– New CHIME-KLAS interoperability report reveals steady
progress in some areas related to interoperability and leaps forward in others.
– A total of 67% of provider organizations reported they
often or nearly always had access to needed records in 2020, up from 28% in
2017. Providers noted improvements in functionality and usability for tasks
like locating and viewing records.
Providers Cite Steady Progress in
The report reveals providers cited steady
progress in some areas related to interoperability and leaps forward in others.
CHIME-KLAS cites a total of 67% of provider organizations reported they often
or nearly always had access to needed records in 2020, up from 28% in 2017. Providers
noted improvements in functionality and usability for tasks like locating and
viewing records. Vendor support of data sharing improved between 2016 and 2020,
with the biggest gains between partnering organizations using different EMRs.
Overall, providers were increasingly optimistic that these changes will allow
record exchange to have a greater impact on patient care in the future.
“For digital health to reach its full
potential, we need to be able to safely and securely exchange information
across the healthcare ecosystem,” said CHIME President and CEO Russell P. Branzell.
“Interoperability is the linchpin. With the Cures Act and other federal
initiatives promoting data sharing, we should see even more gains that
ultimately will improve patient care. As is evident in the survey results,
great strides have been made resulting in remarkable improvements. This
required hard work for all parties involved and they should be congratulated on
their collective efforts.”
10 Key Trends in EMR Interoperability
The report highlights the following 10 EMR
interoperability trends in the industry based on data from a 2020
interoperability survey, with comparisons to results from past surveys.
1. Deep Interoperability Is Progressing, with Many
Organizations Poised for Significant Progress in Coming Years.
The rate of provider organizations achieving deep
interoperability has doubled since 2017. The overall rate leaves much to be
desired, but signs of progress are visible.
2. Almost All EMR Vendors Have Improved Connections to
Outside EMR Solutions
The biggest gains have come because of vendor proactivity;
vendors who take an active role in helping push provider organizations to
success have seen the most progress.
3. Ambulatory Clinics and Smaller Hospitals Are
Connecting More Than Ever Before
KLAS market share data has shown a steady trend of EMR
vendor consolidation over the past several years. Interestingly, this
consolidation has resulted in more needed connections with critical exchange
partners, not fewer.
4. High Costs and Lack of EMR Vendor Technical Readiness
Make Interoperability Harder for Half of Surveyed Providers
The most mentioned barrier to success was cost. Buying the
latest features and functionality, paying for new interfaces and connections,
and the cost to keep up system customization are frequent complaints.
5. National Networks Have Reached a Tipping Point
Today, perceived value and adoption are higher than ever
before, and organizations leveraging these networks are significantly more
likely to report achieving deep interoperability.
6. App Use Still in Early Stages; Patient-Facing App Use
Patient-facing apps are some of the most commonly used
across the healthcare app landscape. Some provider organizations are leveraging
apps from their vendor. Apple is the most common third party being leveraged
for this use case.
7. FHIR Adoption Begins to Take Hold in Large Health
The bulk of FHIR adoption comes from customers of large EMR
vendors, and these organizations are are primarily leveraging FHIR APIs for
patient-record exchange, clinician-enabling tools, and patient-facing tools.
8. Intended ROI of FHIR Unclear for Many
Organizations question the value of FHIR because of three
primary concerns: (1) lack of patient adoption of apps, (2) an unclear
connection between use-case adoption and the intended outcomes, and (3)
difficulty quantifying the potential outcomes they have identified.
9. Proprietary API Adoption Is Proving Valuable
Patient-facing tools, clinician-enabling tools, and
patient-record exchange are the primary use cases for proprietary APIs—just
like with FHIR.
10. Robust Record Exchange and Population Health Are Top
Needs Going Forward
When asked what interoperability use cases their vendor
should focus on in the next two to three years, provider organizations
primarily spoke about enhancements to patient-record exchange.
– Care Simple, Epic,
and MetroHealth System announced that they have entered into a strategic remote
patient monitoring integration partnership.
– Under the terms of
the agreement, CareSimple will empower the Cleveland, Ohio public health system
with simple, patient-friendly RPM solutions to improve health outcomes for
their high-risk senior and chronically ill populations.
The MetroHealth System, a nationally recognized public health care system located in Cleveland, Ohio, and CareSimple, a Remote Patient Monitoring (RPM) solution designed, developed, and operated by Tactio Health Group, today announced a strategic remote patient monitoring (RPM) partnership. As part of the strategic integration partnership, the CareSimple RPM solution will integrate with the hospital’s Epic EHR platform for near real-time access to patient health data in support of virtual care interventions.
Red Carpet Care Remote Patient Monitoring Program
Under the terms of the agreement, the CareSimple solution will empower the health system’s Red Carpet Care
Program, offered by the Population Health Innovation Institute, with patient-friendly RPM solutions. These tools will help
improve health outcomes for Northeast Ohio’s high-risk senior and chronically
The MetroHealth System Red Carpet Care
program offers an extension of their care team and primarily focuses on chronically
ill and at-risk senior patients. The initiative works in parallel with primary
care to proactively and virtually manage chronic conditions in partnership with
multiple ambulatory settings through individualized care plans. The healthcare
organization has already achieved demonstrable successes with the Red Carpet
Care program, with over 400 patients reducing emergency department visits by
17% and inpatient utilization decreasing by 13%.
– As an end-to-end virtual care offering, CareSimple provides everything needed for a successful RPM integration including logistics, software, medical devices, and connectivity
– CareSimple’s solution is known for making RPM simple enough for any patient regardless of age, condition, and socioeconomic status
– For MetroHealth’s providers, it was important to integrate
an RPM solution that required no additional training in order to utilize the
technology while providing Epic compatibility. CareSimple was able to deliver.
– The platform empowers both payers and providers to scale
monitoring beyond traditional home health applications to highly effective
population health management programs
– CareSimple offers a seamless workflow integration through its web-based platform that delivers near real-time clinical alerts when patient data is out of normal ranges and ultimately allows for timely care interventions.
– Through integration with Healthy Planet,
the population health management module in MetroHealth’s Epic electronic health record service, vitals are received
in near real-time from the patients’ cellular-enabled devices in the comfort
and privacy of their own homes. This gives healthcare providers a holistic view
of their patients’ health to help prevent costly readmissions and improves
“The MetroHealth System is pleased to launch CareSimple’s remote patient monitoring services to benefit not only our patients but also our clinical teams,” said Michael Dalton, Vice President, Virtual Care Enterprise, The MetroHealth System. “For our healthcare providers, it was important to integrate an RPM solution that required no additional training in order to utilize the technology, as well as being easy to use for our patients while providing Epic compatibility. CareSimple was able to deliver on all of these important aspects, offering a seamless workflow integration through its web-based platform that delivers near real-time clinical alerts when patient data is out of normal ranges, and ultimately allows for timely care interventions.”
We are witnessing a race in the vaccine rollout. A race towards the light at the end of a tunnel and a race which will likely define the next few years, according to Dr Charles Alessi, chief clinical officer at HIMSS.
– Aledade raises $100 Million in Series D funding to help
more primary care practices thrive in value-based care.
– The new funding will power the growth of a nationwide network of more than one million patients by further expanding into Medicare Advantage Contracts.
a Bethesda, MD-based provider of value-based primary care, today announced it
has closed a $100 million Series D funding round following a year of
significant growth for its national network of risk-taking primary care
practices. Returning investor Meritech Capital led the round, which included new growth
Global Management andIVP,
and returning investor OMERS Growth Equity. The latest round of funding brings the
company’s valuation to over $2.1 billion dollars.
Delivering Value-Based Primary Care
Founded in 2014 by former National Coordinator for Health IT, Farzad Mostashari, Aledade began building ACO networks for independent physicians through the Medicare Shared Savings Program, but now also partners with commercial payers across the country. Aledade now partners with nearly 800 independent primary care practices, including more than 100 federally-qualified health centers, comprising more than 7,800 providers in 31 states. Through this nationwide network of independent practices, Aledade practices manage roughly $12 billion in health care spending through 35 Medicare and 51 other value-based contracts and care for nearly 1.2 million patients.
Why It Matters
As the healthcare system continues to be strained by the
COVID-19 pandemic, these value-based
practices are keeping patients healthy, at home, and out of the hospital with
proactive, coordinated primary care. Aledade technology helps practices
identify and better manage their most at-risk patients. Patients of practices
engaged with Aledade have fewer emergency department visits, inpatient stays
and readmissions; in the most recent year with public results from the Medicare
Shared Savings Program, Aledade practices reduced hospital stays by an average
of 9 percent, avoiding more than 10,000 unnecessary hospitalizations.
Aledade’s growth has been driven by the success of its
physician-led model, in which the company shares in the risk and reward of both
government and commercial value-based contracts with participating independent
practices. Aledade practices have improved the quality of care and health
outcomes while controlling costs in all types of public and private payer
contracts. To date, Aledade’s participating practices have received more than
$115 million in shared savings revenue.
Funding Will Support Strategic Partnerships with Medicare
Aledade will use this infusion of capital to expand its value-based care model with health plans across the country, with a particular focus on growing its strategic partnerships with Medicare Advantage (MA) plans to improve outcomes and quality for more seniors. Already, Aledade works with all of the largest MA payers and multiple Blue Cross plans to give Aledade practices access to Medicare Advantage value-based contracts. In 2020, Aledade more than doubled the number of patients served in these MA contracts, bringing the total to about 100,000.
As the company expands into more MA plan partnerships and
welcomes more practices to its national network of ACOs, Aledade will continue
to invest heavily in its cutting-edge technology platform to ensure primary
care physicians have a world-class operating system for population health.
Aledade also plans to launch several initiatives in 2021 to extend this
These include initiatives to extend the use of integrated
telehealth, predict and prevent the occurrence of unplanned dialysis, reduce
racial disparities in hypertension control, and enable even the smallest
primary care practices in the country to join value-based contracts with
The right to health, not just the access to healthcare, requires a holistic understanding of how we can provide a better quality of life and wellbeing for the individual and society, argues Bogi Eliasen, a futurist at the Copenhagen Institute for Future Studies and a member of the HIMSS Future50 Community.
For many of us 2021 feels like a lot like 2020 with lockdowns imposed and hospital pressures increasing. However, there is light at the end of the tunnel with several vaccines now being rolled-out globally, says Dr Saif Abed, founding partner, AbedGraham.
Seema Verma is administrator of the Centers for Medicare and Medicaid Services.
This article was co-authored with Alexandra Mugge, deputy chief health informatics officer at CMS, and Shannon Sartin, chief technology officer at the Centers for Medicare & Medicaid Innovation.
Connected Communities of Care Definition: An innovative method for effective population health management using social determinants of health. A way to streamline effective coordination between medical, government, and community-based organizations.
We ask this type of question every day. For example, we may ask― “Is this product that I purchased making a difference?” or “Is this advanced training that I completed making a difference?” Implicit in this common question is the expectation that because we have made an investment in something to achieve a result, the result should be better or more improved than the pre-investment state. So too with a Connected Community of Care (CCC). As I have discussed in previous blogs, establishing a CCC requires a substantial investment in both time and money.
Therefore, it is only natural to ask― “Is this CCC making a difference, and how would I know?” Unfortunately, most CCCs are established with very little forethought given to this exact question. While we expect the CCC will help community residents improve their health and well-being, how will we know conclusively that this has happened? How will we demonstrate its impact to a potential partner or― more importantly― a funder? This is where data, measurement, and evaluation come into play. For most people, these three words cause anxiety levels to immediately rise. But this doesn’t need to be the case; a little planning and forethought can go a long way to assuaging one’s anxiety when asked the question, “Is your CCC making a difference?”
Before we think about what data we will need to answer this question or how we will collect it, we first need to establish what we mean by “making a difference”. Understand, there is no one correct answer to this question. What may constitute a positive difference or impact for one organization may be much different for another, even a similar organization. Many factors contribute to the final answer and each is usually organization-, ecosystem- and situation-specific.
In practice, there are many ways to define making a difference. First, we can look at quantitative or numeric information to make this determination. Are we providing more nutritious meals to indigent residents? Is the number of inappropriate Emergency Department visits declining or, conversely, is the number of residents having visits with a primary care provider increasing?
All of these effects can be counted and judged against some predefined goal (more on this later). Second, we can assess making a difference by asking the people that are being touched by the CCC. Through surveys or brief interviews, community residents can tell you in their own words what impact, if any, the CCC has on their lives.
While this qualitative (non-numeric) information can often be more informative than simple quantitative information because it represents the voice of the individual, to answer the question of whether your CCC is making a difference, you will also still likely need to establish numeric goals. A third way to assess whether your CCC is making a difference is indirect via the financial and non-financial opportunities that arise as a result of having a CCC versus not having one.
For example, having a CCC may make it much easier to perform contact tracing among vulnerable populations during a pandemic like COVID-19. Having a CCC may also enable a healthcare system or a community-based organization (CBO) to apply for a grant that it otherwise might not be competitively positioned to do if it did not have an integrated system of healthcare and social service providers such as a CCC.
Regardless of the approach to define making a difference, the importance of planning for 1) what things will be measured to generate the necessary data, 2) how and when that measurement will take place, and 3) how the resulting data will be analyzed and evaluated, cannot be underestimated. Similarly, these decisions cannot be put off until a later date as is often seen with start-ups, including CCCs. While it is natural to want to focus on the more immediate needs associated with launching a CCC, deferring the question of how we will know if the entity is making a difference can prove costly, both from an operational and financial perspective.
At the Parkland Center for Clinical Innovation (PCCI) we encourage those planning a CCC to devote the necessary time early on to setting performance goals and objectives and determining how and when they will be measured and evaluated. While it is important to explicitly build this step into your CCC planning phase, the scope and scale of the work does not have to be extensive.
In fact, at PCCI we strongly encourage CCCs to start small with a limited set of goals, objectives, and requisite measures and then scale up as the CCC grows and matures. This approach has the dual benefit of providing essential core information early on while also not overwhelming the CCC staff with data collection activities that may be a distraction from more pressing, day-to-day activities.
Based on this author’s work with literally hundreds of healthcare and social service provider organizations, experience suggests that most entities (both new and established organizations) do best if they initially establish 1) a limited number of goals― one or two at most, 2) a similar number of objectives to achieve each goal, and 3) no more than three to four performance measures to support each goal.
While this may seem like an insufficient number of performance elements in today’s data-obsessed world, remember that you can always add additional goals, objectives, and measures as your expertise and comfort levels allow and as your CCC evolves.
Even more important than the numbers, however, it is essential to get the selection of the goals, objectives, and performance measures correct. Each of these three performance elements plays an essential role in helping you answer the question “Is my CCC making a difference?”
Your goals focus on the long-term― what do you ultimately want to happen, while your objectives are the short-term accomplishments that help you achieve your goals. In both cases, you must be sure that what you are expecting is both realistic and appropriate for your CCC’s stage of development. For example, assuming a newly established CCC will reduce ED utilization in its first year or two may not be reasonable and may lead to frustration and disillusionment if the goal is not achieved. If you select a BHAG (Big Harry Audacious Goal), you must allow sufficient time (and then some) for all the necessary pieces to come together.
The rule of thumb for large-scale demonstration projects such as launching a CCC is that they 1) take (much) longer than expected, 2) cost more than budgeted, and 3) generally initially deliver less than expected. These facts should not dissuade you from your journey, but rather help you keep things in perspective as the project evolves to one that in the long-term is viewed as valuable in achieving your goals.
If getting the goals and objectives correct is important, then selecting the correct performance measures and designing a feasible measurement plan is paramount. Here again, quality is more important than quantity. A few well-chosen performance measures, implemented correctly, will generate far more in the way of actionable data than a plethora of randomly selected measures.
To optimize your ability to assess if your CCC is making a difference, your performance measures should be collected at regular intervals following the launch of the CCC. While many established programs collect, analyze, and evaluate performance data on a quarterly basis, for fledgling CCCs, PCCI recommends this data be collected monthly for at least the first one to two years or until the CCC reaches a stable level of operations.
