After months of uncertainty, hope is finally on the horizon as three viable COVID-19 vaccine candidates are moving closer towards approvals for public distribution. Getting to this stage was extremely labor-intensive, but unfortunately, it’s not the end of the hardships. The coronavirus vaccine will represent the largest vaccine distribution in U.S. history, and manufacturing and distributing the vaccines will have its own fair share of difficulties for healthcare systems. In order to optimize the distribution of vaccines, healthcare providers will need to employ technology and data collection to stay organized. Unfortunately, vaccine approvals are quickly looming, meaning that the necessary technology infrastructure needs to be implemented soon. Healthcare facilities need to understand what solutions can be deployed to facilitate a safe and efficient distribution plan — and how to implement them before it’s too late.
Vaccine Organization and Distribution
With three potential vaccines, each with different vaccination schedules and side effects, managing distribution will be a complicated effort. Patients will need to be matched to the appropriate vaccine, with consideration paid to medical history. Once a patient is matched to their vaccine, healthcare providers need to track side effects, and in the cases of Pfizer and Moderna, when the patient will receive their second dose. This requires significant data collection, which may leave healthcare providers vulnerable to cybersecurity threats. Data breaches have increased by 171 percent this year due to the pandemic, meaning that cybersecurity and secure data storage need to be at the forefront of any healthcare IT strategy.
The CDC is working to implement a data use agreement to determine which information needs to be reported to various levels of government. This will include information on patient matching, which can help determine how much of each vaccine is being used, the remaining supply and what will need to be ordered. Once these guidelines are in place, healthcare facilities will need to start planning and implementing their cybersecurity strategy. Information sharing will be important over the next few months as the vaccines roll out, but this needs to be balanced with access management to reduce the risk of breaches. Ensure that all members of the team, as well as anyone else who has access to important personal data, understand the risks, as well as the protocols that are in place.
Once vaccines are administered, governments will need to monitor both patients and those who chose not to receive a vaccine closely. Shots are voluntary, which means that there may be parts of the population that refuse to get vaccinated. Many governments and businesses are already discussing the implications of that, including restricting access to things like travel and communal spaces. This means that further data will need to be collected and shared that can inform the public of who is not vaccinated. In the U.K., there has been discussion of an app, similar to the contact tracing app, that discloses the status of a person’s vaccination. In Canada, they have discussed an immunity and vaccination passport. It remains to be seen what route the U.S. government will choose, but there are clear implications for data collection with these new technologies.
Vaccine distribution will also cause problems for healthcare providers due to the sheer volume of patients needing access to services. Currently, hospitals are overwhelmed with COVID-19 patients. It is also flu season, meaning that flu vaccine appointments are rising. In order to provide safe distribution of the flu vaccine, many governments have implemented an appointment-only system where all patients have to pre-register to receive their dose. Similar systems will be crucial for the distribution of COVID-19 vaccinations in order to support the observance of physical distancing requirements. With clinics and healthcare facilities already strained, adding more patients that require vaccinations could cause many issues. Appointments need to be closely managed to ensure that healthcare facilities will still be able to operate safely. Healthcare providers will also need to monitor the number of patients during each distribution phase to ensure that they can handle everyone who needs a vaccine.
Vaccine distribution could begin any day, which means that the technology infrastructure to support the initiative needs to be implemented immediately. This doesn’t leave much time to create new solutions, so healthcare facilities will need to work with existing technology providers to create a secure infrastructure that supports distribution. When selecting a technology provider, careful consideration needs to be paid to both the services it provides and the security protocol that it has in place. Choose trusted vendors that have experience in the healthcare industry. With all healthcare providers going through the same experience, information sharing will also be important. Discuss with other healthcare IT departments what solutions and providers they are considering for vaccine distribution.
Preparing for Distribution
There is no doubt that this vaccine distribution plan will be unlike anything the U.S. has ever experienced. With distribution broken down into phases to determine the priority of who receives the vaccines, healthcare providers will be forced to contend with sick patients at the same time that they are distributing vaccines. This will require extra effort to keep everyone safe and healthy. With the vaccines set to begin distribution at any moment, healthcare providers need to act quickly to ensure that the necessary technology and data collection infrastructure is in place to facilitate a safe and efficient distribution.
About Kevin Grauman Kevin Grauman is the President and CEO of QLess, a line management system used by retail, education and government industries. He is no stranger to the world of startups, with a proven track record as a successful U.S.-based executive leader and entrepreneur. Kevin has been recognized as one of the “100 Superstars of HR Outsourcing in the USA” by HRO Today Magazine.
– Tyto Care announces the launch of its fingertip Pulse
Oximeter device, allowing users to measure their own blood oxygen saturation
level and heart rate from the comfort and safety of home.
– Expanding its clinic-quality remote capabilities, TytoCare users will be able to perform a remote blood oxygen exam, allowing clinicians to better monitor patients with COVID-19 and chronic lung or heart conditions.
Tyto Care, a New York City-based all-in-one modular device and examination platform for AI-powered, on-demand, remote medical exams, today announced the release of its FDA-cleared fingertip Pulse Oximeter (SpO2) medical device. The Pulse Oximeter enables TytoCare users to check blood oxygen saturation levels and heart rate, which are crucial for the monitoring of chronic conditions and COVID-19.
Fingertip At-Home Pulse Oximeter Measures Blood Oxygen and Heart Rate
The Pulse Oximeter connects by cable to the TytoCare device.
Users who choose to perform the blood oxygen exam are prompted to place their
finger in the SpO2 device for 15 seconds. Upon completion of the
exam, the blood oxygen and heart rate results appear immediately on the
handheld TytoCare device and the Pulse Oximeter adaptor itself and are also
recorded within the TytoCare platform for review by the clinician and sent to
the patients’ EHR
(Electronic Health Record). If the examination is performed in real-time
during a live telehealth visit, the clinician will see the results immediately
in the TytoCare Clinician Dashboard. Clinicians are able to assess the
reliability of the results recorded by viewing the heart rhythm graph generated
during the exam.
Why It Matters
This expansion of Tyto Care’s virtual examination solution
is bringing the company even closer to full remote, clinic-level testing
capabilities from the comfort of home. The Pulse Oximeter is a key tool for
monitoring high-risk or infected individuals during the COVID-19 pandemic, as
well as for post-discharge care and home hospitalization. The company’s Pulse
Oximeter device also enables seamless monitoring of patients with chronic lung
and heart conditions, critical during routine times as well.
“We’re excited to announce the release of our Pulse Oximeter, providing patients with more tests that bring the clinic directly to them,” said Dedi Gilad, CEO and Co-Founder of Tyto Care. “The COVID-19 pandemic thrust telehealth into the spotlight, and we are constantly enhancing the TytoCare platform to ensure users have access to the most comprehensive telehealth solution available. The pandemic will eventually be behind us, yet telehealth will remain a key component in the future of healthcare, providing patients with the best possible remote care and clinicians with actionable insights into their patients’ health.”
The SpO2 device is available in the
United States and Israel through partnering health systems. In the future, the
device will also be available in Europe, South Africa, and Asia.
– The ONC today unveiled a series of investments to improve
the sharing of health information related to vaccination.
– The new investments will provide opportunities to track
vaccination progress, help clinicians contact high-risk patients, and help
identify patients due to receive the second dose of the vaccine.
The U.S. Department of Health and Human Services
acting through the Office of the National
Coordinator for Health Information Technology (ONC) today announced a
series of investments to help increase data sharing between health information
exchanges (HIEs) and immunization information systems. These
projects will build on and expand ONC’s Strengthening the Technical Advancement
and Readiness of Public Health Agencies via Health Information Exchange (STAR
HIE) Program by helping communities improve the sharing of health information
related to vaccinations. Through these collaborations, public health agencies
can get additional help tracking and identifying patients who have yet to
receive their second dose of a COVID-19 vaccine and better identify those who
may be high-risk who have not yet received a vaccination.
In addition, ONC will also award funds to the Association of
State and Territorial Health Officials (ASTHO) and CORHIO, the Colorado
Regional Health Information Organization, to support immunization related
health information exchange collaborations.
“These CARES Act funds will allow clinicians to better access information about their patients from their community immunization registries by using the resources of their local health information exchanges,” said Don Rucker, MD, national coordinator for health information technology. “Through these collaborative efforts public health agencies and clinicians will be better equipped to more effectively administer immunizations to at-risk patients, understand adverse events, and better track long-term health outcomes as more Americans are vaccinated.”
Tracking Vaccination Progress
The new investments will provide opportunities to track vaccination progress, help clinicians contact high-risk patients, and help identify patients due to receive the second dose of the vaccine. It will also help provide a statistically and clinically robust way to measure vaccination outcomes. In collaboration with HIEs, the ability to individually correlate every patient who has received the vaccine with all of their clinical data both pre-and post-vaccination could offer more detailed insight into any adverse events and long-term health outcomes than is currently possible.
Increasing Data Collaboration Between HIEs & Immunization
There are currently 63 immunization information systems
across the United States, one in each state, eight in territories, and in five
cities. They are funded in part by through the Centers for Disease Control and
Prevention’s National Center for Immunization and Respiratory Diseases (NCIRD).
Currently, there are approximately 100 health information exchange
organizations in the United States reaching an estimated 92 percent of the U.S.
population, according to the Strategic Health Information Exchange Collaborative,
the national trade association for HIEs.
– Aledade raises $100 Million in Series D funding to help
more primary care practices thrive in value-based care.
– The new funding will power the growth of a nationwide network of more than one million patients by further expanding into Medicare Advantage Contracts.
a Bethesda, MD-based provider of value-based primary care, today announced it
has closed a $100 million Series D funding round following a year of
significant growth for its national network of risk-taking primary care
practices. Returning investor Meritech Capital led the round, which included new growth
Global Management andIVP,
and returning investor OMERS Growth Equity. The latest round of funding brings the
company’s valuation to over $2.1 billion dollars.
Delivering Value-Based Primary Care
Founded in 2014 by former National Coordinator for Health IT, Farzad Mostashari, Aledade began building ACO networks for independent physicians through the Medicare Shared Savings Program, but now also partners with commercial payers across the country. Aledade now partners with nearly 800 independent primary care practices, including more than 100 federally-qualified health centers, comprising more than 7,800 providers in 31 states. Through this nationwide network of independent practices, Aledade practices manage roughly $12 billion in health care spending through 35 Medicare and 51 other value-based contracts and care for nearly 1.2 million patients.
Why It Matters
As the healthcare system continues to be strained by the
COVID-19 pandemic, these value-based
practices are keeping patients healthy, at home, and out of the hospital with
proactive, coordinated primary care. Aledade technology helps practices
identify and better manage their most at-risk patients. Patients of practices
engaged with Aledade have fewer emergency department visits, inpatient stays
and readmissions; in the most recent year with public results from the Medicare
Shared Savings Program, Aledade practices reduced hospital stays by an average
of 9 percent, avoiding more than 10,000 unnecessary hospitalizations.
Aledade’s growth has been driven by the success of its
physician-led model, in which the company shares in the risk and reward of both
government and commercial value-based contracts with participating independent
practices. Aledade practices have improved the quality of care and health
outcomes while controlling costs in all types of public and private payer
contracts. To date, Aledade’s participating practices have received more than
$115 million in shared savings revenue.
Funding Will Support Strategic Partnerships with Medicare
Aledade will use this infusion of capital to expand its value-based care model with health plans across the country, with a particular focus on growing its strategic partnerships with Medicare Advantage (MA) plans to improve outcomes and quality for more seniors. Already, Aledade works with all of the largest MA payers and multiple Blue Cross plans to give Aledade practices access to Medicare Advantage value-based contracts. In 2020, Aledade more than doubled the number of patients served in these MA contracts, bringing the total to about 100,000.
As the company expands into more MA plan partnerships and
welcomes more practices to its national network of ACOs, Aledade will continue
to invest heavily in its cutting-edge technology platform to ensure primary
care physicians have a world-class operating system for population health.
