– Healthcare private equity firm Heritage Group launches a $300M fund to invest in high-growth healthcare services and technology companies.
– Heritage is backed by some of the leading healthcare organizations in the nation, including large provider systems, payers, and healthcare service providers.
Heritage Group, a Nashville, TN-based healthcare-focused private equity firm, today announced the closing of over $300 million in its oversubscribed third fund, an increase of nearly $100 million over its prior fund in 2016. Heritage will continue its successful strategy of investing in solution-oriented, high-growth healthcare services, and technology businesses that are addressing the industry’s most pressing challenges.
“We are very pleased with the market’s response to our offering, especially during such a challenging economic environment,” said Paul Wallace, partner at Heritage. “We are grateful for the ongoing support of our longtime investors, and we’re excited to welcome several new LPs. We’re fortunate to have a great team and a unique model, which combine to create value for all of our stakeholders.”
Investment Model & Approach
The firm was founded by Rock Morphis and David McClellan in 1986, Heritage seeks to make majority and minority investments, ranging from $20 to $40 million per portfolio company, in high-growth healthcare services and healthcare technology businesses that address the challenges of the U.S. healthcare system. Heritage engages deeply with its strategic investors, who provide unique value and insights through all stages of the deal process, including the identification, evaluation, and subsequent growth of its portfolio companies. The firm’s strategic investors operate over 550 hospitals, with 90,000 beds, and handle approximately 3M discharges annually.
Heritage’s strategic investors and partners represent
national leaders in the payer, provider, IT, and service sectors of healthcare.
This diversity is particularly valuable as these sectors begin to converge in
the shift towards value-based care. Limited Partners include Adventist Health
System (Florida); Amedisys (Louisiana); Cardinal Health (Ohio); Cerner Corp.
(Missouri); Community Health Systems (Tennessee); Health Care Service
Corporation (Illinois); Horizon Healthcare Services (New Jersey); Intermountain
Healthcare (Utah); LifePoint Health (Tennessee); Memorial Hermann Health System
(Texas); Sutter Health (California); Tenet Health (Texas); Trinity Health
(Michigan); and UnityPoint Health (Iowa).
“Heritage’s strategic engagement is outstanding and allows us to work together as true partners. We are able to lend our expertise and share the key pain points that we encounter as we strive to provide care in a value-based model, which requires new ways of reaching and treating consumers and patients,” said Scott Nordlund, chief strategy and growth officer at Banner Health. “Heritage has been instrumental in identifying innovative businesses that solve these concerns for our organization.”
Heritage has invested in some of the leading healthcare
services and technology companies, including Aviacode, AllyAlign Health, Medical Solutions,
Sharecare, Abode Healthcare, MDLIVE, Lumere, Reload, Spero Health, etc.
– NeuroFlow raises $20M to expand its technology-enabled behavioral
health integration platform, led by Magellan Health.
– NeuroFlow’s suite of HIPAA-compliant, cloud-based tools
simplify remote patient monitoring, enable risk stratification, and facilitate
collaborative care. With NeuroFlow, health care organizations can finally
bridge the gap between mental and physical health in order to improve outcomes
and reduce the cost of care.
NeuroFlow, a Philadelphia-based digital health startup supporting technology-enabled behavioral health integration (tBHI), announces today the initial closing of a $20M Series B financing round led by Magellan Health, in addition to a syndicate including previous investors. Magellan is a leader in managing the fastest growing, most complex areas of health, including behavioral health, complete pharmacy benefits and other specialty areas of healthcare.
NeuroFlow for Digital Behavioral Health Integration
NeuroFlow works with leading health plans, provider systems,
as well as the U.S. military and government to enhance virtual health programs
by delivering a comprehensive approach to whole-person care through digital
behavioral health integration – an evidence-based model to identify and treat
consumers with depression, anxiety and other behavioral health conditions
across all care settings.
Key features of the behavioral health platform include:
– Interoperability: Seamless EHR and system integrations minimize administrative burden and optimize current IT investments.
– Measurement-based Care & Clinical Decision Support: NeuroFlow enables MBC at scale, keeps the patient in the center of care, and continuously monitors for a consistent connection to critical data and clinical decision support.
– Performance Management & Reporting: Recognize
the impact of your BHI program, monitoring the impact of clinical interventions
on quality and cost of care while recognizing outliers requiring program
– Consumer Engagement & Self-Care: personalized
experience that encourages, rewards and recognizes continuous engagement and
Maximize Efficiency, Revenue and Reimbursements
By integrating behavioral health into the primary care setting, increasing screening and self-care plans – NeuroFlow’s BHI solution can reduce ED utilization by 23% and inpatient visits by 10%. 80% of NeuroFlow users self-reported a reduction in depression or anxiety symptoms and 62% of users with severe depression score improve to moderate or better.
Telehealth Adoption Underscores Need for Behavioral
With record growth in telehealth adoption and historic spikes in depression and anxiety due to the ongoing pandemic, workflow augmentation solutions and the delivery of effective behavioral health care have been identified as top priorities in the industry. NeuroFlow’s technology increases access to personalized, collaborative care while empowering primary care providers, care managers, and other specialists to most effectively support patient populations by accounting for and addressing behavioral health.
“Behavioral health is not independent of our overall health — it affects our physical health and vice versa, yet most underlying behavioral health conditions go unidentified or are ineffectively treated. Most healthcare providers are overburdened, so introducing the concept to account for a person’s mental health in addition to their primary specialty can be overwhelming and lead to inconsistent and inadequate treatment,” said NeuroFlow CEO Chris Molaro. “Technology, when used strategically, can enhance and augment providers, making the concept of holistic and value-based care feasible at scale and easy to implement.”
Strategic Partnership with Magellan
Magellan Health’s network of more than 118,000 credentialed
providers and health professionals are now poised to join NeuroFlow customers
across the country by leveraging the best-in-class integrated data and
analytics platform to meet the rising demand for enhanced mental health
services and support. By partnering with and investing in NeuroFlow, Magellan
has the opportunity to drive further adoption of NeuroFlow’s behavioral health
integration tools and drive collaborative care initiatives with its customers
as well as its vast network of credentialed providers and health professionals
across the country.
NeuroFlow will use the Series B proceeds to scale its
operations and support its growth in data analytics, artificial intelligence,
and direct health record integrations. NeuroFlow’s contracted user base has
grown 10x to over 330,000 in support of almost 200 commercial health systems,
payers, accountable care organizations, independent medical groups, and federal
agencies to provide technology-enabled care solutions.
A century ago, X-rays transformed medicine forever. For the first time, doctors could see inside the human body, without invasive surgeries. The technology was so revolutionary that in the last 100 years, radiology departments have become a staple of modern hospitals, routinely used across medical disciplines.
Today, new technology is once again radically reshaping medicine: artificial intelligence (AI). Like the X-ray before it, AI gives clinicians the ability to see the unseen and has transformative applications across medical disciplines. As its impact grows clear, it’s time for health systems to establish departments dedicated to clinical AI, much as they did for radiology 100 years ago.
Radiology, in fact, was one of the earliest use cases for AI in medicine today. Machine learning algorithms trained on medical images can learn to detect tumors and other malignancies that are, in many cases, too subtle for even a trained radiologist to perceive. That’s not to suggest that AI will replace radiologists, but rather that it can be a powerful tool for aiding them in the detection of potential illness — much like an X-ray or a CT scan.
AI’s potential is not limited to radiology, however. Depending on the data it is trained on, AI can predict a wide range of medical outcomes, from sepsis and heart failure to depression and opioid abuse. As more of patients’ medical data is stored in the EHR, and as these EHR systems become more interconnected across health systems, AI will only become more sensitive and accurate at predicting a patient’s risk of deteriorating.
However, AI is even more powerful as a predictive tool when it looks beyond the clinical data in the EHR. In fact, research suggests that clinical care factors contribute to only 16% of health outcomes. The other 84% are determined by socioeconomic factors, health behaviors, and the physical environment. To account for these external factors, clinical AI needs external data.
Fortunately, data on social determinants of health (SDOH) is widely available. Government agencies including the Census Bureau, EPA, HUD, DOT and USDA keep detailed data on relevant risk factors at the level of individual US Census tracts. For example, this data can show which patients may have difficulty accessing transportation to their appointments, which patients live in a food desert, or which patients are exposed to high levels of air pollution.
These external risk factors can be connected to individual patients using only their address. With a more comprehensive picture of patient risk, Clinical AI can make more accurate predictions of patient outcomes. In fact, a recent study found that a machine learning model could accurately predict inpatient and emergency department utilization using only SDOH data.
Doctors rarely have insight on these external forces. More often than not, physicians are with patients for under 15 minutes at a time, and patients may not realize their external circumstances are relevant to their health. But, like medical imaging, AI has the power to make the invisible visible for doctors, surfacing external risk factors they would otherwise miss.
But AI can do more than predict risk. With a complete view of patient risk factors, prescriptive AI tools can recommend interventions that address these risk factors, tapping the latest clinical research. This sets AI apart from traditional predictive analytics, which leaves clinicians with the burden of determining how to reduce a patient’s risk. Ultimately, the doctor is still responsible for setting the care plan, but AI can suggest actions they may not otherwise have considered.
By reducing the cognitive load on clinicians, AI can address another major problem in healthcare: burnout. Among professions, physicians have one of the highest suicide rates, and by 2025, the U.S. The Department of Health and Human Services predicts that there will be a shortage of nearly 90,000 physicians across the nation, driven by burnout. The problem is real, and the pandemic has only worsened its impact.
Implementing clinical AI can play an essential role in reducing burnout within hospitals. Studies show burnout is largely attributed to bureaucratic tasks and EHRs combined, and that physicians spend twice as much time on EHRs and desk work than with patients. Clinical AI can ease the burden of these administrative tasks so physicians can spend more time face-to-face with their patients.
For all its promise, it’s important to recognize that AI is as complex a tool as any radiological instrument. Healthcare organizations can’t just install the software and expect results. There are several implementation considerations that, if poorly executed, can doom AI’s success. This is where clinical AI departments can and should play a role.
The first area where clinical AI departments should focus on is the data. AI is only as good as the data that goes into it. Ultimately, the data used to train machine learning models should be relevant and representative of the patient population it serves. Failing to do so can limit AI’s accuracy and usefulness, or worse, introduce bias. Any bias in the training data, including pre-existing disparities in health outcomes, will be reflected in the output of the AI.
Every hospital’s use of clinical AI will be different, and hospitals will need to deeply consider their patient population and make sure that they have the resources to tailor vendor solutions accordingly. Without the right resources and organizational strategies, clinical AI adoption will come with the same frustration and disillusionment that has come to be associated with EHRs.
Misconceptions about AI are a common hurdle that can foster resistance and misuse. No matter what science fiction tells us, AI will never replace a clinician’s judgment. Rather, AI should be seen as a clinical decision support tool, much like radiology or laboratory tests. For a successful AI implementation, it’s important to have internal champions who can build trust and train staff on proper use. Clinical AI departments can play an outsized role in leading this cultural shift.
Finally, coordination is the bedrock of quality care, and AI is no exception. Clinical AI departments can foster collaboration across departments to action AI insights and treat the whole patient. Doing so can promote a shift from reactive to preventive care, mobilizing ambulatory, and community health resources to prevent avoidable hospitalizations.
With the promise of new vaccines, the end of the pandemic is in sight. Hospitals will soon face a historic opportunity to reshape their practices to recover from the pandemic’s financial devastation and deliver better care in the future. Clinical AI will be a powerful tool through this transition, helping hospitals to get ahead of avoidable utilization, streamline workflows, and improve the quality of care.
A century ago, few would have guessed that X-rays would be the basis for an essential department within hospitals. Today, AI is leading a new revolution in medicine, and hospitals would be remiss to be left behind.
About John Frownfelter, MD, FACP
John is an internist and physician executive in Health Information Technology and is currently leading Jvion’s clinical strategy as their Chief Medical Information Officer. With 20 years’ leadership experience he has a broad range of expertise in systems management, care transformation and health information systems. Dr. Frownfelter has held a number of medical and medical informatics leadership positions over nearly two decades, highlighted by his role as Chief Medical Information Officer for Inpatient services at Henry Ford Health System and Chief Medical Information Officer for UnityPoint Health where he led clinical IT strategy and launched the analytics programs.
Since 2015, Dr. Frownfelter has been bringing his expertise to healthcare through health IT advising to both industry and health systems. His work with Jvion has enhanced their clinical offering and their implementation effectiveness. Dr. Frownfelter has also held professorships at St. George’s University and Wayne State schools of medicine, and the University of Detroit Mercy Physician Assistant School. Dr. Frownfelter received his MD from Wayne State University School of Medicine.
– 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.
But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a category of information used differently than traditional clinical knowledge, but the volume of data generated through molecular testing alone also requires informatics and management of a higher magnitude than previously required.
The EMR is designed to reflect a snapshot (or collection of snapshots) in time: clinical summaries, annotated lab and test results, operation notes, etc. These are mostly stored as isolated documents, loosely coupled with the rest of the patient chart. They need to remain available for reference over time, in some instances, so providers can chart and contextualize ongoing trends and chronic conditions. However, these views are anchored in time and represent limited actionable value during clinical decision-making months, years, and decades later.
Genomic information, on the other hand, represents a patient’s life signature. DNA rarely changes over the course of an individual’s lifetime. This means the results from germline testing – a patient’s molecular profile – conducted early in life are relevant, meaningful, and actionable during clinical decision making far into the future. They can also deliver insights exposing heritable proclivities that may be life-changing or life-saving for family members as well.
This recognition in and of itself alerts healthcare leaders that they need to adopt an advanced, more sophisticated strategy for data governance, management, and sharing than the approach traditionally applied to other clinical information systems, such as EMRs.
To be successful, healthcare organizations need an accelerator external to the EMR that is built on a data model unique to the management of molecular knowledge so test results and genomic insights can be used and shared across clinical specialties and care settings, as well as overtime. In addition, the rise of precision medicine requires an agile informatics platform that enables the cross-pollination of genomic data with clinical insights and ever-advancing discoveries in genomic science.
Consider these examples of how EMRs fall short of expectations for optimal use of genomic intelligence:
1. Studies have found that, despite ubiquitous availability of molecular tests, providers consistently fail to identify patients most at risk for heritable diseases. The Journal of the American Medical Informatics Association (JAMIA) recently released research showing that half the women meeting national guidelines for genetic screening are not getting the tests they need to determine their breast and ovarian cancer risk.
The reason? “The full story of a patient’s risk for heritable cancer within their record often does not exist in a single location,” says the JAMIA article. “It is fragmented across entries created by many authors, over many years, in many locations and formats, and commonly from many different institutions in which women have received care over their lifetimes.” In other words, no matter which EMRs they use, health systems routinely miss opportunities to improve care for patients they see. To achieve greater success, providers need tools that exceed EMR functionality and span multiple clinical systems.
2. Shortly after birth, Alexander develops a seizure disorder. The neonatologist orders a germline test to help her arrive at a precise diagnosis and begin targeted treatment. This approach is successful and Alexander thrives. In addition to genomic variants identifying the cause of his seizure disorder, the test results also contain information about other heritable risk factors, including cardiovascular disease.
Decades later, in the 70s, Alexander sees his primary care provider (PCP) with a rapid heartbeat and shortness of breath. After doing routine lab work, the PCP diagnoses congestive heart failure (CHF). If, however, the PCP had access to Alexander’s genomic test results – which remain as relevant and accurate as when he was an infant – the PCP would have noted a variation that indicated the CHF was due to dilated cardiomyopathy, requiring a different treatment regime.
It is vital that health leaders immediately begin to plan an informatics strategy that accommodates genetic and genomic data while empowering providers to leverage these insights at the point of care as they make routine, yet critical, clinical decisions. As they evaluate their approach, they would do well to ask the following questions:
– Which providers in my organization are already ordering genomic tests on their patients? How are test results being stored and managed – and can they be easily shared with and accessed by others in the health system?
– As the volume of genetic and genomic testing accelerates – and it will – how will we manage the volume of data generated? How will we apply consistent governance to the ordering process? How can we ensure results will be consumed as discrete data so our organization can optimize its value now and in the future?
– What steps do we need to take so our precision medicine strategy remains current with changing science? Which informatics tools deliver access to up-to-date knowledge bases and clinical guidelines to ensure optimal medical decisions are made?
The advent of precision medicine represents a new standard of care for healthcare providers from coast to coast. Genetic and genomic information supplies a new data set that can be used to arrive at more accurate diagnoses sooner and more effective treatment faster. This, in turn, supports better outcomes, higher patient (and provider) satisfaction, and competitive differentiation for the health system adopting precision medicine first in its market.
But to capture this value, healthcare leaders must look beyond their legacy EMRs, recognizing that they were not developed nor do they have the capacity to properly handle the upcoming data revolution. Instead, industry innovators are looking for platforms agnostic to individual EMRs and integrated with molecular labs to address the next-generation demands of precision medicine.
About Assaf Halevy
Assaf Halevy is the founder and CEO of 2bPrecise, LLC, leading an international team dedicated to bridging the final mile between the science of genomics and making that data useful at the point of care. He joined Allscripts as senior vice president of products and business development in 2013 when the company acquired Israel-based dbMotion. An initial inventor and co-founder of dbMotion, Halevy helped develop the leading clinical integration and population health management platforms in the industry today.
With 13 patents pending in the areas of actionable clinical integration, interoperability, and precision medicine, Halevy leverages his industry expertise by evaluating strategic alliances and partnerships for U.S. and international markets. Halevy was invited to participate in several U.S. government activities and contribute to an HHS privacy committee task force. In 2016, he was part of a small selective group of executives invited to the White House by Vice President Joe Biden to discuss the future of interoperability.
Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows patients, especially high-risk populations like seniors, to connect with their doctors in a safe and efficient way. Telehealth is valuable for many types of visits, mostly clearly ones that involve mental health or physical health issues that do not require a physical exam or procedure. It’s an efficient modality for both the member and provider.
With the growing popularity of telehealth services, we may see permanent changes in regulatory standards. Flexible regulatory standards, such as being able to use platforms like FaceTime or Skype, would lower the barrier to entry for providers to offer telehealth and also encourage adoption, especially among seniors. Second, it’s likely we’ll see an emergence of providers with aligned incentives around value, such as in many Medicare Advantage plans, trying very hard to encourage utilization with their members so that they get the right care at the right time. In theory, the shift towards value-based care will allow better care and lower costs than the traditional fee for service model. If we are able to evolve regulatory and payment environments, providers have an opportunity to grow these types of services into 2021 to improve patient wellness and health outcomes.
Dr. Salvatore Viscomi, Chief Medical Officer, GoodCell
2021 will be the year of patient controlled-health
The COVID-19 pandemic brought the realities of a global-scale health event – and our general lack of preparedness to address it – to the forefront. People are now laser-focused on how they can protect themselves and their families against the next inevitable threat. On top of this, social distancing and isolation accelerated the development and use of digital health tools, from wellness trackers to telehealth and virtual care, most of which can be accessed from the comfort of our homes. The convergence of these two forces is poised to make 2021 the year for patient-controlled health, whereby health decisions are not dictated by – but rather made in consultation with – a healthcare provider, leveraging insights and data pulled from a variety of health technology tools at people’s fingertips.
Anish Sebastian, CEO of Babyscripts
Telemedicine was the finger in the dyke at the beginning of pandemic panic, with healthcare providers grabbing whatever came to hand — encouraged by relaxed HIPAA regulations — to keep the dam from breaking. But as the dust settles, telemedicine is emerging as the commodity that it is, and value-add services are going to be the differentiating factors in an increasingly competitive marketplace. Offerings like remote patient monitoring and asynchronous communication, initially considered as “nice-to-haves,” are becoming standard offerings as healthcare providers see their value for continuous care beyond Covid.
Daniel Kivatinos, COO and Co-Founder of DrChrono
Telehealth visits are going to supersede in-person visits as time goes on.
Because of COVID-19, the world changed and Medicare and Medicaid, as well as other insurers, started paying out for telehealth visits. Telemedicine will continue to grow at a very quick rate, and verticals like mental health (psychology and psychiatry) and primary care fit perfectly into the telemedicine model, for tasks like administering prescription refills (ePrescribing) and ordering labs. Hyperlocal medical care will also move towards more of a telemedicine care team experience. Patients that are homebound families with young children or people that just recently had surgery can now get instant care when they need it. Location is less relevant because patients can see a provider from anywhere.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Virtual Healthcare is Here to Stay (House Calls are Back)
This new normal however is going to put significant pressure on the data support and servicing requirements to do it effectively. As more services are offered to patients outside of established clinical locations, it also means there will be more opportunity to collect data and a higher degree of dependence on interoperability. Providers are going to have to up their game from just providing and recording facts to passing on critical insight back into these interactions to maximize the benefits to the patient.
Sarahjane Sacchetti, CEO at Cleo
Virtual care (of all types) will become a lasting form of care: The vastly accelerated and broadened use of virtual care spurred by the pandemic will become permanent. Although it started with one-off check-ins or virtual mental health coaching, 2021 will see the continued rise in the use and efficacy of virtual care services once thought to be in-person only such as maternity, postpartum, pediatric, and even tutoring. Employers are taking notice of this shift with 32% indicating that expanded virtual health services are a top priority, and this number will quickly rise as employers look to offer flexible and convenient benefits in support of employees and to drive productivity.
Omri Shor, CEO of Medisafe
Digital expansion: The pandemic has accelerated patient technology adoption, and innovation remains front-and-center for healthcare in 2021. Expect to see areas of telemedicine and digital health monitoring expand in new and novel ways, with increased uses in remote monitoring and behavioral health. CMS has approved telehealth for a number of new specialties and digital health tools continue to gain adoption among healthcare companies, drug makers, providers, and patients.
Digital health companions will continue to become an important tool to monitor patients, provide support, and track behaviors – while remaining socially distant due to the pandemic. Look for crossover between medical care, drug monitoring, and health and wellness – Apple
Watch has already previewed this potential with heart rate and blood oxygen monitoring. Data output from devices will enable support to become more personalized and triggered by user behavior.
Kelli Bravo, Vice President, Healthcare and Life Sciences, Pegasystems
The COVID-19 pandemic has not only changed and disrupted our lives, it has wreaked havoc on the entire healthcare industry at a scale we’ve never seen before. And it continues to alter almost every part of life across the globe. The way we access and receive healthcare has also changed as a result of social distancing requirements, patient concerns, provider availability, mobile capabilities, and newly implemented procedures at hospitals and healthcare facilities.
For example, hospitals and providers are postponing elective procedures again to help health systems prepare and reserve ICU beds amid the latest COVID-19 resurgence. While level of care is always important, in some areas, the inability to access a healthcare provider is equally concerning. And these challenges may become even more commonplace in the post-COVID-19 era. One significant transformation to help with the hurdle is telehealth, which went from a very small part of the care offering before the health crisis to one that is now a much more accepted way to access care. As the rise in virtual health continues to serve consumers and provide a personalized and responsive care experience, healthcare consumers expect support services and care that are also fast and personalized – with digital apps, instant claims settlements, transparency, and advocacy. And to better help serve healthcare consumers, the industry has an opportunity to align with digital transformation that offers a personalized and responsive experience.
Brooke LeVasseur, CEO of AristaMD
Issues pertaining to the COVID-19 pandemic will continue to be front-and-center in 2021. Every available digital tool in the box will have to be employed to ensure patients with non-COVID related issues are not forgotten as we try to free up in-person space and resources for those who cannot get care in any other setting. Virtual front doors, patient/physician video and eConsults, which connect providers to collaborate electronically, will be part of a broadening continuum of care – ultimately aimed at optimizing every valuable resource we have.
Bret Larsen, CEO and Co-Founder, eVisit
By the end of 2021, virtual care paths will be fairly ubiquitous across the continuum of care, from urgent care and EDs to specialty care, all to serve patients where they are – at home and on mobile devices. This will be made possible through virtualized end-to-end processes that integrate every step in patient care from scheduling, waiting rooms, intake and patient queuing, to interpretation services, referral management, e-prescribe, billing and analytics, and more.
Laura Kreofsky, Vice President for Advisory & Telehealth for Pivot Point Consulting
2020 has been the year of rapid telehealth adoption and advancement due to the COVID pandemic. According to CDC reports, telehealth utilization spiked as much as 154% in late March compared to the same period in 2019. While usage has moderated, it’s clear telehealth is now an instrumental part of healthcare delivery. As provider organizations plan for telehealth in 2021 and beyond, we are going to have to expect and deliver a secure, scalable infrastructure, a streamlined patient experience and an approach that maximizes provider efficiency, all while seeing much-needed vendor consolidation.
Jeff Lew, SVP of Product Management, Nextech
Earlier this year, CMS enacted new rules to provide practices with the flexibility they need to use telehealth solutions in response to COVID-19, during which patients also needed an alternative to simply visiting the office. This was the impetus to the accelerated acceptance of telehealth as a means to both give and receive care. Specialty practices, in particular, are seeing successful and positive patient experiences due to telehealth visits. Dermatology practices specifically standout and I expect the strong adoption will continue to grow and certainly be the “new normal.” In addition, innovative practices that have embraced this omni-channel approach to delivering care are also establishing this as a “new normal” by selectively using telehealth visits for certain types of encounters, such as post-op visits or triaging patients. This gives patients a choice and the added convenience that comes with it and, in some cases, increases patient volume for the practice.
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.
– Healthcare technology company Forcura names the five
most significant trends for the post-acute care industry in 2021.
The post-acute care (PAC) sector saw some of its most
profound challenges this year, from deadly COVID-19
outbreaks in skilled nursing facilities (SNFs) to a suddenly accelerated need
for the services provided by home health and hospice. The biggest question now
is that what does the post-acute care future hold for all of us?
Forcura, a healthcare technology company that enables safer patient care transitions along the care continuum recently released their report, What Happened and What’s Next in Post-Acute Care,” which synthesizes the top takeaways for the post-acute care industry in 2020, and explores the five themes it projects will be the leading business influencers on the sector in 2021 and for years to come.
The report names these as the five most significant drivers
for the post-acute care industry in 2021:
1. Interoperability: The Industry Inches Closer to a
In its guide to “Interoperability in Healthcare,” HIMSS
as “the ability of different information systems, devices and applications
(systems) to access, exchange, integrate and cooperatively use data in a
coordinated manner, within and across organizational, regional and national
boundaries, to provide timely and seamless portability of information and
optimize the health of individuals and populations globally.”
Individuals and organizations have worked tirelessly for
years to create a technological foundation that will make care transitions
safer and more holistic. They’ve made incredible progress…with patients and PAC
providers beginning to reap the benefits of increased data sharing.
2. Healthcare will be Increasingly Built Around the
Service providers talk about the “user experience” and now
users are finally seeking better care experiences. People are becoming savvier
and more demanding about their healthcare in the same ways they have done so in
consuming other services. While technology is certainly a component of the move
towards patient centricity, it is a tool that enables or enhances care
delivery. Post-acute care is poised for the shift to patient centricity.
3. Payment Models and Reimbursement Plans Remain in Play
The post-acute care industry will continue to be shaped by
regulatory and financial forces. By being proactive, fully understanding the
impacts of payment models (like unified payments), learning from the lessons of
acute care payment reform, and choosing the right partners, PAC providers
should be able to more confidently control their bottom lines in the coming
4. New Business Models are Not Your Parents’ PAC
PAC companies themselves also are beginning to explore new
options for their business operations. Post-acute care is being asked to
deliver better patient outcomes and greater value – and it’s time to respond.
Driven in part by the explosion of home-based health care services from legacy
players and new entrants, PAC organizations will be scrambling to retain as
much patient share as possible. By diversifying, providers can reduce the
vulnerability experienced by single service line agencies.
5. Healthcare for All Remains Elusive
COVID-19 has revealed some harsh realities about the ongoing
effects of structural inequity…to no one’s surprise. Some steps towards equity
are occurring. Research led by Oregon Health & Science University shows
that a new national care program for hip and knee joint replacements seems to
reduce health outcome disparities for Black patients. The CMS Comprehensive
Care for Joint Replacement model is a bundled payment model designed to reduce
spending and improve outcomes for all joint replacement patients. “Although
Black patients were discharged to institutional post-acute care more than white
patients, the gap narrowed under the new bundled payment model. Readmission
risk decreased about 3 percentage points for Black patients under the new
model, and stayed roughly the same for Hispanic and white patients.”
“Everyone realizes that 2020 is historic for the unprecedented disruption and lives lost to the COVID-19 public health crisis” says Forcura founder and CEO, Craig Mandeville, “and operating in-the-moment has been a necessity. It has also possibly reduced the time the industry has to plan for what else is around the corner.” Craig continues, “Our original research and conversations from our CONNECT Summit clearly point to five market drivers that everyone should factor into their strategic initiatives. We’re proud to offer this report and believe it will guide health industry companies to focus more on patients and better secure their bottom lines.”
– Regence and MultiCare ink first-in-the-nation value-based
care partnership to deliver improved health outcomes at lower costs.
Health insurance provider Regence
and MultiCare Health System,
an independent accountable
care organization (ACO) have partnered to deploy a first-in-the-nation value-based model
that delivers better health outcomes to members at lower costs while
simplifying administration for health care providers. Regence serves
approximately 3.1 million members through Regence BlueShield of Idaho, Regence
BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and
Regence BlueShield (select counties in Washington). The new approach between
Regence and MultiCare Connected Care—the Accountable Care Organization that is
a wholly owned subsidiary of MultiCare Health System—marks a milestone in the
evolution of value-based partnerships between insurance payers and providers.
Da Vinci Member Attribution List Standard for Value-Based
The partnership will leverage utilized a soon to be
published HL7® FHIR® (Fast Healthcare Interoperability Resources) Standard
“Da Vinci Member Attribution List” which was developed by the HL7® Da Vinci Project for
value-based arrangements. This national standard provides an
interoperable method to share member attribution data assisting in reducing the
burden on provider organizations managing patient data and allowing providers
to spend more time with patients. The Regence and MultiCare partnership establish
a foundation for the development of future population data interoperability
applications, such as the exchange of data for measuring care quality and
Why It Matters
Value-based arrangements result in improved outcomes, lower
costs and fewer care gaps for health plan members, and higher patient and
provider satisfaction. Providers are eligible to earn financial incentives by
meeting established targets for patient outcomes, costs and satisfaction
By creating efficiencies and security in delivering patient data to providers more frequently, it allows provider organizations to spend less time acquiring the data and more time with the patient.” said Melanie Matthews, president of MultiCare Connected Care. “It frees up providers to do the work of population health and helps us embrace our mission of partnering for a healing and healthy future.”
Although most organizations have now provided WFH employees with secure computers using endpoint detection and response (EDR) solutions or mandated the use of virtual private networks (VPNs), this does not fully solve the security problem.
These solutions may protect the user and network from future attacks, but if network infiltration has already occurred, threats in the form of advanced persistent threats (APTs) may be lying dormant for weeks, months, or maybe even years, on an apparently secure network. To respond to these threats, a network detection and response (NDR) capability is required. This capability looks for activity or patterns of behavior from users or network servers that indicate attacks may be in progress may have taken place or may be developing.
Ideally, EDR and NDR need to be integrated and used together to provide end-to-end network visibility and security.
Cybercriminals and other bad actors were quick to exploit the COVID-19 pandemic with, for example, phishing attacks. These exploited the fears of healthcare consumers and healthcare workers who, in the early days of WFH, were often accessing corporate networks on secured mobile phones and personal computers from their home networks.
This led to a variety of security issues; for example, Mirai botnet–type attacks that exploited WFH practices to infect healthcare organizations’ networks or dropper-based attacks that loaded malware to steal users’ credentials and ultimately lead to ransomware attacks. While these attacks still continue, most healthcare organizations have taken the measures necessary to secure their networks and their patient and organizations’ data.