While monthly data collection requires a little more work, the more frequent feedback allows you to make the necessary program or operational modifications more quickly and with fewer disruptions than that afforded with quarterly feedback. If measurement and evaluation is an area where you don’t have a lot of experience, reach out to others that do, especially individuals and organizations such as PCCI that have experience assessing performance in large-scale, multi-sector collaborative projects.
While we all hope that the answer to the question “Is my CCC making a difference” is yes, the answer may be no early on in the life of a CCC. As disheartening as this news may be, it’s important to not give up but to look critically at what is working and what is not and make adjustments where necessary.
Usually, this examination does not necessitate a complete “reboot” of the CCC initiative, but rather requires making minor changes accompanied by paying closer attention to the CCC’s operations. Seek feedback from your staff and those you serve and be open to change, where change is warranted. As indicated, these types of projects take a lot longer to reach fruition than most people believe, but with a solid plan, patience, and flexibility, you will be able to answer, “Yes, my CCC is definitively making a difference in the lives of the community residents it serves.”
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.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
Industry experts state that orphan drugs will be a major trend to watch in the years ahead, accounting for almost 40% of the Food and Drug Administration approvals this year. This market has become more competitive in the past few years, increasing the potential for reduced costs and broader patient accessibility. Currently, these products are often expensive because they target specific conditions and cost on average $147,000 or more per year, making commercialization optimization particularly critical for success.
This is important because personalized medicine has the capacity to detect the onset of disease at its earliest stages, pre-empt the progression of the disease and increase the efficiency of the health care system by improving quality, accessibility, and affordability.
These factors lay the groundwork for specialty pharmaceutical companies that are developing and commercializing personalized drugs for orphan and ultra-orphan diseases to pursue productive collaboration and meaningful partnership with a specialty pharmacy, distribution, and patient management service provider. This relationship offers manufacturers a patient-first model to align with market trends and optimize the opportunity, maximize therapeutic opportunities for personalized medicines, and help to contain costs of specialty pharmacy for orphan and rare disorders. This approach leads to a more precise way of predicting the prognosis of genetic diseases, helping physicians to better determine which medical treatments and procedures will work best for each patient.
Furthermore, and of concern to specialty pharmaceutical providers, is the opportunity to leverage a patient-first strategy in streamlining patient enrollment in clinical trials. This model also maximizes interaction with patients for adherence and compliance, hastens time to commercialization, and provides continuity of care to avoid lapses in therapy — during and after clinical trials through commercialization and beyond for the whole life cycle of a product. Concurrently, the patient-first approach also provides exceptional support to caregivers, healthcare providers, and biopharma partners.
Integrating Data with Human Interaction
When it comes to personalized medicine for the rare orphan market, tailoring IT, technology, and data solutions based upon client needs—and a high-touch approach—can improve patient engagement from clinical trials to commercialization and compliance.
Rare and orphan disease patients require an intense level of support and benefit from high touch service. A care team, including the program manager, care coordinator, pharmacist, nurse, and specialists, should be 100% dedicated to the disease state, patient community, and therapy. This is a critical feature to look for when seeking a specialty pharmacy, distribution, and patient management provider. The key to effective care is to balance technology solutions with methods for addressing human needs and variability.
With a patient-first approach, wholesale distributors, specialty pharmacies, and hub service providers connect seamlessly, instead of operating independently. The continuity across the entire patient journey strengthens communication, yields rich data for more informed decision making, and improves the overall patient experience. This focus addresses all variables around collecting data while maintaining frequent communication with patients and their families to ensure compliance and positive outcomes.
As genome science becomes part of the standard of routine care, the vast amount of genetic data will allow the medicine to become more precise and more personal. In fact, the growing understanding of how large sets of genes may contribute to disease helps to identify patients at risk from common diseases like diabetes, heart conditions, and cancer. In turn, this enables doctors to personalize their therapy decisions and allows individuals to better calculate their risks and potentially take pre-emptive action.
What’s more, the increase in other forms of data about individuals—such as molecular information from medical tests, electronic health records, or digital data recorded by sensors—makes it possible to more easily capture a wealth of personal health information, as does the rise of artificial intelligence and cloud computing to analyze this data.
Telehealth in the Age of Pandemics
During the COVID-19 pandemic, and beyond, it has become imperative that any specialty pharmacy, distribution, and patient management provider must offer a fully integrated telehealth option to provide care coordination for patients, customized care plans based on conversations with each patient, medication counseling, education on disease states and expectations for each drug.
A customized telehealth option enables essential discussions for understanding patient needs, a drug’s impact on overall health, assessing the number of touchpoints required each month, follow-up, and staying on top of side effects.
Each touchpoint has a care plan. For instance, a product may require the pharmacist to reach out to the patient after one week to assess response to the drug from a physical and psychological perspective, asking the right questions and making necessary changes, if needed, based on the patient’s daily routine, changes in behavior and so on.
This approach captures relevant information in a standardized way so that every pharmacist and patient is receiving the same assessment based on each drug, which can be compared to overall responses. Information is gathered by an operating system and data aggregator and shared with the manufacturer, who may make alterations to the care plan based on the story of the patient journey created for them.
Just as important, patients know that help is a phone call away and trust the information and guidance that pharmacists provide.
About Donovan Quill, President and CEO, Optime Care
Donovan Quill is the President and CEO of Optime Care, a nationally recognized pharmacy, distribution, and patient management organization that creates the trusted path to a fulfilled life for patients with rare and orphan disorders. Donovan entered the world of healthcare after a successful coaching career and teaching at the collegiate level. His personal mission was to help patients who suffer from an orphan disorder that has affected his entire family (Alpha-1 Antitrypsin Deficiency). Donovan became a Patient Advocate for Centric Health Resources and traveled the country raising awareness, improving detection, and providing education to patients and healthcare providers.
– Regence and MultiCare ink first-in-the-nation value-based
care partnership to deliver improved health outcomes at lower costs.
Health insurance provider Regence
and MultiCare Health System,
an independent accountable
care organization (ACO) have partnered to deploy a first-in-the-nation value-based model
that delivers better health outcomes to members at lower costs while
simplifying administration for health care providers. Regence serves
approximately 3.1 million members through Regence BlueShield of Idaho, Regence
BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and
Regence BlueShield (select counties in Washington). The new approach between
Regence and MultiCare Connected Care—the Accountable Care Organization that is
a wholly owned subsidiary of MultiCare Health System—marks a milestone in the
evolution of value-based partnerships between insurance payers and providers.
Da Vinci Member Attribution List Standard for Value-Based
The partnership will leverage utilized a soon to be
published HL7® FHIR® (Fast Healthcare Interoperability Resources) Standard
“Da Vinci Member Attribution List” which was developed by the HL7® Da Vinci Project for
value-based arrangements. This national standard provides an
interoperable method to share member attribution data assisting in reducing the
burden on provider organizations managing patient data and allowing providers
to spend more time with patients. The Regence and MultiCare partnership establish
a foundation for the development of future population data interoperability
applications, such as the exchange of data for measuring care quality and
Why It Matters
Value-based arrangements result in improved outcomes, lower
costs and fewer care gaps for health plan members, and higher patient and
provider satisfaction. Providers are eligible to earn financial incentives by
meeting established targets for patient outcomes, costs and satisfaction
By creating efficiencies and security in delivering patient data to providers more frequently, it allows provider organizations to spend less time acquiring the data and more time with the patient.” said Melanie Matthews, president of MultiCare Connected Care. “It frees up providers to do the work of population health and helps us embrace our mission of partnering for a healing and healthy future.”
At Geisinger in Pennsylvania, a pilot program to bring care to the homes of older patients with complex healthcare needs has shown a 35% reduction in visits to the emergency department visits, a 40% drop in hospital admissions and an average annual savings of nearly $8,000 per patient.
A global health crisis has thrust us into a scenario in which lives quite literally depend on the ability to virtually connect. Telehealth has rapidly emerged as a vital tool, enabling continuity of care, allowing vulnerable individuals to access their physician from home, and freeing up resources for providers to treat the most critical patients. The acceptance of telehealth and expansion of covered services for the senior population demonstrate that this technology will endure long after COVID-19 subsides.
Prior to the pandemic, just 11% of Americans utilized telehealth compared to 46% so far this year, and virtual healthcare interactions are expected to top 1 billion by year’s end. While the technology has been a life-saver for many, usage depends heavily on the availability of audio-video capabilities, internet access, and technological prowess – potentially leaving vulnerable patients behind.
Seniors Face Physical, Technical and Socioeconomic Barriers to Telehealth
Despite telehealth’s surge, there is growing concern that the rapid shift to digitally delivered care is leaving seniors behind. Telehealth is not inherently accessible for all and with many practices transitioning appointments online, it threatens to cut older adults off from receiving crucial medical care. This is a significant concern, considering older adults account for one-quarter of physician office visits in the United States and often manage multiple conditions and medications, and have a higher rate of disability. This puts an already vulnerable population at a higher risk of severe complications from COVID-19.
Research published recently in JAMA Internal Medicine found that more than a third of adults over age 65 face potential difficulties accessing their doctor through telehealth. Obstacles include familiarity using mobile devices, troubleshooting technical issues that arise, managing hearing or vision impairments, and dealing with cognitive issues like dementia. Many of these difficulties stem from the natural aging process; it is imperative for provider organizations employing telehealth and telehealth vendors to improve offerings that consider vision, hearing, and speaking loss for this population.
While barriers associated with aging are a key factor within the senior population, perhaps the greatest challenges in accessing telehealth are socioeconomic. The rapid shift to digital delivery of care may have left marginalized populations without access to the technological tools needed to access care digitally, such as high-speed internet, a smartphone or a computer.
According to the JAMA study, low-income individuals living in remote or rural locations faced the greatest challenges in accessing telehealth. A second JAMA study, also released this summer indicated that “the proportion of Medicare beneficiaries with digital access was lower among those who were 85 or older, were widowed, had a high school education or less, were Black or Hispanic, received Medicaid, or had a disability.”
These socioeconomic factors are systemic issues that existed prior to the pandemic, and the crisis-driven acceleration of telehealth has magnified these pre-existing challenges and widened racial and class-based disparities. Recent initiatives at the federal level, such as the FCC’s rural telehealth expansion task force, are a step in the right direction, though more sustained action is needed to address additional socioeconomic challenges that are deeply rooted within the healthcare system.
Fortunately, Telehealth Hurdles Can Be Overcome
Recognizing that telehealth isn’t a “one-size fits all” solution is the first step towards addressing the barriers that disproportionately impact seniors and work is needed on multiple levels. Telemedicine consults are impossible without access to the internet, so the first step is to provide and expand access to broadband and internet-connected devices. With more than 15% of the country’s population living in rural areas, expanding broadband access for these individuals is especially crucial. In addition, older adults in community-based living environments need greater access to public wi-fi networks.
Access to mobile and other internet-connected devices is also essential. Products designed with large fonts and icons, closed captioning, and easy set-up procedures may be easier for older adults to use. For example, GrandPad is a tablet designed specifically for seniors and has an intuitive interface that includes basic video calling, enabling seniors to virtually connect with their caregivers.
To address affordability, the Centers for Medicaid and Medicare Services (CMS) allowed for mid-year benefit changes in 2020 to allow for payment or provision of mobile devices for telehealth. Many Medicare Advantage organizations are enhancing plans’ provisions of telehealth coverage and devices for 2021.
In addition to increasing access to broadband and internet-connected devices, providing seniors with proper educational resources is another crucial step. Even if older adults are open to using technology for telehealth visits, many will need additional training. Healthcare organizations may want to connect older patients with community-based technology training programs. Some programs take a multi-generational approach, pairing younger instructors with older students.
For example, Papa is an on-demand service that pairs older adults with younger ‘Papa Pals’ who provide companionship and assistance with tasks such as setting up a new smartphone or tablet.
From a socioeconomic perspective, careful consideration is needed to address the concerns that telehealth may reinforce systemic biases and widen health disparities. Providers may be less conscious of systemic bias toward patients based on race, ethnicity, or educational status.
In turn, providers must address implicit bias head-on, such as offering workplace training and incorporating evidence-based tools to adequately measure and address health disparities. This includes pushing for policies that enable widespread broadband access funding to better connect communities in need.
Health plans can support expanded access to care through benefit design, reducing costs for plan members. To match members and patients with the right resources and assistance, health plans and providers should launch outreach campaigns that are segmented by demographic group. Outreach initiatives could include assessments to determine each person’s ability and comfort level with telehealth.
The Path Forward
Without question, telehealth is playing a central role in delivering care during the current pandemic, and many of its long-touted benefits have been accentuated by the current demand. Telehealth, along with other digital monitoring technologies, have the potential to address several barriers to care for seniors and other vulnerable populations for whom access to in-person care may not be viable, such as those based in remote locations or with mobility issues.
In the post-pandemic era, telehealth can provide greater access and convenience, but if not implemented carefully, the permanent expansion of telehealth may worsen health disparities. Careful consideration and collaboration will be essential in embracing the value of telehealth while mitigating its inherent risks.
If implemented correctly, telehealth can provide continued access to care for our vulnerable aging population and can significantly improve care as well. Enhancing the ability to connect with healthcare providers anytime, anywhere can give seniors the freedom to gracefully age in place.
About Anne Davis
Anne Davis is the Director of Quality Programs & Medicare Strategy at HMS, a healthcare technology, analytics, and engagement solutions company, where she’s focused on the company’s Population Health Management product portfolio.
– Virtual maternity care platform Babyscripts announced a
new round of investments from Banner Health, CU Healthcare Innovation Fund, The
Froedtert & Medical College of Wisconsin Health Network, and WellSpan
– Using internet-connected devices for remote monitoring,
Babyscripts offers risk-specific experiences to allow providers to manage up to
90% of pregnancies virtually, allowing doctors to detect risk more quickly and
automate elements of care.
the leading virtual care
platform for managing obstetrics, today announced a new round of
investments through their Strategic Partners Program,
a unique investment bloc composed of health systems interested in
forwarding Babyscripts’ cutting-edge digital solutions for pregnant
populations. Partners include Phoenix-based Banner Health, one of the largest
nonprofit health care systems in the country; the CU Healthcare Innovation Fund, located on
the University of Colorado Anschutz Medical Campus in Aurora, Colorado; the Froedtert & the Medical College of
Wisconsin health network, an integrated health care system based in
Wisconsin; and WellSpan Health, an
integrated health system serving central Pennsylvania and northern
This investment round is structured to leverage the input
and support of clinical and health system partners, ensuring that Babyscripts’
product development and future roadmap aligns with customer needs.
Babyscripts has spent the last six years building a
clinically-validated, virtual care platform to allow OBGYNs to deliver a new
model of prenatal care. Using internet-connected devices for remote monitoring,
Babyscripts offers risk-specific experiences to allow providers to manage up to
90% of pregnancies virtually, allowing doctors to detect risk more quickly and
automate elements of care.
3-Tier Approach Virtual Maternity Care
Babyscripts’ three-tiered approach to virtual maternity care
allows providers to deliver risk-specific care to pregnant mothers at any time,
in any place, through a mobile app and internet-connected monitoring devices:
Maternal Digital Education: Virtually connect with expectant and new mothers between visits with a custom mobile app.
Maternal Health Monitoring: Virtual management of
pregnant patients through remote monitoring for blood pressure, weight, blood
sugar, social determinants of health (SDOH)
Maternal Population Health: Improve patient/member
care through a unique collaboration between the care team and the payer.
The solution is powered by a robust set of vetted user
experiences, integrations, workflows, and best practices.
“From the beginning, we’ve set ourselves apart from other tech companies by partnering with physicians to make sure that we’re developing solutions that will actually be useful and improve outcomes, not just look and feel ‘cutting-edge’,” said Juan Pablo Segura, co-founder and President of Babyscripts. “This investment is validation that health systems see the value of our solution — and they’re willing to put their money on it.
Mature health systems recognize the importance of context and design virtual care programs accordingly: Telehealth looks different for millennials and retirees, rural and urban patients and population groups with fundamentally different healthcare needs.
CVS Health Corporation names Neela Montgomery Executive Vice President and President of CVS Pharmacy/Retail, effective November 30, 2020. Montgomery will oversee the company’s 10,000 pharmacies across the United States. Montgomery, currently a Board Partner at venture capital firm Greycroft, most recently served as chief executive officer of furniture retailer Crate & Barrel and has nearly 20 years of global retail experience.
