Why Hospitals Should Act Now to Create Clinical AI Departments

Why Hospitals Should Act Now to Create Clinical AI Departments
John Frownfelter, MD, FACP, Chief Medical Information Officer at Jvion

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


About  John Frownfelter, MD, FACP

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

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


COVID-19 Deferrals Lead to 3 Major Conditions Payers/Providers Must Address in 2021

COVID-19 Deferrals Lead to 3 Major Conditions Payers/Providers Must Address in 2021

What You Should Know:

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

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


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

Report Background & Methodology

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

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

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

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

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

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

2. Cancer diagnoses will increase by 23%

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

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

3. Fractures will increase by 112%

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

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

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

Why It Matters

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


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.

30 Executives Share Top Healthcare Predictions & Trends to Watch in 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. 


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications

The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.

Modernized PPE Standards
Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.

Improved Capacity

Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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.


30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

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


Microsoft Deploys COVID-19 Vaccine Management Platform

Microsoft Deploys COVID-19 Vaccine Management Platform

What You Should Know:

– Microsoft launches a COVID-19 vaccine management platform with partners Accenture and Avanade, EY, and Mazik Global to help government and healthcare customers provide fair and equitable vaccine distribution, administration, and monitoring of vaccine delivery. 

– Microsoft Consulting Services (MCS) has deployed
over 230 emergency COVID-19 response missions globally since the pandemic began
in March, including recent engagements to ensure the equitable, secure and
efficient distribution of the COVID-19 vaccine.


With COVID-19 vaccines soon to be available, Microsoft
announced it has launched a COVID-19 vaccine management platform together with
industry partners Accenture, Avandae, EY, and Mazik Global. The COVID-19
vaccine management solutions will enable registration capabilities for patients
and providers, phased scheduling for vaccinations, streamlined reporting, and
management dashboarding with analytics and forecasting.

These offerings are helping public health agencies and
healthcare providers to deliver the COVID-19 vaccine to individuals in an
efficient, equitable and safe manner. The underlying technologies and approach
have been tested and deployed with prior COVID-19 use cases, including contact
tracing, COVID-19 testing, and return to work and return to school programs.

To date, Microsoft
Consulting Services (MCS)
 has deployed over 230 emergency COVID-19
response missions globally since the pandemic began in March, including recent
engagements to ensure the equitable, secure and efficient distribution of the
COVID-19 vaccine. MCS has developed an offering, the Vaccination Registration
and Administration Solution (VRAS), which advances the capabilities of their
COVID-19 solution portfolio and enables compliant administration of resident
assessment, registration and phased scheduling for vaccine distribution. 

Key features of the solutions include:

– tracking and reporting of immunization progress through
secure data exchange that utilizes industry standards, such as Health Level
Seven (HL7), Fast Healthcare Interoperability Resources (FHIR) and open APIs.

– health providers and pharmacies can monitor and report on
the effectiveness of specific vaccine batches, and health administrators can
easily summarize the achievement of vaccine deployment goals in large
population groups

Partnership Offerings

Microsoft partners have leveraged the Microsoft cloud to
provide customers with additional offerings to support vaccine management.
These offerings also apply APIs, HL7 and FHIR to enable interoperability and
integration with existing systems of record, artificial intelligence to
generate accurate and geo-specific predictive analytics, and secure
communications using Microsoft Teams.

EY has partnered with Microsoft for the EY Vaccine
Management Solution to enable patient-provider engagement, supply chain
visibility, and Internet of Things (IoT) real-time monitoring of the vaccines.
Additionally, the EY Vaccine Analytics Solution is an integrated COVID-19 data
and analytics tool supporting stakeholders in understanding population and
geography-specific vaccine uptake.

Mazik Global has created the MazikCare Vaccine Flow that is built on Power Apps and utilizes
pre-built templates to implement scalable solutions to accelerate the mass
distribution of the COVID-19 vaccine. Providers will be able to seek out
specific populations based on at-risk criteria to prioritize distribution.
Patients can self-monitor and have peace of mind to head-off adverse reactions.

LeenTaaS Secures $130M for ML Platform to Help Hospitals Achieve Operational Excellence

LeenTaaS Secures $130M for ML Platform to Help Hospitals Achieve Operational Excellence

What You Should Know:

LeanTaaS
raises $130 million in Series D Funding to strengthen its machine learning platform
to continue helping hospitals achieve operational excellence during a time
where they are facing mounting financial pressures due to COVID-19. 

– LeanTaaS provides software solutions that combine lean
principles, predictive analytics, and machine learning to transform hospital
and infusion center operations to improve operational efficiencies, increase
access, and reduce costs.

– LeanTaaS’ solutions have now been deployed in more than
300 hospitals across the U.S., including five of the 10 largest health networks
and 12 of the top 20 hospitals in the U.S.


 LeanTaaS, Inc., a
Silicon Valley software innovator that increases patient access and transforms
operational performance for healthcare providers, today announced a $130
million Series D funding round led by
Insight Partners
with participation from Goldman Sachs. With this
investment, LeanTaaS has raised more than $250 million in aggregate, including
more than $150 million from Insight Partners. As part of the transaction,
Insight Partners’ Jeff Horing and Jon Rosenbaum and Goldman Sachs’ Antoine
Munfa will join LeanTaaS’ Board of Directors.

Lean + Predictive Analytics = Operational Excellence

LeenTaaS Secures $130M for ML Platform to Help Hospitals Achieve Operational Excellence

Healthcare reform, an aging population, and a higher
incidence of chronic disease has caused the demand for healthcare services to
escalate quickly. At the same time, pressure from payers to eliminate waste
requires that healthcare providers do more with less to meet this skyrocketing
demand with the resources in which they have already invested. And this
situation is only going to get worse.