A Spike in State-Sponsored Attacks
Beyond threats from financially motivated cybercriminals looms the threat from highly sophisticated and well-resourced state-sponsored attackers. As widely reported in the media, there has been a spike in state-sponsored security attacks on lab and research facilities working on COVID-19 treatments. For example, the Wall Street Journal cited U.S. officials as suggesting that Chinese and Iranian hackers are targeting universities and pharmaceutical and other healthcare firms that are working to find a vaccine for COVID-19, in an attempt to disrupt this research and slow its development.
In addition to direct attacks on research institutions, software vendors that develop the tools used by these institutions are also at risk. Security is becoming a “supply chain” issue that touches not only all of the network users and assets but also all the precursors to these assets, including the network carriers and software vendors on which network users rely.
Lack of Trust
Who can you trust in this expanded threat environment? To take proper precautions, nobody. As healthcare consumers and the workforce want or need to operate on an “access anywhere, anytime” model, adopting what’s called a Zero Trust security architecture not only makes sense, it is close to an imperative for healthcare organizations.
Zero Trust means that, because the network is under constant attack from a huge array of external and internal threats, all users, devices, applications, and resources on the network must be treated as being hostile. These users and devices need to be rigorously and continuously authenticated, while patient, research, and other data and network assets need to be protected at a much granular level than traditional perimeter-based security models allow.
The Rise of IoMT Devices
Healthcare organizations must also find new, more cost-effective ways to deliver high-quality healthcare to their increasingly tech-savvy consumers – and the use of Internet of Medical Things (IoMT) devices is critical to this process. IoMT devices, ranging from simple telehealth and remote patient monitoring to surgical robots and augmented reality technologies, can reduce operating costs and increase the quality of patient care.
COVID-19 has accelerated the adoption of IoMT technology, a process that will further accelerate with the availability of 5G networks over the coming one to three years. Many of the simpler IoMT devices don’t support traditional security models, so their adoption poses significant new threats unless healthcare institutions act to enhance security by, for example, ensuring that their network detection and response tools are ready for this challenge.
Looking ahead, it’s clear that the world is evolving towards a new normal, which will pose more threats and concerns for the healthcare industry. Recognizing this and preparing for the threats discussed, will create a better game plan for what’s to come and allow for necessary growth within healthcare infrastructure.
About Matyn Crew Martyn Crew is Director of Solutions Marketing at Gigamon. He brings a 30-year background in all aspects of enterprise IT to his role where he focuses on a number of initiatives and products including Gigamon’s Application Visibility and Intelligence solutions.
– Highmark Health signs six-year strategic partnership agreement
with Google Cloud to transform the health experience for patients and
caregivers through the development of Highmark Health’s new Living Health
– The Living Health model is designed to eliminate
the fragmentation in health care by re-engineering the healthcare delivery
model with a more coordinated, personalized, technology-enabled experience.
Highmark’s Living Health model is designed to eliminate the fragmentation in health care by re-engineering the healthcare delivery model with a more coordinated, personalized, technology-enabled experience. In addition to offering seamless, simpler, and smarter interactions with patients, the Living Health model is designed to free clinicians from time-consuming administrative tasks while providing them with timely data and actionable information about each patient. Living Health is not just focused on improving the patient-clinician relationship, it is about changing the way health care delivery operates.
“The Living Health model is about improving each person’s health and quality of life, every day,” commented Dr. Tony Farah, executive vice president and chief medical and clinical transformation officer of Highmark Health. “The traditional health care system is too fragmented and for the most part reactive. The Living Health model takes the information and preferences that a person provides us, applies the analytics developed with Google Cloud, and creates a proactive, dynamic, and readily accessible health plan and support team that fits an individual’s unique needs.”
Living Health Model
Powered by Google Cloud
Highmark Health will lead the collaboration to build its
Living Health Dynamic Platform on Google Cloud. Key elements of the agreement
– The construction of a highly secure and scalable platform
built on Google Cloud
– The application of Google Cloud’s advanced analytic and
artificial intelligence capabilities to supercharge Highmark Health’s existing
clinical and technology capabilities
– The engagement of a highly skilled professional services
team that will collaborate to drive rapid innovation
– The use of Google Cloud’s healthcare-specific solutions, including the Google Cloud Healthcare API, to enable rapid innovation, interoperability, and a seamless Living Health experience.
Highmark Health will control access and use of its patient
data using rigorous long-standing organizational privacy controls and
governance, which will be enhanced through the creation of a joint Highmark
Health-Google Cloud Data Ethics and Privacy Review Board to ensure that uses of
data are consistent with prescribed ethical principles, guidance, and customer
expectations of privacy.
Why It Matters
The strategic partnership reflects Highmark Health’s vision for a remarkable health experience by moving care and disease management of clinical conditions beyond traditional care settings through an engaging digital experience. By providing the insights needed to enable timely interventions, people will be empowered to proactively manage their health. For example, specific outcomes could include proactive intervention based on timely and individual patient data; digital disease management; easily accessible, personalized health plans; and centralized scheduling and management of care teams.
Economic Impact of Partnership
Approximately 125 new jobs are being created at Highmark Health to support the development of the Living Health Dynamic Platform, specifically in the areas of application development, cloud-based computing architectures, analytics, and user experience design.
– Artificial intelligence algorithms can predict outcomes
of COVID-19 patients with mild symptoms in emergency rooms, according to recent
research findings published in Radiology: Artificial Intelligence journal.
– Researchers trained the algorithm from data on 338
positive COVID-19 patients between the ages of 21 and 50 by using diverse
patient data from emergency departments within Mount Sinai Health System
hospitals (The Mount Sinai Hospital in Manhattan, Mount Sinai Queens, and Mount
Sinai Brooklyn) between March 10 and March 26.
Mount Sinai researchers have developed an artificial intelligence algorithm to rapidly predict outcomes of COVID-19 patients in the emergency room based on test and imaging results. Published in the journal, Radiology: Artificial Intelligence, the research reveals that if the AI algorithms were implemented in the clinical setting, hospital doctors can identify patients at high risk of developing severe cases of COVID-19 based on the severity score. This can lead to closer observation and more aggressive and quicker treatment.
They trained the algorithm using electronic medical records (EMRs) of patients between 21 and 50 years old and combined their lab tests and chest X-rays to create this deep learning model. Investigators came up with a severity score to determine who is at the highest risk of intubation or death within 30 days of arriving at the hospital. If applied in a clinical setting, this deep learning model could help emergency room staff better identify which patients may become sicker and lead to closer observation and quicker triage, and could expedite treatment before hospital admission.
Led by Fred Kwon, Ph.D., Biomedical Sciences at the Icahn School of Medicine at Mount Sinai, researchers trained the algorithm from data on 338 positive COVID-19 patients between the ages of 21 and 50 by using diverse patient data from emergency departments within Mount Sinai Health System hospitals (The Mount Sinai Hospital in Manhattan, Mount Sinai Queens, and Mount Sinai Brooklyn) between March 10 and March 26. Data from the emergency room including chest X-rays, bloodwork (basic metabolic panel, complete blood counts), and blood pressure were used to develop a severity score and predict the disease course of COVID-19.
Patients with a higher severity score would require
closer observation. The researchers then tested the algorithm using patient data on other patients in all adult age groups and
ethnicities. The algorithm has an 82 percent sensitivity to predict intubation and death within 30 days of
arriving at the hospital.
Many patients with COVID-19, especially younger ones, may show non-specific symptoms when they arrive at the emergency room, including cough, fever, and
respiratory issues that don’t provide any indication of disease severity. As a
result, clinicians cannot easily identify patients who get worse quickly. This algorithm can provide the probability that a patient may
require intubation before they get worse. That way clinicians can make more accurate decisions for appropriate
Algorithms that predict outcomes of patients with COVID-19 do exist, but they are used in admitted patients who have already developed more severe symptoms and have additional imaging and laboratory
data taken after hospital admission. This algorithm is different since it predicts outcomes in COVID-19 patients while they’re in the emergency room—even in those with mild symptoms. It only uses information from the initial
patient encounter in the hospital emergency department.
“Our algorithm demonstrates that initial imaging and laboratory tests contain sufficient information to predict outcomes of patients with COVID-19. The algorithm can help clinicians anticipate acute worsening (decompensation) of patients, even those who present without any symptoms, to make sure resources are appropriately allocated,” explains Dr. Kwon. “We are working to incorporate this algorithm-generated severity score into the clinical workflow to inform treatment decisions and flag high-risk patients in the future.”
– DispatchHealth launches Clinic Without Walls, a new service line offering patients a telemedicine visit with in-person assistance for more complex medical visits.
– The initial service line will be available in a pilot to MultiCare patients in the Tacoma and Spokane areas in an effort to its senior patients’ alternative visits during the pandemic.
DispatchHealth, a provider of in-home high-acuity medical care, today announced
the launch of Clinic Without Walls. The new service line expands access to care
for vulnerable patients by offering enhanced virtual visits with hands-on
support. Clinic Without Walls is initially being offered to MultiCare patients
in the Tacoma and Spokane areas.
Meeting the Growing Needs of In-Home Medical Care Options
visits have become an increasingly popular option to help decrease a patient’s
risk of exposure to COVID-19. More
advanced capabilities are often required for vulnerable patients who are facing
chronic disease or require medically complex care. The Clinic Without Walls
model offers these patients hands-on support with an emergency medical
technician (EMT) to help guide them through a telemedicine presentation and
connect them with a physician.
“The pandemic has highlighted the need for more in-home medical care options during the pandemic and beyond,” said Dr. Mark Prather, chief executive officer and co-founder of DispatchHealth. “Our unique model continues to expand and meet the growing needs of patients, payers, and provider partners. We are excited to continue to grow our partnership with MultiCare to help their most vulnerable patients by treating medically complex issues through hands-on support and tele-presentation.”
How It Works
During a Clinic Without Walls visit, an EMT from DispatchHealth will visit a patient where they live. The EMT comes equipped with a handheld, telehealth exam kit developed by TytoCare, manufacturer of the hand-held telehealth device DispatchHealth uses. The kit allows them to assist a guided medical exam including assessment of the lungs, ears, throat, skin, and abdomen. In addition, comprehensive vital signs, social determinants of health intervention, and moderate-complexity lab work are available in the home. If additional lab work or imaging is required, the service will be coordinated by DispatchHealth.
“The goal of this program is to keep MultiCare’s vulnerable patients safe and healthy”, said Christi McCarren, senior vice president of retail health and community based care at MultiCare. “Many of these patients have been deferring care due to the fear of contracting COVID-19. Additionally, this program helps patients facing significant mobility and transportation issues receive the care they need.”
Clinical Without Models Care Model
DispatchHealth’s Clinic Without Walls model complements the organization’s additional service lines, which include Advanced Care, Extended Care, and Acute Care. Combined, DispatchHealth is able to reduce avoidable ER visits, hospital admissions, or a stay at a skilled nursing facility. The company has experienced a period of rapid expansion and record growth and has more than doubled its national footprint in 2020, with services available in 28 cities across the United States. DispatchHealth is open seven days a week, 365 days a year, including holidays. For more information, including market hours and areas of service, visit DispatchHealth.com
When 2020 began, no one anticipated that complying with the Merit-based Incentive Payment System (MIPS)—the flagship payment model of the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)—would look so different halfway through the year. Like many other things, the COVID-19 crisis has delayed, diverted, or derailed many organizations’ reporting efforts and capabilities. Lower procedure volumes, new remote work scenarios, and shifting priorities have taken attention away from MIPS work.
Despite the disruptions and uncertainties associated with the pandemic, healthcare organizations should not lose track of MIPS compliance and the program’s intent to improve care quality, reduce costs, and facilitate interoperability. Here are a few strategies for keeping a MIPS program top of mind.
Understand the immediate effects of the pandemic on MIPS reporting
Due to COVID-19, CMS granted several 2019 data reporting exceptions and extensions to clinicians and providers participating in Medicare quality reporting programs. These concessions were enacted to let providers focus 100% of their resources on caring for and ensuring the health and safety of patients and staff during the early weeks of the crisis. For the 2020 MIPS performance period, CMS has also chosen to use the Extreme and Uncontrollable Circumstances policy to allow requests to reweight any or all of the MIPS performance categories to 0%.
Clinicians and groups can complete the application any time before the end of this performance year. If practices are granted reweighting one or more categories but submit data during the attestation period, the reweighting will be void and the practice will receive the score earned in the categories for which they submit data
Seize the opportunity to improve interoperability
Interoperability is a key area that organizations were focused on before the crisis, and this work still warrants attention. If an organization is not on the front lines of the COVID-19 response, it should use this time to shore up communications with other entities so, once things return to “normal,” it will be well prepared to seamlessly exchange information with peer organizations.
Establishing processes for sending and receiving care summaries via direct messaging is important for practices to earn a high score in the Promoting Interoperability category. Direct messaging is a HIPAA-compliant method for securely exchanging health information between providers, which functions as an email but is much more secure due to encryption. A regular pain point organizations face is being unable to obtain direct messaging addresses from peer organizations, including referral partners.
To assist providers in this area, the Office of the National Coordinator for Health Information Technology (ONC) and CMS has created a mandatory centralized directory of provider electronic data exchange addresses published by the National Plan & Provider Enumeration System (NPPES). The NPPES directory is searchable through a public API and allows providers to look up the direct messaging addresses for other providers. To meet current interoperability requirements, providers must have entered their direct messaging address into the system by June 30, 2020. If they haven’t done so, the provider could be publicly reported for failure to comply with the requirement, which could constitute information blocking.
Take time now to ensure direct messaging addresses have been entered correctly for all members of your practice. This is also a good time to begin reaching out to top referral sources to make sure they are also prepared to send and receive information.
Look for ways to streamline quality reporting
Over the next few months, the focus will return to quality measure reporting. As such, it’s wise to take advantage of this time to ensure solid documentation and reporting methods. Electronic medical records (EMRs) can be helpful in streamlining these efforts.
For example, dropdown menus with frequently used descriptions and automated coding can enable greater accuracy and specificity while easing the documentation process for providers. Customizable screens that can be configured to include specialty-specific choices based on patient history and problem list can also smooth documentation and coding, especially if screen layouts mirror favored workflow.
Regarding MIPS compliance in particular, it can be helpful to use tools that offer predictive charting. This feature determines whether a patient qualifies for preselected MIPS measures in real-time and presents the provider with data fields related to those items during the patient encounter—allowing the physician to collect the appropriate information without adding additional charting time later on.
With respect to reporting, providers may benefit from using their certified EMR in addition to reporting through a registry. At the beginning of the MIPS program, providers could report through both a registry and EMR directly and would be scored separately for their quality category through each method. They would then be awarded the higher score of the two. This method had the potential to leave some high-scoring measures on the table.
Beginning in 2019, providers reporting through both registry and EMR direct are scored across the two methods. CMS uses the six highest scoring measures between the two reporting sets to calculate the provider’s or group’s quality score, potentially resulting in a higher score than the provider would earn by reporting through either method alone.
A knowledgeable partner can pave the way to better performance
COVID-19 has impacted healthcare like no other event in recent history, and it’s not surprising that MIPS compliance has taken a back seat to more pressing concerns. However, providers still have the opportunity to make meaningful progress in this area. By working with a technology partner that keeps up with the current requirements and offers strategies and solutions for optimizing data collection and reporting, a provider can realize solid MIPS performance during and beyond this unprecedented time.
About Courtney Tesvich, VP of Regulatory at Nextech
Courtney is a Registered Nurse with more than 20 years in the healthcare field, 15 of which have been focused on quality improvements and regulatory compliance. As VP of Regulatory at Nextech, Courtney is responsible for ensuring that Nextech’s products meet government certification requirements and client needs related to the regulatory environment.
– Cityblock Health, a transformative, value-based healthcare provider focused on improving healthcare outcomes for marginalized communities, today announced a $160M Series C round, bringing its total raised to $300M.
– Cityblock is a care delivery trailblazer working to right the injustices of a healthcare system that cycles vulnerable communities through frequent ER visits and hospital stays. Its tech-enabled model delivers primary care, behavioral care, and social services, virtually and in-person, to the Medicaid and lower-income Medicare beneficiary communities.
– Cityblock provides social services that address core
aspects of poverty in order to improve health outcomes, including access to
nutritious food and support to safely care for oneself.
Health, a Brooklyn, NY-based healthcare provider for lower-income
communities, announced today the completion of a $160 million Series C funding
round and a valuation of over $1 billion. New Cityblock investor General Catalyst
led the round, with participation from crossover investor Wellington Management
and support from major existing investors, including Kinnevik AB, Maverick
Ventures, Thrive Capital, Redpoint Ventures, and more. The investment round
brings Cityblock’s total equity funding to $300 million, as they look to grow
their footprint to democratize access to community-based integrated care in a
more than $1.3 trillion market.
Care That Meets You Where You Are
Spun out of Sidewalk Labs, an Alphabet Company in 2017 and anchored in a first partnership with EmblemHealth, Cityblock is a transformative, value-based healthcare provider focused on improving outcomes for Medicaid and lower-income Medicare beneficiaries. The company provides medical care (both primary care and complex specialty services), behavioral health, and social services to its members virtually, in their homes, in the community, and in its neighborhood hubs. Their model reflects an underlying philosophy that improving health outcomes and minimizing systemic healthcare inequities requires fundamentals that address the root effects of poverty, like having access to nutritious food or the ability to safely care for yourself and others.
Value-Based Care Model
Cityblock leverages a value-based model, instead of a
fee-for-service basis, like most healthcare providers. Cityblock splits the
cost savings that come from better outcomes with the healthcare payer. Cityblock’s
financial structure squarely aligns the health needs of its members to continuously
deliver patient-centric care.
Cityblock is powered by Commons a groundbreaking care delivery platform that brings together distributed community-based care teams, care delivery workflows, data feeds, and multimodal member interactions. It allows social workers, pharmacists, doctors, paramedics, and our virtual care teams to all come together on the same page in real-time. With each new market we enter, our technology reinforces our care model, allowing us to serve more members while ensuring consistently high quality, empathetic, and effective care.
Integrated Care Team
Cityblock’s integrated care teams include doctors, nurses,
advanced practice clinicians, behavioral health specialists, licensed clinical
social workers, and community health partners, and leverage close partnerships
with existing healthcare providers and community-based social services
Today, Cityblock provides care to 70,000 members in Connecticut,
New York, Massachusetts, and Washington D.C., with high member engagement and
NPS scores of high 80s to 90s across its markets. Over the past year, Cityblock
members have seen reductions in in-patient hospital admission rates and
improvements in quality outcomes, keeping people healthier and driving down
costs across the board, while more than doubling membership and revenue,
The Impact of COVID Has Magnified Health Disparities
According to Cityblock, the COVID-19 pandemic has
significantly magnified health disparities highlighting three fundamental
– Inequity of
America’s social infrastructure, including the legacy of systemic racism, has
created unacceptably disparate health outcomes
– Healthcare’s volume-based, fee-for-service payment model contributes
poor outcomes, especially for marginalized communities
– The models that
have to-date addressed key components of these challenges have not successfully
Story of Cityblock Member Sonia
The story of Sonia, a Cityblock member, is featured in the blog post announcing the raise. Counted out and considered
a ‘nuisance’ by the healthcare system, Sonia was visiting the emergency room
several times a week for care and services, resulting in poor outcomes for the
health system and for herself. Cityblock enrolled Sonia in their high-risk
short-term housing program, placing her into a hotel during the peak of her
community’s Covid-19’s outbreak. As her trust in Cityblock grew, Sonia worked
with Cityblock and its community partners to secure permanent housing. Over the
course of two years, Sonia saw a 21% reduction in hospital use and a 24%
reduction in monthly costs, and has had zero ER visits since April 2020.
“The devastating impact of COVID-19 has been a painful
reminder of the vulnerability of lower-income communities and communities of
color,” said Iyah Romm, Cityblock Health co-founder and CEO. “We cannot turn a
blind eye to a healthcare system that cycles vulnerable communities through
frequent ER visits and hospital stays. We believe that new models of care
delivery, rooted in preventative care and augmented with social services, are
one major path forward to righting the injustices of our healthcare system.
This starts with listening to our members, extends through changing payment
models to create sustainability for primary care providers and building
technology to democratize access to the care models that we are building.”
– Virtual maternity care platform Babyscripts announced a
new round of investments from Banner Health, CU Healthcare Innovation Fund, The
Froedtert & Medical College of Wisconsin Health Network, and WellSpan
– Using internet-connected devices for remote monitoring,
Babyscripts offers risk-specific experiences to allow providers to manage up to
90% of pregnancies virtually, allowing doctors to detect risk more quickly and
automate elements of care.
the leading virtual care
platform for managing obstetrics, today announced a new round of
investments through their Strategic Partners Program,
a unique investment bloc composed of health systems interested in
forwarding Babyscripts’ cutting-edge digital solutions for pregnant
populations. Partners include Phoenix-based Banner Health, one of the largest
nonprofit health care systems in the country; the CU Healthcare Innovation Fund, located on
the University of Colorado Anschutz Medical Campus in Aurora, Colorado; the Froedtert & the Medical College of
Wisconsin health network, an integrated health care system based in
Wisconsin; and WellSpan Health, an
integrated health system serving central Pennsylvania and northern
This investment round is structured to leverage the input
and support of clinical and health system partners, ensuring that Babyscripts’
product development and future roadmap aligns with customer needs.
Babyscripts has spent the last six years building a
clinically-validated, virtual care platform to allow OBGYNs to deliver a new
model of prenatal care. Using internet-connected devices for remote monitoring,
Babyscripts offers risk-specific experiences to allow providers to manage up to
90% of pregnancies virtually, allowing doctors to detect risk more quickly and
automate elements of care.
3-Tier Approach Virtual Maternity Care
Babyscripts’ three-tiered approach to virtual maternity care
allows providers to deliver risk-specific care to pregnant mothers at any time,
in any place, through a mobile app and internet-connected monitoring devices:
Maternal Digital Education: Virtually connect with expectant and new mothers between visits with a custom mobile app.
Maternal Health Monitoring: Virtual management of
pregnant patients through remote monitoring for blood pressure, weight, blood
sugar, social determinants of health (SDOH)
Maternal Population Health: Improve patient/member
care through a unique collaboration between the care team and the payer.
The solution is powered by a robust set of vetted user
experiences, integrations, workflows, and best practices.
“From the beginning, we’ve set ourselves apart from other tech companies by partnering with physicians to make sure that we’re developing solutions that will actually be useful and improve outcomes, not just look and feel ‘cutting-edge’,” said Juan Pablo Segura, co-founder and President of Babyscripts. “This investment is validation that health systems see the value of our solution — and they’re willing to put their money on it.
The new Geographic Direct Contracting Model aims to improve quality of care and slash costs for Medicare beneficiaries across an entire region. It involves setting up risk-sharing arrangements where participants will be responsible for the total cost of care for beneficiaries in the region.
– San Francisco-based digital health startup Pair Team
emerges out of stealth with $2.7M in seed funding backed by Kleiner Perkins,
Craft Ventures, & YC.
– Pair Team provides both a remote team and AI that automates workflows, provides infrastructure & improves medical practices — efficiencies and billing as you’d expect, but all driving toward value-based, quality patient care.
– Pair’s wrap-around technology tripled the rate of annual wellness visits and increased revenue by 15% for clinics in 2020.
Pair Team (“Pair”) announced today it has
emerged out of stealth and has raised $2.7 million in seed funding backed by Kleiner Perkins, Craft Ventures, and YCombinator, along with other prominent
funds. Pair is an end-to-end operations platform for value-based primary care,
backed by Pair’s own care team. For patients, Pair provides a digital front door
and helps them navigate healthcare.
Automate Primary Care Operations Infrastructure
Founded in 2019 by Neil Batlivala and Cassie Choi, RN after experiencing how critical a high functioning administrative team is to provide high-quality primary care by building out operations together at leading tech-enabled practices of Forward and Circle Medical. The majority of healthcare is local and fragmented, and no solutions were built to enable existing clinics. Pair came out of that need and provides a simple yet comprehensive solution that covers the front, mid, and back-office. Their automation, along with a human-in-the-loop approach provides end-to-end operations of patient outreach, scheduling, e-forms, care gap reports, record requests, referrals, lab coordination, etc., to offload the traditional job functions of the front desk and medical assistants.
“Primary care is systematically and chronically under-resourced. Pair ensures patients receive the very best practices in health care — from annual checkups, follow-ups after hospital discharge, and preventative care screenings,” commented Neil Batlivala, CEO and co-founder of Pair Team. “We not only monitor patient data, but we go further to operationalize it with automation and our care team.”
Pair provides a revenue-sharing model to the share cost of operations with primary care providers. The platform monitors health plan and system data to trigger automated workflows that engage patients to schedule clinically impactful visits, surface care recommendations to clinicians, and manage follow-up care coordination. Their bolt-on model allows them to work as an extension of your care team within existing processes and accelerate quality programs in days, not months. For practices, this drastically improves care quality and visit efficiency. For plans, this aligns day-to-day operations with a total cost of care.
Helping Medicaid Populations Navigate Their Healthcare
Pair helps Medicaid populations navigate their healthcare with follow-ups, preventive cancer screening, and those recommendations on current (and ever-changing) Medicaid requirements. The company starts with existing processes and accelerates quality programs in days, not months.
Despite COVID and patient’s avoidance of medical offices and care, Pair’s wrap-around operations technology and care team tripled the rate of preventative care visits and are on track to increase clinical revenue by 15% by end of the year through quality incentives alone. To date, Pair manages care for thousands of Medicaid patients in southern California and has closed hundreds of care gaps with their remote care team.
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.
Since the beginning of the COVID-19 pandemic, key elements of hospital operations such as managing inpatient bed capacity, and access to ventilators and PPE have taken center stage. The general public got a crash course on what hospitals need in order to function successfully when disaster hits, and daily news and discussions were centered around ICU bed capacity as cases accelerated across the country.
The nightmarish predictions and reality led to the development of creative measures to help meet such catastrophic needs such as popup temporary screening and triage sites, non-medical and medical spaces being repurposed for COVID units, increased patient transfers to hospitals that had more space, and mathematical models to predict upcoming numbers of new COVID-19 cases.
With the latest surge of COVID-19 cases (see figure 1), some states have or will begin opening up field hospitals (Wisconsin, Texas) while others are considering transfers to other locations (both in and out-of-state), and even the concept of ‘rationing care’ has surfaced.
This public health crisis intensified what happens when hospitals and healthcare providers run out of the right space and resources. As alarming as it has been to watch this play out, the reality is that these capacity and resource challenges are not unique to the pandemic; they happen often in hospitals across the country, just on a different scale. Bed capacity is something hospital leaders manage every day – only 1 of 3 hospital beds are available on any given day in the U.S., per research by the Robert Wood Johnson Foundation 2. Of course, there’s further variation when looking at urban versus rural regions. Many systems are forced to go on ‘diversion’ (patients will literally be re-routed to other hospitals) when the reality is that they are bursting at the seams.
Clearly, the pandemic has been devastating, yet it has (finally) propelled healthcare toward innovation and adoption of technology that was much needed in order to improve access to and utilization of quality and cost-effective care. Although the waves continue, organizations are starting to answer the following questions: What newly applied practices do we keep from the pandemic moving forward as we head into additional COVID-19 waves and the flu season? Can we more vigorously apply lessons of the past and present to tackle our future needs? Are our incentives aligned such that the solutions we pursue can be sustained and still “keep the lights on”?
Delayed access to care and, even worse, lack of access to care, have been among the most devastating consequences of the capacity crises during the pandemic. Though many of our systems started to transition back to their usual state of affairs by July, other factors in addition to the current surge continued to highlight the ongoing need for creating and sustaining ‘good patient flow’.
Under “normal” circumstances, daily chaos is anticipated and actually expected, as hospitals experience the inability to move patients from the emergency room (ER) or operating room (OR) due to a “lack of beds” in the hospital. While this inevitably requires hospital leadership to ‘do something’ about it, it is a scenario that plays repeatedly throughout the day, every day.
The chaos that comes from the lack of visibility into available beds, let alone appropriately available levels of care, can have negative downstream impacts not only on the patients but also on the frontline staff. Patients are subject to suffering the consequences of inappropriate levels of care, poor clinical outcomes, and/or poor provider/patient experiences.3 Staff are subject to the stress of caring for patients for whom they are not necessarily appropriately trained to care for.
Despite the known implications, this lose:lose cycle continues. These “risks” plus the impact of significant revenue losses from the pandemic highlight the urgent need to address poor, inefficient patient throughput. We are at a critical point where healthcare systems must do what is necessary to improve existing practices when it comes to bed management.
Some examples of improvement include:
– Create machine learning models for all locations and patient movements within the hospital, and adjust space and schedules accordingly
– Place patients using sophisticated demand-supply model
– Make data-driven internal transfer decisions
– Right-Sized unit capacity
– Look hard at the degree of specialization to pool capacity where possible
– Smooth the patient flow from the OR
Take a magnifying glass to internal operational workflows – Identify practices that work, areas where support is needed, especially when it comes to discharge planning, and whether or not there are financial implications.
– Improve provider workflow
– Don’t let “a dime hold up a dollar”: take a hard look at staffing, hours of operations, and transportation
– Use predictive discharge planning to focus on case teams and social services
Identify clinical workup that can be prioritized according to disposition, treat outpatient setting
– Prioritize discharge patients in queues for labs/clinical procedures
– Transition some procedures to outpatient
With the recent surge of COVID-19 cases across the nation and the impending flu season, hospitalizations will continue to rise. Although health systems will be able to resurface earlier crafted emergency plans from previous surges, set up incident command centers more quickly, and have a more stable supply inventory, they will likely continue to manage their bed capacity through a very manual process. It is imperative that we start to do things differently to achieve better outcomes!
Implementing operational change and deploying new but proven technologies that incorporate both artificial intelligence and lean principles will increase patient access, improve provider, patient, and staff experience, and, of course, smooth inpatient capacity. As a result, terms such as chaos and crisis can, in time, become things of the past.
3. Mohr et al., Boarding of Critically Ill Patients in the Emergency Department. Critical Care Medicine 2020; 48(8): 1180–1187
4. Agrawal S., Giridharadas M., (2020) Better Healthcare Through Math: Bending the Access and Cost Curves. Forbes, Inc.
About Dr. Pallabi Sanyal-Dey
Dr. Pallabi Sanyal-Dey is the director of client services for ‘iQueue for Beds’ Product at LeanTaaS, a Silicon Valley software innovator that increases patient access and transforms operational performance for more than 300 hospitals across the U.S. Dr. Sanyal-Dey is also a visiting associate professor of medicine, providing career mentorship to trainees at the University of California, San Francisco Medical Center (UCSF) where she attends on the internal medicine inpatient teaching service. Prior to joining LeanTaaS, Dr. Sanyal-Dey was at UCSF, as an assistant clinical professor and an academic hospitalist at Zuckerberg San Francisco General Hospital where she directed clinical operations for the Division of Hospital Medicine, and oversaw the faculty inpatient services.
– CommonHealth has connected to 230
health systems in the United States, allowing patients to gather, manage and
share their health and test data, including COVID test and vaccination status. By
the end of this month, CommonHealth will connect to more than 340 health
– CommonHealth extends the health data
portability and interoperability model pioneered by Apple Health to the 55
percent of Americans with Android devices (85 percent globally)
The Commons Project, a nonprofit public trust established to build digital platforms and services for the public good, today announced that the CommonHealth app has now connected to 230 health systems in the United States, allowing patients using those health systems to gather, manage and share personal health information – including COVID test and vaccine status – on Android devices for free. CommonHealth enables broader and more equitable participation in remote consultations with doctors, telemedicine, innovative care models, next-generation health services, and research.