The Cleveland Clinic and Amwell joint venture appoint Egbert van Acht as Executive Vice Chairman to the Board of Directors and Frank McGillin as CEO. Formed one year ago as a first-of-its-kind company to provide broad access to comprehensive, high-acuity care via telehealth, the company has made great progress scaling digital care through its MyConsult® offering. With an initial focus on clinical second opinions, the organization also offers health information and diagnosis on more than 2,000 different types of conditions including cancer, cardiac, and neuroscience issues.
Healthcare industry veteran Dana Gelb Safran, Sc.D. has joined Well Health Inc. as Senior Vice President, Value-Based Care, and Population Health. In her new role, Dr. Safran will expand WELL’s uses to improve healthcare quality, outcomes, and affordability through partnerships with payers and Accountable Care Organization (ACO) providers.
Talkdesk®, Inc., the cloud contact center for innovative enterprises appoints Cory Haynes to lead Talkdesk’s strategy for the financial service industry and Greg Miller to lead the strategy for healthcare and life sciences. Haynes and Miller are key members of the Talkdesk industries team led by Andrew Flynn, senior vice president of industries strategy for Talkdesk.
Imprivata appoints Mark McArdle to Senior Vice President of Products and Design. Mr. McArdle has more than two decades of experience in software development, Software-as-a-Service (Saas), in Cybersecurity, and advanced products for the enterprise, SMB, and consumer markets.
Eden Health names Jack Stoddard as executive chairman of its board of directors. Formerly serving in COO roles for Accolade and Haven, Stoddard brings two decades of healthcare innovation and operating experience to the board position, providing leadership, wisdom, and counsel during a time of monumental growth and adoption for the company.
Augmedix names Saurav Chatterjee Chief Technology Officer. Prior to joining Augmedix, he most recently served as Vice President of Engineering at Lumiata, Inc., where he led the engineering team that built a leading AI platform, focusing specifically on transforming, cleaning, enriching, featurizing, and visualizing healthcare data, and on building, deploying and operationalizing machine learning and deep-learning models at scale.
Tridiuum, the nation’s premier provider of digital behavioral health solutions names Philip Vecchiolli has joined the company as Chief Growth and Strategy Officer. Vecchiolli, who brings over 30 years of experience to the new role, has a successful track record of leading business development for large and mid-size healthcare companies.
Connect America appoints Janet Dillione as its new chief executive officer (CEO). Prior to joining Connect America, Dillione worked in the healthcare information services industry as CEO of Bernoulli Enterprise, Inc., GM of Nuance Healthcare, and CEO of Siemens Healthcare IT.
Health Catalyst, Inc. announces that current Chief Financial Officer Patrick Nelli has been named President, effective January 1, 2021. Following Nelli’s promotion to the President role, Health Catalyst has named Bryan Hunt, current Senior Vice President of Financial Planning & Analysis, Chief Financial Officer, also effective January 1, 2021.
Two additional promotions, also effective January 1, 2021, include Jason Alger, Senior Vice President of Finance, to Chief Accounting Officer, and Adam Brown, Senior Vice President of Investor Relations, to Senior Vice President of Investor Relations and Financial Planning & Analysis.
Apervita hires health IT veteran Rick Howard as Chief Product Officer. In his role, Rick will oversee product vision, innovation, design, and delivery of Apervita’s digital platform, which enables digital quality measurement, clinical intelligence, as well as value-based contract monitoring and performance measurement.
Conversion Labs, Inc. appoints Roberto Simon to its board of directors and as the chair of its audit committee. Following his appointment, the board now has eight members, with six serving as independent directors. Mr. Simon currently serves as CFO of WEX (NYSE: WEX), a $6+ billion fintech services provider.
PRA Health Sciences, Inc. appoints senior FDA official Isaac Rodriguez-Chavez, Ph.D., MHS, MS, as Senior Vice President, Scientific and Clinical Affairs. He will lead the company’s Global Center of Excellence for Decentralized Clinical Trial (DCT) Strategy. Dr. Rodriguez-Chavez’s responsibilities will involve the continued growth and development of PRA’s industry-leading decentralized clinical trial strategy, regulatory framework creation, and clinical trial modernization.
Proprio appoints three global thought leaders to its Medical Advisory Board. Dr. Sigurd Berven, Orthopedic Surgeon and Professor at the University of California, San Francisco, Dr. Charles Fisher, Professor and Head of the Combined Neurosurgical & Orthopedic Spine Program at Vancouver General Hospital and the University of British Columbia, and Dr. Ziya Gokaslan, Professor and Chair of the Department of Neurosurgery at Brown University and Neurosurgeon-in-Chief at Rhode Island Hospital and The Miriam Hospital will apply their globally respected surgical and research expertise to the development of the Proprio navigation platform.
Kaiser Permanente names Andrew Bindman, MD Executive Vice President and Chief Medical Officer. In this role, Dr. Bindman will collaborate with clinical and operational leaders throughout the enterprise to help lead the organization’s efforts to continue improving the high-quality care provided to members and patients throughout Kaiser Permanente. Dr. Bindman will report directly to Kaiser Permanente chairman and CEO Greg A. Adams.
Greenway names Dr. Michael Blackman Chief Medical Officer at Greenway. Dr. Blackman will further support the company’s ambulatory care customers, ensuring providers are equipped with the solutions and services they need to improve patient outcomes and succeed in value-based care.
Suki expands its leadership team with six key hires to support the company’s rapid commercial growth. Tracy Rentz, formerly Vice President of Implementation at Evolent Health, joins Suki as the Vice President of Customer Success and Operations to lead all customer operations, with a particular focus around deploying new Suki customers. Brian Duffy brings over 20 years of sales experience to Suki, joining the team as Director of Sales-East, after having most recently served as Regional Director at Qventus, Inc. Brent Jarkowski will also join Suki’s sales team this November as the Director of Sales-West, bringing over 15 years of experience in strategic relationship management. Brent joins Suki after serving as Senior Client Development Director at Kyyrus. Together, Brian and Brent will head the company’s efforts in building new partnerships across the country. And Josh Margulies, who previously served as the Director of Integrated Brand Marketing for the Jacksonville Jaguars, will serve as Suki’s new Senior Director of Field Marketing.
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
– 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
The U.S. division of
Global Telehealth following the combination, Cloudbreak, is a leading unified
telemedicine platform performing more than 100,000 encounters per month on over
14,000 video endpoints at over 1,800 healthcare venues nationwide. The
Cloudbreak Platform offers telepsychiatry, telestroke, tele-urology, and other
specialties, all with integrated language services for Limited English Proficient
and Deaf/Hard-of-Hearing patients. Cloudbreak’s innovative, secure platform
removes both distance and language barriers to improve patient care,
satisfaction, and outcomes.
division of Global Telehealth following the combination, Glocal Healthcare
Systems Pvt. Ltd (“Glocal”), is a global provider of virtual consultations and
local care spanning the care continuum. It has designed proven, affordable and
accessible solutions for the delivery of healthcare services globally. The
platform provides a full suite of primary and acute care services, including an
app-based telemedicine suite, digital dispensaries, and hospital centers. The
platform has signed several country-wide contracts with government ministries
across India, Southeast Asia, and Africa.
3. Digital Pharmacy: MedQuest Pharmacy (“MedQuest”) is a leading full-service manufactured and compounded pharmacy licensed in all 50 states that pre-packages and ships medications direct to patients. The company also offers lab services and testing, nutraceuticals, nutritional supplements, education for medical practitioners, and training for organizations, associations, and groups. MedQuest serves an established network of 13,000 providers. The MedQuest platform is poised for strong growth via targeted product expansion and expansive eCommerce capabilities for the entire provider network. UpHealth and MedQuest have mutually executed a merger agreement, the closing of which is awaiting regulatory approval for the transfer of licenses expected by the end of 2020 or early 2021.
4. Tech-enabled Behavioral Health: TTC Healthcare, Inc. (“TTC Healthcare”) and
Behavioral Health Services LLC (“BHS”) offer comprehensive services
specializing in acute and chronic outpatient behavioral health, rehabilitation
and substance abuse, both onsite and via telehealth. UpHealth’s Behavioral
Health capabilities have dramatically expanded use of telehealth for medical
and clinical services and are leveraging UpHealth’s platform to increase
volumes across its services. UpHealth and TTC Healthcare have mutually executed
a merger agreement, the closing of which is awaiting regulatory approval for
the transfer of licenses expected prior to the end of 2020.
Global Financial Impact and Reach
UpHealth will have agreements
to deliver digital healthcare in more than 10 countries globally. These various
companies are expected to generate approximately $115 million in revenue and
over $13 million of EBITDA in 2020 and following the combination, UpHealth
expects to generate over $190 million in revenue and $24 million in EBITDA in
– Change Healthcare launches national data resource on
social determinants of health (SDoH) for doctors, insurers and life sciences
organizations to better understand the connection between where a person lives
and how they live their life to the care a patient receives and their health
– 80% of U.S. health outcomes are tied to a patient’s
social and economic situation, ranging from food, housing, and transportation
insecurity to ethnicity.
Change Healthcare, today announced the launch of Social Determinants of Health (SDoH) Analytics solution that will serve as an innovative national data resource that connects the circumstances of people’s lives to the care they receive. The SDoH Analytics solution is designed for health systems, insurers, and life sciences organizations to explore how geodemographic factors affect patient outcomes.
Understanding Social Determinants of Health
SDoH includes factors such as socioeconomic status, education, demographics, employment, health behaviors, social support networks, and access to healthcare. Individuals who experience challenges in any of these areas can face significant risks to their overall health.
“All the work I do—for Mayo Clinic, the COVID-19 Healthcare Coalition, and The Fight Is In Us— is predicated on equity,” said John Halamka, president, Mayo Clinic Platform. “The only way we can eliminate racism and disparities in care is to better understand the challenges. Creating a national data resource on the social determinants of health is an impactful first step.”
The SDoH Portrait Analysis includes financial attributes, education
attributes, housing attributes, ethnicity, and health behavior attributes.
3 Ways Healthcare Organizations Can Leverage SDoH
Healthcare organizations can now use SDoH Analytics to
assess, select, and implement effective programs to help reduce costs and
improve patient outcomes. Organizations can choose one of three ways to use
1. Receive customized reports identifying SDoH factors that
impact emergency room, inpatient, and outpatient visits across diverse
population health segments.
2. Append existing systems with SDoH data to close
information gaps and help optimize both patient engagement and outcomes.
3. Leverage a secure, hosted environment with ongoing
compliance monitoring for the development of unique data analytics, models, or
Why It Matters
Scientific research has shown that 80% of health outcomes
are SDoH-related. Barriers such as food and housing availability,
transportation insecurity, and education inequity must be addressed to reduce
health disparities and improve outcomes. Change Healthcare’s SDoH Analytics
links deidentified claims with factors such as financial stability, education
level, ethnicity, housing status, and household characteristics to reveal the
correlations between SDoH, clinical care, and patient outcomes. The resulting
dataset is de-identified in accordance with HIPAA privacy regulations.
“Health systems, insurers, and scientists can now use SDoH Analytics to make a direct connection between life’s circumstances and health outcomes,” said Tim Suther, senior vice president of Data Solutions at Change Healthcare. “This helps optimize healthcare utilization, member engagement, and employer wellness programs. Medical affairs and research are transformed. And most importantly, patient outcomes improve. SDoH Analytics makes these data-driven insights affordable and actionable.”
MedCity News is partnering with the New Orleans Business Alliance to host the executive summit November 16-18. It focuses on population health and highlights where innovation and investment are occurring in the field.
We’ve all experienced crises in our lives. They may be personal in nature (e.g., involving our interpersonal relationships), organizational (e.g., relating to our employment or retirement income), or nature-made (e.g., floods, tornados, or the COVID-19 pandemic). When crises hit our communities, the impacts can be widespread and far-reaching. Healthcare providers and community-based organizations (CBOs) are called upon to provide more rapid and extensive care and support to the community than is otherwise the norm. A well-established and highly functioning Connected Community of Care (CCC), as is the case here in Dallas, Texas, can provide a tremendous strategic and tactical advantage over non-connected peers.
Since 2014, the Parkland Center for Clinical Innovation (PCCI) has led an effort to bring together several large healthcare systems and a number of regional social-service organizations such as food banks, homeless assistance associations, and transportation service vendors, along with over 100 smaller CBOs (i.e., neighborhood food pantries, crisis centers, utility assistance centers) and area faith-based organizations to form the Dallas CCC. Over time, civic organizations, such as the Community Council of Greater Dallas, Dallas County Health and Human Services (DCHHS), and select academic institutions have begun to participate in various community-wide projects under the Dallas CCC umbrella.
Central to the success of the Dallas CCC are the partnerships that have been formed between the CBOs and a number of local healthcare systems (Parkland Health & Hospital System [Parkland], Baylor Scott & White Health, Children’s Medical Center, Methodist Health System, and Metrocare Services), clinical practices, and other ancillary healthcare providers serving the Dallas metroplex. These partnerships have proved essential in building a truly comprehensive and functional network aimed at improving both the health and well-being of Dallas residents.
Connecting these various entities and forming a two-way communication pathway is an electronic information exchange platform termed Pieces™ Connect, which allows for real-time, two-way sharing of information pertaining to an individual’s social and healthcare needs, history, and preferences. The information exchange platform is the glue that holds the physical network together and provides one of the mechanisms to disseminate information from public health and healthcare entities to social service providers in the community. It allows the individual community resident, via the CBO, to become better informed about important health issues, such as routine vaccinations or preventive care, such as social distancing and proper mask usage during a pandemic.
Until recently, the primary mission of the Dallas CCC focused on addressing residents’ social determinants of health (SDOH) issues through providing community resources (e.g., food assistance, housing, transportation) to improve the lives of Dallas County residents. While this mission has become even more critical during the COVID-19 pandemic, the work of the Dallas CCChas also evolved to include identifying COVID-19 sites within the County and directing community outreach efforts to help stem the rapid spread of the virus.
The Dallas CCC has provided an innovative model of community governance and cooperation to impact the consequences of the COVID-19 outbreak. From the first days of the pandemic, PCCI has been working with Parkland and DCHHS to help reliably identify and quantify the geographic location and incidence rates of positive COVID-19 cases within Dallas County. This problem is especially challenging when considering vulnerable populations and the transitory nature of these residents in inner-city communities.
Working with data provided by DCHHS, the Dallas-Fort Worth Hospital Council, and CBOs, PCCI built a series of dynamic geo-maps that were able to identify, at the neighborhood and block level, the location of hotspots of positive COVID-19 cases as well as attendant mortality rates. In addition to flagging at-risk patients and populations, the model continues to be used by public health and civic leaders to establish locations for testing sites within the city of Dallas based on COVID-19 incidence and community needs.
With the establishment of the hot-spotting, the next step was to get that information, along with general infection prevention protocols, in the hands of local CBOs to help raise awareness and slow the spread of the virus. With the aforementioned information in hand, public health workers have been able to develop targeted communications and tactical strategies to improve containment efforts through community-wide awareness and educational messaging.
By connecting local CBOs and faith-based organizations with public health workers and clinicians, the Dallas CCC is facilitating effective contact tracing and the implementation of care plans for high-risk individuals in a more efficient and scalable manner.
The value of the CCC communication network linking healthcare providers and CBOs cannot be underestimated, as it represents a highly effective and efficient mechanism to disseminate leading practice information aimed directly at high-risk populations. We have seen first-hand that communications delivered to community residents through familiar food pantries, homeless shelters, and places of worship are much more effective than community-wide public information campaigns broadcast via radio or television.
This increased effectiveness is based on the fact that many of these at-risk individuals frequent the CBOs on a regular basis for essential services and these individuals know and trust the CBO staff delivering the information. From one-on-one conversations to displaying infographic posters and take-away educational leaflets, CBOs provide a ready avenue to communicate with at-risk individuals in the communities they serve.