Aledade also plans to launch several initiatives in 2021 to extend this
These include initiatives to extend the use of integrated
telehealth, predict and prevent the occurrence of unplanned dialysis, reduce
racial disparities in hypertension control, and enable even the smallest
primary care practices in the country to join value-based contracts with
In the face of COVID-19, healthcare witnessed how crises can become the long-awaited push for creativity and innovation that the industry needs. When our healthcare infrastructure’s weaknesses were exposed, telehealth helped to stitch them up, with the number of telehealth claims increasing 8,336% nationally from April 2019 to April 2020. Out of need, patients quickly turned to telehealth as a new model of care delivery; clinicians adapted to a new avenue for engaging with patients, policymakers began to improve incentives for its use; and home became our hospital.
As we continue the fight to control the virus in 2021, the industry is at a pivotal moment in ensuring this year’s telehealth momentum continues post-pandemic. Healthcare organizations should take time now to strategize how best to hardwire telehealth, so it is embedded into care delivery models long-term. In order to achieve this, leaders need to consider their collaboration with other stakeholders, longitudinal integration strategies that go beyond piecemeal solutions and transform the perception of what “home” means in healthcare to meet consumers where they are.
Step 1: Collaborate to advance technology
If we’ve learned anything from healthcare’s digitization over the years, it’s that technology for technology’s sake is not enough – solving healthcare’s issues is a systems problem, not a disease problem. For telehealth to last, there needs to be a clinical transformation where workflows are rewritten, policies strongly incentivize its use and companies and hospitals partner on outcome-based models that support its scalability.
In the last six months, we have seen more innovation and adoption in healthcare than we’ve seen in the last decade, with typical innovation timelines of years becoming weeks or days. In many ways, this creativity and open innovation saved the U.S. healthcare system from collapsing and helped us survive the initial surge. We also saw the collaboration of all sorts reach new heights, with organizations, federal agencies, private and public companies from different industries coming together to manage surge capacity while maintaining quality care. Another benefit of these partnerships is the emphasis on long-term policy changes that will empower lasting change and adoption of these innovative approaches. Industry efforts, like ours with the ATA, aim to promote telehealth’s growth and support hospitals, payers, and patients across care settings. The pandemic’s productive collaboration cannot stop here. Instead, we should continue to bring dimensions of policy, clinical experience, and consumer voices to imbed telehealth into our everyday systems.
Step 2: Determine avenues for seamless data integration across settings
Telehealth’s power is not in its technical claims, but in the power of presenting caregivers with actionable, meaningful patient data so they can make data-driven care decisions with confidence. This is only made possible with interoperable, cloud-based solutions that collect, digest, and analyze data to inform care. With constant transfer of key patient data through connected devices, such as hospital-grade wearables and biosensors, and translating the data into useable insights, remote patient monitoring empowers care teams with the knowledge needed to intervene earlier and keep patients healthy at home.
Telehealth’s power expands beyond the home, supporting a continuum of care no matter what setting a patient is in. Remote monitoring within the hospital is the crux of minimizing infection risk, handling sudden increases in patient volumes and allocating resources appropriately. These include solutions such as centralized clinical command centers to achieve remote, holistic patient views, or technology that activates scalable patient monitoring for ICU ramp-ups. The solutions we deploy need to be enablers of seamless data transfer – from the ED to ICU, to post-acute and home setting. We now must ensure our informatics backbones mature with these solutions, eliminating gaps in care while ensuring a secure flow of data where and when it’s needed. Deploying cloud-based platforms that bring together the right information across the care continuum will make for a powerful, integrated system that enhances patient and staff safety improves outcomes, and reduces costs.
Step 3: Transforming what “home” means in healthcare
2020 has transformed how we view “home.” Home has become the center of life operations for people across the globe – we work from home, we educate our children at home and we exercise at home. Healthcare is now becoming another cornerstone of the home. With a growing volume of telehealth offerings and household names providing care services, consumer behavior is changing to expect customization, convenience, and instant gratification. The consumer’s voice is loud, and tomorrow’s healthcare will move it from a whisper to a shout – We must be prepared to deliver care when and where patients want to receive it, increasingly let go of healthcare’s brick-and-mortar blueprint, and enable healthcare to match the ease and convenience of other areas of a patient’s life.
However, just like all these other ‘at-home’ activities that require getting used to or training, we need to support health literacy and engagement for all users. The pandemic has made the inequalities in our health system raw. Even before the pandemic, 5% of the patients account for about half of U.S. healthcare spending. This is a sign that they are not receiving the proactive care and support they need. We have an opportunity to change this equation with virtual care and bridge the digital divide by tailoring solutions to meet each patient’s needs and ensuring equitable availability to all patients.
Transforming telehealth into a standard of care
Technology isn’t the answer to telehealth’s success alone – it is virtualizing care where it is needed most and ensuring it is fully integrated across an institution. Healthcare organizations should reflect on where their greatest challenges and populations are, and look for systematic solutions for telehealth so that virtualization can scale efficiently and build from existing technology and workflows. With productive collaboration across sectors, robust data integration infrastructures, and an evolved perception of how we view healthcare, these tools have the power to influence how patients view and engage with their health, pushing the industry toward more proactive care that will have long-term benefits on outcomes and cost.
About Karsten Russell-Wood
Karsten Russell-Wood, MBA, MPH is the Portfolio Leader for Post-Acute and Home at Philips where he is responsible for Innovation and cross-business platform strategy and portfolio optimization. Prior to joining Philips, Karsten held global product management roles within GE’s healthcare businesses with an orientation to targeted patient populations and continues to be active in venture capital and startups in the digital health space.
The Internet of Medical Things (IoMT) is changing the face of healthcare and has the potential to significantly improve patient access as well as system efficiencies. The adoption of telemedicine, for example, spurred on by the Covid-19 pandemic, has spread rapidly. Forrester revised its forecasts to predict that virtual care visits in the United States will soar to more than one billion this year—including 900 million visits related to Covid-19 specifically. Likewise, in the United Kingdom, 40% of doctor’s appointments now consist of phone or video calls.
Even before the pandemic, the adoption of IoMT was already growing rapidly, with the market valued at US$44.5 billion in 2018 and predicted to reach US$254 billion in 2026. There are more than 500,000 medical devices on the market, helping to diagnose, monitor, and treat patients – and more and more of these can, and are, becoming connected – not to mention innovations yet to enter the market. The connected medical devices segment specifically is expected to exceed $52 billion by 2022.
The COVID-19 Effect
The COVID-19 pandemic has changed the healthcare landscape more than any other single event in recent memory. The urgent and widespread need for care, coupled with the challenge of physical distancing, has accelerated the creation and adoption of new digital technologies as well as new processes to support their adoption and implementation across healthcare. The MedTech industry is emerging as a key apparatus to combat the virus and provide urgent support.
A simple example demonstrating the potential benefits of IoMT can be seen even within a hospital setting, where monitoring COVID-19 patients is costly in terms of time and PPE (personal protective equipment) consumption, since simply walking into a patient’s room becomes a complex process. IoMT technologies enable medical devices to send data to medical practitioners who can monitor a patient’s condition without having to take readings at the bedside. The same technologies can enable patients who do not require hospitalization to be safely monitored while remaining at home or in a community setting.
From the patients’ perspective, many are embracing virtual healthcare as an alternative to long waits or having to go to a clinic or hospital altogether. And given the growing number and scope of connected medical devices and services, such as remote patient monitoring, therapy, or even diagnosis, there will be even more options in the future.
Catalyzed by the pandemic, the IoMT genie is fully out of the bottle, and it is unlikely to go back.
This is good news for healthcare and good news for patients and families. Patient access is improving as telehealth, supported by connected devices to enable the collection of health-related data remotely, is helping to lift barriers. This increase in accessibility has the potential to improve the convenience, timeliness, and even safety of access to healthcare services for more people in more places.
IoMT is lifting geographic barriers that have impeded access to healthcare since its very inception. Individuals with transportation or mobility challenges will no longer need to travel to receive routine care if they can be safely monitored while at home. Historically underserved rural or remote communities can gain access to medical specialists without needing to fly or drive great distances, while services can be delivered more cost-effectively.
Furthermore, with fewer clinic or hospital-based appointments required for routine monitoring of patients who are otherwise doing well, doctors would be able to concentrate their in-person time and clinic resources on those most in need of care.
The capacity for specialized medicine enabled by IoMT could also have a dramatic impact. The vast quantities of health data becoming available (with the requisite permissions in place), can enable sophisticated AI-driven health applications that can, for example, predict complications before they occur, better understand the health needs of specific populations, or enable stronger patient engagement and self-care. These models can also equip healthcare practitioners with better sources of information, ultimately leading to better patient outcomes.
That said, while technology capabilities expand, innovation must take into consideration the needs of all the stakeholders within healthcare – from patients and caregivers to healthcare practitioners to administrators and payors/funders. Internet access, infrastructure, and comfort with technology, for example, can pose significant barriers for patients and health practitioners alike.
One approach is to minimize the technological burden facing end-users. Devices should be user friendly and “ready to go” right out of the box, taking into consideration the circumstances and abilities of the potential range of users (patients and practitioners alike). Relying on the patient’s home Wi-Fi to provide connectivity is not ideal from either a usability or security perspective – not to mention availability and affordability. It is better for medical devices to have a cellular connection that can be immediately and securely connected to the network from any location, while also being remotely manageable to avoid burdening the user with network and setup requirements, or apps to download.
Another barrier is the concern that both patients and healthcare providers have about security and data privacy risks. According to the 2016 edition of Philips’ Future Health Index, privacy/data security is second only to cost in the list of top barriers to the adoption of connected technology in healthcare across the countries surveyed.
The Cybersecurity and Infrastructure Security Agency, FBI, and U.S. Department of Health and Human Services have warned of cybercrime threats against hospitals and healthcare providers. The WannaCry ransomware attacks affected tens of thousands of NHS medical tools in England and Scotland. The enthusiasm in rolling out new digital health solutions must not overlook security principles or create systems that rely on ad hoc patches.
One way of meeting the stringent security requirements of healthcare is to ensure that connected medical devices have security literally built into their hardware, following the most recent guidelines set out by the GSMA for IoT security, including the GSMA IoT SAFE specifications. In accordance with this globally relevant approach, connected devices have a specially designed SIM that serves as a mini “crypto safe” inside the device to ensure that only authorized communication can occur.
Similarly, new medical devices and software that are difficult to implement or cannot communicate with other systems such as electronic health/medical records risk being “orphaned” in the system or simply not used. The latter is a matter of both developing the necessary integrations and ensuring the appropriate access and permissions are managed. More easily said than done, fully integrated systems take time, and some of the pieces may be added incrementally – the key is that the potential to do so is there from the beginning so future resources can be invested in enhancements rather than replacements.
Early Collaboration is Key
Accessibility and usability must be designed right into IoMT solutions from the outset, and the best way of ensuring that is for developers and healthcare stakeholders to have plenty of interaction long before the product enters the market. Stakeholders are many and healthcare systems are complex, so innovators can look to startup accelerators and other thought leaders to help navigate the territory. The time and effort spent by innovators and healthcare stakeholders in collaborating is a sound investment in the future, ensuring that technology is designed and then applied in meaningful and equitable ways to address the most pressing issues.
The telehealth genie, powered by IoMT, is indeed out of the bottle and is set to revolutionize healthcare. By ensuring that IoMT technologies are developed and implemented with security, accessibility, and ease of use for all stakeholders as priorities, we can make sure that the full benefits of this new dawn can be enjoyed by all.
Heidi Sveistrup, Ph.D. Bio
As the current CEO of the Bruyère Research Institute and VP, Research and Academic Affairs at Bruyère Continuing Care, Heidi Sveistrup, Ph.D. is focusing on increasing the research and innovation supporting pivotal transitions in care; meaningful, enjoyable and doable ways to support people to live where they choose; and creating opportunities to discover and create new approaches to identify, diagnose, treat and support brain health with individuals with memory loss. Fostering new and supporting existing collaborations among researchers, policymakers, practitioners, civil society and industry continues to be a priority.
