The majority of industries have decreased or eliminated their use of the traditional fax machine over the past decade, including aviation, retail, and even finance. While the healthcare industry is at the forefront of disease research and treatment, however, it is still heavily reliant on this aging technology.
Traditional fax has become ubiquitous in healthcare. It worked for health systems for many years, but the overwhelming volume of patient data and paper documents the healthcare industry is now processing makes traditional faxing more challenging. In today’s environment, fax is no longer the most convenient, safe, or secure communications format but it is still an ingrained part of practice workflows. The good news is, there is no need to “axe the fax” in order to improve office communications and alleviate paper overload. By transitioning to electronic fax, healthcare providers can maintain their workflows and the benefits of fax, while incorporating it into their overall virtual communications strategy – further simplifying the business of healthcare.
The Traditional Fax Challenge
The challenge with traditional fax isn’t new. In fact, in 2008 the Obama administration allocated nearly $30 billion to incentivize American hospitals and doctor offices to switch from paper to electronic systems. Since then, the industry has made small steps towards a more digitized system via fax servers and virtual patient communications such as secure text and broadcast messaging. While this solved part of the problem by making documents electronic and streamlining communications, it did not address the issue of inefficiency at its core, as practices are still printing, signing, and scanning paper documents. This inefficiency is causing a bottleneck when it comes to getting information transferred quickly, creates unnecessary costs for practices, and causes a lack of integration between health technologies across our healthcare system.
This fragmented, outdated way of communication is not only inefficient and costly, it also impacts patient privacy and safety. At the onset of the COVID-19 pandemic, one Texas health department received so many test results via fax in one day that it simply couldn’t keep up with the amount of paper being spit out – resulting in hundreds of confidential results being dumped on the floor. In addition, the vast differences between old and new technology being blended together are making it difficult to keep track of patient records, share data between practices or report to the government, and more, including important racial, ethnic and geographic data that the Trump administration required for COVID tests. In addition to these challenges, traditional fax eats up staff time that could instead be spent on patient care.
Addressing Outdated Systems and Driving Transformation
While on the surface the solution seems simple, actually addressing this challenge at its core is not as easy as it seems. Many providers and large health systems face barriers when it comes to implementing this technology, such as:
Compatibility between systems
Fear of competition and/or losing patients to other health systems if e-fax enables patients to easily share data with other physicians
Cost considerations
Regulatory issues around the transfer of data between providers/EHRs through electronic fax
Despite these challenges, the pandemic has highlighted the delayed, disjointed communications that exist within our healthcare system – and underscored the need for practices and health systems to adopt electronic fax technology. For example, a CNBC survey found that due to COVID-19 tests results coming in via fax in such large amounts, almost 40% of Americans had to wait more than three days for their results, which was too late to be clinically meaningful.
It’s time to address this challenge industry-wide. Last year’s MGMA 2020 virtual conference theme, Rise Above, focused on giving providers actionable tools to navigate through the challenges COVID-19 has presented. The importance of virtual care solutions, including communications tools like electronic fax and forms, are unprecedented. Electronic fax technology can help alleviate the bottlenecks and inefficiencies that currently exist in healthcare. These solutions can:
Reduce costs spent on traditional fax hardware, such as paper, ink, toner, etc.
Increase accessibility, allowing providers to view documents via mobile, etc. at their convenience
Improve practice workflow and efficiency, allowing practices to edit, organize, assign and complete patient forms online
Additionally, electronic fax should integrate seamlessly with other patient management solutions that practices are leveraging, such as video chat, SMS text, electronic forms, and a virtual waiting room, ultimately streamlining the entire patient experience.
Healthcare has transformed dramatically this year and will continue to do so — there’s a new expectation of patient care post-COVID. In order to improve patient communications, practice efficiency, system interoperability, and data sharing, practices must adopt an entire virtual care strategy, including electronic fax. Offering telehealth but still communicating via traditional fax will hold your practice back. It’s time for our healthcare system to ditch outdated systems and go completely paperless. This is how we will tap into the true power of the inbox, drive practice profitability and efficiency, and better serve patients.
About Michael Morgan, CEO of Updox With a successful track record in helping organizations use technology to transform the way healthcare is delivered, Mike has more than 25 years of healthcare leadership within software, behavioral health, and HIT organizations. Updox was named to the Inc. 5000 list of fastest-growing companies in America for the past six consecutive years.
– 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
Specialty Pharmacies
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
patients.”
Benefits of On-Site, Integrated Specialty Pharmacies for
Health Systems
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
of hours
– Improve medication adherence rates to over 90 percent, on
average.
Financial details of the acquisition were not disclosed.
– TigerConnect has announced an expansion in their suite
through the acquisition of Critical Alert, a leading provider of
enterprise-grade middleware for hospitals and health systems.
– For the hundreds of thousands of nurses that currently
use TigerConnect, these new capabilities will deliver real-time, contextual
information to their mobile device or desktop to allow them to work smarter,
prioritize responses, and efficiently coordinate care, all within the same
reliable TigerConnect platform they use every day for enterprise messaging.
TigerConnect®,
a care team collaboration solution, today announced the acquisition
of Critical Alert, a Jacksonville,
FL-based leading provider of enterprise-grade middleware for hospitals and
health systems. Critical Alert’s product suite consists of a middleware suite
of products as well as traditional nurse call hardware servicing over 200
hospitals in North America. Financial details of the acquisition were not
disclosed.
Real-Time Care Team Collaboration for Hospitals
Founded in 1983, Cloud-native and mobile-first, Critical
Alert’s middleware solution enables any health system to combine nurse call,
alarm and event management, medical device interoperability, and clinical
workflow analytics. TigerConnect will integrate Critical
Alert’s middleware stack into its platform to power a wide range of alert types
and alarm management enhancements for TigerConnect’s customers. Critical
Alert’s Nurse Call hardware business will continue to operate under its
namesake as a standalone business unit.
When combined with Critical Alert’s middleware, TigerConnect dramatically
enhances the value proposition to nursing, IT leadership, and end-users. This ‘dream
suite’ of capabilities comes at a time when nurse burnout is at a record high
and chronic nurse shortages are severely challenging organizations’ ability to
deliver the best quality care.
“We see the Critical Alert acquisition as highly strategic and
a natural evolution of our already-robust collaboration
platform,” said Brad Brooks, CEO and co-founder of TigerConnect. “For the
hundreds of thousands of nurses that currently use TigerConnect, these new
capabilities will deliver real-time, contextual information to their mobile
device or desktop to allow them to work smarter, prioritize responses, and
efficiently coordinate care, all within the same reliable TigerConnect platform
they use every day for enterprise messaging.”
Post-Acquisition Plans
Joining TigerConnect is Critical Alert CEO John
Elms, who will assume the role as TigerConnect Chief Product Officer,
guiding the integration of the two companies’ technologies and leading the
development of all future product offerings. Wil Lukens, currently VP of Sales
for Critical Alert, will assume the role of General Manager of Critical Alert’s
traditional Nurse Call hardware unit.
“The timing of the deal and the fit of these two companies aligned perfectly,” said John Elms, CEO of Critical Alert. “Two best-in-class, highly complementary solutions coming together to solve some of the chronic challenges—alarm fatigue, response prioritization, resource optimization—that have driven nurse teams to the brink. Together, these unified technologies will make care professionals’ lives easier, not harder, and I couldn’t be more excited to lead the TigerConnect product organization into this next chapter.”
Critical Alert Integration with TigerConnect Plans
TigerConnect’s robust product suite, which includes care
team collaboration (TigerFlow®), on-call scheduling (TigerSchedule®), virtual
care/telemedicine (TigerTouch®), and now virtualized nurse call and
alerts/alarm management (Critical Alert middleware), will help transform
hospitals and healthcare organizations into the real-time health systems of the
future.
Hardware-free Middleware Forms the Foundation
With a shared cloud-native approach, Critical Alert’s
advanced middleware seamlessly fuses TigerConnect’s care team
collaboration with alarm management and event notifications. Deep
enterprise-level integrations with hospital systems enable the centralization
of clinical workflow management and real-time analytics. Integrating these
systems will have a sizable impact on customer organizations’ productivity and
patient care.
Next Generation Nurse Call
Critical Alert’s nurse call solution brings a modern, badly
needed upgrade to legacy systems, extending both their life and feature-set. A
single mobile- or desktop-enabled user-interface brings vital contextual
information about requests while allowing for centralized answering of nurse
call alerts and management of workflows and assignments. These streamlined
workflows reduce noise and clinical interruptions while improving
responsiveness.
Physiological Monitoring – Less Noise, More Signal
The FDA-cleared offering intelligently routes context-rich
alarm notifications from clinical systems to TigerFlow+. An easy-to-use
workflow builder ensures alerts are prioritized accordingly and are routed to
the appropriate caregiver, suppressing unnecessary noise. The filtering,
mobilization, and escalation of alerts pairs with TigerConnect Teams,
allowing for prompt responses in critical situations.
Smart Bed Alarms for Enhanced Patient Safety
Integrations with popular smart bed systems provide remote
monitoring of bed status details, informing nurses whether they should walk or
run to a patient’s room. Staff can review and adjust bed compliance settings
from their mobile device and receive fall prevention notifications if safe-bed
configuration is compromised.
Real-time Location System (RTLS) Measures What Matters
The integration of RTLS with a deployed nurse call
application greatly enhances the data available to clinical leadership. The
combined TigerConnect/Critical Alert offering enables real-time tracking
of staff location (presence) and time spent on tasks, providing deeper insights
into resource planning, workflow effectiveness and ongoing process improvement
initiatives.
Advanced Analytics for Deeper Workflow Insights
A better understanding of patient behavior and workflows
helps reveal areas for optimization that can lead to improved patient care and
staff efficacy. The new combined platform capabilities centralize the
collection and tracking of patient event data and nurse task efficiency,
turning insights into action. Advanced analytics also allow for identifying,
documenting, and benchmarking responsiveness, compliance, resource allocation,
and patient throughput across the health system.
Availability
This new integrated functionality is expected to be
available to TigerConnect customers in Q1 of 2021.
– UnitedHealth Group has reached an agreement to acquire
Change Healthcare in a deal valued at more than $13 billion, marking the first
major acquisition of 2021.
– Change Healthcare will be combined with OptumInsight to
advance a more modern, information, and technology-enabled healthcare platform.
UnitedHealth Group’s
has reached an agreement to acquire
healthcare technology leader Change
Healthcare for more than $13B. As part of the acquisition, Change
Healthcare will be combined with OptumInsight
to provide software and data analytics, technology-enabled services and
research, advisory and revenue cycle management offerings to help make health
care work better for everyone. The acquisition marks one of the largest deals
for UnitedHealth Group as it continues to expand it’s health services under the
Optum division.
Financial Details of Acquisition
UnitedHealth will pay $25.75 a share in cash, the companies said in a joint statement, a 41% premium over Change Healthcare’s closing price Tuesday of $18.24. The $13 billion valuation includes more than $5 billion in debt owed by Change Healthcare. Shares of Change Healthcare were up 31.72% at $24.02 in trading on Wednesday. UnitedHealth shares were up 0.6% at $346.67.
“Together we will help streamline and inform the vital
clinical, administrative and payment processes on which health care providers
and payers depend to serve patients,” said Andrew Witty, President of
UnitedHealth Group and CEO of Optum. “We’re thrilled to welcome Change
Healthcare’s highly skilled team to create a better future for health care.”
Acquisition Impact for Providers and Patients
The combination of OptumInsight and Change Healthcare is expected to simplify services around medical care to improve health outcomes and lower costs
– help clinicians make the most informed and clinically
advanced patient care decisions, more quickly and easily. Change Healthcare
brings widely adopted technology for integrating evidence-based clinical
criteria directly into the clinician’s workflow, while Optum’s clinical
analytics expertise and Individual Health Record can strengthen the evidence
base needed to deliver effective clinical decision support at the point of
care. This can ensure appropriate sites of care and consistently achieve the
best possible health, quality and cost outcomes.
– well-positioned to make health care simpler, more efficient and more effective. A key opportunity is to enhance with insights drawn from billions of claims transactions using Change Healthcare’s intelligent health care network, combined with Optum’s advanced data analytics. This will support significantly faster, more informed and accurate services and processing.
– Change Healthcare’s payment capacities combined with
Optum’s highly automated payment network will simplify financial interactions
among care providers, payers and consumers and accelerate the movement to a
more modern, real-time and transparent payment system. This will ensure
physicians get paid more quickly, accurately and reliably, and provide
consumers the same simplicity and convenience managing their health care
finances they experience with other transactions.
“This opportunity is about advancing connectivity and accelerating innovations and efficiencies essential to a simpler, more intelligent and adaptive health system. We share with Optum a common mission and values and importantly, a sense of urgency to provide our customers and those they serve with the more robust capacities this union makes possible,” said Neil de Crescenzo, President and CEO of Change Healthcare. Upon closing, Mr. de Crescenzo will serve as OptumInsight’s chief executive officer, leading the combined organization.
Electronic medical records (EMRs) are widely expected to serve as a cornerstone technology that drives the delivery of modern patient care.
But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a category of information used differently than traditional clinical knowledge, but the volume of data generated through molecular testing alone also requires informatics and management of a higher magnitude than previously required.
The EMR is designed to reflect a snapshot (or collection of snapshots) in time: clinical summaries, annotated lab and test results, operation notes, etc. These are mostly stored as isolated documents, loosely coupled with the rest of the patient chart. They need to remain available for reference over time, in some instances, so providers can chart and contextualize ongoing trends and chronic conditions. However, these views are anchored in time and represent limited actionable value during clinical decision-making months, years, and decades later.
Genomic information, on the other hand, represents a patient’s life signature. DNA rarely changes over the course of an individual’s lifetime. This means the results from germline testing – a patient’s molecular profile – conducted early in life are relevant, meaningful, and actionable during clinical decision making far into the future. They can also deliver insights exposing heritable proclivities that may be life-changing or life-saving for family members as well.
This recognition in and of itself alerts healthcare leaders that they need to adopt an advanced, more sophisticated strategy for data governance, management, and sharing than the approach traditionally applied to other clinical information systems, such as EMRs.
To be successful, healthcare organizations need an accelerator external to the EMR that is built on a data model unique to the management of molecular knowledge so test results and genomic insights can be used and shared across clinical specialties and care settings, as well as overtime. In addition, the rise of precision medicine requires an agile informatics platform that enables the cross-pollination of genomic data with clinical insights and ever-advancing discoveries in genomic science.
Consider these examples of how EMRs fall short of expectations for optimal use of genomic intelligence:
1. Studies have found that, despite ubiquitous availability of molecular tests, providers consistently fail to identify patients most at risk for heritable diseases. The Journal of the American Medical Informatics Association (JAMIA) recently released research showing that half the women meeting national guidelines for genetic screening are not getting the tests they need to determine their breast and ovarian cancer risk.
The reason? “The full story of a patient’s risk for heritable cancer within their record often does not exist in a single location,” says the JAMIA article. “It is fragmented across entries created by many authors, over many years, in many locations and formats, and commonly from many different institutions in which women have received care over their lifetimes.” In other words, no matter which EMRs they use, health systems routinely miss opportunities to improve care for patients they see. To achieve greater success, providers need tools that exceed EMR functionality and span multiple clinical systems.
2. Shortly after birth, Alexander develops a seizure disorder. The neonatologist orders a germline test to help her arrive at a precise diagnosis and begin targeted treatment. This approach is successful and Alexander thrives. In addition to genomic variants identifying the cause of his seizure disorder, the test results also contain information about other heritable risk factors, including cardiovascular disease.
Decades later, in the 70s, Alexander sees his primary care provider (PCP) with a rapid heartbeat and shortness of breath. After doing routine lab work, the PCP diagnoses congestive heart failure (CHF). If, however, the PCP had access to Alexander’s genomic test results – which remain as relevant and accurate as when he was an infant – the PCP would have noted a variation that indicated the CHF was due to dilated cardiomyopathy, requiring a different treatment regime.
It is vital that health leaders immediately begin to plan an informatics strategy that accommodates genetic and genomic data while empowering providers to leverage these insights at the point of care as they make routine, yet critical, clinical decisions. As they evaluate their approach, they would do well to ask the following questions:
– Which providers in my organization are already ordering genomic tests on their patients? How are test results being stored and managed – and can they be easily shared with and accessed by others in the health system?
– As the volume of genetic and genomic testing accelerates – and it will – how will we manage the volume of data generated? How will we apply consistent governance to the ordering process? How can we ensure results will be consumed as discrete data so our organization can optimize its value now and in the future?
– What steps do we need to take so our precision medicine strategy remains current with changing science? Which informatics tools deliver access to up-to-date knowledge bases and clinical guidelines to ensure optimal medical decisions are made?
The advent of precision medicine represents a new standard of care for healthcare providers from coast to coast. Genetic and genomic information supplies a new data set that can be used to arrive at more accurate diagnoses sooner and more effective treatment faster. This, in turn, supports better outcomes, higher patient (and provider) satisfaction, and competitive differentiation for the health system adopting precision medicine first in its market.
But to capture this value, healthcare leaders must look beyond their legacy EMRs, recognizing that they were not developed nor do they have the capacity to properly handle the upcoming data revolution. Instead, industry innovators are looking for platforms agnostic to individual EMRs and integrated with molecular labs to address the next-generation demands of precision medicine.
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.
– RenalytixAI and DaVita announce a program partnership that
aims to slow kidney disease progression and improve outcomes for the nation’s
estimated 37 million adults with chronic kidney disease (CKD).
– This is the first clinical-grade program that delivers
advanced early-stage prognosis and risk stratification, combined with
actionable care management to the primary care level where the majority of
kidney disease patients are being seen.
– The program will use the KidneyIntelX in vitro
diagnostic platform from RenalytixAI to perform early risk assessment; after
risk stratification, patients identified as intermediate- and high-risk will
receive care management support through DaVita’s integrated kidney care program
RenalytixAI,
a developer of AI-enabled
clinical in vitro diagnostic solutions for kidney disease, and DaVita, the largest provider
of kidney care services in the U.S., today announced a partner program aimed at
slowing disease progression and improving health outcomes for the nation’s
estimated 37 million adults with chronic kidney disease (CKD). The program is
expected to improve patient outcomes and provide meaningful cost reductions for
health care providers and payors by enabling earlier intervention for patients
with early-stage kidney disease (stages 1, 2 and 3) through actionable risk
assessments and end-to-end care management.
The collaboration is expected to launch in three major
markets this year. As the program expands, DaVita and RenalytixAI intend to
pursue risk-sharing arrangements with health care providers and payors to drive
kidney disease patient care innovation, cost efficiencies and improve quality
of life.
Why It Matters
Kidney disease currently affects over 850 million people
globally — 20 times more than cancer. As such, it is a growing concern among
healthcare companies, medical providers and the government, and researchers, who are now investigating its connection to
COVID-19. In July 2019, the Trump administration announced the Advancing American Kidney Health (AAKH) initiative. And,
now organizations, administrations, and companies are calling on the Biden-Harris administration to expand on
that initiative and prioritize kidney disease in the first 100 days.
Early Risk Identification at Core of Innovative Kidney
Care
The program utilizes the KidneyIntelX in vitro diagnostic platform from RenalytixAI, which uses a machine-learning algorithm to assess a combination of biomarkers from a simple blood draw with features from the electronic health record to generate a patient-specific risk score. The initial version of the KidneyIntelX risk score identifies Type 2 diabetic patients with early-stage CKD as low-, intermediate- or high-risk for progressive decline in kidney function or kidney failure. The integrated program may also help reduce kidney disease misclassification, which leaves some higher-risk patients without recommended treatment. The expected outcome of the collaboration will also be used to expand indicated use claims for KidneyIntelX.
After risk stratification, program patients identified as
intermediate- and high-risk will receive care management support through
DaVita’s integrated kidney care program, for which Renalytix will compensate
DaVita in lieu of providing those services itself. DaVita’s integrated kidney
care program is comprised of a coordinated care team, practical digital health
tools, award-winning patient education and other offerings. Focused on the
patient experience, these services are designed to empower patients to be
active in their care, delay disease progression, improve outcomes and lower
costs. DaVita’s team also closely collaborates with the treating nephrologist,
who leads the care team, to create a seamless care experience.
For patients whose kidney disease does progress, earlier
intervention can provide the patient and treating nephrologist more time to
make an informed decision about the treatment option that is best for them,
including pre-emptive transplantation, home dialysis or in-center dialysis. For
those patients who choose to begin dialysis, the extra time increases their
chance for an out-patient dialysis starts, which can help them to avoid
starting dialysis with a costly hospitalization.
“This is the first clinical-grade program that delivers advanced early-stage prognosis and risk stratification, combined with actionable care management right to the primary care level where the majority of kidney disease patients are being seen,” said James McCullough, Renalytix AI Chief Executive Officer. “Making fundamental change in kidney disease health economics and outcomes must begin with providing a clear, actionable understanding of disease progression risk.”
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
Beyond telemedicine
Telemedicine was the finger in the dyke at the beginning of pandemic panic, with healthcare providers grabbing whatever came to hand — encouraged by relaxed HIPAA regulations — to keep the dam from breaking. But as the dust settles, telemedicine is emerging as the commodity that it is, and value-add services are going to be the differentiating factors in an increasingly competitive marketplace. Offerings like remote patient monitoring and asynchronous communication, initially considered as “nice-to-haves,” are becoming standard offerings as healthcare providers see their value for continuous care beyond Covid.
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.
The combination of Teladoc Health and Livongo creates a
global leader in consumer-centered virtual care. The combined company is
positioned to execute quantified opportunities to drive revenue synergies of
$100 million by the end of the second year following the close, reaching $500
million on a run-rate basis by 2025.
Price: $18.5B in value based on each share of Livongo
will be exchanged for 0.5920x shares of Teladoc Health plus cash consideration
of $11.33 for each Livongo share.
Siemens Healthineers Acquires Varian Medical
On August 2nd, Siemens Healthineers acquired
Varian Medical for $16.4B, with the deal expected to close in 2021. Varian is a
global specialist in the field of cancer care, providing solutions especially
in radiation oncology and related software, including technologies such as
artificial intelligence, machine learning and data analysis. In fiscal year 2019,
the company generated $3.2 billion in revenues with an adjusted operating
margin of about 17%. The company currently has about 10,000 employees
worldwide.
Price: $16.4 billion in an all-cash transaction.
Gainwell to Acquire HMS for $3.4B in Cash
Veritas Capital (“Veritas”)-backed Gainwell Technologies (“Gainwell”),
a leading provider of solutions that are vital to the administration and
operations of health and human services programs, today announced that they
have entered into a definitive agreement whereby Gainwell will acquire HMS, a technology, analytics and engagement
solutions provider helping organizations reduce costs and improve health
outcomes.
Price: $3.4 billion in cash.
Philips Acquires Remote Cardiac Monitoring BioTelemetry for $2.8B
Philips acquires BioTelemetry, a U.S. provider of remote
cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion). With $439M in
revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients
remotely; its portfolio includes wearable heart monitors, AI-based data
analytics, and services.
Price: $2.8B ($72 per share), to be paid in cash upon
completion.
Hims & Hers Merges with Oaktree Acquisition Corp to Go Public on NYSE
Telehealth company Hims & Hers and Oaktree Acquisition Corp., a special purpose acquisition company (SPAC) merge to go public on the New York Stock Exchange (NYSE) under the symbol “HIMS.” The merger will enable further investment in growth and new product categories that will accelerate Hims & Hers’ plan to become the digital front door to the healthcare system
Price: The business combination values the combined
company at an enterprise value of approximately $1.6 billion and is expected to
deliver up to $280 million of cash to the combined company through the
contribution of up to $205 million of cash.
SPAC Merges with 2 Telehealth Companies to Form Public
Digital Health Company in $1.35B Deal
Blank check acquisition company GigCapital2 agreed to merge with Cloudbreak Health, LLC, a unified telemedicine and video medical interpretation solutions provider, and UpHealth Holdings, Inc., one of the largest national and international digital healthcare providers to form a combined digital health company.
Price: The merger deal is worth $1.35 billion, including
debt.
WellSky Acquires CarePort Health from Allscripts for
$1.35B
WellSky, global health, and community care technology company, announced today that it has entered into a definitive agreement with Allscripts to acquireCarePort Health (“CarePort”), a Boston, MA-based care coordination software company that connects acute and post-acute providers and payers.
Price: $1.35 billion represents a multiple of greater
than 13 times CarePort’s revenue over the trailing 12 months, and approximately
21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12 months.
Waystar Acquires Medicare RCM Company eSolutions
On September 13th, revenue cycle management
provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue
cycle management, workflow automation, and data analytics tools. The
acquisition creates the first unified healthcare payments platform with both
commercial and government payer connectivity, resulting in greater value for
providers.
Radiology Partners (RP), a radiology practice in the U.S., announced a definitive agreement to acquire MEDNAX Radiology Solutions, a division of MEDNAX, Inc. for an enterprise value of approximately $885 million. The acquisition is expected to add more than 800 radiologists to RP’s existing practice of 1,600 radiologists. MEDNAX Radiology Solutions consists of more than 300 onsite radiologists, who primarily serve patients in Connecticut, Florida, Nevada, Tennessee, and Texas, and more than 500 teleradiologists, who serve patients in all 50 states.
Price: $885M
PointClickCare Acquires Collective Medical
PointClickCare Technologies, a leader in senior care technology with a network of more than 21,000 skilled nursing facilities, senior living communities, and home health agencies, today announced its intent to acquireCollective Medical, a Salt Lake City, a UT-based leading network-enabled platform for real-time cross-continuum care coordination for $650M. Together, PointClickCare and Collective Medical will provide diverse care teams across the continuum of acute, ambulatory, and post-acute care with point-of-care access to deep, real-time patient insights at any stage of a patient’s healthcare journey, enabling better decision making and improved clinical outcomes at a lower cost.
Price: $650M
Teladoc Health Acquires Virtual Care Platform InTouch
Health
Teladoc Health acquires InTouch Health, the leading provider of enterprise telehealth solutions for hospitals and health systems for $600M. The acquisition establishes Teladoc Health as the only virtual care provider covering the full range of acuity – from critical to chronic to everyday care – through a single solution across all sites of care including home, pharmacy, retail, physician office, ambulance, and more.
Price: $600M consisting of approximately $150 million
in cash and $450 million of Teladoc Health common stock.
AMN Healthcare Acquires VRI Provider Stratus Video
AMN Healthcare Services, Inc. acquires Stratus Video, a leading provider of video remote language interpretation services for the healthcare industry. The acquisition will help AMN Healthcare expand in the virtual workforce, patient care arena, and quality medical interpretation services delivered through a secure communications platform.
