpoints required each month, follow-up, and staying on top of side effects.
Each touchpoint should have a care plan. For example, a product may require the pharmacist to reach out to the patient after one week to assess response to the drug from a physical and psychological perspective, asking the right questions and making necessary changes, if needed, based on the patient’s daily routine, changes in behavior and so on.
Capturing information in a standardized way ensures that every pharmacist and patient receives the same assessment based on each drug, which can be compared to overall responses. Information is gathered by an operating system and data aggregator and shared with the manufacturer, who may make alterations to the care plan based on the patient’s story.
Ideally, one phone call with a patient can begin the process of optimizing medication delivery, insurance reimbursement, compliance, and education based on a plan tailored for each patient’s specific needs.
About Dr. Brandon Salke, PHARM.D
Dr. Brandon Salke serves as the pharmacist-in-charge and General Manager at Optime Care in Earth City, MO. He previously served as a team pharmacist for Dohmen Life Science Services, where he helped launch several new care programs and assisted in the management of clinical trial activities.
He is specialized in specialty pharmaceuticals, particularly ultra-orphan, orphan, and rare disease. Dr. Salke has been involved in all aspects of operations (planning, process integration, project management, etc.) for pharmaceutical manufacturers. This includes clinical trials to commercialization and assisting in commercial launches (and relaunch) of specialty pharmaceuticals.
If hackers attack your organization and you’re in an industry such as financial services, engineering, or manufacturing your risks are mostly monetary. But when it comes to healthcare cybersecurity, not only is there significant financial jeopardy, people’s health and wellbeing are also at risk so the stakes are much, much higher.
According to the Department of Health and Human Services, there has been an almost 50 percent increase in healthcare cybersecurity data breaches between February and May 2020 compared to 2019. This is thought to be a result of the COVID-19 pandemic distracting the industry due to the sweeping changes required, putting extra pressure on already inadequate healthcare cybersecurity measures.
Why Are Hackers Attacking Healthcare?
If there’s one thing hackers like, it’s a target that’s “soft” and large, complex organizations in industries that have been slow to adopt and then secure digital technologies are precisely that, soft targets. These organizations usually have broad and mostly poorly defended “attack surfaces,” which provide hackers with many routes to enter and through which they can not only exfiltrate data but also compromise services and hardware.
Healthcare, in general, is one of the most visible and softest targets. Successful hospital cyber-attacks usually cause significant disruption of patient data and routine workflows such as scheduling patient medication, resources management, and other essential services. These hospital cyber-attacks can easily result in what is euphemistically called in healthcare “bad outcomes” … these “bad outcomes” include injury and death.
How Does Healthcare Think About Cyber Risks?
A study by the security consulting firm Independent Security Evaluators concluded:
One overarching finding of our research is that the industry focuses almost exclusively on the protection of patient health records, and rarely addresses threats to or the protection of patient health from a cyber threat perspective … In summary, we find that different adversaries will target or pursue the compromise of patient health records, while others will target or pursue the compromise of patient health itself.
The report argues that protecting patient records has been most of the focus of healthcare cybersecurity planning, and organizations often view threat actors as being “unsophisticated adversaries” such as individual hackers and small hacker collaborations. ISE argues that this framework ignores the potential of far more sophisticated hospital cyber-attacks from political hacktivist groups, organized crime, terrorists, and nation-states who are all highly motivated and well-funded and “As a result, a multitude of attack surfaces are left unprotected, and attack strategies that could result in harm to a patient are not considered.”
The Universal Health Service Hospital Cyber-attacks
In September 2020, Universal Health Services a hospital and health care network with more than 400 facilities across the United States, Puerto Rico, and the United Kingdom, found itself under attack by the Russian “Ryuk” ransomware. This wasn’t the first hospital cyber-attack on UHS. Security firm, Advance Intel’s Andariel intelligence platform, reported that trojan malware-infected Universal Health Services throughout 2020.
UHS has not officially confirmed the details of the attack but reports by UHS employees indicate the attack was the result of a successful phishing expedition. The attack disabled computers and phone systems and forced the hospitals to revert to using paper-based systems to continue operations. Affected network hospitals also had to redirect ambulances and move surgical patients to other unaffected facilities.
As is usually the case with large, complex organizations, cleaning up and restoring the system was neither simple nor quick and a UHS press release on October 12, 2020, announced: “… we have had no indication that any patient or employee data was accessed, copied or misused.” It also stated that operations were mostly back to normal after a total of 16 days. Given that downtime for enterprise security breaches cost upwards of $1,000,000 per day or more this attack will have dealt a serious blow to UHS’ bottom line. Whether UHS paid the ransom is not known.
Cyber Attacks and Murder
When a cyberattack happens to any organization, there are always consequences but when healthcare ransomware is involved there’s a real risk of loss of life. In the case of UHS, there were unconfirmed rumors of four patients dying because doctors had to wait for lab results delivered by couriers instead of by electronic delivery. While those, so far, appear to be just rumors, there is one known case of a patient dying directly due to a hospital ransomware attack.
The University Hospital Düsseldorf (UKD) in Germany suffered a ransomware attack on September 10, 2020. The attackers exploited a vulnerability in the Citrix ADC that had been known since January but the hospital, unfortunately, had not got around to implementing the fix.
As a result of the attack, the hospital immediately announced that “The UKD has deregistered from emergency care. Planned and outpatient treatments will also not take place and will be postponed. Patients are therefore asked not to visit the UKD – even if an appointment has been made” and patients were routed to alternative medical facilities.
The demand note delivered by the hospital ransomware showed that the intended target was not in fact the University Hospital Düsseldorf but rather Heinrich Heine University. The German police contacted the hackers via the instructions in the ransom note dropped by the malware and explained the mistake after which the hackers withdrew their demand and provided the decryption key.
Unfortunately, one patient with a life-threatening illness was diverted to a distant hospital after UKD was deregistered as an emergency care facility. The additional hour’s travel may have been the cause of the patient’s death. On September 18, 2020, German prosecutors launched an official negligent homicide investigation which, if confirmed, would make the patient’s death the first known case of death by hacking.
Protect Critical Systems from Malware
The key to defending your systems from malware and phishing is monitoring and examining all network communications. Now that encryption is becoming the norm for all internet communications, looking “inside” of message streams requires new approaches and technologies so that embedded threats are caught and handled before they can escalate into disasters.
About Babur Nawaz Khan Babur Nawaz Khan is a Technical Marketing Engineer at A10 Networks, a leading provider of secure application services and solutions. He primarily focuses on A10’s Enterprise Security and DDoS Protection solutions and holds a master’s degree in Computer Science from the University of Maryland, Baltimore County.
The combination of Teladoc Health and Livongo creates a
global leader in consumer-centered virtual care. The combined company is
positioned to execute quantified opportunities to drive revenue synergies of
$100 million by the end of the second year following the close, reaching $500
million on a run-rate basis by 2025.
Price: $18.5B in value based on each share of Livongo
will be exchanged for 0.5920x shares of Teladoc Health plus cash consideration
of $11.33 for each Livongo share.
Siemens Healthineers Acquires Varian Medical
On August 2nd, Siemens Healthineers acquired
Varian Medical for $16.4B, with the deal expected to close in 2021. Varian is a
global specialist in the field of cancer care, providing solutions especially
in radiation oncology and related software, including technologies such as
artificial intelligence, machine learning and data analysis. In fiscal year 2019,
the company generated $3.2 billion in revenues with an adjusted operating
margin of about 17%. The company currently has about 10,000 employees
Price: $16.4 billion in an all-cash transaction.
Gainwell to Acquire HMS for $3.4B in Cash
Veritas Capital (“Veritas”)-backed Gainwell Technologies (“Gainwell”),
a leading provider of solutions that are vital to the administration and
operations of health and human services programs, today announced that they
have entered into a definitive agreement whereby Gainwell will acquire HMS, a technology, analytics and engagement
solutions provider helping organizations reduce costs and improve health
Price: $3.4 billion in cash.
Philips Acquires Remote Cardiac Monitoring BioTelemetry for $2.8B
Philips acquires BioTelemetry, a U.S. provider of remote
cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion). With $439M in
revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients
remotely; its portfolio includes wearable heart monitors, AI-based data
analytics, and services.
Price: $2.8B ($72 per share), to be paid in cash upon
Hims & Hers Merges with Oaktree Acquisition Corp to Go Public on NYSE
Telehealth company Hims & Hers and Oaktree Acquisition Corp., a special purpose acquisition company (SPAC) merge to go public on the New York Stock Exchange (NYSE) under the symbol “HIMS.” The merger will enable further investment in growth and new product categories that will accelerate Hims & Hers’ plan to become the digital front door to the healthcare system
Price: The business combination values the combined
company at an enterprise value of approximately $1.6 billion and is expected to
deliver up to $280 million of cash to the combined company through the
contribution of up to $205 million of cash.
SPAC Merges with 2 Telehealth Companies to Form Public
Digital Health Company in $1.35B Deal
Blank check acquisition company GigCapital2 agreed to merge with Cloudbreak Health, LLC, a unified telemedicine and video medical interpretation solutions provider, and UpHealth Holdings, Inc., one of the largest national and international digital healthcare providers to form a combined digital health company.
Price: The merger deal is worth $1.35 billion, including
WellSky Acquires CarePort Health from Allscripts for
Price: $1.35 billion represents a multiple of greater
than 13 times CarePort’s revenue over the trailing 12 months, and approximately
21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12 months.
Waystar Acquires Medicare RCM Company eSolutions
On September 13th, revenue cycle management
provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue
cycle management, workflow automation, and data analytics tools. The
acquisition creates the first unified healthcare payments platform with both
commercial and government payer connectivity, resulting in greater value for
Radiology Partners (RP), a radiology practice in the U.S., announced a definitive agreement to acquire MEDNAX Radiology Solutions, a division of MEDNAX, Inc. for an enterprise value of approximately $885 million. The acquisition is expected to add more than 800 radiologists to RP’s existing practice of 1,600 radiologists. MEDNAX Radiology Solutions consists of more than 300 onsite radiologists, who primarily serve patients in Connecticut, Florida, Nevada, Tennessee, and Texas, and more than 500 teleradiologists, who serve patients in all 50 states.
PointClickCare Acquires Collective Medical
PointClickCare Technologies, a leader in senior care technology with a network of more than 21,000 skilled nursing facilities, senior living communities, and home health agencies, today announced its intent to acquireCollective Medical, a Salt Lake City, a UT-based leading network-enabled platform for real-time cross-continuum care coordination for $650M. Together, PointClickCare and Collective Medical will provide diverse care teams across the continuum of acute, ambulatory, and post-acute care with point-of-care access to deep, real-time patient insights at any stage of a patient’s healthcare journey, enabling better decision making and improved clinical outcomes at a lower cost.
Teladoc Health Acquires Virtual Care Platform InTouch
Teladoc Health acquires InTouch Health, the leading provider of enterprise telehealth solutions for hospitals and health systems for $600M. The acquisition establishes Teladoc Health as the only virtual care provider covering the full range of acuity – from critical to chronic to everyday care – through a single solution across all sites of care including home, pharmacy, retail, physician office, ambulance, and more.
Price: $600M consisting of approximately $150 million
in cash and $450 million of Teladoc Health common stock.
AMN Healthcare Acquires VRI Provider Stratus Video
AMN Healthcare Services, Inc. acquires Stratus Video, a leading provider of video remote language interpretation services for the healthcare industry. The acquisition will help AMN Healthcare expand in the virtual workforce, patient care arena, and quality medical interpretation services delivered through a secure communications platform.
CarepathRx Acquires Pharmacy Operations of Chartwell from
CarepathRx, a leader in pharmacy and medication management
solutions for vulnerable and chronically ill patients, announced today a
partnership with UPMC’s Chartwell subsidiary that will expand patient access to
innovative specialty pharmacy and home infusion services. Under the $400M
landmark agreement, CarepathRx will acquire the
management services organization responsible for the operational and strategic
management of Chartwell while UPMC becomes a strategic investor in CarepathRx.
Cerner to Acquire Health Division of Kantar for $375M in
Cerner announces it will acquire Kantar Health, a leading
data, analytics, and real-world evidence and commercial research consultancy
serving the life science and health care industry.