CommonHealth App Development Background
Developed in collaboration with UCSF, Cornell Tech, and Sage Bionetworks with a team of clinicians, public health experts, technologists, scientists and privacy advocates, CommonHealth is operated by The Commons Project. CommonHealth was first deployed at UCSF Health and underwent substantial testing and user experience research in multiple diverse populations in San Francisco. CommonHealth is the first and only platform designed to allow users of the Android operating system to collect and manage their health data on their mobile devices in a similar way that Apple Health Record operates on iOS.
Already integrated with LabCorp, which
operates one of the largest clinical laboratory networks in the world,
CommonHealth allows individuals to store their COVID test results and vaccination
status, in addition to any health record. CommonHealth plans to integrate with
an additional 110 health systems in December, connecting to more than 340
health systems before the year ends.
Earlier this year, the Center for Medicare and Medicaid (CMS) rolled out new patient health record sharing rules that will require hospitals and physician offices to send standardized medical information, such as lab test results, vaccination records, and imaging tests, directly to third-party apps, like CommonHealth, by July 2021.
Why It Matters
“The COVID pandemic has accelerated the need for the safe sharing of health data as medical consultations go online and individuals are required to demonstrate COVID test and vaccination status in order to travel, work, study and undertake other social activities,” said JP Pollak, co-founder and chief architect at The Commons Project. “CommonHealth extends the privacy-centered data portability and interoperability model pioneered by Apple Health to the 55 percent of Americans who have Android devices.”
– Today, MEDITECH announced MEDITECH Cloud Platform—a
suite of solutions available to healthcare organizations of all sizes that
further extend the possibilities of the Expanse EHR.
– This offering includes: Expanse NOW, High Availability
SnapShot, and Virtual Care solutions, all created to work naturally in the
cloud, and available through a subscription model.
introduced MEDITECH Cloud Platform—a suite of solutions available to healthcare
organizations of all sizes that further extend the possibilities of the Expanse Electronic Health Record
(EHR). Multiple MEDITECH Cloud
Platform solutions are built on Google Cloud, enabling healthcare organizations
to further personalize their EHR in a way that is secure, reliable, and easy to
Subscription-Based Cloud Model
Healthcare organizations can select one or a combination of
the solutions from MEDITECH Cloud Platform. The flexibility of the subscription
model enables a quick setup as well as the ability to add solutions as needed.
Additionally, the cloud combined with the subscription model provides
opportunities to add solutions in the future.
Expanse NOW is a mobility app that empowers
physicians to manage everyday tasks and coordinate care on their smartphone
device. Integrated with Expanse, tasks and messages can flow between workload
and the app in real time.
High Availability SnapShot provides healthcare
organizations with immediate access to key patient data in the event of
unexpected or planned downtime. Patient information such as medications,
allergies, orders, and more is backed up securely and accessible via
Virtual Care gives new and existing patients access
to urgent virtual care on demand through the healthcare organization’s website,
as well as the ability to schedule virtual visit appointments. New patients who
request Virtual Care are automatically enrolled in the Patient Portal,
connecting them to the organization and in turn, enabling organizations to grow
Leveraging Google Cloud’s Capabilities
The Expanse NOW and High Availability SnapShot solutions
leverage Google Cloud’s core capabilities including compute and storage (as
well as their healthcare-specific data, analytics, security, and identity
management solutions) alongside existing on-prem solutions to provide high
availability and continuity of care in a secure and scalable service. They can
be easily accessible to critical care staff to improve healthcare continuity
across MEDITECH-powered healthcare organizations.
For more information about the MEDITECH Cloud platform,
The COVID-19 pandemic has shed light on the shortcomings of today’s hospital and healthcare IT infrastructure, with many healthcare organizations quickly adopting the latest and greatest technology to support remote operations. However, in the scramble to adapt, many IT leaders did not ensure that the acquired technology integrated well with legacy systems – resulting in underused components and wasted costs. As we enter into a new era in healthcare, it is paramount that these organizations adopt technologies that support overall digital transformation and are fiscally responsible. The IT acquisition journey has taken us from focusing on the speed of components to the speed of the cloud, but we must work to innovate further. To adopt infrastructure that works at the speed of the business, healthcare IT providers must evaluate legacy IT acquisition efforts, the current models, and how they can evolve in the future.
The historic view of acquiring healthcare IT has been to move at the speed of the components. This lifecycle management approach was born out of the perception that acquiring new IT systems were too expensive for the return on investment. The focus was on the management of equipment, licenses, and contracts, causing IT leaders to spend the majority of their time patching and updating existing systems. The inability to predict a system’s capacity for computing, storage, and data meant less time spent on security, which left health systems vulnerable to outside threats.
Today’s Operating Model
Today, the focus has shifted to ensuring IT infrastructure moves at the speed of the cloud. Many hospitals and healthcare organizations have adopted an on-premise cloud and consolidated their licenses, equipment, and contracts to streamline service and reduce maintenance interruptions. This allows IT departments to proactively manage infrastructure capacity while also gaining security hardened systems. The technology management approach provides application-based cost management for healthcare organizations that require a variety of different needs, adjusting the perception of IT to that of service providers. Healthcare organizations that embrace this model are able to move and house their applications based on need, rather than pre-existing equipment constraints, which was unattainable before.
The Future of IT Acquisition
Looking ahead, there is no doubt that hospitals and healthcare organizations need to continue to evolve to maintain seamless operations. With COVID-19 highlighting infrastructure vulnerabilities, it is paramount that IT adjusts for increased technology, network traffic, and security weaknesses. Healthcare organizations that are working through issues with tools, cloud skills, and other obstacles that impede hybrid cloud adoption believe these problems will soon be resolved. With that in mind, it is likely that within the next decade there will be aggressive hybrid cloud adoption across the healthcare industry.
Additionally, in response to shifting priorities, subscription and consumption-based service models are growing in popularity because of their ability to flex up or down to optimize costs and efficiencies. In the future, healthcare organizations must move at the speed of the business as well as meeting community needs, like COVID-19 data reporting and analytics.
Instead of investing in legacy solutions that have proven difficult to manage, healthcare organizations looking to adjust their IT infrastructure can consider adopting numerous “as-a-service” models. For organizations that have specific software, application management, and full system infrastructure needs, Software-as-a-service (SaaS), Platform-as-a-service (PaaS), and Infrastructure-as-a-service (IaaS) are top considerations. Some organizations may only need access to software for a set number of users, rather than full support for the entire system, pointing them to subscription-based software instead of the as-a-service options. Conversely, consumption-based software models are growing in popularity.
Organizations that prefer to pay for applications or devices based on actual usage of the product may prefer this model because it often implies the user pays a certain amount in advance and then draws down against the pre-payment based on their use (“consumption”) of the application. This option allows systems to better budget from the onset, rather than determining costs as the year progresses.
Historically, projects and supporting product offerings are based on yearly budget and funding allotments. That is until the product offerings changed. Software subscriptions, software-as-a-service (anything-as-a-service), and consumption-based services are dramatically impacting the way that IT is purchased, which helps reduce costs.
When looking at healthcare IT spending more broadly, organizations allocate millions of dollars each year, even though they often have mixed experiences in the success of implementations. Since companies usually pay based on project implementation milestones, there are rarely performance clauses. With this in mind, organizations need to hold vendors accountable for successful implementations and first-year operations. In the future, many healthcare organizations will pursue shared risk cost models as they allow the provider to develop system improvements while mitigating costs for the organization.
The COVID-19 pandemic has forever changed how health systems assess and acquire IT infrastructure. With unprecedented amounts of network traffic, telehealth needs, and sensitive patient data, organizations need to prioritize IT planning and acquisition to avoid procurement delays and exorbitant costs. As 2021 budgets are being determined, hospital decision-makers should consider adopting subscription and consumption-based models to help them the best support and protect their data and meet the demands of tomorrow.
About Cheryl Rodenfels
Cheryl Rodenfels is the Healthcare Strategist for Nutanix. She is a seasoned technology executive, responsible for improving customer success and experience across the entire portfolio of Nutanix products and services. Cheryl’s responsibilities include developing the healthcare practice at Nutanix by identifying market opportunities, creating industry-specific training and documentation, enabling sales, and improving technology adoption and solution delivery. Cheryl can be found on LinkedIn.
– HealthStream acquires Change Healthcare’s staff
scheduling business for $67.5M in cash which includes the ANSOS™ Staff
Scheduling (“ANSOS”) platform and related products.
– The acquisition will help establish HealthStream as a
market leader in healthcare workforce scheduling business.
leading provider of workforce and provider solutions for the healthcare
industry has entered into a definitive agreement to acquire Change Healthcare’s staff
scheduling business, which includes their market-leading ANSOS™
Staff Scheduling (“ANSOS”) application and related products. : The purchase
price payable upon the closing of the ANSOS acquisition will be approximately
$67.5 million in cash (subject to working capital and other customary purchase
price adjustments), which will be funded with cash on hand.
ANSOS Platform Background
ANSOS is an enterprise solution for healthcare providers
that want to anticipate workload requirements, manage labor costs, apply
complex work rules, and meet credential requirements for shifts—all for the
purpose of optimizing staff deployment. Today, the platform is used by over 300
hospitals and health systems and continues to be recognized as a market leader
in nurse and staff scheduling by KLAS™.
In addition to the ANSOS Staff Scheduling application, the
contemplated acquisition includes related products: Enterprise Visibility™, a
patient tracking system, and Capacity Planner™, a predictive analytics tool.
Importantly, all three products (i.e. ANSOS, Enterprise Visibility, and
Capacity Planner) work in concert with each other, creating a powerful solution
suite for aligning staff and scheduling based on patient acuity, predicting
patient demand, and adjusting resources for optimal outcomes.
Acquisition Expands HealthStream’s Portfolio of Staff
Scheduling & Workforce Solutions
The addition of Change Healthcare’s staff scheduling
business will expand HealthStream’s growing portfolio of solutions for staff
scheduling and workforce management, which began in early 2020 with the
acquisition of NurseGrid and grew further with the acquisition of ShiftWizard
last month. The complementary positioning of ANSOS, ShiftWizard, and NurseGrid
will enable future data integrations and advanced analytics that yield smarter
schedule development while enhancing engagement with staff.
“We are excited to add ANSOS to HealthStream’s growing nurse
and staff scheduling business for healthcare providers as we believe this is a
major win for everyone: customers, partners, employees, and shareholders,” said
Robert A. Frist, Jr., Chief Executive Officer, HealthStream. “The closing of
this transaction will establish HealthStream as an industry leader in nurse and
staff scheduling for healthcare providers. Considering our strong track record
of strengthening acquired products and solutions to deliver even greater value
to customers, I believe we are well positioned for continued growth and
innovation in workforce management.”
Following the acquisition, customer support for each of
these products will remain in place. Approximately 90 employees from Change
Healthcare will join HealthStream upon closing. Together, ANSOS, ShiftWizard,
and NurseGrid represent HealthStream’s portfolio of nurse and staff scheduling
solutions with executive oversight provided by Scott McQuigg, Senior Vice
President, HealthStream. These solutions will be included in HealthStream’s
Workforce Solutions business segment.
Revenues for the business to be acquired are primarily
associated with sales of perpetual software, maintenance, and professional
services. HealthStream expects incremental revenues in 2021 to range between
$16.5 and $19.5 million, taking into account an estimated reduction of between
$7.0 and $8.0 million related to deferred revenue write-downs. While the
business has historically sold perpetual software licenses, future product
development and sales efforts are anticipated to be directed towards a
HealthStream plan to make investments in the areas of sales,
marketing, product development, and operations to support this initiative. In
addition, we anticipate the amortization of acquired intangible assets to range
between $3.0 and $4.0 million during 2021. Considering the additional investments
intended during 2021, the deferred revenue write-downs, the amortization of
intangible assets, and transition services expenses, we expect the acquired
business to generate an operating loss in 2021.
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.
– Zebra Medical Vision, the deep-learning medical imaging analytics company, and Scottish digital transformation consultancy Storm ID were chosen to co-develop new AI-based osteoporosis prevention solutions under EUREKA intergovernmental network.
– The UK-Israel research and development grant will be
co-developed with clinical teams from NHS Greater Glasgow and Clyde and Assuta
Medical Centers in Israel.
Scottish digital transformation consultancy Storm ID and Israeli AI
start-up Zebra Medical Vision have
won a UK-Israel research and development competition with a proposal for a
revolutionary, machine learning-driven model for early detection and prevention
of osteoporosis to improve patient care and reduce healthcare costs. The
collaboration will involve close engagement with clinical teams in NHS Greater Glasgow and Clyde and Assuta Medical Centers. The project is
co-funded in part by the UK and Israel under the EUREKA framework to foster
industrial research collaboration between the UK and Israel.
Early Detection of Osteoporosis Through AI-Based Models
For the next two years, an international, multidisciplinary
team of clinicians, data scientists and computer scientists will develop a
machine learning-driven model for early detection and prevention of
osteoporosis to improve patient care and reduce healthcare costs. The solution
will analyze medical imaging data and patient records to help clinical teams
identify and treat people with risk of fractures before they happen.
“We are pleased to partner on the development of this innovative new service for osteoporosis patients through the expertise of the West of Scotland Innovation Hub. This is another example of a successful collaboration between industry and the NHS to move forward innovative healthcare. Our clinical teams at NHS Greater Glasgow and Clyde will support the aim of this project to ultimately identify and treat patients with increased risk of bone breakage before it happens,” said David Lowe, Emergency Consultant, NHS Greater Glasgow and Clyde, and Clinical Lead, West of Scotland Innovation Hub.
– GigCapital2 Inc has agreed to merge with UpHealth Holdings Inc and Cloudbreak Health LLC to create a public digital healthcare company valued at $1.35 billion, including debt, the blankcheck acquisition company said on Monday.
– The combined company will be named UpHealth, Inc. and
will continue to be listed on the NYSE under the new ticker symbol “UPH”.
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. The deal is valued
at $1.35 billion, including debt. the combined company will be named UpHealth, Inc. and will continue to be
listed on the NYSE under the new ticker symbol “UPH”.
Following the merger, UpHealth will be a leading global
digital healthcare company serving an entire spectrum of healthcare needs and
will be established in fast growing sectors of the digital health industry.
With its combinations, UpHealth is positioned to reshape healthcare across the
continuum of care by providing a single, integrated platform of best-in-class
technologies and tech-enabled services essential to personalized, affordable,
and effective care. UpHealth’s multifaceted and integrated platform provides
health systems, payors, and patients with a frictionless digital front door
that connects evidence-based care, workflows, and services.
“We are excited to partner with UpHealth and Cloudbreak through our Private-to-Public Equity (PPE)™ platform. The combined UpHealth has all the hallmarks we look for in a successful partnership, including a world-class executive team and an exceptional business model with scale, strong growth, and profitability margins in the digital healthcare industry. We are particularly excited about the opportunity to provide our Mentor-Investor™ discipline in partnership with an exceptional global leadership team, as well as participate in a high-tech integrated platform that comprises a variety of cutting edge disciplines, such as the Artificial Intelligence platform being developed by Global Telehealth in conjunction with the tech-enabled Behavioral Health divisions. We are confident UpHealth is at the inflection point and positioned for accelerated growth.” – Dr. Avi Katz – Founder and Executive Chairman of GigCapital2
Combined Company Offerings
Upon closing the pending mergers and the combination with Cloudbreak, UpHealth will be organized across four capabilities at the intersection of population health management and telehealth:
1. Integrated Care Management: Thrasys Inc. (“Thrasys”) has reinvested $100M of customer revenue to
develop its innovative SyntraNet Integrated Care technology platform. The
platform integrates and organizes information, provides advanced
population-based analytics and predictive models, and automates workflows
across health plans, health systems, government agencies, and community
organizations. The platform plans to add at least 40 million lives to UpHealth
in the next 3 years to support global initiatives to transform healthcare.
2. Global Telehealth: will consist of a U.S. division and an international division
that, together, are anticipated to grow revenues by an additional $47 million
The U.S. division of
Global Telehealth following the combination, Cloudbreak, is a leading unified
telemedicine platform performing more than 100,000 encounters per month on over
14,000 video endpoints at over 1,800 healthcare venues nationwide. The
Cloudbreak Platform offers telepsychiatry, telestroke, tele-urology, and other
specialties, all with integrated language services for Limited English Proficient
and Deaf/Hard-of-Hearing patients. Cloudbreak’s innovative, secure platform
removes both distance and language barriers to improve patient care,
satisfaction, and outcomes.
division of Global Telehealth following the combination, Glocal Healthcare
Systems Pvt. Ltd (“Glocal”), is a global provider of virtual consultations and
local care spanning the care continuum. It has designed proven, affordable and
accessible solutions for the delivery of healthcare services globally. The
platform provides a full suite of primary and acute care services, including an
app-based telemedicine suite, digital dispensaries, and hospital centers. The
platform has signed several country-wide contracts with government ministries
across India, Southeast Asia, and Africa.
3. Digital Pharmacy: MedQuest Pharmacy (“MedQuest”) is a leading full-service manufactured and compounded pharmacy licensed in all 50 states that pre-packages and ships medications direct to patients. The company also offers lab services and testing, nutraceuticals, nutritional supplements, education for medical practitioners, and training for organizations, associations, and groups. MedQuest serves an established network of 13,000 providers. The MedQuest platform is poised for strong growth via targeted product expansion and expansive eCommerce capabilities for the entire provider network. UpHealth and MedQuest have mutually executed a merger agreement, the closing of which is awaiting regulatory approval for the transfer of licenses expected by the end of 2020 or early 2021.
4. Tech-enabled Behavioral Health: TTC Healthcare, Inc. (“TTC Healthcare”) and
Behavioral Health Services LLC (“BHS”) offer comprehensive services
specializing in acute and chronic outpatient behavioral health, rehabilitation
and substance abuse, both onsite and via telehealth. UpHealth’s Behavioral
Health capabilities have dramatically expanded use of telehealth for medical
and clinical services and are leveraging UpHealth’s platform to increase
volumes across its services. UpHealth and TTC Healthcare have mutually executed
a merger agreement, the closing of which is awaiting regulatory approval for
the transfer of licenses expected prior to the end of 2020.
Global Financial Impact and Reach
UpHealth will have agreements
to deliver digital healthcare in more than 10 countries globally. These various
companies are expected to generate approximately $115 million in revenue and
over $13 million of EBITDA in 2020 and following the combination, UpHealth
expects to generate over $190 million in revenue and $24 million in EBITDA in
Signify Health, a leading provider of technology-enabled healthcare solutions designed to keep people healthy and happy at home has acquiredPatientBlox, an Atlanta-based technology company with deep expertise in applying distributed ledger technology in healthcare. The acquisition accelerates Signify’s prospective provider payment capabilities for episodes of care, supporting the company’s commitment to advance value-based care through novel payment and risk arrangements. Financial details of the acquisition were not disclosed.
Acquisition Will Accelerate Prospective Episode of Care
The addition of blockchain technology enables a further shift away from traditional fee-for-service models. By making payments to providers at the start of the episode, providers are incentivized to drive care redesign because there is shared measurement and accountability at every step of the process, which results in improved care coordination, outcomes, and cost savings.
An episode of care is a healthcare event — a condition or a treatment — that is marked by a sequence of interactions between a patient and providers. The blockchain can capture each of those interactions and the patient’s care milestones that trigger payments. The PatientBlox platform is designed to manage these transactions without relying on fee-for-service claims.
PatientBlox Integration Offers Payers/Providers Array of Payment Options
As part of the acquisition, Signify will integrate the
PatientBlox technology into its already robust and scalable value-based care
platform, which supports $6B in healthcare spend annually associated with
the federal government’s bundled payment program, BPCI-A, and episodes of care
payment programs by health plans and employers.
The proprietary PatientBlox technology is built-for-purpose and highly-secure, enabling functionality that facilitates contract and payment administration under a prospective payment model. Under its expanded platform, Signify will offer payers and providers a diverse array of payment options to meet them where they are in their value-based care journey.
“We combined our team’s healthcare, fintech, and supply chain experience with machine-learning and Distributed Ledger Technology (DLT) to build the PatientBlox platform for administration and management of prospective bundles,” said PatientBlox Co-Founder and CEO Rahul Sharma. “Our DLT based platform enables collaboration between Healthcare Payers and Providers and provides real time data synchronization across entities thus enabling rapid scaling of prospective bundled payment programs. We are excited to work with Kyle and the Signify team and are proud to have the novel technology developed by the PatientBlox team be part of Signify’s leading platform, which is already driving real change in the healthcare industry.”
– Nuance Communications, Inc. and one of the country’s
largest health systems, Providence, announced a strategic collaboration,
supported by Microsoft, dedicated to creating better patient experiences and ease
– The collaboration centers around Providence harnessing
Nuance’s AI-powered solutions to securely and automatically capture
– As part of the expanded partnership, Nuance and
Providence will jointly innovate to create technologies that improve health
system efficiency by reducing digital friction.
Nuance® Communications, Inc. and Providence, one of the largest health systems in the
country, today announced a strategic collaboration to improve both the patient
and caregiver experience. As part of this collaboration, Providence will
build on the long-term relationship with Nuance to deploy Nuance’s cloud
solutions across its 51-hospital, seven-state system. Together, Providence and
Nuance will also develop integrated clinical intelligence and enhanced revenue cycle
Enhancing the Clinician-Patient Experience
In partnership with Nuance, Providence will focus on the clinician-patient experience by harnessing a comprehensive voice-enabled platform that through patient consent uses ambient sensing technology to securely and privately listen to clinician-patient conversations while offering workflow and knowledge automation to complement the electronic health record (EHR). This technology is key to enabling physicians to focus on patient care and spend less time on the increasing administrative tasks that contribute to physician dissatisfaction and burnout.
“Our partnership with Nuance is helping Providence make it easier for our doctors and nurses to do the hard work of documenting the cutting-edge care they provide day in and day out,” said Amy Compton-Phillips, M.D., executive vice president and chief clinical officer at Providence. “The tools we’re developing let our caregivers focus on their patients instead of their keyboards, and that will go a long way in bringing joy back to practicing medicine.”
Providence to Expand Deployment of Nuance Dragon Medical
To further improve healthcare experiences for both providers
and patients, Providence will build on its deployment of Nuance Dragon
Medical One with the Dragon Ambient eXperience (DAX). Innovated by Nuance and
Microsoft, Nuance DAX combines Nuance’s conversational AI technology with
Microsoft Azure to securely capture and contextualize every word of the patient
encounter – automatically documenting patient care without taking the
physician’s attention off the patient.
Providence and Nuance to Jointly Create Digital Health
As part of the expanded partnership, Nuance and Providence
will jointly innovate to create technologies that improve health system
efficiency by reducing digital friction. This journey will begin with the
deployment of CDE One for Clinical Documentation Integrity workflow management,
Computer-Assisted Physician Documentation (CAPD), and Surgical CAPD, which
focus on accurate clinician documentation of patient care. Providence will also
adopt Nuance’s cloud-based PowerScribe One radiology reporting solution to
achieve new levels of efficiency, accuracy, quality, and performance.
Why It Matters
By removing manual note-taking, Providence enables deeper
patient engagement and reduces burdensome paperwork for its clinicians. In
addition to better patient outcomes and provider experiences, this
collaboration also serves as a model for the deep partnerships needed to
We’ve all experienced crises in our lives. They may be personal in nature (e.g., involving our interpersonal relationships), organizational (e.g., relating to our employment or retirement income), or nature-made (e.g., floods, tornados, or the COVID-19 pandemic). When crises hit our communities, the impacts can be widespread and far-reaching. Healthcare providers and community-based organizations (CBOs) are called upon to provide more rapid and extensive care and support to the community than is otherwise the norm. A well-established and highly functioning Connected Community of Care (CCC), as is the case here in Dallas, Texas, can provide a tremendous strategic and tactical advantage over non-connected peers.
Since 2014, the Parkland Center for Clinical Innovation (PCCI) has led an effort to bring together several large healthcare systems and a number of regional social-service organizations such as food banks, homeless assistance associations, and transportation service vendors, along with over 100 smaller CBOs (i.e., neighborhood food pantries, crisis centers, utility assistance centers) and area faith-based organizations to form the Dallas CCC. Over time, civic organizations, such as the Community Council of Greater Dallas, Dallas County Health and Human Services (DCHHS), and select academic institutions have begun to participate in various community-wide projects under the Dallas CCC umbrella.
Central to the success of the Dallas CCC are the partnerships that have been formed between the CBOs and a number of local healthcare systems (Parkland Health & Hospital System [Parkland], Baylor Scott & White Health, Children’s Medical Center, Methodist Health System, and Metrocare Services), clinical practices, and other ancillary healthcare providers serving the Dallas metroplex. These partnerships have proved essential in building a truly comprehensive and functional network aimed at improving both the health and well-being of Dallas residents.
Connecting these various entities and forming a two-way communication pathway is an electronic information exchange platform termed Pieces™ Connect, which allows for real-time, two-way sharing of information pertaining to an individual’s social and healthcare needs, history, and preferences. The information exchange platform is the glue that holds the physical network together and provides one of the mechanisms to disseminate information from public health and healthcare entities to social service providers in the community. It allows the individual community resident, via the CBO, to become better informed about important health issues, such as routine vaccinations or preventive care, such as social distancing and proper mask usage during a pandemic.
Until recently, the primary mission of the Dallas CCC focused on addressing residents’ social determinants of health (SDOH) issues through providing community resources (e.g., food assistance, housing, transportation) to improve the lives of Dallas County residents. While this mission has become even more critical during the COVID-19 pandemic, the work of the Dallas CCChas also evolved to include identifying COVID-19 sites within the County and directing community outreach efforts to help stem the rapid spread of the virus.
The Dallas CCC has provided an innovative model of community governance and cooperation to impact the consequences of the COVID-19 outbreak. From the first days of the pandemic, PCCI has been working with Parkland and DCHHS to help reliably identify and quantify the geographic location and incidence rates of positive COVID-19 cases within Dallas County. This problem is especially challenging when considering vulnerable populations and the transitory nature of these residents in inner-city communities.
Working with data provided by DCHHS, the Dallas-Fort Worth Hospital Council, and CBOs, PCCI built a series of dynamic geo-maps that were able to identify, at the neighborhood and block level, the location of hotspots of positive COVID-19 cases as well as attendant mortality rates. In addition to flagging at-risk patients and populations, the model continues to be used by public health and civic leaders to establish locations for testing sites within the city of Dallas based on COVID-19 incidence and community needs.
With the establishment of the hot-spotting, the next step was to get that information, along with general infection prevention protocols, in the hands of local CBOs to help raise awareness and slow the spread of the virus. With the aforementioned information in hand, public health workers have been able to develop targeted communications and tactical strategies to improve containment efforts through community-wide awareness and educational messaging.
By connecting local CBOs and faith-based organizations with public health workers and clinicians, the Dallas CCC is facilitating effective contact tracing and the implementation of care plans for high-risk individuals in a more efficient and scalable manner.
The value of the CCC communication network linking healthcare providers and CBOs cannot be underestimated, as it represents a highly effective and efficient mechanism to disseminate leading practice information aimed directly at high-risk populations. We have seen first-hand that communications delivered to community residents through familiar food pantries, homeless shelters, and places of worship are much more effective than community-wide public information campaigns broadcast via radio or television.
This increased effectiveness is based on the fact that many of these at-risk individuals frequent the CBOs on a regular basis for essential services and these individuals know and trust the CBO staff delivering the information. From one-on-one conversations to displaying infographic posters and take-away educational leaflets, CBOs provide a ready avenue to communicate with at-risk individuals in the communities they serve.
As mentioned, early work in Dallas County is beginning to demonstrate the value of CCC in facilitating contact tracing. In this case, the challenge is not simply identifying the location of positive COVID-19 cases but having the ability to connect those cases to other individuals within the neighborhood or community who may have come in contact with the infected individual, all while working in an environment where individuals frequently move from one location to another. Having a well-established communication system at the local neighborhood level can be extremely helpful in identifying contacts and potential contacts.
It is well-known that many individuals in impoverished, underserved neighborhoods are reluctant to speak with individuals they don’t know or trust, especially if those individuals are affiliated with government agencies, no matter how well-intentioned the agency personnel may be. Staff members at local faith-based organizations and CBOs frequented by these vulnerable residents are a highly effective resource for identifying inter-personal relationships and connecting with those individuals, which is something that has proved challenging for public health staff when working outside of a CCC environment. In Dallas, CBOs, public health, and civic staffers, as well as medical student volunteers have all been partnering to help facilitate the contact tracing process with positive results.
CCC’s can materially improve the health and well-being of a community’s residents, especially in times of crisis. The take-away lesson is clear. If you already have a CCC, lean on it to help you through crises impacting your community. If you don’t have a CCC, now is the time to begin the process of establishing one in your community. Even with the challenges that the current pandemic is generating, it is possible to begin building your CCC. Start small and gradually increase the CCC’s scope and scale; don’t be in a rush to grow. The most important thing is to take the plunge and begin the journey!
– Cleveland Clinic develops the COVID-19 risk prediction model through Epic MyChart that is now available to health systems around the world.
– Healthcare organizations can present the clinically
validated model to patients in MyChart to assess their risk of having COVID-19.
Cleveland Clinic researchers have developed a COVID-19 risk prediction model that uses information from the patient’s comprehensive health records combined with patient-centered information in Epic’s patient-facing app, MyChart, to show an individual’s likelihood of testing positive for COVID-19. The COVID-19 risk prediction model is now available to health systems around the world through Epic.
Predicting positive COVID-19 tests could help direct limited healthcare resources, encourage those who are likely to have the virus to get tested, and tailor decision-making about care. Cleveland Clinic’s model was developed and validated using retrospective patient data from more than 11k patients tested for COVID-19 at Cleveland Clinic locations in Northeast Ohio and Florida. Data scientists used statistical algorithms to transform data from patients’ electronic medical records into the first-of-its-kind risk-prediction model. All data collected was housed in a secure database.
How It Works
Patients complete a short self-assessment in MyChart,
documenting information like symptoms they are experiencing and potential
exposure to COVID-19. The model uses that information, as well as clinical and
demographic data already in their electronic chart, to calculate their score.
Patients with high risk for having COVID-19 are advised to receive a test, and
their care team members can be automatically notified of a high-risk score.
Other healthcare providers around the country also have
developed risk prediction models, which they can integrate with Epic. For
organizations that want to use an existing model rather than developing their
own, they can quickly turn on the model designed, developed, and tested–and now
being shared–by Cleveland Clinic researchers.
“We have developed the first validated prediction model that can forecast an individual’s risk for testing positive with COVID-19 and then simplified this tool while retaining exceptional accuracy for easy adoption,” said Lara Jehi, M.D., Chief Research Information Officer at Cleveland Clinic. “We are excited to make this tool available to the 250 million patients around the world who have a record in Epic. The ability to accurately predict which patients are likely to test positive will be paramount in effectively managing a patient’s care as well as allocating our resources.”
A risk prediction model for Covid-19, developed by researchers at Cleveland Clinic, is now available to all health systems worldwide that use the Epic MyChart patient portal. The model will help clinicians estimate the likelihood of a patient testing positive for the disease.
– The Veterans Health Administration has selected Ontrak
in collaboration with Harvard Medical School and Brown University to transform
suicide prevention care for veterans.
– Leveraging AI developed by a Harvard Medical School
professor and the core analytics of the Ontrak platform, the three-year study
will look at the effect of intensive care coaching in addition to the standard
of care for veterans at high risk of suicide after inpatient hospitalization at
a psychiatric hospital. The trial will include 850 patients at six VA
– Suicide prevention is a focus for the military as well
as for the population as a whole as the U.S. grapples with the COVID-19
Ontrak, Inc., an AI-powered
virtualized healthcare company, announced a cooperative research and
development agreement with the Veterans Health Administration (VHA) to conduct
a 3-year research study on the effect of intensive care coaching in addition to
the standard of care for Veterans at high risk of suicide-related behaviors
after psychiatric hospital.