Price: $475M
CarepathRx Acquires Pharmacy Operations of Chartwell from
UPMC
CarepathRx, a leader in pharmacy and medication management
solutions for vulnerable and chronically ill patients, announced today a
partnership with UPMC’s Chartwell subsidiary that will expand patient access to
innovative specialty pharmacy and home infusion services. Under the $400M
landmark agreement, CarepathRx will acquire the
management services organization responsible for the operational and strategic
management of Chartwell while UPMC becomes a strategic investor in CarepathRx.
Price: $400M
Cerner to Acquire Health Division of Kantar for $375M in
Cash
Cerner announces it will acquire Kantar Health, a leading
data, analytics, and real-world evidence and commercial research consultancy
serving the life science and health care industry.
This acquisition is expected to allow Cerner’s Learning
Health Network client consortium and health systems with more opportunities to
directly engage with life sciences for funded research studies. The acquisition
is expected to close during the first half of 2021.
Price: $375M
Cerner Sells Off Parts of Healthcare IT Business in
Germany and Spain
Cerner sells off parts of healthcare IT business in Germany and Spain to Germany company CompuGroup Medical, reflecting the company-wide transformation focused on improved operating efficiencies, enhanced client focus, a refined growth strategy, and a sharpened approach to portfolio management.
Price: EUR 225 million ($247.5M USD)
CompuGroup Medical Acquires eMDs for $240M
CompuGroup Medical (CGM) acquires eMDs, Inc. (eMDs), a
leading provider of healthcare IT with a focus on doctors’ practices in the US,
reaching an attractive size in the biggest healthcare market worldwide. With
this acquisition, the US subsidiary of CGM significantly broadens its position
and will become the top 4 providers in the market for Ambulatory Information
Systems in the US.
Price: $240M (equal to approx. EUR 203 million)
Change Healthcare Buys Back Pharmacy Network
Change
Healthcarebuys
back pharmacy unit eRx Network
(“eRx”), a leading provider of comprehensive, innovative, and secure
data-driven solutions for pharmacies. eRx generated approximately $67M in
annual revenue for the twelve-month period ended February 29, 2020. The
transaction supports Change Healthcare’s commitment to focus on and invest in
core aspects of the business to fuel long-term growth and advance innovation.
Walmart acquires CareZone, a San Francisco, CA-based smartphone
service for managing chronic health conditions for reportedly $200M. By
working with a network of pharmacy partners, CareZone’s concierge services
assist consumers in getting their prescription medications organized and
delivered to their doorstep, making pharmacies more accessible to individuals
and families who may be homebound or reside in rural locations.
Verisk, a data
analytics provider, announced today that it has acquiredFranco Signor, a Medicare Secondary Payer
(MSP) service provider to America’s largest insurance carriers and employers.
As part of the acquisition, Franco Signor will become part of Verisk’s Claims
Partners business, a leading provider of MSP compliance and other analytic
claim services. Claims Partners and Franco Signor will be combining forces to
provide the single best resource for Medicare compliance.
Price: $160M
Rubicon Technology Partners Acquires Central Logic
Private equity firm Rubicon Technology Partners acquires
Central Logic, a provider of patient orchestration and tools to accelerate
access to care for healthcare organizations. Rubicon will be aggressively driving Central Logic’s
growth with additional cash investments into the business, with a focus
on product innovation, sales expansion, delivery and customer support, and
the pursuit of acquisition opportunities.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Improved Capacity
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
– 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
Lofty Goal
In its guide to “Interoperability in Healthcare,” HIMSS
defines interoperability
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
Consumer
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
year
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.”
Catherine Thomas: Co-Founder and VP, Customer Engagement, careMESH
Peter Tippett MD, PhD: Founder and CEO, careMESH
A recent Advisory Board briefing examined the annual Centers for Medicare & Medicaid Services (CMS) Readmission penalties. Of the 3,080 hospitals CMS evaluated, 83% received a penalty for payments to be made in 2021, based on expected outcomes for a wide variety of treated conditions. While CMS indicated that some of these penalties might be waived or delayed due to the impacts of the Covid pandemic on hospital procedure volumes and revenue, they are indicative of a much larger issue.
For too long, patients discharged from the hospital have been handed a stack of papers to fill prescriptions, seek follow-up care, or take other steps in their journey from treatment to recovery. More recently, the patient is given access to an Electronic Health Record (EHR) portal to view their records, and a care coordinator may call in a few days to check-in. These are positive steps, but is it enough? Although some readmissions cannot be avoided due to unforeseen complications, many are due to missed follow-up visits, poor medication adherence, or inadequate post-discharge care.
Probably because communication with outside providers has never worked reliably, almost all hospitals have interpreted ‘care coordination’ to mean staffing a local team to help patients with a call center-style approach. Wouldn’t it be much better if the hospital could directly engage and enable the Primary Care Physician (PCP) to know the current issues and follow-up directly with their patient?
We believe there is still a real opportunity to hold the patient’s hand and do far more to guide them through to recovery while reducing the friction for the entire patient care team.
Strengthening Care Coordination for a Better Tomorrow
Coordinating and collaborating with primary care, outpatient clinics, mental health professionals, public health, or social services plays a crucial role in mitigating readmissions and other bumps along the road to recovery. Real care coordination requires three related communication capabilities:
1. Notification of the PCP or other physicians and caregivers when events such as ED visits or Hospitalization occur.
2. Easy, searchable, medical record sharing allows the PCP to learn important issues without wading through hundreds of administrative paperwork.
3. Secure Messaging allows both clinicians and office staff to ask the other providers questions, clarify issues, and simplify working together.
There are some significant hurdles to improve the flow of patient data, and industry efforts have long been underway to plug the gaps. EHR vendors, Health Information Exchanges (HIEs), and a myriad of vendors and collaboratives have attempted to tackle these issues. In the past few decades, government compliance efforts have helped drive medical record sharing through the Direct Messaging protocol and CCDAs through Meaningful Use/Promoting Interoperability requirements for “electronic referral loops.” Kudos to the CMS for recognizing that notifications need to improve from hospitals to primary care—this is the key driver behind the latest CMS Final Rule (CMS-9115-F) mandating Admission, Discharge, and Transfer (ADT) Event Notifications. (By March 2021, CMS Conditions of Participation (CoPs) will require most hospitals to make a “reasonable effort” to send electronic event notifications to “all” Primary Care Providers (PCPs) or their practice.)
However, to date, the real world falls far short of these ideals: for a host of technical and implementation reasons, the majority of PCPs still don’t receive digital medical records sent by hospitals, and the required notifications are either far too simple, provide no context or relevant encounter data, rarely include patient demographic and contact information, and almost never include a method for bi-directional communications or messaging.
Delivering What the Recipient Needs
PCPs want what doctors call the “bullet” about their patient’s recent hospitalization. They don’t want pages of minutia, much of it repetitively cut and pasted. They don’t want to scan through dozens or hundreds of pages looking for the important things. They don’t want “CYA” legalistic nonsense. Not to mention, they learn very little from information focused on patient education.
An outside practitioner typically doesn’t have access to the hospital EHR, and when they do, it can be too cumbersome or time-consuming to chase down the important details of a recent visit. But for many patients—especially those with serious health issues—the doctor needs the bullet: key items such as the current medication list, what changed, and why.
Let’s look at an example of a patient with Congestive Heart Failure (CHF), which is a condition assessed in the above-mentioned CMS Readmission penalties. For CHF, the “bullet” might include timely and relevant details such as:
– What triggered the decompensation? Was it a simple thing, such as a salty meal? Or missed medication?
– What was the cardiac Ejection Fraction?
– What were the last few BUN and Creatinine levels and the most recent weight?
– Was this left- or right-sided heart failure?
– What medications and doses were prescribed for the patient?
– Is she tending toward too dry or too wet?
– Has she been postural, dizzy, hypotensive?
Ideally, the PCP would receive a quick, readable page that includes the name of the treating physician at the hospital, as well as 3-4 sentences about key concerns and findings. Having the whole hospital record is not important for 90 percent of patients, but receiving the “bullet” and being able to quickly search or request the records for more details, would be ideal.
Similar issues hold true for administrative staff and care coordinators. No one should play “telephone tag” to get chart information, clarify which patients should be seen quickly, or find demographic information about a discharged patient so they can proactively contact them to schedule follow-up.
Building a Sustainable, Long-Term Solution
Having struggled mightily to build effective communications in the past is no excuse for the often simplistic and manual processes we consider care coordination today.
Let’s use innovative capabilities to get high-quality notifications and transitions of care to all PCPs, not continue with multi-step processes that yield empty, cryptic data. The clinician needs clinically dense, salient summaries of hospital care, with the ability to quickly get answers—as easy as a Google search—for the two or three most important questions, without waiting for a scheduled phone call with the hospitalist. X-Rays, Lab results, EKGs, and other tests should also be available for easy review, not just the report. After all, if the PCP needs to order a new chest x-ray or EKG how can they compare it with the last one if they don’t have access to it?
Clerical staff needs demographic information at their fingertips to “take the baton” and ensure quick and appropriate appointment scheduling. They need to be able to retrieve more information from the sender, ask questions, and never use a telephone. Additionally, both the doctor and the office staff should be able to fire off a short note and get an answer to anyone in the extended care team.
That is proper care coordination. And that is where we hope the industry is collectively headed in 2021.
About Peter Tippett MD, PhD: Founder and CEO, careMESH
Dr. Peter S. Tippett is a physician, scientist, business leader and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
About Catherine Thomas: Co-Founder and VP, Customer Engagement, careMESH
Catherine Thomas is Co-Founder & VP of Customer Engagement for careMESH, and a seasoned marketing executive with extensive experience in healthcare, telecommunications and the Federal Government sectors. As co-founder of careMESH, she brings 20+ years in Strategic Marketing and Planning; Communications & Change Management; Analyst & Media Relations; Channel Strategy & Development; and Staff & Project Leadership.
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.
Exploited Fears
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.
– Philips acquires BioTelemetry, a U.S. provider of
remote cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion).
– With $439M in revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients remotely; its portfolio includes wearable heart monitors, AI-based data analytics, and services.
– BioTelemetry business is expected to deliver double-digit growth and improve its Adjusted EBITA margin to over 20% by 2025; the acquisition will be sales growth and adjusted EBITA margin accretive for Philips in 2021.
Philips, today
announced it has entered in an agreement to acquire BioTelemetry, Inc., a U.S.-based provider
of remote cardiac diagnostics and monitoring for $2.8B ($72 per share), to be
paid in cash upon completion.
USD 72.00 per share, to be paid in cash upon
completion. The board of directors of BioTelemetry has approved the transaction
and recommends the offer to its shareholders. The transaction is expected to be
completed in the first quarter of 2021.
BioTelemetry Background
Founded in 1995, BioTelemetry primarily focuses on the diagnosis and monitoring of heart rhythm disorders, representing 85% of its sales. BioTelemetry’s clinically validated offering includes wearable heart monitors (e.g. a mobile cardiac outpatient telemetry patch and extended Holter monitor) that detect and transmit abnormal heart rhythms wirelessly, AI-based data analytics, and services.
With over 30,000 unique
referring physicians per month, BioTelemetry provides services for over one
million patients per year. Additionally, BioTelemetry has a clinical research
business that provides testing services for clinical trials. The total
addressable market is USD 3+ billion, growing high-single-digits driven by an
increasing prevalence of chronic diseases, and the adoption of remote
monitoring and outcome-oriented models.
Acquisition Strengthens Philips’ Cardiac Care Portfolio
The acquisition of BioTelemetry is a strong fit with Philips’ cardiac care portfolio, and its strategy to transform the delivery of care along the health continuum with integrated solutions. The combination of Philips’ leading patient monitoring position in the hospital with BioTelemetry’s leading cardiac diagnostics and monitoring position outside the hospital, will result in a global leader in patient care management solutions for the hospital and the home for cardiac and other patients. Philips’ current portfolio includes real-time patient monitoring, therapeutic devices, telehealth, and informatics. Moreover, Philips has an advanced and secure cloud-based Philips HealthSuite digital platform optimized for the delivery of healthcare across care settings. Every year, Philips’ integrated solutions monitor around 300 million patients in hospitals, as well as around 10 million sleep and respiratory care patients in their own homes.
“The acquisition of BioTelemetry fits perfectly with our strategy to be a leading provider of patient care management solutions for the hospital and the home,” said Frans van Houten, CEO of Royal Philips. “BioTelemetry’s leadership in the large and fast growing ambulatory cardiac diagnostics and monitoring market complements our leading position in the hospital. Leveraging our collective expertise, we will be in an optimal position to improve patient care across care settings for multiple diseases and medical conditions.”
Post-Acquisition Plans
Upon completion of the transaction, BioTelemetry and its
approximately 1,900 employees will become part of Philips’ Connected Care
business segment. The acquisition is projected to be sales growth and adjusted
EBITA margin accretive for Philips in 2021. Philips targets significant
synergies driven by cross-selling opportunities (especially in the U.S.),
geographical expansion, and portfolio innovation synergies, such as Philips’
Health Suite digital platform. Additionally, Philips will drive operational
performance improvements through its proven productivity programs. The
BioTelemetry business is expected to grow double-digits and to improve its
Adjusted EBITA margin to more than 20% by 2025.
– Data analytics and digital health company MDClone
announced a partnership with the Department of Veterans Affairs’ (VA) VHA
Innovation Ecosystem to democratize data and provide better, smarter, faster
healthcare to U.S Veterans.
– By leveraging MDClone’s data platform, the VHA is able to tackle this massive problem by securely accessing, organizing, and analyzing the critical health data of Veterans with the use of synthetic data – a breakthrough method pioneered by MDClone.
MDClone,
a digital health
company, and the VHA Innovation Ecosystem, a division of the United States
Department of Veterans Affairs (VA) today announced a partnership to
democratize data at the Veterans Health Administration (VHA). The partnership
will provide unprecedented, secure access to clinical data to better understand
and improve the health of the more than nine million veterans it serves.
Partnership Details
The VHA Innovation Ecosystem aims to empower a wider network of VHA clinical and operational staff to explore data and discover insights that can be used to impact the lives of veterans nationwide. MDClone worked closely on this initiative with Dr. Amanda Purnell, Senior Innovation Fellow at the VHA Innovation Ecosystem, who is part of the Care & Transformational Initiatives (CTI) in the VHA Innovation Ecosystem. This program is specifically focused on testing and refining innovative care models and transformational initiatives that can be meaningfully scaled to impact Veteran care.
Improving Healthcare for Veterans with Synthetic Data
It’s no secret that Veterans have historically had a difficult time adjusting to normal life following service, which leads to many mental health issues that go unnoticed and un-treated – often leading to homelessness and the tragic loss of lives. By leveraging MDClone’s data platform, the VHA is able to tackle this massive problem by securely accessing, organizing, and analyzing the critical health data of Veterans with the use of synthetic data – a breakthrough method pioneered by MDClone. Synthetic data sets are virtually identical to the original patient data, so there’s no identifying information that can be traced back to individual patients. Synthetic data also has the potential to help the VHA collaborate with external agencies, healthcare providers, and the industry.
Non-technical users can quickly ask important questions, find answers, and take action – dramatically shortening timelines for quality improvement, innovation, and grassroots clinical research. The initial collaboration with MDClone will center around suicide prevention, chronic disease management, precision medicine, health equity, and COVID-19. For example, practitioners can tackle issues like suicide by identifying leading indicators and proactively intervening with patients most at risk.
“The VHA has long been at the forefront of healthcare informatics and the use of data to improve patient outcomes and drive operational improvements,” said Ziv Ofek, Founder and CEO, MDClone. “The selection of MDClone’s unique platform builds upon this tradition. With one of the largest medical databases in the world, the VHA requires enterprise-scale tools to explore data, innovate, and improve patient care. MDClone’s dynamic environment will help VA staff deliver on their mission to provide the best healthcare services to Veterans across the U.S.”
– Mayo Clinic researchers are collaborating with TripleBlind on next generation algorithm sharing and training on encrypted data.
– TripleBlind’s solution functions as the innovative data
encryption conduit that keeps the data and intellectual property in the algorithm
secure.
TripleBlind announced
today it is collaborating with Mayo Clinic researchers
who will use TripleBlind tools to validate interoperability
of encrypted algorithms
on encrypted data and the training of new algorithms on encrypted data. TripleBlind
has created a rapid, efficient and cost effective data privacy focused solution
based on breakthroughs in advanced mathematics, which will be used and
validated by the Mayo team. No Mayo data will be accessed by TripleBlind.
Why It Matters
Today, healthcare systems have to either transfer data or
algorithms outside their institution for experts to train or conduct research.
The encryption conduit being evaluated will eliminate the need for data
transfer or for sharing the algorithm, thus protecting intellectual property.
TripleBlind’s solution functions as the innovative data encryption conduit that
keeps the data and intellectual property in the algorithm secure.
The aim of this collaboration is also to demonstrate that
TripleBlind’s toolset can be applied to train entirely new algorithms from
independent entities anywhere in the world without the need to share raw data,
thus preserving privacy and security while meeting regulatory standards.
“Training novel algorithms on encrypted data sets and
facilitating trust between independent parties is critical to the future of AI
in medicine. By using advanced mathematical encryption technologies, we will
greatly enhance scientific collaboration between groups and allow for more
rapid development and scalable implementation of AI-driven tools to advance
healthcare,” said Suraj Kapa, M.D., a practicing cardiologist and director of
AI for knowledge management and delivery at Mayo Clinic.
Mayo Clinic and Dr. Kapa have financial interest in the
technology referenced in this release. Mayo Clinic will use any revenue it
receives to support its not-for-profit mission in patient care, education and
research.
– Innovaccer partners with SyTrue to uncover powerful insights
and accelerate its efforts to drive healthcare’s digital transformation.
– The integration of SyTrue’s proprietary NLP OS with
Innovaccer’s FHIR-enabled Data Activation Platform will empower healthcare
organizations to identify diagnosis codes and Hierarchical Condition Categories
(HCC) from patient care progress notes and other unstructured texts.
Innovaccer, Inc., a San
Francisco, CA-based healthcare
technology company, announces its partnership with SyTrue, a leading provider of clinical data
extraction, to generate robust, actionable insights from healthcare data. The
partnership allows Innovaccer to leverage healthcare’s most-advanced Natural
Language Processing Operating System, NLP OSTM, and dive deep into clinical
data, extracting valuable details about patient health journeys.
Empowering Healthcare Organizations to Improve Patient
Risk Scores
The integration of SyTrue’s proprietary NLP OS with
Innovaccer’s FHIR-enabled Data Activation Platform will empower healthcare
organizations to identify diagnosis codes and Hierarchical Condition Categories
(HCC) from patient care progress notes and other unstructured texts. With the
ability to gain insights from the unstructured datasets, providers can improve
the accuracy of patient risk scores.
SyTrue’s NLP OS will empower Innovaccer’s data platform to
semantically search, identify, and discover key elements from medical records
across the organization, delivering relevant, actionable insights at the moment
of care. NLP OS will allow Innovaccer to help its clients extract details about
lab records, medications, vital signs, diagnoses, and other elements from
structured and unstructured sources to successfully meet quality requirements.
The partnership will allow Innovaccer’s customer provider organizations to understand their patients’ medical records in a more comprehensive manner and optimize reimbursement through advanced coding, smart cohort identification, and unstructured data normalization.
“Creating a longitudinal record is paramount to enabling an intelligent journey throughout our complex healthcare system. Too often, crucial patient data is not included as part of the complete medical record because it is locked in faxes, portable document formats (PDFs) and other unstructured documentation. To unlock the insights contained within these files is expensive and time-consuming,” says Kyle Silvestro, CEO at SyTrue. “Our partnership with Innovaccer will reduce the time and cost to create intelligent and comprehensive insights which will significantly enhance the patient journey.”
– Cerner Corporation today announced with Xealth new
centralized digital ordering and monitoring for health systems, starting with
Banner Health, to foster digital innovation.
– Health systems can prescribe digital therapeutics, smartphones, and internet apps directly within the EHR to address areas such as chronic disease management, behavioral health, maternity care, and surgery prep.
Cerner, today announced it’s building on the recent collaboration with Xealth to offer health systems new centralized digital ordering and monitoring for clients. These capabilities are designed to help health systems choose, manage, and deploy digital tools and applications while offering clinicians access to remote monitoring and more direct engagement with patients. Phoenix-based Banner Health, one of the country’s largest nonprofit hospital systems, is one of the first Cerner clients to use the new capabilities to benefit its clinicians and patients.
Prescribe Digital Therapeutics Via EHR
With the new capabilities, health systems can prescribe digital therapeutics, smartphones, and internet applications to address areas such as chronic disease management, behavioral health, maternity care, and surgery prep. This access to a more holistic view of the organization’s digital health solutions supports the clinical decisions doctors make every day and provides real opportunities to improve medical outcomes and enhance efficiency, meet the increasing demand for telehealth and offer remote patient monitoring.
For example, the new capabilities can help simplify how
clinicians prescribe tools such as mobile mental health apps to monitor anxiety
triggers or a glucose device to help trace blood sugar levels for diabetes
patients.
Digital solutions will be available in a single location in
the electronic health record where health systems can use apps based on
clinical and financial metrics. A wide array of digital health tools is
integrated with Xealth’s offering today and the list is ever-growing. Early
examples of companies that have previously deployed in health systems using
Xealth include Babyscripts, Glooko, SilverCloud Health, Welldoc, as well as
Healthwise Inc., GetWellNetwork and ResMed that have existing relationships
with Cerner.
“As digital tools are increasingly included in care plans, health systems seek a way to organize and oversee their use across the health system. We anticipate the emergence of digital and therapeutic committees to govern digital tool selection similar to how pharmacy and therapeutic committees have historically governed medication formularies,” said David Bradshaw, senior vice president, Consumer and Employer Solutions, Cerner. “Digital health has extraordinary potential to reshape the way we care for patients and, working with Xealth, we are answering the need and helping providers create more engaging and effective patient experiences.”
Why It Matters
Digital health has great potential to make an immediate difference, especially as it relates to automating patient education, delivering virtual care, supporting telehealth, and offering remote patient monitoring. Health systems with a digital health program and strategy in place have the ability to respond faster and more efficiently.
“Now, more than ever, extending care teams to meet patients where they are is critical,” said Mike McSherry, CEO and co-founder, Xealth. “As digital health programs roll out, they should elevate both the patient and provider experience. Cerner building out a digital formulary, with Xealth at its core, is listening to its strong clinician base by delivering tools to enhance patient care, without adding additional steps for the care team.”
– 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.”
Revenue-Sharing
Business Model
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
Medicaid and Medicare is struggling in an unprecedented way during COVID — many workers are losing access to healthcare through their employer and COVID job loss. During the first week of open enrollment, last month nearly 820,000 people selected plans on HealthCare.gov 2020, according to the Centers for Medicare & Medicaid Services (CMS). Federal Medicaid outlays increased more rapidly through 2nd half FFY 2020, up 22.5% as compared to prior year at 8.7% growth. So the number of patients coming onto the system is at unprecedented levels.
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.
Recent
Traction/Milestones
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.
As if 2020 couldn’t be
any more challenging for healthcare providers, new federal rules on
interoperability and patient access, granting patients direct access to their healthcare
data, begin taking effect this November and continue into 2022. These rules,
while ultimately beneficial to patients, bring an additional level of
operational complexity to many revenue-stressed healthcare organizations.
If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For example, consider the huge increase in 2020 in virtual care visits, projected to be more than 1 billion by year’s end, and with an estimated 90% related to Covid-19. Many of these new virtual health patients will move through different care networks, using different health plans, and seeking remote access to their health records. These are precisely the type of patients’ interoperability is meant to help.
What should healthcare providers be doing now to ensure they’re not only compliant with new interoperability rules, but also applying them as optimally as possible to benefit their patients and organizations? In this article, we review the upcoming rules and suggest five key steps providers can take to ensure their interoperability implementations proceed as smoothly as possible.
What’s Ahead with
Interoperability?
After several years of discussion on interoperability standards, the Office of the National Coordinator (ONC) for Healthcare IT and the Centers for Medicare & Medicaid Services (CMS) issued their final rules on interoperability in the spring of 2020. The new rules, covering both health systems and health plans, are intended to ensure that patients can electronically access their healthcare information regardless of health system or type of electronic health records (EHR) and covering all CMS-regulated plan types, including Medicare Advantage, CHIP, and the Federally Facilitated Exchanges.
Starting Nov. 2, 2020, healthcare systems must begin complying with interoperability rules preventing information blocking, which means not interfering with patients’ access to or use of their electronic health information. Providers must also attest they are acting “in good faith” regarding preventing information blocking, with any non-compliance flagged on the National Plan and Provider Enumeration System. By May 1, 2021, hospitals, psychiatric hospitals, and critical access hospitals with an EHR must send notification of their patients’ admission, discharge, and transfer (ADT) events to providers.
Interoperability will replace the current fragmented and error-prone ways of exchanging vital healthcare information. Near-term benefits of interoperability include improved care coordination and patient experience, greater patient safety, and stronger patient privacy and security. Longer-term benefits include higher provider productivity, reduced healthcare costs, and more accurate public health data.
For providers, the good
news about interoperability is that they’ve had years to think about and
implement many of its fundamental tenets, based on their work meeting
meaningful use requirements. That’s borne out in a 2019 HIMSS survey of
healthcare organizations which found nearly 75% of respondents past the
“foundational” level of interoperability – “foundational” defined as allowing
data exchange from one IT
system to another, but without data interpretation.
Five Steps for
Interoperability Excellence
While healthcare systems
will achieve significant interoperability gains through technology investments,
they should not consider technology as the ultimate sole key to
interoperability success. If anything, financial and political considerations
may be far more important to your organization’s interoperability success. Here
are five critical non-technology factors to consider:
1. Determine your “master”
interoperability strategy
All pertinent stakeholders in your organization should be on the same page about your interoperability strategy, resources, and timing. Know up-front that those implementing interoperability may not have previously worked with patient-centric analytics, partners, or departments in your organization. Plan your resources and timing accordingly. Your strategy should focus on the value-add of interoperability internally, such as access to additional data points on your patients, and externally, such as how you describe the upcoming benefits of interoperability to your patients.
2. Convey your vision, expectations
and expected return
An interoperability implementation is
a massive change management initiative, which requires continuous, top-down
leadership and championship, and proper expectation-setting. Communicate where
your organization currently stands regarding its interoperability capabilities,
and where you wish to have it go. Convey how the organization plans to get to
its future desired state. And perhaps most importantly, share the likely return
on investment in this effort. Be as specific as possible. For example, if you
believe interoperability gains will ultimately enable a 5% decrease in your
hospital readmissions, state that.
3. Examine workflows and identify
specific use cases
Every type of ADT event in your
organization, and its corresponding workflows and system interactions, should
be under review. Consider all types of clinical use cases, the types of data to
be exchanged, and those involved in providing patient care. This will help
determine your optimal approach to data-sharing and how your organization can
strategically use the additional data you receive from other health
systems.