This acquisition is expected to allow Cerner’s Learning
Health Network client consortium and health systems with more opportunities to
directly engage with life sciences for funded research studies. The acquisition
is expected to close during the first half of 2021.
Cerner Sells Off Parts of Healthcare IT Business in
Germany and Spain
Cerner sells off parts of healthcare IT business in Germany and Spain to Germany company CompuGroup Medical, reflecting the company-wide transformation focused on improved operating efficiencies, enhanced client focus, a refined growth strategy, and a sharpened approach to portfolio management.
Price: EUR 225 million ($247.5M USD)
CompuGroup Medical Acquires eMDs for $240M
CompuGroup Medical (CGM) acquires eMDs, Inc. (eMDs), a
leading provider of healthcare IT with a focus on doctors’ practices in the US,
reaching an attractive size in the biggest healthcare market worldwide. With
this acquisition, the US subsidiary of CGM significantly broadens its position
and will become the top 4 providers in the market for Ambulatory Information
Systems in the US.
Price: $240M (equal to approx. EUR 203 million)
Change Healthcare Buys Back Pharmacy Network
back pharmacy unit eRx Network
(“eRx”), a leading provider of comprehensive, innovative, and secure
data-driven solutions for pharmacies. eRx generated approximately $67M in
annual revenue for the twelve-month period ended February 29, 2020. The
transaction supports Change Healthcare’s commitment to focus on and invest in
core aspects of the business to fuel long-term growth and advance innovation.
Walmart acquires CareZone, a San Francisco, CA-based smartphone
service for managing chronic health conditions for reportedly $200M. By
working with a network of pharmacy partners, CareZone’s concierge services
assist consumers in getting their prescription medications organized and
delivered to their doorstep, making pharmacies more accessible to individuals
and families who may be homebound or reside in rural locations.
Verisk, a data
analytics provider, announced today that it has acquiredFranco Signor, a Medicare Secondary Payer
(MSP) service provider to America’s largest insurance carriers and employers.
As part of the acquisition, Franco Signor will become part of Verisk’s Claims
Partners business, a leading provider of MSP compliance and other analytic
claim services. Claims Partners and Franco Signor will be combining forces to
provide the single best resource for Medicare compliance.
Rubicon Technology Partners Acquires Central Logic
Private equity firm Rubicon Technology Partners acquires
Central Logic, a provider of patient orchestration and tools to accelerate
access to care for healthcare organizations. Rubicon will be aggressively driving Central Logic’s
growth with additional cash investments into the business, with a focus
on product innovation, sales expansion, delivery and customer support, and
the pursuit of acquisition opportunities.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
Industry experts state that orphan drugs will be a major trend to watch in the years ahead, accounting for almost 40% of the Food and Drug Administration approvals this year. This market has become more competitive in the past few years, increasing the potential for reduced costs and broader patient accessibility. Currently, these products are often expensive because they target specific conditions and cost on average $147,000 or more per year, making commercialization optimization particularly critical for success.
This is important because personalized medicine has the capacity to detect the onset of disease at its earliest stages, pre-empt the progression of the disease and increase the efficiency of the health care system by improving quality, accessibility, and affordability.
These factors lay the groundwork for specialty pharmaceutical companies that are developing and commercializing personalized drugs for orphan and ultra-orphan diseases to pursue productive collaboration and meaningful partnership with a specialty pharmacy, distribution, and patient management service provider. This relationship offers manufacturers a patient-first model to align with market trends and optimize the opportunity, maximize therapeutic opportunities for personalized medicines, and help to contain costs of specialty pharmacy for orphan and rare disorders. This approach leads to a more precise way of predicting the prognosis of genetic diseases, helping physicians to better determine which medical treatments and procedures will work best for each patient.
Furthermore, and of concern to specialty pharmaceutical providers, is the opportunity to leverage a patient-first strategy in streamlining patient enrollment in clinical trials. This model also maximizes interaction with patients for adherence and compliance, hastens time to commercialization, and provides continuity of care to avoid lapses in therapy — during and after clinical trials through commercialization and beyond for the whole life cycle of a product. Concurrently, the patient-first approach also provides exceptional support to caregivers, healthcare providers, and biopharma partners.
Integrating Data with Human Interaction
When it comes to personalized medicine for the rare orphan market, tailoring IT, technology, and data solutions based upon client needs—and a high-touch approach—can improve patient engagement from clinical trials to commercialization and compliance.
Rare and orphan disease patients require an intense level of support and benefit from high touch service. A care team, including the program manager, care coordinator, pharmacist, nurse, and specialists, should be 100% dedicated to the disease state, patient community, and therapy. This is a critical feature to look for when seeking a specialty pharmacy, distribution, and patient management provider. The key to effective care is to balance technology solutions with methods for addressing human needs and variability.
With a patient-first approach, wholesale distributors, specialty pharmacies, and hub service providers connect seamlessly, instead of operating independently. The continuity across the entire patient journey strengthens communication, yields rich data for more informed decision making, and improves the overall patient experience. This focus addresses all variables around collecting data while maintaining frequent communication with patients and their families to ensure compliance and positive outcomes.
As genome science becomes part of the standard of routine care, the vast amount of genetic data will allow the medicine to become more precise and more personal. In fact, the growing understanding of how large sets of genes may contribute to disease helps to identify patients at risk from common diseases like diabetes, heart conditions, and cancer. In turn, this enables doctors to personalize their therapy decisions and allows individuals to better calculate their risks and potentially take pre-emptive action.
What’s more, the increase in other forms of data about individuals—such as molecular information from medical tests, electronic health records, or digital data recorded by sensors—makes it possible to more easily capture a wealth of personal health information, as does the rise of artificial intelligence and cloud computing to analyze this data.
Telehealth in the Age of Pandemics
During the COVID-19 pandemic, and beyond, it has become imperative that any specialty pharmacy, distribution, and patient management provider must offer a fully integrated telehealth option to provide care coordination for patients, customized care plans based on conversations with each patient, medication counseling, education on disease states and expectations for each drug.
A customized telehealth option enables essential discussions for understanding patient needs, a drug’s impact on overall health, assessing the number of touchpoints required each month, follow-up, and staying on top of side effects.
Each touchpoint has a care plan. For instance, a product may require the pharmacist to reach out to the patient after one week to assess response to the drug from a physical and psychological perspective, asking the right questions and making necessary changes, if needed, based on the patient’s daily routine, changes in behavior and so on.
This approach captures relevant information in a standardized way so that every pharmacist and patient is receiving the same assessment based on each drug, which can be compared to overall responses. Information is gathered by an operating system and data aggregator and shared with the manufacturer, who may make alterations to the care plan based on the story of the patient journey created for them.
Just as important, patients know that help is a phone call away and trust the information and guidance that pharmacists provide.
About Donovan Quill, President and CEO, Optime Care
Donovan Quill is the President and CEO of Optime Care, a nationally recognized pharmacy, distribution, and patient management organization that creates the trusted path to a fulfilled life for patients with rare and orphan disorders. Donovan entered the world of healthcare after a successful coaching career and teaching at the collegiate level. His personal mission was to help patients who suffer from an orphan disorder that has affected his entire family (Alpha-1 Antitrypsin Deficiency). Donovan became a Patient Advocate for Centric Health Resources and traveled the country raising awareness, improving detection, and providing education to patients and healthcare providers.
A recent Advisory Board briefing examined the annual Centers for Medicare & Medicaid Services (CMS) Readmission penalties. Of the 3,080 hospitals CMS evaluated, 83% received a penalty for payments to be made in 2021, based on expected outcomes for a wide variety of treated conditions. While CMS indicated that some of these penalties might be waived or delayed due to the impacts of the Covid pandemic on hospital procedure volumes and revenue, they are indicative of a much larger issue.
For too long, patients discharged from the hospital have been handed a stack of papers to fill prescriptions, seek follow-up care, or take other steps in their journey from treatment to recovery. More recently, the patient is given access to an Electronic Health Record (EHR) portal to view their records, and a care coordinator may call in a few days to check-in. These are positive steps, but is it enough? Although some readmissions cannot be avoided due to unforeseen complications, many are due to missed follow-up visits, poor medication adherence, or inadequate post-discharge care.
Probably because communication with outside providers has never worked reliably, almost all hospitals have interpreted ‘care coordination’ to mean staffing a local team to help patients with a call center-style approach. Wouldn’t it be much better if the hospital could directly engage and enable the Primary Care Physician (PCP) to know the current issues and follow-up directly with their patient?
We believe there is still a real opportunity to hold the patient’s hand and do far more to guide them through to recovery while reducing the friction for the entire patient care team.
Strengthening Care Coordination for a Better Tomorrow
Coordinating and collaborating with primary care, outpatient clinics, mental health professionals, public health, or social services plays a crucial role in mitigating readmissions and other bumps along the road to recovery. Real care coordination requires three related communication capabilities:
1. Notification of the PCP or other physicians and caregivers when events such as ED visits or Hospitalization occur.
2. Easy, searchable, medical record sharing allows the PCP to learn important issues without wading through hundreds of administrative paperwork.
3. Secure Messaging allows both clinicians and office staff to ask the other providers questions, clarify issues, and simplify working together.
There are some significant hurdles to improve the flow of patient data, and industry efforts have long been underway to plug the gaps. EHR vendors, Health Information Exchanges (HIEs), and a myriad of vendors and collaboratives have attempted to tackle these issues. In the past few decades, government compliance efforts have helped drive medical record sharing through the Direct Messaging protocol and CCDAs through Meaningful Use/Promoting Interoperability requirements for “electronic referral loops.” Kudos to the CMS for recognizing that notifications need to improve from hospitals to primary care—this is the key driver behind the latest CMS Final Rule (CMS-9115-F) mandating Admission, Discharge, and Transfer (ADT) Event Notifications. (By March 2021, CMS Conditions of Participation (CoPs) will require most hospitals to make a “reasonable effort” to send electronic event notifications to “all” Primary Care Providers (PCPs) or their practice.)
However, to date, the real world falls far short of these ideals: for a host of technical and implementation reasons, the majority of PCPs still don’t receive digital medical records sent by hospitals, and the required notifications are either far too simple, provide no context or relevant encounter data, rarely include patient demographic and contact information, and almost never include a method for bi-directional communications or messaging.
Delivering What the Recipient Needs
PCPs want what doctors call the “bullet” about their patient’s recent hospitalization. They don’t want pages of minutia, much of it repetitively cut and pasted. They don’t want to scan through dozens or hundreds of pages looking for the important things. They don’t want “CYA” legalistic nonsense. Not to mention, they learn very little from information focused on patient education.
An outside practitioner typically doesn’t have access to the hospital EHR, and when they do, it can be too cumbersome or time-consuming to chase down the important details of a recent visit. But for many patients—especially those with serious health issues—the doctor needs the bullet: key items such as the current medication list, what changed, and why.
Let’s look at an example of a patient with Congestive Heart Failure (CHF), which is a condition assessed in the above-mentioned CMS Readmission penalties. For CHF, the “bullet” might include timely and relevant details such as:
– What triggered the decompensation? Was it a simple thing, such as a salty meal? Or missed medication?
– What was the cardiac Ejection Fraction?
– What were the last few BUN and Creatinine levels and the most recent weight?
– Was this left- or right-sided heart failure?
– What medications and doses were prescribed for the patient?
– Is she tending toward too dry or too wet?
– Has she been postural, dizzy, hypotensive?
Ideally, the PCP would receive a quick, readable page that includes the name of the treating physician at the hospital, as well as 3-4 sentences about key concerns and findings. Having the whole hospital record is not important for 90 percent of patients, but receiving the “bullet” and being able to quickly search or request the records for more details, would be ideal.
Similar issues hold true for administrative staff and care coordinators. No one should play “telephone tag” to get chart information, clarify which patients should be seen quickly, or find demographic information about a discharged patient so they can proactively contact them to schedule follow-up.
Building a Sustainable, Long-Term Solution
Having struggled mightily to build effective communications in the past is no excuse for the often simplistic and manual processes we consider care coordination today.