Elza Seregelyi Bio
Elza Seregelyi is the Director for the TELUS L-SPARK MedTech Accelerator program, which offers participants pre-commercial access to a secure telehealth platform. L-SPARK is currently working with its first cohort of MedTech companies. Elza has an engineering and entrepreneurship background with extensive experience driving collaborative initiatives.
– FCC announces initial 14 pilot project selected for $100M Connected Care Pilot Program that will support connected care service across the country and focus on low-income and veteran patients.
The Federal Communications
Commission (FCC) today announced an initial set of 14 pilot projects with
over 150 treatment sites in 11 states that have been selected for the Connected
Care Pilot Program. A total of $26.6 million will be awarded to these
applicants for proposed projects to treat nearly half a million patients in
both urban and rural parts of the country.
Connected Care Pilot Program Background
Overall, this Pilot Program will make available up to $100
million over a three-year period for selected pilot projects for qualifying
purchases necessary to provide connected care services, with a particular
emphasis on providing connected care services to low-income and veteran
Program will use Universal Service Fund monies to help defray the costs of
connected care services for eligible health care providers, providing support
for 85% of the cost of eligible services and network equipment, which include:
broadband Internet access services
2. health care
provider broadband data connections
connected care information services
These pilot projects will address a variety of critical
health issues such as high-risk pregnancy, mental health conditions, and opioid
dependency, among others. Here is the list initial list of healthcare providers
that were selected into the Pilot Program:
Banyan Community Health Center, Inc.,
Coral Gables, FL.
Banyan Community Health Center’s pilot project seeks $911,833 to provide
patient-based Internet-connected remote monitoring, video visits or consults,
and other diagnostics and services to low-income and veteran patients who are
suffering from chronic/long-term conditions, high-risk pregnancy, infectious
disease including COVID-19, mental health conditions, and opioid
dependency. Banyan Community Health Center plans to serve an estimated
20,847 patients in Miami, Florida, 85% of which are low-income or veteran
Duke University Health System, Durham,
University Health System’s pilot project seeks $1,464,759 to provide remote
patient monitoring and video visits or consults to a large number of low-income
patients suffering from heart failure, cancer, and infectious diseases.
Duke University Health System’s pilot project plans to serve an estimated
16,000 patients in North Carolina, of which 25% are low-income.
Geisinger, consortium with sites in
Lewiston, PA; Danville, PA; Jersey Shore, PA; Bloomsburg, PA; Coal Township,
PA; and Wilkes-Barre, PA.
Geisinger’s pilot project seeks $1,739,100 in support to provide connected care
services and remote patient monitoring to low-income patients in rural
communities in Pennsylvania. Geisinger’s pilot project would serve an
estimated 1,000 patients and would focus on chronic disease management and
high-risk pregnancies, while also treating infectious disease and behavioral
health conditions. Through its pilot program, Geisinger plans to directly
connect all participating patients, 100% of whom are low-income, with broadband
Internet access service.
Grady Health System, Atlanta, GA. Grady Health System’s pilot
project seeks $635,596 to provide Internet connectivity to an estimated 1,896
primarily low-income and high-risk patients who are unable to utilize video
telemedicine services due to lack of a reliable network connection in
Atlanta. The program will focus on using connected care services such as
patient remote monitoring and video visits/consults to treat vulnerable
patients with conditions such as congestive heart failure, COVID19,
hypertension, diabetes, heart disease, and HIV.
Intermountain Centers for Human
Development, consortium with sites in Casa Grande, AZ; Nogales, AZ; Coolidge,
AZ; and Eloy, AZ. Intermountain
Centers for Human Development’s pilot project seeks $237,150 in support to
treat mental health conditions, opioid dependency, and other substance abuse
disorders. The pilot project plans to serve 3,400 patients in Arizona,
including rural areas, of which 90% are low-income.
MA FQHC Telehealth Consortium,
consortium with 76 sites in Massachusetts. MA FQHC Telehealth Consortium’s pilot project
seeks $3,121,879 in support to provide mental health and substance abuse
disorder treatment through remote patient monitoring, video visits, and other
remote treatment to patients in Massachusetts, including significant numbers of
veterans and low-income patients. The pilot project will expand access to
these services by leveraging program funding to increase bandwidth at its
sites, and to provide patients with mobile hotspots. This project would
serve 75,000 patients through 76 federally qualified health centers in
Massachusetts, including rural areas, with an intended patient population of
61.5% low-income or veteran patients.
Mountain Valley Health Center,
consortium with 7 sites in Northeastern California. Mountain Valley Health Center’s
pilot project seeks $550,800 in support to provide telehealth capabilities and
in-home monitoring of patients with hypertension and diabetes. Mountain
Valley’s pilot project plans to serve an estimated 200 patients in rural
Northeastern California, of which at least 24% will be low-income patients and
10% will be veteran patients.
Neighborhood Healthcare – Escondido,
Escondido, CA, Neighborhood Healthcare – Valley Parkway, Escondido, CA,
Neighborhood Healthcare – El Cajon, El Cajon, CA, Neighborhood Healthcare –
Temecula, Temecula, CA, Neighborhood Healthcare – Pauma Valley, Pauma Valley,
Healthcare’s pilot project seeks $129,744 to provide patient broadband access
to primarily low-income patients suffering from chronic and long-term
conditions (e.g., diabetes and high blood pressure). Neighborhood
Healthcare’s collective project plans to serve an estimated 339 patients, 97%
of which are low-income patients, in five sites serving Riverside and San Diego
OCHIN, Inc., consortium with 15 sites in
Ohio, 16 sites in Oregon, and 13 sites in Washington. OCHIN’s pilot project seeks
$5,834,620 in support to lead a consortium of 44 providers in Ohio, Oregon, and
Washington, encompassing 8 federally qualified health centers (FQHCs) serving
rural, urban, and tribal communities. OCHIN’s pilot project will provide
patient broadband Internet access service and wireless connections directly to
an estimated 3,450 low-income patients to access connected care services,
including video visits, patient-based Internet-connected patient monitoring,
and remote treatment and will deliver care to treat high-risk pregnancy,
maternal health conditions, mental health conditions, and chronic and long-term
conditions such as diabetes, hypertension, and heart disease.
Phoebe Worth Medical Center – Camilla
Clinic, Camilla, GA; Phoebe Physicians Group Inc – PPC of Buena Vista, Buena
Vista, GA; Phoebe Physicians Group – Ellaville Primary Medicine Center,
Ellaville, GA; Phoebe Physicians dba Phoebe Family Medicine & Sports
Medicine, Americus, GA; Phoebe Putney Memorial Hospital, Albany, GA; Phoebe
Putney Memorial Hospital dba Phoebe Family Medicine – Sylvester, Sylvester, GA. The Phoebe Putney Health System
projects seek $673,200 to provide patient-based Internet-connected remote
monitoring, video visits, and remote treatment for low-income patients
suffering from chronic conditions or mental health conditions. These projects
plan to serve an estimated 4,007 patients, approximately 1,000 of which will be
low-income patients in six sites serving southwest Georgia.
Summit Pacific Medical Center, Elma, WA. Summit Pacific Medical Center’s
pilot program seeks $169,977 in support to provide patient-based
Internet-connected remote monitoring, other monitoring services, video visits,
diagnostic imaging, remote treatment and other services for veterans and
low-income patients suffering from chronic conditions, infectious diseases,
mental health conditions, and opioid dependency. Summit Pacific Medical
Center’s pilot project would serve an estimated 25 patients in Elma,
Washington, 100% of which would be low-income or veteran patients.
Temple University Hospital,
Temple University Hospital’s pilot project seeks $4,254,250 to provide
patient-based Internet connected remote monitoring and video visits to
patients, including low-income patients, suffering from chronic/long-term
conditions and mental health conditions. This pilot project plans to
serve an estimated 100,000 patients in Philadelphia, Pennsylvania, 45% of which
are low-income patients.
University of Mississippi Medical
Center, Jackson, MS.
The University of Mississippi Medical Center’s (UMMC) pilot project seeks
$2,377,875 in support to provide broadband Internet access service to patients,
enabling remote patient monitoring technologies and ambulatory telehealth
visits to low-income patients suffering from chronic conditions or illnesses
requiring long-term care. UMMC’s pilot project would impact an estimated
237,120 patients across Mississippi and serve up to 6,000 patients
directly. Of these patients, UMMC estimates that 52% would be low-income.
University of Virginia Health System,
Charlottesville, VA. The
University of Virginia (UVA) Health System’s pilot project seeks $4,462,500 in
support to expand the deployment of remote patient monitoring and telehealth
services to an estimated 17,000 patients across Virginia, nearly 30% of whom
will be low-income. The UVA Health System pilot project will support
patient broadband and information services, including systems to capture,
transmit, and store patient data to allow remote patient monitoring, two-way
video, and patient scheduling.
– MEDITECH launches a web-based Quick Vaccination solution enabling healthcare organizations to efficiently administer the vaccine to their patients from multiple care venues, including through tablet devices.
– With Quick Vaccination, healthcare organizations have
the speed and mobility to distribute the vaccine at high-volume locations,
including pop-up inoculation sites.
healthcare organizations’ administration of the COVID-19
vaccine, MEDITECH is extending its
capabilities to include a complimentary, short-form Quick Vaccination solution.
This web-based solution streamlines vaccine administration, enabling healthcare
organizations to efficiently administer the vaccine to their patients from
multiple care venues, including through tablet devices.
Quick Vaccination Overview
Vaccination, healthcare organizations have the speed and mobility to distribute
the vaccine at high-volume locations, including pop-up inoculation sites. And,
since the solution leverages integration within the MEDITECH Immunization
Interface, it automatically transmits vital vaccine data to state immunization
Quick Vaccination is a stand-alone solution that can also be
added to any menu within the EHR. The solution allows for automatic defaults of
key vaccine and administration data using flexible parameters. This
significantly shortens the amount of time it takes to document vaccine
administration, so sites can vaccinate more patients in less time.
How It Works
Per CDC guidelines, Quick Vaccination automatically generates a
certificate of COVID-19 vaccination, which is also accessible from the
patient’s portal. The certificate includes administration details such as the
vaccine’s manufacturer, the date the patient received the vaccine, and the care
setting in which it was administered.
Patients will bring the certificate with them to their
appointment for the second dose to ensure the proper next dose is given. The
next certificate will show validation of receipt of both doses within the
appropriate time frame.
MEDITECH provides guidance and scenarios for vaccine administration
across all integrated care areas, and the EHR has the flexibility for sites to
easily add new vaccine codes. Additionally, MEDITECH’s Scheduling solution
enables customers to schedule vaccine administrations as part of an appointment
set, which means the first and second doses can be scheduled at the same time
with the appropriate eligibility interval between doses. Appointments are
integrated with the patient portal, so the patient is reminded of the second
Furthermore, patient registries can identify eligible patients
and vaccine distribution by phase ― such as residents of long-term-care
facilities or those with specific preexisting conditions. Eligible employees
can also be identified and registered as patients. In addition, registries keep
track of patients who have not received a full course of the vaccine, and may
also be used to alert staff of high-risk patients who may require follow-up
“Time is essential in fighting COVID-19, and we recognize that immunizing as many people as possible is imperative,” said MEDITECH Vice President of Client Services Leah Farina. “We developed the Quick Vaccination solution to streamline the process and enable care providers to efficiently administer the COVID-19 vaccine to their patients while meeting CDC guidelines.”
As healthcare spending continues to rise, so too does the inherent risk for bad actors to take advantage. Today, the United States is estimated to spend nearly 18 percent of its GDP, or $3.6 trillion, on healthcare, and is expected to increase to one-fifth of GDP within the next decade, according to the latest data. This alone provides ample motivation for fraud and abuse. While the full extent of healthcare fraud is difficult to measure,
The National Health Care Anti-Fraud Association (NHCAA) conservatively estimates that 3 percent – $68 billion – of all healthcare spending is lost to fraud each year. Others, such as the Federal Bureau of Investigation (FBI), estimate fraud accounts for up to 10 percent of healthcare expenditures.