As mentioned, early work in Dallas County is beginning to demonstrate the value of CCC in facilitating contact tracing. In this case, the challenge is not simply identifying the location of positive COVID-19 cases but having the ability to connect those cases to other individuals within the neighborhood or community who may have come in contact with the infected individual, all while working in an environment where individuals frequently move from one location to another. Having a well-established communication system at the local neighborhood level can be extremely helpful in identifying contacts and potential contacts.
It is well-known that many individuals in impoverished, underserved neighborhoods are reluctant to speak with individuals they don’t know or trust, especially if those individuals are affiliated with government agencies, no matter how well-intentioned the agency personnel may be. Staff members at local faith-based organizations and CBOs frequented by these vulnerable residents are a highly effective resource for identifying inter-personal relationships and connecting with those individuals, which is something that has proved challenging for public health staff when working outside of a CCC environment. In Dallas, CBOs, public health, and civic staffers, as well as medical student volunteers have all been partnering to help facilitate the contact tracing process with positive results.
CCC’s can materially improve the health and well-being of a community’s residents, especially in times of crisis. The take-away lesson is clear. If you already have a CCC, lean on it to help you through crises impacting your community. If you don’t have a CCC, now is the time to begin the process of establishing one in your community. Even with the challenges that the current pandemic is generating, it is possible to begin building your CCC. Start small and gradually increase the CCC’s scope and scale; don’t be in a rush to grow. The most important thing is to take the plunge and begin the journey!
While most of the public’s attention is focused on the horse race for an approved COVID-19 vaccine, another major hurdle lies just around the corner: the distribution of hundreds of millions of vaccine doses. In today’s highly complex and disconnected health data landscape, technologies like AI, Machine Learning, and robotic process automation (RPA) will be essential to making sure that the highest-risk patients receive the vaccine first.
Why identifying at-risk patients is incredibly difficult
Once a vaccine is approved, it will take months or years to produce and distribute enough doses for the U.S.’ 330 million residents. Hospital systems, primary care physicians (PCPs), and provider networks will inevitably need to prioritize administration to at-risk patients, potentially focusing on those with underlying conditions and comorbidities. That will require an unimaginable amount of work by healthcare employees to identify patient cohorts, understand each patient’s individual priority level, and communicate pre- and post-visit instructions. The volume of coordination required between healthcare systems and the pressing need to get the vaccine to high risks groups makes the situation uniquely different than other nationally distributed vaccinations, like the flu.
One key challenge is that there’s no existing infrastructure to facilitate this process – all of the data necessary to do so is locked away in disparate information silos. Many states have legacy information systems or rely on fax for information sharing, which will substantially hamper efforts to identify at-risk patients. Consider, in contrast, the data available in the U.S. regarding earthquake risk– you can simply open up a federal geological map and see whether you’re in a seismic hazard zone. All the information is in one place and can be sorted through quickly, but that’s just not the case with our healthcare system due to its fragmentation as well as HIPAA and patient privacy laws.
There are several multidimensional barriers that make it nearly impossible for healthcare workers employed by providers and state healthcare organizations to compile patient cohorts manually:
– Providers will need to follow CDC guidelines on prioritization factors, which based on current guidelines for those with increased risk could potentially include specific conditions, ethnicities, age groups, pregnancy, geographies, living situations (such as multigenerational homes), and disabilities. Identifying patients with these factors will require intelligent analysis of patient profiles from existing electronic health record data (EHR) used by a multitude of providers.
– Some hospital networks use multiple EHR and care management systems that have a limited ability to share and correlate data. These information silos will prevent providers from viewing all information about patient population health data.
– Data on out-of-network care that could require prioritization, like an emergency room visit, is often locked away in payer data systems and is difficult to access by hospital systems and PCPs. That means payer data systems must be analyzed as well to effectively prioritize patients.
– All information must be shared and analyzed in accordance with HIPAA laws, and the mountain of scheduling communications and pre- and post-visit guidance shared with patients must also follow federal guidelines.
– Patients with certain conditions, like heart disease, may need additional procedures or tests (such as a blood pressure reading) before the vaccine can be administered safely. Guidelines for each patient must be identified and clearly communicated to their care team.
– Providers may not have the capacity to distribute vaccines to all of their priority patients, so providers will need to coordinate care and potentially send patients to third-party sites like Walgreens, Costco, etc.
All of these factors create a situation in which it’s extremely difficult – and time-consuming – for healthcare workers to roll out the vaccine to at-risk patients at scale. If the entire process to analyze, identify, and administer the vaccine takes only two hours per patient in the U.S., that’s 660 million hours of healthcare workers’ time. A combination of analytics, AI, and machine learning could be a solution that’s leveraged by healthcare workers and chief medical officers in identifying the priority of patients supplemented with CDC norms.
How RPA can automate administration to high-risk patients
Technology is uniquely poised to enable health workers to get vaccines into the hands of those who need them most far faster than would be possible using humans alone. Robotic process automation (RPA) in the form of artificial intelligence-powered digital health workers can substantially reduce the time spent prioritizing and communicating with at-risk patients. These digital health workers can intelligently analyze patient records and send communications 24 hours a day, reducing the time needed per patient from hours to minutes.
Consider, a hypothetical situation in which the CDC prioritizes certain risk profiles, which would put patients with diabetes among those likely to receive the vaccine first. In this scenario, RPA offers significant benefits in the form of its ability to:
Analyze EHR and population health data:
Thousands of intelligent digital health workers could prepare patient data for analysis and then separate patients into different cohorts based on hemoglobin levels. These digital health workers could then intelligently review documents to cross-reference hemoglobin levels with other CDC prioritization factors (like recent emergency room admittance or additional pre-existing or chronic conditions ), COVID-19 testing and antibody tests data to identify those most at risk, then identify a local provider with appointment availability.
Automate patient engagement, communications and scheduling:
After patients with diabetes are identified and prioritized, communications will be essential to quickly schedule those at most risk and prepare them for their appointments, including making them feel comfortable and informed. For example, digital health workers could communicate with diabetes patients about the protocol they should follow before and after their appointment – should they eat before the visit, what they should expect during their visit, and is it safe for them to return to work after. It’s also highly likely that widespread vaccine administration will require a far greater amount of information than with other health communications, given that one in three Americans say they would be unwilling to be vaccinated if a vaccine were available today. At scale, communications and scheduling will take potentially millions of hours in total, and all of that time takes healthcare employees away from actually providing care.
While the timeline for approval of a COVID-19 vaccine is unclear, now is the time for hospitals to prepare their technology and operations for the rollout. By adopting RPA, state healthcare organizations and providers can set themselves up for success and ensure that the patients most critically in need of a vaccine receive it first.
About Ram Sathia
Ram Sathia is Vice President of Intelligent Automation at PK. Ram has nearly 20 years of experience helping clients condense time-to-market, improve quality, and drive efficiency through transformative RPA, AI, machine learning, DevOps, and automation.
A few months ago, who would have thought that going into a hospital or clinic to meet with your doctor would be considered a high-risk experience? And yet, here we are. COVID-19 has forced the entire health care sector to adopt low-contact and contactless experiences for the safety of patients and caregivers alike – an unexpected outcome of the pandemic experience.
– Human API, the consumer-controlled health data platform
announced it has closed a Series C round of $20M+ this week.
– Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers.
– The platform harnesses a machine learning-powered data pipeline
that structures health data into a consistent format, making it easier for
medical researchers and scientists to use actionable data more quickly and
efficiently while ensuring that patients remain in full control of who their
personal data is being shared with.
Human API, a San
Mateo, CA-based company empowering consumers to connect and share electronic
health data with companies they trust, announced today that it has raised over
$20 million in Series C funding. The round includes participation from Samsung
Ventures, CNO Financial Group, Allianz Life Ventures, and Moneta VC, as well as
from existing investors BlueRun Ventures, SCOR Life and Health Ventures, and
Guardian Life Insurance Company.
The capital will be used to scale new products and services
that enable new product design, granular risk stratification, optimize clinical
trial recruitment, support population health management, automate patient
monitoring, and digitize chronic disease management.
The Next Generation of Health Data Exchange
Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers. The platform
harnesses a machine learning-powered data pipeline that structures health data
into a consistent format, making it easier for medical researchers and
scientists to use actionable data more quickly and efficiently while ensuring
that patients remain in full control of who their personal data is being shared
However, going one step further than just solving the data
portability issue, the Human API platform offers users various options to make
their data actionable, such as:
– Sharing their information with specific researchers who can put it to good use
– Enlisting to take part in medical trials or pharma trials
– Speeding up insurance processes to less than 24 hours
– Taking part in wellness programs provided by their employers.
“By facilitating these transactions,” explains Sean Duffy,
Co-Founder & CEO at Omada Health, “Human API is bringing into being a new
consumer health ecosystem driven by consumer-centric health apps and services.”
Appoints New Chief Commercial Officer
To drive forward this period of growth, Human API has
brought on Richard Dufty as Chief Commercial Officer. Having spearheaded
AppDirect’s growth from early stage startup to Unicorn status in just 4 years,
and having led Symantec’s $1B US Consumer and Cloud business, Dufty brings
extensive experience launching and growing software ecosystems.
As Black History Month comes to close, will this mean that the achievements and contribution of black people in the UK and the need to take action will be packed away for another year, asks Dr Shera Chok, co-founder of the Shuri Network.
With the annual INVEST Population Health virtual conference coming up November 16-18, here’s a look at our collaboration partner New Orleans Business Alliance. It plays a vital role in helping to stimulate the local economy by supporting the development and advancement of the healthcare and biotech infrastructure.
For the second year, MedCity News is partnering with the New Orleans Business Alliance to host an executive summit that focuses on population health and highlights where innovation and investment are occurring in the field.
As we have heard repeatedly over the past few months, there is a need to think of managing this pandemic in the same way we prepare for a marathon rather than a sprint, says Dr Charles Alessi, chief clinical officer, HIMSS.
– Banner Health, one of the country’s largest non-profit healthcare systems, has partnered with Innovaccer for its digital transformation.
– Banner Health will leverage the platform to create unified patient records that drive comprehensive, preventive, and whole-person care solutions for patients across the care continuum.
one of the country’s largest non-profit healthcare systems, has partnered with Innovaccer, Inc., a leading healthcare
technology company, to leverage its FHIR-enabled Data Activation
Platform to realize digital transformation in their care delivery. The
partnership will consolidate their health data and several vendors and
transform the way they manage healthcare data to drive actionable insights and
their population health management strategy for more than one million lives.
Creating Unified Patient Records to Drive Whole-Person
Care Across Care Continuum
As an integral part of their digital transformation journey, Banner Health will leverage the platform to create unified patient records that drive comprehensive, preventive, and whole-person care solutions for patients across the care continuum. The health system will integrate clinical and payer data distributed across its multiple practices, hospitals, and systems. The platform supports FHIR APIs and complies with the latest FHIR v4.0.1 version to ensure seamless data exchange across the network.
Digital First Approach to Banner Health Network
As a part of the “digital-first” approach and to gain a more
comprehensive view of its network, Banner Health will leverage InGraph,
Innovaccer’s solution that generates insights using analyses with population
stratification, advanced analytics and customizable dashboards.
With the platform’s point-of-care alerts and digitally
connected ecosystem, Banner Health will engage its network providers with
real-time updates on care gaps, coding gaps, and other relevant information for
a comprehensive view of their patients. Combined with Innovaccer’s referral
management solution, these insights will enable them to conduct value-based
referrals and reduce network leakage.
Banner providers will be able to assign the appropriate care
management pathways for particular patient populations designed in
collaboration with Innovaccer. The digitally connected environment provided by
the platform will enable the organization to personalize healthcare experiences
for their patients with outreach and virtual patient engagement
“Banner Health’s mission is to ‘make health care easier, so that life can be better.’ Technology plays a critical role in our efforts to create a robust population health management strategy. In our partnership with Innovaccer, we are confident in our path forward. Their comprehensive set of solutions is exactly what our population health management program needs,” says Julie F. Smith, VP of Clinical Applications at Banner Health.
– Lyft is continuing to expand rideshare for
non-emergency medical transportation (NEMT) through a first of market direct
integration with Epic, the largest electronic health record (EHR) in the U.S.
– This will have an immediate impact on hospital operations and patients, with currently committed customers including Tampa General and Ochsner Health.
Today, ridesharing leader Lyft announced an integration with EHR provider Epic to enable
health system staff to schedule a Lyft ride for a patient directly from that
patient’s record. Lyft worked directly with Epic to create the Lyft for Epic integration
with Lyft Concierge directly into Epic that will make it
easier for healthcare staff to order a Lyft ride on behalf of a patient.
How Lyft for Epic Works
Staff can send reliable rides directly from a patient’s
profile in the EHR —
simplifying their day-to-day tasks, saving time, and allowing them to focus on
what matters most: the patients. And patients can easily get to their
appointments and back home after the visit without needing an app.
– Simplify sending rides: Nurses, case managers, and
other healthcare workers are already familiar with Epic — adding notes to
patient files, scheduling appointments, and discharging patients. By accessing
Lyft directly from the EHR, staff can schedule rides by directly accessing Lyft
from a patient’s record, rather than needing to sign into a separate tool.
Patient and appointment information will also pre-populate in the ride request
form, reducing friction in the booking process.
– Improve appointment adherence: Arranging a Lyft ride when booking appointment results in fewer missed appointments. Our data shows that Lyft can help providers reduce no-show rates by up to 27 percent.
– Increase operational efficiency: Arranging a Lyft
ride at the time of patient discharge can lead to shorter waiting times, less
crowded waiting rooms, and improved patient throughput.
– Measure patient outcomes: Most health systems have
not collected data on the impact of their transportation programs. With Lyft
for Epic, we’re also working towards giving health systems the ability to generate
reports that make it easier to measure the impact of rideshare on health system
spend and population health outcomes — potentially even tracking patient
segments to proactively identify patients that would benefit from a Lyft ride.
Lyft Continues Significant Investment in Healthcare
Today, Lyft partners with 9 out of the top 10 health systems
in the U.S, representing thousands of hospitals and clinics across the country.
The Lyft for Epic integration will give these organizations even more resources
to ensure transportation is never a barrier to care. Many health systems in the
U.S. use Epic, nearly 30 percent of which already partner with Lyft for their
non-emergency medical transportation (NEMT) programs. Several of our existing
health system partners — including Ochsner Health and Tampa General —
have already committed to using the integration.
“Access to reliable transportation is a common barrier to seeking healthcare, especially for our most vulnerable patients,” said David Carmouche, MD, Senior Vice President, Community Care at Ochsner Health. “By teaming up to integrate Lyft into Epic – our established health record system – Ochsner is providing a solution that makes it easier for patients to seek out high quality care when they need it and without unnecessary delays due to a lack of transportation.”
– Humana Inc. and Fresenius Medical Care North America
(FMCNA) today announced an agreement to broaden their collaboration toward
improving the health of eligible Humana Medicare Advantage members
agreement between Humana and Fresenius Medical Care North America goes into
effect Jan. 1, 2021.
Humana Inc. and leading renal care company Fresenius Medical Care North America (FMCNA) announced an agreement to broaden their collaboration toward improving the health of eligible Humana Medicare Advantage and commercial members with chronic kidney disease (CKD) and end-stage renal disease (ESRD) through more coordinated, holistic care.
The expanded partnership is in keeping with the goals
outlined in the 21st Century Cures Act, which enables people with ESRD to
enroll in Medicare Advantage Plans, and with federal initiatives that call for earlier diagnosis and
treatment of kidney disease; a reduction in the number of Americans developing
ESRD; and support for patient treatment options such as home dialysis or kidney
transplant as applicable.
The agreement between
Humana and Fresenius Medical Care North America goes into effect Jan. 1, 2021,
and encompasses the following:
Expanded Availability of Care Coordination Services:
FMCNA currently provides specialized care coordination services for Humana
members with CKD in three states: Iowa, Kentucky, and North Carolina. The
agreement expands the availability of these services to eligible Humana members
in an additional 39 states, with the goals of improving quality of life and
health outcomes, increasing access to care and minimizing care gaps, slowing
disease progression and lowering hospitalization rates, and reducing the cost
FMCNA’s care coordination services include early detection of CKD to slow
disease progression; medication reviews and regimen adherence guidance;
behavioral health screenings; nutritional counseling; strategies for managing
multiple comorbidities; education about – and support for – home dialysis
treatment when applicable and beneficial to the patient; transplant education;
and palliative care.