4. Rigorously prep your data
Standardized data collection and reporting
which produces quality data is the heart and soul of successful
interoperability. Be sure your organization’s data is clean and meaningful, and
will ultimately be understandable and useful to your patients.
5. Think big-picture differentiation
There’s nothing in the ONC and CMS
interoperability rules that says you need to stop at mere rules compliance.
Consider your pursuit of interoperability as a singular opportunity to be a
patient-centric leader in your market. Let everyone relevant know of the
success you’ve achieved.
While interoperability
offers a chance for healthcare systems to achieve multiple operational gains,
when handled well, it is ultimately a patient-centric endeavor. Always keep the
needs and interests of your patients at the core when facilitating access to
their personal health data. It’s the ultimate smart long-term interoperability
strategy.
When doctors know their patients have been to the hospital, they can act fast to provide needed support. Widespread use of hospital event notifications is associated with all kinds of health benefits, including a 10 percent decrease in readmissions for Medicare beneficiaries. These event notifications are one of the simplest, easiest (most-bipartisan!), and most impactful changes we can make to improve patient outcomes in U.S. healthcare.
To this goal, the Centers for Medicare and Medicaid Services (CMS) released new regulations in March that will require hospitals to share event notifications with community providers when a patient is admitted, discharged, or transferred (ADT). Hospitals have to comply by May 2021 if they want to keep getting paid by Medicare and Medicaid.
This policy will improve care, reduce costs, and save lives. It’s also simple and straightforward. CMS explains, “Lack of seamless data exchange in healthcare has historically detracted from patient care, leading to poor health outcomes, and higher costs.” ADT notifications close these gaps and many healthcare organizations have been using them for years, vastly improving care for patients.
Take the Utah Health Information Network (UHIN) which has utilized ADT notifications to reduce costs and readmissions for over a decade. According to the former UHIN President and CEO, Teresa Rivera,
“This level of care coordination quite literally saves both lives and money.” She continues, “This secure and cost-effective method provides the patient’s entire medical team, regardless of where they work, with the important information they need to coordinate care. That coordination is important to reducing readmission rates, and helps health care professionals provide a better experience to patients.”
ADT notifications are a standard set of messages that most electronic health record (EHR) systems can generate with minimal set-up. In fact, in a 2019 letter from the National Association of ACOs in support of CMS’ proposal to require hospitals participating in Medicare and Medicaid to send event notifications, they expressed that new standards efforts are not needed for the successful implementation.
The authors wrote, “In numerous conversations with HIEs, other intermediaries and providers, we were unable to find a single example where a hospital was unable to send an ADT notification today due to lack of standards.”
But you wouldn’t know it if you listened to the misconceptions that are currently being spread to hospitals about this requirement. Here are five myths that I’ve encountered just this month:
Myth 1: The ADT notification policies are strict and difficult to comply with. Not true. CMS listened to feedback that Meaningful Use requirements were too regimented and promoted a “check the box” not “get it done” mentality. CMS purposely worked to keep these ADT requirements broad and non-prescriptive. Hospitals don’t need to comply with any specific technical standard. The CMS regulations released in March are final.
Myth 2: You have to connect to a nationwide network. Wrong. Hospitals can choose from a wide variety of regional and statewide health information exchange (HIE) partners. The policy requires “reasonable effort” to send notifications to providers in your community. An intermediary can be used to comply with the rule as long as it “connects to a wide range of recipients.” Unlike what some nationwide companies are saying, the regulations do not mandate out-of-state alerts.
Myth 3: The policy creates a big technical burden for hospitals. More than 99 percent of hospitals have EHR systems in place today, and most of those can produce standard ADT transactions with relatively minimal effort. While the time to activate ADT notifications varies, it can usually be done in as little as a day by a hospital IT team.
Myth 4: The timing isn’t right. It’s happening too fast. A global pandemic is exactly the moment when we need this kind of data sharing in our communities. With COVID-19, it is even more crucial that care teams are alerted promptly when a patient is seen in the emergency department or discharged from the hospital so that they can reach out and provide support. Regardless, CMS has given an additional six months of enforcement discretion for hospitals, pushing back the deadline to May 2021.
Myth 5: There’s no funding available for this work. Wrong again. In California and several other states, hospitals can take advantage of public funding to connect to regional HIEs that provide ADT notification services. There’s $50 million in funding available just in California.
This new policy is an exciting step forward for patients and providers. It gives primary care and post-acute providers crucial, needed information to improve patient care. Hospitals can meet the requirements with minimal burden using existing technologies. Patients will have a more seamless experience when they are at their most vulnerable.
In healthcare, it’s easy to assume that great impact requires great complexity. But time and again the opposite is true. So let’s bust the myths, get it done, and keep it simple.
About Claudia Williams
Claudia Williams is the CEO of Manifest MedEx. Previously the senior advisor for health technology and innovation at the White House, Claudia helped lead President Obama’s Precision Medicine Initiative. Before joining the White House, Claudia was director of health information exchange at HHS and was director of health policy and public affairs at the Markle Foundation.
– On the heels of $225.5 million dollars in funding and a
$1.5B valuation this week, Olive today announced its acquisition of Verata
Health to create a combined AI prior authorization solution for providers and
payers under the Olive name.
– Prior authorization is a $31 billion dollar issue in
healthcare, and one of the top reasons patient care is delayed. Olive is now
able to reduce write-offs by over 40% and cut turnaround times for prior
authorizations by up to 80%, ultimately offering hospitals $3.5 million in
savings.
Olive today, announced
the acquisition
of Verata Health to solve prior
authorizations for providers and payers via artificial
intelligence as a combined solution under the Olive name. The acquisition
follows Olive’s recent $225.5 million financing round to bolster the company’s
R&D war chest and drive the growth of Olive’s AI workforce for providers
and payers. With Olive’s recent momentum, Verata’s suite of AI tools will
deepen Olive’s impact as it automates the $31 billion problem of prior authorizations
in healthcare.
Leverage Powerful Prior Authorization AI
Verata is a leading healthcare AI company, enabling
Frictionless Prior Authorization® for providers and payers. Seamlessly
connected to the nation’s top electronic health record
(EHR) systems, Verata’s AI technology automatically initiates prior
authorizations, retrieves payer rules, and helps identify and submit clinical
documentation from the EHR.
When payers leverage its AI platform, Verata enables point-of-care
authorizations for providers and patients, dramatically accelerating access to
care.
Solving the $31B Prior Authorization Burden
Prior authorizations were the most costly and time-consuming transactions for providers in 2019 and are among the top reasons patient care is delayed. As cash-strapped hospitals and health systems strive to meet patient, payer, and provider needs, the demand for AI technologies to increase efficiency and improve the patient experience has become critical. To help improve patient access to care and remedy the $31 billion prior authorization challenge, Olive and Verata’s combined prior authorization solution streamlines the process for providers, patients, and payers by reducing write-offs by over 40% and cutting turnaround time for prior authorizations by up to 80%.
Acquisition Will Provide End-to-End Prior Authorization
By integrating Verata’s solution, Olive is able to provide customers with a true end-to-end prior authorization solution. The solution starts with determining if an authorization is required, includes touchless submission of the prior authorization request, ends with automating denied claim appeals, and grants hospitals a 360-degree view of their authorization performance. This means patients not only get the care they need faster but also eliminates confusing bills patients receive post-service stating their claim has been denied by their insurance.
As part of the acquisition, more than 60 Verata employees
will join the Olive team following the acquisition, bringing Olive’s total
employee count to approximately 500. Olive’s senior executive team will
continue to grow as well:
– Lori Jones, Chief Revenue Officer, will retain her title
and will also take on the role of President, Provider Market
– Dr. Jeremy Friese, Chief Executive Officer at Verata, will
join Olive as President, Payer Market
– Dr. YiDing Yu, Chief Medical Officer at Verata, will
become Olive’s Chief Medical Officer
“A broken healthcare system is one of the biggest challenges humanity faces today and prior authorization issues, in particular, are costing our nation billions of dollars. After partnering with Verata earlier this year, we saw incredible potential for Verata’s technology to reduce the amount of time and money spent on prior authorizations, and to eliminate delays in patient care,” said Sean Lane, CEO of Olive. “This acquisition allows Olive to accelerate innovation in areas where we can drive the biggest impact, and further expands our solutions to providers and payers seeking to transform healthcare.”
Financial details of the acquisition were not disclosed.
Shalini Shah, MD is Vice-Chair and Associate Professor, Department of Anesthesiology & Perioperative Care, and Enterprise Director of Pain Services, UC Irvine Health
The dominant presence of COVID-19 has not meant the absence of cancer, ear infections, heart attacks, chronic pain, or other illnesses that need attention and care. Physicians have continued treatment for all types of maladies, and physician training has continued as well. But this treatment and this training look much different these days. Despite the challenges that came with major COVID shutdowns and changing requirements, the healthcare system and patients have been both creative and resilient in finding robust “temporary” solutions to these challenges. It is now looking like some of these COVID-era transitional steps will be preserved and play a lasting role in the future of medical education and telemedicine. What must be sacrificed to reap the benefits of these new protocols?
The rapid adoption of technology and virtual engagement tools has been both impressive and interesting to watch – Zoom meetings between medical association boards of directors, FaceTime calls between isolated patients and their family members at home, telehealth phone appointments with family practice physicians, or virtual medical conferences through Webex – the increasing reliance on these tools has pushed boundaries and exposed both opportunities and challenges with technology use for the future of healthcare.
As COVID-19 has significantly accelerated the feasibility and acceptance of telehealth care by physicians, patients, and payors, we now see healthcare systems navigating in real-time the complex issues with cybersecurity and patient privacy. Due to waivers, everyday technologies can be utilized right now, including FaceTime, Skype, Facebook Messenger video chat, Google Hangouts, and Zoom, but new regulatory guidance may be needed to develop safe, secure, and patient-friendly telehealth applications for the future. Cyber-security, already an important priority in the healthcare information space, is going to become that much more essential as doctor’s offices and clinics implement even more telehealth protocols faster than they ever would have normally planned or budgeted for.
These changes in practice and patient care have also impacted how controlled substances are prescribed. The Drug Enforcement Agency has modified policies to allow for the remote prescribing of controlled substances during the pandemic. Online counseling, informed consent, and follow-up with patients can be done in a virtual setting. Pill counts can be done in a video call and patients can still have their questions answered regarding their pain therapy, although it is likely that after the crisis, prescribing certain controlled substances may return to in-person visits. It is important that the regulatory climate continues to evolve at the pace needed to address the changing needs and realities of telehealth in the time of COVID.
While we have all become more comfortable on telehealth platforms, there continues to be an important role for in-person visits. Patients may appreciate the convenience of telemedicine; however, they must understand that it can limit a physician’s ability to perform a thorough examination and possibly reduce the chances of a physician detecting an unexpected complication or condition.
Moving forward, I expect there will be much greater reliance on telehealth strategies even post-COVID, but it will always have to be balanced with old-fashioned office visits.
Residency training has also experienced a profound shift this year. Conventional teaching approaches have either been cut back or have been canceled due to COVID risks, and reduced access to personal protective equipment (PPE) has limited the amount of time spent with patients being cared for during residency and fellowship programs. But we can’t stop training for the next generation of physicians or providing quality Continuing Medical Education (CME) for practicing physicians. E-learning techniques, such as webinars and online skills training, certainly play a role – and these may offer ways to actually enhance cross-departmental or multidisciplinary collaborative educational sessions. E-learning may be more cost-effective and easier to participate in than traveling to conferences or symposia, but the hands-on learning and deep discussions that can occur in breakout sessions or clinical training modules will need to be replaced somehow. And there must be careful vetting of online content in order to avoid a proliferation of commercially biased information, plagiarized materials, or simply false information. As we all adjust to new settings and styles for learning, there must be purposeful strategies to ensure online lectures are still supported with opportunities for learning from direct patient contact and collegial support.
Despite these concerns and challenges, new models for CME activities actually pose a great opportunity for increased access, cost-effectiveness, and practicality for busy clinicians.
Even before the first case of COVID-19 was diagnosed, technological innovation had already begun to change education, healthcare, and even social relationships. The COVID-19 crisis has simply accelerated the drive and interest in these new tools. But while the technological tools and platforms to a large extent existed years before COVID-19, they have never been used as purposefully, as rapidly, or with such intentionality as they are being used now.
I am sure the shift toward technology and virtual engagement in medicine will not go away when we finally get past the COVID-19 crisis. There will likely be lasting changes with the reliance on distance-medicine techniques for both patient care and physician training. But we must keep a close eye on regulatory frameworks that need to be updated, and make extra efforts to build and maintain patient-physician relationships.
About Shalini Shah, MD
Shalini Shah, MD is Vice-Chair and Associate Professor, Department of Anesthesiology & Perioperative Care, and Enterprise Director of Pain Services, UC Irvine Health. Dr. Shah completed her residency in Anesthesiology from NYP-Cornell University and a combined fellowship in Adult and Pediatric Chronic Pain at Brigham and Women’s Hospital, Beth Israel Deaconess and Children’s Hospital of Boston, Harvard Medical School.
Healthcare leaders attempting to regain some of the revenue lost during the COVID-19 shutdowns now face a formidable challenge. The American Hospital Association estimates that U.S. hospitals and health systems lost $202.6 billion in just the four months from March 1 through June 30—roughly $50.7 billion per month.
Many variables feed into the overall financial impact for individual healthcare organizations, of course—including geographic location, local ordinances, specialty designations, and speed of service resumption. Regardless, every health system has experienced revenue shortfalls caused by disruptions to their service pipeline. The question now is how to generate enough additional revenue to cover some of those losses without incurring additional operating expenses.
We may be able to take practical inspiration from an unlikely source: the hospitality industry. By solving for something one healthcare organization calls “the motel problem,” health systems can increase workflow efficiency, staff satisfaction, clinic volume, and revenue.
The Motel Problem
Accurately assigning exam rooms with enough flexibility to accommodate continuously changing provider and patient schedules remains a perennial challenge for health systems. In fact, during a recent Porter Research study of 100 executive leaders, roughly two-thirds indicated their health systems lack visibility into exam room utilization.
The leaders of one academic medical center’s 65-physician neurology clinic began referring to this capacity challenge as “the motel problem.” How do motels consistently keep their rooms full of paying customers?. In contrast, their own exam rooms often appeared full on the scheduling spreadsheet but actually sat empty. Staff afraid of accidentally double-booking the space would then let those rooms sit idle.
Despite increasing the administrative time devoted to room management, underutilization in the neurology clinic caused rising patient wait times, lowered physician satisfaction, and decreased revenue. If the Porter Research survey is any indication, this situation is not unique. Approximately 72 percent of the survey’s respondents felt their room utilization rates were significantly subpar. Most said their organizations ran at about 20 points below the 80-89 percent utilization level they deemed optimal.
As the neurology department leadership mused about “the motel problem,” they looked at the similarities between motel and healthcare room management needs. Motels must match each guest to a room with the right accommodations (e.g., two doubles versus one king-sized bed) on the right dates. Health systems must take that same workflow one step further by matching the right patient and the right provider to a properly equipped exam room at the right time. In both cases, empty rooms mean lost revenue. Utilization is key.
Consequently, they came to believe that they needed a system that optimized room capacity with much of the same visibility and flexibility as a hotel or motel reservation system. That would require bringing together data about room availability, room attributes, provider schedules and patient needs—and making the resulting intelligence accessible through real-time displays.
A meaningful solution
When it comes to capacity management within a health system, the real complexity lies with provider and patient schedules. The physical space is always there; it’s the “people” part of the equation that’s fluid. What happens when Dr. Johnson suddenly falls ill, for example? Or Dr. Smith needs to attend a last-minute meeting? Or when patient Mrs. Brown reschedules her appointment?
Clinics typically rely on relatively static spreadsheets or siloed software to track room utilization. But these tools aren’t designed to make such real-time adjustments, especially at the enterprise level—which means the exam rooms assigned to an absent Dr. Johnson or Dr. Smith likely remain empty even as patients wait to be seen by other providers.
On the other hand, an organization’s scheduling system is aware when a provider calls in sick, heads to a meeting, or arrives at the clinic early. With a cloud-based scheduling platform, organizations can achieve near real-time visibility into provider availability across the enterprise.
Consider, then, what can happen when room management software is layered on top of an enterprise scheduling platform. Providers’ movements are then connected to exam room status. The entire organization gains transparency into how providers’ availability affects room availability. That allows staff to quickly and easily move providers into unused rooms and call patients in for appointments faster. Plus, by “tagging” various room attributes—like whether it’s equipped with oxygen or an ENT chair, for instance—such platforms ensure that the proper clinical accommodations are available when providers and patients need them.
Bottom-line results
Such real-time visualization of room availability can have a substantial impact on health system revenue. One regional health system, for example, calculated that underutilization in its orthopedic clinic costs at least $2,000 per provider per day in lost revenue.
Another large health system quantified the effect from a different perspective. It contemplated how maximizing capacity would enable increased patient throughput without investing in additional space or staff. With that in mind, the organization determined that every one percent increase in utilization results in an annual operational savings of $140,000.
At the neurology clinic, solving “the motel problem” by implementing a solution to standardize capacity generated both revenue growth and increased provider satisfaction. The organization has captured revenue previously missed through underutilization and has recognized that revenue scales directly proportional to volume.
To that end, gaining visibility into capacity has helped the clinic achieve a 7.4 percent increase in patient visits and a 4.7 percent increase in-clinic session volume. As important, providers now trust that the right exam rooms will be ready for them when needed—just like a reservation at a high-end hotel.
About Rich Miller
Rich Miller is the Chief Strategy Officer of QGenda, a healthcare workforce management provider, enabling organizations to optimize capacity across the enterprise. Leading physician groups, hospitals, academic medical centers, and enterprise health systems use QGenda to optimize their workforce which allows them to provide the best possible patient care.
– 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.
Jenifer Leaf Jaeger, MD, MPH, Senior Medical Director, HealthEC
Senior isolation is a health risk that affects at least a quarter of seniors over 65. It has become recognized over the past decade as a risk factor for poor aging outcomes including cognitive decline, depression, anxiety, Alzheimer’s disease, obesity, hypertension, heart disease, impaired immune function, and even death.
Physical limitations, lack of transportation, and inadequate health literacy, among other social determinants of health (SDOH), further impair access to medical and mental health treatment and preventive care for older adults. These factors combine to increase the impact of chronic comorbidities and acute issues in our nation’s senior population.
COVID-19 exacerbates the negative impacts of social isolation. The consequent need for social distancing and reduced use of the healthcare system due to the risk of potential SARS-CoV-2 exposure are both important factors for seniors. Without timely medical attention, a minor illness or injury quickly deteriorates into a life-threatening situation. And without case management, chronic medical conditions worsen.
Among Medicare beneficiaries alone, social isolation is the source of $6.7 billion in additional healthcare costs annually. Preventing and addressing loneliness and social isolation are critically important goals for healthcare systems, communities, and national policy.
Organizations across the healthcare spectrum are taking a more holistic view of patients and the approaches used to connect the most vulnerable populations to the healthcare and community resources they need. To support that effort, technology is now available to facilitate analysis of the socioeconomic and environmental circumstances that adversely affect patient health and mitigate the negative impacts of social isolation.
Addressing Chronic Health Issues and SDOH
When we think about addressing chronic health issues and SDOH in older adults, it is usually after the fact, not focused on prevention. By the time a person has reached 65 years of age, they may already be suffering from the long-term effects of chronic diseases such as diabetes, hypertension or heart disease. Access points to healthcare for older adults are often in the setting of post-acute care with limited attention to SDOH. The focus is almost wholly limited to the treatment and management of complications versus preventive measures.
Preventive outreach for older adults begins by focusing on health disparities and targeting patients at the highest risk. Attention must shift to care quality, utilization, and health outcomes through better care coordination and stronger data analytics. Population health management technology is the vehicle to drive this change.
Bimodal Outreach: Prevention and Follow-Up Interventions
Preventive care includes the identification of high-risk individuals. Once identified, essential steps of contact, outreach, assessment, determination, referral, and follow-up must occur. Actions are performed seamlessly within an organization’s workflows, with automated interventions and triggered alerts. And to establish a true community health record, available healthcare and community resources must be integrated to support these actions.
Social Support and Outreach through Technology
Though older adults are moving toward more digitally connected lives, many still face unique barriers to using and adopting new technologies. So how can we use technology to address the issues?
Provide education and trainingto improve health literacy and access, knowledge of care resources, and access points. Many hospitals and health systems offer day programs that teach seniors how to use a smartphone or tablet to access information and engage in preventive services. For example, connecting home monitoring devices such as digital blood pressure reading helps to keep people out of the ED.
Use population health and data analyticsto identify high-risk patients. Determining which patients are at higher risk requires stratification at specific levels. According to the Centers for Disease Control and Prevention, COVID-19 hospitalizations rise with age, from approximately 12 per 100,000 people among those 65 to 74 years old, to 17 per 100,000 for those over 85. And those who recover often have difficulty returning to the same level of physical and mental ability. Predictive analytics tools can target various risk factors including:
– Recent ED visits or hospitalizations
– Presence of multiple chronic conditions
– Depression
– Food insecurity, housing instability, lack of transportation, and other SDOH
– Frailty indices such as fall risk
With the capability to identify the top 10% or the top 1% of patients at highest risk, care management becomes more efficient and effective using integrated care coordination platforms to assist staff in conducting outreach and assessments. Efforts to support care coordination workflows are essential, especially with staffing cutbacks, COVID restrictions, and related factors.
Optimal Use of Care Coordination Tools
Training and education of the healthcare workforce is necessary to maximize the utility of care coordination tools. Users must understand all the capabilities and how to make the most of them. Care coordination technology simplifies workflows, allowing care managers to:
– Risk-stratify patient populations, identify gaps in care, and develop customized care coordination strategies by taking a holistic view of patient care.
– Target high-cost, high-risk patients for intervention and ensure that each patient receives the right level of care, at the right time and in the right setting.
– Emphasize prevention, patient self-management, continuity of care and communication between primary care providers, specialists and patients.
This approach helps to identify the resources needed to create community connections that older adults require. Data alone is insufficient. The most effective solution requires a combination of data analytics to identify patients at highest risk, business intelligence to generate interventions and alerts, and care management workflows to support outreach and interventions.
About Dr. Jenifer Leaf Jaeger
Dr. Jenifer Leaf Jaeger serves as the Senior Medical Director for HealthEC, a Best in KLAS population health and data analytics company. Jenifer provides clinical oversight to HealthEC’s population health management programs, now with a major focus on COVID-19. She functions at the intersection of healthcare policy, clinical care, and data analytics, translating knowledge into actionable insights for healthcare organizations to improve patient care and health outcomes at a reduced cost.
Prior to HealthEC, Jenifer served as Director, Infectious Disease Bureau and Population Health for the Boston Public Health Commission. She has previously held executive-level and advisory positions at the Massachusetts Department of Public Health, New York City Department of Health and Mental Hygiene, Centers for Disease Control and Prevention, as well as academic positions at Harvard Medical School, Boston University School of Medicine, and the Warren Alpert Medical School of Brown University.
– 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
in 2021.
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.
The international
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
2021.
– Nuance announced that it’s planning to sell
two sections of its healthcare business – Health Information Management (HIM)
and Electronic Health Record (EHR) Go-Live Services – to a new independent
company, called DeliverHealth, in early 2021.
– Nuance will be a minority shareholder of DeliverHealth
and continue to provide its technology to the company.
The HIM Transcription business includes both Nuance Transcription Services (NTS) and the eScription technology platform. The transaction is expected to be completed in early 2021. As part of the self-off, Nuance will be a minority shareholder of DeliverHealth and will continue to provide its technology to the company. DeliverHealth plans to build on HIM, transcription, technology and EHR services already in place while expanding into intelligent, technology-enabled revenue cycle automation and clinical documentation improvement services within the EHR’s workflow in 2021. DeliverHealth will include both Nuance Transcription Services (NTS) and the eScription technology platform. Financial details of the transaction were not disclosed.
Sell-Off Accelerate Growth as Conversational AI Market
Leader
The sale
demonstrates Nuance’s continuing execution to focus R&D investments in the
healthcare and enterprise markets – where the company has substantial
competitive advantages and opportunities for growth and value creation. In
2019, for example, Nuance sold its document imaging business to Kofax and
spun-off its automotive business into Cerence, Inc., an independent,
publicly-traded company.
Nuance’s goal with the sale is to enable:
– Existing customers with continued service quality, newly
expanded offerings, and enhancements from DeliverHealth in close collaboration
with Nuance
– Nuance to focus its innovation and market resources as a
pure-play conversational AI market leader while providing continuity of EHR
Go-Live Services and HIM Transcription businesses to existing and new customers
via DeliverHealth
– DeliverHealth to leverage a leading position in healthcare
professional and technology-enabled services, expand global market share,
advance growth plans for the EHR Go-Live and Optimization Services, and provide
enhanced HIM technology and services to a worldwide market in partnership with
Nuance
Nuance’s growth and market leadership in healthcare are
driven by the accelerating adoption and development of its core cloud-based AI
solutions, including the Nuance® Dragon® Ambient eXperience™ (Nuance DAX™)
ambient clinical intelligence (ACI) solution, Nuance Dragon Medical One, Nuance
CDE One, and its array of diagnostic imaging solutions such as PowerScribe One™
and PowerShare™.
“The dramatic acceleration in the digital transformation of healthcare continues as organizations deploy the power of conversational AI and deeply integrated cloud-based solutions at scale to address physician burnout, expand patient access, and improve system efficiencies and the revenue cycle,” said Mark Benjamin, CEO of Nuance. “With this strategic transaction, we’re aligning our resources to increase our market and technical leadership position in high-growth, high-impact areas that help our customers in a transformative way to improve patient care and operational performance. At the same time, we’re enabling the medical transcription and EHR Go-Live Services businesses to reach their full potential as a separate, focused company benefiting from the enhanced investment and operational experience of AHP and Aeries and technology support from Nuance.”
Many in the healthcare industry are keeping an eye on the rollout of 5G wireless, which promises to connect people and things at higher speed and lower latency. In the healthcare realm, this means high-resolution images such as CT scans and X-rays can be taken and transmitted instantaneously to doctors. But it also means good things for lower-bandwidth applications, such as the volumes of rich data found in home healthcare applications.
One of the beneficiaries of 5G will be remote patient monitoring (RPM), which helps seniors live independently and transforms their care. With RPM solutions, vital statistics such as blood pressure, oxygen level, blood glucose, weight, temperature, and other metrics are consistently monitored. Reliable connectivity is required to transmit data between the patient and the physician’s office or hospital. RPM solutions can also be two-way, with voice communications-enabled between doctors and patients. Some RPM solutions can also track data over time and spot abnormalities in readings such as low or high blood pressure or oxygen levels and can connect the patient to the doctor to explore solutions. The goal: Keeping patients healthy and allowing them to take a greater role in their healthcare.