Unfortunately, the COVID-19 pandemic has only accelerated the motivation for fraud and abuse amid the increased fear, confusion, and a relaxed regulatory environment. From fake cures to malware and illegitimate charities, fraudsters are taking advantage. Telehealth, which has experienced exponential growth aided by regulatory accommodations to facilitate its widespread adoption, is an area of particular concern. In turn, states and healthcare organizations must optimize their program integrity operations and telehealth strategy to stay protected amid healthcare’s new normal.
Greater Access Brings Greater Risk
The pandemic-driven expansion of telehealth has been profound in terms of enabling care access and continuity while reducing the risk of infection. When the Centers for Medicare and Medicaid Services (CMS) temporarily expanded telehealth coverage at the start of the pandemic, adoption soared to unprecedented levels.
According to a McKinsey report, providers have seen 50 to 175 times more patients through telehealth appointments compared to any year prior. At the same time, once-strict regulations governing telehealth services have been relaxed during the COVID-19 emergency, and the federal government has proposed to make permanent many of the regulatory changes initially meant to temporarily increase access to telehealth.
In parallel and perhaps unsurprisingly, there is a growing sentiment that telehealth is here to stay. According to a recent CynergisTek survey, 70 percent of consumers plan to continue using telehealth post-pandemic. From a provider perspective, new research from Bain & Company found that more than 80 percent of providers will continue to use telehealth as much or more than they do now.
All this considered, we must acknowledge the inherent risks of this technology. Telehealth has a poor track record for fraud, waste and abuse, with some of the largest healthcare fraud schemes involving telehealth providers. This September, for example, the Department of Justice announced the largest case of healthcare fraud in history, involving more than 300 individuals who submitted over $6 billion in fraudulent claims, with telehealth accounting for $4.5 billion of those claims.
With providers struggling to meet fluctuating demand amid unprecedented revenue shortfalls, improper billing practices — both intentional and inadvertent — are, to some degree, inevitable. Factor in hundreds of new telehealth codes and coding considerations as well as the overall stress on the healthcare system, and it is clear we must examine existing risk mitigation measures through a new, post-pandemic lens.
Strategies for Mitigating Telehealth Fraud & Abuse
For healthcare organizations and, specifically, special investigation units (SIUs) tasked with combatting fraud and abuse, the shift to telehealth adds an additional layer of complexity. Fortunately, there are strategies healthcare organizations can implement to successfully navigate the evolving landscape while strengthening the integrity of their operations for healthcare’s new normal.
Data visualization is a key component of an effective fraud investigation. Charts and graphs provide a clear representation of trends and outliers, including connections that could indicate a kickback or collusion scheme. Critical to the success of these tools, however, is the quality of the data that underlies them. Collecting sample data based on the appropriate modifiers and conducting thorough background research provides an accurate portrayal of events from which SIUs can clearly identify and pursue potential fraud schemes.
Integrating qualitative research into telehealth strategies is a great way to capture fraud at the source. When appropriate, conducting interviews with patients can validate whether services were in fact rendered as billed. For instance, a provider may bill for audio-only services as if they were delivered in an audio-visual capacity, resulting in an unjustifiably higher reimbursement rate. Similarly, using data visualization techniques to identify suspect trends, such as blanket billing or an implausibly high volume of services during a known low-demand period, can inform pointed questions for patients.
As we traverse this unprecedented territory, being on high alert for potential indicators of fraud and abuse is critical to protecting healthcare organizations and consumers. If something doesn’t make sense, whether clinically or in the context of the larger healthcare landscape, it is worth investigating. Understanding the limitations of telehealth and other key considerations surrounding its use will help to ensure we are maximizing the benefits of these services while mitigating their inherent risks.
Healthcare providers and patients alike have embraced telehealth during the COVID-19 crisis and, in doing so, confirmed what advocates have been saying for years — that telehealth promotes greater access to care. While ultimately good news for stakeholders across the healthcare spectrum, the environment we find ourselves in today has also created new avenues for fraudsters to take advantage. As telehealth becomes an inseparable part of the healthcare ecosystem, we are quickly learning how to identify telehealth fraud schemes, and, more importantly, strategies to mitigate the risks they post to integrity and security in the space.
About Gary Call, M.D.
Gary Call, M.D., is senior vice president and Chief Medical Officer at HMS, where he leads the company’s clinical program development and execution. Dr. Call has more than 25 years of experience in the practice of medicine and managed care. Dr. Call graduated from the University of Washington School of Medicine and completed his residency training at the University of Utah. He is a board-certified family physician.
– NeuroFlow raises $20M to expand its technology-enabled behavioral
health integration platform, led by Magellan Health.
– NeuroFlow’s suite of HIPAA-compliant, cloud-based tools
simplify remote patient monitoring, enable risk stratification, and facilitate
collaborative care. With NeuroFlow, health care organizations can finally
bridge the gap between mental and physical health in order to improve outcomes
and reduce the cost of care.
NeuroFlow, a Philadelphia-based digital health startup supporting technology-enabled behavioral health integration (tBHI), announces today the initial closing of a $20M Series B financing round led by Magellan Health, in addition to a syndicate including previous investors. Magellan is a leader in managing the fastest growing, most complex areas of health, including behavioral health, complete pharmacy benefits and other specialty areas of healthcare.
NeuroFlow for Digital Behavioral Health Integration
NeuroFlow works with leading health plans, provider systems,
as well as the U.S. military and government to enhance virtual health programs
by delivering a comprehensive approach to whole-person care through digital
behavioral health integration – an evidence-based model to identify and treat
consumers with depression, anxiety and other behavioral health conditions
across all care settings.
Key features of the behavioral health platform include:
– Interoperability: Seamless EHR and system integrations minimize administrative burden and optimize current IT investments.
– Measurement-based Care & Clinical Decision Support: NeuroFlow enables MBC at scale, keeps the patient in the center of care, and continuously monitors for a consistent connection to critical data and clinical decision support.
– Performance Management & Reporting: Recognize
the impact of your BHI program, monitoring the impact of clinical interventions
on quality and cost of care while recognizing outliers requiring program
– Consumer Engagement & Self-Care: personalized
experience that encourages, rewards and recognizes continuous engagement and
Maximize Efficiency, Revenue and Reimbursements
By integrating behavioral health into the primary care setting, increasing screening and self-care plans – NeuroFlow’s BHI solution can reduce ED utilization by 23% and inpatient visits by 10%. 80% of NeuroFlow users self-reported a reduction in depression or anxiety symptoms and 62% of users with severe depression score improve to moderate or better.
Telehealth Adoption Underscores Need for Behavioral
With record growth in telehealth adoption and historic spikes in depression and anxiety due to the ongoing pandemic, workflow augmentation solutions and the delivery of effective behavioral health care have been identified as top priorities in the industry. NeuroFlow’s technology increases access to personalized, collaborative care while empowering primary care providers, care managers, and other specialists to most effectively support patient populations by accounting for and addressing behavioral health.
“Behavioral health is not independent of our overall health — it affects our physical health and vice versa, yet most underlying behavioral health conditions go unidentified or are ineffectively treated. Most healthcare providers are overburdened, so introducing the concept to account for a person’s mental health in addition to their primary specialty can be overwhelming and lead to inconsistent and inadequate treatment,” said NeuroFlow CEO Chris Molaro. “Technology, when used strategically, can enhance and augment providers, making the concept of holistic and value-based care feasible at scale and easy to implement.”
Strategic Partnership with Magellan
Magellan Health’s network of more than 118,000 credentialed
providers and health professionals are now poised to join NeuroFlow customers
across the country by leveraging the best-in-class integrated data and
analytics platform to meet the rising demand for enhanced mental health
services and support. By partnering with and investing in NeuroFlow, Magellan
has the opportunity to drive further adoption of NeuroFlow’s behavioral health
integration tools and drive collaborative care initiatives with its customers
as well as its vast network of credentialed providers and health professionals
across the country.
NeuroFlow will use the Series B proceeds to scale its
operations and support its growth in data analytics, artificial intelligence,
and direct health record integrations. NeuroFlow’s contracted user base has
grown 10x to over 330,000 in support of almost 200 commercial health systems,
payers, accountable care organizations, independent medical groups, and federal
agencies to provide technology-enabled care solutions.
A century ago, X-rays transformed medicine forever. For the first time, doctors could see inside the human body, without invasive surgeries. The technology was so revolutionary that in the last 100 years, radiology departments have become a staple of modern hospitals, routinely used across medical disciplines.
Today, new technology is once again radically reshaping medicine: artificial intelligence (AI). Like the X-ray before it, AI gives clinicians the ability to see the unseen and has transformative applications across medical disciplines. As its impact grows clear, it’s time for health systems to establish departments dedicated to clinical AI, much as they did for radiology 100 years ago.
Radiology, in fact, was one of the earliest use cases for AI in medicine today. Machine learning algorithms trained on medical images can learn to detect tumors and other malignancies that are, in many cases, too subtle for even a trained radiologist to perceive. That’s not to suggest that AI will replace radiologists, but rather that it can be a powerful tool for aiding them in the detection of potential illness — much like an X-ray or a CT scan.
AI’s potential is not limited to radiology, however. Depending on the data it is trained on, AI can predict a wide range of medical outcomes, from sepsis and heart failure to depression and opioid abuse. As more of patients’ medical data is stored in the EHR, and as these EHR systems become more interconnected across health systems, AI will only become more sensitive and accurate at predicting a patient’s risk of deteriorating.
However, AI is even more powerful as a predictive tool when it looks beyond the clinical data in the EHR. In fact, research suggests that clinical care factors contribute to only 16% of health outcomes. The other 84% are determined by socioeconomic factors, health behaviors, and the physical environment. To account for these external factors, clinical AI needs external data.
Fortunately, data on social determinants of health (SDOH) is widely available. Government agencies including the Census Bureau, EPA, HUD, DOT and USDA keep detailed data on relevant risk factors at the level of individual US Census tracts. For example, this data can show which patients may have difficulty accessing transportation to their appointments, which patients live in a food desert, or which patients are exposed to high levels of air pollution.
These external risk factors can be connected to individual patients using only their address. With a more comprehensive picture of patient risk, Clinical AI can make more accurate predictions of patient outcomes. In fact, a recent study found that a machine learning model could accurately predict inpatient and emergency department utilization using only SDOH data.
Doctors rarely have insight on these external forces. More often than not, physicians are with patients for under 15 minutes at a time, and patients may not realize their external circumstances are relevant to their health. But, like medical imaging, AI has the power to make the invisible visible for doctors, surfacing external risk factors they would otherwise miss.
But AI can do more than predict risk. With a complete view of patient risk factors, prescriptive AI tools can recommend interventions that address these risk factors, tapping the latest clinical research. This sets AI apart from traditional predictive analytics, which leaves clinicians with the burden of determining how to reduce a patient’s risk. Ultimately, the doctor is still responsible for setting the care plan, but AI can suggest actions they may not otherwise have considered.
By reducing the cognitive load on clinicians, AI can address another major problem in healthcare: burnout. Among professions, physicians have one of the highest suicide rates, and by 2025, the U.S. The Department of Health and Human Services predicts that there will be a shortage of nearly 90,000 physicians across the nation, driven by burnout. The problem is real, and the pandemic has only worsened its impact.
Implementing clinical AI can play an essential role in reducing burnout within hospitals. Studies show burnout is largely attributed to bureaucratic tasks and EHRs combined, and that physicians spend twice as much time on EHRs and desk work than with patients. Clinical AI can ease the burden of these administrative tasks so physicians can spend more time face-to-face with their patients.
For all its promise, it’s important to recognize that AI is as complex a tool as any radiological instrument. Healthcare organizations can’t just install the software and expect results. There are several implementation considerations that, if poorly executed, can doom AI’s success. This is where clinical AI departments can and should play a role.
The first area where clinical AI departments should focus on is the data. AI is only as good as the data that goes into it. Ultimately, the data used to train machine learning models should be relevant and representative of the patient population it serves. Failing to do so can limit AI’s accuracy and usefulness, or worse, introduce bias. Any bias in the training data, including pre-existing disparities in health outcomes, will be reflected in the output of the AI.