Let’s use innovative capabilities to get high-quality notifications and transitions of care to all PCPs, not continue with multi-step processes that yield empty, cryptic data. The clinician needs clinically dense, salient summaries of hospital care, with the ability to quickly get answers—as easy as a Google search—for the two or three most important questions, without waiting for a scheduled phone call with the hospitalist. X-Rays, Lab results, EKGs, and other tests should also be available for easy review, not just the report. After all, if the PCP needs to order a new chest x-ray or EKG how can they compare it with the last one if they don’t have access to it?
Clerical staff needs demographic information at their fingertips to “take the baton” and ensure quick and appropriate appointment scheduling. They need to be able to retrieve more information from the sender, ask questions, and never use a telephone. Additionally, both the doctor and the office staff should be able to fire off a short note and get an answer to anyone in the extended care team.
That is proper care coordination. And that is where we hope the industry is collectively headed in 2021.
About Peter Tippett MD, PhD: Founder and CEO, careMESH
Dr. Peter S. Tippett is a physician, scientist, business leader and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
About Catherine Thomas: Co-Founder and VP, Customer Engagement, careMESH
Catherine Thomas is Co-Founder & VP of Customer Engagement for careMESH, and a seasoned marketing executive with extensive experience in healthcare, telecommunications and the Federal Government sectors. As co-founder of careMESH, she brings 20+ years in Strategic Marketing and Planning; Communications & Change Management; Analyst & Media Relations; Channel Strategy & Development; and Staff & Project Leadership.
– GoodRx, today
announced the addition of telehealth and mail order benefits to its subscription
program, GoodRx Gold.
– GoodRx Gold Savings Program members can now receive
exclusive discounts on online doctor visits and free mail delivery via the
GoodRx app, in addition to the exclusive lower prices on prescription drugs
that are already available.
– Using the 5-star rated GoodRx app, GoodRx Gold members can
now see a licensed healthcare provider to receive treatment in the comfort and
safety of their own home.
– Visits for members start at just $10 (55% off non-member
rates) and patients can be seen for over 150 conditions, including cold and
flu, UTI, cold sores, acne, birth control, COVID-19 screenings, refills for
common medications and more. If the patient is prescribed medication, they can
use a GoodRx Gold discount of up to 90% at pharmacies near them or have it sent
directly to their house via free mail delivery.
– GoodRx Gold now offers more than 1,000 common, low-priced
medications via mail delivery, with nearly 300 of them priced under $10.
– Cerner Corporation today announced with Xealth new
centralized digital ordering and monitoring for health systems, starting with
Banner Health, to foster digital innovation.
– Health systems can prescribe digital therapeutics, smartphones, and internet apps directly within the EHR to address areas such as chronic disease management, behavioral health, maternity care, and surgery prep.
Cerner, today announced it’s building on the recent collaboration with Xealth to offer health systems new centralized digital ordering and monitoring for clients. These capabilities are designed to help health systems choose, manage, and deploy digital tools and applications while offering clinicians access to remote monitoring and more direct engagement with patients. Phoenix-based Banner Health, one of the country’s largest nonprofit hospital systems, is one of the first Cerner clients to use the new capabilities to benefit its clinicians and patients.
Prescribe Digital Therapeutics Via EHR
With the new capabilities, health systems can prescribe digital therapeutics, smartphones, and internet applications to address areas such as chronic disease management, behavioral health, maternity care, and surgery prep. This access to a more holistic view of the organization’s digital health solutions supports the clinical decisions doctors make every day and provides real opportunities to improve medical outcomes and enhance efficiency, meet the increasing demand for telehealth and offer remote patient monitoring.
For example, the new capabilities can help simplify how
clinicians prescribe tools such as mobile mental health apps to monitor anxiety
triggers or a glucose device to help trace blood sugar levels for diabetes
Digital solutions will be available in a single location in
the electronic health record where health systems can use apps based on
clinical and financial metrics. A wide array of digital health tools is
integrated with Xealth’s offering today and the list is ever-growing. Early
examples of companies that have previously deployed in health systems using
Xealth include Babyscripts, Glooko, SilverCloud Health, Welldoc, as well as
Healthwise Inc., GetWellNetwork and ResMed that have existing relationships
“As digital tools are increasingly included in care plans, health systems seek a way to organize and oversee their use across the health system. We anticipate the emergence of digital and therapeutic committees to govern digital tool selection similar to how pharmacy and therapeutic committees have historically governed medication formularies,” said David Bradshaw, senior vice president, Consumer and Employer Solutions, Cerner. “Digital health has extraordinary potential to reshape the way we care for patients and, working with Xealth, we are answering the need and helping providers create more engaging and effective patient experiences.”
Why It Matters
Digital health has great potential to make an immediate difference, especially as it relates to automating patient education, delivering virtual care, supporting telehealth, and offering remote patient monitoring. Health systems with a digital health program and strategy in place have the ability to respond faster and more efficiently.
“Now, more than ever, extending care teams to meet patients where they are is critical,” said Mike McSherry, CEO and co-founder, Xealth. “As digital health programs roll out, they should elevate both the patient and provider experience. Cerner building out a digital formulary, with Xealth at its core, is listening to its strong clinician base by delivering tools to enhance patient care, without adding additional steps for the care team.”
– Lightspeed Venture Partners, the VC behind Nest and GrubHub, is leading a $10 million round for Freespira, an FDA-cleared digital therapeutic proven to significantly reduce or eliminate panic attacks and PTSD symptoms by training users to normalize respiratory irregularities.
– In 28 days, Freespira can reduce or eliminate panic
attacks and PTSD symptoms from home with just a tablet, sensor, and custom app.
There’s no medicine with possible side effects and no need to see a doctor or
therapist in person.
Palo Alto Health Sciences, Inc.), a Kirkland, WA-based maker of the first
FDA-cleared digital therapeutic that significantly reduces or eliminates
symptoms of panic attacks, panic disorder and post-traumatic stress disorder
(PTSD) in only 28 days, announced it has completed a $10 million capital raise led
by Lightspeed Venture Partners. Joining
the financing round, the largest in the company’s history, were previous
investors Aphelion Capital, Medvest Capital, and Freespira Chairman,
Free from Panic Attacks & PTSD in 28 Days
Founded in 2013, Freespira® is the only FDA-cleared digital therapeutic proven
to significantly reduce or eliminate Panic Disorder and PTSD symptoms by
training users to normalize respiratory irregularities in just 28 days. This
4-week medication-free program can be done from the comfort of your home for 17
minutes, twice daily. Treatment is authorized and completed under the
supervision of a licensed healthcare provider and is clinically proven to
reduce or eliminate panic attacks and other symptoms of panic disorder. Freespira
uses a custom sensor to train patients to stabilize their respiration rate and
exhaled carbon dioxide levels, thereby reducing or eliminating panic attacks
and PTSD symptoms.
Recent Peer-Reviewed Studies
Numerous peer-reviewed studies have demonstrated the
clinical effectiveness and cost savings of the Freespira solution, including:
– A clinical trial conducted at the VA Palo Alto Health Care
System in Palo Alto, Calif. demonstrated the efficacy of Freespira for veterans
and non-veterans suffering from PTSD. Significant reductions in measures of
PTSD severity were achieved by 85% of subjects post-treatment, with half of
subjects reporting remission scores six months post-treatment. Patient
satisfaction was 84% at six months post-treatment, and mean patient adherence
to the treatment protocol was 77%.
– A large multi-center trial conducted by David Tolin, PhD,
Director of the Anxiety Disorders Center at The Institute of Living, and Adjunct
Professor of Psychiatry at Yale University School of Medicine, found that
Freespira produced a clinically significant reduction in panic symptoms 12
months post-treatment in 82% of subjects, with 84% adherence and 88% patient
– A study led by Alicia Kaplan, MD at the Allegheny Health
Network in Pittsburgh found that use of Freespira not only resulted in 91% of
patients reporting significant reduction in symptoms at 12-months but also
significant cost savings for the patients’ insurance provider, Highmark Blue
Cross Blue Shield. These included a 65% reduction in emergency department
costs; a 68% reduction in pharmacy costs; and a 35% reduction in total medical
costs for treatment of the study subjects.
“We’re honored that Lightspeed, one of Silicon Valley’s premier venture firms, has joined our existing investors to help speed the commercialization of Freespira to benefit the millions of people who suffer from panic attacks and PTSD, including veterans, first responders, and increasingly, frontline healthcare workers,” said Dean Sawyer, Chief Executive Officer of Freespira. “Now that we have accumulated overwhelming evidence of the clinical and cost effectiveness of Freespira and achieved FDA clearance for its use treating both panic disorder and PTSD, we believe health plans and employers across the country will support the use of Freespira for their members and employees.”
Telehealth and virtual care are not brand-new phenomena suddenly cobbled together as a rapid response to the onset of the COVID-19 pandemic, but the average US patient could be forgiven for thinking that it is. Indeed, virtual visits to care providers and remote patient monitoring have been available for quite some time, delivering two key benefits:
– Providing a platform to address cost-efficiencies and accessibility to quality healthcare for the populace at large
– Playing a key role in managing a growing population of chronically ill seniors.
Prior to 2020, however, the rules of reimbursement and implementation for associated telehealth services were difficult to navigate, wildly differing at the state and federal level with a host of regulations further complicating matters. Federal reimbursement policies are centered on Medicare, via the Centers for Medicare and Medicaid Services (CMS) – the single largest payer for seniors and chronically ill patients. Additionally, compliance with the Health Insurance Portability and Accountability Act (HIPAA) dictated rigorous standards for direct and monitoring communications between care providers and patients. Complicating matters further, US states offered a patchwork of individual telehealth laws dictating separate Medicaid policies.
The result was a lack of clarity of how healthcare providers could overcome regulatory and financial reimbursement barriers to implement effective telehealth programs as well as a lack of parity in coverage services and payments for patients. To address this at the federal level, CMS released new guidance in 2020 to relax reimbursement restrictions for providers. Now, we’re at the cusp of a new era of telemedicine where providers could widely offer:
– Virtual office visits that address traditionally in-person services such as primary care, behavioral health, and specialty care (e.g. pulmonary or cardiac health rehabilitation)
– On-demand virtual urgent care to address pressing concerns and urgently needed consultations
– Virtual broader home health services such as remote patient monitoring, outpatient disease management, and various forms of therapy (e.g. physical, speech)
– Tech-enabled home medication administration helping patients receive injectable or consumable medication via monitored self-administration
This is all, of course, dependent upon the mobile technology (e.g. tablets, wearables, etc.) and associated services that telehealth providers will rely upon to make these services happen at parity and scale for their patients. Even more importantly, virtual care programs being scaled up to cover a larger percentage of patients will fall apart if providers don’t have the resources to offer robust support and maintenance options for these devices and services. Quality of virtual care is highly dependent on persistent device and service availability and dependability.
Whether providers have already begun purchasing the mobile devices needed or are still struggling with the choice of what devices and services they need and/or can afford, however, they now face a different quandary: How to stand up these virtual care services at scale in a sustainable way that works within current budget resources and doesn’t pass on ballooning costs to your patients?
One way to make complex mobile technology deployments financially manageable is opting for a mobile device as a service (mDaaS) model which allows you to shift from a CapEx-based spending model to an OpEx spending model for purchasing hardware and allows telehealth providers to bundle or roll up a range of devices, accessories, services, maintenance and support into a single, predictable monthly per-device price. With mobile device technology rapidly evolving, telemedicine providers will need the operational agility to pivot to different solutions and quick technology refreshes as the need arises.
When done with the right third-party partner, it offers the additional advantages of outsourcing end-to-end support and lifecycle management to highly trained agents, who can free up precious IT resources. Most importantly, it creates a level of control over technology and spend that makes standing up virtual care programs convenient and stress-free.
There are many options to consider when expanding telemedicine services rapidly to larger patient bases, whether during disruptive events such as the COVID-19 pandemic or in the years to come. The key to making these services sustainable is finding a financing model that will free up internal resources, offer greater spending flexibility, and offer end-to-end support for your healthcare mobile technology ecosystem.
About Don Godbee Senior Mobile Solutions Architect at Stratix
Don brings a unique perspective to mobility in the Healthcare Vertical with over 25 years of consulting and delivery of critical solutions. Don has delivered various solutions from OEM integration of sensors in medical devices to mobile point of care solutions and services with major EHR software solution providers such as Epic, Cerner, GE Healthcare, Allscripts, and McKesson.