By being able to take these vital signs at home and delivering them to their provider automatically and in real-time, the paradigm of care is shifted from episodic to preventative. This gives senior patients and their doctors much more flexibility in patient care and helps to reduce the need to visit the doctor’s office or hospital. With RPM, healthcare providers can:
– Speak in real-time with a patient who might not be feeling well
– Discuss a patient’s status and review their statistics in real-time
– Proactively care for patients so they don’t end up at the doctor’s office or emergency room
– Intervene in the patient’s care to get their health back to normal
RPM solutions usually connect to the internet via WiFi or cellular. As we move towards 5G, which is the best solution to provide connectivity to RPM solutions?
WiFi
WiFi is the defacto home connectivity option for many people. It is relatively inexpensive, upload and download speeds have been consistently upgraded by service providers, and, in general, it works when needed. But it faces some challenges for home healthcare:
– Lack of ubiquity: According to Pew Research Group, as of 2019, only 59 percent of people over 65 have access to broadband connectivity at home. That makes it challenging to utilize WiFi in RPM solutions, which require a continuously reliable 24×7 data connection.
– Limited ease of use: Wi-Fi can be strongly protected, but that protection comes at a price: the use of complex, multi-variable passwords and other configuration steps, which some seniors may struggle with.
– Lack of 24/7 reliability: WiFi signals drop frequently. If Wi-Fi has a weak signal, loses power, or goes offline for another reason—even if it’s infrequently—it impacts the ability to deliver consistent patient results back to healthcare professionals—and vice versa.
Cellular
Cellular is a more reliable option for home care providers and the patients they serve. Some of the benefits of using cellular connectivity include:
Ubiquity: People understand how cellular works. For patients aged 65 and older, 91 percent own a cellphone and of those, 53 percent own a smartphone, according to Pew Research Group.
Simplicity of set-up: For many RPM devices, complicated configuration is not required. While some solutions providers retrofit tablets, others have purpose-built RPM solutions that simply need to be turned on.
Consistent real-time data sets: Gathering data sets developed in real-time and over time allows healthcare providers to see trends and take preventative action. Cellular is a stronger fit for this type of application.
Upgrade path to 5G, when available: Some vendors are building 5G capabilities into their devices today to prepare for its arrival. RPM solutions that use cellular have a clear upgrade path to 5G’s high-bandwidth connectivity.
The use of open standards and existing infrastructure. Cellular is well-proven, and RPM can use existing infrastructure as the underlying medium to connect patients and their healthcare providers and help patients take a greater role in their healthcare.
The ability to cover hundreds of devices simultaneously. Cellular macrocells are able to cover a wide area, ensuring connectivity is always available for the patient
Doctors and healthcare providers can now gather patients’ rich health data by including real-time and daily readings. This allows patients to get more involved with their care, assess situations in real-time, and speak with a physician when they are not feeling well, and generally to keep patients healthy and out of the doctors’ office or emergency room. RPM solutions are becoming increasingly easier to use and more feature-rich making connectivity choice imperative. Cellular connectivity will ensure solutions are available 24/7 to help keep seniors safe, and when 5G is more readily available at scale, there is a clear upgrade path for RPM solutions.
About Mark Dennissen
Mark Denissen serves as the president and chief executive officer of Anelto. He has a storied career in the technology sector. Mr. Denissen worked for more than three decades with Texas Instruments (TI), serving in various roles before becoming the Vice President of Worldwide Strategic Marketing. In this role, he was responsible for the startup of businesses such as Medical Devices, LED lighting solutions, and motor control solutions. Additionally, he was responsible for the commercialization of breakthrough technologies developed in Kilby Labs, TI’s long-range research and development center, and worked directly with TI’s Chief Technical Officer to move numerous projects towards commercialization. He holds a BSEE degree from the University of California Los Angeles.
– Central Logic has acquired Omaha-based Ensocare, which
automates the referral process for patients from hospital to post-acute care
(PAC) when they are being discharged.
– This acquisition means that Central Logic’s technology
solution will now expand its reach across the care continuum, from acute to
post-acute care—into, through and out of the health system. This combined
capability is key to increasing patient satisfaction while also increasing
patient census by ensuring beds are available when they are needed by new
patients.
Central Logic,
the leading healthcare access and orchestration company, announced today that
it has acquired
Omaha-based Ensocare, which automates
the inpatient referral process to post-acute care (PAC). Central Logic’s health
system technology solution currently focuses on referrals and transfers into a
health system by uniting all available provider, facility and transportation
resources. Financial details of the acquisition were not disclosed.
Making Care Transition More Efficient
About 40% of Medicare beneficiaries are discharged from the hospital to post-acute facilities. With a
large aging population, U.S. health systems face growing pressures to improve
care access and streamline transitions of care to optimize patient outcomes,
increase operating margins, and control costs.
Founded in 1999, Ensocare provides hospitals and post-acute care
providers software and proactive support to manage patient transitions of care,
improve efficiency in the referral management process and streamline
communication between healthcare organizations. Backed by live, 24/7 customer
support and tapping into the nation’s largest no-cost post-acute care network,
we’ll help you lower costs, enhance patient satisfaction and increase
profitability by automating workflows and eliminating inefficient systems.
Acquisition Expands Central Logic’s Solutions to Post-Acute
Care
The acquisition of Ensocare expands Central Logic’s solution
to include successful transitions out of hospitals to post-acute care
settings—including skilled nursing and rehabilitation facilities, long-term
acute care centers, and even the home—by tapping into Ensocare’s active,
curated network of more than 50,000 PAC providers nationwide. Placement
confirmations are secured on average within 30 minutes.
In light of the Ensocare
acquisition, Central Logic becomes the only solution in the market that
provides region-wide acute care transfer, transport and post-acute care
transfer capabilities in one platform, enabling health systems to more
cohesively operate as one.
Private Equity firm Rubicon Technology partners, a leading
private equity firm based in Boulder, Colo., made a strategic majority investment in Central Logic in June,
with a commitment to accelerating growth. Two weeks before Rubicon’s majority
investment in Central Logic, the PE firm announced a new $1.25 billion fund that exceeded the fund target
of $850 million in less than 6 months. The Ensocare acquisition marks the first
major milestone in Central Logic’s growth trajectory that Rubicon committed to
when making its strategic majority investment in the company earlier this year.
Expanded Footprint
Central Logic’s technology will now span 800 hospitals and
health systems, covering 150,000 providers and more than 5 million
patients—representing 14% of U.S. annual inpatient visits. he company now
employs 125 team members and will continue to operate Ensocare’s Omaha, Neb.,
location, as well as existing Central Logic offices in St. Paul, Minn., and
Sandy, Utah.
“This strategic acquisition means that our solutions will now span the care continuum from acute to post-acute care, which will improve transitions into, through and out of the health system, creating true ‘systemness’ for our clients,” said Angie Franks, CEO of Central Logic. “By operating as one, health systems can offer a more seamless experience for their patients across all acuity levels while enabling providers to stay connected and strengthening the relationships with PAC providers in their communities.”
Our fully integrated solution will provide visibility and access to data that ensures hospital beds are freed in a timely manner when inpatient care is no longer necessary. This decreases length of stay and increases throughput,” Franks said. “Further, this kind of efficient orchestration and navigation creates bed availability and access for incoming patients, creates more time for clinicians to operate at the top of their license and elevates revenue capture and reduction of system leakage.”
Central Logic’s existing solutions already deliver 10x ROI to health system clients in the first year, and Franks says that clients that expand their engagement to include the acute to post-acute orchestration and access solution will see even greater results. “This is more important now than ever as health systems across the country implement the necessary controls and programs to rebuild operating margin deficits due to COVID-19,” Franks added.
– Nuance Communications, Inc. and one of the country’s
largest health systems, Providence, announced a strategic collaboration,
supported by Microsoft, dedicated to creating better patient experiences and ease
clinician burden.
– The collaboration centers around Providence harnessing
Nuance’s AI-powered solutions to securely and automatically capture
patient-clinician conversations.
– As part of the expanded partnership, Nuance and
Providence will jointly innovate to create technologies that improve health
system efficiency by reducing digital friction.
Nuance® Communications, Inc. and Providence, one of the largest health systems in the
country, today announced a strategic collaboration to improve both the patient
and caregiver experience. As part of this collaboration, Providence will
build on the long-term relationship with Nuance to deploy Nuance’s cloud
solutions across its 51-hospital, seven-state system. Together, Providence and
Nuance will also develop integrated clinical intelligence and enhanced revenue cycle
solutions.
Enhancing the Clinician-Patient Experience
In partnership with Nuance, Providence will focus on the clinician-patient experience by harnessing a comprehensive voice-enabled platform that through patient consent uses ambient sensing technology to securely and privately listen to clinician-patient conversations while offering workflow and knowledge automation to complement the electronic health record (EHR). This technology is key to enabling physicians to focus on patient care and spend less time on the increasing administrative tasks that contribute to physician dissatisfaction and burnout.
“Our partnership with Nuance is helping Providence make it easier for our doctors and nurses to do the hard work of documenting the cutting-edge care they provide day in and day out,” said Amy Compton-Phillips, M.D., executive vice president and chief clinical officer at Providence. “The tools we’re developing let our caregivers focus on their patients instead of their keyboards, and that will go a long way in bringing joy back to practicing medicine.”
Providence to Expand Deployment of Nuance Dragon Medical
One
To further improve healthcare experiences for both providers
and patients, Providence will build on its deployment of Nuance Dragon
Medical One with the Dragon Ambient eXperience (DAX). Innovated by Nuance and
Microsoft, Nuance DAX combines Nuance’s conversational AI technology with
Microsoft Azure to securely capture and contextualize every word of the patient
encounter – automatically documenting patient care without taking the
physician’s attention off the patient.
Providence and Nuance to Jointly Create Digital Health
Solutions
As part of the expanded partnership, Nuance and Providence
will jointly innovate to create technologies that improve health system
efficiency by reducing digital friction. This journey will begin with the
deployment of CDE One for Clinical Documentation Integrity workflow management,
Computer-Assisted Physician Documentation (CAPD), and Surgical CAPD, which
focus on accurate clinician documentation of patient care. Providence will also
adopt Nuance’s cloud-based PowerScribe One radiology reporting solution to
achieve new levels of efficiency, accuracy, quality, and performance.
Why It Matters
By removing manual note-taking, Providence enables deeper
patient engagement and reduces burdensome paperwork for its clinicians. In
addition to better patient outcomes and provider experiences, this
collaboration also serves as a model for the deep partnerships needed to
transform healthcare.
Peter S. Tippett, MD, Ph.D., Founder & CEO of careMesh
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.
Conclusion
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.
Matt Dickson, VP, Product, Strategy, and Communication Solutions at Stericycle
COVID-19 terms such as quarantine, flatten the curve, social distance, and personal protective equipment (PPE) have dominated headlines in recent months, but what hasn’t been discussed in length are the hidden costs of COVID-19 as it relates to patient adherence.
The coronavirus pandemic has amplified this long-standing issue in healthcare as patients are delaying routine preventative and ongoing care for ailments such as mental health and chronic disease. Emergency care is also suffering at alarming rates. Studies show a 42 percent decline in emergency department visits, measuring the volume of 2.1 million visits per week between March and April 2019 to 1.2 million visits per week between March and April 2020. Patients are not seeking the treatment they need – and at what cost?
When the SARS outbreak occurred in 2002, particularly in Taiwan, there was a marked reduction in inpatient care and utilization as well as ambulatory care. Chronic-care hospitalizations for long-term conditions like diabetes plummeted during the SARS crisis but skyrocketed afterward. Similar to the 2002 epidemic, people are currently not venturing en masse to emergency rooms or hospitals, but if history repeats itself, hospital and ER visits will happen at an influx and create a new strain on the healthcare system.
So, if patients aren’t going to the ER or visiting their doctors regularly, where have they gone? They are staying at home. According to reports from the Kaiser Family Foundation, 28 percent of Americans polled said they or a family member delayed medical care due to the pandemic, and 11 percent indicated that their condition worsened as a result of the delayed care. Of note, 70 percent of consumers are concerned or very concerned about contracting COVID-19 when visiting healthcare facilities to receive care unrelated to the virus. There is a growing concern that patients will either see a relapse in their illness or will experience new complications when the pandemic subsides.
Rather than brace for a tidal wave of patients, healthcare systems should proactively take steps (or act now) to drive patient access, action, and adherence.
1. Identify Who Needs to Care The Most
Healthcare providers should consider risk stratifying patients. High-risk people, such as an 80-year-old male with comorbidities and recent cardiac bypass surgery, may require a hands-on and frequent outreach effort. A 20-year-old female, however, who comes in annually for her physical but is healthy, may not require that level of engagement. Understanding which patients are at risk for the potential for chronic conditions to become acute or patients who have a hard time staying on their care plan may need prioritized attention and a more thorough engagement effort.
For example, patients with a history of mental health issues may lack motivation or momentum to seek care. Their disposition to be disengaged may require greater input to push past their disengagement.
Especially important is the ability to educate and guide patients to the appropriate venue of care (ER, telehealth visit, in-person primary care visit, or urgent care) based on their self-reported symptoms. Allowing patients to self-triage while scheduling appointments helps them make more informed decisions about their care while reducing the burden on over-utilized emergency departments.
2. Capture The Attention of The Intended Audience and Induce Action
Once you’ve identified who needs care the most, how do you break through the “information clutter” to ensure healthcare messages resonate with the intended audience? The more data points, the better. It is important to understand the age of the patient, their preferred communication channel, and the intended message for the recipient, but effective communication exceeds those three data points. Consider factors like the presence of mental health conditions, comorbidities, or health literacies. Then, think beyond the patient’s channel of choice and select the appropriate channel of communication (text, phone call, email, paid social media advertisement, etc.), that will most likely induce action. As an organization, also consider running A/B tests to detect and analyze behavior. As you collect more data, determine what exactly is inducing patient action.
Of note, don’t underestimate the power of repetition. Patients may need to be reminded of the intended action a few times in a few different ways before moving forward with seeking the care they need. Repetition is also shown to decrease no-show rates, a critical metric. Proactive, prescriptive, and tailored communication will help increase engagement. Moving past the channel of choice and toward the channel of action is key.
3. Engage Patients Through Personalized and Tailored Communication
In addition to identifying the right communication channel, it’s also important to ensure you deliver an effective message. Communication with patients should be relevant to their particular medical needs while paying close attention to where each person is in their healthcare journey. Connecting with patients on both an emotional and rational level is also important. For example, sending a positive communication via phone, email, or text to lay the foundation for the interaction shows interest in the patient’s wellbeing.
A “Hey, here’s why you need to come in” note makes a connection in a direct and personalized way. At the same time, and in a very pointed manner, sharing ways providers and health systems are keeping patients safe (e.g., telehealth, virtual waiting rooms, separate entrances, and mandating masks), also provides comfort to skittish patients. Additionally, consider all demographic information when tailoring communications. And don’t forget to analyze if changes in content impact no-show rates. Low overall literacy may impact health literacy and may require simpler and more positive words to positively impact adherence.
It may sound daunting, especially for individual health systems, to personalize patient communication efforts, but the use of today’s data tools and technological advancements can relieve the burden and streamline efforts for an effective communication approach.
4. Use Technology to Your Advantage (With Caution)
Once you have developed your communication strategy, don’t stop there. Consider all aspects of the patient journey to drive action. A virtual waiting room strategy, for example, can help ease patient concerns and encourage them to resume their care. Health systems can help patients make reservations, space out their arrival times, and safeguard social distancing measures—all while alleviating patient fears. Ideally, the patient would be able to seamlessly book an appointment and receive a specific arrival time, allowing ER staff to prepare for the patient’s arrival while minimizing onsite wait time.
When implemented properly, telehealth visits can also improve continuity of care, enhance provider efficiency, attract and retain patients who are seeking convenience, as well as appeal to those who would prefer not to travel to their healthcare facility for their visit. Providers need to determine which appointments can successfully be resolved virtually. Additionally, some patients might not have the means for a successful telehealth visit due to a lack of internet access, a language barrier, or a safe space to talk freely.
To ensure all patients receive quality care, health systems should make plans to serve patients who lack the technology or bandwidth to participate in video visits in an alternative manner. For example, monitor patients remotely by asking them to self-report basic information such as blood sugar levels, weight, and medication compliance via short message service (SMS). This gives providers the ability to continuously monitor their patients while enhancing patient safety, increasing positive outcomes, and enabling real-time escalation whenever clinical intervention is needed.
It is important we ensure all patients stay on track with their health, despite uncertain and fearful times. Health systems can enhance patient adherence and induce action through the implementation of tools that increase patient engagement and alleviate the impending strain on the healthcare system.
About Matt Dickson
Matt Dickson is Vice President of Product, Strategy, and General Manager of Stericycle Communication Solutions, a patient engagement platform that seamlessly combines both voice and digital channels to provide the modern experience healthcare consumers want while solving complex challenges to patient access, action, and adherence. . He is a versatile leader with strong operational management experience and expertise providing IT, product, and process solutions in the healthcare industry for nearly 25 years. Find him on LinkedIn.
– Today, Sony announced an update to our NUCLeUS medical
imaging platform, which improves support for remote patient observation.
– NUCLeUS has added new functionality and features,
including powerful bi-directional telestration capabilities allowing multiple
remote users to simultaneously annotate, draw or highlight areas of interest in
a live stream video or still image.
Sony today
announced an update to its vendor-neutral medical imaging platform NUCLeUS. The latest release introduces Remote
Patient Monitoring (observation) functionality with recording functionalities
for use in the operating room (OR), Intensive Care Units (ICU), endoscopy
suites, procedure rooms or anywhere else in the hospital.
The Smart Digital Imaging Platform for Medical Environments
Developed in consultation with leading surgeons and with vendor
neutrality in mind, NUCLeUS guides clinical staff through the planning,
recording and sharing of video, still images and other patient-related data.
Seamlessly linking Sony and third-party devices, applications, video and most
importantly, people, NUCLeUS focuses on hospital staff requirements and use
cases, adding value to imaging workflows.
New
Bi-Directional Telestration Capabilities
NUCLeUS has added
new functionality and features, including powerful bi-directional telestration
capabilities allowing multiple remote users to simultaneously annotate, draw or
highlight areas of interest in a live stream video or still image. This can be
securely shared with authorized viewers to discuss as a group in real time,
ideally suited for socially distanced environments. Equipped with a full
set of recording functionalities, NUCLeUS is also a valuable tool for
hospitals, outpatient surgery centers and private practices serving a variety
of specialties including Urology, ENT, Obstetrics, Ophthalmic, Plastic surgery,
and Robotics
New NUCLeUS Functionality Features
New functionalities of NUCLeUS include:
Mosaic
Video Wall,
presenting video streams from image sources in multiple ORs and ICUs
simultaneously on a single display, thus providing a situational overview of
activity in a tiled or mosaic format.
An
iPad Streaming function, allowing clinical staff to access images from any modality via
an iPad in virtual real time within the OR, so medical staff can follow the
intervention on their handheld device.
High
quality 4K conversion, allowing any HD resolution video content to be converted to 4K
using advanced resolution-augmentation algorithms superior to conventional
upscaling, giving a crisp ultra-high resolution view of converted video
footage.
Customizable
Expanded Patient Distraction – helping to reduce patient anxiety through music tracks and
video imagery that can be played in the OR to create a more relaxing and
comfortable atmosphere.
Patient
Time-Out Functionality, featuring checklists that simplify time out of safety
standards at the start, during and end of an operation.
Enhanced
Printing capabilities, allowing hard copies of still images captured by NUCLeUS to be
created inside the OR using an optional UP-DR80MD A4 digital color printer. The
Auto Print function also extends CMS (Content Management System) print
functionality to collect a preconfigured number of stills, printing them
automatically.
Full
compatibility with the latest Sony PTZ and fixed cameras including HD and 4K
models.
“Sony is committed to developing NUCLeUS to suit the needs of patients and medical staff at all times,” said Theresa Alesso, pro division President, Sony Electronics. “The Remote Patient Monitoring capabilities within NUCLeUS are a primary example of this and were developed to help hospitals manage day-to-day requirements through the COVID-19 pandemic. We are committed to helping hospitals and healthcare providers reinvent their workflows and provide medical staff with the tools they need to continue delivering excellent patient care.”
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.
If you work in healthcare, chances are that the COVID-19 pandemic forced you to quickly scale up or move staff around to manage the onslaught of patients. The demand for clinicians and support staff grew alongside the spread of the virus, making organizations add clinicians or reassign employees with new or modified roles: Ambulatory nurses went down in the Emergency Department or Isolation Ward, revenue cycle folks started doing transport, and so on. In some cases, former staff or retired workers were called back to help with the surge. In the midst of these time-compressed changes, organizations remained rightly focused on their number one priority: patient care delivery. In the background, IT professionals were struggling to manage the slew of new digital identities while ensuring fast-access to new applications, workflows, and devices to accommodate remote work. Giving clinicians this access meant having to quickly provision and deprovision access during the staff ramp-up. Inevitably, access became a problem – whether to the systems or applications needed to do their jobs. In worst-case scenarios, organizations had to balance security and compliance with the delivery of healthcare services to patients. Security protocols were also compromised – a trade-off that should never have to happen.
Pandemic Spotlights Needs for IGA In response to the identity management challenges presented by the COVID-19 pandemic, healthcare IT organizations that had and Identity Governance Administration (IGA) systems came to the rescue. Those that didn’t, well….. IGA systems provide a fast, reliable way to manage digital identities through provisioning, governance, risk and compliance, and de-provisioning for healthcare workers who need access to workstations and applications. This is even more so the case in a crisis environment. A recent study conducted by Forrester Consulting found that an automated system helps organizations manage, streamline, and secure transactions across hypercomplex ecosystems of healthcare users, locations, devices, and locations. What’s more, according to Forrester, automation also saves time and money and results in a higher quality patient experience.
Fact is, even in the normal times, healthcare organizations rarely excel at tracking personnel moves, especially the adds and changes due to the time and system constraints often involved. That leads to what I call a “stacked shares” situation. These typically involve a person with decades of experience in your organization who has worked in multiple administrative or clinical areas within the organization and has access to about 80 percent of your network shares because she/he was never deprovisioned from ANY shares. In these instances, the network shares just kept getting “stacked,” one on top of the other. That’s probably exactly what happens during the COVID-19 pandemic as people move around to adapt to the ongoing crisis.
Another unexpected challenge created by the pandemic relates to furloughs. What is your healthcare organization doing with them? Are you disabling and then re-enabling accounts? Re-provisioning when/if they come back? What if they’ve come back but in a new role? Again, the “stacked shares” situation arises. You will likely regret it if your organization doesn’t have an automated IGA system to help you keep track of these movements through an integrated GRC system.
Moving to a Remote Workforce COVID-19 forced many healthcare organizations to rapidly accommodate a remote workforce. Only a few departments worked remotely before the pandemic, so routers, network, architecting, and bandwidth all had to be upgraded. Most health systems also required additional licensing to successfully ramp up services. Above all, the priority was to prevent any serious disruptions for clinicians.
Here again, health systems faced the challenge of balancing usability with security concerns. Tools like Zoom and Microsoft Teams proved useful, but they created additional risks including diminished safety of our healthcare workers, cybersecurity intrusions, and hacks – like theft of PHI, ransomware, and more. IT staff had to ensure the security of both the devices and the platforms being used, which is also easily managed by solid IGA systems.
In these cases, IGA systems analyze login data in real-time via Login Activity reports. They weave digital identity and access management, single-sign-on capabilities, and governance into workflows to strengthen security without compromising care delivery. This includes remote identity proofing to enable electronic prescribing of controlled substances (EPCS), as well as ensure compliance with DEA regulations while avoiding in-person interactions.
We will no doubt be living in a world of both in-person and remote healthcare for some time given the COVID-19 crisis. One lesson we already learned from the big experiment we just completed is that healthcare organizations benefit from having an IGA system in place to help balance their healthcare delivery, efficiency, and safety, as well as security and compliance. Implementing an IGA strategy no doubt makes it easy for clinicians to securely and seamlessly transition between workstations and applications and have their identity follow them.
About Wes Wright
Wes Wright is the Chief Technology Officer at Imprivata and has more than 20 years of experience with healthcare providers, IT leadership, and security. Prior to joining Imprivata, Wes was the CTO at Sutter Health, where he was responsible for technical services strategies and operational activities for the 26-hospital system. Wes has been the CIO at Seattle Children’s Hospital and has served as the Chief of Staff for a three-star general in the US Air Force.
Analysing real-world health data could help overcome the bias towards men in traditional medical research, says Sensyne Health’s Dr Lucy Mackillop.
Collecting and analysing anonymised patient data has the potential to generate valuable insights that can catalyse research, lead to improved patient care, and power the development of new treatments.
Being able to analyse large data sets can provide a better understanding of how some patients will respond to a treatment or predict who may develop a disease based on data collected during clinical care.
Medical research has often focused on men, meaning that the insights gained have not always been reflective of how women would react to a treatment or disease. Women are likely to have different symptoms to men for the same illness and do not necessarily have the same reactions to certain drugs or respond to the same doses as a male counterpart.
Therefore, it is important to increase the collection and analysis of women’s health data so better insights can be gained for supporting their care.
“The effect of failing to include women proportionately in clinical trials may have consequences for the quality of medical care women receive, with therapies, doses and risk assessment tools being tailored to the male population”
The impact of underrepresenting women
Research from the Allen Institute for Artificial Intelligence found that over the past 25 years, although women have made up nearly half (49%) of participants across drug trials, for many types of disease the proportion of female participants did not match the gender breakdown of real-world patients. In trials for cardiovascular, HIV, kidney disease and digestive diseases, women have especially been underrepresented.
The effect of failing to include women proportionately in clinical trials may have consequences for the quality of medical care women receive, with therapies, doses and risk assessment tools being tailored to the male population. The use of real-world medical data from women may change this – and more broadly, ensure that representative samples of data are used for the disease or issue.
What we can learn during pregnancy
As well as collecting more representative samples of data from women for conditions like cardiovascular disease, accurate data collected during pregnancy could offer a valuable information.
This is because typically, ‘real-world’ medical data is collected from patients who are ill. However, pregnancy is a unique time when large quantities of data are collected in otherwise ‘healthy’ women.
Pregnancy can also act as a cardiometabolic stress test for women and reveal underlying susceptibilities to conditions such as diabetes or hypertension.
Therefore, by analysing the data collected during a woman’s pregnancy, clinicians can view a window into future health risks and understand who is most at risk. This helps develop better preventative strategies and also prioritises care.
Research has found that the environment in which a baby grows has a significant impact on its health throughout its life. This means that being able to improve the way we care for pregnant women through collecting and analysing data can also significantly influence the health of their offspring.