As more healthcare data gets digitized, the opportunity exists to leverage that data to help providers meet these challenges and more efficiently match supply and demand. Founded in 2010, LeanTaaS believes hospitals should use objective data and predictive analytics – not intuition and “tribal rules”– to better match resource supply with demand and to amplify the business impact of investments they have already made in EHR, BI, and Lean/Six Sigma.

Better Healthcare Through Math

LeenTaaS Secures $130M for ML Platform to Help Hospitals Achieve Operational Excellence

LeanTaaS develops software that increases patient access to
medical care by optimizing how health systems use expensive, constrained
resources like infusion chairs, operating rooms, and inpatient beds. More than
100 health systems and 300 hospitals – including 5 of the 10 largest systems,
12 of US News and World Report’s top 20 hospitals. These hospitals use the iQueue
platform to optimize capacity utilization in infusion centers, operating rooms,
and inpatient beds. iQueue for
Infusion Centers
is used by 7,500+ chairs across 300+ infusion centers
including 70 percent of the National
Comprehensive Cancer Network
 and more than 50 percent of National Cancer Institute hospitals. iQueue for
Operating Rooms
is used by more than 1,750 ORs across 34 health systems to
perform more surgical cases during business hours, increase competitiveness in
the marketplace, and improve the patient experience.

Related: How
Hospitals Can Create Better Inpatient Bed Capacity Through Math

Expansion Plans

The funds will be used to invest in building out the existing suite of products (iQueue for Operating Rooms, iQueue for Infusion Centers, and iQueue for Inpatient Beds) as well as scaling the engineering, product, and go to market teams, and expanding the iQueue platform to include new products. 

“LeanTaaS is uniquely positioned to help hospitals and health systems across the country face the mounting operational and financial pressures exacerbated by the coronavirus. This funding will allow us to continue to grow and expand our impact while helping healthcare organizations deliver better care at a lower cost,” said Mohan Giridharadas, founder and CEO of LeanTaaS. “Our company momentum over the past several years – including greater than 50% revenue growth in 2020 and negative churn despite a difficult macro environment – reflects the increasing demand for scalable predictive analytics solutions that optimize how health systems increase operational utilization and efficiency. It also highlights how we’ve been able to develop and maintain deep partnerships with 100+ health systems and 300+ hospitals in order to keep them resilient and agile in the face of uncertain demand and supply conditions.”

Chief Marketing Officer Appointment

Concurrent with the funding, LeanTaaS announced that Niloy Sanyal, the former CMO at Omnicell and GE Digital, would be joining as its new Chief Marketing Officer. Also, Sanjeev Agrawal has been designated as LeanTaaS’ Chief Operating Officer in addition to his current role as the President. “We are excited to welcome Niloy to LeanTaaS. His breadth and depth of experience will help us accelerate our growth as the industry evolves to a more data-driven way of making decisions” said Agrawal.

HealthStream Acquires Change Healthcare’s Staff Scheduling Business for $67.M

HealthStream Acquires Change Healthcare’s Staff Scheduling Business for $67.M

What You Should Know:

– HealthStream acquires Change Healthcare’s staff
scheduling business for $67.5M in cash which includes the ANSOS™ Staff
Scheduling (“ANSOS”) platform and related products.

– The acquisition will help establish HealthStream as a
market leader in healthcare workforce scheduling business.


HealthStream, a
leading provider of workforce and provider solutions for the healthcare
industry has entered into a definitive agreement to acquire
Change Healthcare’s staff
scheduling business, which includes their market-leading ANSOS™
Staff Scheduling (“ANSOS”)
application and related products. : The purchase
price payable upon the closing of the ANSOS acquisition will be approximately
$67.5 million in cash (subject to working capital and other customary purchase
price adjustments), which will be funded with cash on hand.

ANSOS Platform Background

ANSOS is an enterprise solution for healthcare providers
that want to anticipate workload requirements, manage labor costs, apply
complex work rules, and meet credential requirements for shifts—all for the
purpose of optimizing staff deployment. Today, the platform is used by over 300
hospitals and health systems and continues to be recognized as a market leader
in nurse and staff scheduling by KLAS™.

In addition to the ANSOS Staff Scheduling application, the
contemplated acquisition includes related products: Enterprise Visibility™, a
patient tracking system, and Capacity Planner™, a predictive analytics tool.
Importantly, all three products (i.e. ANSOS, Enterprise Visibility, and
Capacity Planner) work in concert with each other, creating a powerful solution
suite for aligning staff and scheduling based on patient acuity, predicting
patient demand, and adjusting resources for optimal outcomes.

Acquisition Expands HealthStream’s Portfolio of Staff
Scheduling & Workforce Solutions

The addition of Change Healthcare’s staff scheduling
business will expand HealthStream’s growing portfolio of solutions for staff
scheduling and workforce management, which began in early 2020 with the
acquisition of NurseGrid and grew further with the acquisition of ShiftWizard
last month. The complementary positioning of ANSOS, ShiftWizard, and NurseGrid
will enable future data integrations and advanced analytics that yield smarter
schedule development while enhancing engagement with staff.

“We are excited to add ANSOS to HealthStream’s growing nurse
and staff scheduling business for healthcare providers as we believe this is a
major win for everyone: customers, partners, employees, and shareholders,” said
Robert A. Frist, Jr., Chief Executive Officer, HealthStream. “The closing of
this transaction will establish HealthStream as an industry leader in nurse and
staff scheduling for healthcare providers. Considering our strong track record
of strengthening acquired products and solutions to deliver even greater value
to customers, I believe we are well positioned for continued growth and
innovation in workforce management.”