– Ro announced it has acquired Workpath, a technology
platform that powers on-demand, in-home healthcare and diagnostics services
– Through this acquisition, Ro’s platform will now
uniquely bring together a patient’s doctor, pharmacy, and
diagnostics/lab–offering a personalized, end-to-end experience with no
– Ro is also announcing a partnership with Quest
Diagnostics, which operates more than 2,200 locations nationwide, to process
its lab tests.
Ro, the healthcare technologycompany, today announced it has acquiredWorkpath, a software platform that enables healthcare companies to offer on-demand, in-home care, and diagnostic services with a simple API. The acquisition will enable Ro to seamlessly integrate virtual and in-person care on its own platform and offer these in-home capabilities to other healthcare companies. The ability to send healthcare professionals to, and conduct diagnostic tests in, a patient’s home significantly expands the scope of Ro’s vertically-integrated platform and advances the company’s strategy of becoming a patient’s first call for all of their healthcare needs.
End-to-End In-Home Care Solution
Founded in 2015, Workpath is a technology platform that powers on-demand, in-home healthcare services nationwide. Workpath’s API enables healthcare companies to dispatch phlebotomists and other providers to perform services ranging from blood draws to vaccinations, all from the comfort of a patient’s home. The company’s full-service platform includes scheduling and dispatch software, a nationwide network of healthcare professionals, diagnostic processing and reporting, and more. Workpath is available to 95% of patients across the country and facilitates in-home healthcare services for clinical trial operators, Fortune 100 companies, and the nation’s largest diagnostic laboratories.
Acquisition Creates A New Paradigm for
As part of the acquisition, Workpath will
continue to operate independently as an autonomous entity. Workpath and its API
will continue to be available to other healthcare companies, enabling them to
dispatch healthcare professionals to perform services ranging from blood draws
to vaccinations and other primary care services, all from the comfort of a
patient’s home. The company’s full-service platform includes scheduling and
dispatch software, a nationwide network of healthcare providers, diagnostic
processing and reporting, and more. Ro’s offering of Workpath’s platform will
position the combined company as an integral part of the healthcare industry’s
transition to connect the best of virtual and in-person care.
Enabling End-to-End Care
Ro-affiliated providers will leverage Workpath’s
API to order in-home care or diagnostic services for patients, greatly
expanding the scope of conditions that can be treated or managed through Ro’s
platform. In doing so, Ro will seamlessly connect a patient’s doctor, pharmacy,
and lab on its vertically-integrated platform, enabling end-to-end care from
diagnosis to the delivery of medication to ongoing care. Given that seven of
every ten healthcare decisions require blood work, Ro will start by offering in-home
phlebotomy (blood test) services with results directly delivered through Ro’s
Zachariah Reitano, Co-Founder and CEO of Ro, said: “Ten years from now, more healthcare services will be delivered online or in-home than in every hospital, doctors office, or pharmacy combined, and this acquisition will help accelerate that change. The powerful new platform we’re creating enables Ro, and countless other healthcare companies, to deliver care whenever and wherever patients need it. We look forward to welcoming Workpath to the Ro family and together setting a new standard for vertically integrated healthcare delivery.”
Financial details of the acquisition were not disclosed.
– Innovaccer launches COVID-19 Command
Center to assist healthcare organizations in optimizing their COVID-19
– The solution offers a unified
information hub to manage COVID-19 resources and operations and empower teams
with unprecedented visibility into their environment.
Innovaccer, Inc., a San
Francisco, CA-based healthcare technology company, today announced the launch
of its COVID-19
Command Center to assist healthcare organizations in optimizing their COVID-19
operations. The solution provides real-time insights and predictions into
patient and resource status and helps organizations adjust to their fluctuating
Connect Your Systems to Create a COVID-19 Command Center
Innovaccer helps healthcare organizations build a network of
intelligence while sitting on top of systems of records to provide
enterprise-wide insights and improve efficiencies in financial, operational,
and clinical outcomes. Innovaccer’s COVID-19 Command Center provides a
unified information hub for users to manage their COVID-19 resources by
integrating data from Electronic Health Records (EHRs), supply chains, human
resources, and financial systems.
Manage Your COVID-19 Resources and Information in Real-Time
Dashboards on the solution provide real-time monitoring of
bed capacity, medication inventory, staffing plans, PPE supplies, and other
critical resources. It also automatically generates CDC-compliant reports on
these resources and gives an up-to-date detailed overview of the consumption
rates at each facility.
360-Degree View into COVID Operations
The plug-and-play integrations of the Command Center provide
360-degree visibility into all COVID-19 operations and a system-wide overview
of daily and total year-to-date COVID-19 cases. Its descriptive pandemic
population maps allow continuous tracking of cases across the region and the
COVID-19 Resource Optimization and Inventory Management
Additionally, the solution enables healthcare organizations
to take full control of their COVID-19 management activities by furnishing them
with smart analytics and forecasting capabilities and action plans based on
detailed analyses of COVID-19 trends and resources. The COVID-19 Command Center
provides visibility of their caseloads, inventory, and resource requirements to
more accurately predict upcoming demands.
Why It Matters
“The need for visibility across the network has never been more crucial than during these pandemic times. Healthcare organizations are struggling to gain an edge with visibility into their patients, resources, and facilities,” says Abhinav Shashank, CEO at Innovaccer. “With our COVID-19 Command Center, we aim to solve this problem by providing them with true transparency and in-depth visibility across their networks, operations, and patients. Our solution is built to support the digital transformation of their COVID-19 operations and to help them care as one.”
– CarepathRx will
acquire the University of Pittsburgh Medical Center’s pharmacy operations in a
– The company fully
integrates pharmacy operations, expands healthcare services, improves
ambulatory access, minimizes clinical variation and creates new health system
– CarepathRx serves more than 15 health systems and 600
hospitals, with more than 1,500 employees nationwide, 400 payor contracts.
Already CarepathRx has treated more than 100,000 patients.
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.
This new partnership expands CarepathRx’s specialty and home infusion capabilities. “Our partnership with UPMC and Chartwell is an important step for CarepathRx. We set out to create a new approach to pharmacy care in the market—one that is centered on the patient and that works collaboratively with both the provider and the payor of health care,” said Figueroa, chief executive officer of CarepathRx. “We welcome the team at Chartwell to the CarepathRx family and are thrilled to partner with UPMC to help us achieve our mission.”
Optimize Your Hospital Pharmacy
Founded in 2019 by seasoned health care executive John Figueroa and middle-market private equity firm Nautic Partners LLC, CarepathRx has rapidly become a leader in delivering comprehensive pharmacy solutions to patients undergoing complicated medication therapies. By focusing on the most vulnerable patients, CarepathRx is seeking to break down the barriers of typical pharmacy care and medication management. Its suite of solutions caters to patients undergoing specialty and infusion therapies, often for a variety of chronic conditions. CarepathRx works closely with partners across the health care spectrum—including health systems, community physicians, home health agencies and payors. Today, CarepathRx delivers its services to more than 600 hospitals across the country.
The transaction is expected to close
within 30 days. Cantor Fitzgerald & Co. served as financial advisor to
Chartwell in the formation of the management services organization and
partnership with CarepathRx.
Each year, Adverse Drug Events (ADE) account for nearly 700,000 emergency department visits and 100,000 hospitalizations in the US alone. Nearly 5 percent of hospitalized patients experience an ADE, making them one of the most common types of inpatient errors. What’s more, many of these instances are hard to discover because they are never reported. In fact, the median under-reporting rate in one meta-analysis of 37 studies was 94 percent. This is especially problematic given the negative consequences, which include significant pain, suffering, and premature death.
While healthcare providers and pharmaceutical companies conduct clinical trials to discover adverse reactions before selling their products, they are typically limited in numbers. This makes post-market drug safety monitoring essential to help discover ADE after the drugs are in use in medical settings. Fortunately, the advent of electronic health records (EHR) and natural language processing (NLP) solutions have made it possible to more effectively and accurately detect these prevalent adverse events, decreasing their likelihood and reducing their impact.
Not only is this important for patient safety, but also from a business standpoint. Pharmaceutical companies are legally required to report adverse events – whether they find out about them from patient phone calls, social media, sales conversations with doctors, reports from hospitals, or any other channel. As you can imagine, this would be a very manual and tedious task without the computing power of NLP – and likely an unintentionally inaccurate one, too.
The numbers reflect the importance of automated NLP technology, too: the global NLP in healthcare and life sciences market size is forecasted to grow from $1.5 billion in 2020 to $3.7 billion by 2025, more than doubling in the next five years. The adoption of prevalent cloud-based NLP solutions is a major growth factor here. In fact, 77 percent of respondents from a recent NLP survey indicated that they use at least one of the four major NLP cloud providers, Google is the most used. But, despite their popularity, respondents cited cost and accuracy as key challenges faced when using cloud-based solutions for NLP.
It goes without saying that accuracy is vital when it comes to matters as significant as predicting adverse reactions to medications, and data scientists agree. The same survey found that more than 40 percent of all respondents cited accuracy as the most important criteria they use to evaluate NLP solutions, and a quarter of respondents cited accuracy as the main criteria they used when evaluating NLP cloud services. Accuracy for domain-specific NLP problems (like healthcare) is a challenge for cloud providers, who only provide pre-trained models with limited training and tuning capabilities. This presents some big challenges for users for several reasons.
Human language very contexts- and domain-specific, making it especially painful when a model is trained for general uses of words but does not understand how to recognize or disambiguate terms-of-art for a specific domain. In this case, speech-to-text services for video transcripts from a DevOps conference might identify the word “doctor” for the name “Docker,” which degrades the accuracy of the technology. Such errors may be acceptable when applying AI to marketing or online gaming, but not for detecting ADEs.
In contrast, models have to be trained on medical terms and understand grammatical concepts, such as negation and conjunction. Take, for example, a patient saying, “I feel a bit drowsy with some blurred vision, but am having no gastric problems.” To be effective, models have to be able to relate the adverse events to the patient and specific medication that caused the aforementioned symptoms. This can be tricky because as the previous example sentence illustrates, the medication is not mentioned, so the model needs to correctly infer it from the paragraphs around it.
This gets even more complex, given the need for collecting ADE-related terms from various resources that are not composed in a structured manner. This could include a tweet, news story, transcripts or CRM notes of calls between a doctor and a pharmaceutical sales representative, or clinical trial reports. Mining large volumes of data from these sources have the power to expose serious or unknown consequences that can help detect these reactions. While there’s no one-size-fits-all solution for this, new enhancements in NLP capabilities are helping to improve this significantly.
Advances in areas such as Named Entity Recognition (NER) and Classification, specifically, are making it easier to achieve more timely and accurate results. ADE NER models enable data scientists to extract ADE and drug entities from a given text, and ADE classifiers are trained to automatically decide if a given sentence is, in fact, a description of an ADE. The combination of NER and classifier and the availability of pre-trained clinical pipeline for ADE tasks in NLP libraries can save users from building such models and pipelines from scratch, and put them into production immediately.
In some cases, the technology is pre-trained with tuned Clinical BioBERT embeddings, the most effective contextual language model in the clinical domain today. This makes these models more accurate than ever – improving on the latest state-of-the-art research results on standard benchmarks. ADE NER models can be trained on different embeddings, enabling users to customize the system based on the desired tradeoff between available compute power and accuracy. Solutions like this are now available in hundreds of pre-trained pipelines for multiple languages, enabling a global impact.
As we patiently await a vaccine for the deadly Coronavirus, there have been few times in history in which understanding drug reactions are more vital to global health than now. Using NLP to help monitor reactions to drug events is an effective way to identify and act on adverse reactions earlier, save healthcare organizations money, and ultimately make our healthcare system safer for patients and practitioners.
About David Talby
David Talby, Ph.D., MBA, is the CTO of John Snow Labs. He has spent his career making AI, big data, and data science solve real-world problems in healthcare, life science, and related fields. John Snow Labs is an award-winning AI and NLP company, accelerating progress in data science by providing state-of-the-art models, data, and platforms. Founded in 2015, it helps healthcare and life science companies build, deploy, and operate AI products and services.
Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest costs. Cost-sharing and insurance premiums are rising consistently since the last decade for employer plans, which covers nearly half of the country’s population. Plan members are shouldering a part of the healthcare cost burden, so they want to keep it as low as possible. At the same time, they want maximum value for their money with access to quality care.