While collecting data from patients is important in development of new treatments, clinical research, and patient care, there must be a greater focus on ensuring that women are well represented in trials.
For pregnant women in particular, the information that their medical records can offer must be recognised, and databases that can be used to support the improvement of care and outcomes has the potential to provide important insights.
About the author
Dr Lucy Mackillop is a consultant obstetric physician at Oxford University Hospitals NHS Foundation Trust; honorary senior clinical lecturer, Nuffield Department of Women’s and Reproductive Health, University of Oxford; and chief medical officer at Sensyne Health.
– Nuance Communications, Inc. announced the Kettering
Health Network has selected ED Guidance for Nuance Dragon Medical Advisor.
– This AI-powered computer-assisted physician
documentation (CAPD) solution will help reduce physicians’ administrative
burden while lowering the risk of adverse safety events, missing diagnoses, and
malpractice litigation – priorities for all physicians, especially in the ED
where the nature of care presents special challenges and risks.
Kettering Health is deploying ED Guidance for Nuance Dragon
Medical Advisor to improve patient safety, alleviate the administrative burden
on clinicians, and reduce the risk of missing diagnoses by:
– Extending the Nuance CAPD solution to physicians in its 12
full-service emergency centers through its existing use of the Nuance Dragon
Medical One HITRUST CSF-certified conversational AI platform for documenting
care in the electronic health record (EHR).
– Empowering physicians with integrated real-time,
evidence-based emergency medical guidance from The Sullivan Group.
– Supporting best-practices-based clinical decision-making
and accurate documentation of the severity of illness and acuity of each
patient at the point of care within clinician’s standard EHR workflows.
– Using Nuance conversational AI to automatically identify
and add critical details that may impact patient treatment in real-time.
Sullivan Group Outcomes/Results
The Sullivan Group’s content has been shown to decrease the
occurrence of adverse safety events and reduce diagnosis-related malpractice
claims by up to 70 percent, and with the integration into Nuance Dragon Medical
Advisor, this guidance can be delivered in real-time while the patient is still
in the ED. ED Guidance for Nuance Dragon Medical Advisor also provides powerful
analytics for assessing ED performance and improving care quality and financial
outcomes.
“We see Nuance Dragon Medical One and Dragon Medical Advisor as essential tools that help physicians use the EHR efficiently for delivering high-quality patient care,” said Dr. Charles Watson, DO, Chief Medical Information Officer at Kettering Health. “Patient safety and reducing the administrative burdens of documentation and compliance are priorities for all physicians, especially in the ED, where the nature of care presents special challenges and risks. The ability to add those tools and data analytics via the cloud will help us align our clinical and compliance practices with diagnostic drivers more quickly and accurately.”
Vanessa Kuhn, Director of Health Policy, PatientPing
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.
Risk-Sharing Options:
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.
Bottom Line:
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.
– ARC Innovation brings new technologies into the hospital
and community healthcare ecosystem to further improve patient care. It enables
data fluidity and integration amongst innovators; scientists; startups;
high-level developers; large and small companies; investors; and academia all
under one roof.
– ARC includes six medical tracks, with a senior Sheba
physician leading each: telemedicine, precision medicine, digital innovation
focusing on big data and artificial intelligence, augmented and virtual
reality, rehabilitation and surgical innovation.
– “Working in tandem with Sheba will enable us to participate in an open collaboration with world leaders in global healthcare innovation, all of us working together to find new and innovative ways to deliver patient care,” said Holy Name Medical Center, President & CEO Michael Maron in a statement.
Clinicians in healthcare settings typically have information coming at them from all directions, at all times, and often with little distinction as to the level of urgency. It makes for inefficiency and confusion for today’s busy doctor.
In today’s hospital setting, that disjointed communication creates dissonance and distraction. Even though the world has gravitated to the ubiquitous use of smartphones, that’s not the dominant form of connection for physicians. The vast majority of hospitals still depend on paging systems to quickly reach doctors as they circulate through a facility and even outside it.
In fact, a study published in the Journal of Hospital Medicine in 2017 found that hospitals provided pagers to 80 percent of hospital-based clinicians, and more than half of all physicians in the survey reported that they received patient care-related communication most commonly by pager. Other information sources reported in the study included unsecured standard text messaging (53 percent of clinicians), and 27 percent used a secure messaging application.
While paging systems seem like a throwback form of technology, they have a history of providing reliable connections between clinicians in hospital settings. They operate on a frequency that is less prone to interference, and they travel significantly farther than messages traveling on cellular networks or Wi-Fi. That means pager signals reach hospital areas that are likely to have bad reception, such as radiology departments or basements. In addition, pager signals are not susceptible to surges in demand or network overload situations, which may occur during emergencies.
However, many hospitals are taking steps to resolve some of these issues. For example, a variety of technologies, such as repeaters, range extenders, or boosters, can improve coverage to challenge areas for both Wi-Fi and cellular networks.
Even so, pagers – a technology that was patented in 1949 and first used in New York City’s Jewish Hospital – are now a duplicative device that does not match the capability of the smartphones that physicians rely on. Many report that it’s frustrating to have to carry a separate paging device that does not fully meet their communication needs.
Pagers don’t work like physicians need them to. For example, it’s frustrating to receive a page, then return the call as requested, only to find that the doctor or nurse who initiated the page is no longer on duty or otherwise inaccessible. That typically requires a message to voicemail or further calls to find out how to reach the other clinician. Communication that could be handled in two minutes with a smartphone could take as much as half an hour to complete with a pager-based system. And that interferes with other work that a clinician should be accomplishing during hospital rounds.
Here’s one real-life example from a surgeon at a major Boston-area hospital. The doctor needed to reach a radiology technologist after regular work hours to get post-surgery X-ray images of a patient uploaded to another EHR system. The physician eventually calls the technologist’s pager number, but there are no instructions for how to ensure the message was left or even if the page went through. The physician calls a nurse to have her call the technologist’s page number on his behalf, but still has no assurance that the call went through. Finally, the technologist returned the call after 35 minutes and multiple phone calls.
Paging systems also have security shortcomings. Many pagers are not fully secure, exposing messages sent over a system to anyone who can tap into the frequency being used. As a result, many pagers and pager messaging systems are not HIPAA compliant, exposing hospitals to potential liability or even hacking or service attacks that could impact communications.
To improve efficiency and security, healthcare organizations need to look to gravitate toward an all-encompassing medical communications system that captures all pager-like messages and seamlessly incorporates them into a collaboration platform that does not rely on store-and-forward functionality.
Over recent years, clinicians have come to accept and widely use smartphones as a form factor, and their multi-tasking capability also enables clinicians to do more than one task – for example, communicate via text messages, consult an electronic health records system and engage in verbal communication with one or more clinicians.
While the utility of the pager network remains and pager systems are likely to stay in use for the foreseeable future, it is important for healthcare systems to keep the technology but get away from the pager form factor. Transforming the system won’t get rid of pagers completely but will enable physicians to get pager messages in a different way, connecting the current highly accessible pager network directly to a medical professional’s smartphone.
Such a strategy combines the ease of use and convenience of a smartphone with the advantages of a pager network.
About Fred Lizza
Fred Lizza is CEO of Statum Systems , a developer of advanced mobile collaboration platforms geared to caregivers. He was previously CEO of StrategicClaim, an insurance claims platform, and Freestyle Solutions, an e-commerce leader. Fred earned his MBA from Harvard University.
Kelly Patrick, Principal Analyst at Signify Research
Without a doubt 2020 has been a devastating year for many; the impact of COVID-19 on both personal lives and businesses has had long-term consequences. At the end of September, the number of COVID-19 cases fell just short of 350 million, with just over 1 million deaths reported. The expectation of a second peak in many countries exposed to the deadly illness is being handled with care, with many governments attempting to minimize the impact of an extreme rise in cases.
COVID-19 the aftermath will be the new normal?
Despite the chaotic attempts to dampen the impact of a second peak, it is inevitable that healthcare facilities will be stretched once again. However, there are key learnings to be had from the first few months of the pandemic, with several healthcare providers opting to be armed with as much information to tackle the likely imminent surge of patients with COVID-19 head-on. The interest in solutions that offer support to clinicians through data analysis is starting to emerge with several COVID-19 specific Artificial Intelligence (AI) algorithms filtering through the medical imaging space.
Stepping into the ICU, the use of analytics and AI-based clinical applications is drawing more attention. Solutions that collect relevant patient information, dissect the information, and offer clinical decision support are paving the way to a more informed clinical environment. Already, early-warning scoring, sepsis detection, and predictive analytics were becoming a focus. The recent COVID-19 outbreak has also driven further interest in COVID-19 specific applications, and tele-ICU solutions, that offer an alternative way to ensure high-risk patients are monitored appropriately in the ICU.
What does the future hold?
Signify Research is currently in the process of assessing the uptake of clinical decision support and AI-based applications in the high acuity and perinatal care settings. An initial assessment has highlighted various solutions that help improve not only the efficiency of care but also improve its quality. Some of the core areas of focus include:
Clinical Decision Support & Predictive Analytics
Due to the abundance of patient data and information required to be regularly assessed and monitored, the high-acuity and perinatal care settings benefit from solutions offering clinical decision support.
The ICU specifically has been a focus of many AI solution providers, with real-time analysis and support of data to provide actionable clinical decision support in time-critical situations. Clinical decision support solutions can collate data and identify missing pieces of information to provide a complete picture of the patient’s status and to support the treatment pathway. Some of the key vendors pathing the way for AI in clinical decision support in the ICU include AiiNTENSE; Ambient Clinical Analytics; Etiometry; BetterCare; AlertWatch; and Vigilanz Corp.
Early-warning
Early-warning protocols are commonly used in hospitals to flag patient deterioration. However, in many hospitals this is often a manual process, utilizing color coding of patient status on a whiteboard in the nurse’s station. Interest in automated early-warning systems that flag patient deterioration using vital signs information is increasing with the mounting pressure on stretched hospital staff.
Examples of early-warning software solutions include the Philips IntelliVue Guardian Solution and the Capsule Early Warning Scoring System (EWSS). Perigen’s PeriWatch Vigilance is the only AI-based early-warning scoring system that is developed to enhance clinical efficiency, timely intervention, and standardization of perinatal care.
The need for solutions that support resource-restricted hospitals has been further exacerbated during the COVID-19 pandemic. Many existing early-warning vendors have updated their surveillance systems to enable more specific capabilities for COVID-19 patients, specifically for ventilated patients. Companies such as Vigilanz Corp’s COVID Quick Start and Capsule Tech’s Clinical Surveillance module for ventilated patients enables healthcare professionals to respond to COVID-19 and other viral respiratory illnesses with customizable rules, reports, and real-time alerts.
Sepsis Detection
Sepsis is the primary cause of death from infection, accounting for 20% of global deaths worldwide. Sepsis frequently occurs from infections acquired in health care settings, which are one of the most frequent adverse events during care delivery and affect hundreds of millions of patients worldwide every year. As death from Sepsis can be prevented, there is a significant focus around monitoring at-risk patients.
Several health systems employ their own early-warning scoring protocol utilizing in-house AI models to help to target sepsis. HCA Healthcare, an American for-profit operator of health care facilities, claims that its own Sepsis AI algorithm (SPOT) can detect sepsis 18-hours before even the best clinician. Commercial AI developers are also focusing their efforts to provide supporting solutions.
The Sepsis DART™ solution from Ambient Clinical Analytics uses AI to automate early detection of potential sepsis conditions and provides smart notifications to improve critical timeliness of care and elimination of errors. Philips ProtocolWatch, installed on Philips IntelliVue bedside patient monitors, simplifies the implementation of evidence-based sepsis care protocols to enable surveillance of post-ICU patients.
Tele-ICU
The influx of patients into the ICU during the early part of 2020 because of COVID-19 placed not only great strain on the number of ICU beds but also the number of healthcare physicians to support them. Due to the nature of the illness, the number of patients that were monitored through tele-ICU technology increased, although the complex nature of implementing a new tele-ICU solution has meant the increase has not been as pronounced as that of telehealth in primary care settings.
However, its use has enabled physicians to visit and monitor ICU patients virtually, decreasing the frequency and need for them to physically enter an isolation room. As the provision of healthcare is reviewed following the pandemic, it is likely that tele-ICU models will increase in popularity, to protect both the patient and the hospital staff providing direct patient care. Philips provides one of the largest national programs across the US with its eICU program.
Most recently, GE Healthcare has worked with Decisio Health to incorporate its DECISIOInsight® into GE Healthcare’s Mural virtual care solution, to prioritize and optimize ventilator case management. Other vendors active within the tele-ICU space include Ambient Clinical Analytics, Capsule Health, CLEW Med, and iMDsoft.
Figure 1 Signify Research projects the global tele-ICU market to reach just under $1 billion by 2024.
Interoperable Solutions
More and more solutions are targeted toward improving the quality of patient care and reducing the cost of care provision. With this, the requirement for devices and software to be interoperable is becoming more apparent. Vendors are looking to work collaboratively to find solutions to common problems within the hospital. HIMMS 2020 showcased several collaborations between core vendors within the high acuity market. Of note, two separate groups demonstrated their capabilities to work together to manage and distribute alarms within a critical care environment, resulting in a quieter experience to aid patient recovery. These included:
– Trauma Recovery in the Quiet ICU – Ascom, B Braun, Epic, Getinge, GuardRFID, Philips
About Kelly Patrick, Principal Analyst at Signify ResearchKelly Patrick, Principal Analyst at Signify Research
Kelly Patrick is the Principal Analyst at Signify Research, a UK-based market research firm focusing on health IT, digital health, and medical imaging. She joined Signify Research in 2020 and brings with her 12 years’ experience covering a range of healthcare technology research at IHS Markit/Omdia. Kelly’s core focus has been on the clinical care space, including patient monitoring, respiratory care and infusion.
– “The Patient Keepage & Leakage Report” offers an in-depth, state of the industry look at health system executives’ views on the challenge of patient leakage, in which patients seek care beyond their networks. Although 96% of health system execs surveyed said that addressing patient leakage is a top priority, very little research had been done on this topic—until now.
– The report, conducted by an independent market research firm, includes responses from a random sample of 138 senior health system and hospital executives (80% C-suite) responsible for patient care, hospital administration, finance, or operations.
Nearly all (96%) of healthcare executives say patient
leakage is a priority this year, but only 31% of leaders who have a plan to
keep patients within their health system networks believe they have the right
tools to accomplish their goals, according to survey results released today
from Central Logic, the
industry innovator in enterprise visibility and tools to accelerate access to
care.
Central Logic
commissioned an independent market research firm to conduct a survey about
patient leakage and care access, with respondents consisting of a random sample
of 138 double-verified senior health system and hospital executives responsible
for patient care, hospital administration, finance or operations. The challenge
of patient leakage—in which patients seek care beyond their network—has taken
on greater importance during COVID-19, as
hospitals’ and health systems’ operating margins have dropped
precipitously. While CARES Act funding has offered some financial relief, these
organizations are expected to lose more than $323 billion in 2020 due
in large part to restrictions on elective procedures and patients canceling or
deferring care.
“The
Patient Keepage & Leakage Report, based on the results of our
survey, highlights a crisis of confidence among healthcare executives that
started even before COVID-19,” said Angie Franks, CEO of Central
Logic. “The pandemic has exacerbated this crisis, but attracting,
retaining and repatriating patients back into health system networks is now an
incredibly important financial priority for health system leaders, given the
massive financial losses they have suffered.”
In the Patient Leakage & Keepage Report, 80% of
executives said value-based care models have made addressing patient leakage more
important, but more than 38% either were unconfident or didn’t know if their
organization had visibility into leakage.
Of the survey respondents, 80% were C-level executives, and
two-thirds represented hospital networks with 251 or more beds—of those, more
than 20% represented networks of 1,500 beds or more.
Other highlights of the Patient Leakage & Keepage Report
include:
– 75% said patient leakage is a significant obstacle to
their financial goals
– Only 31% of the healthcare systems who definitely have a
strategy to reduce patient leakage said they have the right tools to get it
done
– Organizations that don’t use technology to quantify
patient leakage were less likely to know which service lines were most affected
by loss of patients
For more information, click the download now button below:
– Nuance Communications, Inc. announced the U.S.
Department of Veterans Affairs (VA) is using the Nuance Dragon Medical One
speech recognition cloud platform and its mobile app, PowerMic Mobile.
– The solution helps VA doctors better document patient
care in-person, and now remotely through expanded telehealth services necessary
in the COVID-19 era.
Helping Physicians Document Care During Virtual Visits
The cloud-based technology allows VA physicians to use their voices to capture and document patient stories securely, accurately, and more efficiently during virtual visits conducted by phone and the widely deployed VA Video Connect platform. Nuance Dragon Medical One is the leading medical speech recognition solution today used by over 550,000 physicians. Compatible with the VA CPRS and Cerner Millennium, it is a key productivity component in EHR solutions throughout the Federal Government, including Veterans Affairs and the Military Health System. Because the VA first standardized on Nuance cloud-based Dragon Medical solutions system-wide in 2014, physicians could readily adopt the added capabilities and mobile flexibility of Dragon Medical One for telehealth services.
“Helping frontline clinicians at the VA and other major health systems has been our highest priority since the pandemic began,” said Diana Nole, executive vice president and general manager of healthcare, Nuance. “The combination of our cloud-based platforms, organizational agility and deep experience working with the VA health system made it possible for us to act quickly and deliver the technology solutions needed to protect and assist physicians treating patients remotely. While our strong sense of mission and purpose in serving critical healthcare organizations and businesses already is very clear, it becomes amplified knowing that our technology solutions are playing a role in caring for our nation’s Veterans.”
– FUJIFILM Medical Systems U.S.A., Inc. and Volpara
Solutions announced the extension of their partnership to provide mammography
facilities and clinicians with breast imaging solutions designed to improve
image quality, streamline workflow and accurately assess a patient’s breast
density.
– Building on a successful 6-year partnership, Fujifilm’s
customers using ASPIRE Cristalle with Digital Breast Tomosynthesis (DBT) now
have access to the latest innovations from Volpara’s Breast Health Platform.
FUJIFILM
Medical Systems U.S.A., Inc., a provider of diagnostic imaging
and medical informatics solutions, and Volpara Solutions, a
purpose-driven software company on a mission to prevent advanced-stage breast
cancer, today announced an expanded partnership to provide mammography
facilities and clinicians with breast imaging solutions designed to improve
image quality, streamline workflow and accurately assess a patient’s breast
density.
Building on a successful 6-year partnership, Fujifilm’s
customers using ASPIRE
Cristalle with Digital Breast Tomosynthesis (DBT) will now have access
to the latest innovations from Volpara’s Breast Health Platform. Volpara®Live!
helps reduce patient recalls due to poor image quality by giving mammographers
instant feedback on positioning and compression—which the FDA attributes as the
cause of most image deficiencies—for adjustment before the patient leaves the
room. Volpara Enterprise provides a comprehensive analysis of quality on
every mammogram and tomosynthesis image taken at the facility to identify
opportunities for improvement.
Early Detection is Critical to Breast Cancer Survival
Dense breast tissue is associated with an increased risk of developing breast cancer. Volpara’s Enterprise includes a module that uses proprietary x-ray physics, AI, and machine learning to generate an accurate volumetric measure of breast composition. It provides a repeatable, consistent, and objective means of scoring breast density.
“Early detection is critical to breast cancer survival. It’s essential that clinicians and patients have as many resources available to them to quickly and accurately find any possible signs of disease,” said Christine Murray, Women’s Health Product Manager, FUJIFILM Medical Systems U.S.A., Inc. “Fujifilm is thrilled to expand our relationship with Volpara Solutions to offer our customers the clinical decision-support tools they need to improve mammography quality and enhance patient care.”
– UAB Medicine has announced a large-scale, strategic
telemedicine partnership with Advanced ICU Care that will encompass the entire
health system, one of the top three largest public hospital facilities in the
U.S.
– The relationship initiates the development of a new
tele-ICU care operations center and envisions serving up to 750 ICU beds in
Alabama and surrounding states.
UAB Medicine, a nationally recognized leader in patient care, research and training and Advanced ICU Care, a provider of high-acuity telemedicine services, announced a large strategic telemedicine partnership with the technology, operations, and care partnership encompass the entire UAB Health System including the University of Alabama at Birmingham Hospital, the third-largest public hospital facility in the U.S. The relationship initiates with the development of a new tele-ICU operations center in Birmingham and envisions serving up to 750 ICU beds in Alabama and surrounding states.
Tele-ICU Supports Critically Ill Patients Throughout UAB Health
System
As the nation’s leading provider of high-acuity telemedicine
services, Advanced ICU Care’s proprietary HUB workflow management software
platform uniquely addresses the challenges associated with the customized
delivery of acute patient care at high volumes across multiple care venues. In
addition, the company’s technical, operational, and clinical expertise draw
upon its care of over a half million tele-ICU patients and care partnerships
with more than 100 hospitals nationwide. UAB Medicine brings to the
collaborative relationship additional clinical expertise as a national leader
in pulmonary and critical care medicine.
“Advanced ICU Care’s clinical and operational expertise and proprietary HUB workflow management software are assets that are well aligned with UAB’s vision for our tele-ICU programs,” said Reid Jones, CEO of UAB Medicine. “Telehealth and tele-ICU have become increasingly important vehicles for healthcare delivery, and we look forward to leveraging Advanced ICU Care’s assets to deliver high-acuity telemedicine to patients across Alabama and beyond.”
– Health technology leader WellSky has agreed to acquire
CarePort Health to power coordinated care transitions for acute and post-acute
care patients for $1.35B.
– By providing end-to-end visibility across the
continuum, WellSky and CarePort can improve outcomes, lower costs, and increase
patient satisfaction.
WellSky, a global health, and community care technology company, announced today that it has entered into a definitive agreement with Allscripts to acquireCarePort Health (“CarePort”), a Boston, MA-based care coordination software company that connects acute and post-acute providers and payers.
Financial Details
The agreed sale price of $1.35 billion represents a multiple
of greater than 13 times CarePort’s revenue over the trailing 12 months, and
approximately 21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12
months. CarePort is included in Allscripts Data, Analytics and Care Coordination
reporting segment and represents approximately 6% of Allscripts consolidated
revenues. Reference should be made to the Allscripts quarterly earnings reports
and supplemental financial data for a reconciliation of non-GAAP Adjusted
EBITDA. William Blair and J.P. Morgan Securities, LLC acted as financial
advisors to Allscripts in connection with the sale of CarePort.
Acquisition Enhances Care Coordination Across Acute,
Post-Acute Continuum
As part of the acquisition, WellSky and CarePort will facilitate effective patient care transitions across the continuum — driving better outcomes for patients, providers, and payers. With the addition of CarePort, WellSky is uniquely positioned to manage the acute care discharge process, track patients across post-acute care settings, apply patient and population-level analytics, and support EMR-based care protocols.
CarePort’s EHR-agnostic suite of solutions connects the
discharge process with post-discharge care coordination — allowing providers
and payers to track and manage patients throughout their care journey. By
providing end-to-end visibility across the continuum, WellSky and CarePort can
improve outcomes, lower costs, and increase patient satisfaction.
“As part of the WellSky team, we will be able to accelerate our mission to connect providers across the continuum. Both of our organizations are aligned in our dedication to proactively bridging gaps in care. Together, we have the technology, analytics, and network to ensure that patients receive seamless care,” said Dr. Lissy Hu, CEO of CarePort. “Joining WellSky means that we can increase vital connections between acute, post-acute, and community care providers to make a meaningful difference in the lives of more patients in more places.”
With WellSky’s deep experience in post-acute care and
CarePort’s suite of care coordination solutions, this combination is a natural
fit. CarePort clients will gain access to a broader network of post-acute
providers and can leverage WellSky’s powerful predictive analytics suite, and
leading value-based care technologies. This combination of capabilities will
enable health systems, payers, and post-acute providers to more effectively
collaborate in a data-driven way and enhance patient outcomes.
“Together with CarePort, WellSky will establish new, meaningful connections between historically disparate settings of care. We have the exciting opportunity to bring care coordination to more providers in service of delivering more informed, personalized care,” said Bill Miller, CEO of WellSky. “Through this agreement, we’re ensuring our clients have the intelligent technology they need to do right by their patients, collaborate with payers, and succeed in value-based care models. It’s WellSky’s mission to realize care’s potential, and this moves us that much closer to achieving it.”
Jerry Carlson, Product Support Manager, BG DI BU IC Sales, Dunlee
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.
– Augmedix closes $25 million in private placement
funding and completion of a reverse merger transaction with Malo Holdings Corp.
– Following the transaction, the merged entity will be
named “Augmedix, Inc.”, and will continue the historic and innovative
business of Augmedix.
Augmedix, a company
specializing in providing remote medical documentation and live clinical
support services, today announced the closing of a $25 million private
placement financing and completion of a reverse merger with Malo Holdings Corp.
In connection with the financing, current investors Redmile Group, DCM, and
McKesson Ventures invested alongside new investors. Financial advisory firms, Stifel, Nicolaus
& Company, Incorporated, B. Riley Securities, Inc., and GP Nurmenkari, Inc.
(as consulted by Intuitive Venture Partners) acted as placement agents for the
private placement. Montrose Capital
Partners was the sponsor for this transaction.
Reverse Merger Details
Augmedix further announced the completion of a reverse
merger transaction with Malo Holdings Corp., an SEC-reporting public Delaware
corporation. Following the transaction, the merged entity will be named
“Augmedix, Inc.”, and will continue the historic and innovative
business of Augmedix. In connection with
the financing and merger, Augmedix agreed to cause its common stock to be
quoted on the OTC Markets QB tier, subject to certain terms and conditions.
Remote Medical Documentation & Live Clinical Support
Founded in 2012, Augmedix converts natural clinician-patient
conversation into medical documentation and provides live support, including
referrals, orders, and reminders, so clinicians can focus on what matters most:
patient care. The Augmedix platform is powered by a combination of proprietary
automation modules and human-expert assistants operating in HIPAA-secure
locations to generate accurate, comprehensive, and timely-delivered medical
documentation.
Augmedix services are compatible with over 35 specialties
and are trusted by over one dozen American health systems supporting
telemedicine, medical offices, clinics, and hospitals. We estimate that our solution saves
clinicians 2–3 hours per day, increases productivity by as much as 20%, and
increases certain clinicians’ satisfaction with work-life balance by 49%
Manny Krakaris, Augmedix Chief Executive Officer, said, “We’re thrilled to complete this financing, which we believe puts Augmedix on the path of accelerated expansion, and will enable us to broaden our operational capabilities, accelerate our technology research and product development, and strengthen our marketing and sales.” Krakaris noted that the COVID-19 pandemic has accelerated the growth of telemedicine and enabled Augmedix to showcase its competitive advantages in the medical documentation market. “Because the Augmedix service is accessed through mobile devices and is telemedicine application-agnostic, our innovative technology allows clinicians access to medical note documentation, regardless of their location,” Krakaris said.