Every hospital’s use of clinical AI will be different, and hospitals will need to deeply consider their patient population and make sure that they have the resources to tailor vendor solutions accordingly. Without the right resources and organizational strategies, clinical AI adoption will come with the same frustration and disillusionment that has come to be associated with EHRs.
Misconceptions about AI are a common hurdle that can foster resistance and misuse. No matter what science fiction tells us, AI will never replace a clinician’s judgment. Rather, AI should be seen as a clinical decision support tool, much like radiology or laboratory tests. For a successful AI implementation, it’s important to have internal champions who can build trust and train staff on proper use. Clinical AI departments can play an outsized role in leading this cultural shift.
Finally, coordination is the bedrock of quality care, and AI is no exception. Clinical AI departments can foster collaboration across departments to action AI insights and treat the whole patient. Doing so can promote a shift from reactive to preventive care, mobilizing ambulatory, and community health resources to prevent avoidable hospitalizations.
With the promise of new vaccines, the end of the pandemic is in sight. Hospitals will soon face a historic opportunity to reshape their practices to recover from the pandemic’s financial devastation and deliver better care in the future. Clinical AI will be a powerful tool through this transition, helping hospitals to get ahead of avoidable utilization, streamline workflows, and improve the quality of care.
A century ago, few would have guessed that X-rays would be the basis for an essential department within hospitals. Today, AI is leading a new revolution in medicine, and hospitals would be remiss to be left behind.
About John Frownfelter, MD, FACP
John is an internist and physician executive in Health Information Technology and is currently leading Jvion’s clinical strategy as their Chief Medical Information Officer. With 20 years’ leadership experience he has a broad range of expertise in systems management, care transformation and health information systems. Dr. Frownfelter has held a number of medical and medical informatics leadership positions over nearly two decades, highlighted by his role as Chief Medical Information Officer for Inpatient services at Henry Ford Health System and Chief Medical Information Officer for UnityPoint Health where he led clinical IT strategy and launched the analytics programs.
Since 2015, Dr. Frownfelter has been bringing his expertise to healthcare through health IT advising to both industry and health systems. His work with Jvion has enhanced their clinical offering and their implementation effectiveness. Dr. Frownfelter has also held professorships at St. George’s University and Wayne State schools of medicine, and the University of Detroit Mercy Physician Assistant School. Dr. Frownfelter received his MD from Wayne State University School of Medicine.
Since the onset of the COVID-19 pandemic, hospitals and health systems have pushed forward with innovative technology solutions with great expediency and proficiency. Healthcare organizations were quick to launch telehealth solutions and advance digital health to maintain critical patient relationships and ensure continuity of care. Behind the scenes, hospitals and health systems have been equally adept at advancing technology solutions to support and enhance clinical care delivery. This includes adopting clinical surveillance systems to better predict and prevent an escalation of the coronavirus.
Clinical surveillance systems use real-time and historical patient data to identify emerging clinical patterns, allowing clinicians to intervene in a timely, effective manner. Over time, these clinical surveillance systems have evolved to help healthcare organizations meet their data analytic, surveillance, and regulatory compliance needs. The adaptability of these systems is evidenced by their expanded use during the pandemic. Healthcare organizations quickly pivoted to incorporate COVID-19 updates into their clinical surveillance activities, providing a centralized, global view of COVID-19 cases.
To gain insight into the COVID-19 crisis, critical data points include patient age, where the disease was likely contracted, whether the patient was tested, and how long the patient was in the ICU, among other things. Surveillance is also able to factor in whether patients have pre-existing conditions or problems with blood clotting, for example. This data trail is helping providers create a constantly evolving coronavirus profile and provides key data points for healthcare providers to share with state and local governments and public health agencies. In the clinical setting, the data are being used to better predict respiratory and organ failure associated with the virus, as well as flag COVID-19 patients at risk for developing sepsis.
What’s driving these advancements? Clinical surveillance systems powered by artificial intelligence (AI). By refining the use of AI for clinical surveillance, we can proactively identify an expanding range of acute and chronic health conditions with greater speed and accuracy. This has tremendous implications in the clinical setting beyond the current pandemic. AI-powered clinical surveillance can save lives and reduce costs for conditions that have previously proven resistant to prevention.
Eliminating healthcare-associated infections
Despite ongoing prevention efforts, healthcare-associated infections (HAIs) continue to plague the US healthcare system, costing up to $45 billion a year.According to the Centers for Disease Control and Prevention (CDC), about one in 31 hospitalized patients will have at least one HAI on any given day. AI can analyze millions of data points to predict patients at-risk for HAIs, enabling clinicians to respond more quickly to treat patients before their infection progresses, as well as prevent spread among hospitalized patients.
Building trust in AI
While the benefits are clear, challenges remain to the widespread adoption and use of AI in the clinical setting. Key among them is a lack of trust among clinicians and patients around the efficacy of AI. Many clinicians remain concerned over the validity of the data, as well as uncertainty over the impact of the use of AI on their workflow. Patients, in turn, express concerns over AI’s ability to address their unique needs, while also maintaining patient privacy. Hospitals and health systems must build trust among clinicians and patients around the use of AI by demonstrating its ability to enhance outcomes, as well as the patient experience.
3 keys to building trust in AI
Building trust among clinicians and patients can be achieved through transparency, expanding data access, and fostering focused collaboration.
1. Support transparency
Transparency is essential to the successful adoption of AI in the clinical setting. In healthcare, just giving clinicians a black box that spits out answers isn’t helpful. Clinicians need “explainability,” a visual picture of how and why the AI-enabled tool reached its prediction, as well as evidence that the AI solution is effective. AI surveillance solutions are intended to support clinical decision making, not serve as a replacement.
2. Expand data access
Volume and variety of data are central to AI’s predictive power. The ability to optimize emerging tools depends on comprehensive data access throughout the healthcare ecosystem, no small task as large amounts of essential data remain siloed, unstructured, and proprietary.
3. Foster focused collaboration
Clinicians and data scientists must collaborate in developing AI tools. In isolation, data scientists don’t have the context for interpreting variables they should be considering or excluding in a solution. Conversely, doctors working alone may bias AI by telling it what patterns to look for. The whole point of AI is how great it is at finding patterns we may not even consider. While subject matter expertise should not bias algorithms,
it is critical in structuring the inputs, evaluating the outputs, and effectively incorporating those outputs in clinical workflows. More open collaboration will enable clinicians to make better diagnostic and treatment decisions by leveraging AI’s ability to comb through millions of data points, find patterns, and surface critically relevant information.
AI-enabled clinical surveillance has the potential to deliver next-generation decision-support tools that combine the powerful technology, the prevention focus of public health, and the diagnosis and treatment expertise of clinicians. Surveillance is poised to assume a major role in attaining the quality and cost outcomes our industry has long sought.
John Langton is director of applied data science at Wolters Kluwer, Health, where artificial intelligence is being used to fundamentally change approaches to healthcare. @wkhealth
– 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
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
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
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
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
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.”
– Healthify and CareSource are teaming up to
build a statewide network of community-based organizations in Ohio.
– This new network will provide social services
to CareSource’s members throughout the state of Ohio with referrals
to address Social Determinants of Health (SDoH).
CareSource, a nonprofit multi-state managed care plan has partnered with Healthify to build a statewide network of community-based organizations in Ohio. The new network will provide social services to CareSource’s members throughout the state with referrals to address Social Determinants of Health (SDoH). This new collaboration will expand upon the existing CareSource Life Services program and Healthify OH social services network.
The network will be made up of community organizations that
provide a range of services that address SDOH such as food insecurity,
lack of transportation, unemployment, inadequate housing, and financial
instability. CareSource will also use Healthify’s population
analysis modeling to identify social risk across OH and target
hard-to-reach members to ensure they are connected to critical services.
Identifying Social Risk Across OH to Target Hard-to-Reach
In addition to the statewide network, CareSource will use
Healthify’s population analysis modeling to identify social risk across OH and
target hard-to-reach members to ensure they are connected to critical services.
By layering this on top of clinical and cost data, CareSource can meaningfully
improve member engagement among membership while tracking their long-term
outcomes. Please visit the following link to learn more and join the statewide
network to better coordinate care between healthcare and social services.
Why It Matters
“Healthify is committed to helping vulnerable populations get the social services they need to live their best lives,” said Manik Bhat, cofounder and CEO of Healthify. “I grew up in Ohio and it’s great to partner with like-minded organizations like CareSource that are dedicated to helping members with unmet social needs using strong local partnerships. We are excited that the partnerships established across the state will provide the infrastructure to also support COVID-19 recovery efforts.
HIT Consultant sat down with Mike McSherry, CEO, and co-founder of Seattle-based digital prescription platform Xealth to discuss digital health lessons learned in 2020 and what we can expect in 2021. As Xealth’s CEO, Mike also works with Duke Health, UPMC, Atrium Health, and The Froedtert & the Medical College of Wisconsin health network where he uses his background in digital health to connect patients and care teams outside of traditional care settings.
HITC: In 2021, How can digital health reduce race and minority disparities in healthcare?
McSherry: The U.S. has struggled with health disparities, which this pandemic has widened. Many of these disparities can be linked to access, which digital health can assist with – telehealth makes care virtual from any location, clinical decision support can reduce human errors, remote patient monitoring helps keep patients home while linked to care.
Digital health removes hurdles related to transportation, taking time off work, or finding childcare in order to travel in-person for an appointment. It brings care to the patient instead of the other way around, making access simpler. Care through these pathways is also more cost-efficient.
There are still hurdles to overcome. Broadband is widespread but not everywhere and inclusive design of these tools should be considered. How digital tools, including wearables, are built should address differences in gender and ethnicity, especially as these tools are used more frequently in clinical trials, so as not to inadvertently perpetuate disparities.
HITC: Why some hospitals are offering digital health tools to staff but not patients?
McSherry: There are a few factors at play when hospitals offer digital health tools to staff but not patients. One, most health systems are not currently deploying system-wide digital health initiatives, leaving the decisions to individual departments or providers. This can lead to inconsistent patient experiences and more data siloes as solutions are brought in as one-offs.
The second issue is reimbursement. A hospital acting as an employer offering digital health tools as part of its benefits package is different than a patient, who must rely on their health insurance, whether it is a public or private plan. The fact healthcare organizations see digital health tools as a perk shows their value. Now, it is time for CMS and commercial payers to consistently enable their use to help providers care for patients and incorporate digital health as clinicians see fit.
HITC: How hospitals can remain competitive in 2021, especially after tighter margins from COVID-19?
McSherry: Large tech companies, like Google and Amazon, and huge retailers, including Walmart and Best Buy, are looking to deliver the promise of health care that has so far eluded the industry. Venture capital money has been pouring in for funding innovation, with digital health funding hitting a new high in 2020.
These initiatives are all racing to control health care’s front door and if hospitals don’t innovate as well, they run a very real risk of having patients turn elsewhere for care. Payers are also building digital front doors and telling members to go there. People have long expressed their desire to have the same consumer experience in health care that they receive in other industries. The technology is there. It needs to be incorporated with the correct care pathways.
One silver lining during the COVID-19 pandemic is that it showed fast-moving innovation can happen in health care. We worked with hospitals to stand up workflows around telehealth in four days and remote patient monitoring in seven days – an amazing pace. The key is to keep this stride going once we are on the other side of this crisis.
Providers are becoming more digitally savvy to engage patients and deliver holistic care. Hospitals should support this.
HITC: What will be Biden’s impact on COVID-19, how hospital leaders should respond, and what it means that we have a divided congress?
McSherry: Under the current administration, telehealth rules have been relaxed, at least temporarily, along with cross-state licensure so providers are better able to build a front door strategy, helping organizations roll out remote patient monitoring and chronic care management apps. Biden has been a proponent of digitalization in health care and will have a broader engagement. This could lead toward more funding and more covered lives.
A divided Congress will not make much easy for the Biden administration, however, getting on the other side of this pandemic as quickly and as safely as possible is best for everyone. Biden has shown he will make fighting COVID-19 a top priority.