CMS identified this as an opportunity and issued the Final Interoperability and Patient Access rule. The rule allows patients to access electronic health data through any third-party application of their choice. The rule intends to allow patients to take control of their data and determine who can see which data. It will also make transferring data from provider to provider easier. So that patients can be ensured that their provider is fully aware of their medical history.
The Challenge of Providing Members Access to Healthcare Data
The biggest challenge that health plans will face is to extract data from multiple sources in-house, clean and scrub it, and ensure it is in the appropriate format as required by the Centers for Medicare and Medicaid Services (CMS). Some health plans have been in business for a really long time. Patient data has been accumulating through these years in legacy systems. Providing access to that data through certified third-party applications will require a lot of effort on the part of health plans. The health plans also have to ensure tight authentication standards so that only the people requested by the members have access to their healthcare data.
In addition, there are multiple problems associated with provider data. Incorrect data in the provider database costs close to $3 billion annually. CMS has also issued warnings for inaccurate provider directories, high claim-reprocessing volumes, and substantial encounter-data rejection rates. Payers have been addressing the data issues with short term solutions. But now they have to resolve the provider data problems for good and make health data readily available to the members.
The COVID Crisis Upended The Payer Compliance Initiatives
Payers are in solidarity with providers and patients in this time of crisis. While providers work tirelessly to help an increased number of patients access the required care, payers are providing support through fast track reimbursements and reduced utilization management.
Many health plans are focused on ensuring that their members have access to resources to fight COVID, which is why CMS extended the deadline for the Final Interoperability rule. Utilization patterns are witnessing a significant change. Many members are not receiving scheduled care as some elective surgeries are rescheduled and some provider offices are shut down. There has been a drop in certain kinds of utilization. Conversely, there has been a dramatic surge in telehealth office visits and behavioral health services.
The Road Ahead for Health Plans
Healthcare payers have endured significant claims-based, economic, and operational challenges during the pandemic. While they battle those bottlenecks, they also have to ascertain and prepare for the future and devise ways to ensure that their members have access to quality care.
Health plans will have to try to anticipate what utilization patterns will look like in the future, especially in the next year. Telehealth utilization will not be the same as it was pre-COVID. They will also have to ensure that members have access to care. They will have to reach out to members, especially those who are the most vulnerable. They will have to make sure members are not suffering from social isolation, they are taking their medication and they have access to transportation to get to the doctor.
Provider Alliance for CMS Compliance
CMS is handing over the reins of the care journey to the patients to improve care delivery through the Interoperability rule. Providers will play a key role in enabling access to healthcare data to patients by streamlining data and closing coding gaps. Payers must assist providers with their data needs to ensure compliance with the CMS rules.
As the pandemic ends and CMS comes out with more definitive long term rules and coverages, it is going to be important to ensure that providers are on the same page with payers. Health plans can partner with providers to educate them about the acceptable telehealth codes and what type of services are to be performed using those codes. Providers want to take care of their patients and they want to do it well. They want to leverage technology to ensure patient access to care and ensure their safety, especially for patients who suffer from multiple comorbidities.
About Elizabeth Bierbower
Elizabeth Bierbower is a strategic leader with more than thirty years of executive experience in the health insurance industry. She has experience scaling cost-effective and profitable growth strategies through internal innovation, and a reputation as being one of the industry’s most fiscally responsible and progressive leaders. Bierbower currently serves on the Boards of Iora Health, the American Telemedicine Association, and is on Innovaccer’s Strategic Advisory.
Previously Beth was a member of Humana’s Executive Management Team and held various roles including Segment President, Group and Specialty Benefits, and was an Enterprise Vice President leading Humana’s Product Development and Innovation teams.
– UCB has selected Medisafe to develop branded digital
drug companions for antiepileptic medications, marking the company’s official
entry into the digital therapeutics space.
– The initial collaboration will primarily be focused on their antiepileptic medications, but they are exploring its use for additional brands.
a leading digital
therapeutics company specializing in digital companions, has been selected
by UCB to develop branded digital drug
companions for its antiepileptic medications, with greater capabilities to
expand across additional brands. The digital companions streamline support for
patients to access financial assistance, patient diaries, and doctor discussion
guides throughout their treatment journey.
UCB is launching both digital companions in November in
support of National Epilepsy Awareness Month and the more than 3.4 million
patients in the US who live with the neurological condition. 1 in 26 people in
the US will develop epilepsy at some point in their lives and UCB wants to make
managing medication therapies easier through new digital companions from Medisafe. UCB
is a leader in antiepileptic medications commonly used to treat epilepsy and
the new digital experience for users will deliver condition-specific
content to help support patients through any medication challenges. To
date, nearly 7MM users rely on Medisafe’s digital therapeutics platform,
which applies real-world evidence to build connected medication management
programs and influence patients’ behavior on therapy.
The collaboration will raise awareness and drive engagement
with a content-rich digital experience for patients to gain support and
community throughout the course of their treatment. The Medisafe app
is available to Android and iPhone users through both the Google play and Apple
app stores. Patients can experience the antiepileptic medication resource
centers within the Medisafe app, unlocking a world of advanced
patient support and guidance as a result of this collaboration.
“At UCB, we focus on fostering collaborations that deliver a purposeful impact to people living with epilepsy. As part of our ongoing digitalization efforts, the Medisafe app will allow us to continue supporting patients with new, innovative ways of navigating their health,” said Anita Moser, Head of Assets and Optimization for U.S. Neurology, UCB. “During the COVID crisis, the ability to support patients digitally is more important than ever, and we are pleased to deliver personalized and immediate support directly to epilepsy patients and their caregivers.”
– New study out from Propeller and Chicago’s NorthShore
University HealthSystem shows that asthma patients maintain higher medication
adherence and decrease their rescue inhaler use when using a digital health
– The study looked at 100 patients recruited from
NorthShore practices, half of whom used Propeller to manage their condition and
half of whom did not.
– The treatment group maintained their high medication adherence at 68%, while the control group experienced a 17% decline in adherence over the course of the study. The treatment group also increased days without needing their rescue inhaler by 19%, 13% more than in the control group.
Poor adherence to asthma medication and overuse of rescue
inhalers have both been associated with increased asthma morbidity in previous
research. Studies reveal that patients often overestimate their level of
adherence to their clinician, leading to costly treatments that may not be
appropriate or necessary to curb symptoms.
Randomized Clinical Trial Details
The published study features a randomized controlled trial
that enrolled 100 patients with uncontrolled asthma, 25 to 65 years of age.
Patients were recruited between April 2018 and 2019 from allergist and
pulmonologist practices at NorthShore University HealthSystem in Chicago. Treatment
and control group participants were both attached a small sensor to their
controller and rescue inhalers. The treatment group received insights on their
medication use in the Propeller app, including reminders to take missed or late
doses and reports on their usage and possible triggers.
Utilizing Propeller’s digital health platform, clinicians
had had access to the treatment patients’ controller and rescue medication
data. If patient utilization indicated poor adherence or worsening control,
patients were contacted to address adherence and review asthma control status. The
control group’s medication use was remotely monitored, but they did not receive
insights in the app or outreach from providers.
Clinical Trial Outcomes/Results
The study’s treatment group maintained its high medication adherence at 68%, while the control group experienced a 17% decline in adherence over the course of the study. In addition, Propeller users’ days without needing their rescue inhaler increased 19% in the treatment group, 13% more than in the control group.
“Increasing adherence and reducing rescue use are critical to improving the health and well-being of asthma patients,” said Giselle Monsaim, MD, lead author of the study and attending physician in the Departments of Medicine, Division of Pulmonary, Critical Care, Allergy and Immunology at NorthShore University HealthSystem. “We’re pleased to add to the body of research that shows digital health can play an important role in maintaining high adherence rates and increasing days without symptoms for people with asthma.”
COVID-19 terms such as quarantine, flatten the curve, social distance, and personal protective equipment (PPE) have dominated headlines in recent months, but what hasn’t been discussed in length are the hidden costs of COVID-19 as it relates to patient adherence.
The coronavirus pandemic has amplified this long-standing issue in healthcare as patients are delaying routine preventative and ongoing care for ailments such as mental health and chronic disease. Emergency care is also suffering at alarming rates. Studies show a 42 percent decline in emergency department visits, measuring the volume of 2.1 million visits per week between March and April 2019 to 1.2 million visits per week between March and April 2020. Patients are not seeking the treatment they need – and at what cost?
When the SARS outbreak occurred in 2002, particularly in Taiwan, there was a marked reduction in inpatient care and utilization as well as ambulatory care. Chronic-care hospitalizations for long-term conditions like diabetes plummeted during the SARS crisis but skyrocketed afterward. Similar to the 2002 epidemic, people are currently not venturing en masse to emergency rooms or hospitals, but if history repeats itself, hospital and ER visits will happen at an influx and create a new strain on the healthcare system.
So, if patients aren’t going to the ER or visiting their doctors regularly, where have they gone? They are staying at home. According to reports from the Kaiser Family Foundation, 28 percent of Americans polled said they or a family member delayed medical care due to the pandemic, and 11 percent indicated that their condition worsened as a result of the delayed care. Of note, 70 percent of consumers are concerned or very concerned about contracting COVID-19 when visiting healthcare facilities to receive care unrelated to the virus. There is a growing concern that patients will either see a relapse in their illness or will experience new complications when the pandemic subsides.
Rather than brace for a tidal wave of patients, healthcare systems should proactively take steps (or act now) to drive patient access, action, and adherence.
1. Identify Who Needs to Care The Most
Healthcare providers should consider risk stratifying patients. High-risk people, such as an 80-year-old male with comorbidities and recent cardiac bypass surgery, may require a hands-on and frequent outreach effort. A 20-year-old female, however, who comes in annually for her physical but is healthy, may not require that level of engagement. Understanding which patients are at risk for the potential for chronic conditions to become acute or patients who have a hard time staying on their care plan may need prioritized attention and a more thorough engagement effort.
For example, patients with a history of mental health issues may lack motivation or momentum to seek care. Their disposition to be disengaged may require greater input to push past their disengagement.
Especially important is the ability to educate and guide patients to the appropriate venue of care (ER, telehealth visit, in-person primary care visit, or urgent care) based on their self-reported symptoms. Allowing patients to self-triage while scheduling appointments helps them make more informed decisions about their care while reducing the burden on over-utilized emergency departments.
2. Capture The Attention of The Intended Audience and Induce Action
Once you’ve identified who needs care the most, how do you break through the “information clutter” to ensure healthcare messages resonate with the intended audience? The more data points, the better. It is important to understand the age of the patient, their preferred communication channel, and the intended message for the recipient, but effective communication exceeds those three data points. Consider factors like the presence of mental health conditions, comorbidities, or health literacies. Then, think beyond the patient’s channel of choice and select the appropriate channel of communication (text, phone call, email, paid social media advertisement, etc.), that will most likely induce action. As an organization, also consider running A/B tests to detect and analyze behavior. As you collect more data, determine what exactly is inducing patient action.
Of note, don’t underestimate the power of repetition. Patients may need to be reminded of the intended action a few times in a few different ways before moving forward with seeking the care they need. Repetition is also shown to decrease no-show rates, a critical metric. Proactive, prescriptive, and tailored communication will help increase engagement. Moving past the channel of choice and toward the channel of action is key.
3. Engage Patients Through Personalized and Tailored Communication
In addition to identifying the right communication channel, it’s also important to ensure you deliver an effective message. Communication with patients should be relevant to their particular medical needs while paying close attention to where each person is in their healthcare journey. Connecting with patients on both an emotional and rational level is also important. For example, sending a positive communication via phone, email, or text to lay the foundation for the interaction shows interest in the patient’s wellbeing.
A “Hey, here’s why you need to come in” note makes a connection in a direct and personalized way. At the same time, and in a very pointed manner, sharing ways providers and health systems are keeping patients safe (e.g., telehealth, virtual waiting rooms, separate entrances, and mandating masks), also provides comfort to skittish patients. Additionally, consider all demographic information when tailoring communications. And don’t forget to analyze if changes in content impact no-show rates. Low overall literacy may impact health literacy and may require simpler and more positive words to positively impact adherence.