– Amazon Web Services (AWS) and the Pittsburgh Health Data Alliance (PHDA) announce a collaboration to produce more accurate machine learning models for breast cancer screening and depression.
– In work funded through the PHDA-AWS collaboration, a research team led by Shandong Wu, an associate professor at the University of Pittsburgh Department of Radiology, is using deep-learning systems to analyze mammograms in order to predict the short‐term risk of developing breast cancer.
– A team of experts in computer vision, deep learning,
bioinformatics, and breast cancer imaging, including researchers from the
University of Pittsburgh Medical Center (UPMC), the University of Pittsburgh,
and Carnegie Mellon University (CMU), are working together to develop a more
personalized approach for patients undergoing breast cancer screening.
Last August, the Pittsburgh Health Data Alliance (PHDA)
and Amazon Web Services (AWS)
announced a new collaboration to advance innovation in areas such as cancer
diagnostics, precision medicine, electronic health records,
and medical imaging. One year later: AWS collaboration with Pittsburgh Health
Data Alliance begins to pay dividends with new machine learning innovation.
Researchers from the University of Pittsburgh Medical Center
(UPMC), the University of Pittsburgh, and Carnegie Mellon University (CMU),
who were already supported by the PHDA, received additional support
from Amazon Research Awards to use machine learning
techniques to study breast cancer risk, identify depression markers, and
understand what drives tumor growth, among other projects.
Accurate Machine Learning Models for Breast Cancer Screening
and Depression
In work funded through the PHDA-AWS collaboration, a
research team led by Shandong Wu, an associate professor in the University of
Pittsburgh Department of Radiology, is using deep-learning systems to analyze
mammograms in order to predict the short‐term risk of developing breast
cancer. A team of experts in computer vision, deep learning,
bioinformatics, and breast cancer imaging are working together to develop a
more personalized approach for patients undergoing breast cancer screening.
Wu and his colleagues collected 452 de-identified normal
screening mammogram images from 226 patients, half of whom later developed
breast cancer and half of whom did not. Leveraging AWS tools, such as
Amazon SageMaker,
they used two different machine learning models to analyze the images for
characteristics that could help predict breast cancer risk. As they reported in
the American Association of Physicists in Medicine, both
models consistently outperformed the simple measure of breast density, which
today is the primary imaging marker for breast cancer risk, The team’s
models demonstrated between 33% and 35% improvement over these existing
models, based on metrics that incorporate sensitivity and specificity.
Why It Matters
“This preliminary work demonstrates the feasibility and promise of applying deep-learning methodologies for in-depth interpretation of mammogram images to enhance breast cancer risk assessment,” said Dr. Wu. “Identifying additional risk factors for breast cancer, including those that can lead to a more personalized approach to screening, may help patients and providers take more appropriate preventive measures to reduce the likelihood of developing the disease or catching it early on when interventions are most effective. “
Tools that could provide more accurate predictions from screening images could be used to guide clinical decision making related to the frequency of follow-up imaging and other forms of preventative monitoring. This could reduce unnecessary imaging examinations or clinical procedures, decreasing patients’ anxiety resulting from inaccurate risk assessments, and cutting costs.
Moving forward, researchers at the University of Pittsburgh
and UPMC will pursue studies with more training samples and longitudinal
imaging data to further evaluate the models. They also plan to combine deep
learning with known clinical risk factors to improve upon the ability to
diagnose and treat breast cancer earlier.
Second Project to Develop Biomarkers for Depression
In a second project, Louis-Philippe Morency, associate
professor of computer science at CMU, and Eva Szigethy, a clinical researcher
at UPMC and professor of psychiatry, medicine, and pediatrics at the University
of Pittsburgh, are developing sensing technologies that can automatically measure
subtle changes in individuals’ behavior — such as facial expressions and use of
language — that can act as biomarkers for depression.
These biomarkers will later be compared with the results of
traditional clinical assessments, allowing investigators to evaluate the
performance of their technology and make improvements where necessary. This
machine learning technology is intended to complement the ability of a
clinician to make decisions about diagnosis and treatment. The team is working with a gastrointestinal-disorder
clinic at UPMC, due to the high rate of depression observed in patients with
functional gastrointestinal disorders.
This work involves training machine learning models on tens
of thousands of examples across multiple modalities, including language (the
spoken word), acoustic (prosody), and visual (facial expressions). The
computational load is heavy, but by running experiments in parallel on multiple
GPUS AWS services have allowed the researchers to train their models in a few
days instead of weeks.
A quick and objective marker of depression could help
clinicians more efficiently assess patients at baseline, identify patients who
would otherwise go undiagnosed, and more accurately measure patients’ responses
to interventions. The team presented a paper on the work, “Integrating
Multimodal Information in Large Pretrained Transformers”, at the July 2020
meeting of the Association for Computational Linguistics.
“Depression is a disease that affects more than 17 million adults in the United States, with up to two-thirds of all depression cases are left undiagnosed and therefore untreated,” said Dr. Morency. “New insights to increase the accuracy, efficiency, and adoption of depression screening have the potential to impact millions of patients, their families, and the healthcare system as a whole.”
The research projects on breast cancer and depression
represent just the tip of the iceberg when it comes to the research and
insights the collaboration across PHDA and AWS will ultimately deliver to
improve patient care. Teams of researchers, health-care professionals, and
machine learning experts across the PHDA continue to make progress on key
research topics, from the risk of aneurysms and predicting how cancer cells
progress, to improving the complex electronic-health-records
system.
– New Jersey Urology (NJU) becomes the first urology-only group to launch a urologic-centric Epic electronic health record (EHR).
– NJU is the largest urology practice providing complete
urologic care and comprehensive individualized treatment at more than 60
convenient locations, including six state-of-the-art Cancer Treatment Centers.
New Jersey Urology (“NJU”), the leading urology service provider in New Jersey, and Urology Management Associates (“UMA”), NJU’s administrative practice management, today announced the launch of its urologic-centric Epicelectronic health record (EHR). The launch marks NJU as the first urology-only group to launch Epic.
NJU is the largest urology practice in the United States providing
complete urologic care and comprehensive individualized treatment at more than
60 convenient locations, including six state-of-the-art Cancer Treatment
Centers.
“NJU will now have a toolset designed to treat urological conditions and meet the unique needs of their patients,” said Leela Vaughn, Epic Vice President. “As the first large, independent urology group to install Epic on its own, NJU is creating a new option for other independent urology practices to get Epic and benefit from NJU’s expertise.”
Why It Matters
As one of the key drivers of becoming a more patient-centric organization, NJU is also using Epic’s patient-facing app, MyChart. Patients can use MyChart to connect with their care team, view their health record, update their demographic and clinical information, request prescription refills , and more. This will vastly improve patient accessibility, increasing patient engagement, and satisfaction.
Amid the COVID-19 pandemic, this offers patients a safer, simplified, and much more streamlined contactless check-in process. The integrated enterprise EHR system pulls together data from NJU’s four legacy systems into one single, merged view within NJU’s 60+ practices across New Jersey and Pennsylvania.
“We selected Epic because it allows NJU to perform under one integrated platform. It supports seamless workflows, efficient coordination, and built-in analytics to improve operational efficiencies,” said Derek Grimes, CIO of NJU. “We began our Epic project back in June 2019, and this launch represents a significant milestone. In partnership with Epic, this initiative is a testament to our amazing NJU Epic team consisting of IT, clinicians, physician champions and Epic Super Users across the entire organization. Epic will revolutionize and transform the daily interactions within our practices, facilitate better patient care, and vastly improve patient outcomes.”
Ruby Raley, VP of Healthcare and Life Sciences at Axway
Twenty years ago, technology consultants started advising CIOs to build less. That’s when the movement towards Commercial Off the Shelf (COTS) began.
Today, there are many shops, especially those in small and medium-sized organizations, with few programmers who build new applications from scratch.
Yes, they have programmers who configure, script, and integrate various applications but very little is built. For the provider community, we have a habit of either sourcing our needs from our Electronic Health Records (EHR) application vendor or buying a “best of breed” application from a niche vendor.
Moving to Software as a Service (SaaS) has even reduced the dread of upgrades. No doubt buying commercial software has enabled all of us to have access to better solutions and in some cases, may have reduced the ongoing run rate. Still, it means technology costs have gone up and a lot of our technology goals have not been achieved.
For example, interoperability remains a point to point problem. ONC and CMS are still pushing to remove barriers to interoperability and have mandated data exchange with penalties.
CIOs are struggling with the realities of constraint budgets where new programs are starving while dollars go to pay maintenance, integration costs associated with prior purchases (e.g. tech debt).
New Challenges
Then, in a year of the normal pull-and-tug between maintaining current and delivering new systems, COVID-19 arrived and our planning fell short. Technology teams were challenged as never before. They suddenly needed to:
– Enable teams to work from home – even teams who have never worked remotely.
– Stand up telehealth solutions in days – not months.
– Find a good external data source with statistics to integrate and then discover a newer, better source days later.
– Provide real-time updates on the availability of hospital rooms to leadership.
– Provide rapidly evolving guidance to patients on admissions changes, new requirements for entrance to facilities reduced access to admitted patients.
– Be a trusted, consistent source of guidance to reduce the spread of the disease.
Unplanned work
This was all new, unplanned work. Work that took resources from other budget areas and other teams. Work that didn’t always meet our aim for better patient care or patient experience.
For example, we saw some providers advertising the availability of telehealth services but requiring a patient to call their primary care doctor to schedule instead of requesting an appointment online. Then due to staff shortages, the patient would land in voice mail, further delaying access to care.
Patients needing tests have been told to get an order from their physician. The truth is telehealth isn’t integrated and isn’t part of our daily processes.
Unsung hero
The story here is the emergence of an unsung hero you can’t find on the nightly news: our IT Teams. We need to arm this group of heroes with better tools. Tools where delivery of new programs, updates to existing processes and integrating new data from external sources can be done in days, not months.
Did your clients link to external data sources such as John Hopkins? Did they need to enable test sources from new partners? Did they need to build new mobile applications to integrate workstations in parking lots and third-party locations?
New approach – Low-Code
Today’s challenges require a new approach that is “low-code.” Low-code is shorthand for an application development environment that is primarily visual and uses simple declarative statements to create applications. The primary goal of low-code is to accelerate program delivery.
This is surely a goal for every healthcare technology team. As enterprise clients embrace low-code, they can ensure readiness by putting these building blocks in place so clients can realize the promised value:
– Authentication Management through APIs (OAuth)
– Standardized access through APIs
– Management and Monitoring
Preparation
In preparation for the adoption of a low-code application platform (LCAP), it is essential to assess the adoption of authentication best practices.
The technology landscape now spans on-prem, private cloud, and public cloud solutions requiring a standardized, tokenized approach to authentication. Without this, security processes will inevitably fall short of the CISO’s goals or will require additional manpower to monitor and maintain.
OAuth is the building block
Given the number of vendors, environments, and the velocity of human interactions (non-employee clinicians, temporary resources of all types, patients, etc.), OAuth is the building block for scalable secure authentication. OAuth is a delegated authentication framework that replaces the need to send credentials in program calls (APIs).
It has been required by CMS for the interoperability rule as a foundation for data sharing. If you haven’t, invest in a centralized identity management system and move to use OAuth to authenticate service and access requests. Standardizing authentication is foundational. Do it before selecting a low-code vendor.
LCAP platforms deliver a variety of methods to access data from other applications. Typical integration patterns include files, database calls (ODBC, JDBC, etc.), and scripting.
Now is the time to adopt API-First and design thinking. Stop building point-to-point integrations – the velocity of LCAP will result in a proliferation of connection methods if interfaces are not standardized.
Using APIs – fast delivery
Using APIs will enable faster delivery and better performance. Providing a set of standardized interfaces that meet the needs of consumers (a fundamental goal of API-First) will reduce test time, production breakage, and upgrade complexity. Don’t wait.
Doing APIs right requires a culture shift – slapping an API on an enterprise application is not the goal. Delivering APIs that drive consumption and adoption by citizen developers and go-to-market programs will power user experiences that truly do more with less.
Management and monitoring
Last but not least is the management and monitoring of your new agile applications, especially the application interactions with your core enterprise applications and external integrations. We have all seen it, a new program or upgrade is delivered, and performance slows to a crawl.
Monitoring and metering access (limited access to X number of calls per time period) is essential to proactively prevent coding errors and shield your client from bad actors. Knowing who is accessing what, and how the load varies, is necessary to achieve the goals of delivery velocity and efficient use of resources.
API Management vendor leaders include policy engines, management, and embedded analytics in their gateways to protect and scale service integrations.
Better, faster, cheaper is our mantra (once again, some of us mutter under our breaths). Adopting low-code will accelerate delivery and help us meet the demands of the new normal.
LCAP demands standardized authentication, application program interfaces (APIs), and secure, monitoring gateways to accelerate adoption while protecting and securing enterprise resources.
About Ruby Raley
Ruby Raley is VP of Healthcare and Life Sciences at Axway. Axway empowers customers to compete and thrive in dynamic marketplaces using hybrid integration solutions to better connect their people, systems, businesses, and digital ecosystems. More than 11,000 organizations in 100 countries rely on Axway to solve their data integration challenges.
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.
– Change Healthcare acquires Nucleus.io to create the first of its kind end-to-end, cloud-native Enterprise Imaging to integrate Change Healthcare’s next-generation medical imaging platform.
– The acquisition will accelerate Change Healthcare’s
timeline to implement a complete cloud-based, end-to-end Enterprise Imaging
solution with customers by leveraging the 7,500+ organizations Nucleus.io
currently serves.
Change Healthcare (Nasdaq: CHNG) today announced the acquisition of Nucleus.io, a leader in the development of advanced, fully enabled, cloud-native imaging, and workflow technology. Nucleus.io’s state-of-the-art, cloud-native imaging technology, including a zero-footprint diagnostic viewer with patented streaming technology, workflow, and image sharing solutions, completes Change Healthcare’s next-generation medical imaging platform.
Medical Image Exchange Solution
Nucleus.io ingests, stores, routes, and provides lightning-fast access – from just about anywhere – to all medical images regardless of file size. Nucleus.io’s market-leading medical image exchange solution is utilized by over 7,500 organizations across the U.S., with approximately 150 new organizations onboarding each month. Their advanced, fully enabled, cloud-native imaging technology includes a zero-footprint diagnostic viewer with patented streaming technology, workflow, and image sharing solutions, and more.
“We began our journey eight years ago with the goal of improving patient care by using the power of the web to make medical imaging instantly accessible to patients, providers, and hospitals,” said Dr. Vishal Verma, chief executive officer, NucleusHealth. “Change Healthcare was the clear choice when searching for an organization to deliver our technology to the world. We couldn’t be happier about the opportunity to have Change Healthcare bring our unified vision to light.”
Today’s acquisition supports Change Healthcare’s commitment
to focus on and invest in core aspects of the business to fuel long-term growth
and advance innovation. This will accelerate Change Healthcare’s timeline to
implement a complete cloud-based, end-to-end Enterprise Imaging solution with
customers. Nucleus.io expands Change Healthcare’s addressable market by
leveraging the over 7,500 organizations Nucleus.io currently serves.
Change Healthcare’s Enterprise Imaging Network (EIN) is the
first of its kind, fully managed, cloud-native platform. The foundations of the
platform, including its Archive and Analytics applications, have been
successfully delivered to the market as a cloud-native solution. The
combination of both companies’ technologies and experienced teams will enable
physicians to read, diagnose, and collaborate from anywhere, reduce IT
complexities, and leverage data and Artificial Intelligence (AI) to improve
outcomes.
Why It Matters
“Now more than ever, customers are seeking ways to lower cost, reduce complexity, protect their patient data, and deliver the best care possible. Our next-generation Enterprise Imaging Network platform helps meet those needs in ways not previously possible and delivers exceptional value to our customers,” said Tracy Byers, senior vice president and general manager, Enterprise Imaging, Change Healthcare. “This transaction will accelerate the realization of our vision and the innovation our industry has been waiting for.”
Financial terms of the acquisition were not disclosed.
The importance of handwashing has never been more obvious than in recent months, but as experts continue to share information on the spread of the virus, there’s a need to disinfect more than just our hands. In healthcare settings where the spread of infectious diseases is not just a possibility, but a likelihood on any given day, healthcare leaders are examining the best methods to clean devices, such as mobile computers.
According to a recent study by the Healthcare Infection Society, almost all (99.2%) hospital staff smartphones were contaminated with potential pathogens and thought to pose an infection risk. As mobile devices become even more prominent in everyday care settings, this number shows just how crucial it is for facilities to implement device cleaning protocols. Without a policy in place, the chance of disease spreading in healthcare environments is exponentially higher, putting both patients and providers at risk. In some instances, nurses have been known to have as many as 10 patients in one shift, showing just how many points of contact there are during each nurse’s workday.
Where to Start
As healthcare facilities look to implement their own device cleaning policy, one of the most important factors to remember is that not every device is the same, and as such, not every device will have the same cleaning regimen. The best way for organizations to determine which cleaning agents are safe to use is to refer to the device user guide from the manufacturer. These guidelines typically include the purity or formulation levels for each ingredient, including the types of cleaning agents to avoid. Failure to follow these protocols could result in device damage if the wrong cleaning agents or ingredients are used to wipe it down.
To ensure an optimal cleaning policy and disinfection schedule, it will also be important to consider the environment in which the devices will be used. Devices that are used in patient rooms will need to be disinfected more frequently compared to other locations within a hospital. Determining the number of patients being helped by each practitioner and the reason they are each being cared for can also help facilities develop an appropriate schedule for device disinfection.
Disinfecting Versus Cleaning
Although the terms “cleaning” and “disinfecting” are often used interchangeably in healthcare settings, the two processes are significantly different and suited for very different use cases. When cleaning a device, most facilities are referring to the steps taken to wipe the dirt and other grime from the surface of a mobile device or barcode scanner. This process helps remove visible debris from the device that can be seen by the human eye.
However, this does not remove bacteria and potential pathogens that could be sitting on the device. In order to properly remove bacteria, healthcare workers need to disinfect their devices with the correct cleaning agents. This is where a regular cleaning schedule with guidelines is necessary because routine device cleaning does not always eliminate the dangerous bacteria that can pose a risk to patients and clinicians.
Considering the Right Technologies
One of the biggest limitations holding some organizations back from implementing a proper device wipe down protocol is the durability of the devices in use. Unfortunately, not all mobile devices are purpose-built for healthcare environments and capable of withstanding the rigorous cleaning and disinfection needed to reduce the spread of infectious diseases and bacteria. This is most commonly seen when physicians are using their own consumer-grade devices during patient care. These devices can’t hold up to disinfectant procedures and the chemicals used in these solutions can lead to cracks and breaks in the material. Not only does this pose a risk for cross-contamination and the spread of bacteria from one patient to another, but providers using these devices outside of healthcare facilities can take the bacteria and pathogens home with them.
In order for mobile devices to meet a hospital’s cleaning policies, the right ingress protection (IP) sealing is needed to prevent damage from chemical cleaning solutions. For hospitals allowing physicians to use their own devices, the right sealing will need to be added to their devices to reduce the damage from cleaning agents. Many hospitals though utilize durable or rugged enterprise-class mobile devices that are purpose-built for healthcare environments and can withstand harsher cleaning protocols during their long lifecycle.
As healthcare organizations continue to evolve to meet the needs of today’s environment, having proper device wipe down protocols in place will become a priority to help reduce the spread of infectious diseases in their facilities.
About Rikki Jennings, BSN, RN, CPN
Rikki Jennings, BSN, RN, CPN is the Chief Nursing Informatics Officer (CNIO) at Zebra Technologies where she is responsible for combining her knowledge of patient care, informatics concepts, and change management to effectively address the information and knowledge needs of healthcare professionals and patients to promote safe, effective, and efficient use of IT in clinical settings. She also serves as the strategic liaison for health IT efforts representing nursing and clinician needs.
– Innovaccer launches a perioperative
optimization solution for surgeons to realize clinical and financial goals with
patient-risk analysis.
– 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
Medical Care
COVID-19
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.”
XRHealth appoints Deepa Javeri as CFO and is significantly expanding their US headquarters.
XRHealth, a
Boston, MA-based provider of extended reality therapeutic applications and XR telehealth
services, today announced Deepa Javeri – a seasoned, global
financial expert and executive – has been named Chief Financial Officer
effective immediately. Javeri’s appointment comes at an exciting moment of
global growth and expansion for XRHealth.
“Deepa brings XRHealth a high level of expertise in fundraising, resource allocation, strategic planning and international financial markets at a time when our company is growing exponentially,’’ says Eran Orr, CEO of XRHealth. “Having her on board will enable XRHealth to continue to expand both domestically and internationally.”
Javeri Bio/Background
Prior to joining XRHealth, she served as the Chief
Financial Officer at FRANK, where she closed a $10m Series A financing
round. Earlier in her career, Javeri spent fifteen years as a capital
markets investor most recently at Bank of America Merrill
Lynch. Throughout her time at Bank of America Merrill Lynch, she held a
variety of positions in the U.S., Asia, and Europe focused on equity portfolio
management, corporate bankruptcies, and reorganizations.
“We are living in a moment that is asking us to transform the way healthcare is delivered,” says Deepa Javeri, CFO at XRHealth. “It is exciting to be part of a team that is answering that call. At XRHealth, we are revolutionizing remote patient care.”
XRHealth’s Telehealth Clinic operates in the US, Israel and
Australia, utilizing immersive medical applications which are FDA & CE
registered. Using an advanced data analytics platform and external controls,
XRHealth-certified clinicians manage and customize their patients’ care.
The amount of data generated by the healthcare industry is staggering—and constantly increasing. Healthcare data encompasses the personal information of patients, doctors, nurses, and administrators. It includes diagnostic information, test results, ultrasound images, x-ray images, and of course insurance and financial information. With so much sensitive patient information there for the taking, it comes as little surprise that the healthcare industry—perhaps more than any other sector—has become a primary target for cyberattacks. Now, more than ever, it is critical that healthcare organizations take decisive action to protect their data.
There has been no shortage of major (and notably costly) data breaches in recent years. The Equifax breach, for example, affected nearly half of all Americans. Last year’s Facebook breach was also headline news, thanks in large part to the number of users affected. Then there was a lesser-known yet costly LifeLabs breach—the largest in Canadian history—affecting more than 15 million people and prompting a lawsuit seeking north of $1 billion in damages for failure to adequately protect data.
Healthcare data heists yield a premium, making them particularly attractive to hackers. The Center for Internet Security (CIS) notes that the “average cost of a data breach incurred by a non-healthcare related agency, per stolen record, is $158,” compared with $355 for healthcare records.
Though large, the LifeLabs incident isn’t even close to the largest healthcare data breach in history. That dubious honor goes to Anthem, which suffered a breach in 2015 that resulted in nearly 80 million compromised records. Although Anthem was able to reach a settlement with the victims for the relatively paltry sum of $115 million, both the standards for data protection and the expected remediation for failure have changed considerably in the five years since the attack.
Regulations Raise the Stakes for Security
As the regulatory environment surrounding data breaches of all types grows more strict, hospitals and insurers have found themselves in the crosshairs of an increasingly brazen and sophisticated set of attackers. Part of the reason for this targeting stems from the relative value of healthcare records. There is a reason why “HIPAA” is an acronym known to most Americans, while other data protection laws are not.
Personal Health Information (PHI) tends to be more valuable than standard Personally Identifiable Information (PII) in large part due to its static nature. Patients can change a compromised credit card number or social security number, but not their medical history—and scammers prepared to exploit that history may render victims more vulnerable to certain types of fraud.
New regulations are further raising the stakes for compliance. Although the California Consumer Privacy Act (CCPA) is not specifically targeted at healthcare organizations, the sector represents potentially one of the most vulnerable industries under the new law. If an organization is found to be in violation of CCPA, they have 30 days to rectify the situation or be subject to a fine of up to $7,500 per record exposed.
To put this in context: if CCPA were adopted nationwide, the LifeLabs breach that affected 15 million individuals would potentially be subject to a fine of $112.5 billion. That $1 billion lawsuits that LifeLabs is facing might sound like a lot, but under CCPA, it might mean getting off easy. This should underscore the necessity of protecting data of any kind today—let alone healthcare records.
Ecosystems Span Email to Equipment
With the healthcare industry becoming an increasingly popular target and the penalties for breaches growing steeper, it’s important to consider that every endpoint, from desktops to devices, present attack paths for hackers. Measures as simple as stronger email security can make a big difference: in 2018 alone, Business Email Compromise (BEC) attacks resulted in more than $1.2 billion in victim losses. Spear phishing attacks, which are carried out using social engineering techniques to convince the target to relay confidential personal or financial information to what they believe is a legitimate recipient, represent an increasingly common method for attackers to gain access to user credentials or even directly obtain PII or PHI. Securing email with S/MIME (Secure/Multipurpose Internet Mail Extensions), which authenticates the sender of an email, enables employees not only to digitally sign and encrypt email communications but also to detect whether an email received has been authenticated or should not be trusted or opened.
Digital certificates are an essential part of protecting medical devices. Because they can be incorporated during the manufacturing process, these certificates allow device identity and integrity to be established from the moment they are first powered on. They also eliminate the potential for device spoofing, which protects against the possibility of counterfeit devices connecting to the network. These certificates serve as an effective proof point for savvy healthcare organizations. When vetting device suppliers and manufacturers, asking about their approach to device identity is essential. By learning to trust only manufacturers with a responsible approach to authentication, healthcare organizations can help protect one of the areas most susceptible to costly breaches.
Medical equipment itself has also become more vulnerable. Today’s diagnostic devices are rarely standalone—most are connected to the internet, and anything connected to the internet can potentially be compromised. In fact, this compromise could occur before devices even leave the factory, potentially undermining even the most secure networks and leading medical device manufacturers to consider security starting at the assembly line; the point where device identity measures and digital certificate authentication become critical. Technologies such as secure boot can protect the integrity of a device or piece of software from the first time it is powered on. Similarly, embedded firewall and secure remote update technologies help ensure that software updates are authenticated before installation and that any communication with unauthorized devices stops before harm can be done.
Moving Forward with New Security Strategies
Today, health insurers, hospitals, and other patient care organizations must manage a truly massive amount of data. It is simply a fact of life. That data comes in many forms, and it can be valuable to cyber attackers for a multitude of reasons. At its core, this data is the healthcare industry’s most valuable asset—one that it must protect at all costs.
Vulnerabilities can take many forms, from a human error to compromised devices. And while no solution can shield every possible form of attack, data and IT security administrators (and even OEMs) can take concrete steps to protect their organizations, patients, or chipsets against common attack vectors and better comply with today’s strict data protection regulations. Yes, the cloud has introduced new vulnerabilities, but it also has helped enable new security strategies and solutions that ensure every application, cell phone, server, or other connected “thing” has an authenticated digital identity. The stakes are simply too high, and hackers have become too savvy, to rely on yesterday’s security status quo.