HITC: Will remote patient monitoring become financially viable for hospital leaders in 2021?
McSherry: Why does a diabetic patient need to have every check-in be in-person or a healthy, pregnancy met every few weeks with an in-person visit as opposed to remote monitoring for key values and a telehealth check-in in place of a couple of those visits? Moving forward, hospitals will see the benefit of remote monitoring in terms of lower overhead, along with better patient engagement, outcomes and retention.
To make this work, providers must share risk, and determine digital strategies around attracting patients and then manage them in a capitated way with more digital tools because of the cost efficiencies.
HITC: How do we foster tighter physician-patient relationships?
McSherry: Patients trust their doctors, period. The struggle is going to be more obvious as more people do not have a PCP and turn to health care with a bandage approach to take care of an immediate concern. That will lead to entire populations without that trusted bond who are sicker when they finally do seek care, due to the lack of continuity and engagement early on.
By connecting with people now, where they are comfortable, there is a tighter physician-patient relationship by making it more accessible and reciprocal.
But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a category of information used differently than traditional clinical knowledge, but the volume of data generated through molecular testing alone also requires informatics and management of a higher magnitude than previously required.
The EMR is designed to reflect a snapshot (or collection of snapshots) in time: clinical summaries, annotated lab and test results, operation notes, etc. These are mostly stored as isolated documents, loosely coupled with the rest of the patient chart. They need to remain available for reference over time, in some instances, so providers can chart and contextualize ongoing trends and chronic conditions. However, these views are anchored in time and represent limited actionable value during clinical decision-making months, years, and decades later.
Genomic information, on the other hand, represents a patient’s life signature. DNA rarely changes over the course of an individual’s lifetime. This means the results from germline testing – a patient’s molecular profile – conducted early in life are relevant, meaningful, and actionable during clinical decision making far into the future. They can also deliver insights exposing heritable proclivities that may be life-changing or life-saving for family members as well.
This recognition in and of itself alerts healthcare leaders that they need to adopt an advanced, more sophisticated strategy for data governance, management, and sharing than the approach traditionally applied to other clinical information systems, such as EMRs.
To be successful, healthcare organizations need an accelerator external to the EMR that is built on a data model unique to the management of molecular knowledge so test results and genomic insights can be used and shared across clinical specialties and care settings, as well as overtime. In addition, the rise of precision medicine requires an agile informatics platform that enables the cross-pollination of genomic data with clinical insights and ever-advancing discoveries in genomic science.
Consider these examples of how EMRs fall short of expectations for optimal use of genomic intelligence:
1. Studies have found that, despite ubiquitous availability of molecular tests, providers consistently fail to identify patients most at risk for heritable diseases. The Journal of the American Medical Informatics Association (JAMIA) recently released research showing that half the women meeting national guidelines for genetic screening are not getting the tests they need to determine their breast and ovarian cancer risk.
The reason? “The full story of a patient’s risk for heritable cancer within their record often does not exist in a single location,” says the JAMIA article. “It is fragmented across entries created by many authors, over many years, in many locations and formats, and commonly from many different institutions in which women have received care over their lifetimes.” In other words, no matter which EMRs they use, health systems routinely miss opportunities to improve care for patients they see. To achieve greater success, providers need tools that exceed EMR functionality and span multiple clinical systems.
2. Shortly after birth, Alexander develops a seizure disorder. The neonatologist orders a germline test to help her arrive at a precise diagnosis and begin targeted treatment. This approach is successful and Alexander thrives. In addition to genomic variants identifying the cause of his seizure disorder, the test results also contain information about other heritable risk factors, including cardiovascular disease.
Decades later, in the 70s, Alexander sees his primary care provider (PCP) with a rapid heartbeat and shortness of breath. After doing routine lab work, the PCP diagnoses congestive heart failure (CHF). If, however, the PCP had access to Alexander’s genomic test results – which remain as relevant and accurate as when he was an infant – the PCP would have noted a variation that indicated the CHF was due to dilated cardiomyopathy, requiring a different treatment regime.
It is vital that health leaders immediately begin to plan an informatics strategy that accommodates genetic and genomic data while empowering providers to leverage these insights at the point of care as they make routine, yet critical, clinical decisions. As they evaluate their approach, they would do well to ask the following questions:
– Which providers in my organization are already ordering genomic tests on their patients? How are test results being stored and managed – and can they be easily shared with and accessed by others in the health system?
– As the volume of genetic and genomic testing accelerates – and it will – how will we manage the volume of data generated? How will we apply consistent governance to the ordering process? How can we ensure results will be consumed as discrete data so our organization can optimize its value now and in the future?
– What steps do we need to take so our precision medicine strategy remains current with changing science? Which informatics tools deliver access to up-to-date knowledge bases and clinical guidelines to ensure optimal medical decisions are made?
The advent of precision medicine represents a new standard of care for healthcare providers from coast to coast. Genetic and genomic information supplies a new data set that can be used to arrive at more accurate diagnoses sooner and more effective treatment faster. This, in turn, supports better outcomes, higher patient (and provider) satisfaction, and competitive differentiation for the health system adopting precision medicine first in its market.
But to capture this value, healthcare leaders must look beyond their legacy EMRs, recognizing that they were not developed nor do they have the capacity to properly handle the upcoming data revolution. Instead, industry innovators are looking for platforms agnostic to individual EMRs and integrated with molecular labs to address the next-generation demands of precision medicine.
About Assaf Halevy
Assaf Halevy is the founder and CEO of 2bPrecise, LLC, leading an international team dedicated to bridging the final mile between the science of genomics and making that data useful at the point of care. He joined Allscripts as senior vice president of products and business development in 2013 when the company acquired Israel-based dbMotion. An initial inventor and co-founder of dbMotion, Halevy helped develop the leading clinical integration and population health management platforms in the industry today.
With 13 patents pending in the areas of actionable clinical integration, interoperability, and precision medicine, Halevy leverages his industry expertise by evaluating strategic alliances and partnerships for U.S. and international markets. Halevy was invited to participate in several U.S. government activities and contribute to an HHS privacy committee task force. In 2016, he was part of a small selective group of executives invited to the White House by Vice President Joe Biden to discuss the future of interoperability.
– RenalytixAI and DaVita announce a program partnership that
aims to slow kidney disease progression and improve outcomes for the nation’s
estimated 37 million adults with chronic kidney disease (CKD).
– This is the first clinical-grade program that delivers
advanced early-stage prognosis and risk stratification, combined with
actionable care management to the primary care level where the majority of
kidney disease patients are being seen.
– The program will use the KidneyIntelX in vitro
diagnostic platform from RenalytixAI to perform early risk assessment; after
risk stratification, patients identified as intermediate- and high-risk will
receive care management support through DaVita’s integrated kidney care program
a developer of AI-enabled
clinical in vitro diagnostic solutions for kidney disease, and DaVita, the largest provider
of kidney care services in the U.S., today announced a partner program aimed at
slowing disease progression and improving health outcomes for the nation’s
estimated 37 million adults with chronic kidney disease (CKD). The program is
expected to improve patient outcomes and provide meaningful cost reductions for
health care providers and payors by enabling earlier intervention for patients
with early-stage kidney disease (stages 1, 2 and 3) through actionable risk
assessments and end-to-end care management.
The collaboration is expected to launch in three major
markets this year. As the program expands, DaVita and RenalytixAI intend to
pursue risk-sharing arrangements with health care providers and payors to drive
kidney disease patient care innovation, cost efficiencies and improve quality
Early Risk Identification at Core of Innovative Kidney
The program utilizes the KidneyIntelX in vitro diagnostic platform from RenalytixAI, which uses a machine-learning algorithm to assess a combination of biomarkers from a simple blood draw with features from the electronic health record to generate a patient-specific risk score. The initial version of the KidneyIntelX risk score identifies Type 2 diabetic patients with early-stage CKD as low-, intermediate- or high-risk for progressive decline in kidney function or kidney failure. The integrated program may also help reduce kidney disease misclassification, which leaves some higher-risk patients without recommended treatment. The expected outcome of the collaboration will also be used to expand indicated use claims for KidneyIntelX.
After risk stratification, program patients identified as
intermediate- and high-risk will receive care management support through
DaVita’s integrated kidney care program, for which Renalytix will compensate
DaVita in lieu of providing those services itself. DaVita’s integrated kidney
care program is comprised of a coordinated care team, practical digital health
tools, award-winning patient education and other offerings. Focused on the
patient experience, these services are designed to empower patients to be
active in their care, delay disease progression, improve outcomes and lower
costs. DaVita’s team also closely collaborates with the treating nephrologist,
who leads the care team, to create a seamless care experience.
For patients whose kidney disease does progress, earlier
intervention can provide the patient and treating nephrologist more time to
make an informed decision about the treatment option that is best for them,
including pre-emptive transplantation, home dialysis or in-center dialysis. For
those patients who choose to begin dialysis, the extra time increases their
chance for an out-patient dialysis starts, which can help them to avoid
starting dialysis with a costly hospitalization.
“This is the first clinical-grade program that delivers advanced early-stage prognosis and risk stratification, combined with actionable care management right to the primary care level where the majority of kidney disease patients are being seen,” said James McCullough, Renalytix AI Chief Executive Officer. “Making fundamental change in kidney disease health economics and outcomes must begin with providing a clear, actionable understanding of disease progression risk.”
If hackers attack your organization and you’re in an industry such as financial services, engineering, or manufacturing your risks are mostly monetary. But when it comes to healthcare cybersecurity, not only is there significant financial jeopardy, people’s health and wellbeing are also at risk so the stakes are much, much higher.
According to the Department of Health and Human Services, there has been an almost 50 percent increase in healthcare cybersecurity data breaches between February and May 2020 compared to 2019. This is thought to be a result of the COVID-19 pandemic distracting the industry due to the sweeping changes required, putting extra pressure on already inadequate healthcare cybersecurity measures.
Why Are Hackers Attacking Healthcare?
If there’s one thing hackers like, it’s a target that’s “soft” and large, complex organizations in industries that have been slow to adopt and then secure digital technologies are precisely that, soft targets. These organizations usually have broad and mostly poorly defended “attack surfaces,” which provide hackers with many routes to enter and through which they can not only exfiltrate data but also compromise services and hardware.
Healthcare, in general, is one of the most visible and softest targets. Successful hospital cyber-attacks usually cause significant disruption of patient data and routine workflows such as scheduling patient medication, resources management, and other essential services. These hospital cyber-attacks can easily result in what is euphemistically called in healthcare “bad outcomes” … these “bad outcomes” include injury and death.
How Does Healthcare Think About Cyber Risks?
A study by the security consulting firm Independent Security Evaluators concluded:
One overarching finding of our research is that the industry focuses almost exclusively on the protection of patient health records, and rarely addresses threats to or the protection of patient health from a cyber threat perspective … In summary, we find that different adversaries will target or pursue the compromise of patient health records, while others will target or pursue the compromise of patient health itself.
The report argues that protecting patient records has been most of the focus of healthcare cybersecurity planning, and organizations often view threat actors as being “unsophisticated adversaries” such as individual hackers and small hacker collaborations. ISE argues that this framework ignores the potential of far more sophisticated hospital cyber-attacks from political hacktivist groups, organized crime, terrorists, and nation-states who are all highly motivated and well-funded and “As a result, a multitude of attack surfaces are left unprotected, and attack strategies that could result in harm to a patient are not considered.”
The Universal Health Service Hospital Cyber-attacks
In September 2020, Universal Health Services a hospital and health care network with more than 400 facilities across the United States, Puerto Rico, and the United Kingdom, found itself under attack by the Russian “Ryuk” ransomware. This wasn’t the first hospital cyber-attack on UHS. Security firm, Advance Intel’s Andariel intelligence platform, reported that trojan malware-infected Universal Health Services throughout 2020.
UHS has not officially confirmed the details of the attack but reports by UHS employees indicate the attack was the result of a successful phishing expedition. The attack disabled computers and phone systems and forced the hospitals to revert to using paper-based systems to continue operations. Affected network hospitals also had to redirect ambulances and move surgical patients to other unaffected facilities.