It may sound daunting, especially for individual health systems, to personalize patient communication efforts, but the use of today’s data tools and technological advancements can relieve the burden and streamline efforts for an effective communication approach.
4. Use Technology to Your Advantage (With Caution)
Once you have developed your communication strategy, don’t stop there. Consider all aspects of the patient journey to drive action. A virtual waiting room strategy, for example, can help ease patient concerns and encourage them to resume their care. Health systems can help patients make reservations, space out their arrival times, and safeguard social distancing measures—all while alleviating patient fears. Ideally, the patient would be able to seamlessly book an appointment and receive a specific arrival time, allowing ER staff to prepare for the patient’s arrival while minimizing onsite wait time.
When implemented properly, telehealth visits can also improve continuity of care, enhance provider efficiency, attract and retain patients who are seeking convenience, as well as appeal to those who would prefer not to travel to their healthcare facility for their visit. Providers need to determine which appointments can successfully be resolved virtually. Additionally, some patients might not have the means for a successful telehealth visit due to a lack of internet access, a language barrier, or a safe space to talk freely.
To ensure all patients receive quality care, health systems should make plans to serve patients who lack the technology or bandwidth to participate in video visits in an alternative manner. For example, monitor patients remotely by asking them to self-report basic information such as blood sugar levels, weight, and medication compliance via short message service (SMS). This gives providers the ability to continuously monitor their patients while enhancing patient safety, increasing positive outcomes, and enabling real-time escalation whenever clinical intervention is needed.
It is important we ensure all patients stay on track with their health, despite uncertain and fearful times. Health systems can enhance patient adherence and induce action through the implementation of tools that increase patient engagement and alleviate the impending strain on the healthcare system.
About Matt Dickson
Matt Dickson is Vice President of Product, Strategy, and General Manager of Stericycle Communication Solutions, a patient engagement platform that seamlessly combines both voice and digital channels to provide the modern experience healthcare consumers want while solving complex challenges to patient access, action, and adherence. . He is a versatile leader with strong operational management experience and expertise providing IT, product, and process solutions in the healthcare industry for nearly 25 years. Find him on LinkedIn.
– Apstar Pharma acquires the assets of respiratory health company Cohero Health to expands its digital portfolio with a focus on respiratory disease management.
– Cohero Health develops digital tools and technologies to improve respiratory care, reduce avoidable costs, and optimize medication utilization.
AptarGroup, Inc., a global leader in consumer dispensing, active packaging, drug delivery solutions, and services, announces that it has acquired all operating assets and the proprietary portfolio of Cohero Health, Inc. (“Cohero Health”), a digital therapeutics company transforming respiratory disease management for asthma and chronic obstructive pulmonary disorder (COPD). Financial details of the acquisition were not disclosed.
Start breathing smarter
Founded in 2013, New York-based Cohero Health develops innovative digital tools and technologies to improve respiratory care, reduce avoidable costs, and optimize medication utilization. With this transaction, Aptar Pharma acquires Cohero Health’s turnkey digital health platform and device assets including:
· BreatheSmart Connect digital health platform – care coordination and HIPAA-compliant SaaS cloud service which captures and securely stores data from Cohero Health’s devices and BreatheSmart® software for remote monitoring and patient communications to help manage patient therapy;
· BreatheSmart® App – designed for patient habit creating and behavior change, driving appropriate medication utilization. Provides real-time tracking of medication adherence and lung function, along with reminders, educational materials, and symptom/trigger recording;
HeroTracker® Sensors – Bluetooth enabled medication smart inhaler sensors
designed for both control and rescue medications. Attaches to respiratory
medications to automatically record time and date of doses taken
· mSpirometer™ and cSpirometer™lung function diagnostic sensors – enable comprehensive pulmonary lung function testing in a handheld wireless device.
Acquisition Expands Aptar’s Digital Portfolio
“Cohero Health further strengthens and expands Aptar’s digital portfolio, in this case, with a focus in respiratory disease management,” commented Sai Shankar, Aptar Pharma’s Vice President, Global Digital Healthcare Systems. “Aptar has made previous investments in digital respiratory company Sonmol in China and digital health company Navia Life Care in India. With this strategic bolt on, Aptar now has global capabilities to deploy digital respiratory health, utilizing either the Cohero or Aptar device portfolio/platform. The investment will also facilitate Aptar’s ability to provide diagnostic solutions in respiratory and a significant number of other disease categories.”
– Despite pressure to take an Epic-first approach to
software decisions, many pharmacies at Epic organizations have held on to
third-party products due to the relative immaturity of some of Epic’s more
recently developed pharmacy solutions.
– Latest KLAS report explores medication inventory
management (MIM) and IV workflow management—the two areas where Epic has
focused much of their development efforts—to validate what capabilities these
modules deliver and where gaps still exist.
Despite pressure to take an Epic-first approach to software decisions, many pharmacies at Epic organizations have held on to third-party products due to the relative immaturity of some of Epic’s more recently developed pharmacy solutions, according to the latest KLAS report. Recently, Epic has put a significant focus on broad pharmacy development (the only enterprise EMR vendor to have done so), and customers want to know—is it time to switch?
To answer this question, the latest KLAS report, Epic
Pharmacy Solutions 2020 explores medication inventory management (MIM) and
IV workflow management—the two areas where Epic has focused much of their
development efforts—to validate what capabilities these modules deliver and
where gaps still exist.
What Progress Has Epic Made with Medication Inventory and
IV Workflow Management
Customers agree that Epic does well at helping with initial
implementations and continuing to develop needed interfaces. Once live,
customers are highly reliant on their own internal Willow analyst teams to
customize workflows and deliver reporting to drive optimization. As a result,
pharmacy managers and directors can feel they lack a direct Epic connection and
the ongoing vendor guidance and expertise that many third-party pharmacy
vendors typically provide.
Other key findings of the report include:
– Willow tracks in-Scope medications well, but gaps remain
– Completeness of data from solutions outside the Epic ecosystem
varies, requiring significant IT investment from customers, who would like both
Epic and the hardware vendors to partner better around interfaces.
– IV dispense prep meets core needs for customers, but
additional gaps include Epic’s lack of deep expertise in clean-room safety and
lack of hardware (which precludes customers from being able to completely
– Epic pharmacy functionality delivers breadth but not
Cerner announces an open call for additional health systems to sign on as testing partners of their EHR-integrated Voice Assist technology. Voice Assist will allow clinicians to interact with the EHR by just using their voice. Clinicians will be able to issue voice commands to complete a range of tasks that can save significant time and reduce the administrative burden on care teams by replacing manual data documentation.
How Voice Assist Technology Works
Using the phrase ‘Hey
Cerner,’ clinicians will be able to search for and retrieve information from
patient records, place medication orders and set up reminders. Clinicians will
be able to seamlessly switch between dictating the clinical note and navigating
the patient’s chart, improving efficiency and enhancing the health care
Examples of Voice Assist’s current functionality
“What is the latest white blood cell
“Remind me to call the patient in 6 months
about their high cholesterol”
“St. Joseph’s Health is excited to pilot Cerner’s Voice Assist technology, which will enable our clinicians to complete several tasks in the EHR via voice commands. We envision that this technology will be conducive to more meaningful clinician patient interaction since the clinicians will spend less time manually documenting. We hope to see improved efficiency, clinician and patient satisfaction throughout this trial period.” – Lisa Green, Director Clinical Information Systems, St. Joseph’s Health.
“At IU Health, we’re creating designated innovations centers where we trial the latest new technologies in real clinical workflows. This allows us to move new tools into our system rapidly and iteratively. We’re excited to pilot Cerner’s Voice Assist, which will allow our clinician’s to handle several tasks in the EHR with their voice. This technology will help our clinicians to focus their attention on their patients. We believe voice has the potential to increase clinician efficiency and hopefully, result in higher patient and clinician satisfaction.” – Cliff J. Hohban, Vice President, IS, Applications & PMO, IU Health
Voice Assist is supported with Nuance’s virtual assistant
capability and is expected to be widely available in 2021.
– 65% of patients say they will wait to receive the
forthcoming COVID-19 vaccine even if it becomes available before the end,
according to a new Medisafe survey.
– Consumers cited greater trust in Dr. Anthony Fauci and established protocols as a leading factor in determining whether to take the vaccine, and listed President Trump as the leading detractor in driving COVID-19 vaccine skepticism and hesitancy in its effectiveness.
Real-world results show users prefer to wait on COVID-19 vaccine dose, refer to a physician for guidance on timing, according to a new survey from Medisafe, a digital therapeutics platform that supports users with advanced medication management. The survey reveals sixty-five percent of patients say they will wait to receive the forthcoming COVID-19 vaccine even if it becomes available before the end of 2020. The majority of survey participants cited uncertainty in its overall effectiveness and potential side-effects from the vaccine as top reasons for the delay.
The survey, conducted from Sept. 27 – Oct. 2, 2020, included more than 16,000 U.S. patients who use Medisafe’s digital therapeutics platform to regularly manage their medication therapy. This new survey is the latest in a series of reports conducted by Medisafe on users’ viewpoints and insights in adapting to the COVID-19 pandemic, measuring elements such as changes in medication habits, virtual doctor visits, increased use of digital health tools, and trust in pharmaceutical companies. The company is a leading digital therapeutic platform with more than seven million users who utilize the system to help manage their medication therapy, stay engaged on their medication therapy, and engage with other users to create a virtual support system in living healthier lives while managing acute and chronic conditions.
COVID-19 Vaccine & Patients
Sixty percent of respondents say they don’t expect a COVID-19 vaccine to be available before the end of 2020. While 21% said they would receive the vaccine as soon as it becomes available, 11% of respondents said they would never take the vaccine. Forty-nine percent believe the COVID-19 vaccine is being rushed to market, side-stepping normal regulations and testing, creating additional concern and hesitancy to become vaccinated. Many respondents also cited confusion over the handling of the pandemic in the U.S. as a primary reason to resist taking the vaccine.
Political Uncertainty Drives Mistrust of COVID-19 Vaccine
In open-ended responses, users cited greater trust in Dr. Anthony Fauci and established protocols as a leading factor in determining whether to take the vaccine and listed President Trump as the leading detractor in driving skepticism and hesitancy in its effectiveness. Survey participants prefer to obtain recommendations from their own physicians to determine if the vaccine is suitable for them and their families, and when it’s appropriate to take the vaccine.
“Despite the apolitical nature of the survey, the open-ended responses and results clearly show that users feel many issues surrounding the vaccine have been politicized, created additional challenges in driving utilization of the vaccine once it becomes available,” said Medisafe Chief Marketing Officer Jennifer Butler. “This survey provides greater visibility into users’ concerns with taking the vaccine and its potential interaction with chronic conditions and medication therapy, creating opportunities to build awareness and support throughout their journey. Medisafe aims to help manufacturers in creating personalized guidance in formats that are beneficial and accessible to patients, whenever any new challenges arise.”
– Humana Inc. and Fresenius Medical Care North America
(FMCNA) today announced an agreement to broaden their collaboration toward
improving the health of eligible Humana Medicare Advantage members
agreement between Humana and Fresenius Medical Care North America goes into
effect Jan. 1, 2021.
Humana Inc. and leading renal care company Fresenius Medical Care North America (FMCNA) announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage and commercial members with chronic kidney disease (CKD) and end-stage renal disease (ESRD) through more coordinated, holistic care.
The expanded partnership is in keeping with the goals
outlined in the 21st Century Cures Act, which enables people with ESRD to
enroll in Medicare Advantage Plans, and with federal initiatives that call for earlier diagnosis and
treatment of kidney disease; a reduction in the number of Americans developing
ESRD; and support for patient treatment options such as home dialysis or kidney
transplant as applicable.
The agreement between
Humana and Fresenius Medical Care North America goes into effect Jan. 1, 2021,
and encompasses the following:
Expanded Availability of Care Coordination Services:
FMCNA currently provides specialized care coordination services for Humana
members with CKD in three states: Iowa, Kentucky, and North Carolina. The
agreement expands the availability of these services to eligible Humana members
in an additional 39 states, with the goals of improving quality of life and
health outcomes, increasing access to care and minimizing care gaps, slowing
disease progression and lowering hospitalization rates, and reducing the cost
FMCNA’s care coordination services include early detection of CKD to slow
disease progression; medication reviews and regimen adherence guidance;
behavioral health screenings; nutritional counseling; strategies for managing
multiple comorbidities; education about – and support for – home dialysis
treatment when applicable and beneficial to the patient; transplant education;
and palliative care.