Post-Acquisition Plans

Following the acquisition, customer support for each of
these products will remain in place. Approximately 90 employees from Change
Healthcare will join HealthStream upon closing. Together, ANSOS, ShiftWizard,
and NurseGrid represent HealthStream’s portfolio of nurse and staff scheduling
solutions with executive oversight provided by Scott McQuigg, Senior Vice
President, HealthStream. These solutions will be included in HealthStream’s
Workforce Solutions business segment.

Financial Details

Revenues for the business to be acquired are primarily
associated with sales of perpetual software, maintenance, and professional
services. HealthStream expects incremental revenues in 2021 to range between
$16.5 and $19.5 million, taking into account an estimated reduction of between
$7.0 and $8.0 million related to deferred revenue write-downs. While the
business has historically sold perpetual software licenses, future product
development and sales efforts are anticipated to be directed towards a
software-as-a-service model.

HealthStream plan to make investments in the areas of sales,
marketing, product development, and operations to support this initiative. In
addition, we anticipate the amortization of acquired intangible assets to range
between $3.0 and $4.0 million during 2021. Considering the additional investments
intended during 2021, the deferred revenue write-downs, the amortization of
intangible assets, and transition services expenses, we expect the acquired
business to generate an operating loss in 2021.

How Care Coordination Technology Addresses Social Isolation in Seniors

How Care Coordination Technology Addresses Social Isolation in Seniors
Jenifer Leaf Jaeger, MD, MPH, Senior Medical Director, HealthEC

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

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

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

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

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

Addressing Chronic Health Issues and SDOH 

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

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

Bimodal Outreach: Prevention and Follow-Up Interventions

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

Social Support and Outreach through Technology 

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

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

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

– Recent ED visits or hospitalizations

– Presence of multiple chronic conditions

– Depression 

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

– Frailty indices such as fall risk

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

Optimal Use of Care Coordination Tools

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

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

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

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

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


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.


International Life Science Awards Recognize Reaxys

The International Life Sciences Awards, an initiative from Global Health & Pharma Magazine (GHP) that is now in its fifth year, recognizes industry innovators – and this year that has included honoring Reaxys as an innovation leader by awarding it the Best Chemistry Predictive Analytics Specialists 2020 for its best-in-class Predictive Retrosynthesis software.

GHP acknowledges the hard work and industry leadership from the Reaxys team in making an already powerful chemistry data solution even more so by developing an AI solution for drug discovery, noting that the Predictive Retrosynthesis software “combines reaction data with a deep learning algorithm to support innovation in synthetic and medicinal chemistry.”

In their profile of Reaxys, GHP highlights the incredible work of the Elsevier team in curating and verifying scientific knowledge, its groundbreaking partnerships with other innovators, and the company’s thirst to help develop new technologies. It was a collaboration with start-up Pending.AI (PAI) that yielded the Reaxys-PAI Predictive Retrosynthesis solution, and the tool is already being utilized by pharmaceutical and chemical companies for synthesis planning.

GHP also
highlights the fact that Reaxys is helping organizations to digitalize by
“enabling the extraction, curation and harmonization of chemistry data from
companies’ electronic lab notebooks and combining it with published chemistry
data.” This breaks down information silos and saves time by providing a single
point to conduct searches. It also ensures the predictive retrosynthesis model
is drawing from both published knowledge and a wealth of in-house research.

“With the recent outbreak of COVID-19 there is no better time to take our hats off to those who dedicate their professional lives to making our everyday lives safer,” said GHP about the International Life Sciences Awards. Reaxys is an important tool for all of drug discovery, but has certainly distinguished itself in the fight against COVID-19 this year. Elsevier has even offered complimentary access to it for researchers focusing on the coronavirus through our Coronavirus Research Hub.

“We are so pleased that the Reaxys team has been recognized as a leader in innovation by the International Life Sciences Awards for our work in retrosynthesis,” said Ivan Krstic, Director of Chemistry Solutions at Elsevier. “We will strive to continue making advances in this area that we hope will help drive amazing discoveries in drug research.”

You can find out more about Reaxys Predictive Retrosynthesis here, and read the full article from GHP to learn more about why Reaxys was chosen for this special award.

Also visit our Coronavirus Research Hub to learn how researchers and data scientists can get access to valuable information.

Fern Health Taps 10M Mass General De-Identified Patient Records for Pain Management

Massachusetts General Hospital to Deploy CarePassport’s Digital Health Platform for Clinical Trials

What You Should Know:

– Fern Health will reveal a
first-of-its-kind collaboration with Mass General Hospital where it will inform
existing and future digitally-delivered pain management programs through the
marriage of AI + predictive analytics with 10 million de-identified Mass
General patient records.

– MGH will validate emerging Fern Health products and pilot new products in clinical environments, setting the stage for Fern expansion into all aspects of non-invasive multimodal pain management.


Fern Health, a digital health company pioneering virtual musculoskeletal pain programs and pain neuroscience education through employers, announced that it has expanded its collaboration with Massachusetts General Hospital (MGH) and the MGH Center for Innovation in Digital HealthCare (CIDH). MGH is the original and largest teaching hospital of Harvard Medical School and home to one of the world’s leading pain management clinics.

Fern Health’s relationship with MGH, formed 18 months ago, will now broaden to entail a multi-year collaboration in which MGH will validate emerging Fern Health product lines, pilot new products in a clinical setting, and investigate new scientific approaches to pain management.

The expansion supports Fern Health’s long-term vision of democratizing access to non-invasive multimodal pain management. Fern Health’s current product suite, which includes an evidence-based, digitally delivered musculoskeletal (MSK) pain management program, was originally developed with experts from within Mass General, in consultation with their clinical collaborators at the world-renowned Spaulding Rehabilitation Network. Fern’s biopsychosocial pain management solution was validated with the clinical rigor of MGH’s renowned hospital-based research enterprise.