As is usually the case with large, complex organizations, cleaning up and restoring the system was neither simple nor quick and a UHS press release on October 12, 2020, announced: “… we have had no indication that any patient or employee data was accessed, copied or misused.” It also stated that operations were mostly back to normal after a total of 16 days. Given that downtime for enterprise security breaches cost upwards of $1,000,000 per day or more this attack will have dealt a serious blow to UHS’ bottom line. Whether UHS paid the ransom is not known.
Cyber Attacks and Murder
When a cyberattack happens to any organization, there are always consequences but when healthcare ransomware is involved there’s a real risk of loss of life. In the case of UHS, there were unconfirmed rumors of four patients dying because doctors had to wait for lab results delivered by couriers instead of by electronic delivery. While those, so far, appear to be just rumors, there is one known case of a patient dying directly due to a hospital ransomware attack.
The University Hospital Düsseldorf (UKD) in Germany suffered a ransomware attack on September 10, 2020. The attackers exploited a vulnerability in the Citrix ADC that had been known since January but the hospital, unfortunately, had not got around to implementing the fix.
As a result of the attack, the hospital immediately announced that “The UKD has deregistered from emergency care. Planned and outpatient treatments will also not take place and will be postponed. Patients are therefore asked not to visit the UKD – even if an appointment has been made” and patients were routed to alternative medical facilities.
The demand note delivered by the hospital ransomware showed that the intended target was not in fact the University Hospital Düsseldorf but rather Heinrich Heine University. The German police contacted the hackers via the instructions in the ransom note dropped by the malware and explained the mistake after which the hackers withdrew their demand and provided the decryption key.
Unfortunately, one patient with a life-threatening illness was diverted to a distant hospital after UKD was deregistered as an emergency care facility. The additional hour’s travel may have been the cause of the patient’s death. On September 18, 2020, German prosecutors launched an official negligent homicide investigation which, if confirmed, would make the patient’s death the first known case of death by hacking.
Protect Critical Systems from Malware
The key to defending your systems from malware and phishing is monitoring and examining all network communications. Now that encryption is becoming the norm for all internet communications, looking “inside” of message streams requires new approaches and technologies so that embedded threats are caught and handled before they can escalate into disasters.
About Babur Nawaz Khan Babur Nawaz Khan is a Technical Marketing Engineer at A10 Networks, a leading provider of secure application services and solutions. He primarily focuses on A10’s Enterprise Security and DDoS Protection solutions and holds a master’s degree in Computer Science from the University of Maryland, Baltimore County.
Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows patients, especially high-risk populations like seniors, to connect with their doctors in a safe and efficient way. Telehealth is valuable for many types of visits, mostly clearly ones that involve mental health or physical health issues that do not require a physical exam or procedure. It’s an efficient modality for both the member and provider.
With the growing popularity of telehealth services, we may see permanent changes in regulatory standards. Flexible regulatory standards, such as being able to use platforms like FaceTime or Skype, would lower the barrier to entry for providers to offer telehealth and also encourage adoption, especially among seniors. Second, it’s likely we’ll see an emergence of providers with aligned incentives around value, such as in many Medicare Advantage plans, trying very hard to encourage utilization with their members so that they get the right care at the right time. In theory, the shift towards value-based care will allow better care and lower costs than the traditional fee for service model. If we are able to evolve regulatory and payment environments, providers have an opportunity to grow these types of services into 2021 to improve patient wellness and health outcomes.
Dr. Salvatore Viscomi, Chief Medical Officer, GoodCell
2021 will be the year of patient controlled-health
The COVID-19 pandemic brought the realities of a global-scale health event – and our general lack of preparedness to address it – to the forefront. People are now laser-focused on how they can protect themselves and their families against the next inevitable threat. On top of this, social distancing and isolation accelerated the development and use of digital health tools, from wellness trackers to telehealth and virtual care, most of which can be accessed from the comfort of our homes. The convergence of these two forces is poised to make 2021 the year for patient-controlled health, whereby health decisions are not dictated by – but rather made in consultation with – a healthcare provider, leveraging insights and data pulled from a variety of health technology tools at people’s fingertips.
Anish Sebastian, CEO of Babyscripts
Telemedicine was the finger in the dyke at the beginning of pandemic panic, with healthcare providers grabbing whatever came to hand — encouraged by relaxed HIPAA regulations — to keep the dam from breaking. But as the dust settles, telemedicine is emerging as the commodity that it is, and value-add services are going to be the differentiating factors in an increasingly competitive marketplace. Offerings like remote patient monitoring and asynchronous communication, initially considered as “nice-to-haves,” are becoming standard offerings as healthcare providers see their value for continuous care beyond Covid.
Daniel Kivatinos, COO and Co-Founder of DrChrono
Telehealth visits are going to supersede in-person visits as time goes on.
Because of COVID-19, the world changed and Medicare and Medicaid, as well as other insurers, started paying out for telehealth visits. Telemedicine will continue to grow at a very quick rate, and verticals like mental health (psychology and psychiatry) and primary care fit perfectly into the telemedicine model, for tasks like administering prescription refills (ePrescribing) and ordering labs. Hyperlocal medical care will also move towards more of a telemedicine care team experience. Patients that are homebound families with young children or people that just recently had surgery can now get instant care when they need it. Location is less relevant because patients can see a provider from anywhere.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Virtual Healthcare is Here to Stay (House Calls are Back)
This new normal however is going to put significant pressure on the data support and servicing requirements to do it effectively. As more services are offered to patients outside of established clinical locations, it also means there will be more opportunity to collect data and a higher degree of dependence on interoperability. Providers are going to have to up their game from just providing and recording facts to passing on critical insight back into these interactions to maximize the benefits to the patient.
Sarahjane Sacchetti, CEO at Cleo
Virtual care (of all types) will become a lasting form of care: The vastly accelerated and broadened use of virtual care spurred by the pandemic will become permanent. Although it started with one-off check-ins or virtual mental health coaching, 2021 will see the continued rise in the use and efficacy of virtual care services once thought to be in-person only such as maternity, postpartum, pediatric, and even tutoring. Employers are taking notice of this shift with 32% indicating that expanded virtual health services are a top priority, and this number will quickly rise as employers look to offer flexible and convenient benefits in support of employees and to drive productivity.
Omri Shor, CEO of Medisafe
Digital expansion: The pandemic has accelerated patient technology adoption, and innovation remains front-and-center for healthcare in 2021. Expect to see areas of telemedicine and digital health monitoring expand in new and novel ways, with increased uses in remote monitoring and behavioral health. CMS has approved telehealth for a number of new specialties and digital health tools continue to gain adoption among healthcare companies, drug makers, providers, and patients.
Digital health companions will continue to become an important tool to monitor patients, provide support, and track behaviors – while remaining socially distant due to the pandemic. Look for crossover between medical care, drug monitoring, and health and wellness – Apple
Watch has already previewed this potential with heart rate and blood oxygen monitoring. Data output from devices will enable support to become more personalized and triggered by user behavior.
Kelli Bravo, Vice President, Healthcare and Life Sciences, Pegasystems
The COVID-19 pandemic has not only changed and disrupted our lives, it has wreaked havoc on the entire healthcare industry at a scale we’ve never seen before. And it continues to alter almost every part of life across the globe. The way we access and receive healthcare has also changed as a result of social distancing requirements, patient concerns, provider availability, mobile capabilities, and newly implemented procedures at hospitals and healthcare facilities.
For example, hospitals and providers are postponing elective procedures again to help health systems prepare and reserve ICU beds amid the latest COVID-19 resurgence. While level of care is always important, in some areas, the inability to access a healthcare provider is equally concerning. And these challenges may become even more commonplace in the post-COVID-19 era. One significant transformation to help with the hurdle is telehealth, which went from a very small part of the care offering before the health crisis to one that is now a much more accepted way to access care. As the rise in virtual health continues to serve consumers and provide a personalized and responsive care experience, healthcare consumers expect support services and care that are also fast and personalized – with digital apps, instant claims settlements, transparency, and advocacy. And to better help serve healthcare consumers, the industry has an opportunity to align with digital transformation that offers a personalized and responsive experience.
Brooke LeVasseur, CEO of AristaMD
Issues pertaining to the COVID-19 pandemic will continue to be front-and-center in 2021. Every available digital tool in the box will have to be employed to ensure patients with non-COVID related issues are not forgotten as we try to free up in-person space and resources for those who cannot get care in any other setting. Virtual front doors, patient/physician video and eConsults, which connect providers to collaborate electronically, will be part of a broadening continuum of care – ultimately aimed at optimizing every valuable resource we have.
Bret Larsen, CEO and Co-Founder, eVisit
By the end of 2021, virtual care paths will be fairly ubiquitous across the continuum of care, from urgent care and EDs to specialty care, all to serve patients where they are – at home and on mobile devices. This will be made possible through virtualized end-to-end processes that integrate every step in patient care from scheduling, waiting rooms, intake and patient queuing, to interpretation services, referral management, e-prescribe, billing and analytics, and more.
Laura Kreofsky, Vice President for Advisory & Telehealth for Pivot Point Consulting
2020 has been the year of rapid telehealth adoption and advancement due to the COVID pandemic. According to CDC reports, telehealth utilization spiked as much as 154% in late March compared to the same period in 2019. While usage has moderated, it’s clear telehealth is now an instrumental part of healthcare delivery. As provider organizations plan for telehealth in 2021 and beyond, we are going to have to expect and deliver a secure, scalable infrastructure, a streamlined patient experience and an approach that maximizes provider efficiency, all while seeing much-needed vendor consolidation.
Jeff Lew, SVP of Product Management, Nextech
Earlier this year, CMS enacted new rules to provide practices with the flexibility they need to use telehealth solutions in response to COVID-19, during which patients also needed an alternative to simply visiting the office. This was the impetus to the accelerated acceptance of telehealth as a means to both give and receive care. Specialty practices, in particular, are seeing successful and positive patient experiences due to telehealth visits. Dermatology practices specifically standout and I expect the strong adoption will continue to grow and certainly be the “new normal.” In addition, innovative practices that have embraced this omni-channel approach to delivering care are also establishing this as a “new normal” by selectively using telehealth visits for certain types of encounters, such as post-op visits or triaging patients. This gives patients a choice and the added convenience that comes with it and, in some cases, increases patient volume for the practice.
Healthcare data security has been a growing concern for CIOs for the last year or so, as hackers are increasingly targeting health information. Now, with a global pandemic forcing a shift to telemedicine and remote work, and new rules from the ONC and CMS introducing more regulatory burden, healthcare CIOs have more to manage than ever. Fortunately, it is possible to roll out new capabilities while simultaneously improving cybersecurity by following these three rules:
Rule 1: Think Like an Attacker
The coronavirus pandemic has forced healthcare providers everywhere to roll out new capabilities, processes, and workflows, such as telemedicine systems and new patient check-in procedures. These measures are being taken in addition to the necessary work being done to comply with the new mandates from ONC and CMS regarding patient data accessibility. Though these changes need to be implemented quickly, it’s important to follow cybersecurity best practices to avoid providing new openings for attackers.
When a hacker sees new systems and processes being implemented, they are thinking about:
– What software is being introduced? Are there known vulnerabilities or frequently unpatched exploits associated with it?
– How are new endpoints being added and are they secure?
– Since the new ONC and CMS rules require publicly exposed FHIR APIs, how can those be attacked? Are there social engineering exploits that can provide a way around security?
– Are there ways to perpetrate identity fraud if a patient does not need to be physically present to receive healthcare?
This approach should lead to a cybersecurity plan that puts measures in place for each identified risk. By thinking like the adversary, it is possible to identify and lock down the possible attack vectors.
Rule 2: Minimize the Attack Surface
Every way into an organization’s network needs to be secured, monitored, and maintained. The best way to make this process as efficient and fool-proof as possible is to minimize the number of ways into the network.