FMCNA partners with InterWell Health, a physician-led population health
management company working to improve clinical outcomes and lower medical costs
through its network of over 1,100 nephrologists across the country.
Transitional Care Units: These units are
designed to help people recently diagnosed with kidney failure learn about
treatment options available to them – including transplant and home dialysis –
and be more empowered in managing their own care. Transitional Care Units may be either a space within a
dialysis center or a standalone facility, offering comprehensive, hands-on
education from dedicated staff that is individualized for each patient. This
includes the importance of renal nutrition, medication adherence, and vascular
access care; assisting patients transitioning between modalities (e.g., from
in-center dialysis to home dialysis); and supporting individuals returning to
dialysis from transplant. The agreement is intended to locate Transitional Care
Units in select areas where Humana has significant Medicare Advantage
Value-Based Agreement: The expanded
collaboration also improves upon the parties’ existing clinic network contract,
which provides eligible Humana Medicare Advantage and commercial members with
ESRD access to dialysis at more than 2,600 centers of Fresenius Kidney Care, the dialysis services division of
Fresenius Medical Care North America. By implementing a value-based payment
model for in-center and home dialysis services and at Transitional Care Units,
as well as for CKD care coordination services, compensation will be based on
meeting agreed-upon quality improvement and patient outcome goals, and reducing
overall costs to the system.
Individuals with CKD have kidneys that do not filter blood
properly, which causes waste and fluid levels that can be dangerously high. CKD
and ESRD affect a wide spectrum of the population but the degree of impact is
not uniform. For example, kidney failure rates among Black Americans are about
three times that of white Americans. In total, approximately 15% of American
adults, or about 37 million people, have CKD, but many are unaware of their
condition. CKD management is complex, and failure to appropriately manage the
condition may cause considerable symptoms and worsening health outcomes,
This agreement represents an evolution of our work with
Humana and leverages our over 10 years of industry leadership in value-based
care,” said Bill Valle, Fresenius Medical Care North America’s Chief Executive
Officer. “Our scale, integrated nephrology network, and standardized clinical
interventions and protocols uniquely position us to predictably and
consistently improve health outcomes and reduce overall costs. We welcome this
opportunity to offer more coordinated, holistic care to Humana’s members, with
a keen focus on education, comorbidity management, early detection, and
treatment options, including home dialysis. This approach also helps eliminate
barriers to keep renal disease treatment uninterrupted for at-risk
This question initially brings to mind many possibilities such as connection to the latest 5G cellular service, a new super-fast internet provider, or maybe one of the many new energy suppliers jockeying for market share from traditional utility companies. While all of these might represent legitimate opportunities to improve one’s community, here we are talking about a different concept; specifically, whether your community is ready to have a Connected Community of Care (CCC) to advance whole-person health.
The image of a CCC may seem obvious. After all, we all live in communities where we have some connections between hospitals, physician practices, ambulatory care centers, and pharmacies to name just a few. But here we are talking about a broader sense of connected community that includes not just health care organizations, but social service organizations, such as schools and civic organizations and community-based organizations (CBOs) like neighborhood food pantries and temporary housing facilities. A true CCC links together local healthcare providers along with a wide array of CBOs, faith-based organizations, and civic entities to help address those social factors, such as education, income security, food access, and behavioral support networks, which can influence a population’s risk for illness or disease. Addressing these factors in connection with traditional medical care can reduce disease risk and advance whole-person care. Such is the case in Dallas Texas, where the Dallas CCC information exchange platform has been operating since 2012. Designed to electronically bring together local healthcare systems, clinicians, and ancillary providers with over a hundred CBOs, the Dallas CCC provides a real-time referral and communication platform with a sophisticated care management system designed and built by the Parkland Center for Clinical Innovation (PCCI) and Pieces Technologies, Inc.
Long before this information exchange platform was implemented, the framers of the Dallas CCC came together to consider whether Dallas needed such a network and whether the potential partners in the community were truly ready to make the commitments needed to bring this idea to fruition. As more and more communities and healthcare provider entities realize the tremendous potential of addressing the social determinants of health by bringing together healthcare entities and CBOs and other social-service organizations, the question of community readiness for a CCC is being asked much more often. But how do you know what the right answer is?
Before looking at the details of how we might answer this, let’s remember that a CCC doesn’t don’t just happen in a vacuum. It requires belief, vision, commitment― and above all― alignment among the key stakeholders. Every CCC that has formed, including the Dallas CCC, begins with a vision for a healthier community and its citizens. This vision is typically shared by two or more large and influential key community stakeholders, such as a large healthcare system, school district, civic entity, or social- service organization like the United Way or Salvation Army.
Leaders from these organizations often initially connect at informal social gatherings and advance the idea of what if? These informal exchanges soon lead to a more formal meeting where the topic is more fully discussed and each of the participants articulates their vision for a healthier community and what that might look like going forward. This stage in the evolution of a CCC is perhaps the key step in the transformation process, as while all stakeholders will have a vision, achieving alignment among those visions is no small feat. Many hopeful CCCs never pass this stage, as the stakeholders cannot come to an agreement on a common vision that each can support. For the fortunate few, intrinsic organizational differences can be successfully set aside to allow the CCC to move forward.
It’s at this point in the CCC’s evolution that details begin to matter in truthfully answering the question, “Is this community ready to be connected?” While there may be agreement among the key stakeholders on a vision, the details around readiness may still divert or delay the best-laid plans. It is safe to say that the key to understanding a community’s readiness to form a CCC lies in the completion of a formal, comprehensive, and transparent readiness assessment.
A readiness assessment is a process to collect, analyze, and evaluate critical information gathered from the community to help identify actual clinical and socio-economic needs, current capabilities and resources (including technology), and community interest and engagement. Taken together, a comprehensive readiness assessment can help identify a community’s strengths and weaknesses in preparation for establishing a CCC.
A readiness assessment is not a tactical plan for building a CCC, nor is it a governance document that provides how all members of the CCC will relate to each other. Instead, the readiness assessment provides communities interested in establishing a CCC with an honest and unbiased yardstick to measure preparedness. Conducting and using the results of the readiness assessment is one of the best ways to ensure a successful CCC deployment.
A typical CCC readiness assessment covers five areas: (1) community demographics; (2) clinical areas of need (including trends); (3) social areas of need (including trends); (4) technology competency (e.g., what percent of the potential network participants are computer literate?), availability (e.g., what percent of the potential network participants have internet access?), and suitability (e.g., is the internet access, high speed?); and (5) what are the needs of potential network participants and can these be modeled as use cases for the information exchange network? This information is essential to help key stakeholder decision-makers decide to move forward with establishing a CCC and to know what specific challenges may lie ahead.
The collection of this essential information can be done in a number of ways, such as making use of existing publicly reported data or conducting surveys, interviews, focus groups and town hall meetings with community leaders and residents and clinical and CBO leaders and staff. Experience conducting the readiness assessment that provided the foundation for the Dallas CCC showed that no single information-collection method was sufficient to collect the necessary level and robustness of the data. In Dallas, we utilized all five approaches but found that in addition to researching publicly available data, initial surveys, followed by interviews and focus groups, yielded the most voluminous and reliable information to chart the course ahead.
In addition to the various methods to collect this essential information, the key to obtaining useful and reliable information requires a sufficient number of respondents/participants who are drawn from various organizations and organizational levels. Simply put, you must have a large enough sample and you must have diversity within the sample. It’s not enough to just interview leaders of potential network participants, as their understanding of the needs, trends, and capabilities may look very different from that of frontline staff.
Similarly, surveying only one category of potential network participants may not provide enough information to fully understand the socio-economic needs in the community or even the perspectives surrounding the prevalence of chronic conditions. Beyond the qualitative methods involved, it is important to note that if done right, this process takes a lot of time to complete. Cutting corners by reducing the sample size, for example, or doing selective sampling to speed the readiness assessment process along will only cause problems later when this insufficient information results in erroneous decision-making.
Once the data has been collected, it is important to carefully analyze what the data is trying to tell you. Results of the readiness assessment must be shared openly and honestly with all key stakeholders, particularly those serving in a governance capacity. The governance group (a topic for another day) that has formed in parallel with the readiness assessment must be able to evaluate and understand the main messages from the readiness assessment to make an informed decision as to whether to move forward with establishing a CCC.
Like the need for alignment around the key stakeholder’s vision for the CCC, there must be universal agreement by the key stakeholders as to the message of the readiness assessment and its implications for the road ahead. As with the vision alignment stage, substantive disagreements among the group at this stage are a sign of trouble ahead unless differences can be resolved.
At this point, you might be thinking that this all seems very complicated and fraught with potential land mines waiting to derail your effort to answer the original question “Is your community ready to be connected?” Again, I would emphasize the importance of unwavering commitment and alignment to achieve the vision. But I would also offer advice gleaned from working in the CCC space for the last eight years, which is to get help early and don’t wait until the horse is out of the barn!
We have seen first-hand many communities and consultants approach the conduct of a readiness assessment with a cavalier attitude, often exemplified by the statement, “we already know all of this,” only later to have to backtrack their pronouncements at substantial additional cost in time and resources. Fortunately, today there are a number of excellent organizations, including PCCI, with the experience, credibility, and integrity in the CCC space to help you on this journey. Don’t be afraid to seek them out. It will be a wise investment that you will not regret, particularly when you begin to see the results of improved whole-person health and well-being in your community.
Whichever way you look at it, many countries across the globe are experiencing a rise in COVID-19 cases coinciding with the start of the Autumn/Winter seasons, says Dr Saif Abed, founding partner at The AbedGraham Group.
Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these pernicious trends on overall mental health will take time. However, precedents like the Great Recession suggest that these trends are likely to worsen the conditions driving suicide and substance-related deaths, the “deaths of despair” that claimed 158,000 lives in 2017 and contributed to a three-year decline in US life expectancy among adults of all racial groups.
Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 2018 data showed that only 43% of adults with mental health needs, 10% of individuals with SUD, and 7% of individuals with co-occurring conditions were able to receive services for all necessary conditions.
The treatment gap is staggering, and COVID-19 is exacerbating it: an estimated 45% of adults report the pandemic has negatively impacted their mental health, to say nothing of the disruption of essential in-person care and services. In a similar vein, a recent CDC report has highlighted the staggering and “disproportionately worse mental health outcomes, [including] increased substance use, and elevated suicidal ideation” experienced by “younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.”
Consistent with the CDC report’s findings, the crisis can be felt most acutely by the very workforce that must deal with COVID-19 itself. Hospitals, health systems, and clinical practices – together with other first responders – comprise the essential front line. They bear the burden of their employees’ stress and illness, and must also cope with the many patients who present with a range of mental illnesses and substance use disorder (SUD).
But providers don’t have to face this burden alone: numerous behavioral health-focused digital solutions can support providers in meeting their most urgent needs in the era of COVID-19. Many of these solutions have made select services available for free or at a discount to healthcare providers in recognition of the immense need and challenging financial circumstances. Some solutions also help systems take advantage of favorable, albeit time-sensitive, conditions, enabling them to lay the foundation for broader behavioral health initiatives in the long term. Several of these solutions are described below, in the context of three key focus areas for health systems.
Focus Area 1: Supporting the Frontline Workforce
Health system leaders need to keep their workforces healthy, focused, and productive during this period of extreme stress, anxiety, and trauma. Providing easily accessible behavioral health resources for the healthcare workforce is therefore of paramount importance.
Health systems should consider providing immediate, free access to behavioral health services to employees and their families and consider further extending that access to first responders, other healthcare workers, and other essential services workers in the community.
Many digital product companies are granting temporary access to their services and are expanding their offerings to include new, COVID-19-specific modules, resources, and/or guidance at no cost.
Fortunately, the market is rife with solutions that have demonstrated effectiveness and an ability to scale. However, many of these rapidly-scalable solutions are oriented toward low-acuity behavioral health conditions, so it is important that health systems consider the unique needs of their populations in determining which solution(s) to adopt.
The following are several solutions to consider:
Online CBT solutions. These tools are being used to expand access to lower-acuity behavioral health services, targeting both frontline workers and the general population. MyStrength, SilverCloud and others have deployed COVID-19-specific programming.
Text-based peer support groups. Organizations are using Marigold Health to address loneliness and social isolation in group-based chat settings, one-on-one interactions between individuals and peer staff, and broader community applications.
Focus Area 2: Maintaining Continuity of Care
As the pandemic continues to ripple across the country, parts of the delivery system remain overwhelmingly focused on containing and treating COVID-19. This can and has led to the disruption of care and services, of particular significance to individuals with chronic conditions (e.g., serious mental illness (SMI) and SUD), who require longitudinal care and support. Standing up interventions — digital and otherwise — to ensure continuity of care will be critical to preventing exacerbations in patients’ conditions that could drive increased rates of ED visits and admissions at a time when hospital capacity can be in short supply.
In the absence of in-person care, many digital solutions are hosting virtual recovery meetings and providing access to virtual peer support groups. Additionally, shifts in federal and state policies are easing restrictions around critical services, including medication-assisted treatment (e.g., buprenorphine can now be prescribed via telephone), that can mitigate risky behavior and ensure ongoing access to treatment.
The use of paraprofessionals has also emerged as a promising extension of the historically undersupplied behavioral health treatment infrastructure. Capitalizing on the rapid expansion of virtual care, providers should consider leveraging digital solutions to scale programs that use peers, community health workers (CHWs), care managers, health coaches, and other paraprofessionals, to reduce inappropriate hospital utilization and ensure patients are navigated to the appropriate services.
The following are several solutions to consider:
Medication-assisted therapy (MAT) via telemedicine. These solutions provide access to professionals who can prescribe and administer MAT medications, provide addiction counseling, and conduct behavioral therapy (e.g., CBT, motivational interviewing) digitally. Solution companies providing these critical services include Eleanor Health, PursueCare, and Workit Health.
Behavioral health integration. Providing screening, therapy, and psychiatric consultations in a variety of care settings — especially primary care — will help address the increased demand. Historically, providers have had difficulty scaling such solutions due to challenging reimbursement, administrative burden, and stigma, among other concerns. Solutions like Valera Health and Concert Health were created to address these challenges and have seen success in scaling collaborative care programs.
Recovery management tools for individuals with SUD. WEConnect Health and DynamiCare Health are both offering free daily online recovery support groups.
Focus Area 3: Leveraging New Opportunities to Close the Treatment Gap
As has been widely documented, the pandemic has spurred unprecedented adoption of telehealth services, aided by new funding opportunities (offered through the CARES Act and similar channels) and the widespread easing of telehealth requirements, including the allowance of reimbursement for audio-only services and temporarily eased provider licensure requirements.
Tele-behavioral health services are no exception; the aforesaid trends ensure that what was one of the few high-growth areas in digital behavioral health before the pandemic will remain so for the foreseeable future. This is unquestionably a positive development, but there is still much work to be done to close the treatment gap. Critically, a meaningful portion of this work is beyond the reach of the virtual infrastructure that has been established to date. For example, there remains a dearth of solutions that have successfully scaled treatment models for individuals with acute illnesses, like SMI or dual BH-SUD diagnoses.
Health system leaders should continue to keep their ears to the ground for new opportunities to expand their virtual treatment infrastructure, paying particular attention to synergistic opportunities to build on investments in newly-developed assets (like workforce-focused solutions) to round out the continuum of behavioral health services.
COVID-19 has all but guaranteed that behavioral health will remain a major focus of efforts to improve healthcare delivery. Therefore, health systems that approach today’s necessary investments in behavioral health with a long-term focus will emerge from the pandemic response well ahead of their peers, having built healthier communities along the way.
About Victor Siclovan
Victor Siclovan is a Director on the Medicaid Transformation Project at AVIA where he leads work in behavioral health, chronic care, substance use disorder, and Medicaid population health strategy. Prior to AVIA, Victor spent nearly 10 years at Oliver Wyman helping large healthcare organizations navigate the transition to value-based care. He holds a BA in Economics from Northwestern.