“There are a multitude of gaps in the U.S. healthcare system that unfortunately fail our patients with chronic pain, from lack of access to high-quality pain care to the proliferation of costly and often ineffective treatments,” said Mihir M. Kamdar, MD, MGH Pain Physician and Digital Health Advisor. “Evidence-based models of care are still rare in digital health solutions even though they have the potential to address these gaps and give clinicians innovative and effective care options for their patients.”

Leverage Data-Driven Insights from De-Identified Patient Data

Fern Health will leverage clinical validation and implementation science, clinical protocol development, access to data-driven insights derived from de-identified patient data, third-party corroboration for peer-review publications, and FDA approval processes. 

“By evaluating digital health tools in a real-world clinical setting, we can provide distinctive insights, understand user preferences, and validate clinical protocols for optimal implementation and outcomes,” added Joseph C. Kvedar, MD, Senior Advisor, Virtual Care, Mass General Brigham; Professor of Dermatology, Harvard Medical School; and Senior Advisor, MGH Center for Innovation in Digital HealthCare. “This collaboration is designed to help advance pain management through digitally-delivered personalized exercise therapy, education, and health coaching—which early results suggest is occurring.” Dr. Kvedar is also President of the American Telemedicine Association (ATA).

Expansion into All Aspects of Non-Invasive Multimodal Pain Management

The collaboration also gives Fern Health substantial clinical and scientific data to expand into the broader ecosystem of digitally-delivered pain management platforms: 

– The Fern user experience will replicate how a patient might experience evidence-based, personalized treatment at a hospital-based pain management clinic. Rather than delivered in-person, treatment is delivered digitally and is accessible from anywhere.

– Informed by predictive analytics and an expansive MGH data set of 10 million de-identified patient records, personalized, evidence-based Fern patient treatment plans will leapfrog the performance of “one-size-fits-all” pain management platforms that are limited to publicly available data or their own user data.

– The collaboration will form the foundation from which Fern will launch new products and services rooted in collaborative care aimed at treating the whole person across physical, emotional, and behavioral considerations.

Why It Matters

One out of every two people suffer from MSK pain and the U.S. spends $380 billion on MSK conditions each year, contributing to MSK pain being the top driver of employer healthcare costs. Fern Health eases the burden on employers who face daunting pain management treatment economics. Provided as a benefits add-on for self-insured employers, Fern Health offers a biopsychosocial approach to pain management, including personalized restorative therapy, pain neuroscience education and virtual 1:1 health coaching. The company is currently engaged in pilot programs with several mid-size and large employers spanning the professional services, manufacturing and transportation sectors.

“At least half of the population suffers from physical pain and its cascade of effects across social, mental and emotional well-being,” said Travis Bond, CEO, Fern Health. “This initiative marries science, clinical rigor, artificial intelligence and incredibly rich historical patient data sets with digital care delivery. It’s a huge first step into a better future for pain management science and for the millions of people living with musculoskeletal pain today.” 

The Future of the ICU? How Clinical Decision Support Is Advancing Care

The Future of the ICU? How Clinical Decision Support Is Advancing Care
Kelly Patrick, Principal Analyst at Signify Research

Without a doubt 2020 has been a devastating year for many; the impact of COVID-19 on both personal lives and businesses has had long-term consequences. At the end of September, the number of COVID-19 cases fell just short of 350 million, with just over 1 million deaths reported. The expectation of a second peak in many countries exposed to the deadly illness is being handled with care, with many governments attempting to minimize the impact of an extreme rise in cases.  

COVID-19 the aftermath will be the new normal?

Despite the chaotic attempts to dampen the impact of a second peak, it is inevitable that healthcare facilities will be stretched once again. However, there are key learnings to be had from the first few months of the pandemic, with several healthcare providers opting to be armed with as much information to tackle the likely imminent surge of patients with COVID-19 head-on. The interest in solutions that offer support to clinicians through data analysis is starting to emerge with several COVID-19 specific Artificial Intelligence (AI) algorithms filtering through the medical imaging space. 

Stepping into the ICU, the use of analytics and AI-based clinical applications is drawing more attention. Solutions that collect relevant patient information, dissect the information, and offer clinical decision support are paving the way to a more informed clinical environment. Already, early-warning scoring, sepsis detection, and predictive analytics were becoming a focus. The recent COVID-19 outbreak has also driven further interest in COVID-19 specific applications, and tele-ICU solutions, that offer an alternative way to ensure high-risk patients are monitored appropriately in the ICU. 

What does the future hold?

Signify Research is currently in the process of assessing the uptake of clinical decision support and AI-based applications in the high acuity and perinatal care settings. An initial assessment has highlighted various solutions that help improve not only the efficiency of care but also improve its quality. Some of the core areas of focus include:

Clinical Decision Support & Predictive Analytics

Due to the abundance of patient data and information required to be regularly assessed and monitored, the high-acuity and perinatal care settings benefit from solutions offering clinical decision support. 

The ICU specifically has been a focus of many AI solution providers, with real-time analysis and support of data to provide actionable clinical decision support in time-critical situations. Clinical decision support solutions can collate data and identify missing pieces of information to provide a complete picture of the patient’s status and to support the treatment pathway. Some of the key vendors pathing the way for AI in clinical decision support in the ICU include AiiNTENSE; Ambient Clinical Analytics; Etiometry; BetterCare; AlertWatch; and Vigilanz Corp.

Early-warning

Early-warning protocols are commonly used in hospitals to flag patient deterioration. However, in many hospitals this is often a manual process, utilizing color coding of patient status on a whiteboard in the nurse’s station. Interest in automated early-warning systems that flag patient deterioration using vital signs information is increasing with the mounting pressure on stretched hospital staff.