FMCNA partners with InterWell Health, a physician-led population health
management company working to improve clinical outcomes and lower medical costs
through its network of over 1,100 nephrologists across the country.
Transitional Care Units: These units are
designed to help people recently diagnosed with kidney failure learn about
treatment options available to them – including transplant and home dialysis –
and be more empowered in managing their own care. Transitional Care Units may be either a space within a
dialysis center or a standalone facility, offering comprehensive, hands-on
education from dedicated staff that is individualized for each patient. This
includes the importance of renal nutrition, medication adherence, and vascular
access care; assisting patients transitioning between modalities (e.g., from
in-center dialysis to home dialysis); and supporting individuals returning to
dialysis from transplant. The agreement is intended to locate Transitional Care
Units in select areas where Humana has significant Medicare Advantage
Value-Based Agreement: The expanded
collaboration also improves upon the parties’ existing clinic network contract,
which provides eligible Humana Medicare Advantage and commercial members with
ESRD access to dialysis at more than 2,600 centers of Fresenius Kidney Care, the dialysis services division of
Fresenius Medical Care North America. By implementing a value-based payment
model for in-center and home dialysis services and at Transitional Care Units,
as well as for CKD care coordination services, compensation will be based on
meeting agreed-upon quality improvement and patient outcome goals, and reducing
overall costs to the system.
Individuals with CKD have kidneys that do not filter blood
properly, which causes waste and fluid levels that can be dangerously high. CKD
and ESRD affect a wide spectrum of the population but the degree of impact is
not uniform. For example, kidney failure rates among Black Americans are about
three times that of white Americans. In total, approximately 15% of American
adults, or about 37 million people, have CKD, but many are unaware of their
condition. CKD management is complex, and failure to appropriately manage the
condition may cause considerable symptoms and worsening health outcomes,
This agreement represents an evolution of our work with
Humana and leverages our over 10 years of industry leadership in value-based
care,” said Bill Valle, Fresenius Medical Care North America’s Chief Executive
Officer. “Our scale, integrated nephrology network, and standardized clinical
interventions and protocols uniquely position us to predictably and
consistently improve health outcomes and reduce overall costs. We welcome this
opportunity to offer more coordinated, holistic care to Humana’s members, with
a keen focus on education, comorbidity management, early detection, and
treatment options, including home dialysis. This approach also helps eliminate
barriers to keep renal disease treatment uninterrupted for at-risk
Cleveland Clinic’s top clinicians and researchers present the top 10 medical innovations transforming medical advancements and new awards to recognize healthcare innovation.
The list of breakthrough technologies was selected by a committee of Cleveland Clinic subject matter experts, led by Will Morris, M.D., executive medical director for Cleveland Clinic Innovations, and Akhil Saklecha, M.D., managing director of Cleveland Clinic Ventures.
Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these pernicious trends on overall mental health will take time. However, precedents like the Great Recession suggest that these trends are likely to worsen the conditions driving suicide and substance-related deaths, the “deaths of despair” that claimed 158,000 lives in 2017 and contributed to a three-year decline in US life expectancy among adults of all racial groups.
Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 2018 data showed that only 43% of adults with mental health needs, 10% of individuals with SUD, and 7% of individuals with co-occurring conditions were able to receive services for all necessary conditions.
The treatment gap is staggering, and COVID-19 is exacerbating it: an estimated 45% of adults report the pandemic has negatively impacted their mental health, to say nothing of the disruption of essential in-person care and services. In a similar vein, a recent CDC report has highlighted the staggering and “disproportionately worse mental health outcomes, [including] increased substance use, and elevated suicidal ideation” experienced by “younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.”
Consistent with the CDC report’s findings, the crisis can be felt most acutely by the very workforce that must deal with COVID-19 itself. Hospitals, health systems, and clinical practices – together with other first responders – comprise the essential front line. They bear the burden of their employees’ stress and illness, and must also cope with the many patients who present with a range of mental illnesses and substance use disorder (SUD).
But providers don’t have to face this burden alone: numerous behavioral health-focused digital solutions can support providers in meeting their most urgent needs in the era of COVID-19. Many of these solutions have made select services available for free or at a discount to healthcare providers in recognition of the immense need and challenging financial circumstances. Some solutions also help systems take advantage of favorable, albeit time-sensitive, conditions, enabling them to lay the foundation for broader behavioral health initiatives in the long term. Several of these solutions are described below, in the context of three key focus areas for health systems.
Focus Area 1: Supporting the Frontline Workforce
Health system leaders need to keep their workforces healthy, focused, and productive during this period of extreme stress, anxiety, and trauma. Providing easily accessible behavioral health resources for the healthcare workforce is therefore of paramount importance.
Health systems should consider providing immediate, free access to behavioral health services to employees and their families and consider further extending that access to first responders, other healthcare workers, and other essential services workers in the community.
Many digital product companies are granting temporary access to their services and are expanding their offerings to include new, COVID-19-specific modules, resources, and/or guidance at no cost.
Fortunately, the market is rife with solutions that have demonstrated effectiveness and an ability to scale. However, many of these rapidly-scalable solutions are oriented toward low-acuity behavioral health conditions, so it is important that health systems consider the unique needs of their populations in determining which solution(s) to adopt.
The following are several solutions to consider:
Online CBT solutions. These tools are being used to expand access to lower-acuity behavioral health services, targeting both frontline workers and the general population. MyStrength, SilverCloud and others have deployed COVID-19-specific programming.
Text-based peer support groups. Organizations are using Marigold Health to address loneliness and social isolation in group-based chat settings, one-on-one interactions between individuals and peer staff, and broader community applications.
Focus Area 2: Maintaining Continuity of Care
As the pandemic continues to ripple across the country, parts of the delivery system remain overwhelmingly focused on containing and treating COVID-19. This can and has led to the disruption of care and services, of particular significance to individuals with chronic conditions (e.g., serious mental illness (SMI) and SUD), who require longitudinal care and support. Standing up interventions — digital and otherwise — to ensure continuity of care will be critical to preventing exacerbations in patients’ conditions that could drive increased rates of ED visits and admissions at a time when hospital capacity can be in short supply.
In the absence of in-person care, many digital solutions are hosting virtual recovery meetings and providing access to virtual peer support groups. Additionally, shifts in federal and state policies are easing restrictions around critical services, including medication-assisted treatment (e.g., buprenorphine can now be prescribed via telephone), that can mitigate risky behavior and ensure ongoing access to treatment.
The use of paraprofessionals has also emerged as a promising extension of the historically undersupplied behavioral health treatment infrastructure. Capitalizing on the rapid expansion of virtual care, providers should consider leveraging digital solutions to scale programs that use peers, community health workers (CHWs), care managers, health coaches, and other paraprofessionals, to reduce inappropriate hospital utilization and ensure patients are navigated to the appropriate services.
The following are several solutions to consider:
Medication-assisted therapy (MAT) via telemedicine. These solutions provide access to professionals who can prescribe and administer MAT medications, provide addiction counseling, and conduct behavioral therapy (e.g., CBT, motivational interviewing) digitally. Solution companies providing these critical services include Eleanor Health, PursueCare, and Workit Health.
Behavioral health integration. Providing screening, therapy, and psychiatric consultations in a variety of care settings — especially primary care — will help address the increased demand. Historically, providers have had difficulty scaling such solutions due to challenging reimbursement, administrative burden, and stigma, among other concerns. Solutions like Valera Health and Concert Health were created to address these challenges and have seen success in scaling collaborative care programs.
Recovery management tools for individuals with SUD. WEConnect Health and DynamiCare Health are both offering free daily online recovery support groups.
Focus Area 3: Leveraging New Opportunities to Close the Treatment Gap
As has been widely documented, the pandemic has spurred unprecedented adoption of telehealth services, aided by new funding opportunities (offered through the CARES Act and similar channels) and the widespread easing of telehealth requirements, including the allowance of reimbursement for audio-only services and temporarily eased provider licensure requirements.
Tele-behavioral health services are no exception; the aforesaid trends ensure that what was one of the few high-growth areas in digital behavioral health before the pandemic will remain so for the foreseeable future. This is unquestionably a positive development, but there is still much work to be done to close the treatment gap. Critically, a meaningful portion of this work is beyond the reach of the virtual infrastructure that has been established to date. For example, there remains a dearth of solutions that have successfully scaled treatment models for individuals with acute illnesses, like SMI or dual BH-SUD diagnoses.
Health system leaders should continue to keep their ears to the ground for new opportunities to expand their virtual treatment infrastructure, paying particular attention to synergistic opportunities to build on investments in newly-developed assets (like workforce-focused solutions) to round out the continuum of behavioral health services.
COVID-19 has all but guaranteed that behavioral health will remain a major focus of efforts to improve healthcare delivery. Therefore, health systems that approach today’s necessary investments in behavioral health with a long-term focus will emerge from the pandemic response well ahead of their peers, having built healthier communities along the way.
About Victor Siclovan
Victor Siclovan is a Director on the Medicaid Transformation Project at AVIA where he leads work in behavioral health, chronic care, substance use disorder, and Medicaid population health strategy. Prior to AVIA, Victor spent nearly 10 years at Oliver Wyman helping large healthcare organizations navigate the transition to value-based care. He holds a BA in Economics from Northwestern.
– Nuance advances conversational AI with Dragon Medical virtual
assistant for Hey Epic! virtual assistant in Epic Hyperspace.
– Building upon Nuance’s Dragon Medical solution already
used by more than 550,000 physicians, this integration with Hey Epic! enables
clinicians to conversationally navigate the EHR, search for information, place
orders, and seamlessly switch hands-free between voice assistant and dictation.
Virtual assistant technology is viewed as essential to
enable clinicians to complete administrative and clinical tasks more
efficiently and easily during in-person and virtual visits – to improve both
physician and patient experiences before, during, and after each encounter.
The Nuance virtual assistant technology for Hey Epic! in Hyperspace is
available through Dragon Medical One, Nuance’s leading cloud-based solution for
To date, nearly 80,000 physicians and nurses using Epic have
licensed access to Nuance virtual assistant technology in Epic Haiku and Epic
Rover mobile apps to conversationally navigate the EHR more efficiently, while
conveniently retrieving information such as schedules, patient information,
laboratory results, medication lists and visit summaries.
“I have been using Nuance virtual assistant technology with Hey Epic! in the Haiku mobile application to quickly navigate the EHR, access and dictate clinical notes, and complete other tasks simply by using my voice. This saves time that can be dedicated to patients instead of searching through documentation. Now, having access to this technology in Hyperspace will further our ability to gain situational awareness and access to accurate, timely information that helps us treat the patient to the best of our ability in the moment,” said Dr. Patrick Guffey, CMIO, Children’s Hospital Colorado.
– Brightline raises $20 million to bring its virtual behavioral
healthcare platform to kids and families across California and beyond.
– Brightline delivers integrated care through innovative
technology, virtual behavioral health services, and a collaborative care team
focused on supporting children across developmental stages and their families.
Palo Alto, CA-based provider of technology-enabled pediatric behavioral healthcare,
announced it has raised $20M in Series A funding led by Threshold Ventures and
previous investor Oak HC/FT. Leading healthcare organizations Blue Shield of
California, Blue Cross Blue Shield of Massachusetts, and Boston Children’s
Hospital joined the round, as well as SemperVirens VC, Rock Health, and City
Light Capital. In addition, the company announced the expansion of its telehealth
services to children and families across the State of California, with
additional states coming soon.
Founded in 2019, Brightline is reinventing behavioral health
care for children and families. Brightline’s treatment programs are grounded in
proven clinical methods and designed to track progress and move children
forward in their care. Their virtual behavioral health services available now
● Behavior therapy with child and adolescent psychologists
and clinical social workers
● Psychiatry evaluation and medication support, in
combination with therapy
● Speech-language therapy
● Coaching support and training for parents
● Free clinician-led classes for parents
● Digital treatment programs families can use between
● Mobile app to make it all easier
The round follows exciting news earlier this summer about
Brightline’s decision to launch four months ahead of schedule to bring urgently
needed telehealth services (including behavior therapy, psychiatry,
speech-language therapy, coaching support, and more) to families feeling the
overwhelming impact of a global pandemic on their kids. Brightline plans to use
the funds primarily to enhance its technology and innovations, expand
telehealth capabilities and treatment programs, and grow the team to support
children and families across the country.