– Value-based reimbursement (VBR) contracts now account
for 26% of hospital revenue, according to a new report from KLAS research and
– Report reveals providers are looking first to their
electronic health record (EHR) systems to drive PHM, and are most interested in
investing in new healthcare information technology (HIT) when they know there
is a clear ROI.
With value-based reimbursement (VBR) adoption slowing, healthcare providers are searching for ways to manage risk and achieve ROI on population health management (PHM) solutions adoption, according to a new report from KLAS Researchand CHIME – the College of Healthcare Information Management Executives. The new report, issued, reveals that providers are looking first to their electronic health record (EHR) systems to drive population health management (PHM), and are most interested in investing in new healthcare information technology (HIT) when they know there is a clear ROI. The findings were based on findings from KLAS Decision Insights, the KLAS 2019 Population Health Management Cornerstone Summit, and CHIME’s 2019 HealthCare’s Most Wired data.
Value-Based Reimbursement in 2020: How Far Have We Come?
VBR contracts now account for 26% of hospital revenue. Fee-for-service still outpaces VBR, and over time, the lack of significant progress toward VBR has eroded healthcare organizations’ confidence that the change will happen in the near future. The biggest factors limiting the adoption of VBR are uncertainty that an ROI will be achieved and a lack of needed infrastructure.
How Is Technology Being Used to Support VBR?
Once organizations decide to invest in technology to help
with VBR, they generally turn first to their EMR. Though provider organizations
may not ultimately choose their EMR for certain population health management
(PHM) needs, EMRs are almost always considered, due to (1) assumed integration
with EMR data; (2) anticipated cost savings; and (3) increased ease of access
to PHM data in the EMR.
EMRs are slightly less likely to be used for administrative
and financial reporting—EMRs have historically struggled to provide the nuanced
views needed in these areas, so organizations often opt for third-party
solutions that provide additional analysis, visualization, and ad hoc reporting.
Third-party solutions may be used on their own or in conjunction with EMR
Organizations invest in HIT when there is a concrete ROI
Solutions that help organizations identify and act on care
gaps see some of the broadest adoption as they can be helpful with just about
any VBR contract. Once a gap is identified, organizations need to reach out to
the patient and close it, so patient engagement tools are also highly sought
Functionality is a significant driver in PHM purchase
Healthcare organizations are looking for enterprise EMRs and
broad BI platforms capable of tackling a large swath of their PHM and
VBR-related functionality needs (e.g., root cause analysis, A/B testing, etc.).
In this quest for consolidation, organizations are seeking to eliminate ad hoc
interfaces and replace vendors who haven’t delivered on functionality or
“Providers are trying to find positive ROI on their population health management investments,” said Adam Gale, president of KLAS Research. “This report offers a useful roadmap for how they can meet that challenge.”
The COVID-19 pandemic is not just a medical crisis. Since the highly contagious disease hit American shores in early 2020, the virus has dramatically changed all sectors of society, negatively impacting everything from food supply chains and sporting events to the nation’s mental and behavioral health.
For some people, work-from-home plans and limited access to entertainment are manageable obstacles. For others, the shuttered schools, lost wages, and social isolation spell disaster – especially for individuals already living with socioeconomic challenges.
The social determinants of health have always been important for understanding why some populations are more susceptible to increased rates of chronic conditions, reduced healthcare access, and shorter lifespans. COVID-19 is throwing the issue into high relief.
Now more than ever, healthcare providers need to gain full visibility into their populations and the non-clinical challenges they face in order to help individuals maintain their health and keep their communities as safe as possible during the ongoing pandemic.
Exploring correlations between socioeconomic circumstances and COVID-19 vulnerability
Clinicians and researchers have worked quickly to identify patterns in the spread of COVID-19. Early results have emphasized the danger posed by advanced age and preexisting chronic conditions such as obesity, diabetes, and heart disease.
Further, data from the Johns Hopkins University and American Community Survey indicates that the infection rate in predominantly black counties is three times higher than in mostly white counties. The death rate is six-fold higher.
Data from the Centers for Medicare and Medicaid Services (CMS) confirms the trend: black Medicare beneficiaries are hospitalized at a rate of 465 per 100,000 compared to just 123 per 100,000 white beneficiaries. Hispanic Medicare beneficiaries had 258 hospitalizations per 100,000, more than double the white population’s hospitalization rate.
Researchers suggest that the social determinants of health may be largely responsible for these disconnects in infection and mortality rates. Racial, ethnic, and economic factors are strongly correlated with increased health concerns, including longstanding disparities in access to care, higher rates of underlying chronic conditions, and differences in health literacy and patient education.
Leveraging data-driven tools to identify vulnerable patients
Healthcare providers will need to take a proactive role in identifying which of their patients may be at enhanced risk of contracting the virus and experiencing worse outcomes from the disease.
They will also need to ensure that person gets adequate treatment and participate in contact tracing efforts after a positive test. Lastly, providers will have to ensure their public health reporting data is accurate to inform local and regional efforts to contain the disease.
The process begins by developing confidence in the identity of each individual under the provider’s care. Healthcare organizations often struggle with unifying multiple electronic health record (EHR) systems and other health IT infrastructure, resulting in medical records that are incomplete, inaccurately duplicated, or incorrectly merged.
Access to current and complete medical histories is key for highlighting at-risk patients. An enterprise master patient index (EMPI) can provide the underlying technical foundation for initiating this type of population health management.
EMPIs help organizations create and manage reliable unique patient identifiers to ensure that records are always associated with the correct individual as they move throughout the healthcare system.
When paired with claims data feeds, health information exchange (HIE) results, and interoperability connections with other healthcare partners, EMPIs can bring a patient’s complete healthcare status into focus.
This approach ensures that providers stay informed about past and present clinical issues and service utilization rates. It can also support a deeper dive into the social determinants of health.
Combining EHR data with standardized data about socioeconomic needs can help providers develop more comprehensive and detailed portraits about their patients’ holistic health status.
By including this information in EHRs and population health management tools, providers can develop condition-specific registries to guide outreach activities. Providers can deploy improved care management strategies, close gaps in care, and connect individuals with the resources they need to stay healthy.
Healthcare organizations can acquire socio-economic data about their communities in a variety of ways, including integrating public data sources into their population health management tools and collecting individualized data using standardized questionnaires.
Once providers start to understand their patients’ non-clinical challenges, including the ability to avoid situations that may expose them to COVID-19, they can begin to prioritize patients for outreach and develop personalized care plans.
Conducting effective outreach and interventions for high-needs patients
COVID-19 has taken a staggering economic toll on many families, including those who may have been financially secure before the pandemic. Routine healthcare, prescription medications, and even some urgent healthcare needs are often the first to fall by the wayside when finances get tight.
Healthcare providers have gotten creative about staying connected to patients through telehealth, drive-in consults, and other contactless strategies. But they must also ensure that their vulnerable patients are aware of these options – and that they are taking advantage of them.
Contacting a large number of patients can be challenging since phone numbers, emails, and home addresses change frequently and are prone to data entry errors during intake. Organizations with EMPIs can leverage their tools to ensure contact information is up to date, accurate, and associated with the correct individual.
Care managers should prioritize outreach to patients with complex medical histories and known clinical risks for vulnerability to COVID-19. These conversations are a prime opportunity to collect social determinants of health information or refresh existing data profiles.
Looking to the future of healthcare in a COVID-19 world
Combining technology-driven strategies with targeted outreach will be essential for healthcare organizations aiming to provide holistic support for their populations during – and after – the COVID-19 pandemic.
By developing certainty about patient identities and synthesizing that information with data about the social determinants of health, providers can efficiently and effectively connect with their patients to offer much-needed resources.
Taking a proactive approach to addressing the social determinants of health during the outbreak will help providers maintain relationships with high-needs patients while building new connections with those facing unanticipated challenges.
With a combination of population health management strategies and innovative technology tools, healthcare providers and public health officials can begin to view the social determinants of health as a fundamental component of the fight against COVID-19.
Andy Aroditis, is CEO of NextGate, the global leader in healthcare enterprise identification.
The clinical manifestations of COVID-19 are varied, and patients are known to have rapidly changing signs and symptoms that must be tracked with laboratory testing. A patient may start his treatment journey with his primary care physician and will include lab centers, diagnostic centers, inpatient, and home quarantine centers.
Data science and clinical teams at PCCI, in collaboration with Parkland informaticists, have developed an AI-driven predictive model that predicts for individual COVID-19 exposure risk, based on population density and their proximity to positive cases.
– Dignity Health Management Services (DHMSO), the largest
health system in the state of California to transform their network health data
into actionable insights.
– With this partnership, the organization will leverage
Innovaccer’s FHIR-enabled Data Activation Platform to better manage healthcare
services for its attributed patients.
Dignity Health Management Services
(DHMSO), a healthcare management company part of CommonSpirit Health, that helps providers
and payers deliver better clinical outcomes through innovative tools and
partnering with Innovaccer. As part of
the partnership, DHMSO will leverage Innovaccer’s FHIR-enabled Data Activation
Platform and built-in solutions to enhance its care management approach while
engaging their network providers and payers in real-time.
Transform Network Health Data Into
DHMSO will integrate its clinical
and financial data from multiple sources on Innovaccer’s FHIR-enabled Data
Activation Platform. Once the data is integrated on the platform, the
organization will power multiple care processes. This platform supports
critical FHIR API resources and solves numerous data-exchange challenges for
providers and payers. DHMSO will have the advantage of real-time data sharing
and true interoperability with the platform.
To achieve a comprehensive overview
of its network, Dignity Health Management Services will also use InGraph,
Innovaccer’s population health management solution built on top of the
FHIR-enabled Data Activation Platform. DHMSO’s leaders will view drilled-down
analysis of their under-performing parameters through InGraph’s 60+ patient
stratification features and advanced analytics offered by customizable
dashboards. They will be able to identify, have a complete overview of, and
gain insight into their cohort of at-risk patients to track utilization and
trends. The organization will be empowered to implement care management
improvements and follow results within different management spheres, adjusting
as needed to drive optimum healthcare delivery and patient outcomes.
Additionally, billing processes for patient visits will be simplified and
automated through the platform’s automated reporting feature.
InNote, Innovaccer’s point-of-care technology, the organization will furnish
its providers with a full view of their patient’s healthcare journey right at
the moment of care. This will enable DHMSO and its healthcare teams to focus on
closing the care and coding gaps in real-time to deliver quality outcomes with
Health Management Services, we believe in keeping our patients happy, healthy,
and whole every day. It is our goal to meet the physical, mental, and spiritual
needs of every patient. This partnership with Innovaccer will strengthen our
approach towards achieving this goal. Innovaccer’s FHIR-enabled Data Activation
Platform will assist us as we work toward improvements in our care delivery,
and will be a great addition to our strategy,” says Dr. Soham Shah, Medical
Director of Clinical Informatics & Quality Management, Dignity Health
One of the more remarkable features of the NHS’s response to the coronavirus pandemic has been its rapid uptake of technology in the UK says director of international relations at NHS Confederation, Dr Layla McCay.
– emids – a leader in digital engineering and
transformation solutions for the healthcare and life sciences industries –
today announced the acquisition of Nevada-based FlexTech, a payer IT consulting
firm recognized by KLAS as a category leader.
– The FlexTech deal will drive expanded channel
partnership opportunities for emids among leading core platform vendors and
position emids as the go-to partner for advancing adoption of new digital
emids, a Nasvhille, TN-based provider of digital engineering
and transformation solutions to the healthcare and life sciences industry, today
announced it has acquired FlexTech, an Incline Village, NV-based information technology
consulting company with deep expertise in leading payer core administration and population health platforms, in a deal that closed late last month. The partnership, driven by heightened urgency for health
plans to adopt breakthrough digital-based strategies, enhances emids’ ability
to help its clients accelerate their digital transformation journeys.
Acquisition Benefits for emids
The acquisition is part of emids’ purposeful growth plan and comes on the heels of a strategic equity investment earlier this year from the Blue Venture Fund, a majority investment last fall from New Mountain Capital. The FlexTech deal will drive expanded channel partnership opportunities for emids among leading core platform vendors and position emids as the go-to partner for advancing the adoption of new digital business models. FlexTech, a KLAS 2020 category leader in payer IT consulting services, brings a proven and experienced team of 120+ subject matter experts, each with an average 20 years of experience in managed care, core administration and population health platforms, and strong partner relationships with the leading healthcare payer technology vendors.
“The need for deep domain expertise combined with digital transformation capabilities is vital as our payer and ‘payvider’ clients expand their government-sponsored business lines, and we’re excited to bring our clients the proven payer platform expertise that FlexTech has built over 30+ years, delivering more than 250 core platform implementation programs,” said emids Founder and CEO Saurabh Sinha.
Financial details of the acquisition were not disclosed.
– Eden Health raises $25M to give employers and
commercial real estate owners and operators the ability to offer medical care on-site,
near-site, and virtually.
– Eden’s membership model makes high-quality healthcare an affordable benefit for the average employer, with low to no out-of-pocket costs for their employees.
– Since the first signs of the US coronavirus outbreak in
early February, Eden Health has worked with Boylan Bottling, Connell, Convene, Emigrant
Harry’s, Kramer Levin, Newscred, evidence-based, medically-informed plans and
protocols for supporting essential workers and bringing workforces back. And
they’ve embedded dedicated, on-demand doctors (called Medical Directors) in the
C-Suites of several customers.
Eden Health, a New
York City-based national medical practice, today announced it has raised $25
million in Series B funding led by Flare
Capital Partners with participation from principals from Stone Point Capital, a private equity
firm that focuses on the financial services industry including the HR benefits,
insurance and real estate sectors. Existing investors who participated in the
Series B round include Greycroft, PJC, Max
Ventures and Aspect
Ventures. The oversubscribed round brings Eden Health’s total
raise to $39M.
Founded in 2016, Eden Health is known for its innovative
direct-to-employer healthcare delivery model, bringing in-person and virtual
healthcare together to deliver an exceptional patient experience to the
employees of mid-market companies. Eden Health empowers employers to
supercharge their benefits packages whether or not they are self-insured.
Designed to meet the needs of companies of all sizes, Eden Health lets them
fill gaps in their employees care with a fully integrated healthcare option.
Eden Health membership services are not tethered to open
enrollment, meaning employees and their families can join at any time and begin
using services immediately. And one of Eden Health’s core services is insurance
navigation, to make sure employees get the care they need without surprise
costs Although Eden Health’s approach is direct-to-employer, its mission is to
ensure that superior care is as widely available as possible.
Eden Health’s medical practice provides members with a
dedicated Care Team. Care Teams are composed of highly credentialed clinicians
delivering evidence-based, top-quality care. Each Care Team offers digital care
around the clock, same-day in-person primary care, behavioral health services
and benefits navigation. Employees interact with the same dedicated Care Team,
regardless of whether they are communicating virtually or in-person. Where
necessary, Eden Health consults specialists to determine needs, before
connecting employee members with fully-vetted, cost-effective in-network
Over the past four years, Eden Health has become a trusted
benefits partner for more than 33,000 employees, spanning more than 100
employers across a broad range of industries, including finance, retail, real
estate and technology. Since the very first signs of the US coronavirus
outbreak in early February, Eden Health has worked with Boylan Bottling, Connell, Convene, Emigrant Bank,Golf Magazine, Harry’s, Kramer Levin, Newscred, and others
to roll out evidence-based, medically-informed plans and protocols to support
workforce health. It has guided employers, property owners and workers through
the outbreak using real-time monitoring, proactive outreach, and team-based
care. And as employers and property owners began to phase workforces back into
offices and worksites, Eden Health introduced a comprehensive back-to-work
program spanning COVID-19 screening, virtual primary care, PCR testing,
on-site antibody testing, immediate triage and patient consults.
Through the crisis, Eden Health customers have also chosen
to embed dedicated Eden Health Medical Directors into their c-suites to manage
employee population health. Thanks in large part to early monitoring and proactive
protocols to slow the spread, Eden Health employers have been able to maintain
high levels of productivity, deploying essential workers safely while
protecting their health and the health of fellow employees.