Examples of early-warning software solutions include the Philips IntelliVue Guardian Solution and the Capsule Early Warning Scoring System (EWSS). Perigen’s PeriWatch Vigilance is the only AI-based early-warning scoring system that is developed to enhance clinical efficiency, timely intervention, and standardization of perinatal care.

The need for solutions that support resource-restricted hospitals has been further exacerbated during the COVID-19 pandemic. Many existing early-warning vendors have updated their surveillance systems to enable more specific capabilities for COVID-19 patients, specifically for ventilated patients. Companies such as Vigilanz Corp’s COVID Quick Start and Capsule Tech’s Clinical Surveillance module for ventilated patients enables healthcare professionals to respond to COVID-19 and other viral respiratory illnesses with customizable rules, reports, and real-time alerts.

Sepsis Detection

Sepsis is the primary cause of death from infection, accounting for 20% of global deaths worldwide. Sepsis frequently occurs from infections acquired in health care settings, which are one of the most frequent adverse events during care delivery and affect hundreds of millions of patients worldwide every year. As death from Sepsis can be prevented, there is a significant focus around monitoring at-risk patients.

Several health systems employ their own early-warning scoring protocol utilizing in-house AI models to help to target sepsis. HCA Healthcare, an American for-profit operator of health care facilities, claims that its own Sepsis AI algorithm (SPOT) can detect sepsis 18-hours before even the best clinician. Commercial AI developers are also focusing their efforts to provide supporting solutions.

The Sepsis DART™ solution from Ambient Clinical Analytics uses AI to automate early detection of potential sepsis conditions and provides smart notifications to improve critical timeliness of care and elimination of errors. Philips ProtocolWatch, installed on Philips IntelliVue bedside patient monitors, simplifies the implementation of evidence-based sepsis care protocols to enable surveillance of post-ICU patients. 

Tele-ICU

The influx of patients into the ICU during the early part of 2020 because of COVID-19 placed not only great strain on the number of ICU beds but also the number of healthcare physicians to support them. Due to the nature of the illness, the number of patients that were monitored through tele-ICU technology increased, although the complex nature of implementing a new tele-ICU solution has meant the increase has not been as pronounced as that of telehealth in primary care settings.

However, its use has enabled physicians to visit and monitor ICU patients virtually, decreasing the frequency and need for them to physically enter an isolation room. As the provision of healthcare is reviewed following the pandemic, it is likely that tele-ICU models will increase in popularity, to protect both the patient and the hospital staff providing direct patient care. Philips provides one of the largest national programs across the US with its eICU program.

Most recently, GE Healthcare has worked with Decisio Health to incorporate its DECISIOInsight® into GE Healthcare’s Mural virtual care solution, to prioritize and optimize ventilator case management. Other vendors active within the tele-ICU space include Ambient Clinical Analytics, Capsule Health, CLEW Med, and iMDsoft.

Figure 1 Signify Research projects the global tele-ICU market to reach just under $1 billion by 2024.

Interoperable Solutions

More and more solutions are targeted toward improving the quality of patient care and reducing the cost of care provision. With this, the requirement for devices and software to be interoperable is becoming more apparent. Vendors are looking to work collaboratively to find solutions to common problems within the hospital. HIMMS 2020 showcased several collaborations between core vendors within the high acuity market. Of note, two separate groups demonstrated their capabilities to work together to manage and distribute alarms within a critical care environment, resulting in a quieter experience to aid patient recovery. These included:

– Trauma Recovery in the Quiet ICU – Ascom, B Braun, Epic, Getinge, GuardRFID, Philips

– The Quiet Hospital – Draeger, Epic, ICU Medical, Smiths Medical, Spok​


About Kelly Patrick, Principal Analyst at Signify Research

The Future of the ICU? How Clinical Decision Support Is Advancing Care
Kelly Patrick, Principal Analyst at Signify Research

Kelly Patrick is the Principal Analyst at Signify Research, a UK-based market research firm focusing on health IT, digital health, and medical imaging. She joined Signify Research in 2020 and brings with her 12 years’ experience covering a range of healthcare technology research at IHS Markit/Omdia. Kelly’s core focus has been on the clinical care space, including patient monitoring, respiratory care and infusion.


WellSky Acquires CarePort Health from Allscripts for $1.35B

WellSky Acquires CarePort Health from Allscripts for $1.35B

What You Should Know:

– Health technology leader WellSky has agreed to acquire
CarePort Health to power coordinated care transitions for acute and post-acute
care patients for $1.35B.

– By providing end-to-end visibility across the
continuum, WellSky and CarePort can improve outcomes, lower costs, and increase
patient satisfaction.


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


Financial Details

The agreed sale price of $1.35 billion represents a multiple
of greater than 13 times CarePort’s revenue over the trailing 12 months, and
approximately 21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12
months. CarePort is included in Allscripts Data, Analytics and Care Coordination
reporting segment and represents approximately 6% of Allscripts consolidated
revenues. Reference should be made to the Allscripts quarterly earnings reports
and supplemental financial data for a reconciliation of non-GAAP Adjusted
EBITDA. William Blair and J.P. Morgan Securities, LLC acted as financial
advisors to Allscripts in connection with the sale of CarePort.


Acquisition Enhances Care Coordination Across Acute,
Post-Acute Continuum

As part of the acquisition, WellSky and CarePort will facilitate effective patient care transitions across the continuum — driving better outcomes for patients, providers, and payers. With the addition of CarePort, WellSky is uniquely positioned to manage the acute care discharge process, track patients across post-acute care settings, apply patient and population-level analytics, and support EMR-based care protocols.

CarePort’s EHR-agnostic suite of solutions connects the
discharge process with post-discharge care coordination — allowing providers
and payers to track and manage patients throughout their care journey. By
providing end-to-end visibility across the continuum, WellSky and CarePort can
improve outcomes, lower costs, and increase patient satisfaction.