We need behavioral health and developmental support for kids and their families more than ever,” said Naomi Allen, Brightline CEO and co-founder. “Bringing strong new investors and strategic partners into the Brightline family allows us to continue innovating on our breakthrough model of integrated clinical teams, coaching support for parents, and care through telehealth and our mobile app for families when they need it most. We’re thrilled to have an exceptional Series A investment to continue building a brighter future for families.”
– Same day
pharmacy delivery startup NowRx raises $20 Million in Series B funding to expand
into new U.S. territories and accelerate its technology roadmap, transforming
the way consumers get their prescriptions.
advantage is its proprietary pharmacy management system, which leverages AI and
robotics to fill and deliver prescriptions in record time, including
interfacing with insurance, checking for drug interactions, bottling/labeling
in 30 seconds, offering video chats & text with pharmacists, as
well as safe, reliable and convenient home delivery from NowRx’s HIPAA-trained drivers.
– In the
last year, NowRx has grown its new customer base by 84% and increased
revenues by 78%. Since its first delivery in 2016, it has delivered over
200,000 prescriptions to more than 28,000 customers.
NowRx, a Mountain View,
CA-based same-day pharmacy delivery company experiencing rapid growth during
the coronavirus pandemic, has raised $20 million
in Series B funding round through SeedInvest.com, a leading Regulation A+ crowdfunding platform. This round is the largest
in SeedInvest history and brings the company’s total funding to $30 million.
Retail pharmacy is a $400 billion industry that relies on expensive real estate to drive foot traffic and depends on outdated, legacy software systems to manage prescriptions. Founded in 2015, NowRx exists to provide the most convenient pharmacy experience available, with free, same-day delivery of prescription medications. Expedited one-hour delivery is also offered for a $5.00 charge. All pharmacy services are provided from a low cost, highly automated “virtual pharmacy” location, utilizing end-to-end robotic dispensing (“One-Click Fill”) and artificially intelligent chatbots, coupled with NowRx drivers and plug-in electric vehicles, to provide a more efficient and effective pharmacy experience for busy customers.
“The real reason you are stuck waiting in line for your prescription is that the large chain pharmacies actually want you in their stores so you’ll make other purchases while you’re there,” said NowRx CEO and co-founder Cary Breese. “This flawed strategy ignores the fact that consumers are eager to avoid the hassle and risk of in-store shopping, especially during a pandemic.” According to Breese, these retailers are unable to offer a good customer experience with prescriptions because their legacy software systems and manual processes create bottlenecks and inefficiencies. “By re-engineering pharmacy management software and deploying modern automation technology in our low-overhead, high-tech micro-fulfillment centers, NowRx provides a far better customer experience at the same or better margins than the largest players in the industry,” he added.
How It Works
Customers and physicians are able to use the services through the NowRx app, by text, by telephone, and through virtual assistants such as Google Home. Physicians are able to send prescriptions to NowRx through electronic prescribing, fax, the NowRx app, or telephone. Current services provided include fulfilling new prescriptions or refills, transferring prescriptions from other pharmacies, consulting pharmacists via phone, and applying of drug manufacturer coupons.
NowRx Pharmacy is easy to use and works in 3 simple steps.
1. You or your doctor sends a prescription to NowRx Pharmacy
2. Once NowRx has received your prescription, they will
reach out to you in order to get some basic information (insurance, payment
method, preferred delivery time, etc.).
3. Once everything has been confirmed NowRx will deliver
your medication in under 5 hours for your regular copay.
Quickfill Pharmacy Automation
NowRx’s competitive advantage comes from its proprietary pharmacy management software technology, QuickFill (v3.5), which was built from the ground up to streamline and simplify prescription fulfillment and delivery while reducing costs and improving customer service. QuickFill was recently certified by the nation’s leading health information network, Surescripts Health Alliance Network, which unifies electronic health records (EHR) vendors, pharmacy benefit managers (PBMs), pharmacies, clinicians, and health plans and connects QuickFill to more than 1.5 million physicians across the U.S.
The Quickfill technology suite includes both a consumer app that provides customers with transparency and control over their prescriptions as they are being processed, as well as Wheelz, the driver app that coordinates delivery by NowRx’s HIPAA-trained drivers, enables delivery signatures and transactions, and tracks deliveries in real-time through GPS.
QuickFill technology also incorporates end-to-end robotic dispensing. When a customer clicks on the button to order a refill, that order is automatically routed to the nearest NowRx micro-fulfillment center, where the robots sort, count, bottle and label each medication in less than 30 seconds. The Quickfill software also streamlines the insurance approval process and even has an automated coupon feature that has saved customers millions of dollars by automatically searching for and applying drug manufacturer coupons. Since deploying its fully automated, end-to-end robotic dispensing technology, NowRx has filled more than 15,000 prescriptions (each in less than 30 seconds)
NowRx recently opened one of its high-tech micro-fulfillment facilities in Burlingame, its fourth in California, and has recently received its pharmacy permit to operate another facility in Arizona. In the last year, NowRx has grown its new customer base by 84% and increased revenues by 78%. Since its first delivery in 2016, NowRx has delivered over 200,000 prescriptions to more than 28,000 customers.
NowRx is on track to achieve profitability even as it
exceeds customer expectations by providing free, same-day delivery. According
to SeedInvest CEO and Co-Founder Ryan Feit, investors on the popular Regulation
A+ crowdfunding platform were quick to grasp the advantages of NowRx even
before the COVID-19 pandemic because so many have first-hand experience with
the hassle of getting prescriptions filled. “Investors understand the
problem NowRx is solving,” he said.
Fueling Expansion into Additional Territories
The funds will be used to launch more of NowRx’s high-tech micro-fulfillment centers to bring free same-day prescription medication delivery to customers in additional territories. NowRx will also use the funds to accelerate the technology roadmap for its proprietary pharmacy management software and logistics technology to increase efficiencies and improve profitability.
NowRx pharmacy currently has multiple locations throughout the Silicon Valley and Orange County California areas.
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.
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.
– CVS introduced Spoken Rx™, a new feature of the
CVS Pharmacy app that can read important prescription information out loud. It
is vitally important for patient safety and adherence that prescription labels
are clear and visible, but for patients with visual impairments or those who
can’t read standard print labels, that’s not always the case.
– Spoken Rx provides an audible label option that reads
important info such as patient name, medication name, dosage and directions, in
either English or Spanish to ensure patients are taking the correct
prescriptions, as prescribed.
– More than 7 million U.S. adults suffer from a visual
disability, though that number is expected to increase exponentially in the
coming years due to the increasing prevalence of diabetes and other chronic
CVS Pharmacy announced that it has developed Spoken Rx™, a new feature of the CVS Pharmacy app that can read a specific type of label for patients with visual impairments and those who cannot read standard print labels. Spoken Rx is the first in-app prescription reader application to be developed by a national retail pharmacy. The announcement is the result of the collaboration between CVS Pharmacy and the American Council of the Blind, which worked with CVS and tested the technology throughout its development.
RFID‐Tagged Prescription Label
Today, more than
7 million U.S. adults suffer from a visual disability, though that number is
expected to increase exponentially in the coming years due to the increasing
prevalence of diabetes and other chronic conditions. By the end of 2020, 1,500
CVS Pharmacy locations will be equipped to affix special RFID labels to
prescription vials. When the RFID labels are scanned by Spoken Rx in the
CVS Pharmacy app, which can be accessed by users using Siri or Google Assistant
on their phones, prescription label information will be spoken out loud.
Enrollment in the program is seamless and can be done either over the phone or in-store where a pharmacist can ensure the patient’s app is appropriately set up for the service. Spoken Rx is free to CVS Pharmacy patients and the app will read prescription label information aloud in either English or Spanish.
This information, which is important for patient safety and adherence, currently includes patient name, medication name, dosage, and directions and will be enhanced to include additional information over the months to come. Spoken Rx will be available in all CVS Pharmacy locations by the end of 2021.
“The in-app feature gives patients more flexibility, providing the pertinent prescription information out loud wherever and whenever they need it,” said Ryan Rumbarger, Senior Vice President, Store Operations at CVS Health. “Spoken Rx provides a more seamless experience to our patients who are visually impaired.”
– Propeller Health announced
it will co-package a new asthma medication from Novartis, which was
approved by the European Commission this week for use in the EU.
Breezhaler® plus Propeller Health sensor is the first asthma medication to be
co-packaged and co-prescribed with a digital health platform.
– Propeller’s solution
works by attaching a sensor to the Enerzair® Breezhaler® inhaler, which then
delivers objective data on medication use to the Propeller app on the patient’s
Propeller Health today announced a collaboration with Novartis to co-packaged the Propeller digital health platform with Enerzair® Breezhaler® (QVM149; indacaterol acetate, glycopyrronium bromide and mometasone furoate [IND/GLY/MF]), a recently approved Novartis medication developed to treat uncontrolled asthma. Propeller previously announced a collaboration with Novartis to develop a custom add-on sensor for the Breezhaler® inhaler, a device used for the company’s portfolio of COPD treatments (Ultibro® Breezhaler®, Onbrez® Breezhaler®, and Seebri® Breezhaler®), connecting these medications to Propeller’s digital health platform. The same sensor will be co-packaged with Enerzair® Breezhaler®.
Why It Matters
This collaboration marks the first time a digital health tool will be packaged and prescribed alongside an inhaled asthma medication. Enerzair® Breezhaler® and Propeller sensor and app received approval from the European Commission in July and will launch across Europe starting in 2020. Healthcare professionals in Europe will have the option to prescribe Enerzair® Breezhaler® with or without the companion digital health platform. The medication is not available in the U.S.
Enerzair® Breezhaler® was approved as a maintenance treatment of
asthma in adult patients not adequately controlled with a maintenance
combination of a long-acting beta2-agonist
(LABA) and a high dose of an inhaled corticosteroid (ICS) who experienced one
or more asthma exacerbations in the previous year.
Impact of Uncontrolled Asthma
Asthma affects an estimated 358 million people worldwide and can cause a significant personal, health, and financial burden when not adequately controlled. Despite current therapy, over 40% of patients with asthma at Global Initiative for Asthma (GINA) Step 3, and over 45% at GINA Steps 4 and 5 remain uncontrolled. Patients with uncontrolled asthma may downplay or underestimate the severity of their disease and are at a higher risk of exacerbation, hospitalization, or death. Barriers, such as less than optimal adherence, incorrect inhaler technique, treatment mismatch, safety issues with oral corticosteroids, and ineligibility for biologics, have created an unmet medical need in asthma.
Enerzair Breezhaler is provided in a transparent capsule that allows patients to see that they have taken their medication and will be administered via the dose-confirming Breezhaler® device, which enables once-daily inhalation using a single inhaler. The digital companion includes a sensor that attaches to the Breezhaler device and can be linked to the Propeller Health smartphone app, providing patients with inhalation confirmation, medication reminders, and access to objective data that can be shared with their physician in order to help them make better therapeutic decisions.
Propeller’s solution works by attaching a sensor to the
Enerzair® Breezhaler® inhaler, which then delivers objective data on medication
use to the Propeller app on the patient’s smartphone. The app also sends the
patient reminders to take their prescribed dose and keeps a record of adherence
data over time. The patient can share that data with their clinician to help
inform the patient’s treatment plan.
In previous clinical studies unrelated to this collaboration, the Propeller platform has been shown to increase asthma control by up to 63 percent, increase medication adherence by up to 58 percent, and reduce asthma-related emergency department visits and hospitalizations by as much as 57 percent.
“Our collaboration with Novartis to co-package Propeller with Enerzair® Breezhaler® is the first time a pharmaceutical company and digital health company have worked together to package a digital health platform with an asthma medication,” said David Van Sickle, co-founder and CEO of Propeller Health. “The ability to prescribe a maintenance medication with Propeller will make it easier for healthcare professionals to engage their patients in self-management.”