Senior Fellow Tim Callan contributes to the company’s standards and practices effort, industry relations, product roadmap, and go-to-market strategy. Tim has more than twenty years’ experience as a strategic marketing and product leader for successful B2B software and SaaS companies, with fifteen years’ experience in the SSL and PKI technology spaces.
– Lumeon, the leader in care pathway orchestration
announced it has raised $30M in Series D funding to extend the reach of its
Care Pathway Management (CPM) platform.
– The platform empowers providers to improve care
quality, deliver better outcomes, reduce costs, and ultimately develop and
scale new models of care delivery – particularly important right now as
COVID-19 accelerates the technology-driven transformation of healthcare.
Lumeon, a Boston, MA-based provider of care pathway orchestration, today
announced that it has closed $30M in Series D funding led by new investors
Optum Ventures and Endeavour Vision, with participation from current investors
LSP, MTIP, IPF Partners, Gilde and Amadeus Capital Partners. The investment
will enable the company to extend the reach of its Care Pathway Management
(CPM) platform, which helps healthcare providers automate their patient care coordination
to improve care quality, deliver better outcomes and reduce costs.
Why Care Pathways?
With proven ability to reduce unwarranted
variation and lower the overall cost of care delivery, care pathways are
an increasingly attractive proposition for healthcare providers.
The challenge, however, has always been to take paper-based pathways off the
page and into operational reality. This means being able to direct tasks and
coordinate care across clinicians, ward managers, nurses, patient educators –
the entire team responsible for successful care delivery – even the patient
themselves.
Deliver Engaging Virtual Care Journeys
Founded in 2005, Lumeon’s platform connects
the care journey across the care continuum, operationalizing care plans beyond
the four walls of your hospital. Lumeon’s CPM platform
uses real-time data to dynamically guide patients and care teams along their
care journeys. By automating, orchestrating and virtualizing care delivery
across care settings, Lumeon’s solutions allow health systems to operate with
predictability and efficiency, delivering optimal care to each patient while
substantially lowering costs for healthcare providers.
Lumeon’s CPM platform
integrates with all electronic health record (EHR) systems in addition to
incorporating required clinical and administrative data from point solutions
and devices, addressing the fragmented nature of healthcare technology and the
challenge of interoperability. By extending beyond the confines of a healthcare
provider’s EHR, Lumeon’s configurable solutions maximize current investments as
organizations evolve their care delivery models.
“While the markets for data analytics, clinical decision support and patient engagement are well established, what is missing today is the ability to effectively connect them to solve the problem of personalizing care delivery in a scalable way,” said Lumeon Founder and CEO Robbie Hughes. “The ‘last mile’ that turns the insight into action is the hardest part for health systems, and is the core of the Lumeon proposition.”
As the COVID-19 pandemic continues to change healthcare operations in the world, foundational systems are being adapted to meet these new demands. Sometimes it takes extreme circumstances to see the cracks in a system. COVID-19 has exposed areas with more room for improvement in the healthcare system, such as optimizing operational efficiency. Organizations and individuals have changed their interactions, processes, ways of working, treatment plans, and even foundational technology. As the United States is beginning to reopen, many questions arise – namely, are these changes temporary fixes during the pandemic, or are they here to stay?
Physicians have been inundated during this time of crisis, and their ongoing main priorities amplified: saving as many lives as possible and providing the best patient care. Recent estimates from the beginning of July say, worldwide there have been more than 10.7 million COVID-19 cases and at least 516,000 deaths from the disease, according to Johns Hopkins University (JHU). JHU also revealed that in the United States, there have been 128,000 deaths out of a total of over 2.6 million cases. To say this has been a time of great stress and pressure for physicians who are on the frontlines is an understatement.
This pandemic has increased providers’ already heavy workload, amplifying where physicians need support. Patients need to remain the top priority, even in the first generations of the digital age where the list of backend administrative tasks and paperwork can feel endless, thus reducing the number of patients physicians can see each day. Finding a way to streamline administrative tasks with advanced technology can bring physicians back to why they went to medical school in the first place: to help patients.
One example of an important, and time-sensitive task is communicating with payers around treatment plans and reimbursement. Using technology to streamline this process to get the patient the optimal treatment and maximize use of their insurance coverage is essential, especially in this time of crisis where there is an increased number of patients in need and a depressed economy. Whether processing prior authorizations or checking eligibility, hospitals and health systems need technology to keep operations efficient, including smooth payer-provider communication to ease physicians’ workload, help to ensure providers will be reimbursed for care, and optimize business operations, ultimately providing an improved patient experience.
Three foundational ways in which payer-provider information exchange technology provides immense value to healthcare organizations are:
– Creating Administrative Efficiency: To help physicians stay focused on patients, administrative efficiency is key. Solutions can come in many shapes and sizes – technology can help to automate workflows and avoid care delays. Modernizing the prior authorization workflow can shorten average time to care, reduce the risk of treatment abandonment, and improve the quality of care. With changing legislation, updated laws encourage the use of technology to increase efficiency while keeping data secure in near real-time exchanges.
– Streamlining Exchange of Information: Interoperability and the technology standards needed to achieve it is an ongoing discussion in healthcare. Technologies that provide efficient, secure, and near real-time and even automated exchange of information are in high demand and will bring about the next era of healthcare. For example, technology has the power to align providers and payers efficiently and consistently, create an open exchange of information, centralize information, provide rapid and organized data transfer, ensure appropriate reimbursement by treatment plan, show pre-authorized treatment plans for the most successful and affordable care and aid health plans’ adaptability in health crises, like COVID-19.
– Increasing Value-Based Care: Optimizing the quality and cost of patient care is a leading principle of healthcare. The COVID-19 pandemic has exposed areas of healthcare where improvements in patient experience and provider reimbursement desperately need to be accelerated. Using technology with built-in normative databases of accepted treatment paths allows for evidence-based treatment decisions, which in conjunction with efficient payer-provider communication to ensure reimbursement, allows for optimal patient outcomes – creating value for all stakeholders.
Adopting technology to provide administrative efficiency, streamline information exchange and increase the value of all aspects of care will continue to be a fundamental pillar of healthcare; the pandemic has ignited a critical need for even faster change. COVID-19 has brought with it increased stress and uncertainty across the healthcare industry, amplifying the burden on physicians and their staff. Organizations have moved quickly to adopt technologies, such as those that provide a more efficient way to organize and analyze massive amounts of treatment plan decision inputs and aid communication between stakeholders, in order to better support physicians, and ultimately patients.
Tools and technology that automate processes, streamline communications and provide dynamic solutions have proven their value and are now “need to have” rather than “nice to have” for providers. These technologies are foundational to the healthcare system, providing the base from which all stakeholders operate. The pandemic has helped to realize the true value of efficiency technologies, galvanizing the adoption of these tools. Ultimately, more operational efficiency can bring the focus of care back to the patient.
About Christina Perkins
Christina Perkins is VP of Product Management and Strategy for NaviNet at NantHealth. She joined NaviNet in 2003 and has spent the last 17 years expanding the company’s products and services. Prior to joining NaviNet Christina spent seven years designing and building web-based solutions for Partners Healthcare and other hospitals in the Northeast U.S. and Ontario, Canada. Christina on LinkedIn.
– To help meet the needs of ambulatory care practitioners in a post-COVID environment, Greenway Health, a leading health information technology, and services provider, today announced a new strategic partnership with Amazon Web Services (AWS).
– Leveraging AWS cloud services, Greenway is developing a
new cloud-based, data services platform, Greenway Insights, that creates new
data insights and healthcare interventions to advance the breadth of Greenway’s
products and services.
Greenway Health, a leading health information technology, and services provider, today announced a new agreement with Amazon Web Services (AWS), Inc. The agreement will promote collaboration in the healthcare industry with the primary goal of developing transformative healthcare products that will further meet the needs of ambulatory care practices in a post-COVID-19 world.
Greenway
Insights Build on AWS
Greenway
will develop a new cloud-based, data services platform, Greenway InsightsTM, on AWS that creates new data insights and healthcare
interventions to advance the breadth of Greenway’s products and services.
Greenway Insights will leverage AWS cloud services, giving Greenway engineering
teams direct access to a robust set of data analytics and machine learning
capabilities, such as Amazon SageMaker and Amazon Comprehend Medical, that will
enable product innovation to occur at an accelerated pace.
Initially, Greenway will leverage the platform to deliver a
regulatory analytics solution to help customers meet the evolving reporting
requirements of quality payment programs and value-based care
initiatives. The solution will enable practices to receive data insights in
real time, increasing practice performance and positively impacting patient
outcomes.
“Technology is key to improving patient care and health outcomes. This collaboration via our Digital Innovation Program to deliver the Greenway Insights data and analytics platform will bring needed solutions to the market quickly,” said Paul Zimmerman, Worldwide Head, Private Equity at AWS. “Our team is currently working with three Vista portfolio companies on innovative solutions, and we are particularly proud of our work with Greenway. The project is operating on a rapid implementation timeline, and we have already seen initial success and proof of concept. We are looking forward to a continued collaboration in developing solutions that streamline workflows and improve the way healthcare providers care for their patients.”
– Cerner expands its AI collaboration with Nuance to
provide joint customers with more advanced natural language virtual assistant
technology to navigate electronic health records (EHRs) using just
their voice, giving clinicians more time to spend with patients and less time
with a computer.
– As part of the expanded collaboration, Nuance will
offer Cerner deeply embedded virtual assistant technology that
delivers sophisticated conversational dialogues and skills to automate
high-value clinical tasks inside Cerner Millennium, such as chart
search, navigation, intelligent computerized physician order entry (CPOE), and
scheduling.
Nuance®
Communications, Inc. today announced that it has expanded its
long-standing AI collaboration with Cerner
to include the integration of Nuance’s virtual assistant technology into
the Cerner Millennium® electronic health record
(EHR). Building upon the existing integration between Nuance’s Dragon®
Medical platform and Cerner Millennium, joint clients can utilize
Nuance’s advanced natural language virtual assistant technology to navigate the
EHR using just their voice, giving clinicians more time to spend with their
patients and less time with their computer.
COVID-19 Underscores Importance of Addressing Physician
Burnout
The expanded Nuance-Cerner relationship is driven by the healthcare industry’s need to mitigate what the World Medical Association is calling a “pandemic of physician burnout” with 51 percent of physicians reporting frequent or constant feelings of burnout. This is caused by a staggering administrative workload of electronic paperwork to document patient care and to meet requirements for insurance coverage, financial reimbursement, and medicolegal liability protection.
Research shows that more than 80 percent of physicians believe virtual assistants in health care can reduce the burden on care teams and improve the patient experience. Nuance’s virtual assistant technology helps physicians rapidly accomplish tasks and communicate more naturally while allowing them to use specialized medical terminology across a range of devices and applications with high accuracy.
Virtual Assistant Platform Integration Benefits
Nuance’s deeply embedded virtual assistant technology delivers sophisticated conversational dialogues and skills that automate high-value clinical tasks inside Cerner Millennium, such as chart search, navigation, intelligent computerized physician order entry (CPOE), and scheduling. Nuance technology’s high accuracy rates, rich set of voice-activated skills and ability to understand the user’s intent in context provides higher levels of workflow automation, and more efficient and complete documentation of patient care. Additionally, Nuance’s pre-built, HIPAA-compliant natural language understanding models and cloud platform will support Cerner to deploy the solution quickly and easily to joint clients.
“Together with Cerner, we’re bringing the next level of conversational AI directly to our joint clients with the goals of improving patient experiences, combating clinician burnout, and reducing costs,” said Joe Petro, CTO, Nuance. “Building on our Dragon Medical platform, already used by over 550,000 physicians in the U.S. alone, our new virtual assistant technology will help deliver solutions that automate time-consuming tasks, eliminate inefficiencies, and bring clinical intelligence and better decision-support to clinicians at the point of care.”
Availability
Select joint Cerner and Nuance clients can expect
to start deploying this integrated virtual assistant technology late this
year.
– Philips receives 510(k) clearance from the FDA for its pre-hospital
wireless monitoring solution (Tempus LS- Manual), now offering its remote
monitor and defibrillator solution (Tempus ALS) to EMS customers in the U.S.
– Solution delivers real-time bidirectional data transfer
for remote patient monitoring, giving EMS responders a new approach to
pre-hospital care.
Philips, today announced the launch of its
remote monitoring and defibrillator solution (Tempus
ALS) for pre-hospital settings in the U.S. The solution is a complete
end-to-end system that combines innovative hardware and advanced software to
expand the pre-hospital scope of care for first responders. The professional
defibrillator (Tempus LS-Manual) is the final element of the overall
solution to receive 510(k) clearance from the U.S. Food and Drug Administration
(FDA) and is now available for sale in the U.S. market.
Tempus
ALS with IntelliSpace Corsium
As a
unique modular platform, the remote monitoring and defibrillator solution (Tempus
ALS) consists of a remote portable vital signs patient monitor (Tempus Pro),
and remote professional defibrillator (Tempus LS-Manual). While the monitor and
defibrillator can be used separately, the devices also connect wirelessly to
share data and transfer vitals, waveforms and images into Philips web-based
software platform (IntelliSpace Corsium). The software platform provides
robust, real-time transfer of clinical data and events, interactive ECG
measurement, two-way communication and more, enabling rapid clinical and
transport decision support and seamless electronic patient care recording
(ePCR) integration outside the hospital in emergency settings.
“In emergency situations, where seconds count, having access to advanced patient data collection and sharing and real-time secure data streaming, can help inform confident treatment and transport decisions outside the hospital,” said Arman Voskerchyan, General Manager of Therapeutic Care at Philips. “The integrated remote monitoring and defibrillator solution combined with our web-based software platform will help front line responders provide emergency care, diagnosis, and treatment – including defibrillation therapy, data management, and clinical and operational efficiency features – in a fully integrated solution.”
Emergencies and care events outside the hospital continue to rise, with an estimated 240 million calls made to 9-1-1 in the U.S. each year. In addition to the stress of the unknown and what to expect at the scene of the call, emergency medical providers must deal with manual handling issues. Equipment carried is heavy, often damaged due to use in unpredictable conditions, and has limited data connectivity – inhibiting the ability for on-scene support. In an effort to address these challenges, both elements of the Philips remote monitoring and defibrillator (Tempus ALS) solution are designed with a small, rugged exterior and a long-lasting battery to allow emergency medical providers to focus on caring for the patient without the hassle or distraction of bulky equipment.
Philips leadership in Emergency Care solutions
Earlier this year, Philips launched its new emergency care
informatics suite in the U.S. market, previously in use in Europe, helping
care teams spot life-threatening conditions remotely, improve accuracy of
support from on-scene crews, and enhance tailoring of in-hospital care based on
pre-hospital physiology. In October 2019, Philips announced a
first-of-its-kind collaboration with Air Ambulance Kent Surrey Sussex (AAKSS) where
helicopter Emergency Service (HEMS) teams were able to live stream patient
medical information from the scene to the hospital through the Philips
pre-hospital solution. Philips offers a wide range of emergency care offerings,
including automated external defibrillators (AEDs), advanced life support
monitors, and more.
– Ciox Health has acquired Medal, Inc., a biomedical
Natural Language Processing (biomed-NLP) technology company.
– The acquisition will lead Ciox to better and more
quickly enable real-world data in support of research that advances patient
care.
Ciox
Health, a leading health technology company, today announced its acquisition
of San Francisco-based biomedical Natural Language Processing (biomed-NLP)
technology company, Medal, Inc., a leader
in the application of AI techniques to the interrogation of unstructured
medical record data. The acquisition accelerates capabilities to enable
real-world data (RWD) in support of research that advances patient care.
The Real-World Data Advantage
As more pharmaceutical and research organizations look to real-world data to accelerate clinical research, reliable identification, and interpretation of phenotypic data from deep inside medical records are becoming paramount. The most relevant information resides in the unstructured data: the surgical reports, pathology reports, imaging reports, discharge summaries, and other clinician-scribed narrative text. Medal’s software helps identify, contextualize, and interpret narrative-based medical notes, leading to the creation of research-grade data sets at scale. The company’s approach to biomed-NLP and deep learning AI is guided and informed by consensus from clinical expert reviewers across therapeutic areas.
“More than 100 million medical records are retrieved and reviewed by Ciox each year from the vast majority of U.S. providers, presenting an unprecedented opportunity to actually bring a true longitudinal perspective to clinical investigation. Ciox works at the first and last mile of U.S. healthcare data,” says Andy McMurry, Ph.D., Chief Science Officer of Medal. “Using Medal AI, Ciox will reduce human expert time and increase the utility of patient data to support biomedical discovery and clinical trials research across many disease areas, including COVID-19. Combining vast biomedical knowledge sources with clinically trained Artificial Intelligence enabling human experts, we are reinventing real-world data for clinical investigation.”
Acquisition Benefits for Ciox Health
This acquisition is the third major recent announcement from
Ciox’s growing Real World Data business, following two prior announcements of
strategic collaborations with LabCorp and Merck. As health data remains
fragmented throughout the U.S. healthcare ecosystem, Ciox is attracting
interest in its RWD division from medical research organizations and other
partners. This additional feature of the Ciox DataFit Platform through the
acquisition of Medal will enable faster and more consistent translational
research.
Why It Matters
“We’re proud to bolster the Ciox Real World Data offering with Medal’s technology and team,” says Pete McCabe, CEO, Ciox. “The team and the biomed-NLP product, combined with Ciox’s technology-enabled ability to create longitudinal records across EHRs and provider systems, remove the friction related to medical records-based clinical research. We will consistently supply consented, HIPAA-compliant, de-identified, research-grade RWD for complex clinical use cases to commercial researchers in pharma and biotech, as well as government sponsored researchers. The need is particularly highlighted in the COVID-19 research questions being asked by agencies like the FDA, CDC and NIH.”
– Sharecare acquires WhiteHatAI to provide health plan
and provider clients with additional capabilities to ensure healthcare payment
integrity
– WhiteHatAI’s ability to detect erroneous claims before
they are paid will help Sharecare’s health plan partners reduce costs
associated with FWA.
– Sharecare will integrate WhiteHatAI’s capabilities to
foster deeper engagement by enabling patients to both verify recent medical
procedures and report satisfaction.
Sharecare, the
digital health company that helps people manage all their health in one
place, today announced its acquisition
of WhiteHatAI, an innovator
in artificial
intelligence (AI) healthcare payment integrity applications. WhiteHatAI
marks Sharecare’s 16th acquisition; financial terms of the
deal were not disclosed.
WhiteHateAI Acquisition Benefits for Sharecare
Over the last several years, Sharecare
has introduced a range of capabilities and services to
support payers’ and providers’ workflows –
including digital clinical data solutions and medical
records management; quality, performance and risk-adjustment tools; and
billing contract compliance. Given traditional retrospective systems
fail to recover 99% of erroneously paid medical claims, WhiteHatAI’s
ability to detect erroneous claims before they are paid will help
Sharecare’s health plan partners reduce costs associated with FWA.
Additionally, these capabilities better position Sharecare’s provider
clients to succeed in value-based environments by enabling more timely
payments and fewer claim denials – resulting in cash flow generation
and better revenue
cycle management.
Impact of FWA in Healthcare
“Fraud, waste and abuse in our healthcare system is already a $900 billion problem, which – prior to the pandemic – was expected to increase 6.5% annually through 2024; but given the necessity to fast-track claims in the face of COVID-19, this challenge is likely to grow even bigger, faster,” said Jeff Arnold, founder, chairman and CEO of Sharecare. “By acquiring WhiteHatAI and integrating their suite of AI-driven capabilities across our portfolio, we are bringing industry leading innovation to our payer and provider client partners that will help them not simply detect FWA but do so before it occurs, thus increasing efficiency and accuracy throughout healthcare organizations.”
WhiteHatAI Integration with Sharecare App
WhiteHatAI’s proprietary AI-driven platform also will
empower providers to extract unstructured clinical data from medical
charts – which can contain meaningful insights not available in the
structured record – and enable the identification and calculation of
CMS quality measures. Additionally, as the digital health company partners with physician practices to help
patients manage their own health day-to-day between office
visits with the Sharecare app, it will integrate WhiteHatAI’s
capabilities to foster deeper engagement by enabling patients to both
verify recent medical procedures and report satisfaction. Sharecare
can then message users based on the treatment or care plan addressed during the
medical visit, thereby improving outcomes and lowering the cost curve.
“Sharecare has a track record of innovation and collaboration unlike any other digital health company, and we are excited to merge our expertise in AI and healthcare payment integrity with their ability to convene, rally and engage people, providers and payers in improving health and well-being,” said Pete Ransome, CEO of WhiteHatAI. “Joining the Sharecare family enables us to capitalize on our ability to combat the prolific and fast-growing problem of fraud, waste, and abuse in healthcare, which will save millions of dollars for our collective clients and, ultimately, advance patient care and satisfaction.”
As COVID-19 continues to impact the country, providers across the continuum face new challenges delivering care and ensuring safety for their patients and themselves. During this period, sharing real-time information about patients’ care encounters across provider types and care settings matter more than ever. In particular, hospitals sharing admission, discharge, and transfer (ADT) events with COVID-19 patients’ community-based providers is critical to ensure the best treatment course and safer more seamless care transitions for infected and recovering patients.
Real-time ADT-based notifications include information about a patient’s current care encounter, demographic details, information about the provider or institution sending the notification, and, as permissible, clinical information. This data enables providers across the continuum to make informed and coordinated decisions about their patients’ treatment and care transition plans. Even before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) recognized the importance of such ADT notifications in supporting patient care and finalized a new Condition of Participation (CoP) as part of the recently published Interoperability and Patient Access Final Rule (85 FR 25510). The CoP requires hospitals to share electronic patient event notifications, or e-notifications, with other community providers, such as primary care physicians (PCPs) and post-acute care providers, to facilitate better care coordination and improve patient outcomes.
The necessity and benefit of these e-notifications has come into stark relief as providers and the healthcare system more broadly fight COVID-19. ADT-based e-notifications are an accessible and easy way to help enable better safety for COVID-19 patients and their providers while also ensuring efficient use and appropriate allocation of scarce resources. For example, ADT-based e-notifications can:
Enhance Safety for PatientsProtecting patient safety and providing appropriate treatment is especially urgent during a crisis like COVID-19 when resources are limited and staff is stretched. E-notifications allow hospitals that treat COVID-19 patients to more rapidly get in touch with a patient’s other providers and obtain important medical histories to help guide treatment and clinical decision-making. Traditional exchange of data facilitated by phone calls, faxes, or labor-intensive data searches can introduce treatment delays, unnecessary or harmful interventions, and frustrations for providers. The faster information can be exchanged and a patient’s history is known by the hospital care team, the easier it is to effectively and safely treat the patient with the most appropriate interventions.
Enhance Safety for Providers: Hospital e-notifications are especially important for post-acute and other community-based providers that will continue treatment for COVID-19 patients discharged from the hospital. Because e-notifications provide context about the patient’s most recent encounter, including diagnoses where permissible, they help guide the continuation of care. Receiving e-notifications from hospitals allows such providers to appropriately prepare staff and put safety measures in place prior to treating COVID-19 patients. In particular, Skilled Nursing Facilities need time to properly and safely intake infected patients while Home Health Agencies need to prepare and equip their nurses for visits to homes of infected patients.
Open Hospital Beds for the Sickest Patients: Through real-time e-notifications, hospitals are able to more easily and quickly communicate and share information with COVID-19 patients’ other community-based providers who will care for recovering patients after they are discharged from the hospital. This exchange of information allows hospital care teams to more seamlessly and quickly transition recovering COVID-19 patients to the next level of care, which opens scarce hospital beds for the sickest patients.
Improve Care for COVID-19 Patients:Real-time e-notifications from hospitals allow PCPs and care coordinators to know when their patients have inpatient or ED events. In particular, discharge notifications can trigger critical follow-up services, including telehealth-based visits, to ensure COVID-19 patients recover safely and fully after they leave the hospital. Engaging COVID-19 patients after a hospitalization can help prevent readmissions and keep patients healthy in their homes. At the same time, PCPs are able to support the financial viability of their practices by being able to provide and bill for Transitional Care Management Services and ensure patient engagement in ongoing preventive and other clinical care.
Bolster Public Health Response:Aggregated and de-identified ADT-based notifications offer wide-ranging and powerful real-time data for local, state, and federal public health officials to detect emerging COVID-19 hotspots and intense ED, hospital, ICU strain. Real-time data about the hospital and ED utilization can help public health officials direct and allocate scarce resources to the highest need areas quickly.
These are just some examples of how ADT-based e-notifications can play an important part in helping healthcare organizations effectively, efficiently, and safely deliver care for their patients during the ongoing pandemic – and beyond.
About Jay Desai, CEO & Co-Founder, PatientPing
Jay started PatientPing in 2013 with one goal in mind: to connect providers everywhere to seamlessly coordinate patient care. Prior to founding PatientPing, Jay worked at the CMS Innovation Center (CMMI) where he helped develop ACOs, bundled payments, and other payment initiatives. Jay’s passion lies at the intersection of technology, policy, and community building. He has an MBA in healthcare management from Wharton and a BA from the University of Michigan.
Muthu Alagappan, MD, Medical Director at Notable Health
The COVID-19 pandemic has caused an unprecedented shift in the way consumers view and access a variety of goods and services—and healthcare is no exception. Recent studies show that many patients, including vulnerable populations like those living with cancer, are delaying recommended care and procedures—and will continue to do so for at least several months amid fears over the safety of in-person visits. In response, reports of providers adapting to offer care virtually are all the more commonplace, with almost half of physicians now treating patients through telemedicine platforms, up from just 18 percent in 2018.
These trends have solidified virtual care as a mainstay, and as a result, the virtual visit has become a commodity—a service that can be provided by many capable vendors. However, the logistics that power the adoption of virtual care are often overlooked. As healthcare administrators turn to telemedicine to resume “non-urgent” healthcare services, we must ensure that best-in-class technology solutions are utilized to improve the virtual care experience—for providers, clinical staff, and, importantly, patients.
Health systems and their networks face significant operational issues when delivering care in a remote setting, due to the range of potential interactions and diversity of devices—adding to the already recognized administrative burden that comes with routine patient care. With each patient visit comes over a dozen manual tasks, including patient intake and registration, in-visit clinical note writing, as well as back-office billing and claims processing. The virtual visit adds even more steps, such as helping patients access the appropriate technology for a two-way video interface or sending custom links to a “virtual waiting room” at the right time.
Facilitating a seamless virtual care experience before, during, and after a patient’s visit should be top-of-mind—particularly as patient expectations have heightened and healthcare has progressed towards a technology-enabled future. Fortunately, the automation of operational workflows can help healthcare administrators smooth the friction around conducting virtual visits at scale.