Research Study Details
The study will leverage AI developed by Dr. Ronald Kessler
of the Harvard Medical School, as well as the core analytics of the Ontrak
platform. Dr. Kessler is the McNeil Family Professor of Health Care Policy at
Harvard Medical School and a principal in the STARRS Longitudinal Study of
suicide prevention among US Army soldiers. “We are excited to have Ontrak
helping us evaluate the effects of an intensive intervention to prevent
suicidal behaviors among Veterans at very high risk,” stated Dr. Kessler.
Why It Matters
Suicidal ideation has been elevated since the pandemic and
the CDC reported on August 14 that a survey of U.S. adults in June 2020
indicated that 11% had seriously considered suicide in the past 30 days, which
was twice as high as in the previous 12 month period.
Addressing Veteran suicide is a top VHA priority and Ontrak is proud to apply their AI and virtual care coaching model in a trial of 850 patients at 6 VHA hospitals selected from a total of 98 in the country. This study has the potential to not only reduce suicide risk but also to produce secondary reductions in risk through interventions that address co-occurring medical conditions.
Dr. Judy Feld, Medical Director of Ontrak, stated, “Suicide is the 10th leading cause of death in the U.S. with rates steadily increasing over the past decade and worsening during the Covid-19 pandemic. We know that individuals with behavioral health conditions such as depression, substance use disorder, and post-traumatic stress disorder are at higher risk for suicidal ideation or attempt. Importantly, the rate of suicide among our country’s military Vets is double that of non-Veterans. As a pioneer in the development of evidence-based interventions for engaging individuals in care for anxiety, depression, and substance use disorders, Ontrak is honored to partner with the VHA healthcare system and collaborators from Harvard Medical School and Brown University to advance the medical community’s understanding of the most impactful case management for Veterans at high risk of suicide after inpatient hospitalization.”
Interoperability in healthcare is a national disgrace. After more than three decades of effort, billions of dollars in incentives and investments, State and Federal regulations, and tens of thousands of articles and studies on making all of this work — we are only slightly better off than we were in 2000.
Decades of failed promises and dozens of technical, organizational, behavioral, financial, regulatory, privacy, and business barriers have prevented significant progress and the costs are enormous. The Institute of Medicine and other groups put the national financial impact somewhere between tens and hundreds of billions of dollars annually. Without pervasive and interoperable secure communications, healthcare is missing the productivity gains that every other industry achieved during their internet, mobile, and cloud revolutions.
The Human Toll — On Both Patients and Clinicians
Too many families have a story to tell about the dismay or disaster wrought by missing or incomplete paper medical records, or frustration by the lack of communications between their healthcare providers. In an era where we carry around more computing power in our pockets than what sent Americans to the moon, it is mystifying that we can’t get our doctors digitally communicating.
I am one of the many doctors who are outraged that the promised benefits of Electronic Medical Records (EHRs) and Health Information Exchanges (HIEs) don’t help me understand what the previous doctor did for our mutual patient. These costly systems still often require that I get the ‘bullet’ from another doctor the same way as my mentors did in the 1970s.
This digital friction also has a profoundly negative impact on medical research, clinical trials, analytics, AI, precision medicine, and the rest of health science. The scanned PDF of a fax of a patient’s EKG and a phone call may be enough for me to get the pre-op done, but faxes and phone calls can’t drive computers, predictive engines, multivariate analysis, public health surveillance programs, or real-time alerting needed to truly enable care.
Solving the Surround
Many companies and government initiatives have attempted to solve specific components of interoperability, but this has only led to a piecemeal approach that has thus far been overwhelmed by market forces. Healthcare interoperability needs an innovation strategy that I call “Solving the Surround.” It is one of the least understood and most potent strategies to succeed at disruptive innovation at scale in complex markets.
“Solving the Surround” is about understanding and addressing multiple market barriers in unison. To explain the concept, let’s consider the most recent disruption of the music industry — the success of Apple’s iPod.
The iPod itself did not win the market and drive industry disruption because it was from Apple or due to its great design. Other behemoths like Microsoft and Philips, with huge budgets and marketing machines, built powerful MP3 players without market impact. Apple succeeded because they also ‘solved the surround’ — they identified and addressed numerous other barriers to overcome mass adoption.
Among other contributions, they:
– Made software available for both the PC and Mac
– Delivered an easy (and legal) way for users to “rip” their old CD collection and use the possession of music on a fixed medium that proved legal “ownership”
– Built an online store with a massive library of music
– Allowed users to purchase individual tracks
– Created new artist packaging, distribution, licensing, and payment models
– Addressed legalities and multiple licensing issues
– Designed a way to synchronize and backup music across devices
In other words, Apple broke down most of these barriers all at once to enable the broad adoption of both their device and platform. By “Solving the Surround,” Apple was the one to successfully disrupt the music industry (and make way for their iPhone).
The Revolution that Missed Healthcare
Disruption doesn’t happen in a vacuum. The market needs to be “ready” to replace the old way of doing things or accept a much better model. In the iPod case, the market first required the internet, online payment systems, pervasive home computers, and much more. What Apple did to make the iPod successful wasn’t to build all of the things required for the market to be ready, but they identified and conquered the “surround problems” within their control to accelerate and disrupt the otherwise-ready market.
Together, the PC, internet, and mobile revolutions led to the most significant workforce productivity expansion since WWII. Productivity in nearly all industries soared. The biggest exception was in the healthcare sector, which did not participate in that productivity revolution or did not realize the same rapid improvements. The cost of healthcare continued its inexorable rise, while prices (in constant dollars) leveled off or declined in most other sectors. Healthcare mostly followed IT-centric, local, customized models.
Solving the Surround for Healthcare Interoperability
‘Solving the Surround’ in healthcare means tackling many convoluted and complex challenges.
Here are the nine things that we need to conquer:
1. Simplicity — All of the basics of every other successful technology disruptor are needed for Health communications and Interoperability. Nothing succeeds at a disruption unless it is perceived by the users to be simple, natural, intuitive, and comfortable; very few behavioral or process changes should be required for user adoption.
Simplicity must not be limited to the doctor, nurse, or clerical users. It must extend to the technical implementation of the disruptive system. Ideally, the new would seamlessly complement current systems without a heavy lift. By implication, this means that the disruptive system would embrace technologies, workflows, protocols, and practices that are already in place.
2. Ubiquity — For anything to work at scale, it must also be ubiquitous — meaning it works for all potential players across the US (or global) marketplace. Interoperability means communicating with ease with other systems. Healthcare’s next interoperability disruptor must work for all healthcare staff, organizations, and practices, regardless of their level of technological sophistication. It must tie together systems and vendors who naturally avoid collaboration today, or we are setting ourselves up for failure.
3. Privacy & Security — Healthcare demands best-in-class privacy and security. Compliance with government regulations or industry standards is not enough. Any new disruptive, interoperable communications system should address the needs of different use cases, markets, and users. It must dynamically provide the right user permissions and access and adapt as new needs arise. This rigor protects both patients from unnecessary or illegal sharing of their health records and healthcare organizations in meeting privacy requirements and complying with state and federal laws.
4. Directory — It’s impossible to imagine ubiquitous national communications without a directory. It is a crucial component for a new disruptive system to connect existing technologies and disparate people, organizations, workflows, and use cases. This directory should maintain current locations, personnel, process knowledge, workflows, technologies, keys, addresses, protocols, and individual and organizational preferences. It must be comprehensive at a national level and learn and improve with each communication and incorporate each new user’s preferences at both ends of any communication. Above all, it must be complete and reliable — nothing less than a sub-1% failure rate.
5. Delivery — Via the directory, we know to whom (or to what location) we want to send a notification, message, fetch request or record, but how will it get there? With literally hundreds of different EHR products in use and as many interoperability challenges, it is clear that a disruptive national solution must accommodate multiple technologies depending on sender and recipient capabilities. Until now, the only delivery “technology” that has ensured reliable delivery rates is the mighty fax machine.
With the potential of a large hospital at one end and a remote single-doctor practice at the other, it would be unreasonable to take a one size fits all approach. The system should also serve as a useful “middleman” to help different parties move to the model (in much the same way that ripping CDs or iTunes gave a helping hand to new MP3 owners). Such a delivery “middleman” should automatically adapt communications to each end of the communication’s technology capabilities, needs, and preferences..
6. Embracing Push — To be honest, I think we got complacent in healthcare about how we designed our technologies. Most interoperability attempts are “fetch” oriented, relying on someone pulling data from a big repository such as an EHR portal or an HIE. Then we set up triggers (such as ADTs) to tell someone to get it. These have not worked at scale in 30+ years of trying. Among other reasons, it has been common for even hospitals to be reluctant to participate fully, fearing a competitive disadvantage if they make data available for all of their patients.
My vision for a disruptive and innovative interoperability system reduces the current reliance on fetch. Why not enable reliable, proactive pushing of the right information in a timely fashion on a patient-by-patient basis? The ideal system would be driven by push, but include fetch when needed. Leverage the excellent deployment of the Direct Trust protocol already in place, supplement it with a directory and delivery service, add a new digital “middleman,” and complement it with an excellent fetch capability to fill in any gaps and enable bi-directional flows.
7. Patient Records and Messages — We need both data sharing and messaging in the same system, so we can embrace and effortlessly enable both clinical summaries and notes. There must be no practical limits on the size or types of files that can easily be shared. We need to help people solve problems together and drive everyday workflows. These are all variations of the same problem, and the disruptor needs to solve it all.
8. Compliance — The disruptor must also be compliant with a range of security, privacy, identity, interoperability, data type, API, and many other standards and work within several national data sharing frameworks. Compliance is often showcased through government and vendor certification programs. These programs are designed to ensure that users will be able to meet requirements under incentive programs such as those from CMS/ONC (e.g., Promoting Interoperability) or the forthcoming CMS “Final Rule” Condition of Participation (CoP/PEN), and others. We also must enable incentive programs based on the transition to value-based and quality-based care and other risk-based models.
9. On-Ramp — The iPod has become the mobile phone. We may use one device initially for phone or email, but soon come to love navigation, music, or collaboration tools. As we adopt more features, we see how it adds value we never envisioned before — perhaps because we never dreamed it was possible. The healthcare communications disruptor will deliver an “On-Ramp” that works at both a personal and organizational scale. Organizations need to start with a simple, driving use case, get early and definitive success, then use the same platform to expand to more and more use cases and values — and delight in each of them.
So here we are, decades past the PC revolution, with a combination of industry standards, regulations, clinician and consumer demand, and even tens of billions in EHR incentives. Still, we have neither a ‘killer app’ nor ubiquitous medical communications. As a result, we don’t have the efficiency nor ease-of-use benefits from our EHRs, nor do we have repeatable examples of improved quality or lower errors — and definitively, no evidence for lower costs.
I am confident that we don’t have a market readiness problem. We have more than ample electricity, distributed computing platforms, ubiquitous broadband communications, and consumer and clinician demand. We have robust security, legal, privacy, compliance, data format, interoperability, and related standards to move forward. So, I contend that our biggest innovation inhibitor is our collective misunderstanding about “Solving the Surround.”
Once we do that, we will unleash market disruption and transform healthcare for the next generation of patient care.
About Peter S. Tippett
Dr. Peter 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.
He was a member of the President’s Information Technology Advisory Committee (PITAC) under G.W. Bush, and served with both the Clinton Health Matters and NIH Precision Medicine initiatives. Throughout his career, Tippett has been recognized with numerous awards and recognitions — including E&Y Entrepreneur of the Year, the U.S. Chamber of Commerce “Leadership in Health Care Award”, and was named one of the 25 most influential CTOs by InfoWorld.
Tippett is board certified in internal medicine and has decades of experience in the ER. As a scientist, he created the first synthetic immunoglobulin in the lab of Nobel Laureate Bruce Merrifield at Rockefeller University.
Abbott recently released global research on vascular patient care, designed to shine a light on the vascular patient journey. The report called “Beyond Intervention” uncovers the universal challenges faced by physicians who deliver vascular care, their patients, and the hospital administrators who support them. It also explores how the right use of technology and data could potentially enable more precise diagnoses and better treatment strategies to ensure the best possible patient outcomes.
To establish what the state of vascular care looks like around the world today, Abbott surveyed over 1,400 patients, physicians, and health system administrators from nine countries.
The research revealed how important personalized care is for patients. This was a sentiment that came through loud and clear from all the patients surveyed, regardless of geography. Patients desire more of a “tailored for me” approach from their physicians. This includes more face-to-face interaction and time with their doctor, with the ability to have all of their questions addressed.
Likewise, doctors sighted a scarcity of time spent with their patients as well as their limited visibility into patient adherence to treatment and lifestyle changes and challenges with other key factors that influence the quality of care they can provide.
What exactly does more personalized care look like? Here are some of the ideas that resonated with the vascular patients who responded to the survey:
– A consultative, two-way patient-doctor relationship, with the patient playing an active role in informed decision-making
– An individualized treatment plan based on the doctor’s ability to review relevant data pertaining to successes achieved with similar patients (“How did patients like me get better?”)
– Effective and seamless information-sharing among the primary care provider, hospital specialists, and healthcare systems, as well as with individual patients themselves via computer or smart applications.
– The ability for the doctor to monitor the patient’s progress remotely and provide information to verify that the personalized treatment is working, and to pick up early warning signs of relapse or deterioration
If more personalized care is what patients desire, then how can the use of technology and data enable this? We already see signs of this in the form of telemedicine and personalized care plans used to treat patients with chronic disease. We have also seen remote patient monitoring become a necessity and, in the age of COVID-19, a new standard of care, keeping patients “connected” with their physicians. This suggests that health care is moving in the right direction. Rather than simply treating the patient at a point in time for an illness, technology has the potential to harness the power of data to optimize care across the entire patient journey – before, during, and after the intervention. By focusing on the whole patient, and by placing him or her at the center of the healthcare world, providers can see beyond the intervention alone.
The survey also revealed that hospital administrators’ top priority focused on patient satisfaction; successful outcomes that boost the number of satisfied and healthy patients while reducing hospital readmissions and costs. The results showed that administrators place a greater priority on plugging data gaps pertaining to outcomes than the total cost of care.
If the intention is to build data-driven technological solutions that see the whole patient, that could shift the focus from illness and intervention to wellness and prevention, potentially lightening the burden on providers, and delivering a higher quality of life for patients, also at a lower cost.
The existing model of care is clearly not working to its full potential, to the detriment of everyone who must navigate it. But overhauling a healthcare system that is so entrenched in structure and institutional practices is not something that can happen overnight. Change will happen incrementally with the input of all stakeholders. It is up to us in the world of medical devices and technology to take our cues from the medical community, patient advocates, and healthcare systems big and small.
The research motivates us to continuously improve upon what we have already delivered and ask ourselves how we can make our products even better. Without knowledge of their pain points or insights into the challenges they face daily, we would not be able to effectively meet patients’ needs. This research also reinforces what Abbott is consistently striving to achieve: building life-changing technologies to improve the patient’s quality of life and help them live their best lives.
With its share price falling from more than $66 to less than $24, September was a tumultuous month for Nanox.
On August 25th, the medical imaging start-up closed its initial public offering, having raised $190m from the sale of 10,555,556 ordinary shares at a price of $18 each. Money poured in as investors were sold on Nanox’s cold cathode x-ray source and the subsequent reduction in costs that it would enable, as well as the vendor’s pay-per-scan pricing model that would let the company access new, untapped markets.
A week later the shares were being traded for almost double their opening amount, and by the 11th of September, they had reached a peak of $66.67. This meteoric rise soon came to an end though, as activist short-seller Andrew Left of Citron Research published a report comparing the Israeli start-up to disgraced medical testing firm Theranos and asserted that the company’s shares were worthless.
Other commentators added to Left’s criticism, causing investors to abandon the stock. Class action lawsuits followed, with legal firms hoping to defend shareholders against the imaging company’s alleged fabrication of commercial agreements and of misleading investors.
Nanox defended itself against the Citron attack, insisting that the allegations in the report are ‘completely without merit’, but the extra scrutiny and threat of legal repercussions have left the share price continuing to plummet, falling to $23.52 at month’s end.
– New business and payment models could capture demand from new customers in untapped and emerging markets
– Vendors should be reactive. A successful launch of Nanox’s X-ray system could channel more focus and resources on the portfolio of low-end X-ray systems
– Once established, recurring services are hard to displace
– However, brand loyalty and hard-earned reputations aren’t easily forgotten
– Potential for disruptive technology to expand access to medical imaging and provide affordable X-ray digital solutions, delivering a significant and rapid overall market expansion
– New customer bases could have less expertise and a lack of trained professionals – ease of use becomes a critical feature
– Where X-ray system price is a battleground, and a fundamental factor driving purchasing decisions, Nanox’s proposed ecosystem offers revenue-generating opportunities
The Signify View
Assessing the viability and long-term potential of any business is a dangerous game, doubly so if it depends on a closely guarded game-changing technological innovation as is the case with Nanox. Fortunes are won and lost on a daily basis by investors, speculators, and gamblers trying to get in on the ground floor of the next ground-breaking company after being convinced by slick presentations and thorough prospectuses.
There is likely merit in some of the arguments being put forward by those on either side of the Nanox debate. For example, the lack of peer-reviewed journal articles about new technology is questionable. But, the skepticism around the feasibility of Nanox’s technology seems to ignore that research into cold-cathode x-ray generation, the cornerstone of Nanox’s offering has been ongoing for numerous years, and isn’t as out of the blue as the naysayers may suggest.
Regardless of these and other specifics in the ongoing fracas between short-sellers, Nanox, investors, and lawyers, all of whom have their own agendas, the voracity with which the stocks were initially purchased shows the keen appetite investors have for a company that would bring disruption to the X-ray systems market.
When delving into Signify Research’s data on this market, it is easy to see why. Across many developed and mature regions, the market has become relatively stable. It is one of replacement and renewal rather than selling to new customers and increasing the accessibility of X-ray imaging. Developed markets do continue to drive growth for X-ray manufacturers to some extent, particularly as a result of digitalization and favored reimbursement for digital X-ray imaging. However, by and large, the market remains broadly flat, with a CAGR of just 2.7% forecast for the period 2018-2023.
Figure 1: While there are some growth areas, the X-ray market as a whole is very stable
Nanox has strong ambitions to outperform this underwhelming outlook by utilizing its unique and more affordable technology to offer a relatively feature-rich system, dubbed the Arc, at a far lower price than existing digital X-ray systems. Competing on price is only one part of the equation, however.
After all, there are countries where, despite their economies of scale, the multi-national market leaders in medical imaging are unable to compete with domestic manufacturers, which are able to produce X-ray systems locally, with lower overheads, and no importation costs. Globally, there are also a large number of smaller imaging vendors, which have limited, yet low-cost offerings at the value end of the market, with this increased competition driving down average selling prices.
To differentiate itself further, Nanox also plans to launch with a completely new business model. Instead of traditional transactional sales, which see providers simply purchase and pay the full cost of the imaging system in one installment, use the system for the entire shelf life of the product and then replace with an equivalent model, Nanox plans to retain ownership of its machines, but charge providers to use them on a pay-per-scan basis.
There are some regions and some situations where legislation and other factors make this model unfeasible, so Nanox will also make its products available to purchase outright, as well as licensing its technology to other firms. However, the start-up’s focus is on offering medical imaging as a service.
The company says that this shift from a CapEx to a managed service approach means that instead of competing with established vendors over market share, it will be able to expand the total market, enabling access to imaging systems in settings where they have been hitherto absent, with urgent care units, outpatient clinics, and nursing homes being suggested as targets.
According to the Nanox investor’s prospectus, current contracts already secured (although the legitimacy of these deals is one of the issues raised by the short-sellers) feature a $40 per scan cost, of which Nanox receives $14 – although the exact figure varies depending on regional economics. The contracts feature a minimum service fee equivalent to seven scans a day, although the target is somewhat higher, with each machine expected to be used to produce 20 scans a day, for 23 days a month.
If Nanox’s order book is as valid as the company insists, and it already has deals for 5,150 units in place, each system will consequently be bringing in a minimum of $27,048 dollars per year for a minimum total revenue of $139m. If the systems are used 20 times a day as Nanox hopes, that means almost $400m in sticky recurring revenues annually. To put that in perspective, one of the market leaders for X-ray imaging systems in 2018 was Siemens Healthineers, which turned over almost $2.8bn across its general radiography, fluoroscopy, mammography, mobile, angiography, and CT imaging divisions.
With an order book that is, on the face of it, this healthy, there have been questions as to why Nanox went public at all, but the listing may be required for this business model to work. The Israeli vendor says that the vast majority of the investment will be sunk into producing the Nanox scanners, and the associated manufacturing capacity. This is necessary because unlike other imaging companies selling systems on a CapEx basis, Nanox will receive nothing for delivering scanners to customers. Revenue is generated later as the systems are used.
This means that the company is effectively fronting the initial cost of the systems, so needs to get as many units installed and being used as quickly as possible to recoup its initial costs. Unlike other vendors, it cannot rely on sales of a first tranche to fund the second and so on, in its new managed service model, it is better to mass produce everything at once.
Open to exposure
There is, however, nothing to stop other, established players from switching to a similar model. This should be of concern to Nanox, after all, Siemens Healthineers or GE Healthcare already have the manufacturing capacity and capital ready to offer products in a similar way.
And of course, Nanox, shouldn’t underestimate the difficulty of disrupting a long-established market. Despite ample funding and solid products, other companies are still struggling to make an impact in other markets. For example, Butterfly Network, a vendor offering an affordable handheld ultrasound solution, has a valuation of over $1 billion and has received more than $350m in funding.
In 2019, the company turned over $28m, enough to make it the market leader in the nascent handheld category, but in a global ultrasound market worth almost $7bn, at present, it is little more than a drop in the ocean.
Nanox hopes that its own new business model would be disruptive by opening up the market to a far greater range of customers than are currently served. A nursing home, for example, might not be able or willing to allocate the cost of a CT machine from a single year’s budget, but spreading that cost as the scanner is used, and particularly if that cost is passed on to patients at a time of use, on-site imaging suddenly becomes a far more feasible proposition.
What’s more, if a company was able to increase its product’s user base there is a strong possibility for upselling additional services, software, and tools. These could be things like AI modules that increase workflow efficiency, or, especially pertinent given the pricing model could allow machines to be installed in new settings that lack on-site expertise, tools that aid clinical decision making.
Beyond that, there is also ample scope for an imaging vendor to entice a customer into its ecosystem with a scanner that has no cost at the point of delivery, before getting it to commit to its own PACS and other IT systems. Being able to fully exploit these new customers relies, in the first instance, on being able to get a foot in the door. That is why an imaging service model could be so beneficial, even if the returns on the scans themselves aren’t especially lucrative.
While adopting a new business model and securing revenue from add-ons and upselling would help established vendors countenance the price differential Nanox proposes, if we are to take the start-up at its word, addressing its feature set might be another matter entirely.
As well as just providing imaging hardware, Nanox is offering a service that, at face value, is more complete. The Arc automatically uploads all imaging data to its cloud SaaS platform. This platform would initially use AI systems to ‘provide first response and decision assistive information’ before radiologists could provide final diagnoses that could then be shared with hospitals in real-time.
Figure 2: With teleradiology read volumes increasing, it makes sense that the necessary hardware comes baked into the Arc
There is currently limited information available about the exact nature of the so-called Nanox.CLOUD and its integration with the Arc, although several assumptions can be made:
– Firstly, although built-in connectivity is being touted as a feature with clinical benefits, its inclusion is as likely to be a necessity as a design choice, given that Nanox presumably needs to be able to communicate with the systems in order to find out scan volumes and bill accordingly. Or, more drastically, render the system inoperable if people don’t keep up with payments.
– Another assumption that can be made is that the full suite of tools wouldn’t be included in the basic pay-per-scan fee. Signify’s Teleradiology World – 2020 report found that in 2020, the average revenue per read for a teleradiology platform is, in North America for example, $24.40. As such, teleradiology services would only be able to be offered at an additional cost, creating another revenue stream for Nanox.
– Another sticking point could also be Nanox’s promise to enable the integration of its cloud into existing medical systems, via APIs. While well and good in theory, the competitiveness, complexity, and proprietary nature of many medical imaging workflows, combined with the fact that many vendors have absolutely no incentive to make integration easy for the newcomer, mean that in practice, it is likely to either be a prohibitively expensive, or frustratingly limited offering. This is one area where established vendors, which already offer comprehensive medical imaging packages, have a distinct advantage.
Back down to Earth
The short positions promoted by commentators including Citron Research and Muddy Waters Research postulate that the Nanox.ARC scanner isn’t real. There are some legitimate questions, but running through their papers is also an attitude that Nanox’s claims are simply implausible, whether that is because it has an R&D budget a fraction of the size of GE, or because anonymous radiologists unrelated to the company haven’t seen anything like it before.
It is worth remembering, though, that these short sellers will benefit financially if Nanox slumps. Nanox conversely, is obviously financially incentivized to promote its technology and its potential, and it wouldn’t be the first company, to promote the limited fruits of its start-up labor in a flattering light.
As so often happens in these he said, she said situations, the truth could well lie somewhere between the two extremes. Even in this instance, even if Nanox fails to deliver on some of its more impressive promises, the fact is, it has suggested bringing a whole new customer base into play and laid out a strategy for selling to them.
With that being the case, for a big vendor the issue of whether Nanox is legitimate almost becomes moot, their focus should be what these other customers require, how to get these customers into their product ecosystems, and what add-on products, and additional services they can feasibly sell them at a later date.
If nothing else, the entire Nanox furor shows that to achieve growth in mature markets, a vendor’s innovation needs to extend beyond its products.
About Alan Stoddart
Alan Stoddart is the Editor at Signify Research, a UK-based market research firm focusing on health IT, digital health, and medical imaging. Alan joined Signify Research in 2020, using his editorial expertise to lead on the company’s insight and analysis services.
– Intermountain Healthcare and Sanford Health sign a letter of intent to merge that will created a combined health system employing more than 89k people at 70 hospitals and 435 clinics across seven states.
Intermountain Healthcare and Sanford Health, one of the nation’s leading systems in rural health care delivery and clinical research, have signed a letter of intent to develop a strategic partnership. The boards of both not-for-profit organizations approved a resolution to support moving forward with the due diligence process. The organizations will enter this activity with the goal to sign a merger agreement that will bring both health systems together as a model for improving access to high-value healthcare across the U.S. The merger is expected to close in 2021 pending federal and state approvals.
The combined organization will employ more than 89,000
people, and operate 70 hospitals, many in rural communities. It will operate
435 clinics across seven states, provide senior care and services in 366
locations in 24 states, and insure 1.1 million people. The organization will
have headquarters in Salt Lake City, Utah, and corporate offices in Sioux
Falls, South Dakota.
“Intermountain and Sanford have a shared vision of the future of health care and have the aligned values needed to better serve more communities across the nation,” says Marc Harrison, M.D., president and CEO of Intermountain Healthcare. “This merger enables our organizations to move more quickly to further implement value-based strategies and realize economies of scale. Through coordinated care, increased use of telehealth and digital health services, we will make health care more affordable for our communities.”
The Centers for Medicare and Medicaid Innovation (CMMI) created the Direct Contracting Model to expand opportunities for more diverse providers and healthcare organizations to participate in value-based care arrangements for Medicare fee-for-service (FFS) beneficiaries.
The goal of the new model is to create the next generation of risk-sharing arrangements to improve outcomes for patients, lower costs, and ensure high-quality care. In developing the Direct Contracting model and associated payment options, CMMI decided to build on lessons learned from accountable care initiatives, in particular, the Next-Generation ACO (NGACO) Model, as well as Medicare Advantage and other innovative private payers. The new model specifically aims to attract providers new to Medicare FFS and Innovation Center models: “the payment model options appeal to a broad range of physician practices and other organizations because they are expected to reduce burden, support a focus on beneficiaries with complex, chronic conditions, and encourage participation from organizations that have not typically participated in Medicare FFS or CMS Innovation Center models.”
High risk equals high reward for the new Direct Contracting Entities (DCE). The payment model options that participants can choose from aim to (1) increase risk-sharing arrangements through capitated and partially capitated population-based payments, (2) include providers and organization new to Medicare FFS, (3) increase access and empower beneficiaries in their care, and (4) decrease provider burden by emphasizing only core quality metrics and making certain care delivery waivers available. Importantly, the model offers options for new entrant DCEs, meaning DCEs that have no or limited experience with Medicare FFS beneficiaries and associated Medicare risk-based contracts, as well as high needs DCEs that will focus specifically on high cost, high acuity beneficiaries.
The Direct Contracting model begins with an optional six-month implementation period on October 1, 2020, which is intended to support organizations that need additional time to align beneficiaries and optimize their care coordination and management functions. In light of COVID-19’s overwhelming impact on healthcare this year, CMMI announced the first Direct Contracting Model performance year will start April 1, 2021—a three-month delay from the original start date, with five performance years to follow. The second cohort of Direct Contracting participants will begin in January 2022.
The Innovation Center will initially test two risk-sharing options:
Professional – includes a 50% shared savings/shared losses provisions and Primary Care Capitation, a capitated, risk-adjusted monthly payment for enhanced primary care services that’s equal to seven percent of the total cost of care benchmark for enhanced primary care services
Global – is 100% full risk option with either Primary Care Capitation or Total Care Capitation, which is a capitated, risk-adjusted monthly payment for all services provided by Direct Contracting Participants and preferred providers.
CMS may test a third option, the Geographic Option, in the future, which would also be a 100% risk arrangement offering an opportunity for participants to assume the total cost of care risk for Medicare FFS beneficiaries in a defined region.
Achieving Success in the Direct Contracting Model:
Similar to existing accountable care models, critical elements to achieve success in the Direct Contracting model include a focus on workflows, systems, and partnerships that support care coordination activities, including connections to needed healthcare and wrap-around services, as well as supporting providers in attaining quality benchmarks while managing overall utilization. Underlying these capabilities is access to real-time actionable information to drive timely interventions and coordination activities.
Real-time information through admission, discharge, and transfer (ADT) event notifications for Emergency Department, hospital, or post-acute encounters enable care coordination teams to deploy workflows and resources to more easily and quickly support patients. Knowing when and where patients are receiving care and understanding the clinical context for their care allows providers and care teams to more seamlessly work together to provide the right care at the right time without unnecessary or duplicative interventions. It also allows care teams to identify patients at high risk for complications, including readmissions and can prompt time-sensitive outreach and connection to additional resources.
Having access to real-time information can not only improve patient outcomes and quality but will also help to maximize payment incentives for Direct Contracting participants. Coordinated care consistently leads to shorter lengths of stay, which not only has positive quality implications for patients but also financial benefits for Direct Contracting Entities.
In addition, healthcare organizations can use real-time information to continuously strengthen and refine care network partnerships and collaborations.
To effectively manage Medicare FFS patients within the Direct Contracting Model, participants will need to coordinate with other providers across care settings and deploy timely interventions that support patients’ health and well-being. Real-time information, through ADT data, will provide participants with a new level of clinical intelligence to successfully prioritize and deploy care coordination services and ensure seamless transitions of care for patients while also creating optimal opportunities to achieve shared savings.
About Vanessa Kuhn, Ph.D
Vanessa Kuhn, Ph.D., is the Director of Policy at PatientPing, a care collaboration platform that provides real-time visibility into patient care events across the continuum. PatinetPing works with hospitals, post-acutes, health plans, ACO’s and beyond, the platform connects providers across the nation to improve patient and organizational outcomes.
The COVID-19 pandemic has forever changed patient expectations for healthcare delivery, including offered services and health office operations. Although health systems have remained dynamic in adopting telehealth capabilities, their long-term capital, like real estate and supply chain management (SCM) protocols, have not adapted to match these expectations. Health systems must be aware of current trends in both areas to inform their future decisions.