“As part of the WellSky team, we will be able to accelerate our mission to connect providers across the continuum. Both of our organizations are aligned in our dedication to proactively bridging gaps in care. Together, we have the technology, analytics, and network to ensure that patients receive seamless care,” said Dr. Lissy Hu, CEO of CarePort. “Joining WellSky means that we can increase vital connections between acute, post-acute, and community care providers to make a meaningful difference in the lives of more patients in more places.”


With WellSky’s deep experience in post-acute care and
CarePort’s suite of care coordination solutions, this combination is a natural
fit. CarePort clients will gain access to a broader network of post-acute
providers and can leverage WellSky’s powerful predictive analytics suite, and
leading value-based care technologies. This combination of capabilities will
enable health systems, payers, and post-acute providers to more effectively
collaborate in a data-driven way and enhance patient outcomes.


“Together with CarePort, WellSky will establish new, meaningful connections between historically disparate settings of care. We have the exciting opportunity to bring care coordination to more providers in service of delivering more informed, personalized care,” said Bill Miller, CEO of WellSky. “Through this agreement, we’re ensuring our clients have the intelligent technology they need to do right by their patients, collaborate with payers, and succeed in value-based care models. It’s WellSky’s mission to realize care’s potential, and this moves us that much closer to achieving it.”


Geisinger, OSF, Presbyterian Double Down on Digital Transformation with AVIA

Geisinger, OSF, Presbyterian Double Down on Digital Transformation with AVIA

What You Should Know:

– AVIA, a healthcare innovation network comprised of 50+
health systems and other healthcare stakeholder groups, today announced that
Geisinger, Presbyterian Healthcare Services, and OSF HealthCare have renewed or
expanded their partnerships with the organization to accelerate digital
transformation within their individual systems.

– While hospital spending has steeply declined due to the
COVID-19 pandemic, today’s announcement indicates that AVIA Members value the
Network’s shared learnings and rely on AVIA’s unique service model to better
understand new markets and select/scale digital solutions.


While hospitals and health systems across the country face
tremendous financial pressures and declining consumer confidence, AVIA Network
Members continue to lead healthcare toward practical, impactful, and
sustainable digital
transformation
. AVIA is the nation’s leading digital
transformation partner for healthcare organizations. Through renewed and
expanded partnerships with Members and new initiatives underway with consulting
clients, AVIA sees strong momentum across the country in the
strategic moves powered by digital.

This momentum is accelerated by AVIA’s differentiated
service model. Unlike other services firms, AVIA enables sustained
results through its membership insights and customized support. Insights are
distilled and delivered to Members from AVIA’s deep expertise coupled with
long-term relationships and understanding of where health systems are acting.

Renewed membership

Geisinger,
a nationally-renowned leading health system in innovation, renewed their
membership in the AVIA Network. “At Geisinger, we’re constantly
seeking new ways to improve care for our patients, our members, and our
communities,” said Dr. Karen Murphy, Executive Vice President, Chief Innovation
Officer, and Founding Director of the Steele Institute for Healthcare
Innovation. “In AVIA, we’ve found a partner to help us operationalize and
accelerate our innovation efforts.”

In the next chapter of Geisinger’s AVIA membership, the two organizations will work closely together in support of the Steele Institute’s Digital Transformation Office (DTO). With a charge that includes purview over advanced and predictive analytics, informatics, software development, experience strategy, product design, and product management, Geisinger will prioritize their key capabilities with AVIA’s support. AVIA will help the DTO team assess the market for digital solutions that enable these capabilities, and accelerate technology selection and deployment.

Expanded partnership and tailored support

Presbyterian Healthcare Services was
looking to innovatively improve how they digitally serve their patients, to
extend support both locally and to remote communities through telehealth and
innovative models of care. In a time of great uncertainty, Presbyterian wanted
to partner with an organization they trusted to catalyze the work, and chose to
partner with AVIA.

“AVIA knows us, and they’re already an extension of my team. The support they provide goes beyond what a traditional consulting firm would provide, because they have an active membership of like-minded health systems, and are gaining real-time insight into what other organizations are doing successfully, and where there are roadblocks. This sets us up to innovate effectively and with speed, especially during unprecedented times,” said Ries Robinson, Chief Innovation Officer at Presbyterian.

OSF
HealthCare
 engaged AVIA to assess the opportunity for
digital technology across the system to inform their operational and transformational
activities in support of current year financial targets. Specifically, AVIA mobilized
and assessed OSF stakeholders to identify where AI and robotic process
automation could enable Mission Partners to more meaningfully contribute to the
Ministry as well as support a sustainable cost structure for the system. In the
next phase of work, AVIA will develop a prioritization framework and
make final recommendations to the OSF executive team.

 AVIA furthers its Members’ insights through tailored support that provides strategic advice for action, grounded in what is possible, not theoretical. “It has been exciting to see health systems both embrace digital and AVIA’s service model. Through membership, we’ve been able to offer a combination of market research, advisory support, and peer collaboration,” said AVIA’s Chief Product Officer, Eric Jensen. “This unique mix is helping our members to move faster.”

Cerner Launches AI-Powered Command Center Dashboard for COVID-19 Response

Cerner Launches AI-Powered Command Center Dashboard for COVID-19 Response

What You Should Know:

– Cerner launches a new Command Center dashboard to help organizations visualize and optimize operations in a centralized location by leveraging real-time data and predictive analytics to provide situational awareness and decision support during COVID-19.

– Powered by AI and predictive models, helps organizations align patient needs, staffing, and resources to improve care and operational efficiency.