Health and care have been inexorably moving towards a new paradigm – one where the nature of the interactions are more personalised and require the person to be more active in their pursuit of reducing risks that have an adverse effect upon the development of non-communicable diseases, says Dr Charles Alessi, chief clinical officer at HIMSS.
– Philips announced the launch of Virtual Care Station, a
telehealth environment delivering virtual care services to patients in
convenient neighborhood locations, such as retail settings, libraries, town
halls and universities.
– Using proven Philips technology developed for the ATLAS
program (Accessing Telehealth through Local Area Stations), which was created
to serve healthcare needs of U.S. Veterans, Virtual Care Station provides all
patients, including those in underserved rural or urban areas, with a low-cost,
community-based option to improve patient outcomes while minimizing infection
Philips, today announced the launch of Virtual Care Station, a telehealth environment that delivers virtual care services in convenient neighborhood locations such as retail settings, libraries, town halls, and universities. The pod-based solution connects provider and insurance networks, allowing health providers and patients to have a local, community-based choice for care.
Whether in underserved rural or urban areas, Virtual Care
Station helps deliver on the Quadruple Aim by giving patients access to virtual
face-to-face care, and is designed to help improve clinical outcomes, lower
costs and increase patient and staff satisfaction. Virtual Care Station is
based on Philips technology developed for the ATLAS program (Accessing
Telehealth through Local Area Stations), which was created to serve the
healthcare needs of U.S. veterans.
Why It Matters
With the COVID-19 pandemic came a boom in the telehealth
industry, serving as a viable way to reduce staff and patient exposure to
infection, preserve PPE and lessen the impact of patient surges. However, at-home
telehealth isn’t always an option for those without reliable internet access,
or private areas to have sensitive clinical conversations.
Built with insights from patients, physicians and
caregivers, and designed to emulate traditional face-to-face visits, the
Virtual Care Station pod-based solution promises:
– Camera, lighting and speakers designed for enhanced
– Spacious layouts to accommodate the needs of patients in
wheelchairs or with service dogs
– Supplemental in-home virtual telehealth check-ins to track
patients between visits, allowing clinicians the opportunity to manage health
“By expanding our telehealth solution, we hope to give providers an option to engage in population health and support patients closer to home in lower cost settings that can lead to the potential for more follow-up visits, and the opportunity for clinicians to identify at-risk patients earlier and manage health escalations,” said Vitor Rocha, Chief Market Leader for Philips North America. “Not only does it mean the convenience of shorter drive times for patients, it could mean better health outcomes and a safer environment for providers as people benefit from getting the quality care they need in the right place at the right time.”
Michael Seres was an entrepreneur, patient advocate, husband and father of three. He died on 30 May 2020, in California, US, of a sepsis infection. This news not only shook the patient community, but also the global healthcare IT space.
– Innovaccer has recently partnered with CareSignal to
address healthcare’s urgent need amidst the COVID-19 pandemic: to create and
maintain solid, clinically actionable relationships with patients in a new set
of predominantly virtual care.
– CareSignal offers evidence-based end-to-end support services for chronic medical conditions such as asthma, CHF, COPD, diabetes, depression, hypertension, and hospital discharge support, and maternal health monitoring.
Innovaccer, Inc., and CareSignal today announce a partnership to address healthcare’s urgent need amidst the COVID-19 pandemic: to create and maintain solid, clinically actionable relationships with patients in a new setting of predominantly virtual care.
The partnership combines more than two dozen
condition-specific patient monitoring programs with population
health data insights for a more integrated care and improved clinical
outcomes with industry-leading financial returns.
CareSignal offers evidence-based end-to-end support services for chronic medical conditions such as asthma, CHF, COPD, diabetes, depression, hypertension and hospital discharge support, and maternal health monitoring. With a focus on prevention and addressing the social determinants of health, each program offers personalized clinically-validated features to deliver even more value from Innovaccer’s population health, care management, and organization-specific offerings.
“Innovaccer has always stayed on top of delivering on promises to our customers, and our partnerships with leading organizations have been instrumental in achieving 100% client satisfaction,” says Abhinav Shashank, CEO at Innovaccer. “Working with CareSignal supports our mission to help healthcare care as one. With CareSignal as our partner, we will strengthen our approach towards better patient engagement and enable smart deviceless remote patient monitoring.”
COVID-19 has presented healthcare with a challenge like no other, with nearly nine million cases all over the world and over 470,000 lives lost. The speed of the outbreak and the disruption caused by it has created unforeseen challenges for communities and economies, and it’s especially apparent in healthcare delivery. Healthcare systems in nations around the globe have dedicated substantial resources to respond to the pandemic and the growth has only somewhat stymied.
While the U.S. healthcare brings all hands on deck to treat the COVID-19 patients, we have seen a massive acceleration in the use of telehealth to make sure care delivery is not delayed for other patients. The U.S. telehealth market is expected to reach around $10 billion by the end of the year- a dynamic that will remain on its course after the pandemic as well. According to a report, the telehealth market is set to be valued at $175.5 billion by 2026.
During this period, hospitals across the country will invest more in telehealth solutions to create familiarity with virtual care. However, virtual care encompasses many more benefits than video conferencing with patients. While many health systems have stepped up to leverage telehealth, there is still a long way to go.
COVID-19 has led to wide-spread telehealth adoption
COVID-19 has certainly changed the outlook towards telehealth. While it was already experiencing significant momentum prior to the pandemic, it has gone from a ‘good-to-have’ to a vital component of care delivery today for providers and patients alike. A McKinsey survey revealed that the number of patients that had used telehealth increased from 11 percent in 2019 to 76 percent in 2020. Even the providers have witnessed 50 to 175 times the number of patients via telehealth than before.
One of the most important considerations behind the increase in telehealth adoption is that while a significant number of the U.S. population is under stay-at-home orders, this is the only way people can communicate with their physicians. Additionally, the adoption of telehealth can also be instrumental in mitigating the competition for healthcare resources. The use of personal protective equipment (PPE) can be saved for medical staff on the line while other providers can care for their patients from the safety of their homes or clinics. Importantly, the recent CARES Act waived the historical restrictions of telehealth availability to patients in rural areas, and that these services could only be offered from an institutional setting. Telehealth can now be provided to patients at any location with physicians connecting with them from their preferred location.
Another important development is the relaxed HIPAA privacy standards to allow the use of standard video conferencing apps such as Zoom, Skype or FaceTime. As long as the use of these applications gives providers the flexibility to connect with patients remotely, this selective regulation could be in good faith.
However, this begs the question: could non-HIPAA compliant solutions be a viable, long-term solution? Does the telehealth domain extend as far as video conferencing? How can telehealth be modified to suit the new normal in healthcare?
Extending the use of telehealth to engage healthcare in a broader way
While the surge in telehealth adoption was somewhat dramatic, the shift to a new normal has to be step-wise and planned for a more efficient healthcare system. There are still factors to consider that could be a potential challenge in the adoption of telehealth, such as lack of awareness of telehealth offerings, poor infrastructure or access to support virtual care and suitable insurance coverage.
The applications of telehealth can be leveraged in multiple ways. Healthcare organizations can leverage telehealth as an alternative to emergency departments (ED) and urgent care visits. Patients can connect with their physicians remotely regarding their immediate concerns such as an unexplained stomach ache or unusual skin rash to avoid a trip to the ED or urgent care. This could prove extremely important in reducing the number of ED visits and subsequently, lower the cost of care.
Building on that, virtual consultations with an established provider can also be considered. These consultations can include primary care visits for regular check-ups for chronic conditions, a common cold or psychotherapy. Providers can also conduct follow-up visits and decide later if the patient requires in-person care. This combination of virtual care along with in-person care can help in devising a dynamic care plan for patients and better manage population health.
Combining telehealth with a healthcare data platform can be the foundation of a connected care framework that can focus on improving access to care and its continuity. A platform that is HIPAA-compliant can be easily used by the providers to connect with their patients and is an optimal way to have effective virtual consultations. Ideally, providers and patients should connect on a platform that gives providers access to their patients’ previous clinical information from across the continuum of care. This would help in reducing the time that goes into shuffling patient files, gathering patient histories, and keying it back into electronic health records.
A virtual, connected care framework could be crucial in connecting all the dots in care. With virtual visits and remote monitoring being conducted on the same platform, providers can coordinate care among each other to ensure minimal friction in the care for patients. For example, real-time changes in the vital signs of a patient diagnosed with Type-2 diabetes can be recorded by the primary care physician and be communicated to the care team. The care team can devise a care plan to address the needs of the patient or direct them to an urgent care clinic to be further assessed. This could be followed by a virtual check-in call with the physician and appropriate follow-up care.
Preparing for the new normal in healthcare
Amid the urgency of the pandemic, it is important to consider what the U.S. healthcare system may look like after the pandemic is over and how the strategies we have implemented during this time will evolve.
For healthcare systems to truly embrace the potential for virtual care, physicians have to realize that telehealth is not just a substitute for face-to-face care delivery but a way of enhancing the care experience. To have telehealth as a concrete foundation for virtual care, all digital capabilities and patient information have to be accessible in real-time. Virtual care in healthcare has emerged as an enabler of change and healthcare organizations should sufficiently leverage this opportunity to improve their outcomes, their management of population health, and enhance the health of all of their patients.
COVID-19 will alter our healthcare permanently. The demand for care has changed and any future value-based care efforts will likely be accelerated. The goal is to achieve a lower cost of care while improving the quality of care leading to a healthier population- telehealth is an important tool to achieve that goal. The future of healthcare will be dependent on taking on risk, delivering care to patients in real-time and implementing strategies that are focused on providing care using the most efficient technologies.
About Abhinav Shashank
Abhinav Shashank is the CEO and Co-founder of Innovaccer Inc., a leading healthcare data activation platform. In his role as the CEO, Abhinav has laid the foundation for Innovaccer’s success as a leading data activation platform company and registering a 400% y-o-y growth. Abhinav has also been given a coveted spot in ‘Forbes- 30 Under 30 Asia 2017: Enterprise Tech’ and recognized by Becker’s Hospital Review as one of the ‘Top 50 rising leaders in US healthcare under 40.’”
A healthcare system in which stakeholders share, adopt and apply medical knowledge in real time enables improved care, accelerated workflows, streamlined business processes and a better balance of resources with demand.
Population health management advocates need to demonstrate how redefining care management by adopting a holistic viewpoint to include what’s happening outside the hospital will help systems influence health at scale and improve care at a lower cost.
– Holon and Cerner announced a partnership
to advance the delivery of relevant patient insights to providers when they
need it most.
– Holon and Cerner will deploy patented
technology that automatically delivers contextually relevant patient information
from Cerner’s HealtheIntent® population health platform, which
is EHR-agnostic, directly to clinicians in their workflow to inform care
one of health care’s most advanced knowledge delivery companies, and Cerner Corporation, announced
they are joining forces to accelerate the seamless delivery of critical patient
information to providers. Working together, Holon and Cerner will
deploy patented technology that automatically delivers contextually relevant
patient information from Cerner’s HealtheIntent® population
health platform directly to clinicians in their workflow to inform care
Advancing Value-Based Care Success
Simply having access to patient data is not enough for
today’s providers, especially those caring for at-risk patients through
value-based care arrangements. With mounting clinical and administrative
demands, providers do not have time to search through multiple systems for critical
patient information. To optimize clinical decision-making, treatment planning
and care delivery, Holon and Cerner are bringing providers curated,
patient-specific knowledge directly into their workflows during a care episode
to improve outcomes and reimbursements.
Holon’s CollaborNet® patented technologies sense provider workflow activity
and automatically surface relevant patient information from Cerner, such
as gaps in care, to providers in an unobtrusive “ribbon” that displays
alongside the patient chart in the provider’s EHR. The advanced
capabilities of the Holon technology are designed to support quicker and
more efficient delivery of valuable care insights without interruption for the
“Delivering critical knowledge at the point of need is the foundation of Holon’s mission in the market,” said Jon Zimmerman, CEO, Holon Solutions. “We are thrilled to be collaborating with Cerner to ensure the valuable information generated reaches providers when and where they need it – with no effort on the provider’s part – as a huge step toward better quality care, provider experience, business performance, and improving outcomes. We look forward to continuing this exciting journey with the Cerner team, their HealtheIntent clients, and provider users, as we work together to advance better healthcare for everyone.”
Without cross-border co-operation the potential of personalised health cannot be realised, acccording to Bogi Eliasen, director at the Health Copenhagen Institute for Futures Studies and HIMSS Future50 leader, who will be speaking at HIMSS & Health 2.0 European Digital Event taking place 7-11 September.
– In the age of COVID-19, healthcare CIOs cite interoperability,
cybersecurity, and operationalizing SDOH data priorities as top three priority
areas, according to the third annual LexisNexis focus group of CHIME
– The survey results also highlighted the importance of
a team approach with support across the organization in helping CIOs
achieve the vision of connected healthcare.
The Health Care business of LexisNexis® Risk Solutions announced
the results of its annual
focus group, comprised of over 20 healthcare IT executives that are members
of the College of Healthcare Information
Management Executives (CHIME). The focus group participants accepted more
accountability than in previous years to provide the safe and
reliable technology tools necessary to deliver high-quality, connected,
and cost-effective care. The survey results also highlighted the importance of
a team approach with support across the organization in helping CIOs
achieve the vision of connected healthcare.
In light of the COVID-19
pandemic, data sharing and security to using data analytics to help vulnerable
populations – have become more urgent in light of the pandemic challenges. For
example, recent months have illustrated the need for data access to inform
decisions about population health, wellness and care capacity.
The surveyed healthcare CIOs identified three main priority
1. Managing interoperability: Members acknowledged
challenges amid the surge of digital touchpoints, such as mobile phones, smart
devices and remote services. Goals include a common patient identifier to combine
and verify disparate patient records for a true health information exchange.
2. Bolstering cybersecurity: Members are confronting
new cybersecurity risks, confusion over who bears the ultimate responsibility
for patient data, and the competing goals of seamless user experience and data
safety. To address that final challenge and strike an appropriate balance,
executives are moving to multifactor authentication strategies for optimal user
workflow and security.
3. Integrating Social Determinants of Health (SDOH):
As the pandemic has highlighted, incorporating SDOH
data is a vital, immediate requirement for improving the delivery of patient
support and value-based care, and ultimately, outcomes. Executives shared SDOH
implementation challenges, including data aggregation and operationalization
within IT and EHR systems, especially when not utilizing third-party data to
support their efforts. While CIOs previously had not perceived specific
accountability for SDOH data, that changed as its value was demonstrated.
“CHIME’s executive health IT members are approaching evolving patient and industry needs with careful consideration, ingenuity and focus,” said Josh Schoeller, chief executive officer of LexisNexis Risk Solutions Health Care. “Our annual focus group presents valuable insights about how healthcare decision-makers are strategically using technology solutions to overcome hurdles regarding cybersecurity, data governance, and interoperability, all of which have become more urgent during the COVID-19 pandemic. It’s a big challenge but with the right data integration and analytics they continue to make great progress even in the face of the COVID-19 pandemic.”
To access the group insights, download the report here.
– 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
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.
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.”
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
“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.
Prior to the outbreak of COVID-19, the healthcare industry in the United States was in the midst of an intense refocusing on patient-centered care. This evolution was defined by a number of innovations, policies, and even federal reimbursement programs that prioritized emphasis on and impact on the patient experience. It led to changes in everything from the quality of hospital food, valet parking, and room amenities to fundamentally reimagined standards of care for even mundane procedures like blood draws.
The rapid spread of coronavirus and the consequences of the resulting pandemic on health systems around the country are significantly reframing this dynamic. An all-in focus on treating COVID-19 patients sidelined elective procedures, routine care, and caused many patients to avoid or defer timely treatment for conditions like heart attacks and strokes. The result is that our country’s health system is just now emerging from “on pause” with truncated timelines and “build the plane as you fly it” mentalities for how to restart and even contemplate a new abnormal.
As we peer ahead to imagine what the future might look like, it’s clear that patient experience as we knew it just earlier this year will cease to exist. Instead, it will be replaced by the dual and interrelated realities of patient and practitioner demands. These two groups harbor pandemic-driven negative perceptions, fears, and concerns about our healthcare infrastructure that have the potential to impair the practice of even the most basic medical care.