Divesting in healthcare real estate is also key to reducing unnecessary costs to a health system, especially if optimal use of these spaces is already lacking. The overwhelming costs of ownership and management lock money away in underutilized and obsolete real estate spaces. Divesting provides more capital liquidity, and frees capital to go towards investment in telehealth, diagnostic technology, and emerging specialties, assets that go towards increasing patient and workforce engagement and satisfaction. In addition, eliminating unused real estate assets allows freedom from liabilities and human capital investments, like facility maintenance and upkeep, not to mention the increased frequency of deep cleaning necessary in the post-COVID-19 bi-lateral operations era.
Further, years of mergers and acquisitions in the healthcare industry have left many health systems with the unwanted result of increases in real estate assets. This has led to increased consolidation of these assets, a trend that has been exacerbated by the pandemic pressure on health system funds. Future consolidation and reevaluation of assets should be informed by trends in patient expectations as well as trends in the market.
Here are five emerging trends driving the future of healthcare real estate and assets. Each encourages divestment out of health system real estate ventures or restructuring of existing spaces in order to better cater to forever changed patient expectations.
1. Rise of Telehealth
According to the Department of Health & Human Services, telehealth use is up around 50% in primary care settings since the beginning of the public health emergency and is projected to remain high in the time following. Most recently, in-person visits have increased and as a result, telehealth visits have declined due to the state’s reopening, and thereby some critics posit that this trend may not continue. However, that could not be further from the truth.
Moving forward, despite health system fear regarding long-term reimbursement may be lacking from federal, state, and commercial health plan payers for virtual care delivery, leveraging telehealth to augment traditional healthcare delivery will become a necessity because consumers will demand it and physicians in some studies have shown satisfaction with their video visit platforms. This will no doubt have an impact on office layout and services.
2. Convenience of Outpatient Services
Motivated in part by telehealth utilization, patients seek convenience and accessibility in their healthcare now more than ever. Health system expansion may therefore mean satellite offices in high traffic areas to cater to the patient’s need for accessibility, marking a movement away from the traditional, centralized hospital campuses.
3. Value-Based Care Transitions
As legislation and CMS regulation moves more towards a value-based care system, trends show a natural move towards lower-cost facilities that provide preventive care. These could also contribute to continued trends to more off-campus real estate and planning for alternative care delivery options, for example, mobile vans reaching more vulnerable, at-risk populations for care such as life-saving vaccinations.
4. Pandemic Precautions
Bilateral operations are likely to be maintained for some time even after more normal operations return, and healthcare real estate, especially with consolidation, will need to accommodate this precaution, and others like it in all locations.
New diagnostic and testing tools are constantly being released, forcing health systems to reevaluate their current assets and make room for new ones which contributes to wasted space. Furthermore, remote monitoring apps will continue to proliferate in the market and become more affordable and accessible to consumers while advancing interoperability standards and federal information blocking requirements will allow information to flow more freely.
Strategies to Optimize Healthcare Real Estate & Strategy
In order to unlock money trapped in assets, health systems should look to make their assets work better in response to current trends and patient expectations. To accommodate patient demands and changes to health industry regulation and reimbursement, it makes sense to ensure efficient use of all facilities and optimize real estate and assets using the following strategies:
– Divest underutilized assets of any kind: Begin with real estate and move smaller to reduce unneeded capital investment.
– Remove or reduce administrative spaces: Transition non-clinical workforces to partial or complete work from home status, including finance, legal, marketing, revenue cycle, and other back-office functions. Shared space or “hotel” workspaces are popular.
– Reconfigure medical office or temporary care buildings: As these are often empty several days a week, they must be consolidated.
– Get out of expensive leases for care that can be given remotely or in lower-cost options or by strategic partners: Take full advantage of telehealth capabilities and eliminate offices that have become obsolete.
– Integrate telehealth into real estate only where it makes sense: Telehealth is more applicable to some services and care modalities than others. Offices should reconfigure to meet these novel needs where necessary, even if it means forgoing leases for the near term.
– Assess other expensive assets: Appraise assets like storage and diagnostic tools. Those not supportive of the new post-COVID-19 care model or prioritized service lines and are otherwise not producing revenues should be sold or outsourced to strategic partners.
– Diversify with off-campus offices: Provide convenient access to outpatient care and new outpatient procedures by investing in outpatient medical offices in high foot traffic locations.
– Create space for services in high demand: Services like preventive care and behavioral health should be given physical or virtual space in the system to cater to patient needs.
About Moha Desai
Moha Desai is a Principal of Healthcare Strategy and Transformation where she focuses on driving forward strategic, planning, financial, revenue cycle, operational improvement, and patient engagement healthcare projects for providers, federal government health agencies, and various firms requiring growth, business development, and project implementation and management. She has previously served in leadership roles at Partners HealthCare, Deloitte Consulting, Bearing Point, etc. Moha received her B.A. in Economics and her M.B.A. at Yale University.
– Babyscripts today announced a commercial partnership with
Roche Diagnostics, a division of the world’s largest biotech company and a
global pioneer in pharmaceuticals and diagnostics.
– Roche will partner with Babyscripts on the
development of Babyscripts’ remote patient monitoring (RPM) programs to
leverage groundbreaking data science through the next generation of RPM in
Washington D.C.-based virtual care platform for managing obstetrics, today
announced a commercial partnership with Roche
Diagnostics, a division of the world’s largest biotech company and a
global pioneer in pharmaceuticals and diagnostics. Roche Diagnostics and Babyscripts will collaborate on the next generation of
digital and diagnostic combinations in women’s health.
Commercial Partnership to Power Next-Generation of RPM in
Under the terms of this collaboration,
Roche will partner with Babyscripts on the
development of Babyscripts’ remote patient
monitoring (RPM) programs to leverage groundbreaking data science through the
next generation of RPM in pregnancy. These programs will be focused on solving
issues of blood pressure-related complications through RPM, such as prenatal
hypertension. Babyscripts participated in Startup
Creasphere, Roche’s digital health accelerator
program, which was instrumental in initiating this collaboration.
Care Platform Background
Babyscripts has spent
the last six years building a clinically-validated, virtual care platform to
allow OBGYNs to deliver a new model of prenatal and postpartum care. Using
internet-connected devices for remote monitoring, Babyscripts offers
risk-specific experiences to allow providers to manage up to 90% of pregnancies
virtually, allowing doctors to detect risk more quickly and automate elements
“Roche’s investment in Babyscripts solutions is a tremendous validation of our vision for improving maternal care, and an example of the kind of strategic collaboration essential to moving the needle on outcomes,” said Juan Pablo Segura, co-founder and President of Babyscripts. “Roche’s vast expertise in the field of women’s health diagnostics and clinical science combined with our on-the-ground experience in the virtual maternal health space is going to prove a game changer for rethinking how we approach prenatal and postpartum care.”
– RLDatix acquires Verge Health, creating
the largest safety-led compliance and credentialing software platform specifically
designed for healthcare.
– The acquisition will accelerate the adoption of RLDatix’s applied safety intelligence framework and create an industry-standard for proactive risk mitigation.
RLDatix, the leading global provider of intelligent patient safety solutions, announced today that it has acquiredVerge Health, the recognized best-in-class credentialing software provider. This acquisition joins two leaders in the Governance, Risk, and Compliance (“GRC”) healthcare software market and will dramatically accelerate an essential shift from a reactive approach to risk management to one rooted in safety and prevention. The acquisition is effective immediately.
remain the third leading cause of death in the U.S., and the World Health Organization
estimates that adverse events due to unsafe care rank as one of the top 10 causes of death and disability around the world. These adverse, yet
preventable, events are incredibly costly and account for an estimated 15
percent of all hospital expenditures across OECD countries.
Creating Industry Standard for Proactive Risk Mitigation in Healthcare
RLDatix is the only
provider that partners with healthcare delivery organizations globally to provide a comprehensive
view of enterprise risk through a safety-first lens. With this acquisition, RLDatix unifies the four
key pillars of GRC under one roof: Safety, Compliance, Provider Management,
and Strategic Advisory Services. By elevating conversations about compliance,
credentialing, safety, and risk to the enterprise level, RLDatix helps leaders make
the systemic changes necessary to achieve true harm reduction in a way that
will transform the delivery of care.
“Healthcare’s traditionally siloed approach to risk management, patient safety, provider management, and compliance has limited the ability for organizations to mitigate avoidable harm,” said Jeff Surges, CEO of RLDatix. “With Verge Health, we are unifying at an enterprise level all of the tools necessary to recognize flawed practices and prevent adverse events. This acquisition represents an enormous acceleration of Applied Safety Intelligence and solidifies our position as the global leader in patient safety software at a time when accreditation organizations like The Joint Commission are expected to take more active steps to reduce adverse events.”
Why It Matters
The timing of the acquisition is important. Hospital safety has been under a microscope
all year as millions of Americans have avoided non-emergency medical care for fear of contracting COVID-19, impacting public health and costing
providers billions in lost revenue. Health systems that want
to make their facilities and procedures safer need a partner who can show them
how to minimize risk through an enterprise-wide approach that addresses all of the potential pitfalls. This a model that has been widely
accepted outside health care but scarcely so within medicine—until now.
With the added
provider management, compliance, and analytics solutions of Verge, RLDatix offers healthcare delivery and insurance companies a clear path forward to
strengthen trust, capture revenues and to prevent the occurrence of adverse safety events.
“We’re excited to adopt RLDatix’s Applied Safety Intelligence framework and bring together several of our disparate processes,” said Sherri Hess, Chief Nursing Informatics Officer of Banner Health. “The opportunity to have two key vendors join forces so that our safety and provider data, CANDOR training, and oneSOURCE documentation can be united to drive our high reliability efforts is paramount in ensuring we continue to drive safe, efficient healthcare.”
Financial details of the acquisition were not disclosed.
– Today, Blue Cross and Blue Shield of North Carolina partners
with Carrot Inc. and Virta Health to help address two of the largest ongoing
health issues facing Americans today – smoking and type 2 diabetes.
– Virta and Carrot’s programs will be available to
individual under-65 members and fully insured group members beginning November
Blue Cross and Blue Shield of North Carolina (Blue Cross NC), today announced it is teaming up with Carrot Inc. and Virta Health to launch no-cost virtual programs to help members quit smoking and reverse type 2 diabetes. Virta and Carrot’s programs will be available to individual under-65 members and fully insured group members beginning November 2020 at no cost. They support Blue Cross NC’s commitment to make health care better, simpler and more affordable by providing members easy access to care through digital technology.
“We resolve to make whole person care a priority, and that means we have to think beyond treating conditions, and work to prevent and reverse them,” said Von Nguyen, vice president of clinical operations and innovations at Blue Cross NC. “We are excited to team up with Carrot and Virta and bring their innovative, life-changing programs directly to the homes of our members and address some of North Carolina’s most pressing health issues.”
Carrot’s Clinically-Proven Program Empowers People to
In addition to being the leading cause of preventable death in the U.S., smoking remains a tremendous burden on our nation’s health care system. According to the Centers for Disease Control and Prevention, more than 16 million Americans are living with a disease caused by smoking, and for every person who dies because of smoking, at least 30 people live with a serious, smoking-related illness such as diabetes, COPD, heart disease, or cancer. Smoking-related illness costs the State of North Carolina over $13 billion every year.
Carrot’s clinically-proven, app-based program Pivot, combines innovative technology, human-centered design, and behavioral science to empower people to quit smoking and remain non-smokers. In a recent clinical study 42 percent of participants achieved a successful quit over the course of the study, and seven months after the onset of the study, 86 percent of those who quit were smoke-free.
Pivot’s digital solution includes text-based access to
trained tobacco experts, a first-of-its-kind personal breath sensor to track
progress, nicotine therapy products, and access to Pivot’s online community for
collective wisdom and inspiration.
“Carrot is excited to collaborate with Blue Cross NC to ease the burden smoking has long placed on the state of North Carolina and the American health care system,” said David S. Utley, M.D., CEO of Carrot Inc. “Quitting smoking is hard – every year, millions try to stop smoking. We’re proud to bring Pivot to the hundreds of thousands of Blue Cross NC members who want to live life tobacco free and help them prevent or reverse the severity of chronic conditions like diabetes, heart disease and COPD.”
Diabetes Reversal with Virta Health
More than 3.7 million people in North Carolina—nearly half of the adult
population—have either prediabetes or type 2 diabetes. According to the
CDC, diabetes increases the risk for severe illness for those with COVID-19.
Virta Health, the leader in type 2 diabetes reversal, uses an innovative virtual care model that helps patients achieve normal blood sugar while eliminating the need for diabetes-specific medications. Patients receive near-real-time access to board-certified physicians and health coaches who provide expert, individualized guidance on nutrition and behavioral change through the Virta app. Virta also serves as a partner to Primary Care Providers, integrating its specialized diabetes reversal treatment into existing care plans.
In Virta’s peer-reviewed clinical outcomes, at one year 94
percent of participants reduced or eliminated the need for insulin. The
majority of patients eliminated all diabetes-specific prescriptions while
achieving normal blood sugar. Results also include 12 percent (30lbs) weight
loss, and improvement in over 20 markers of cardiovascular health, including
“This is a massive opportunity to change the direction of health of an entire state, save lives, and significantly reduce healthcare spend along the way,” said Sami Inkinen, Virta Health co-founder and CEO. “Our collaboration with Blue Cross NC provides strong optimism that we can solve the type 2 diabetes crisis our nation is facing.”
As the COVID-19 pandemic creates surges in acute care, many imaging departments are experiencing a decrease in volume, due to patients deferring or canceling non-urgent appointments and surgeries. The impact of this makes it painfully obvious that — because imaging departments rely on a fee-for-service model – when the volume is down, finances suffer. As an aspect of healthcare that has historically been hyper-focused on volume, adoption of a value-based care approach in radiology has evolved slowly, even before the pandemic. Despite the hurdles COVID-19 has presented, the rationale behind value-based care remains – there is a need to drive improved patient outcomes at a lower cost – and healthcare reimbursement will continue to shift, encouraging quality care and enhanced patient experiences. Radiology can take an important role in realizing this transformation, influencing the entire process of early diagnosis, efficient treatment, and follow-up care.
So how can imaging departments thrive when confronted with a value-based care model? One way is to make sure referrers value radiologists’ expertise as part of the care team. Active participation in care team discussions, as well as case study presentations, can demonstrate the extent to which imaging affects outcomes. Imaging departments can also invest in building referrals for areas where imaging intersects more directly with care, such as oncology. But perhaps the most direct way is to focus on an area over which the imaging department has the most control: the cost-effective use of resources. The strategies chosen today could help or hurt a practice in the future, and departments should look toward reliable technology that delivers consistent results and allows staff to focus less on technical issues and more on patient care.
An efficient department with the right mix of technology can thrive in a value-based healthcare environment. Answering these three questions can guide your technology strategy and help you weather the pandemic disruption and the continuing adoption of value-based care:
Are your imaging systems appropriate for your patient demand?
As it relates to value-based care, you can expect the future to entail less “confirmation” imaging and more investigational, prevention-focused imaging. However, different imaging solutions have different purposes; while confirmation CT studies don’t demand as high performance, investigational imaging will often require more sophisticated systems with the image quality and performance to support complex studies and confident diagnoses, and potentially even spot incidental findings that circumvent health issues down the line. When purchasing new systems, consider the type of studies that make up the majority of your business, as well as new areas in which you’d like to increase expertise and referrals.
How cost-effective are your imaging technology operations?
Consider every aspect of your operation to uncover opportunities to decrease costs without affecting quality. For best results, involve the entire imaging department team in these explorations. One possible budget drain is consumables. Sometimes the easiest way to service your car is by bringing it to the dealer, but that’s not always the most cost-effective option. The same goes for imaging technology; be sure to consider third-party options, in addition to Original Equipment Manufacturer (OEM) parts. Today, alternate parts are available for almost every piece of your organization, even technically sophisticated components such as x-ray tubes.
Is your technology reliable?
Speed to diagnosis may impact patient outcomes. Your referrers are looking for a quick turnaround of imaging studies. Highly advanced technology with reliable uptime can help you become a partner of choice, and reduce time spent maintaining equipment. For example, radiation oncology depends on CT for treatment planning, and oncologists need radiology partners who have CT systems that are dependable, integrate easily into their workflow, and do not distract from patient care. Even a small change, such as CT tubes that use highly reliable liquid metal bearings to eliminate the need to wait for tube cooling between studies, will impact your throughput and thus your ability to meet referrers’ needs.
Are you putting unnecessary stress on your imaging systems?
Educate all system users about manufacturer-recommended procedures for system use and upkeep to keep your systems running at high performance. For example, shutting the system down by turning off the power, rather than by following manufacturer-recommended procedures, places unnecessary stress on components that need time to cool.
While it’s important to take a measured approach as we navigate the repercussions of COVID-19, now is the time to begin adapting to value-based care. As the pandemic has taught us, a nimble imaging department can adapt to changing circumstances and create lasting value. Revisit these questions frequently, because consistent assessment and vigilance is key to a department’s success.
– AVIA, a healthcare innovation network comprised of 50+
health systems and other healthcare stakeholder groups, today announced that
Geisinger, Presbyterian Healthcare Services, and OSF HealthCare have renewed or
expanded their partnerships with the organization to accelerate digital
transformation within their individual systems.
– While hospital spending has steeply declined due to the
COVID-19 pandemic, today’s announcement indicates that AVIA Members value the
Network’s shared learnings and rely on AVIA’s unique service model to better
understand new markets and select/scale digital solutions.
While hospitals and health systems across the country face
tremendous financial pressures and declining consumer confidence, AVIA Network
Members continue to lead healthcare toward practical, impactful, and
transformation. AVIA is the nation’s leading digital
transformation partner for healthcare organizations. Through renewed and
expanded partnerships with Members and new initiatives underway with consulting
clients, AVIA sees strong momentum across the country in the
strategic moves powered by digital.
This momentum is accelerated by AVIA’s differentiated
service model. Unlike other services firms, AVIA enables sustained
results through its membership insights and customized support. Insights are
distilled and delivered to Members from AVIA’s deep expertise coupled with
long-term relationships and understanding of where health systems are acting.
a nationally-renowned leading health system in innovation, renewed their
membership in the AVIA Network. “At Geisinger, we’re constantly
seeking new ways to improve care for our patients, our members, and our
communities,” said Dr. Karen Murphy, Executive Vice President, Chief Innovation
Officer, and Founding Director of the Steele Institute for Healthcare
Innovation. “In AVIA, we’ve found a partner to help us operationalize and
accelerate our innovation efforts.”
In the next chapter of Geisinger’s AVIA membership, the two organizations will work closely together in support of the Steele Institute’s Digital Transformation Office (DTO). With a charge that includes purview over advanced and predictive analytics, informatics, software development, experience strategy, product design, and product management, Geisinger will prioritize their key capabilities with AVIA’s support. AVIA will help the DTO team assess the market for digital solutions that enable these capabilities, and accelerate technology selection and deployment.
Expanded partnership and tailored support
Presbyterian Healthcare Services was
looking to innovatively improve how they digitally serve their patients, to
extend support both locally and to remote communities through telehealth and
innovative models of care. In a time of great uncertainty, Presbyterian wanted
to partner with an organization they trusted to catalyze the work, and chose to
partner with AVIA.
“AVIA knows us, and they’re already an extension of my team. The support they provide goes beyond what a traditional consulting firm would provide, because they have an active membership of like-minded health systems, and are gaining real-time insight into what other organizations are doing successfully, and where there are roadblocks. This sets us up to innovate effectively and with speed, especially during unprecedented times,” said Ries Robinson, Chief Innovation Officer at Presbyterian.
HealthCare engaged AVIA to assess the opportunity for
digital technology across the system to inform their operational and transformational
activities in support of current year financial targets. Specifically, AVIA mobilized
and assessed OSF stakeholders to identify where AI and robotic process
automation could enable Mission Partners to more meaningfully contribute to the
Ministry as well as support a sustainable cost structure for the system. In the
next phase of work, AVIA will develop a prioritization framework and
make final recommendations to the OSF executive team.
AVIA furthers its Members’ insights through tailored support that provides strategic advice for action, grounded in what is possible, not theoretical. “It has been exciting to see health systems both embrace digital and AVIA’s service model. Through membership, we’ve been able to offer a combination of market research, advisory support, and peer collaboration,” said AVIA’s Chief Product Officer, Eric Jensen. “This unique mix is helping our members to move faster.”
– 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
– Virta is expanding its suite of treatment options to
include prediabetes reversal, obesity reversal, and type 2 diabetes management.
– By making this crucial expansion, Virta can scale its
treatment to support the tens of millions of additional patients with
prediabetes and obesity, as provide an on-ramp to reversal for those with T2D
that aren’t yet ready to reverse.
Virta Health, the
leader in type 2 diabetes reversal, today introduced the addition of new
services including prediabetes reversal, obesity treatment, and provider-led
management for type 2 diabetes. The expansion provides payers and covered
beneficiaries a single, full-service virtual clinic that offers
industry-leading outcomes for the most critical needs in metabolic health.
Virta’s fully-virtual, high-touch model demonstrates hope
for change, and stands in stark contrast to approaches that only slow the
diabetes downward spiral, as opposed to reversing it. Virta provides
individualized guidance from medical providers and behavioral specialists,
whenever and wherever it is needed. Patients interact with their dedicated
clinical team often multiple times per day. This novel telehealth
approach—called Continuous Remote Care—ensures successful adoption of Virta’s
individualized medical nutrition therapies and long-lasting results.
Why It Matters
Nearly half of adults in the United States suffer from obesity,
prediabetes, or type 2 diabetes. Thirty people die per hour of diabetes-related causes. The
economic burden continues to grow, and people with diabetes incur nearly $17,000
in medical expenses per year. They are also at high risk for severe illness
from COVID-19, and risk of dying from the disease is twice as high compared to
those without diabetes.
Obesity and prediabetes patients will benefit from the same
treatment that delivers the sustained type 2 diabetes reversal outcomes in Virta’s
clinical trial and commercially-covered population. Patients receiving type 2
diabetes management will receive support from a provider-led care team, with
personalized guidance and an option for a seamless transition to Virta’s
reversal treatment. All patients will receive individualized care via Virta’s
provider-led Continuous Remote Care platform.
Virta Type 2 Diabetes Reversal Results
Virta’s results in type 2 diabetes reversal have fueled continued triple-digit year-over-year growth for the company while creating strong demand to bring Virta’s evidence-based approach to other metabolic conditions. In Virta’s peer-reviewed clinical trial results, 60% of people at one-year reverse type 2 diabetes, and 94% reduce insulin use or eliminate it altogether.
Additionally, patients completing one year of the Virta
Treatment experience 14% weight loss. This figure exceeds the goal of the
National Diabetes Prevention Program and the FDA benchmark for weight loss
drugs by nearly 200%.
“This expansion provides our commercial partners and patients with the transformational outcomes they’ve come to expect from Virta, but don’t receive from other solutions on the market,” said Sami Inkinen, CEO & co-founder of Virta Health. “We can now meet every patient wherever they are on their metabolic health journey, while uniquely offering a path to reversing their chronic disease.”
This question initially brings to mind many possibilities such as connection to the latest 5G cellular service, a new super-fast internet provider, or maybe one of the many new energy suppliers jockeying for market share from traditional utility companies. While all of these might represent legitimate opportunities to improve one’s community, here we are talking about a different concept; specifically, whether your community is ready to have a Connected Community of Care (CCC) to advance whole-person health.
The image of a CCC may seem obvious. After all, we all live in communities where we have some connections between hospitals, physician practices, ambulatory care centers, and pharmacies to name just a few. But here we are talking about a broader sense of connected community that includes not just health care organizations, but social service organizations, such as schools and civic organizations and community-based organizations (CBOs) like neighborhood food pantries and temporary housing facilities. A true CCC links together local healthcare providers along with a wide array of CBOs, faith-based organizations, and civic entities to help address those social factors, such as education, income security, food access, and behavioral support networks, which can influence a population’s risk for illness or disease. Addressing these factors in connection with traditional medical care can reduce disease risk and advance whole-person care. Such is the case in Dallas Texas, where the Dallas CCC information exchange platform has been operating since 2012. Designed to electronically bring together local healthcare systems, clinicians, and ancillary providers with over a hundred CBOs, the Dallas CCC provides a real-time referral and communication platform with a sophisticated care management system designed and built by the Parkland Center for Clinical Innovation (PCCI) and Pieces Technologies, Inc.
Long before this information exchange platform was implemented, the framers of the Dallas CCC came together to consider whether Dallas needed such a network and whether the potential partners in the community were truly ready to make the commitments needed to bring this idea to fruition. As more and more communities and healthcare provider entities realize the tremendous potential of addressing the social determinants of health by bringing together healthcare entities and CBOs and other social-service organizations, the question of community readiness for a CCC is being asked much more often. But how do you know what the right answer is?
Before looking at the details of how we might answer this, let’s remember that a CCC doesn’t don’t just happen in a vacuum. It requires belief, vision, commitment― and above all― alignment among the key stakeholders. Every CCC that has formed, including the Dallas CCC, begins with a vision for a healthier community and its citizens. This vision is typically shared by two or more large and influential key community stakeholders, such as a large healthcare system, school district, civic entity, or social- service organization like the United Way or Salvation Army.
Leaders from these organizations often initially connect at informal social gatherings and advance the idea of what if? These informal exchanges soon lead to a more formal meeting where the topic is more fully discussed and each of the participants articulates their vision for a healthier community and what that might look like going forward. This stage in the evolution of a CCC is perhaps the key step in the transformation process, as while all stakeholders will have a vision, achieving alignment among those visions is no small feat. Many hopeful CCCs never pass this stage, as the stakeholders cannot come to an agreement on a common vision that each can support. For the fortunate few, intrinsic organizational differences can be successfully set aside to allow the CCC to move forward.
It’s at this point in the CCC’s evolution that details begin to matter in truthfully answering the question, “Is this community ready to be connected?” While there may be agreement among the key stakeholders on a vision, the details around readiness may still divert or delay the best-laid plans. It is safe to say that the key to understanding a community’s readiness to form a CCC lies in the completion of a formal, comprehensive, and transparent readiness assessment.
A readiness assessment is a process to collect, analyze, and evaluate critical information gathered from the community to help identify actual clinical and socio-economic needs, current capabilities and resources (including technology), and community interest and engagement. Taken together, a comprehensive readiness assessment can help identify a community’s strengths and weaknesses in preparation for establishing a CCC.
A readiness assessment is not a tactical plan for building a CCC, nor is it a governance document that provides how all members of the CCC will relate to each other. Instead, the readiness assessment provides communities interested in establishing a CCC with an honest and unbiased yardstick to measure preparedness. Conducting and using the results of the readiness assessment is one of the best ways to ensure a successful CCC deployment.
A typical CCC readiness assessment covers five areas: (1) community demographics; (2) clinical areas of need (including trends); (3) social areas of need (including trends); (4) technology competency (e.g., what percent of the potential network participants are computer literate?), availability (e.g., what percent of the potential network participants have internet access?), and suitability (e.g., is the internet access, high speed?); and (5) what are the needs of potential network participants and can these be modeled as use cases for the information exchange network? This information is essential to help key stakeholder decision-makers decide to move forward with establishing a CCC and to know what specific challenges may lie ahead.
The collection of this essential information can be done in a number of ways, such as making use of existing publicly reported data or conducting surveys, interviews, focus groups and town hall meetings with community leaders and residents and clinical and CBO leaders and staff. Experience conducting the readiness assessment that provided the foundation for the Dallas CCC showed that no single information-collection method was sufficient to collect the necessary level and robustness of the data. In Dallas, we utilized all five approaches but found that in addition to researching publicly available data, initial surveys, followed by interviews and focus groups, yielded the most voluminous and reliable information to chart the course ahead.
In addition to the various methods to collect this essential information, the key to obtaining useful and reliable information requires a sufficient number of respondents/participants who are drawn from various organizations and organizational levels. Simply put, you must have a large enough sample and you must have diversity within the sample. It’s not enough to just interview leaders of potential network participants, as their understanding of the needs, trends, and capabilities may look very different from that of frontline staff.
Similarly, surveying only one category of potential network participants may not provide enough information to fully understand the socio-economic needs in the community or even the perspectives surrounding the prevalence of chronic conditions. Beyond the qualitative methods involved, it is important to note that if done right, this process takes a lot of time to complete. Cutting corners by reducing the sample size, for example, or doing selective sampling to speed the readiness assessment process along will only cause problems later when this insufficient information results in erroneous decision-making.
Once the data has been collected, it is important to carefully analyze what the data is trying to tell you. Results of the readiness assessment must be shared openly and honestly with all key stakeholders, particularly those serving in a governance capacity. The governance group (a topic for another day) that has formed in parallel with the readiness assessment must be able to evaluate and understand the main messages from the readiness assessment to make an informed decision as to whether to move forward with establishing a CCC.
Like the need for alignment around the key stakeholder’s vision for the CCC, there must be universal agreement by the key stakeholders as to the message of the readiness assessment and its implications for the road ahead. As with the vision alignment stage, substantive disagreements among the group at this stage are a sign of trouble ahead unless differences can be resolved.
At this point, you might be thinking that this all seems very complicated and fraught with potential land mines waiting to derail your effort to answer the original question “Is your community ready to be connected?” Again, I would emphasize the importance of unwavering commitment and alignment to achieve the vision. But I would also offer advice gleaned from working in the CCC space for the last eight years, which is to get help early and don’t wait until the horse is out of the barn!
We have seen first-hand many communities and consultants approach the conduct of a readiness assessment with a cavalier attitude, often exemplified by the statement, “we already know all of this,” only later to have to backtrack their pronouncements at substantial additional cost in time and resources. Fortunately, today there are a number of excellent organizations, including PCCI, with the experience, credibility, and integrity in the CCC space to help you on this journey. Don’t be afraid to seek them out. It will be a wise investment that you will not regret, particularly when you begin to see the results of improved whole-person health and well-being in your community.
– NVIDIA and Massachusetts General Brigham Hospital
researchers develop an AI model that determines whether a person showing up in
the emergency room with COVID-19 symptoms will need supplemental oxygen hours
or even days after an initial exam.
– The ultimate goal of this model is to predict the
likelihood that a person showing up in the emergency room will need
supplemental oxygen, which can aid physicians in determining the appropriate
level of care for patients, including ICU placement.
The original AI model, named CORISK, was developed by scientist Dr. Quanzheng Li at Mass General Brigham. It combines medical imaging and health records to help clinicians more effectively manage hospitalizations at a time when many countries may start seeing the second wave of COVID-19 patients.
EXAM (EMR CXR AI Model) & Results
To develop an AI model that doctors trust and that
generalizes to as many hospitals as possible, NVIDIA and Mass General Brigham
embarked on an initiative called EXAM (EMR CXR AI Model) the largest,
most diverse federated
learning initiative with 20 hospitals from around the world.
In just two weeks, the global collaboration achieved a model
with .94 area under the curve (with an AUC goal of 1.0), resulting in excellent
prediction for the level of oxygen required by incoming patients. The federated
learning model will be released as part of NVIDIA
Clara on NGC in the coming weeks.
Leveraging NVIDIA’s Clara Federated Learning Framework
Using NVIDIA Clara
Federated Learning Framework, researchers at individual hospitals were able
to use a chest X-ray, patient vitals and lab values to train a local model and
share only a subset of model weights back with the global model in a
privacy-preserving technique called federated learning.
The ultimate goal of this model is to predict the likelihood
that a person showing up in the emergency room will need supplemental oxygen,
which can aid physicians in determining the appropriate level of care for
patients, including ICU placement.
Dr. Ittai Dayan, who leads the development and deployment of AI at Mass General Brigham, co-led the EXAM initiative with NVIDIA and facilitated the use of CORISK as the starting point for the federated learning training. The improvements were achieved by training the model on distributed data from a multinational, diverse dataset of patients across North and South America, Canada, Europe, and Asia.