Healthcare IT leader Cerner recently launched a new tool to help organizations visualize and optimize operations in a centralized location by leveraging real-time data and predictive analytics to provide situational awareness and decision support. The Cerner Command Center dashboard, powered by AI and predictive models, helps organizations align patient needs, staffing, and resources to improve care and operational efficiency.

Helping Provider Manage Operational Efficiency During COVID-19

Cerner Launches AI-Powered Command Center Dashboard for COVID-19 Response

The need for healthcare systems to have situational awareness has never been greater. To help organizations manage operational efficiency during COVID-19, Cerner offered and is offering rapid deployment of the Cerner Command Center dashboard. The Cerner Command Center culminates people, processes, and technology into a single physical space to execute collaborative decision-making and workflows supporting the improvement of patient throughput. This approach focuses on patients — aligning the patient with the appropriate caregiver, in the right place, at the right time. The Cerner Command Center centralizes operational solutions that provide situational awareness and trigger the team to take immediate action when needed.

Other key
features of the Cerner Command Center include:

– real-time
data and predictive analytics to provide health systems clear line of sight
into critical resources such as available beds or equipment in order to respond
to patient needs and plan for the next.

– visualize key clinical and operational metrics in a centralized location, aligning throughput, staffing, and resources to optimize operations and drive action.

– standardized and near real-time dashboard that is accessible to the right staff at the right time can be used for making important operational decisions that can help facilitate the delivery of quality care to patients, support transformational change, and predictable operational excellence.

Deployment at Northern Light Health

Northern Light Health in Maine was the first health
system to deploy the Cerner Command Center dashboard, as
part of its COVID-19 response. The ability to capture and display real-time
data and analytics has been vital for Northern Light Health to effectively
address managing bed capacity and care activities during this health
crisis. With a cloud-based machine learning ecosystem, Cerner used
3 years of historical data from Northern Light Health to go beyond the current
and predict operational needs in the near future.

Waystar Acquires Medicare RCM Company eSolutions at $1.3B Valuation

Waystar Acquires Medicare RCM Company eSolutions at $1.3B Valuation

What You Should Know:

– Revenue cycle management provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue cycle management, workflow automation, and data analytics tools at a $1.3B valuation.

– The acquisition will create the first unified
healthcare payments platform with both commercial and government payer
connectivity, resulting in greater value for providers.


Waystar, a provider of healthcare payments software, today
announced a definitive agreement to acquire Francisco Partners-backed eSolutions, a revenue cycle
technology company with unique Medicare-specific solutions at a $1.3B valuation,
according to sources close to the deal. In bringing these two industry leaders
together, Waystar will be the first technology to unite both commercial and
government payers onto a single payments platform. The transaction is expected
to close later this year, subject to customary conditions and approvals.

eSolutions Background

Founded in 1999, eSolutions’ technology maximizes revenue
collection, accelerates cash flow, and reduces administrative burden across
numerous sites of care. The company has over 6,000 payer connections and
maintains a powerful and growing data set of billions of transactions. In addition
to hospitals and ambulatory providers, eSolutions has deep expertise in serving
the post-acute market across the entire revenue cycle, including skilled
nursing, senior living facilities, home care, hospice, federally qualified
healthcare centers (FQHCs), and durable medical equipment providers. eSolutions
is backed by Francisco Partners.

“eSolutions is thrilled to be joining forces with Waystar, a company like ours that relentlessly focuses on delivering exceptional customer service,” said Gerry McCarthy, Chief Executive Officer of eSolutions. “The combination of our technology platforms and data solves a major pain point in revenue cycle management to drive stronger results for our clients, partners, and for healthcare.”

Acquisition Creates Unified Healthcare Payments Platform 

Medicare has become the largest payer in the United
States and as baby boomers age, the mix of insurance coverage is
increasingly shifting to Medicare. Historically, providers have had to leverage
two different systems – one to handle commercial claims, and another to handle
Medicare. For healthcare providers, leveraging a single, end-to-end platform to
manage both private and government payments solves a major pain point and
creates significant efficiencies, freeing up time to deliver care.

“Together, Waystar and eSolutions will deliver unprecedented innovation to the industry, helping healthcare organizations accelerate revenue collection while reducing administrative expenses and repetitive tasks,” said Matthew Hawkins, Chief Executive Officer and board member of Waystar. “Uniting our companies’ data sets will further power Waystar Hubble, our artificial intelligence solution, providing access to even greater insights and value for our clients. We have long-admired eSolutions for its unique Medicare-specific revenue cycle capabilities, which are a perfect complement to the Waystar platform. We are excited to move forward as one team.”

6th Waystar Acquisition Since 2018

Waystar has integrated several other transformational
technologies onto its single instance cloud-based platform since uniting
Navicure and ZirMed in 2017. This marks Waystar’s sixth acquisition in the last
couple years, as the company rapidly expands within the space (not including
their own $2.3B acquisition by two private equity firms last year). 

Recent acquisitions include Recondo, a patient estimation and prior authorization
technology, PARO, a presumptive charity scoring solution, UPMC’s Ovation, a claims monitoring tool, and Connance, leveraging predictive analytics to offer agency
manager, advanced propensity to pay (AP2P), and presumptive charity. Waystar is
backed by EQT, Canada Pension Plan Investment Board, and Bain Capital.

Verisk Launches EHR Triage Engine to Help Speed Approval of Life Insurance Apps

Verisk Launches EHR Triage Engine to Help Speed Approval of Life Insurance Apps

What You Should Know:

– Verisk launches its new EHR Triage Engine, a tool that
uses data from consumer-authorized electronic health records (EHRs) to help
life insurers fast-track many applications for coverage.

– The EHR Triage Engine bypasses manual workflows,
leveraging advanced predictive analytics and automation to digitally ingest and
analyze EHRs and the tool can evaluate 95,000 impairments in five minutes or
less.