Intelligent automation extends our capacity in healthcare by enabling us to do more with the same workforce and technology infrastructure. In fact, digital medical assistants can use artificial intelligence to automate repetitive, cognitively tiring, and error-prone tasks. This technology can support the influx of virtual visits by offloading administrative processes, such as co-payment collection, clinical documentation, and pre-population of common clinical orders.
For patients not as familiar with digital interactions and the variety of telemedicine modalities, which can include platforms like Amwell, Doctor on Demand, and Teladoc or video conference solutions like RingCentral and Zoom, participating in virtual visits can be a daunting change. Additional technological challenges associated with virtual care can result in heightened frustration, increased no-show rates, or decreased activation, so maintaining patient engagement throughout the patient journey is even more important in a virtual environment. Digital medical assistants can automate appointment reminders, offer detailed setup guidance for patients, and provide “just-in-time” virtual visit links to ensure patients and providers can make the most of their time together.
The COVID-19 pandemic has also introduced new variables and risks that patients, providers, and healthcare institutions at-large must consider when seeking and delivering care. Until recently, it was a relatively straightforward process to determine where a patient should receive routine care. Now given the risk of disease spread, providers find themselves considering which patients to see when to see them and whether to see them virtually or in-person.
This creates additional complexity in determining when to schedule patients and in which medium to conduct the visit. Platforms that leverage intelligent automation can help clinical teams to pre-screen all scheduled patients, collect a thorough medical history, intelligently segment patients into risk cohorts and triage each cohort to an individualized destination, be it a return to in-person care or a virtual environment.
In the “virtual exam room,” things also look a little different. From the provider’s perspective, one of the oft-cited drawbacks of virtual visits is the limited ability to measure vital signs, perform a physical exam or order point-of-care diagnostics. At-home diagnostics, wearable devices and remote patient monitoring tools allow providers to collect continuous clinical data that can be gathered asynchronously and quickly, resulting in a more comprehensive picture of a patient’s health. Further, platforms that use intelligent automation algorithms to organize data collected across the care continuum can parse these data streams to identify at-risk patients and then automate outreach and care management to follow clinical care pathways.
The COVID-19 pandemic has given us a unique opportunity to reimagine healthcare using a modern suite of technology for patients, providers and staff that does away with outdated and inefficient processes. But we also have a responsibility to replace them with solutions that improve digital experiences by supporting patients before visits, automating repetitive workflows, and parsing large amounts of data to support clinical decision-making.
Combining intelligent automation with virtual visits creates a powerful tool to efficiently manage patient populations and offer an experience that feels intuitive while enabling healthcare systems to do more with less. By accelerating the digital transformation of healthcare today, we can position ourselves for a future of increased capacity, decreased overhead, and improved quality.
Muthu Alagappan, MD, is an attending physician at Massachusetts General Hospital, a trained engineer, and medical director at Notable Health, a healthcare experience automation company.
– Israel’s
Sheba Medical Center launches “Mega Lab” solution that improves patient
care through lab technology advances that expedite lab test results and
decrease human error.
– The “Mega
Lab” simultaneously processes routine as well as urgent tests, under world
regulatory standards of the medical lab-specific ISO 15189. An automated system
sorts tests according to urgency, performing 7-8 tasks simultaneously,
including identifying the type of test tube and amount of fluid inside it.
Israel’s Sheba
Medical Center, Tel HaShomer, the largest hospital in the Middle East,
announces the launch of the “Mega Lab.” The innovative hospital lab improves
patient care and medical decision-making through advanced technology that
reduces human error and generates faster turnaround times in lab results.
Mega Lab Driven by Automation
Sheba’s “Mega Lab” operates 24 hours a day to provide a novel,
automated, advanced response while increasing efficiency and improving service,
quality and safety. The “Mega Lab” simultaneously processes routine as
well as urgent tests, under world regulatory standards of the medical
lab-specific ISO 15189. An automated system sorts tests according to urgency,
performing 7-8 tasks simultaneously, including identifying the type of test
tube and amount of fluid inside it. The automated system was developed at Sheba
Medical Center’s ARC Innovation Center.
“At the Mega Lab we run biochemistry,
hematology, hemodynamic acid base status, urinalysis, coagulation, inflammation
parameters and some pharmacological tests for patients with positive diagnosis
of COVID-19 as part of their hospitalization and rehabilitation at Sheba’s
coronavirus dedicated units,” said Dr. Ram Doolman, PhD, NED, MPHA,
Director, Laboratories Division & Automated Mega-Laboratory. “With the
new total laboratory automation (TLA) we are able to react within thirty to
sixty minutes rather than three to five hours for these patients.”
Over the last two years, Dr. Doolman
and his team have upgraded the “Mega Lab’s” automation and analytic mechanisms
with cutting-edge technology supplied by Beckman
Coulter headquartered in Brea, California in cooperation with
Rhenium Medical.
“Our staff has undergone intensive
training to function in this complex, dynamic environment, and the
technological advantages implemented in the lab, which will very soon include
microbiology diagnostics, puts the Mega Lab in a class by itself, as the most
advanced in the world,” said Dr. Doolman.
Benefits of Lab Automation
It is known in the medical
laboratories community that errors that occur in the pre-analytical phase of
testing may contribute up to 70 percent of erroneous test results, with 25
percent possibly having adverse effects on patient care.
“One area in which automation has significantly improved processes
is during pre-analytical activities. These steps include order entry,
centrifugation, barcode verification, sample check and more,” said Dr. Doolman.
“The layout of a laboratory also has a direct effect on productivity and
workflow because there must be enough space, so that work remains unhindered
and employee safety is upheld.”
Mega Lab Response to COVID-19 Pandemic
Since the onset of the COVID-19 pandemic in Israel, Sheba’s “Mega
Lab” has produced more than 500,000 lab results of positively verified patients
for SARS-CoV2, while maintaining the safety of its medical personnel at the
topmost level. The biohazardous safety features of the DxA 5000 allows the
“Mega Lab” staff to continue with their everyday protection as with every
routine BSL2 laboratory.
– Boston-based health IT start-up Cohere Health announced the official launch of its company with a $10 million Series A funding round led by Flare Capital Partners.
– The company’s patient journey-focused platform improves the notoriously difficult prior authorization process and replaces an existing patchwork of legacy, siloed processes, and antiquated technologies that contribute to the enormous administrative burden for physicians and health plans.
– The end goal is transparent, high-value care alignment across the entire patient care journey, to improve the quality of care delivered, the lower total cost of care, and transform the patient and physician experience.
Cohere Health, a
Boston, MA-based health
ITstartup,
today announced its company launch, with the mission of aligning the
relationship between physicians and health plans around the care journey in a
way that is appropriate for each patient. Cohere Health’s launch is
flanked by the news of its recent $10 million Series A funding round led by Flare Capital Partners, with Define Ventures as an investor and partner
as well as participation from an additional leading national strategic partner.
Every Health Journey Should Be A Win-Win-Win
Confusion and complexity shouldn’t define a patient’s journey. Patients deserve clearer paths to health, more transparency, and fewer bumps on the way. Assessing every transaction without any context creates an undue burden for physicians and health plans alike. Administrative complexity should never stand in the way of patient care.
Led by Co-Founder and CEO Siva Namasivayam, Cohere Health aims to improve the quality of care delivered, the lower total cost of care, and transform the patient and physician experience. Cohere’s patient journey platform, CohereNext replaces the existing patchwork of legacy, siloed processes, and antiquated technologies that contribute to enormous administrative burden for physicians and health plans. It further facilitates the transition from fee-based services to value-based arrangements by providing an evolutionary path that can support all payment arrangements while reducing unnecessary variation in clinical outcomes.
Benefits of Care Journey Recommendations
Cohere leverages care journey recommendations to fundamentally change the healthcare system through:
– Evidence-based care paths: increase transparency and trust among patients and their physicians.
– Advanced analytics and rules: help identify high-value care and, ultimately, improved outcomes
– Payments and incentives: incentivize physicians by ensuring that behavior leading to optimal patient outcomes also benefits practice economics
Proven Leadership Team
Cohere Health has assembled an impressive team of proven
leaders, including Gary Gottlieb, MD, former CEO of Partners Healthcare (now
MassGeneral Brigham) as Chairperson of the Board of Directors. “As a physician,
it’s clear to me that the administrative complexity of the current system gets
in the way of delivering the care that patients deserve, that physicians want
to provide, and that health plans want for their members,” Gottlieb said. “If
we’re going to realize the promise of value-based care, we need an approach
that is based on all available evidence, shared expectations and transparency.”
Siva Namasivayam, CEO of Cohere Health, explained: “The current system is resource-intensive, unwieldy and creates a frustrating experience for patients, physicians and health plans. There’s no reason it should be so miserable for everyone involved. We have the evidence-based clinical algorithms, human-centered design and innovative technology to improve the system dramatically.” Namasivayam, who has more than 20 years of experience working on transformational healthcare businesses, was previously the CEO/Founder of SCIO Health Analytics.
– Mayo Clinic in Rochester, MN performed the first-ever shoulder arthroplasty procedure using Wright Medical’s groundbreaking BLUPRINT Mixed Reality Technology, which provides surgeons a 3-D holographic view of the patient’s pre-operative plan.
– The Mixed Reality Application is the
latest addition to Wright’s BLUEPRINT ecosystem and enables a surgeon to
maintain a direct view of the surgical site and simultaneously visualize and
manipulate a holographic representation of the patient’s native anatomy and
pre-operative plan.
Wright Medical Group N.V. (NASDAQ: WMGI) announced
that the first shoulder arthroplasty procedure was performed using
groundbreaking BLUEPRINT Mixed Reality Technology at
Mayo Clinic’s campus in Rochester, Minnesota. Joaquin Sanchez-Sotelo,
M.D., Ph.D, performed the procedure utilizing BLUEPRINT OR Visualization Mixed Reality software,
which provides a 3-D holographic view of the patient’s pre-operative
plan.
Mixed Reality Application Overview
The Mixed Reality Application is the latest
addition to Wright’s BLUEPRINT ecosystem and enables a surgeon to maintain a
direct view of the surgical site and simultaneously visualize and manipulate a
holographic representation of the patient’s native anatomy and pre-operative
plan. By using hand gestures and voice commands, the surgeon can interact with
a more robust data set to optimize the position of the 3-D holographic models
displayed by the Mixed Reality application. This can allow the
surgeon to replicate the pre-operative plan as closely as possible given the
availability of information while operating.
Why It Matters
“This procedure is an important milestone for shoulder arthroplasty and marks a major step in the evolution of BLUEPRINT mixed reality technology in shoulder surgery. For the first time in shoulder arthroplasty, surgeons will be able to interact with their 3-D pre-op plan in real-time to more precisely tailor shoulder joint replacement procedures to the unique needs and anatomy of their patients. By integrating other solutions in the future, such as artificial intelligence, case planning optimization and mixed reality modules for medical education, the BLUEPRINT ecosystem offers an opportunity to significantly reduce variability in the way shoulder arthroplasties are performed, potentially reducing complications and improving overall patient outcomes,” said Robert Palmisano, president, and chief executive officer of Wright .
Palmisano continued, “In addition to Dr. Sanchez-Sotelo, we
would like to recognize and thank the entire surgeon team who have been
integral to the development of this groundbreaking platform: George Athwal –
London, ON, CA; Julien Berhouet – Tours, FR; Philippe Collin – Rennes, FR;
Ashish Gupta – Brisbane, AU; Gilles Walch – Lyon, FR; and Jon J.P. Warner –
Boston, USA.”
Dr. Sanchez-Sotelo, stated, “I was able to visualize,
rotate, and tilt three-dimensional holographic objects right in front of the
surgical field. As mixed reality continues to develop, it will
provide a very unique, cost-effective tool for execution of our surgical plan.”
Dr. Sanchez-Sotelo and Mayo Clinic have financial interest
in Wright Medical Group N.V. Mayo Clinic will use any revenue it receives
to support its not-for-profit mission in patient care, education and research.
– Cerner and long-time client Banner Health announced
a new deal to implement a comprehensive suite of revenue cycle management
solutions as part of a long-standing strategic alignment to use health care
technology to drive population health improvement.
– The revenue cycle integration will take place across
Banner Health’s entire system, including 28 hospitals and clinics in six
states.
Banner Health and Cerner,
today announced it is expanding its
relationship to implement an end-to-end, comprehensive suite of revenue cycle
management (RCM) solutions, building on a multi-year, long-standing
strategic alignment using health care technology to drive population health
improvement. The revenue cycle integration is designed to streamline and
simplify the clinician and patient experience across Banner Health’s entire
system, including 28 hospitals and clinics in six states.
RCM Implementation
Approach
Banner Health will integrate Cerner’s registration, scheduling, patient billing, practice management solutions, and transaction services with its existing EHR on the Cerner Millenniumplatform. This integration between the revenue cycle and clinical systems will help connect a patient’s clinicals and financials to one single view across the health system ultimately streamlining billing operations and improving the overall patient experience. Cerner’s open platform also offers a way to more easily integrate third-party applications to help meet Banner Health’s specific needs.
Why It Matters
To successfully manage
business today, health systems need clinical, financial and operational data
that works together. Cerner’s clinically-drive revenue cycle solution uses a
common, single and integrated platform designed to help improve savings,
cost-effectiveness and build a healthier bottom line for health systems.
“After comprehensive planning and alignment between our two organizations, we are confident that teaming with Cerner to achieve a fully integrated revenue cycle platform will meet our business needs now and into the future,” said Dennis Laraway, CFO, Banner Health. “Building on our past successful collaborations with Cerner for mainly clinical applications, adoption of their revenue cycle management solution is now a critical next step to streamline both clinical and financial solutions for our patients across the entire Banner Health enterprise.”
This
expansion is expected to better position Banner Health to flexibly adapt to new
payment structures, more quickly adjust to policy and compliance changes,
better coordinate single registration between acute and ambulatory services and
centralize single-source patient charting and reporting across multiple care
locations.
“The integrated approach housed within Cerner Millennium supports a more efficient and cost-effective approach for our providers and enhances the patient care experience as their health information easily follows them across the Banner Health continuum of care,” said Laraway.
– 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
patients.
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
integrity.
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
Healthcare Providers
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.
Medly Pharmacy (Medly), an industry-leading full-service digital pharmacy, today announced the close of their $100M Series B funding round co-led by Boston growth equity firm Volition Capital and seed-to-growth venture capital firm Greycroft with the participation of Horsley Bridge and Lerer Hippeau.
A Better Pharmacy for Everyone
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
app.
Recent Traction/Milestones
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.”
– Fenway
Health has been selected as the pilot site to participate in the Advancing
Standards for Precision Medicine (ASPM) project.
– The ASPM project
is focused on how healthcare providers can systematically identify the
socio-economic factors that may impact the health of patients in order to
provide more individualized care that reflects patients’ needs.
Fenway Health, a
Boston, MA-based Federally Qualified Community Health Center (FQCHC) dedicated
to making enhancing the wellbeing of the LGBTQIA+ community, people living with
HIV/AIDS and the broader population has been selected as the pilot site to participate
in the Advancing
Standards for Precision Medicine (ASPM) project. Conducted by the U.S. Department of Health and
Human Service’s Office of the National Coordinator for Health Information
Technology (ONC), in partnership with Audacious
Inquiry, the University of Washington’s Clinical Informatics Research Group
and athenahealth, the project aims to develop standards for the
collection of social determinants of health data (unmet needs in areas such as income, educational attainment, employment
status, food security, housing, and more).
Advancing Standards for Precision Medicine Background
Data sharing is critical to realizing the future of
precision medicine. Launched in 2018, the Advancing Standards for Precision
Medicine (ASPM) project works to further the development and testing of
standards for new and diverse types of health data. The ultimate goal is to
make health data easier to share, curate, aggregate, and synthesize.
The project will leverage digital tools and questionnaires
to advance the standardized collection of data. Social determinants of health
play a major role in individual health outcomes. “athenahealth’s
partnerships with Fenway health and others ground us to the realities and
challenges of healthcare today to improve health outcomes” said Kedar
Ganta, athenahealth’s Product Leader for Interoperability Strategy.
“Transforming Patient Care by prioritizing the collection and sharing of
interoperable SDOH data will better identify patient needs and create impact
across the communities”
In fact, patients’ unmet social needs have been found to
account for up to 40 percent of individual health outcomes. Increasingly,
health care organizations are focused on addressing these needs to help improve
treatment and care in a way that addresses the whole patient.
EHR Data Collection Approach
Fenway Health will employ their current web-based assessment
tool, ePRO, which was developed by the University of Washington’s Clinical
Informatics Research Group (CIRG), as a prototype for testing and transmitting
the systematic capture of SDOH data, as well as ASPM’s proposed standards and
implementation guides as part of their effort. That data will then be sent to
athenahealth, Fenway Health’s electronic health record (EHR) vendor, and be
incorporated into the patient’s health record in a standardized format.
“Standardizing SDOH data and incorporating that information into the EHR along with other patient-reported outcomes, allows health care providers to better understand the context in which their patients live and what they experience, and helps providers offer more personalized and relevant care”, said Dr. Bill Lober, Professor at the University of Washington, and director of CIRG.
Pilot Project Timeline
The ASPM project is set to last through the Fall of 2020 and
will culminate in an evaluation report to be shared with ONC and the National
Institute of Health (NIH). The evaluation will be used to identify challenges
in data collection and sharing between health care providers and to develop
solutions that will lead to better implementation of collection initiatives and
protocols in the future.
The project hopes to expand the types of data that can be
integrated into EHRs
to create a more complete picture of the patient that would reflect the
patient’s practical reality and the issues that may impact their health in the
future. Ultimately, the project’s goal is to give health care providers the
data and tools needed to provide patients with individualized treatment and to
help them achieve better outcomes.
– Paige secures an additional $15M from Goldman Sachs for a total Series B funding round of $70M for its AI-native digital pathology ecosystem.
– The company’s continued product portfolio of innovation in telepathology and digital diagnostics accelerated by further investment.
Paige, an NYC-based leader in computational pathology transforming the diagnosis and treatment of cancer, today announced it received an additional $15M from Goldman Sachs Merchant Banking Division, totaling $20M from the firm. The funding will be added to previously announced Series B financing, bringing the total round to $70M, including an additional investment from Healthcare Venture Partners of $5M on top of their previous $10M investment. The funding brings the Company’s total capital raised to over $95M.
Transforming Diagnosis & Treatment of Cancer
Founded in 2017 by Thomas Fuchs, Dr.Sc., Paige’s mission is
to revolutionize the diagnosis and treatment of cancer by providing
pathologists, clinicians and researchers with insights drawn from decades of
data diagnosed by world experts in cancer care. Spun out of Memorial Sloan
Kettering, Paige builds powerful, clinical-grade computational technologies to
transform the diagnosis, treatment and biomarker discovery for cancer. With AI
positioned to open a new future of pathology, Paige has created an AI-native
digital pathology ecosystem that enables the Pathologist to achieve higher
quality, faster throughput, and lower cost diagnosis and treatment
recommendations. Additionally, Paige
accelerates new biomarker discovery and is built to generate new insights into
pathways and drug efficacy.
Paige will use this new capital to further accelerate its global leadership position in transforming pathology workflows in the field of cancer while working closely with biopharma companies to create custom diagnostic and clinical trial solutions to improve patient care.
“We appreciate the continued recognition and support we’ve received from Goldman Sachs as we gain traction and prove early results in the clinical and biopharma space,” said Leo Grady, Ph.D., CEO of Paige. “This new funding will help ensure that the Paige Platform and our advanced computational pathology products will drive the next generation of pathology and improve cancer care globally.”
Jeff Fountaine, Director, Healthcare Vertical Market, Elo
A clinician’s mission is to deliver the best possible care to his or her patients. However, when technology gets in the way of the workflow, clinicians are obligated to spend valuable time making sure data inputs are accurate and complete across disparate systems. Nowhere is this more prevalent than with electronic medical records (EMRs).
Dr. Peter Greene, MD, CMIO, with Johns Hopkins, said, “Efficiency is really at the heart of what troubles us most. Clinicians really want the EMR to make their work easier. Current EMRs take up too much of their time and pull them away from face-to-face time with patients and care teams.”
Dr. Greene’s reflections embody the concerns that the design of the EMR system in critical workflows does not put the patient first. To address this, EMR developers are devoting significant effort into making the EMR design work on behalf of the clinician and patient. Many are finding the greatest room for improvement is in implementing touchscreen technology into the workstation on wheels (WoW) or on in-room wall mounts. Such technology allows clinicians to quickly access key sections of the EMR and input important data like physical exam findings and medication type and dosage.
Transform Healthcare With Touch Technology
EMR developers are recognizing that touchscreens significantly enhance the clinician’s experience and patient interaction. From the chief medical officer to the clinicians and medical staff, everyone is familiar with touchscreen technology in their daily lives via their mobile devices. Bringing this technology to clinicians’ and nurses’ workflows frees them from needing to use a keyboard and mouse in favor of a more intuitive and dynamic display. This allows them to more quickly and easily access medical records, view medical images, prescribe medication and document care, and improve their efficiency by up to 20%.
It’s faster and easier to clean touchscreen displays too, especially when comparing them to a traditional keyboard and mouse. With a solid piece of glass and a seamless surface, the touchscreen is easily cleaned with wipes commonly available is patient settings. Whether it’s COVID-19, common influenza, or another infectious disease, implementing a streamlined touchscreen solution can help protect patients.
Build a Unified Architecture for Clinicians
Many modern touchscreen-based workflows are built on a mobile architecture like Android. As healthcare organizations invest in streamlined solutions for clinicians, there’s often a gap that occurs when the mobile operating system doesn’t link seamlessly with the desktop architecture. Without a unified platform connecting every touchpoint, organizations lose precious time continually replacing outdated platforms and hardware. Making the decision to invest in a unified architecture will streamline the entire ecosystem, shorten future deployment time, and enable flexibility across the organization.
The first step for CIOs, CMIOs, CNIOs, and health systems to achieve this is to create a proof of concept that brings together key leaders within the clinical staff to showcase inclusion of touch technology at the desktop level, coupled with mobile devices for a variety of clinical applications. Next, they can deploy a trial built on a flexible, scalable architecture to help the organization better envision the investment they are making before committing more money.
In this trial, they can demonstrate how the EMR improves key workflows as clinicians more easily enter data and health information while taking care of their patients. From this demonstration, CIOs and health systems can receive feedback from clinicians to share with the EMR engineering team to help them better understand how they can improve the design of their UI/UX to get the most out of the unified desktop and mobile experience.
From trial and iteration to solution deployment, the objective remains the same – to create an infrastructure that scales to the demands of the environment while leaving the user satisfied. The outcome of patient care is always first and foremost in the minds of clinicians, so the technology should enable them to focus on care and deliver on that ultimate goal.
About Jeff Fountaine
As director of the healthcare vertical market for Elo, Jeff Fountaine develops and delivers solutions that enhance provider experiences and patient engagement in the healthcare and medical market. With 15 years of experience, he addresses critical workflow challenges for clinicians while ensuring positive patient outcomes through the use of technology.
– The COVID-19 crisis has significantly impacted the
patient care paradigm, and the ripple effects have altered patient behaviors
and expectations, requiring a significant change in how life sciences companies
engage with and support patients
– Accenture surveyed 2700 patients about changes in care
during COVID-19 and found a major shift to virtual care, which patients
embraced.
– Virtual care is here to stay and can be an integral
part of the patient experience with health care providers and as part of
clinical trials.
– With 70% of patients deferring or canceling treatment, virtual tools were widely adopted as an essential lifeline for continuing care.
The COVID-19 pandemic has permanently shifted patient behavior towards virtual care, according to a new survey from Accenture. The Accenture COVID-19 Patient Survey conducted in May across China, France, Germany, Japan, the U.K., and the U.S. asked 2,700 oncology, cardiology, or immunology patients globally how patient care has changed during COVID-19. The survey revealed patients have embraced virtual care and communications at very high rates as a result of COVID-19 and nine out of 10 reported the quality of care was as good or better than before.
Patients Chose to Defer and Change their Care
As restrictions came into effect, patients faced difficult choices about whether and how to continue their treatments. Many healthcare providers canceled appointments, and transportation options were shut down. Patients were afraid to risk exposure to COVID-19 by going to their healthcare providers for regular treatment, and many (70%) deferred or canceled at least some elements of their treatment.
But nearly half of all surveyed patients also started getting some treatment at home instead of going to their healthcare provider’s office and they began using virtual tools such as video conference calls, online chat, and apps. 1 out of 5 patients switched to a different therapy due to COVID-19, while nearly half considered making a change. Patients were concerned about how treatment might affect their risk of COVID-19, and about the method and timing required for specific treatments.
Sixty-three percent of those who used video conferencing
said it was very good or excellent, an impressive response given 70% were using
video conferencing for treatment for the first time. By using technology to
support communication and care, healthcare providers were largely able to
maintain or even improve on the patient experience.
Other key findings of the survey include:
Trust in the Healthcare Ecosystem Increased
Forty-seven percent of respondents said they received better, more personalized responses; 41% said quicker responses and 40% said it was more convenient to access through new communications channels.
In addition, the overall trust in the healthcare system has increased. Sixty percent of patients surveyed said their trust in healthcare providers has increased, and 45% said their trust in pharmaceutical and medical device companies has increased.
Virtual care helped keep some clinical trials going
Worryingly, many clinical trials were disrupted by COVID-19.
Seventy-seven percent of patients said their clinical trials were suspended or
delayed, which could have a knock-on effect on the speed in which new
treatments come to market.
However, for trials that continued, the use of virtual care was critical for
consultations, treatment, and monitoring. Consider that 61% of patients whose
trials continued used some form of virtual communication or care.
Using virtual technologies as a regular part of the clinical trial process would not only improve resilience to disruptions but would help to improve the patient experience.
Patients said they want to be consulted more, but they are currently far from the center of the clinical trial design process. As decisions were being made on how to modify clinical trials due to COVID-19, only 14% of surveyed patients were asked about what changes would work for them. This held true across all therapeutic areas and geographies.
“Increasing virtual communication and treatment options offers multiple benefits for clinical trials, as one-third of all patients in trials reported that even before COVID-19, they had difficulty making appointments or physically getting to clinics for treatment,” said Michel. “Patients want more video conferencing and fewer clinic visits, which would make clinical trials more convenient and accessible.”
For more information, the full report is available for
download here.
– Health Catalyst announces an agreement to acquire
clinical workflow optimization solution healthfinch using a mix of stock and
cash.
– As part of the acquisition, healthfinch will be a new
application suite category called EMR Embedded Insights and its refills, care
gaps closure, and visit planning applications will continue to be available in
their original configuration.
Health
Catalyst, Inc., a provider of data and analytics technology and services to
healthcare organizations, today announced that it