Participating Hospitals in EXAM Initiative
In addition to Mass Gen Brigham and its affiliated
hospitals, other participants included: Children’s National Hospital in Washington,
D.C.; NIHR Cambridge Biomedical Research Centre; The Self-Defense Forces
Central Hospital in Tokyo; National Taiwan University MeDA Lab and MAHC and
Taiwan National Health Insurance Administration; Kyungpook National
University Hospital in South Korea; Faculty of Medicine, Chulalongkorn
University in Thailand; Diagnosticos da America SA in Brazil; University of
California, San Francisco; VA San Diego; University of Toronto; National
Institutes of Health in Bethesda, Maryland; University of Wisconsin-Madison
School of Medicine and Public Health; Memorial Sloan Kettering Cancer Center in
New York; and Mount Sinai Health System in New York.
Each of these hospitals used NVIDIA Clara to
train its local models and participate in EXAM. Rather than needing to pool
patient chest X-rays and other confidential information into a single location,
each institution uses a secure, in-house server for its data. A separate
server, hosted on AWS, holds the global deep neural network, and each
participating hospital gets a copy of the model to train on its own dataset.
NVIDIA Announces Partnership with GSK’s AI-Powered Lab
for Discovery of Medicines and Vaccines
In addition, the new AI model, NVIDIA today announced a
partnership with global healthcare company GSK and its AI group, which is
applying computation to the drug and vaccine discovery process. GSK has
recently established a new London-based AI hub, one of the first of its kind,
which will leverage GSK’s significant genetic and genomic data to improve the
process of designing and developing transformational medicines and vaccines.
Located in London’s rapidly growing Knowledge Quarter, GSK’s hub will utilize biomedical data, AI methods, and advanced computing platforms to unlock genetic and clinical data with increased precision and scale. The GSK AI hub, once fully operational, will be home to its U.K.-based AI team, including GSK AI Fellows, a new professional training program, and now scientists from NVIDIA.
NVIDIA Building UK’s Most Powerful Supercomputer,
Dedicated to AI Research in Healthcare
NVIDIA today announced that it is building the United
Kingdom’s most powerful supercomputer, which it will make available to U.K.
healthcare researchers using AI to solve pressing medical challenges, including
those presented by COVID-19.
Expected to come online by year end, the “Cambridge-1”
supercomputer will be an NVIDIA DGX SuperPOD™ system capable of delivering more
than 400 petaflops of AI performance and 8 petaflops of Linpack performance,
which would rank it No. 29 on the latest TOP500 list of the world’s most powerful
supercomputers. It will also rank among the world’s top 3 most energy-efficient
supercomputers on the current Green500 list.
CorroHealth—driven by helping clients navigate regulatory and
compliance complexities, ease physician burdens and improve financial
outcomes—emerges at a time when financial health is particularly important for
health systems and payers. CorroHealth combines the industry-leading domestic
middle revenue cycle group of TrustHCS, with the full-service global delivery
model of Visionary RCM, the emergency documentation technology solutions of
T-System, and the advanced coding solutions of RevCycle+.
“We knew health systems and plans would have a growing need for our solutions, so we worked hard and found a way to bring all 4,000 employees together as one company, united by our core. It’s been pretty amazing to see this joint venture come together at such a time as this,” said CorroHealth CEO Patrick Leonard.
The four legacy company names will remain through the end of
2020 with a final move to the CorroHealth name across all companies beginning
January 1, 2021.
Global investment firm The
Carlyle Group owns a majority stake in CorroHealth, with Cannae Holdings,
Inc. (NYSE: CNNE), Sanaka Group, and affiliates of TripleTree Holdings also
serving as investors.
When food production technology made it possible, wheat flour processors started to eliminate the tough exterior (bran) and nutrient-rich core (germ) of the kernel to get at the large, starchy part (the endosperm) only. The bread produced from this process is white and fluffy, and it makes great PB&Js and takes forever to grow mold, but it is almost totally lacking nutritional value.
Nutrition experts eventually pointed this out, of course, after which commercial bakers tried fortifying their bread by adding back essential nutrients stripped out by processing. It didn’t work. While white bread from refined flour is still available, nutrition experts strongly recommend whole grain products as the healthier alternative.
Opposition to this reductionist approach to nutrition is perhaps best captured by the idea of the sum being the whole of its parts: If inputs are lacking, the end result will fall short also.
Each human being is also a sum of parts, and the reductionist approach to healthcare is essential when it comes to advancing many aspects of medicine and healthcare.
“Historically, the invention of the microscope, the defining of Koch’s four infectious disease postulates, the unraveling of the human genome, and even intelligent computers are salient examples of the dramatic benefits of biomedical reductionism,” explained Dr. George Lundberg.
These successes, however, may have convinced many in both the medical community and society at large that reductionism is a necessary, if not sufficient, approach. The numbers say otherwise.
“Classical medical care interventions contribute only about 10 percent to reducing premature deaths compared to other elements such as genetic predisposition, social factors, and individual health behaviors,” Lundberg goes on to say. “Most contemporary medical researchers have concluded that the chronic degenerative diseases of modern Western humans have multiple contributory causes, thus not lending themselves to the single agent-single outcome model.”
Paging Dr. House. It turns out your particular form of genius just isn’t frequently that useful.
And nowhere is the single agent-single outcome model arguably less effective than in behavioral health and chronic disease management. What many in medicine and healthcare now realize is that a vicious cycle of alternating physical and mental ailments are the norm with both chronic illness and long-term mental health challenges.
“Depression and chronic physical illness are in a reciprocal relationship with one another: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses,” says Professor David Goldberg of the Institute of Psychiatry in London.
It’s an unsurprisingly intuitive conclusion to reach. A man with depression lacks the desire to eat well, exercise, often practice necessary daily hygiene. As his untreated depression deepens, his physical health declines as well. A woman with chronic, untreated pain feels like it will never end and her life is over. Faced with a seemingly unmanageable challenge, she falls into a funk that eventually metastasizes into full-blown depression.
A reductionist approach to these scenarios might be to encourage more exercise or prescribe antidepressants. While both are necessary, neither will likely be sufficient.
So why hasn’t a more holistic approach to patient care become the norm? In a nutshell, because it’s expensive. Chronic illnesses, generally, are the most expensive component of healthcare.
According to a New England Journal of Medicine study, patients “with three or more chronic conditions (43 percent of Medicare beneficiaries) account for more than 80 percent of Medicare health care costs.”
For this expensive, highly at-risk group, holistic care is what actually works.
The NEJM articles conclude that “an intervention involving proactive follow-up by nurse care managers working closely with physicians, integrating the management of medical and psychological illnesses, and using individualized treatment regimens guided by treat-to-target principles improved both medical outcomes and depression in depressed patients with diabetes, coronary heart disease, or both.”
Of course, the regimen included in the NEJM study is expensive—perhaps more so than what qualifies as holistic care now.
But it requires a certain type of twisted logic to argue for holding down costs by rationing care inputs—by reductively treating only just the most obvious health concerns—when this approach invariably leads to readmissions, more office visits, more disability payments, more days of work missed.
Indeed, a reductive approach to accounting—silos of financial impact across the continuity of a life lived—hides the fact that specific healthcare costs are not alone the measure of how chronic illness detracts from both individual life satisfaction and broader societal efficiencies.
The key, then, is to make holistic health both the norm and affordable. How can that be done? By creating initiatives designed to achieve a core set of goals:
Incentivize primary care: In the last two decades, the number of primary care providers (PCPs) available to patients in the United States has decreased by about 2 percent. This may not sound like a lot, but the decline comes as the population has increased, naturally, which means fewer patients have a PCP. As healthcare shifts to pay for performance, not services, the PCP is the natural quarterback of patient care. The country needs many more PCPs, not fewer, and the federal government has an opportunity to use loan forgiveness incentives and other tools to nudge medical school students in that direction.
Embrace technology: Arguably, holistic care only became possible with the digital age. Chronic disease management requires frequent measurement of patient vitals, which is very expensive without wearables and similar digital age technologies. Now, patients can regularly provide data with no clinical intervention, that data can automatically upload to an electronic health record, and that EHR can alert the clinician when results are alarming.
Make poor choices expensive: Perhaps only because smoking has become so socially unacceptable can the cost of cigarettes be so high ($7.16 per pack in Chicago with all taxes) without creating significant protests. But the data is clear that higher costs equal fewer smokers. The same types of behavioral economics programs can also apply to fast food, soda, etc. Yes, people will get upset and complain about the nanny state, but absent some attempt to change behavior, we may want to consider changing the name to the United States of Diabetes.
Reward smart choices: Healthy people use healthcare and insurance less often, which drives down costs. Duh. Combining technology and incentives (avoiding diabetes), Utah’s Intermountain Healthcare engaged almost 1,500 pre-diabetic employees in a program through Omada Health that collectively yielded 9,162 pounds lost. Omada billed Intermountain based on the level of success, and without speaking to specific numbers, Intermountain felt the cost of the program was a wise investment when compared with the costs of diabetes treatment.
These four bullets are probably just the most obvious suggestions, of course. They don’t account for the complexities of the American healthcare system focused on payment models, the profit motive, or what to do with the uninsured, homeless, and devastatingly mentally ill.
But the benefits of holistic thinking when reductionism is inadequate applies to both individual care and the healthcare system as a whole. Public health, for example, takes a holistic approach to communities by looking at how housing, transportation, and education impact general overall health. Where this approach is done well, the benefits are obvious.
Reductionist isolation will always be necessary when identifying specific genes or determining which natural elements are effective in treating disease. But it’s wise to always bring the right tools for the job.
– Validic launches the newest version of its remote
patient monitoring (RPM) offerings, Validic Impact: Rapid Deployment.
– This new standalone version of Validic Impact requires
no EHR integration and can be used as a fully standalone solution.
Validic, a Durham,
NC-based provider of health data platforms and solutions for scaling remote
patient monitoring (RPM), has announced the release of a major update to its
remote patient monitoring solution, Validic
Impact. This new release offers the ability to deploy an end-to-end
technology solution for chronic and acute condition monitoring, rapidly.
Validic Impact: Rapid Deployment Features
Impact: Rapid Deployment offers providers a standalone, web-based
application to manage device-driven RPM programs. The solution is designed for
scale and offered with an ease of use that allows provider groups to quickly
purchase and launch.
Validic’s RPM solutions offer the alerting, visualization
and analytics capabilities needed to engage and manage patients from their
home. The Validic Impact solutions can support the management of acute and
chronic conditions, such diabetes, hypertension, heart failure, and COVID-19
(coronavirus). This new version of Validic Impact requires no EHR integration
and can be used as a fully standalone solution.
– Set up and launch rapidly – with no technology
integration and minimal configuration requirements, providers can deploy
comprehensive RPM programs rapidly.
– Create protocol templates – standardize
templates for the conditions you want to manage with default programmed alerts,
consent language, etc.
– Enroll patients quickly – invite a patient to
a program within seconds – enabling them to consent and connect their device(s)
from any browser.
– Personalize and monitor – easily adjust and
personalize goals and alerts for each patient; automate outreach to patients
who are not submitting readings, trending in the wrong direction, or flag
readings of concern for timely interventions.
Validic’s RPM model allows physicians to tap into the
devices their patients already own and use. The solution can integrate over 480
consumer and clinical health devices via Validic’s core health data
platform. In addition to supporting a bring-your-own-device (BYOD), Validic
Impact also supports kitted device fulfillment and 24/7 device support through
strategic relationships with device logistics companies.
Why It Matters
“COVID-19 was a call to action for healthcare,” Drew Schiller, CEO of Validic said. “Our platform-first RPM approach enhances virtual visit offerings. Right now, that means quickly replacing clinical data usually gathered during in-person visits, such as weight and blood pressure, with home health data.”
Schiller added, “Beyond improving the quality of care delivered through telehealth, RPM will continue to serve as a staple of virtual care and extend in-person care offerings.”
– Sonde Health acquires NeuroLex Laboratories, Inc. to forms
one of the world’s preeminent biobanks focused on vocal biomarkers.
– NeuroLex’s core product, SurveyLex, makes it easy to
create and distribute voice surveys in less than a minute as URL links through
Sonde Health, a
Boston-based digital vocal biomarker technology platform announced it has acquired NeuroLex Laboratories, Inc., a leading
voice-enabled survey and data acquisition platform. The
acquisition brings together two of the leading forces in the vocal biomarker
Sonde will acquire NeuroLex’s popular web-enabled voice
survey and analysis platform, as well as its rich dataset, which when combined
with Sonde’s leading voice-based dataset, forms one of the world’s preeminent
biobanks focused on vocal biomarkers. In addition, merging Sonde’s mobile and
voice-assistant platforms with NeuroLex’s web-based capabilities will enable
the delivery of voice-enabled heath detection and monitoring over any platform.
Democratizing Voice Computing
Over the past two years, NeuroLex has built one of the
largest laboratories in the world to collect, label, and model voice data
tagged with health conditions comprised of over 40 research fellows across 12
universities that have published over 5 peer-reviewed journal articles.
NeuroLex’s core product, SurveyLex, makes it easy to create and distribute
voice surveys in less than a minute as URL links through web browsers. With
this product, NeuroLex has curated a biobank comprised of over 500,000 voice samples
from over 30,000 individuals alongside a host of pharmaceutical and academic
Benefits for Sonde
“At Sonde, we have unlocked voice as a new vital sign to enable secure, accessible, and non-intrusive monitoring of health. Incorporating NeuroLex’s impressive work in voice-based surveys and research moves us significantly forward in becoming the one-stop shop for health condition detection and monitoring through voice,” said David Liu, CEO of Sonde Health. “NeuroLex’s voice-based survey platform and biobank will accelerate our research and development, and our collection and analysis of high-quality voice data, bolstering all the products we provide to our customers.”
Sonde’s proprietary technology works by sensing and
analyzing subtle changes in the voice due to changes in a person’s physiology.
The company’s respiratory and depression health checks are available
As part of the acquisition, Jim Schwoebel, the chief executive
officer of NeuroLex, will join Sonde’s leadership team as Vice President, Data
“I am thrilled to bring Jim and his team on board,” continued Liu. “His experience in building NeuroLex, shared mission of using vocal biomarkers to move healthcare forward, and expertise in building large voice-based datasets and machine learning make Jim a tremendous addition to the Sonde team.”
Financial details of the acquisition were not disclosed.
– Alphabet’s Verily has established a new subsidiary,
Coefficient, with a mission to create value by combining innovative health
technology solutions with new insurance and payment models. Verily is the
majority shareholder and Swiss Re Corporate Solutions, an established player in
the employer stop-loss market, has a minority stake in the new company.
– Coefficient will enter a segment of insurance called
employer stop-loss. Employer stop-loss typically protects self-funded employers
from unexpected and large health insurance claims.
Verily, an Alphabet company is announcing a new subsidiary, Coefficient Insurance Company, that will be backed by Swiss Re Corporate Solutions, the commercial insurance unit of the Swiss Re Group. Coefficient will combine innovative health technology solutions with novel insurance and payment models. It’s precision risk solution helps self-funded employers to control cost volatility through a data-driven model that is unique in the traditional employer stop-loss market. Employer stop-loss is a segment of commercial insurance that protects self-funded employers from unexpected and large employee health benefit claims by reimbursing employers for claims above a defined amount.
How Coefficient Works
Coefficient will leverage Verily’s core strengths integrating hardware, software, and data science and will also leverage Swiss Re Corporate Solutions’s risk knowledge, distribution capabilities, and reputation in the employer stop-loss market. Coefficient’s precision risk solution is designed to provide self-funded employers with more predictable benefit plan protection. It uses an analytics-based underwriting engine to identify unexpected areas of cost volatility and cover those exposures with more dynamic and precise insurance policy provisions. Over time, Coefficient plans to integrate Verily’s suite of health devices and tech-driven interventions for workers and dependents into its precision risk solution to improve health outcomes and control cost.
“Employers have been facing rising and increasingly unpredictable healthcare costs for years,” said Andy Conrad, CEO, Verily. “Coefficient is aimed at reducing blind spots and providing greater cost control mechanisms for self-funded employers, and we expect that partnering with Swiss Re Corporate Solutions will help us to better develop and distribute our precision risk solution to the employer stop-loss market. Over time, we look forward to integrating Coefficient with Verily’s employer health solutions, including mobile health devices and innovative care management programs, in order to align payment models with better health outcomes.”
Corporate Solutions has agreed to make a minority investment in Coefficient,
subject to the satisfaction of certain closing conditions including regulatory
approvals. In connection with this investment, Ivan Gonzalez, CEO North
America, Swiss Re Corporate Solutions, is expected to join the Coefficient
Board of Directors upon closing.
– 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.”
– Bridge Connector raises $25.5 million in Series B funding to advance interoperability layer for healthcare organizations as demand for integrated health data intensifies during COVID-19 pandemic.
– The investment will support the growth of Destinations,
the company’s new integration-platform-as-a-service (iPaaS) that connects
health data systems using use-case-based interoperability blueprints to speed
integrations with major vendors.
a Nashville, TN-based interoperability company changing the way health care
communicates, today announced it has raised $25.5 million in Series B funding led
by Axioma Ventures. The round was also joined by all existing investors,
including veteran investor Jeff Vinick, and brings Bridge Connector’s total
funding to over $45 million.
COVID-19 Underscores Growing Demand for Integrated Health
The last decade has seen an explosion of digital health platforms and the U.S. health care system has taken incremental steps toward achieving interoperability between them. In March, the Department of Health and Human Services (HHS) issued new rules that force formerly closed vendor solutions to become interoperable.
However, the COVID-19 pandemic has exposed the urgent need for data liquidity as healthcare providers across the country have struggled to share essential patient information and provide comprehensive care via remote delivery methods such as telehealth. In the face of the pandemic’s disproportionate effect on minority communities, the industry has also recognized the critically important role that social determinants of health — the environments in which we are born, live and work — play in our overall well-being and the need to make this information available to health care providers.
A True Interoperability Layer for Healthcare
Founded in 2017, Bridge Connector provides a suite of vendor-agnostic integration solutions and a full-service delivery model, helping health care vendors, providers, and payers more easily share data between disparate systems, such as electronic health records (EHRs) or patient engagement solutions. The company’s technology is designed to democratize health care by allowing organizations of any size to equitably connect data systems and empower care teams with the most accurate patient data in real-time. Unlike other health care interoperability vendors, Bridge Connector’s unique approach does not lock customers into a forced data model or proprietary APIs, instead of employing a vendor-agnostic integration layer that works across data models without the need for standardization.
The investment will further support the company’s increasing
market share in healthcare interoperability and growth of Destinations, a new
integration-platform-as-a-service (iPaaS) that connects health data systems
using use-case-based interoperability blueprints to speed integrations with
Recent Integrations with Key HIT Stakeholders
The new funding comes shortly after Bridge Connector finalized various collaborations with some of the most influential stakeholders in health IT, including Epic, Allscripts, and Salesforce, as well as other system integrators such as MuleSoft. Those collaborations represent calculated steps toward creating a centralized hub of integration solutions for all data platforms that any health care provider or payer can access. The average hospital today uses approximately 16 disparate electronic health records platforms that limit data sharing within the walls of a single hospital, let alone between separate hospitals.
– Innovaccer launches a perioperative
optimization solution for surgeons to realize clinical and financial goals with
– The solution redefines surgical planning and
post-surgical recovery with machine learning-based patient stratification for
optimized surgery experience and personalized patient care management.
Innovaccer, Inc., a San Francisco, CA-based healthcare technology company, recently launched its perioperative optimization solution for health systems. The solution optimizes surgeries and ramps up volumes by identifying high-risk patients for pre-surgical intervention while reducing the length of stay, readmissions, and cost. The solution uses advanced analytics and machine learning-based algorithms to proactively identify patients at greater risk for post-surgical complications. Patients are then referred to the pre-surgical optimization clinic for pre-surgical strategies which are personalized for individual patients and specifically designed to minimize post-surgical complications.
Impact of COVID-19 on Elective Surgeries, Non-Essential
has challenged traditional healthcare delivery systems and caused the
postponement of elective surgeries and other non-essential medical care. As
patients wait for their surgeries, it is likely their conditions could
deteriorate and/or patients would return to clinics during a pandemic surge.
Health systems will need to be prepared to address the potential for more
complicated patient health conditions with careful risk assessment.
Pre-Surgical Optimization Platform Features
Innovaccer’s “Pre-Surgical Optimization” solution guides patient prioritization based on an algorithm that factors medical history, patient demographics, allergies, chronic conditions, history, and social determinants of health. Based on the previous data on these patients from the electronic medical record, claims, and the individual’s risk factors, the algorithm estimates the future cost of care for the patient. The algorithm also assigns patients to appropriate case managers using a smart rule engine that assesses a variety of factors including the number of appointments, and the surgeon’s expertise to map the patient to the provider. This approach helps hospitals identify high-risk patients and focus on the patients that will benefit most from pre-surgical interventions.
Return on Investment Model for Healthcare Organizations
Innovaccer has also incorporated a refined return on
investment model designed to make the optimization process revenue positive for
healthcare organizations. The three key pillars of the exclusive model are
sensitivity analysis tools, deep data insights, and performance analytics.
Using this solution, hospitals can track their return on investment in
real-time on a customizable dashboard with metrics including reduced
readmissions, reduced length of stay, and emergency department visits with
their associated costs.
“With about 28 million surgeries canceled worldwide, non-COVID medical care has suffered tremendously. Canceled elective surgeries have impacted patient health conditions and the economic sustainability of health systems,” says Abhinav Shashank, CEO and Co-founder of Innovaccer. “As health systems plan to resume surgical procedures, care managers will need to engage the patient remotely for pre-surgical interventions. Our solution is created to redefine the entire process of optimizing surgery planning and to become more patient-centered and adaptable to the changing care environment. We want to ensure exemplary pre-optimization and post-discharge engagement to reduce readmissions and improve the hospital’s financial impact using the pre-surgical optimization process.”
Founded in 2017 by Steven Gutentag and Demetri
Karagas, Thirty Madison was launched with a single vision: To build the
highest quality care experiences for treating chronic health conditions. Through
Thirty Madison’s three portfolio brands — Keeps, Cove, and Evens — patients can easily access
specialist-level care combined with the convenience of telemedicine and
treatment delivery. Each platform offers individualized health care to patients
suffering from hair loss (Keeps), migraine (Cove), and acid reflux (Evens) at
an affordable cost. With virtual doctor visits and a wide range of therapeutic
treatments, tools, and educational content individually tailored to the needs
of patients, these groundbreaking brands are reimagining and improving the way
chronic conditions are treated.
Thirty Madison offers not only a differentiated platform –
which allows Keeps, Cove, and Evens to deliver specialist-level care across a
spectrum of health issues, but also a novel approach to modernizing healthcare.
For Thirty Madison, there is no one-size-fits-all approach when it comes to
treatment—or to products. In addition to providing a range of issue-appropriate
treatment options, the brands also partner directly with innovative healthcare
companies to provide patients with increased access to the latest treatment
options and offer meaningful cost savings.
Thirty Madison’s first brand, Keeps, launched in January
2018. Halfway through 2020, Keeps has surpassed its 2019 revenue and is a
recognized leader in the hair loss space, helping hundreds-of-thousands of
customers manage hair loss while improving and expanding access to treatments.
Using Keeps’ success as a proof-of-concept, Thirty Madison built on the
capabilities of their platform to launch their next care model, Cove, the first
direct-to-consumer treatment option for migraine, in early 2019. Cove has made
high-quality migraine care more accessible, affordable, and actionable than
ever, helping 70% of patients see a reduction in migraine severity and driving
a 79% reduction in ER visits due to migraine. Evens, launched at the end of
2019, is the first telehealth solution for acid reflux, a chronic condition
that causes heartburn and affects over one-quarter of Americans.
With this new round of investment, Thirty Madison plans to
further innovate in the digital healthcare space, specifically making the
overall experience more enjoyable for those with chronic conditions. Steven
Gutentag, co-founder and CEO of Thirty Madison notes, “We are excited to
have JJDC as an investor, given Johnson & Johnson’s leadership across
healthcare and consumer health, and their commitment to putting consumers and
– Eden Health raises $25M to give employers and
commercial real estate owners and operators the ability to offer medical care on-site,
near-site, and virtually.
– Eden’s membership model makes high-quality healthcare an affordable benefit for the average employer, with low to no out-of-pocket costs for their employees.
– Since the first signs of the US coronavirus outbreak in
early February, Eden Health has worked with Boylan Bottling, Connell, Convene, Emigrant
Harry’s, Kramer Levin, Newscred, evidence-based, medically-informed plans and
protocols for supporting essential workers and bringing workforces back. And
they’ve embedded dedicated, on-demand doctors (called Medical Directors) in the
C-Suites of several customers.
Eden Health, a New
York City-based national medical practice, today announced it has raised $25
million in Series B funding led by Flare
Capital Partners with participation from principals from Stone Point Capital, a private equity
firm that focuses on the financial services industry including the HR benefits,
insurance and real estate sectors. Existing investors who participated in the
Series B round include Greycroft, PJC, Max
Ventures and Aspect
Ventures. The oversubscribed round brings Eden Health’s total
raise to $39M.
Founded in 2016, Eden Health is known for its innovative
direct-to-employer healthcare delivery model, bringing in-person and virtual
healthcare together to deliver an exceptional patient experience to the
employees of mid-market companies. Eden Health empowers employers to
supercharge their benefits packages whether or not they are self-insured.
Designed to meet the needs of companies of all sizes, Eden Health lets them
fill gaps in their employees care with a fully integrated healthcare option.
Eden Health membership services are not tethered to open
enrollment, meaning employees and their families can join at any time and begin
using services immediately. And one of Eden Health’s core services is insurance
navigation, to make sure employees get the care they need without surprise
costs Although Eden Health’s approach is direct-to-employer, its mission is to
ensure that superior care is as widely available as possible.
Eden Health’s medical practice provides members with a
dedicated Care Team. Care Teams are composed of highly credentialed clinicians
delivering evidence-based, top-quality care. Each Care Team offers digital care
around the clock, same-day in-person primary care, behavioral health services
and benefits navigation. Employees interact with the same dedicated Care Team,
regardless of whether they are communicating virtually or in-person. Where
necessary, Eden Health consults specialists to determine needs, before
connecting employee members with fully-vetted, cost-effective in-network
Over the past four years, Eden Health has become a trusted
benefits partner for more than 33,000 employees, spanning more than 100
employers across a broad range of industries, including finance, retail, real
estate and technology. Since the very first signs of the US coronavirus
outbreak in early February, Eden Health has worked with Boylan Bottling, Connell, Convene, Emigrant Bank,Golf Magazine, Harry’s, Kramer Levin, Newscred, and others
to roll out evidence-based, medically-informed plans and protocols to support
workforce health. It has guided employers, property owners and workers through
the outbreak using real-time monitoring, proactive outreach, and team-based
care. And as employers and property owners began to phase workforces back into
offices and worksites, Eden Health introduced a comprehensive back-to-work
program spanning COVID-19 screening, virtual primary care, PCR testing,
on-site antibody testing, immediate triage and patient consults.
Through the crisis, Eden Health customers have also chosen
to embed dedicated Eden Health Medical Directors into their c-suites to manage
employee population health. Thanks in large part to early monitoring and proactive
protocols to slow the spread, Eden Health employers have been able to maintain
high levels of productivity, deploying essential workers safely while
protecting their health and the health of fellow employees.
If you’ve been to a big-brand grocery or department store recently, you probably noticed some form of healthcare outlet – or maybe you didn’t. These in-store pharmacies and clinics have become so omnipresent, right there next to the diapers, dog food, and green beans, that unless you use them, you may not notice them at all.
This convergence of healthcare and retail has been happening for a few years and represents one of the fastest-growing corners of the healthcare market. In fact, retail health is growing at 10% each year – twice as fast as conventional healthcare.
The shared spaces are the latest and most obvious ways healthcare providers have emulated their retail counterparts. Just as retailers moved on from the 1980s mall archetype toward a more individualized, customer-friendly model, so too are healthcare providers – perhaps grudgingly. A large, decentralized healthcare system is more complicated than similar retail models, but patient expectations and other drivers are pushing the change. As a result, today’s hospitals increasingly are foregoing the traditional, centralized architecture in favor of distributed points of care – separate or offsite surgical, imaging and testing facilities are the norm for the modern health system.
The goal is the same whether it’s a hospital or a hardware store – improve and enhance the customer experience. Today’s hospitals are changing their models to make using their services easier, faster and, if not more enjoyable, certainly less irritating. Healthcare customers may not have the universe of options available to retail customers, but they do have options, including the easiest option of all – staying home.
Of course, this shift is about more than convenience. Because of the wave of healthcare consolidations across the country, rural America is increasingly underserved when it comes to healthcare. In those areas, these clinics offer an opportunity to receive expert care from medical professionals in other parts of the country through advanced applications and technologies. We also can’t ignore the affordability angle for patients. To some extent, productizing care and being able to access existing infrastructure in other, larger facilities, drives down cost in the overall system.
The Technology of Customer Experience
Of course, there is more to customer experience than physical accessibility. Retailers are leading the way in implementing technology to improve their customer interactions, and it’s about more than just e-commerce. You see it in everything from streamlined checkout and smart shelves to mobile coupons tailored to customer history.
The deployment of 5G networks will enable even more advanced, customer-friendly applications, something retailers and healthcare providers understand well. For that reason, they are exploring creative ways not just to leverage 5G services, but to partner with telecommunications providers to reach their shared customers.
The thinking is simple and sound: The ultra-low latency capabilities of 5G will enable innovations in all sorts of areas, including for the purposes of this conversation, intelligent retail and healthcare and telemedicine. In order for centrally located medical experts to access, read, and diagnose patients in remote clinic settings, often exchanging high-resolution medical imaging and other diagnostic information, low latency and high bandwidth are required. That’s where 5G comes in.
However, these networks require much denser networks with powerful computing that doesn’t yet exist across today’s networks. For users to take advantage of 5G’s many anticipated benefits, the network must be pervasive, and existing 4G LTE networks aren’t there yet.
That doesn’t mean providers aren’t trying. In fact, they clearly see an opportunity. Before COVID-19, Verizon estimated half the country would have access to 5G by the end of 2020, and in March the company announced an additional $500 million investment in its own 5G network. Our own industry survey conducted with 451 Research found that 86% of operators expect to be delivering 5G services by 2021. The projections are aggressive for good reason: IHS Markit expects 5G to generate some $12.3 trillion in annual revenue by 2035.
Meeting those timelines requires upgrades at existing cell sites but also fast, widespread deployment of new sites. Finding available real estate for that many new deployments – especially in the densely populated areas at the front of the line for 5G service – isn’t easy.
Enter the retail industry. Large retailers are in the business of reaching as much of the population as they can, and many of them already have a footprint that is the envy of cellular providers. The nation’s largest retail chain has 4,500 stores, and about 90% of the U.S. population lives within 10 miles of one of them. We look at that and see fast, easy, one-stop shopping. Telco providers see rooftops crying out for 5G equipment, with the potential to accelerate network densification and gain instant access to the vast majority of the U.S. population.
There is an opportunity emerging here for a symbiotic relationship between retailers, healthcare providers, and telecom operators to form a high-tech, customer-friendly hub for shopping and healthcare services. Let’s look at the possibilities from the perspectives of each party.
Telcos: It’s All About the Footprint
As always with network deployments, activity around 5G will follow demand, and demand follows the population. That means urban environments are likely to be first in the queue, and real estate in most cities is at a premium. Every rooftop and light pole are potential homes for 5G towers or equipment, a reality that has been the subject of considerable discussion – only recently moving toward a clear resolution.