Verisk, a data
analytics provider, announced today the launch of its new EHR
Triage Engine
, a tool that uses data from consumer-authorized electronic health records
(EHRs)
to help life insurers fast-track many applications for
coverage—potentially cutting decision time from weeks to minutes.

EHR Triage Engine Overview

The typical life underwriting process traps companies and
agents in slow, manual workflows—and subjects customers to intrusive physical
exams and lab work. The EHR Triage Engine bypasses manual workflows, leveraging
advanced predictive analytics and automation to digitally ingest and analyze
EHRs.

The tool can evaluate 95,000 impairments in five minutes or
less, so life insurers can qualify as much as 85 percent of applicants for
coverage with minimal or no underwriter review. With automated processing of
low-risk cases, carriers can provide a streamlined customer experience for the
vast majority of their applications and enable underwriters to focus their
energy on complex risks.

Research shows that it takes four weeks to underwrite the
average life policy, but half of all life insurance shoppers are more likely to
buy if they can forego the most intrusive and time-consuming element—a required
physical exam. The EHR Triage Engine helps respond to those customer
expectations, an effort supported by a team of Verisk experts in biostatistics,
data science, medical research, regulatory compliance, and data privacy.

Development Background

Verisk developed the EHR Triage Engine in collaboration with
SCOR, a global Tier 1 reinsurer. SCOR plans to integrate Verisk’s EHR Triage
Engine into SCOR Global Life’s Velogica underwriting system. The Verisk
solution can also be easily delivered via a stand-alone API or integrated into technology
from FAST, a Verisk business and leading provider of end-to-end software for
the life insurance and annuity markets.

“Many life insurers are looking to implement digital strategies to modernize and streamline their business for a competitive advantage,” said Maroun Mourad, president of global underwriting at Verisk. “Verisk is at the forefront of a revolution in analyzing structured digital health data for insurers that’s shared by their applicants, and is indispensable for automating real-time, low-, or no-touch decision making. This can help insurers deliver a quick purchase process for the vast majority of applicants who are relatively low risk.”

VA, Philips to Create World’s Largest Tele-Critical Care System for Veterans

VA, Philips to Create World’s Largest Tele-Critical Care System for Veterans

What You Should Know:

– U.S. Department of Veterans Affairs selects Philips to create the world’s largest tele-critical care system, further integrating tele-health and delivering quality care for veterans.

– The ten-year contract, which enables
VA to invest up to $100 million with Philips for
tele-critical care technology and services, leverages Philips history of innovation, including research into
technologies that can better support veterans, telehealth, tele-critical care
(eICU), diagnostic imaging, sleep solutions and patient monitoring.


U.S. Department of Veterans Affairs (VA) has awarded a contract to Philips to expand VA’s tele-critical care program, creating the world’s largest system to provide veterans remote access to intensive care expertise, regardless of their location. The ten-year contract, which enables VA to invest up to $100 million with Philips for tele-critical care technology and services, leverages Philips history of innovation, including research into technologies that can better support veterans, telehealth, tele-critical care (eICU), diagnostic imaging, sleep solutions and patient monitoring.

VA’s Committed Focus to Telehealth for Veterans

VA is
the largest integrated healthcare system in the U.S., consisting of more than
1,700 sites and serving nearly nine million veterans each year. It has become a
leader in developing telehealth services in order to improve access to care and
federate care delivery. In fiscal year 2019 alone, VA delivered more than 2.5
million telehealth episodes. Additionally, VA was able to expand video to home
appointments from approximately 10,000 to 120,000 per week between February and
May of 2020 during the COVID-19 pandemic. Overall, the pandemic has increased
the share of Americans participating in telehealth from 11% in 2019 to 46%
today, with healthcare systems reporting a 50 to 175-fold increase in
telehealth volume compared to pre-pandemic levels.

Tele-Critical Care Program

As part
of an overall telehealth
program
, eICU enables a co-located team of specially trained critical
care physicians and nurses to remotely monitor patients in the ICU regardless
of patient location. With VA managing 1,800 ICU beds nationwide, eICU not only
gives patients access to specialists, but also helps them deliver on the
Quadruple Aim: optimizing care costs, enhancing clinician and patient
satisfaction and improving outcomes. Research has shown that patients in eICU
settings spend less time in the ICU and have better outcomes. Moreover,
family members can talk to clinicians via integrated audio and video technology
to support decision making.

“VA’s
relationship with Philips will help to expand
and improve our tele-critical care program,” said Robert Wilkie, U.S.
Secretary of Veterans Affairs. “This is particularly critical to provide
Veterans access to quality health care when and where they need it
and for improving their health outcomes.”

To
date, more than 20% of U.S. adult ICU beds and 1 in 8 adult ICU patients are
monitored by a 24/7 continuous demand model powered by Philips’ eICU Program,
which combines A/V technology, predictive analytics, data visualization and
advanced reporting capabilities [3, 4]. The core of these proven solutions
is Philips eCareManager software, which uses
advanced analytics and AI to synthesize patient data and deliver actionable
insights to support proactive care in coordination with onsite staff.

Today, Philips continues to work closely with the DoD, VA and
academic partners to drive innovations that can better
support care for troops, as well as telehealth technologies that
can bring care closer to home for our nation’s veterans.

“Philips is committed to improving the lives of 3 billion
people a year by 2030 and is working closely with VA to support one of our most
important initiatives: improving the health of our service men and women,” said
Vitor Rocha, Chief Market Leader for Philips North
America. “By connecting advanced telehealth technologies, clinical data, as
well as clinicians, patients and their families, Philips can
help VA make virtual care a reality and deliver quality health care for one of
our most deserving communities: our nation’s veterans.”