Routine Care Avoidance
These fears from a patient perspective were brought home to me twice in the past few weeks. Since I was diagnosed with Crohn’s disease as a teenager some 30-years ago, I have had regular visits with my physician. Normally, I am a “people person” who prefers face-to-face interactions with those in my personal and professional lives. But last month, I conducted my first-ever telehealth appointment for a routine check-up because I refused to set foot in a hospital.
It simply makes sense to handle the routine at a remove – why expose me and my subpar immune system unnecessarily? I was pleasantly surprised by the experience itself. At a time when we’re all meeting over Zoom, having my regular check-up “at a distance” felt natural and informative – and it was just about the only way I’d ever consider engaging with the hospital…at least for now.
Amidst this all, my three-year-old terrified my wife and me when he developed a 105-degree fever. We are no strangers to childhood fevers, but this was a frightening scenario made all the more so because of the growing prevalence of COVID-19 at the time. After much consultation, handwringing, and debate, we decided to treat him at home instead of risk exposure in the hospital.
I’m relieved to say that everything turned out fine and it was a short-lived spike, but it’s a telling insight into the mindset of patients today – including those of us who work in the healthcare industry. Even a minor fever normally sends most parents rushing to their child’s doctor’s office or emergency room. To incorrectly assume that a hospital was a greater risk to my child then self-treating a 105-degree fever speaks to the irrational fear and misinformed decision-making this pandemic has fostered and its power to keep us all out of the healthcare system.
Practitioner Skepticism and Resentment
This same basic risk-reward computation will also surely play out for our healthcare workers. We’ve already seen nurses and physicians critique their employers for what they feel is inadequate protection or faulty leadership and priorities during this outbreak. While many have remained on the job out of a sense of duty to their patients, the growing doubt and resentment will certainly linger long after the pandemic has (hopefully) subsided.
As we learn to live with the virus and we begin to see electives and routine care once again allowed, it’s easy to envision a range of workers from transport and cafeteria staff to nurses and aides deciding to stay away from the job until they feel reasonable expectations about safety, prevention, and compensation are being met. And the number of clinicians and healthcare staffers who will either retire or seek employment in alternative industries, could, unfortunately, become significant.
Planning for the Hospital of Tomorrow
Health system leaders must begin planning now for this new reality. Conversations have certainly already begun about the hospital of the future and what changes lie in store for standards of care, physical infrastructure and layout, budgets, workplace safety, and practitioner well-being, and innovation paths.
But, top-down decisions based on historical trends or projections absent real input from patients and practitioners at this moment will lead to a long-term undermining of confidence in the system. There is simply no modern precedent for this sudden and dramatic shift in expectations, and Patient Advisory Councils alone won’t cut it.
The reality is that the lists of “nice to haves” and “need to have” for patients and practitioners will become increasingly polarized, with the latter defining the table stakes they will require before returning to the hospital. These demands will then become the financial lens through which health systems and leaders must make future decisions about standards of care, innovations, and investments.
If they have not already, providers will soon realize they are no longer in the driver’s seat when it comes to care decisions and that employee and consumer trust in them has been severely compromised. They must begin to take strong and decisive action to meet patient and practitioner demands or people will not walk back through their doors. Over the coming months, no decision about a hospital or its operation will be made without first asking how it not only satisfies patient and practitioner demands but also reassures and delights both stakeholders.
So how must health systems think about and plan for this eventuality?
Protection & Safety
Outbreaks of antibiotic-resistant bugs or Ebola have always made patients and even practitioners queasy about entering the hospital, but these were often short-lived episodes. Now, health leaders must double down on promises to keep patients and practitioners safe in the face of an invisible but persistent virus that has changed our trust in the system.
This response could take the form of deliberate decisions on hospital infrastructure and layout, bringing changes to the very physical plant that supports our medical care. The concept of “social design” looks at how everything within a hospital’s walls contributes to the level and quality of care it can deliver. From the placement of beds to ventilation systems to the flow of staff into and out of a nursing station, leaders must revisit these basic assumptions post-COVID. And a new onus exists for administrators to communicate these decisions and capabilities to patients and potential patients in their encachment area.
Systems will also likely maintain existing social distancing guidelines, perhaps even taking them a step further with wayfinding in the halls and waiting rooms using explicit signage and direction. Enforcement of these protocols will be essential. And of course, systems must stock and deploy adequate stores of PPE…easier said than done.
New infection standards will also emerge. Consider the fast boil of Kinnos, an upstart founded amidst the Ebola crisis with a new technology that enforces real-time quality control and compliance every single time a surface is disinfected.
We have already seen the dramatic remaking of care in the midst of COVID-19. The boon in telehealth is just one example that will certainly continue to grow and expand. But there will certainly be more changes on the horizon, perhaps new robotic technologies for arms-length treatment protocols and remote or personal health monitoring from home, as a result of this outbreak. But it will all be focused on transforming how patients and practitioners engage with health systems across the country – while both reassuring and delighting.
Finally, recent events remind us that we are all members of the community, and hospitals have an integral seat at the table as facilitators of population health. Systems and leadership cannot rely on philanthropy and good corporate citizenship, they must actively engage on the issues that matter most to their staff and patients – as these stakeholders are members of the extended community.
From food drives to financial education to emerging health policies, hospitals must become more deeply entrenched alongside those in their communities. The early and immediate signs are promising, as our hospitals are our extended homes. I’m cautiously optimistic, and appreciative of all that our caregivers and administrators are doing to keep us healthy.
About Eric Stone
Eric M. Stone is the Co-Founder and Chief Executive Officer at Velano Vascular. A patient advocate and serial healthcare entrepreneur, Stone is a National Trustee of the Crohn’s and Colitis Foundation. Prior to Velano, he served as the Vice President of Sales and Marketing of Molecular Health, and earlier in his career launched a series of pioneering conventional cardiology devices for Abbott while based in Brussels, Belgium, and California.
Stone was a founding member of Model N’s Life marketing with Trilogy Software and has since co-founded social sector programs at Harvard and Wharton. He served for a decade on Harvard University’s Alumni Association (HAA) Board of Directors and is a past and current Director and Advisor to multiple healthcare upstarts. Stone received an MBA from The Wharton School, a Master’s from Harvard University, and a BA from the University of Pennsylvania.
– Emtiro Health, an
innovative population health company in North Carolina has selected Innovaccer
to deliver data-powered solutions to enhance the efficiency and effectiveness
of care delivery.
– Powered by Innovaccer’s FHIR-enabled Data Activation
Platform, Emtiro Health will create unified patient records that drive
comprehensive, whole-person care management, no matter where they are on the
care continuum. The FHIR-enabled Data Activation Platform will also deliver
highly actionable data, automated care management workflows, and smart patient
Emitro Health, a
Winston Salem, NC-based population
health company, today announced a partnership with Innovaccer, a San Francisco, CA-based
healthcare technology to enable the effective delivery of services to the
patients and providers supported by Emtiro Health.
Emitro Health Background
Emtiro Health supports providers, systems, and payers with unparalleled expertise and knowledge augmented by data and analytics. This platform enhances the patient experience and improves outcomes while delivering effective healthcare at a lower cost. Emtiro Health addresses the systemic barriers to total wellbeing and helps patients chart a course to brighter futures. The organization’s experienced team brings diverse backgrounds and skillsets to complement a whole-practice approach from practice optimization and transformation, data analytics, and quality reporting to the integration of services, such as clinical pharmacy and behavioral health.
Data Activation Platform
Powered by Innovaccer’s FHIR-enabled Data Activation Platform, Emtiro Health will create unified patient records that drive comprehensive, whole-person care management, no matter where they are on the care continuum. The FHIR-enabled Data Activation Platform will also deliver highly actionable data, automated care management workflows, and smart patient engagement. Emtiro Health’s provider partners will be equipped with point-of-care insights that surface relevant information for patient health in real-time. The entire suite of solutions will enable Emtiro Health to improve the effectiveness and efficiency of both providers and care, management teams, allowing them to care as one for patients.
Unified Health Record
FHIR-enabled Data Activation Platform helps healthcare organizations obtain a
complete picture through their unified patient record. The data is then
activated for smart analytics and decision support — so, care teams have the
crucial information they need to provide better care and to care as one.
“Emtiro Health selected Innovaccer to provide customized business intelligence and analytics solutions to our partners to revolutionize how the right level of care is delivered to the right patient at the right time. The Innovaccer data platform coupled with Emtiro Health’s expertise in delivering a total population health model of care management is a game-changer for providers and patients alike,” said Kelly Garrison, President and CEO of Emtiro Health. “In practice, this collaboration will mean more informed care, healthier individuals and healthier communities in North Carolina.”
– Health Catalyst announces an agreement to acquire
clinical workflow optimization solution healthfinch using a mix of stock and
– 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.
Catalyst, Inc., a provider of data and analytics technology and services to
healthcare organizations, today announced that it has entered into a definitive
agreement to acquire healthfinch, Inc., a Madison,
Wisconsin-based company that provides a workflow integration engine delivering
insights and analytics into EMR workflows to
automate physicians’ ability to close patient care gaps in real-time. Health
Catalyst expects to fund the transaction using a mix of stock and cash.
Clinical Workflow Optimization
Founded in 2011, healthfinch has developed the healthcare
industry’s most trusted, most used clinical workflow optimization solution,
Charlie. Charlie’s unique combination of EMR-integrated technology and protocol
content streamlines key workflows such as prescription renewal processing,
visit planning, and care gap closure. With Charlie, health systems are able to
deliver a better, safer patient experience, while also achieving lower rates of
provider and staff burnout, increased care gap closure, improved quality
metrics, and significant time and cost savings for providers and clinical
Integration with Health
Catalyst Analytics Application Portfolio
The healthfinch acquisition, which will allow Health
Catalyst’s customers to enhance clinical workflows in the EMR, further
strengthens the Health Catalyst Population Health portfolio, which was
bolstered by the Able Health acquisition in February 2020 and Care
Management Suite launch earlier this month.
Within the Health Catalyst analytics application portfolio,
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. Additionally, the
healthfinch technology will augment workflows across Health Catalyst’s product
portfolio, with data and insights powered by Health Catalyst’s cloud-based Data
Operating System (DOS™), a healthcare-specific, open, flexible, and scalable
data platform that provides customers with a single comprehensive environment
to integrate and organize data.
healthfinch’s industry-leading capabilities are already in demand from Health Catalyst customers and prospects across multiple product areas including quality measures, care management, population health, patient safety, and others. Providing these capabilities will bring even greater value to Health Catalyst customers by making the critical insights and analytics from the DOS platform actionable within clinical workflows – providing more effective care for patients and saving time for both doctors and staff through automation so they can work at the top of their license.
“We are thrilled to benefit from healthfinch’s decades of collective experience gained from working with customers across the United States that are using a variety of different EMRs. And we also find deeply compelling the strong mission and cultural alignment with our respected healthfinch teammates. We are excited to have the healthfinch leadership team and their talented colleagues join Health Catalyst, and we are grateful for the tremendous insights, knowledge and perspectives they bring, which will accelerate the achievement of our mission to be the catalyst for massive, measurable, data-informed healthcare improvement,” said Health Catalyst CEO Dan Burton.
Burton added, “This acquisition highlights Health Catalyst’s ability to integrate and scale software applications on top of our DOS platform. The healthfinch technology will easily serve up actionable insights, derived from DOS and other Health Catalyst analytics applications into the EMR, at the point of care.”
– Philips integrates the BioIntelliSense FDA-cleared
BioSticker™ sensor as part of its remote patient monitoring solutions for
patients outside the hospital.
– Multi-parameter sensors aid monitoring across multiple chronic conditions with medical-grade vital signs for physicians to remotely track core symptoms, including COVID-19.
– Healthcare Highways is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S.
Philips, today announced it has formed a strategic collaboration with BioIntelliSense, a continuous health monitoring, and clinical intelligence company, to integrate its BioSticker™ medical device into Philips’ remote patient monitoring (RPM) offering to help monitor at-risk patients from the hospital into the home. With the addition of multi-parameter sensors, Philips’ solutions can enhance how clinicians monitor patient populations living with chronic conditions – including diabetes, cancer, congestive heart failure and more – in their homes with passive monitoring of key vital signs, physiological biometrics, and symptomatic events via a discreet wearable patch for monitoring up to 30 days.
COVID-19 Pandemic Underscores Need for Remote Patient Monitoring
Remote patient monitoring and telehealth-enabled clinical programs offer care teams a sustainable and scalable way to manage patient populations with chronic or complex conditions at home and plays a key role in supporting care for COVID-19 patients who do not require hospitalization. By regularly transmitting patient data that can provide critical insights into a patient’s condition, the collaboration will empower care teams in the U.S. with a more holistic patient view and the ability to intervene earlier before adverse events occur. With single-use sensors and patient-owned technology supporting remote monitoring, care teams can also help reduce the need for clinicians and patients to interact in person.
“With more patients interacting with their doctors from home and more hospitals developing strategies to virtually engage with their patients, remote patient monitoring is now, more than ever, an essential tool,” said Roy Jakobs, Chief Business Leader Connected Care, member of the Executive Committee at Royal Philips. “Building on Philips’ global leadership in patient monitoring, which includes an extensive suite of advanced monitoring solutions, platforms, and sensors, this is the latest example of our capability to allow more seamless, cloud-based data collection across multiple settings from the home to the hospital and back into the home. Patient data, coupled with our clinically differentiated and leading AI-powered technology, quantifies the data into relevant actionable insights to help detect deterioration trends and support care interventions – all while outside the walls of the hospital.”
Wireless, Secure Data Transfer of Key Vital Signs
BioSticker is a single-use, FDA-cleared 510k class II wearable medical device
to enable at-home continuous passive monitoring with minute level data across a
broad set of vital signs, physiological biometrics and symptomatic events (skin
temperature, resting heart rate, resting respiratory rate, body position,
activity levels, cough frequency) on a single device for thirty-days. Symptoms,
including those directly associated with COVID-19 such as temperature and
respiratory rate, can be remotely monitored in confirmed cases of Coronavirus
and also for those patients not sick enough to be hospitalized, or those
suspected of having COVID-19.
addition to COVID-19, the BioSticker device will help transform the way
clinicians monitor and manage patients living with chronic conditions from the
sensors are the natural next phase for remote monitoring, especially at a time
when more patients are engaging with their physicians from home,” said James
Mault, MD, Founder and Chief Executive Officer of BioIntelliSense. “Clinicians
need medical grade monitoring and algorithmic clinical insights for COVID-19
exposure, symptoms and management. Accelerated by the COVID-19 crisis, the
practice of medicine has been irreversibly enlightened as to the safety and
efficacy of virtual care. Philips is a demonstrated leader in remote patient
monitoring, and we look forward to BioIntelliSense’s technology playing
an integral role in simplifying and enhancing outcomes for patients and their
Healthcare Highways first to leverage BioSticker as a part of
Philips’ RPM solutions
Healthcare Highways, a provider of health plans, high-performance provider networks, pharmacy benefit management, population health management, and benefit plan administration, is the first to leverage the BioSticker sensor as a part of Philips’ RPM program in the U.S. Out of the seven programs that will be deployed with Healthcare Highways, one will focus specifically on monitoring patients with COVID-19. The remaining six will focus on conditions across the acuity spectrum, including patients with congestive heart failure, hypertension, diabetes, total joint replacement, cancer and asthma. The program will help Healthcare Highways improve insights to patient health status across its provider network.
“Healthcare Highways was built on the idea of delivering measurable value and access to quality care to our members. We work in partnership with our providers to innovate on the care model, and look at Remote Patient Monitoring as the next frontier of how providers will connect with patients,” said Creagh Milford, DO, MPH, Chief Medical Officer of Healthcare Highways and Chief Executive Officer of HighCare Health. “COVID-19 has underscored the need for proactive care management. Resources are strained and by integrating an RPM program with biosensor technology, we’ll be able to drive further value for our unique member base, providers and employers to establish a new way of care delivery.”
Let’s invest in an interoperable health data system that connects all providers, hospitals, nursing homes, insurance companies, state and local governments, public health and patients who need access to medical records.