Retailers already know the math, and most stores are placed strategically in proximity to as many consumers as possible. This is fertile ground for telcos, simplifying right-of-way negotiations and deployment times and ensuring significant network penetration. They also have ready-made customers in the retailers and healthcare providers occupying the buildings that support their towers.
Retail: Powering the Customer Experience
Customer experience has become a great differentiator in the retail space, as retailers evolve to meet the expectations of the Amazon generation. The last two years have been marked by growth in distribution centers and in the allocation of data center space supporting online retail and distribution.
Enabling the online shopping experience and bringing all the simplicity of online shopping to in-store customers are the threads that connect today’s most successful retail organizations. The tools and tactics making the in-store part of that possible include sensor and customer tracking, demand analytics, 360o customer learning, and artificial intelligence deployed in interactive customer environments that leverage the Internet of Things in new and creative ways.
These applications are only as effective as the networks upon which they exist and operate and 5G is simply far superior to our current 4G networks. The increase in bandwidth will enable speeds up to 100 times faster than 4G, eliminating the slow or dropped service common in highly populated environments – such as crowded department stores.
A retailer with a 5G antenna on the roof providing pristine service for all of its in-store technologies and large swaths of customers faces few limits in its deployment and adoption of advanced technologies.
Healthcare: Expanding With Confidence
The goal of retail healthcare is to make many common health services more accessible, and it’s working. There are more than 2,700 Convenient Care clinics (CCCs) in the U.S., and those clinics have received more than 40 million patient visits. Today’s consumers can buy a gallon of milk, pick up a prescription from the pharmacy, and get a flu shot in a single stop.
While these retailers and healthcare providers increasingly are sharing physical space and many of the same motivations – improving customer experience chief among them – there are some important differences. Protecting customer data certainly is a priority for retail stores – and a challenge, considering estimates that 80-90% of those who log in to a retailer’s e-commerce site are hackers using stolen data – but patient privacy may in fact be even more sensitive.
With that in mind, the security enhancements offered with 5G can harden existing retail healthcare networks and potentially open the door to even more patient services in those CCC settings. 5G has anti-tracking and spoofing features, including more encrypted data, to reduce the amount of raw data being transmitted and help protect against hackers. 5G relies more on software and cloud support than 4G, which enables better monitoring, and 5G networks can be sliced into smaller, virtual networks with security tailored for various devices and applications.
Those kinds of advanced security features may eliminate some lingering reservations among healthcare providers reluctant to dive fully into retail healthcare and embolden the more aggressive to expand their offerings. The increased bandwidth of 5G makes it easier to share and access not only sensitive files but also larger patient records, such as high-definition images and even videos from patient procedures. With no technological or security restrictions, it’s not a stretch to envision a world where anything short of surgery could happen in a CCC.
The Opportunity of Integration
There are plenty of arguments for this three-way marriage of convenience, but the full potential of this telco-retail-healthcare convergence will only be realized if the parties collaborate. There may be benefits for all parties in spite of siloed planning, but they’re also will be opportunities lost.
Retailers and healthcare providers who work closely with telcos can build offerings that take advantage of the on-site 5G capabilities, and telcos can gain not just rooftop real estate, but enthusiastic customers itching to stretch their data plans.
Of course, maximizing the partnership may mean new investments in IT systems and infrastructure. For example, you wouldn’t want to build the industry’s most robust customer experience program and then cross your fingers every time a storm threatened utility power. When you lean heavily into IT-enabled smart retail, power protection becomes paramount.
Similarly, retail healthcare centers, or CCCs, may seize the opportunity to expand their offerings and collect and/or transmit more sensitive patient data, but the enhanced security capabilities of 5G networks only go so far. Employees switching between external networks – to find an address for an insurance provider, for example – and more sensitive internal networks with private patient information will want to protect that sensitive information with secure KVM switches.
These types of investments can be managed separately or more efficiently as a single, integrated system. Mobile edge computing (MEC) is an increasingly common model for 5G-enabled computing hubs, and it brings the power and planning of an integrated, modular data center to these types of network edge locations.
MEC deployments can be housed inside or out, preserving valuable space in the store. They can be configured to support AC power-reliant IT systems as well as the DC power plants and equipment common to 5G sites. As with all modular solutions, they can be configured to meet the needs of a specific site and deployed in a matter of days. MEC systems also provide low-latency local computing when even 5G isn’t fast or secure enough for the user; most commercial transactions in these types of settings would be handled with local computing.
The key to optimizing these retail-healthcare-telco hubs is early communication between all parties and proactive planning to ensure the 5G capabilities are fully realized. A failure to communicate will result in squandered opportunities for everyone.
The Final Word
Eventually, all of this will happen with or without coordination between the interested parties. Retailers are going to continue to test the limits of technology to better serve their customers and give them more enjoyable experiences in their stores. Health systems are going to continue to decentralize their facilities and find ways to be closer to their patients and provide better interactions and outcomes. And telcos are going to find homes for their 5G antennas and expand their networks to deliver 5G services to both their subscribers and enterprises. There is an opportunity now, however, while all of these things are happening simultaneously, to do it all better, faster, and more efficiently while meeting the needs of all parties and their customers.
About Mitzi Amon, Director of Healthcare Marketing at Vertiv
Amon is the Director of Healthcare Marketing at Vertiv, where she has more than 20 years of experience in helping customers in healthcare, industrial and commercial environments optimize their operations. From researching the latest trends in the market to understanding the challenges faced by leading healthcare providers, payers, and vendors, Amon’s goal is to inspire conversations and build a collaborative environment where ideas are shared and solutions are created to help the industry stay ahead of what’s next.
– DreaMed Diabetes, the developer of personalized,
AI-based diabetes management solutions, will participate in a clinical study,
led by Jaeb Center for Health Research Foundation, to evaluate the efficacy of virtual
treatment for diabetes patients. The research is funded by a $5 million grant
from The Leona M. and Harry B. Helmsley Charitable Trust.
– DreaMed uses AI-powered technology to seamlessly treat
patients remotely with its virtual diabetes management service by providing
personalized recommendations on insulin dosage for people with type 1 diabetes.
– As part of Helmsley’s research, the study will
determine if the virtual clinic model improves clinical and psychological
outcomes for people with diabetes. DreaMed, together with Aetna and Cecilia
Health, will provide a multi-faceted platform to fully evaluate the
effectiveness of virtual clinics using DreaMed’s technology.
DreaMed Diabetes Ltd., the developer of personalized, AI-based diabetes management solutions, announces it will be serving as a subcontractor on a $5,025,099 grant from The Leona M. and Harry B. Helmsley Charitable Trust to the Jaeb Center for Health Research Foundation. DreaMed’s technology will include a comprehensive data system that can pull information from CGM, SMBG, insulin pumps, and connected insulin pens. It will visualize this information for the healthcare provider and for the participants through web and mobile applications as well as operate decision support algorithms to optimize insulin treatment plans for people with type 1/type 2 on insulin pumps or multiple daily injections therapy.
Growing Need for Virtual Diabetes Care
Due to the sheer size of the United States, many people with
diabetes lack the necessary medical support required, particularly access to
endocrinologists who provide them with critical guidance and information. This
includes the overseeing of continuous glucose monitoring (CGM), insulin-dosing
support, and pertinent mental health support. The lack of support alongside
today’s social distancing guidelines has encouraged a host of remote medical
initiatives, many of which aim to provide people with diabetes a comprehensive
virtual solution. While virtual solutions have proved exciting, questions
remain as to whether virtual care, including CGM, provides better outcomes than
Jaeb Center’s Pilot Study
In January 2019, the Jaeb Center’s pilot study assessed
whether CGM could be successfully introduced outside of a clinic over a
three-month period. The results found participants using CGM received
personalized support, enabling them to improve their glycemic outcomes and
quality of life. While the study proved invaluable, there was a need for a
larger study that truly evaluates the efficacy of remote diabetes care, which
will be accomplished within the scope of this new grant from the Helmsley
Charitable Trust to the Jaeb Center.
New Study Explores the Efficacy of Virtual Diabetes Care
The new study represents a more rigorous model for analyzing
virtual diabetes management, because it will evaluate CGM use over time,
glycemic- and participant-reported outcomes, healthcare utilization and cost,
the use of decision support tools, and the impact of mental health support.
Jaeb will evaluate the efficacy of a virtual specialty
clinic model for improving clinical and psycho-social outcomes for people with
diabetes. This evaluation will include 300 patients who don’t currently utilize
CGM, with type 1 and type 2 diabetes nationwide over the course of a six-month
period. To integrate the virtual management of insulin dosage, the initiative
will utilize the DreaMed Advisor Platform, which gives providers a way to view
and manage recommendations.
For the first time, DreaMed Advisor’s state-of-the-art
cloud-based technology will provide, in this study, personalized
recommendations on insulin dosage for people with type 1 or type 2 diabetes
treated with insulin pumps or multiple daily injections. The investigational
version of DreaMed Advisor will also manage the virtual presentation of
data derived from CGM, glucometers, insulin pumps, and connected insulin
pens. Furthermore, the platform supports virtual communications of new
treatment plans as well as a virtual clinic team, which provides behavioral
health coaching to help participants address certain diabetes-related
“We are thrilled to be involved in Jaeb’s VDiSC study,” says Eran Agmon, Chief Product Officer of DreaMed Diabetes. “Virtual care is the future of medicine, and the technology is ripe for deployment in diabetes. We are confident in the model and proud that our technology is providing the support necessary to enable its implementation”
– Salesforce and CVS Health announced
a strategic relationship to help organizations, including employers and
universities, return critical populations to the workplace or campus. With this
new joint offering, which combines Salesforce Work.com capabilities
with CVS Health’s Return Ready, worksite and campus
locations will be able to provide complementary services for wellness
assessments, COVID-19 testing and manual contact tracing for their personnel.
– Building on each company’s respective leadership in developing solutions to help address the global pandemic, Salesforce, and CVS Health are strengthening their respective return to worksite and campus capabilities by joining forces to address a critical marketplace need.
announced a strategic relationship with CVS
Health that will allow customers to use each company’s COVID-19 return to
work and campus solutions together, as they transition employees and students
back to worksite and campus locations. The offering will enable customers to
use Salesforce Work.com workplace management capabilities, including wellness
monitoring and manual contact tracing solutions, informed by CVS Health’s
Return Ready, a flexible COVID-19 testing solution, to support comprehensive
reopening strategies for customers and their stakeholders.
Joint Effort to Help
Customers Reopen Safely
launched separate solutions to help organizations strengthen their response to
COVID-19. Salesforce created Work.com, a suite of applications and advisory
resources, to help businesses reopen their workplaces while prioritizing the
health of their stakeholders. CVS Health launched Return Ready, providing organizations with the flexibility
of choosing from multiple COVID-19 testing options—from testing with licensed
professionals onsite at the workplace to testing at one of the more than 1,800
CVS Pharmacy COVID-19 drive-thru testing locations.
“While COVID-19 testing is an important tool to responsibly reopen worksite and campus locations, a comprehensive strategy requires wellness monitoring and contact tracing to help prevent an onsite outbreak and spread of the virus,” said Troyen Brennan, M.D., M.P.H., Chief Medical Officer of CVS Health. “While there are a lot of COVID-19 tools hitting the market, the Work.com capabilities use the latest science and technology, and we believe together, with our Return Ready testing solution and clinical protocols, we can help our customers activate a comprehensive plan to return and maintain critical populations onsite.”
Integrated Complementary Services Enable Integrated Process
Salesforce and CVS Health are providing complimentary return to work and campus solutions through a data and workflow model that can be integrated in one centralized place when enabled by customers using the Work.com Workplace Command Center. Customers that adopt the solutions provided by both companies:
Wellness Monitoring: Salesforce’s survey tool helps organizations monitor and assess their personnel’s health and wellness. When personnel are identified as eligible for testing, they will receive an email with additional information about how and where to complete testing.
COVID-19 Testing: CVS Health’s testing solution, guided by clinical consultation, allows organizations to develop a customized testing strategy by letting those organizations choose who, how and where to test individuals returning to worksite and campus locations; and integrates online test scheduling and testing results notification capabilities for enhanced user experience.
Reporting: COVID-19 test results that are sponsored by an organization will be shared with that organization by CVS Health, with authorization from the patient or patient’s representative, and with alerts for positive results and state and federal reporting of test results as required. Organizations can then view data securely in Salesforce Work.com to manage risk and assess an organization’s current reopening status in three key areas: personnel, spaces and policies.
Contact Tracing: When individuals have a positive test result, Salesforce’s manual contact tracing solution can facilitate notifications to those who may have been exposed and identify possible points of transmission, such as colleagues the individual may have come into contact with. Those exposed are notified and receive an email with additional information about how and where to complete testing, either onsite or at a CVS Pharmacy drive-thru testing location based on the organization’s own testing strategy.
Shift Management: Built directly into Work.com, organizations can monitor facility preparedness and manage shift schedules to determine how to safely adjust or resume business operations. Organizations can better balance workplace coverage and employee availability while creating new capacity models designed to help enable a safe return to work by adjusting office density.
“Testing and manual contact tracing are key factors for organizations to reopen their shared locations and other shared spaces safely,” said Dr. Ashwini Zenooz, Chief Medical Officer at Salesforce. “Together, Salesforce and CVS Health are able to help organizations access solutions and services to help decrease the risks that individuals face as they transition back to their worksite and campus locations.”
In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need to provide healthcare for all in the event of calamity upending the basic functions of a civilized society. With that, the UK’s National Health Service (NHS) was born.
In 2020, all perspectives about quality and the time it takes to see a provider aside, the NHS remains quite popular among UK citizens and is an enduring source of national pride.
With the United States in the midst of its own upheaval, it’s for a related question: Might the current COVID-19 situation give rise to significant changes to the American healthcare system?
Virtually no one thinks the correct answer is ‘No.’ Things will change. The question is how and to what extent. The healthcare system in place in the United States now is dramatically more complex than that in use by Britons after WW II. There are so many moving parts, so many things that can break.
So, in which aspects of the current American healthcare system are we likely to see changes after COVID-19 is dealt with?
Telehealth: Someone always benefits in a catastrophe. In this case, that someone may be Zoom shareholders.
From 10 million daily users in December, Zoom rocketed to 200 million in March and nearly 300 million a month later. Much of that was healthcare related.
Of course, Zoom is not the only direct beneficiary of coronavirus as venerable meeting platforms like WebEx and Skype, among others, have also experienced dramatic growth.
Hospitals and health systems were incrementally implementing telehealth services prior to the coronavirus outbreak, but there was no sense of urgency that accompanies a rapidly spreading virus. Since then, the federal government, states and insurance companies have allocated funds and rewritten regulation to expand the use of telehealth.
But there are more telehealth related-issues to address, some of which have thorns. Service and payment parity across insurance companies is an issue. If telehealth is going to be a regular component of healthcare, technology gaps will have to be addressed, especially in rural areas.
This is something the federal government recognizes. The White House recently drafted an executive order oriented around improving rural health by expanding technology access, developing new payment models and reducing regulatory burdens. The EO tasks the secretaries of health and human services and agriculture to work with the Federal Communications Commission to “develop and implement a strategy to improve rural health by improving the physical and communications healthcare infrastructure available to rural Americans.” But until Congress gets involved and provides funding for something like this, it will probably never get out of the proposal phase.
In fact, there are enough concerns—parity, technology gaps, added costs—associated with telehealth to wonder if it will endure after coronavirus is in the rear view. Enough about telehealth benefits both providers and patients for it to stick and proliferate, but that could also be said about any number of healthcare initiatives that seem to languish for lack of coordination and political will.
Health Insurance: This is where the NHS analogy is the most relevant. Many millions of workers are furloughed or simply laid off with the impact of COVID-19 on frontline jobs like restaurant worker, massage therapist and barista. Those who had insurance through work may not have it anymore, leaving them doubly vulnerable—no coverage, no income—to illness or accident.
Mass unemployment episodes reveal, each time, the weakness in the patchwork employment-based healthcare insurance system we’ve sort of made peace with for decades. Sure, Medicaid exists to fill the gaps, but it may make sense to render Medicaid unnecessary, especially since its value is questionable in particular states.
“You notice the number of band-aids that Congress is having to apply to help people who have lost their jobs,” said former CMS Administrator Don Berwick, MD. “What we have now is a whole series of band-aids and special measures. What if instead, we just had universal health insurance?”
What if, indeed. Will COVID-19 be the straw that burns the bridge of employer-based health insurance, to mangle a metaphor? That may depend on how long the pandemic lasts, who is president sometime after November 3 and how much damage is done to the national fabric before economy and society start a process of repair.
Payment Models: For years now, hospitals have been in the middle of slow shift from fee-for-service care to value-based care and alternative payment models. That transition didn’t happen quickly enough to prevent most hospitals from falling into a financial chasm. If elective procedures are a big part of revenue, it follows that revenue will fall if those procedures disappear.
To be fair, the hit to hospital finances has been catastrophic enough—more than $200 billion in losses over four months, according to the American Hospital Association—that federal government support would have been necessary even if a full pay-for-quality model had been in place.
But the pandemic spotlights the downside of treating essential services like healthcare as though they are mere services one selects or rejects. And it exposes the folly of not making sure everyone has insurance coverage (a payer) when the individual costs for COVID-19-related hospital admission can range from $20,000 to $88,000.
End-of-Life Care: According to one analysis, 42 percent of COVID-19 deaths have occurred in nursing homes or assisted living facilities. The families of those unfortunate souls who’ve died while in a facility have generally endured the agony of saying goodbye outside a window or over a video link. It’s hard to believe, after COVID-19, that the assisted living industry will continue as before.
“The crisis surely will lead nursing home administrators to reconsider the way patients are cared for,” says Modern Healthcare. “Among the ideas Harvard’s [Professor David] Grabowski believes will get a longer look in the wake of the pandemic are using telemedicine services, creating specialized Medicare Advantage plans for the homes and pursuing smaller settings.”
Perhaps. And perhaps a son or daughter that remembers coronavirus will simply choose not to risk everything by putting their parent in a home. Could enough of them make such a decision that the industry contracts? Is forced to take quality care more seriously? Attracts more serious federal regulation?
As the deaths mount, it’s hard not to give every option serious consideration.
Supply Chain: These days we’re bickering in public and on social media (looking at you, maskless Karen throwing food in Trader Joes) about whether or not masks should be mandated. Look back with me to February, however, and you’ll fondly recall concerns about there being enough masks at all.
Back then we learned that the United States had exactly one mask manufacturer, and that all other masks are sourced from overseas. That it takes longer to get stuff from China than from Amarillo creates obvious potential problems when a crisis hits, but it also pits hospitals and government entities against one another and guarantees that the winner will pay more for supplies than they would in less-critical times.
It also creates weird, unnecessary scenarios that could be avoided using coordination and leadership. The governor of Maryland, for example, used his wife’s connections to South Korea (her country of birth) to secure 500,000 coronavirus tests, which he then put in an undisclosed location and protected using national guard troops.
What’s the remedy?
Modern Healthcare has called for a national supply chain czar, which in other times may have just been the head of FEMA. The suggestion, however, highlights the need for a coordinated central clearing house where supplies can be ordered, managed and dispersed based on need.
Individual hospitals, clinics and health systems can also help themselves by using a robust supply chain software system that keeps track in real time of available supplies, covers all ordering systems and methodologies, and reacts swiftly to certain thresholds.
The uniquely unfortunate aspect of the American political system among western democracies is that, for the most part, it responds to the demands of special interests. Think about your local representative. Chances are good the shouts of specific business interests are ringing in his or her hears so loudly that little else is audible.
As such, there is a significant danger that the American healthcare system will return, post-COVID-19, to the same dynamic it had when the virus arrived, which will be unfortunate. What we need post-pandemic is not necessarily specific changes to hospitals, clinics, insurance companies, etc., though they could be part of an overall solution. What will be necessary is an examination of where every aspect of the healthcare system overall, inasmuch as there is one, didn’t do its job.
Disasters are social sodium pentothal that, while active, force groups of people to take an honest look at their failures. Once the disaster is passed, however, there is a danger that Upton Sinclair’s maxim—“It is difficult to get a man to understand something when his salary depends upon his not understanding it”—will rule the day.
No one hopes for more dramatic damage to the American economy and social fabric, but the irony is that necessary change sometimes only comes when reality is undeniable, as in a shellshocked Britain instituting the NHS. If COVID-19 doesn’t shock us sufficiently into making substantial changes to the healthcare system, it’s a pretty safe bet the same disaster will occur again.
– Ginger announces $50 Million in Series D funding to expand
access to its on-demand mental healthcare system led by Advance Venture
Partners and Bessemer Venture Partners; joined by Cigna Ventures and existing
– Company has more than tripled revenue over the past year, now brings access to on-demand mental healthcare to millions around the world through 200+ employer clients and leading health plans.
Ginger, a San Francisco, CA-based provider of on-demand
mental healthcare, today announced a $50 million Series D funding round led by
Advance Venture Partners and Bessemer Venture Partners. Additional participants
include Cigna Ventures and existing investors such as Jeff Weiner, Executive
Chairman of LinkedIn, and Kaiser Permanente Ventures. This latest round of
investment brings the company’s total funding to over $120 million.
On-Demand Mental Health Support
Founded in 2011, Ginger’s on-demand mental healthcare system
brings together behavioral health coaches, therapists, and psychiatrists, who
work as a team to deliver personalized care, right through your smartphone. The
Ginger app provides members with access to the support they need within
seconds, 24/7, 365 days a year. Millions of people have access to Ginger
through leading employers, health plans, and its network of partners.
By delivering evidence-based behavioral health coaching,
therapy and psychiatry right from a smartphone, Ginger is the only end-to-end
telemental health provider designed to meet this skyrocketing demand at a
fraction of the cost of traditional care.
Key benefits of Ginger’s on-demand mental health platform
On-demand, anywhere: On average, members in 30
countries around the world can text with a Ginger behavioral health coach
within 44 seconds, 24/7, 365 days per year; first available video appointments
with a therapist or psychiatrist are available on average within 10.5
Measurement-based: The company’s proprietary
collaborative care model has been proven to be more than twice as effective as
standard therapeutic interventions; 70 percent of people using Ginger
experience an improvement in their depression symptoms within 10-14
Loved by members: Ginger members give an average
rating of 4.7 out of 5 stars after each session.
COVID-19 Underscores Record Demand for Mental Health
This announcement comes at a time when the world’s mental
health crisis has reached an all-time high following the onset of the COVID-19
pandemic. According to Ginger’s 2020
Workforce Attitudes Toward Mental Health Report, nearly 70 percent of U.S.
workers believe this is the most stressful period of their careers, including
major events like the September 11 terror attacks, the 2008 Great Recession and
others. Ginger has observed record-high demand for mental health support;
during July 2020, weekly utilization rates were 125% higher for coaching and
265% higher for therapy and psychiatry when compared to pre-COVID-19 averages.
Millions of people have access to Ginger through the
company’s partnerships with innovative employers, health plans, and strategic
partners. Today, over 200 companies ranging from startups to Fortune 100s,
including Delta Air Lines, Sanofi, Chegg, Domino’s, SurveyMonkey, and Sephora,
partner with Ginger to cost-efficiently provide employees with high-quality
mental healthcare. Ginger members can also access virtual therapy and
psychiatry sessions as an in-network benefit through the company’s
relationships with leading regional and national health plans, including Optum
Behavioral Health, Anthem California, and Aetna Resources for Living.
The company recently announced the formation of the Ginger Advisory Board, bringing together world-renowned experts from MIT, Massachusetts General Hospital, and the University of Washington to advance mental health research and innovation.
“Our mental healthcare system has long been inadequate. But in the midst of a worldwide pandemic and a tumultuous sociopolitical climate, we’re facing uncharted territory,” said Russell Glass, CEO, Ginger, “People are demanding better care, and the largest payers of healthcare are recognizing the need to respond. Ginger is uniquely able to reverse the course of this crisis at scale. With this investment, we can accelerate our work to deliver incredible mental healthcare at a fraction of the cost to the hundreds of millions of people around the world who deserve it.”
COVID-19 models are being used every day to predict the course and short- and long-term impacts of the pandemic. And we’ll be using these COVID-19 models for months to come. While many of us in healthcare are not epidemiologists or data scientists, we’re all sifting through the data to get a handle on how many people are going to get sick, how many will end up in the hospital or on a ventilator, and ultimately, how many people will die.
Government agencies are using models to set public policy, such as social distancing or shelter-in-place mandates, but confusion sets in because the various models often disagree. To understand the inherent disagreement in models, you must look at what goes into their development. Having this information will help you determine the best way to use and interpret predictive COVID-19 models.
Building a Model
For most of us, the process behind developing a model seems a little bit like the Wizard of Oz. It’s hard to pull back the curtain on the underlying details to understand how they work together to generate the ultimate output: predicting the future.
To appreciate the power of a model’s predictions, it’s important to start with the inputs. Model-building is an iterative (and non-linear) process with five basic steps:
1. Problem identification A critical part of the process is identifying what you are trying to solve, which in turn will help you identify the data needed for the model and narrow the types of models to test.
2. Data acquisition and cleaning This step consumes a significant portion of the time it takes to build a model. It is incredibly important to ensure the data is clean and accurate. Bad data produces bad models and ultimately leads to poor decision-making: garbage in, garbage out. (You also may need to return to data acquisition and cleaning multiple times throughout the model-building lifecycle.)
3. Model selection When selecting test models, you’ll need to select the features (input variables) to help the model predict the target variable (model output). In the COVID-19 models, examples of features and target variables include:
– Percent of social distancing observed by the population – Population density of location – Date of first case of COVID-19 detected – Percent of patients classified as high risk
Number of positive COVID-19 cases
Number of patients who end up in ICU
Number of patients who need a ventilator
Number of deaths
4. Model fitting Use of different features, models and parameters for the same model, or even different data sources for the same target variables, will significantly impact the prediction.
5. Model validation In building the model, you must thoroughly investigate data sources, methodologies used and assumptions made before accepting any predictions as reality.
How Certain is Certain?
It’s difficult to be certain about the outcomes derived through a predictive model because of the model’s inherent uncertainty.
Outputs are sometimes deemed to be facts, rather than the probability-driven predictions they really are. As statistician George Box famously said, “All models are wrong, but some are useful.” When a COVID-19 model predicts 120,000 US deaths, many people:
Accept that with a degree of certainty, such as “This is what will happen”; and
Apply a level of exactness to it, such as “Exactly120,000 people will die,” despite the range of probabilities.
Ultimately, when using COVID-19 models to drive policy and to inform operational, financial or clinical decisions, proceed with caution and be sure to look beyond the graphs to the underlying assumptions and supporting data, including the potential for bias. You may find for yourself and your organization that the best option is to use your data and train the models yourself to ensure you understand its mechanics. Make yourself the Wizard of Oz.
You can find examples of COVID-19 models and predictions in the links below. As noted at the Centers for Disease Control and Prevention website, “It is important to bring these forecasts together to help understand how they compare with each other and how much uncertainty there is about what may happen in the upcoming four weeks.”
About Kim Babberl
Kim Babberl is the Product Consulting Group Director at MedeAnalytics. Before joining MedeAnalytics, she spent 11 years as a business analyst lead with a Blues system, and 10 years in public accounting, various healthcare consulting, auditing and analysis roles, supporting providers and payers.
Additional information about COVID-19 models can be found at:
– Cerner announced a new offering, CommunityWorks
Foundations aimed at reducing costs and speeding up the implementation process
for Rural and Critical Access Hospitals.
– This much-needed offering caters to small rural healthcare providers, who often face challenges such as geographic isolation, workforce shortages, educational disparities, and diminishing resources that can make it harder to deliver high-quality care.
– Rural hospitals serve about 20% of all Americans, and
Cerner is committed to providing technology and services to help individuals in
all communities get access to quality comprehensive healthcare.
today announced a new tailored cloud-based technology offering, CommunityWorks Foundations, created to help
Critical Access Hospitals across the U.S. reduce financial burdens. This new
technology, geared toward smaller and rural hospitals, offers a fixed-fee
payment structure with no up-front capital spend to help reduce costs and
lengthy implementation processes.
Rapid Cloud-based Deployment
CommunityWorks Foundations, a cloud-based
version of the Cerner Millennium® electronic health record
(EHR), is designed to expedite implementation with a six-month kick-off to
go-live timeline and will make it easier for small hospitals to better serve their
As with all hospitals deploying CommunityWorks, those using CommunityWorks Foundations will also leverage Cerner’s solutions and services designed to help improve clinical and business outcomes, the patient and provider experience and satisfaction while reducing physician burnout. CommunityWorks clients have seen success, with more than 70% of new clients beating baseline accounts receivable by 180 days post-implementation. These hospitals averaged a 5.5% improvement in this area.
Why It Matters
Healthcare providers in small communities often face challenges such as geographic isolation, workforce shortages, educational disparities, and diminishing resources that can make it harder to deliver high-quality care. The National Rural Health Association found COVID-19 has exacerbated these trends, with significant financial impact on these specialty hospitals – half of which were operating at a financial loss prior to the pandemic. Rural hospitals serve about 20% of all Americans, and Cerner is committed to providing technology and services to help individuals in all communities get access to quality comprehensive health care.
“Working with this segment of clients for more than a decade, we have evolved this cloud-based model to meet the various challenges community and rural health care organizations face,” said Mitchell Clark, president, CommunityWorks, Cerner. “CommunityWorks Foundations is the next evolution based on what we’ve learned from our more than 200 rural and critical access clients and the broader industry. It is built to help reduce financial barriers and better support communities that sometimes face challenges accessing the most innovative health care technology.”
With the successful early adoption of CommunityWorks Foundations
at organizations like Macon
Community Hospital, Cerner continues to demonstrate value to clients.
Johnson County Hospital (JCH), an 18-bed Critical Access Hospital with two
clinics located in southeast Nebraska, recently signed for CommunityWorks Foundations.
Hospital leaders cite cost, ease of implementation and vendor support as top
drivers behind the switch to Cerner.
“The numbers don’t lie,” is a famous old adage and quite appropriate with regard to the rapid rise and deployment of telehealth solutions in the medical community. It may have taken a global pandemic for society to recognize and investigate the rewards of its adoption, but statistics reveal that telehealth’s moment has indeed come. And it certainly seems like it’s here to stay.
How did we come so far, so fast? By undertaking forward-thinking policies and bold action, the health care industry nimbly and quickly adopted this technology to mitigate the immediate threat of COVID-19’s lethal contagiousness.
As it pertains to effectiveness, the federal government’s overwhelming response to shore up commerce, industry, and unforeseen unemployment levels has been met with mixed reviews. But the designated programs specific to the healthcare industry have been an undeniable success. Thanks to a sudden and massive infusion of funding and support for telehealth medicine, initiated by federal and state governments, the health care industry is witnessing a historic sea-change in its processes, procedures, and practices. The widespread, rapid adoption of telehealth solutions is the prime example.
Beyond the impact of funding, now in the hundreds of millions of dollars, the utilization of telehealth also benefited from additional measures which simultaneously boosted its appeal for trial and adoption. For the first time, health care providers were permitted to use telehealth to treat Medicare patients, opening the door for insurance companies and state governments to follow suit.
Subsequently, many of the nation’s largest private insurance providers then took it a step further—waiving copays for patient consultations via telehealth. For both the insured and uninsured, the elimination of out-of-pocket costs is likely to increase consumer trial and adoption of virtual physician visits. The bold and swift decisions to relax certain restrictions and requirements within the traditional health care model has created fertile ground for telehealth’s trial and adoption.
The use of telehealth as a practical solution has been available for some time, but its adoption by consumers faced difficulty, as many perceived virtual visits would not measure up to the value of in-person doctor appointments. But recent research and surveys on telehealth’s usage reveal this barrier may be crumbling. In April, Sage Growth Partner (SGP) and Black Book Market Research collaborated on a survey revealing that, prior to COVID-19, only a quarter of respondents had used telehealth. But amidst the backdrop of our current pandemic, nearly 60% of those surveyed say they are now likely to consider telehealth in addressing their personal health care needs. Additionally, other studies have concluded that after an initial trial of telehealth, a majority of consumers expressed high levels of satisfaction with their experience—and a strong likelihood of follow-up use.
Yet only viewing the benefits of telehealth through the narrow lens of a physician-patient consultation is to overlook its full value proposition across the health care industry as a whole. What are some other examples of how telehealth is changing the health care landscape for the better? Here are a few ways in which its adoption and use are improving our models of caregiving:
Protecting our Collective Health
Amidst the COVID-19 pandemic, an obvious benefit is the option to seek care remotely while maintaining isolation through the practice of social distancing. There are no crowded waiting rooms or hospital hallways to deal with, thereby lessening the risk of exposure and infection to patients and caregivers alike.
Meeting the Caregiver Demand
In some areas of the U.S., a steep demand for health advisors has spiked, due to postponement of elective surgeries and the need for ongoing treatment of patients with chronic health care conditions. Pack Health, Birmingham, Al. chronic care coaching provider utilizes certified Health Advisors to help patients get access to care options while helping them develop self-management skills to gradually improve their conditions. With a surge of over 50,000 new patients, the company rapidly transformed its onboard training program to a telehealth platform to meet the demand for new hires. In doing so, Pack Health was able to scale up staffing much faster and cheaper than ever before.
Impact on Rural Health Care
According to the consultants at Guidehouse, one in four rural hospitals are deemed high-risk for closing—and this was reported before the pandemic. Through the use of telehealth platforms, a large portion of the rural United States can now receive access to clinical care services and at-home monitoring services. In effect, telehealth can become a new tool to help alleviate rural America’s serious deficit of accessing critical care.
Impact on Mental Health Care
The rise in telehealth adoption is also having a positive effect for patients who require access to mental health services. Even before the pandemic, many people with various mental health needs chose not to seek treatment due to perceived social stigmas. Using telehealth as a solution, they can now obtain access to providers, care, therapy, and treatment in the privacy of their homes. Likewise, those patients already under the care of mental health professionals are able to keep routine appointments, in spite of COVID-19’s disruption.
As for telehealth’s future, it is certain to benefit in multiple ways from its current trial by fire. Perhaps there is no better proving ground for assessing its total value proposition than during a global health crisis that shows no sign of relenting. Being at the right place at the right time can be an invaluable proving ground and the future of the telehealth industry appears to be positioned for staggering growth. In April, Global Market Insights, market research, and consulting company released a report predicting the telemedicine market will reach $175.5B by the year 2026.
Furthermore, healthcare providers need to think of telehealth as only one component of comprehensive care. Patients need to have several different touchpoints throughout the healthcare continuum to ensure the best quality of care. Examples of these touchpoints include advanced biometric wearables, real-time data collection, and advanced analytics to provide actionable data for patients and care teams.
As technology continues to drive the rapid pace of improvements in digitalization, platforms, high-speed broadband access, and mobile devices, the widespread adoption of telehealth and telemedicine solutions will become even more commonplace. As a result, the ever-increasing capacity to improve our traditional health care delivery models may indeed be forever changed for the better.
About Ernie Ianace
Ernie Ianace is the Executive Vice President of Sales and Marketing at VitalTech® Affiliates, LLC. Based in Plano, TX, VitalTech is a rapidly growing provider of fully integrated digital health solutions and smart biomedical wearables that provide real-time monitoring for patient wellness and safety. The company’s connected care platform, VitalCare®, enables health systems, skilled nursing facilities, home health providers, physicians, and senior living facilities to streamline workflows while improving health outcomes, increasing patient safety, and lowering the cost of care.
Prior to the outbreak of COVID-19, the healthcare industry in the United States was in the midst of an intense refocusing on patient-centered care. This evolution was defined by a number of innovations, policies, and even federal reimbursement programs that prioritized emphasis on and impact on the patient experience. It led to changes in everything from the quality of hospital food, valet parking, and room amenities to fundamentally reimagined standards of care for even mundane procedures like blood draws.
The rapid spread of coronavirus and the consequences of the resulting pandemic on health systems around the country are significantly reframing this dynamic. An all-in focus on treating COVID-19 patients sidelined elective procedures, routine care, and caused many patients to avoid or defer timely treatment for conditions like heart attacks and strokes. The result is that our country’s health system is just now emerging from “on pause” with truncated timelines and “build the plane as you fly it” mentalities for how to restart and even contemplate a new abnormal.
As we peer ahead to imagine what the future might look like, it’s clear that patient experience as we knew it just earlier this year will cease to exist. Instead, it will be replaced by the dual and interrelated realities of patient and practitioner demands. These two groups harbor pandemic-driven negative perceptions, fears, and concerns about our healthcare infrastructure that have the potential to impair the practice of even the most basic medical care.
Routine Care Avoidance
These fears from a patient perspective were brought home to me twice in the past few weeks. Since I was diagnosed with Crohn’s disease as a teenager some 30-years ago, I have had regular visits with my physician. Normally, I am a “people person” who prefers face-to-face interactions with those in my personal and professional lives. But last month, I conducted my first-ever telehealth appointment for a routine check-up because I refused to set foot in a hospital.
It simply makes sense to handle the routine at a remove – why expose me and my subpar immune system unnecessarily? I was pleasantly surprised by the experience itself. At a time when we’re all meeting over Zoom, having my regular check-up “at a distance” felt natural and informative – and it was just about the only way I’d ever consider engaging with the hospital…at least for now.
Amidst this all, my three-year-old terrified my wife and me when he developed a 105-degree fever. We are no strangers to childhood fevers, but this was a frightening scenario made all the more so because of the growing prevalence of COVID-19 at the time. After much consultation, handwringing, and debate, we decided to treat him at home instead of risk exposure in the hospital.
I’m relieved to say that everything turned out fine and it was a short-lived spike, but it’s a telling insight into the mindset of patients today – including those of us who work in the healthcare industry. Even a minor fever normally sends most parents rushing to their child’s doctor’s office or emergency room. To incorrectly assume that a hospital was a greater risk to my child then self-treating a 105-degree fever speaks to the irrational fear and misinformed decision-making this pandemic has fostered and its power to keep us all out of the healthcare system.
Practitioner Skepticism and Resentment
This same basic risk-reward computation will also surely play out for our healthcare workers. We’ve already seen nurses and physicians critique their employers for what they feel is inadequate protection or faulty leadership and priorities during this outbreak. While many have remained on the job out of a sense of duty to their patients, the growing doubt and resentment will certainly linger long after the pandemic has (hopefully) subsided.
As we learn to live with the virus and we begin to see electives and routine care once again allowed, it’s easy to envision a range of workers from transport and cafeteria staff to nurses and aides deciding to stay away from the job until they feel reasonable expectations about safety, prevention, and compensation are being met. And the number of clinicians and healthcare staffers who will either retire or seek employment in alternative industries, could, unfortunately, become significant.
Planning for the Hospital of Tomorrow
Health system leaders must begin planning now for this new reality. Conversations have certainly already begun about the hospital of the future and what changes lie in store for standards of care, physical infrastructure and layout, budgets, workplace safety, and practitioner well-being, and innovation paths.
But, top-down decisions based on historical trends or projections absent real input from patients and practitioners at this moment will lead to a long-term undermining of confidence in the system. There is simply no modern precedent for this sudden and dramatic shift in expectations, and Patient Advisory Councils alone won’t cut it.
The reality is that the lists of “nice to haves” and “need to have” for patients and practitioners will become increasingly polarized, with the latter defining the table stakes they will require before returning to the hospital. These demands will then become the financial lens through which health systems and leaders must make future decisions about standards of care, innovations, and investments.
If they have not already, providers will soon realize they are no longer in the driver’s seat when it comes to care decisions and that employee and consumer trust in them has been severely compromised. They must begin to take strong and decisive action to meet patient and practitioner demands or people will not walk back through their doors. Over the coming months, no decision about a hospital or its operation will be made without first asking how it not only satisfies patient and practitioner demands but also reassures and delights both stakeholders.
So how must health systems think about and plan for this eventuality?
Protection & Safety
Outbreaks of antibiotic-resistant bugs or Ebola have always made patients and even practitioners queasy about entering the hospital, but these were often short-lived episodes. Now, health leaders must double down on promises to keep patients and practitioners safe in the face of an invisible but persistent virus that has changed our trust in the system.
This response could take the form of deliberate decisions on hospital infrastructure and layout, bringing changes to the very physical plant that supports our medical care. The concept of “social design” looks at how everything within a hospital’s walls contributes to the level and quality of care it can deliver. From the placement of beds to ventilation systems to the flow of staff into and out of a nursing station, leaders must revisit these basic assumptions post-COVID. And a new onus exists for administrators to communicate these decisions and capabilities to patients and potential patients in their encachment area.
Systems will also likely maintain existing social distancing guidelines, perhaps even taking them a step further with wayfinding in the halls and waiting rooms using explicit signage and direction. Enforcement of these protocols will be essential. And of course, systems must stock and deploy adequate stores of PPE…easier said than done.
New infection standards will also emerge. Consider the fast boil of Kinnos, an upstart founded amidst the Ebola crisis with a new technology that enforces real-time quality control and compliance every single time a surface is disinfected.
We have already seen the dramatic remaking of care in the midst of COVID-19. The boon in telehealth is just one example that will certainly continue to grow and expand. But there will certainly be more changes on the horizon, perhaps new robotic technologies for arms-length treatment protocols and remote or personal health monitoring from home, as a result of this outbreak. But it will all be focused on transforming how patients and practitioners engage with health systems across the country – while both reassuring and delighting.
Finally, recent events remind us that we are all members of the community, and hospitals have an integral seat at the table as facilitators of population health. Systems and leadership cannot rely on philanthropy and good corporate citizenship, they must actively engage on the issues that matter most to their staff and patients – as these stakeholders are members of the extended community.
From food drives to financial education to emerging health policies, hospitals must become more deeply entrenched alongside those in their communities. The early and immediate signs are promising, as our hospitals are our extended homes. I’m cautiously optimistic, and appreciative of all that our caregivers and administrators are doing to keep us healthy.
About Eric Stone
Eric M. Stone is the Co-Founder and Chief Executive Officer at Velano Vascular. A patient advocate and serial healthcare entrepreneur, Stone is a National Trustee of the Crohn’s and Colitis Foundation. Prior to Velano, he served as the Vice President of Sales and Marketing of Molecular Health, and earlier in his career launched a series of pioneering conventional cardiology devices for Abbott while based in Brussels, Belgium, and California.
Stone was a founding member of Model N’s Life marketing with Trilogy Software and has since co-founded social sector programs at Harvard and Wharton. He served for a decade on Harvard University’s Alumni Association (HAA) Board of Directors and is a past and current Director and Advisor to multiple healthcare upstarts. Stone received an MBA from The Wharton School, a Master’s from Harvard University, and a BA from the University of Pennsylvania.
– Wake Forest Baptist Health will establish a hospital drone delivery network to carry patient-specific time- and temperature-sensitive medicines and PPE for medical professionals treating COVID-19.
– In partnership with Matternet and UPSFF today started
operating on two routes from one location at Wake Forest Baptist Health to two
other health system locations, marking one of the first hub-and-spoke operating
models for the U.S. drone delivery industry.
Wake Forest Baptist
Health and Matternet, a developer of the
world’s leading urban drone
logistics platform announced the launch of a new hospital delivery network with
Matternet’s M2 drone system. In collaboration with UPS Flight Forward (UPSFF), the
service will use a hub-and-spoke routing model to provide rapid delivery of
time-and temperature-sensitive medicines and supplies, including PPE for
medical professionals treating COVID-19
Drone Hospital Delivery Network
Matternet and UPSFF today started operating on two routes from one location at Wake Forest Baptist Health to two other health system locations, marking one of the first hub-and-spoke operating models for the U.S. drone delivery industry. One route will transport scheduled deliveries of specialty infusion medicines. These medicines are patient-specific, high-cost, and have a short shelf-life, making delivery by drone within minutes an ideal solution. The second route will transport on-demand supplies of personal protective equipment (PPE), such as surgical masks for medical professionals in their fight against COVID-19.
Integrating Automated Drone Delivery with Hospital Labs
& Pharmacy Operations
The Matternet Station, a beautifully designed architectural
structure, occupies a small footprint and can be installed at ground or rooftop
locations. At around 10 feet (3 meters) tall, it keeps the vehicles high enough
off the ground to not compromise safety if installed in a public area. The
Station is equipped with technology that guides the Matternet M2 Drone to
precision landing on the Station’s platform. After landing, the Station locks
the drone in place and automatically swaps its battery and payload. When the
drone is not in use, it’s parked in a hangar on top of the Station.
The Station gives hospitals and their supply partners the ability to integrate automated drone delivery into their laboratory and pharmacy operations. Hospitals can now move blood diagnostics, pathology specimens, and medicine between their facilities and suppliers with secure, extremely fast, and predictable aerial delivery.
The Station uses an integrated authentication system to
allow only authorized personnel to deposit or retrieve a payload by scanning
their hospital ID badge. Payloads are tracked at every touchpoint to maintain a
strong chain of custody. In its standard configuration, the Station holds four
payload boxes, which are kept at a controlled temperature to ensure specimen
Why It Matters
“Increasing efficiency of our supply chain routes helps provide better service to our patients and their families,” said Conrad Emmerich, chief supply chain officer at Wake Forest Baptist Health. “Partnering with UPS Flight Forward through our iQ Healthtech Labs opens new doors for us to do just that through drone delivery.”
“Now more than ever it’s important for hospitals to have reliable, predictable and efficient methods for transporting critical medicines and time-sensitive lab samples that need results quickly,” said Andreas Raptopoulos, CEO of Matternet. “We are thrilled to expand our partnership with UPSFF to other U.S. hospitals and work with Wake Forest Baptist to implement our drone logistics network that will help transform their operations and patient care.”
Matternet’s Previous Experience in Drone Delivery for
Matternet has been operating in the U.S. since August 2018. In partnership with UPSFF, the companies initiated the first ongoing revenue-generating drone delivery service at WakeMed’s flagship hospital and the campus in Raleigh, N.C. in 2019. Since then, more than 1,850 deliveries (3,700 flights) of lab samples have been completed. The new service at Wake Forest Baptist Health, as well as WakeMed, are part of the North Carolina Department of Transportation’s participation in the FAA’s Integration Pilot Program (IPP).
Matternet’s technology is also enabling UPSFF to provide
drone delivery service of prescription medicines for a retirement community in
Florida. The service provides an option for seniors at higher risk for the
Coronavirus infection to receive prescriptions without going to a store.
– Medly Pharmacy raises $100M investment co-led by
Volition Capital and Greycroft to propel Medly’s leadership in the $500B+
digital on-demand pharmacy market.
– Medly will use the funding to expand its digital on-demand pharmacy platform, enter new markets, and provide category-leading services to patients and partners across the country that is well-positioned to meet new customer needs.
Founded in 2017 by second-generation pharmacy owners Marg
and Sahaj Patel, Medly Pharmacy is a full-service, digital pharmacy under
parent company Medly Health that offers free same-day prescription delivery.
Combining dedicated customer service with two generations of pharmacy
expertise, Medly works with providers and patients to personalize every aspect
of the care journey.
No-Cost Prescription Delivery Model
Medly provides no-cost prescription delivery to customers’
homes from its branded physical retail locations, which also accommodate
walk-in patients. Medly maximizes convenience and personalized service,
enabling customers to schedule their own delivery window, consult with
pharmacists, and manage their prescriptions directly from a desktop or mobile
Medly has quickly grown into a category-leading digital
pharmacy known for continuously innovating and setting the leading edge of the
fast-growing $500B digital pharmacy segment. Medly has invested heavily in
customer experience as well as the underlying pharmacy technology that creates
value for stakeholders across the entire healthcare ecosystem. Since its
inception, Medly has grown 100X in revenue, added 15,000 providers, 50,000
patients, and delivered over 500,000 prescriptions. The company has a net
promoter score of 87, which is 4.5 times greater than the average pharmacy.
With the investment, Medly will continue to expand its
platform, enter new markets, and provide category-leading services to patients
and partners across the country. The company’s hybrid pharmacy model is
well-positioned to meet new customer needs, especially as healthcare technology
and innovation have come directly into focus in response to coronavirus.
“We continue to improve patient care by empowering customers to access prescription drugs on their own terms through a potent combination of physical and digital pharmacy services,” said Marg Patel, CEO and Co-Founder of Medly. “We are excited to continue to build on that vision by opening locations in new markets and forging meaningful, long-lasting relationships with patients, physicians, drug manufacturers, and insurance companies.”
– Emtiro Health, an
innovative population health company in North Carolina has selected Innovaccer
to deliver data-powered solutions to enhance the efficiency and effectiveness
of care delivery.
– Powered by Innovaccer’s FHIR-enabled Data Activation
Platform, Emtiro Health will create unified patient records that drive
comprehensive, whole-person care management, no matter where they are on the
care continuum. The FHIR-enabled Data Activation Platform will also deliver
highly actionable data, automated care management workflows, and smart patient
Emitro Health, a
Winston Salem, NC-based population
health company, today announced a partnership with Innovaccer, a San Francisco, CA-based
healthcare technology to enable the effective delivery of services to the
patients and providers supported by Emtiro Health.
Emitro Health Background
Emtiro Health supports providers, systems, and payers with unparalleled expertise and knowledge augmented by data and analytics. This platform enhances the patient experience and improves outcomes while delivering effective healthcare at a lower cost. Emtiro Health addresses the systemic barriers to total wellbeing and helps patients chart a course to brighter futures. The organization’s experienced team brings diverse backgrounds and skillsets to complement a whole-practice approach from practice optimization and transformation, data analytics, and quality reporting to the integration of services, such as clinical pharmacy and behavioral health.
Data Activation Platform
Powered by Innovaccer’s FHIR-enabled Data Activation Platform, Emtiro Health will create unified patient records that drive comprehensive, whole-person care management, no matter where they are on the care continuum. The FHIR-enabled Data Activation Platform will also deliver highly actionable data, automated care management workflows, and smart patient engagement. Emtiro Health’s provider partners will be equipped with point-of-care insights that surface relevant information for patient health in real-time. The entire suite of solutions will enable Emtiro Health to improve the effectiveness and efficiency of both providers and care, management teams, allowing them to care as one for patients.
Unified Health Record
FHIR-enabled Data Activation Platform helps healthcare organizations obtain a
complete picture through their unified patient record. The data is then
activated for smart analytics and decision support — so, care teams have the
crucial information they need to provide better care and to care as one.
“Emtiro Health selected Innovaccer to provide customized business intelligence and analytics solutions to our partners to revolutionize how the right level of care is delivered to the right patient at the right time. The Innovaccer data platform coupled with Emtiro Health’s expertise in delivering a total population health model of care management is a game-changer for providers and patients alike,” said Kelly Garrison, President and CEO of Emtiro Health. “In practice, this collaboration will mean more informed care, healthier individuals and healthier communities in North Carolina.”
– Allscripts and Microsoft sign a five-year partnership extension to support Allscripts’ cloud-based Sunrise electronic health record and drive co-innovation.
– The alliance will enable Allscripts to harness the power of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams, and Power BI, creating a more seamless and highly productive user experience.
Today Allscripts and Microsoft Corp. announced the
extension of their long-standing strategic alliance to enable the expanded
development and delivery of cloud-based health IT solutions.
The five-year extension will support Allscripts’ cloud-based Sunrise electronic health record
(EHR), making Microsoft the cloud provider for the solution and opening up
co-innovation opportunities to help transform healthcare with smarter, more
scalable technology. The alliance will enable Allscripts to harness the power
of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams
and Power BI, creating a more seamless and highly productive user experience.
Partnership Impact for Cloud-based Sunrise EHR
Sunrise is an integrated EHR that connects all aspects of
care, including acute, ambulatory, surgical, pharmacy, radiology and laboratory
services including an integrated revenue cycle and patient administration
system. Cloud-based Sunrise will offer many added benefits beyond the
on-premise version that will improve organizational effectiveness, solution
interoperability, clinician ease of use and an improved patient experience.
Client benefits include a subscription model delivering faster implementations
and lower annual upgrade costs, helping organizations leverage the software
without increasing burdens on their internal IT resources.
The cloud-based Sunrise solution will provide enhanced
security, scalability and flexibility, as well as the opportunity to add new
capabilities quickly as business needs and the cloud evolve. The cloud-based
solution will also include expanded analytics and insights functionality that
can quickly engage with the Internet of Things. Finally, the cloud-based
Sunrise solution will include a marketplace that enables healthcare apps and
third parties to easily integrate with a hospital EHR. Allscripts clients will
begin to see these updates by the end of 2020.
Why It Matters
“The COVID-19 pandemic will forever change how healthcare is
delivered, and provider organizations around the world must ensure they are
powered by innovative, interoperable, comprehensive and lower-cost IT solutions
that meet the demands of our new normal,” said Allscripts chief executive
officer Paul Black. “Healthcare delivery is no longer defined by location —
providers need to have the capability to reach patients where they are to truly
deliver the care they require. Cloud solutions, mobile options, telehealth
functionality — these are the foundational tools for not just the future of
healthcare, but the present. Collaborating with Microsoft, the leader in the
public cloud sector, we will efficiently deliver the tools caregivers need to
improve the clinical outcomes of their patients and operational performance of
– Philips integrates the BioIntelliSense FDA-cleared
BioSticker™ sensor as part of its remote patient monitoring solutions for
patients outside the hospital.
– Multi-parameter sensors aid monitoring across multiple chronic conditions with medical-grade vital signs for physicians to remotely track core symptoms, including COVID-19.
– Healthcare Highways is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S.
Philips, today announced it has formed a strategic collaboration with BioIntelliSense, a continuous health monitoring, and clinical intelligence company, to integrate its BioSticker™ medical device into Philips’ remote patient monitoring (RPM) offering to help monitor at-risk patients from the hospital into the home. With the addition of multi-parameter sensors, Philips’ solutions can enhance how clinicians monitor patient populations living with chronic conditions – including diabetes, cancer, congestive heart failure and more – in their homes with passive monitoring of key vital signs, physiological biometrics, and symptomatic events via a discreet wearable patch for monitoring up to 30 days.
COVID-19 Pandemic Underscores Need for Remote Patient Monitoring
Remote patient monitoring and telehealth-enabled clinical programs offer care teams a sustainable and scalable way to manage patient populations with chronic or complex conditions at home and plays a key role in supporting care for COVID-19 patients who do not require hospitalization. By regularly transmitting patient data that can provide critical insights into a patient’s condition, the collaboration will empower care teams in the U.S. with a more holistic patient view and the ability to intervene earlier before adverse events occur. With single-use sensors and patient-owned technology supporting remote monitoring, care teams can also help reduce the need for clinicians and patients to interact in person.
“With more patients interacting with their doctors from home and more hospitals developing strategies to virtually engage with their patients, remote patient monitoring is now, more than ever, an essential tool,” said Roy Jakobs, Chief Business Leader Connected Care, member of the Executive Committee at Royal Philips. “Building on Philips’ global leadership in patient monitoring, which includes an extensive suite of advanced monitoring solutions, platforms, and sensors, this is the latest example of our capability to allow more seamless, cloud-based data collection across multiple settings from the home to the hospital and back into the home. Patient data, coupled with our clinically differentiated and leading AI-powered technology, quantifies the data into relevant actionable insights to help detect deterioration trends and support care interventions – all while outside the walls of the hospital.”
Wireless, Secure Data Transfer of Key Vital Signs
BioSticker is a single-use, FDA-cleared 510k class II wearable medical device
to enable at-home continuous passive monitoring with minute level data across a
broad set of vital signs, physiological biometrics and symptomatic events (skin
temperature, resting heart rate, resting respiratory rate, body position,
activity levels, cough frequency) on a single device for thirty-days. Symptoms,
including those directly associated with COVID-19 such as temperature and
respiratory rate, can be remotely monitored in confirmed cases of Coronavirus
and also for those patients not sick enough to be hospitalized, or those
suspected of having COVID-19.
addition to COVID-19, the BioSticker device will help transform the way
clinicians monitor and manage patients living with chronic conditions from the
sensors are the natural next phase for remote monitoring, especially at a time
when more patients are engaging with their physicians from home,” said James
Mault, MD, Founder and Chief Executive Officer of BioIntelliSense. “Clinicians
need medical grade monitoring and algorithmic clinical insights for COVID-19
exposure, symptoms and management. Accelerated by the COVID-19 crisis, the
practice of medicine has been irreversibly enlightened as to the safety and
efficacy of virtual care. Philips is a demonstrated leader in remote patient
monitoring, and we look forward to BioIntelliSense’s technology playing
an integral role in simplifying and enhancing outcomes for patients and their
Healthcare Highways first to leverage BioSticker as a part of
Philips’ RPM solutions
Healthcare Highways, a provider of health plans, high-performance provider networks, pharmacy benefit management, population health management, and benefit plan administration, is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S. Out of the seven programs that will be deployed with Healthcare Highways, one will focus specifically on monitoring patients with COVID-19. The remaining six will focus on conditions across the acuity spectrum, including patients with congestive heart failure, hypertension, diabetes, total joint replacement, cancer and asthma. The program will help Healthcare Highways improve insights to patient health status across its provider network.
“Healthcare Highways was built on the idea of delivering measurable value and access to quality care to our members. We work in partnership with our providers to innovate on the care model, and look at Remote Patient Monitoring as the next frontier of how providers will connect with patients,” said Creagh Milford, DO, MPH, Chief Medical Officer of Healthcare Highways and Chief Executive Officer of HighCare Health. “COVID-19 has underscored the need for proactive care management. Resources are strained and by integrating an RPM program with biosensor technology, we’ll be able to drive further value for our unique member base, providers and employers to establish a new way of care delivery.”
– Doctor On Demand raises $75M in Series D
funding led by General Atlantic to expand comprehensive virtual care.
– Doctor On Demand is seeing record usage
this year – up 139% – for COVID-19 screenings, routine health issues, chronic
conditions and behavioral health.
San Francisco, CA-based Doctor On Demand, today announced it
has raised $75 million in Series D funding led by General Atlantic, a leading
global growth equity firm, with participation from existing investors. The
funds will be used to accelerate Doctor On Demand’s investments in growth and
further expand access to high-quality, comprehensive virtual care for patients
Founded in 2012, Doctor On Demand offers immediate,
video-based access to top physicians and psychologists for just $40 per visit,
with no subscription fees for partners via the iPhone, iPad,Android and
desktop. With over 98 million covered lives and a 4.9/5 patient
satisfaction rating, Doctor On Demand is the preferred
virtual care provider of consumers, health plans and employers. The company’s
unmatched technology platform and clinical model of fully employed providers
gives patients a continuum of care and the ability to build trusted, personal
relationships with their providers.
Following robust growth in 2019, Doctor On Demand
experienced accelerated momentum in the first half of 2020, with the COVID-19
pandemic driving increased demand for the company’s integrated medical and
behavioral health services. The company more than doubled its covered lives in
the past six months, propelling Doctor On Demand to its 3 millionth virtual visit.
In response to the public health emergency, the company mobilized quickly to
roll out its critical virtual medical services to 33 million Medicare Part B
beneficiaries across all 50 states, just weeks after the Centers for Medicare
and Medicaid Services (CMS) expanded coverage to allow for the reimbursement of
telemedicine visits for this high-risk patient population.
While COVID-19 has driven a sharp increase in utilization of
Doctor On Demand’s urgent care and behavioral health services, more than half
of the company’s 2020 future growth is focused on the continued expansion of
its Virtual Primary Care offering. This service enables health plans and
employers to deliver cost-efficient, comprehensive virtual care inclusive of
integrated behavioral health, 24/7 everyday & urgent care, and chronic care
management to their populations while reducing costs.
“In April 2019, Humana and Doctor On Demand launched On
Hand™, a first-of-its-kind health plan that centered on comprehensive virtual
primary care,” said Chris Hunter, Segment President, Group and Military
Business at Humana. “This new plan design represented a paradigm shift in
healthcare, and demonstrated that our members can and will build long-term
relationships with primary care providers and care teams in a virtual-first
“Even before the pandemic, we recognized the importance of
providing integrated, virtual medical and emotional health care for our
associates,” said Adam Stavisky, SVP, US Benefits at Walmart. “Our early
decision to partner with Doctor On Demand helped us respond quickly as the
crisis hit, allowing us to immediately meet the care needs of our associates
and their families where and when they need it.”
– U.S. Department of Veterans Affairs selects Philips to create the world’s largest tele-critical care system, further integrating tele-health and delivering quality care for veterans.
– The ten-year contract, which enables
VA to invest up to $100 million with Philips for
tele-critical care technology and services, leverages Philips history of innovation, including research into
technologies that can better support veterans, telehealth, tele-critical care
(eICU), diagnostic imaging, sleep solutions and patient monitoring.
U.S. Department of Veterans Affairs (VA) has awarded a contract to Philips to expand VA’s tele-critical care program, creating the world’s largest system to provide veterans remote access to intensive care expertise, regardless of their location. The ten-year contract, which enables VA to invest up to $100 million with Philips for tele-critical care technology and services, leverages Philips history of innovation, including research into technologies that can better support veterans, telehealth, tele-critical care (eICU), diagnostic imaging, sleep solutions and patient monitoring.
VA’s Committed Focus to Telehealth for Veterans
the largest integrated healthcare system in the U.S., consisting of more than
1,700 sites and serving nearly nine million veterans each year. It has become a
leader in developing telehealth services in order to improve access to care and
federate care delivery. In fiscal year 2019 alone, VA delivered more than 2.5
million telehealth episodes. Additionally, VA was able to expand video to home
appointments from approximately 10,000 to 120,000 per week between February and
May of 2020 during the COVID-19 pandemic. Overall, the pandemic has increased
the share of Americans participating in telehealth from 11% in 2019 to 46%
today, with healthcare systems reporting a 50 to 175-fold increase in
telehealth volume compared to pre-pandemic levels.
Tele-Critical Care Program
of an overall telehealth
program, eICU enables a co-located team of specially trained critical
care physicians and nurses to remotely monitor patients in the ICU regardless
of patient location. With VA managing 1,800 ICU beds nationwide, eICU not only
gives patients access to specialists, but also helps them deliver on the
Quadruple Aim: optimizing care costs, enhancing clinician and patient
satisfaction and improving outcomes. Research has shown that patients in eICU
settings spend less time in the ICU and have better outcomes. Moreover,
family members can talk to clinicians via integrated audio and video technology
to support decision making.
relationship with Philips will help to expand
and improve our tele-critical care program,” said Robert Wilkie, U.S.
Secretary of Veterans Affairs. “This is particularly critical to provide
Veterans access to quality health care when and where they need it
and for improving their health outcomes.”
date, more than 20% of U.S. adult ICU beds and 1 in 8 adult ICU patients are
monitored by a 24/7 continuous demand model powered by Philips’ eICU Program,
which combines A/V technology, predictive analytics, data visualization and
advanced reporting capabilities [3, 4]. The core of these proven solutions
is Philips eCareManager software, which uses
advanced analytics and AI to synthesize patient data and deliver actionable
insights to support proactive care in coordination with onsite staff.
Today, Philips continues to work closely with the DoD, VA and
academic partners to drive innovations that can better
support care for troops, as well as telehealth technologies that
can bring care closer to home for our nation’s veterans.
“Philips is committed to improving the lives of 3 billion
people a year by 2030 and is working closely with VA to support one of our most
important initiatives: improving the health of our service men and women,” said
Vitor Rocha, Chief Market Leader for Philips North
America. “By connecting advanced telehealth technologies, clinical data, as
well as clinicians, patients and their families, Philips can
help VA make virtual care a reality and deliver quality health care for one of
our most deserving communities: our nation’s veterans.”