This is especially difficult in light of the ONC and CMS rules, which require that clinical systems must share data through publicly available FHIR APIs. At first, this seems like a mandate to radically expand the organization’s attack surface. Indeed, this is precisely what happens if the straightforward approach of exposing every clinical system through public APIs is followed.
A different approach, which provides the same capabilities and compliance with the rules, would be to route all API traffic through a central hub. Attaching all the clinical systems to a single point of API access provides a number of benefits:
– Most importantly, compliance is achieved while minimizing the new attack vectors.
– All traffic between clinical systems and the outside world can be monitored from a single place.
– The API hub can act as a façade that makes legacy systems compliant with the new rules, even if those systems lack native FHIR API capabilities.
The API hub need not be an expensive new component of the network architecture. Most healthcare organizations are already using a clinical integration engine to move HL7, XML, and DICOM traffic among their internal systems. The same technology can serve as an API hub. This is especially effective if a new instance of the integration engine is placed in an isolated part of the network without full access to other systems.
Rule 3: Have an Expert Review the Defenses
Even for healthcare organizations with cybersecurity experts on staff, it can be worthwhile to bring in a cybersecurity consultant to cross-check new implementations. Novel threats are constantly shifting and emerging, making it nearly impossible for internal IT staff to keep up with the looming threats of ransomware hacks, while also adequately carrying out the day-to-day responsibilities of their jobs. For that reason, it makes sense to bring in a professional who focuses exclusively on security. It is also often useful to have an independent review from someone who is looking at the implementation from an outsider’s perspective. Independent consultants can provide the necessary guidance, risk assessments, and other security support, to set healthcare organizations up for success and operate more securely.
Expanding an organization’s IT capabilities often means more exposure to risk, especially when implementations are subject to time constraints. However, given the value and importance of the data that’s being generated, transmitted, and stored, it is imperative not to let cybersecurity fall out of focus. By following best practices around design, implementation, and testing healthcare organizations can rise to meet the current challenges of the pandemic, address the mandates of the interoperability rules, and simultaneously improve data security measures.
About Scott Galbari, Chief Technology Officer
As Chief Technology Officer for Lyniate, Scott leads the development and delivery of all products and services. Scott has been in the healthcare IT domain for the past twenty years and has experience in developing and delivering imaging, workflow, nursing, interoperability, and patient flow solutions to customers in all geographies. He was most recently the General Manager for multiple businesses within McKesson and Change Healthcare and started his career as a software developer.
About Drew Ivan, Chief Product & Strategy Officer
Drew’s focus is on how to operationalize and productize integration technologies, patterns, and best practices. His experience includes over 20 years in health IT, working with a wide spectrum of customers, including public HIEs, IDNs, payers, life sciences companies, and software vendors, with the goal of improving outcomes and reducing costs by aggregating and analyzing clinical, claims, and cost data.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
Industry experts state that orphan drugs will be a major trend to watch in the years ahead, accounting for almost 40% of the Food and Drug Administration approvals this year. This market has become more competitive in the past few years, increasing the potential for reduced costs and broader patient accessibility. Currently, these products are often expensive because they target specific conditions and cost on average $147,000 or more per year, making commercialization optimization particularly critical for success.
This is important because personalized medicine has the capacity to detect the onset of disease at its earliest stages, pre-empt the progression of the disease and increase the efficiency of the health care system by improving quality, accessibility, and affordability.
These factors lay the groundwork for specialty pharmaceutical companies that are developing and commercializing personalized drugs for orphan and ultra-orphan diseases to pursue productive collaboration and meaningful partnership with a specialty pharmacy, distribution, and patient management service provider. This relationship offers manufacturers a patient-first model to align with market trends and optimize the opportunity, maximize therapeutic opportunities for personalized medicines, and help to contain costs of specialty pharmacy for orphan and rare disorders. This approach leads to a more precise way of predicting the prognosis of genetic diseases, helping physicians to better determine which medical treatments and procedures will work best for each patient.
Furthermore, and of concern to specialty pharmaceutical providers, is the opportunity to leverage a patient-first strategy in streamlining patient enrollment in clinical trials. This model also maximizes interaction with patients for adherence and compliance, hastens time to commercialization, and provides continuity of care to avoid lapses in therapy — during and after clinical trials through commercialization and beyond for the whole life cycle of a product. Concurrently, the patient-first approach also provides exceptional support to caregivers, healthcare providers, and biopharma partners.
Integrating Data with Human Interaction
When it comes to personalized medicine for the rare orphan market, tailoring IT, technology, and data solutions based upon client needs—and a high-touch approach—can improve patient engagement from clinical trials to commercialization and compliance.
Rare and orphan disease patients require an intense level of support and benefit from high touch service. A care team, including the program manager, care coordinator, pharmacist, nurse, and specialists, should be 100% dedicated to the disease state, patient community, and therapy. This is a critical feature to look for when seeking a specialty pharmacy, distribution, and patient management provider. The key to effective care is to balance technology solutions with methods for addressing human needs and variability.
With a patient-first approach, wholesale distributors, specialty pharmacies, and hub service providers connect seamlessly, instead of operating independently. The continuity across the entire patient journey strengthens communication, yields rich data for more informed decision making, and improves the overall patient experience. This focus addresses all variables around collecting data while maintaining frequent communication with patients and their families to ensure compliance and positive outcomes.
As genome science becomes part of the standard of routine care, the vast amount of genetic data will allow the medicine to become more precise and more personal. In fact, the growing understanding of how large sets of genes may contribute to disease helps to identify patients at risk from common diseases like diabetes, heart conditions, and cancer. In turn, this enables doctors to personalize their therapy decisions and allows individuals to better calculate their risks and potentially take pre-emptive action.
What’s more, the increase in other forms of data about individuals—such as molecular information from medical tests, electronic health records, or digital data recorded by sensors—makes it possible to more easily capture a wealth of personal health information, as does the rise of artificial intelligence and cloud computing to analyze this data.
Telehealth in the Age of Pandemics
During the COVID-19 pandemic, and beyond, it has become imperative that any specialty pharmacy, distribution, and patient management provider must offer a fully integrated telehealth option to provide care coordination for patients, customized care plans based on conversations with each patient, medication counseling, education on disease states and expectations for each drug.
A customized telehealth option enables essential discussions for understanding patient needs, a drug’s impact on overall health, assessing the number of touchpoints required each month, follow-up, and staying on top of side effects.
Each touchpoint has a care plan. For instance, a product may require the pharmacist to reach out to the patient after one week to assess response to the drug from a physical and psychological perspective, asking the right questions and making necessary changes, if needed, based on the patient’s daily routine, changes in behavior and so on.
This approach captures relevant information in a standardized way so that every pharmacist and patient is receiving the same assessment based on each drug, which can be compared to overall responses. Information is gathered by an operating system and data aggregator and shared with the manufacturer, who may make alterations to the care plan based on the story of the patient journey created for them.
Just as important, patients know that help is a phone call away and trust the information and guidance that pharmacists provide.
About Donovan Quill, President and CEO, Optime Care
Donovan Quill is the President and CEO of Optime Care, a nationally recognized pharmacy, distribution, and patient management organization that creates the trusted path to a fulfilled life for patients with rare and orphan disorders. Donovan entered the world of healthcare after a successful coaching career and teaching at the collegiate level. His personal mission was to help patients who suffer from an orphan disorder that has affected his entire family (Alpha-1 Antitrypsin Deficiency). Donovan became a Patient Advocate for Centric Health Resources and traveled the country raising awareness, improving detection, and providing education to patients and healthcare providers.
– Healthcare technology company Forcura names the five
most significant trends for the post-acute care industry in 2021.
The post-acute care (PAC) sector saw some of its most
profound challenges this year, from deadly COVID-19
outbreaks in skilled nursing facilities (SNFs) to a suddenly accelerated need
for the services provided by home health and hospice. The biggest question now
is that what does the post-acute care future hold for all of us?
Forcura, a healthcare technology company that enables safer patient care transitions along the care continuum recently released their report, What Happened and What’s Next in Post-Acute Care,” which synthesizes the top takeaways for the post-acute care industry in 2020, and explores the five themes it projects will be the leading business influencers on the sector in 2021 and for years to come.
The report names these as the five most significant drivers
for the post-acute care industry in 2021:
1. Interoperability: The Industry Inches Closer to a
In its guide to “Interoperability in Healthcare,” HIMSS
as “the ability of different information systems, devices and applications
(systems) to access, exchange, integrate and cooperatively use data in a
coordinated manner, within and across organizational, regional and national
boundaries, to provide timely and seamless portability of information and
optimize the health of individuals and populations globally.”
Individuals and organizations have worked tirelessly for
years to create a technological foundation that will make care transitions
safer and more holistic. They’ve made incredible progress…with patients and PAC
providers beginning to reap the benefits of increased data sharing.
2. Healthcare will be Increasingly Built Around the
Service providers talk about the “user experience” and now
users are finally seeking better care experiences. People are becoming savvier
and more demanding about their healthcare in the same ways they have done so in
consuming other services. While technology is certainly a component of the move
towards patient centricity, it is a tool that enables or enhances care
delivery. Post-acute care is poised for the shift to patient centricity.
3. Payment Models and Reimbursement Plans Remain in Play
The post-acute care industry will continue to be shaped by
regulatory and financial forces. By being proactive, fully understanding the
impacts of payment models (like unified payments), learning from the lessons of
acute care payment reform, and choosing the right partners, PAC providers
should be able to more confidently control their bottom lines in the coming
4. New Business Models are Not Your Parents’ PAC
PAC companies themselves also are beginning to explore new
options for their business operations. Post-acute care is being asked to
deliver better patient outcomes and greater value – and it’s time to respond.
Driven in part by the explosion of home-based health care services from legacy
players and new entrants, PAC organizations will be scrambling to retain as
much patient share as possible. By diversifying, providers can reduce the
vulnerability experienced by single service line agencies.
5. Healthcare for All Remains Elusive
COVID-19 has revealed some harsh realities about the ongoing
effects of structural inequity…to no one’s surprise. Some steps towards equity
are occurring. Research led by Oregon Health & Science University shows
that a new national care program for hip and knee joint replacements seems to
reduce health outcome disparities for Black patients. The CMS Comprehensive
Care for Joint Replacement model is a bundled payment model designed to reduce
spending and improve outcomes for all joint replacement patients. “Although
Black patients were discharged to institutional post-acute care more than white
patients, the gap narrowed under the new bundled payment model. Readmission
risk decreased about 3 percentage points for Black patients under the new
model, and stayed roughly the same for Hispanic and white patients.”
“Everyone realizes that 2020 is historic for the unprecedented disruption and lives lost to the COVID-19 public health crisis” says Forcura founder and CEO, Craig Mandeville, “and operating in-the-moment has been a necessity. It has also possibly reduced the time the industry has to plan for what else is around the corner.” Craig continues, “Our original research and conversations from our CONNECT Summit clearly point to five market drivers that everyone should factor into their strategic initiatives. We’re proud to offer this report and believe it will guide health industry companies to focus more on patients and better secure their bottom lines.”
Communication problems and inadequate information flow are two of the most common root causes of medical errors. The potential for miscommunication and faulty exchange of information in healthcare is substantial.
Consider: patient information is dispersed among multiple providers and payers along the continuum of care. Electronic Health Records (EHRs) and other clinical systems do not capture patient information or format medical documentation in a standardized manner. In an environment with incompatible systems, the easiest way for healthcare organizations to exchange records is to generate those records in a document format. It is not surprising then that many healthcare organizations are still heavily dependent on traditional, paper-based fax, which adds its own challenges to the process. Fax hardware and communication equipment are often unreliable, resulting in document delivery failures and delays.
As a result, an inadequate information flow can cause problems that impact the availability of essential knowledge needed for prescribing decisions, timely and reliable delivery of test results, and coordination of medical orders. The ensuing administrative and medical errors raise healthcare costs and may lead to poor health outcomes, including patient harm and readmissions.
The reality of mundane, manual processes
Document-based information exchange processes are highly inefficient. Staff often print and copy documents, creating a risk of accidental exposure of protected health information and resulting in needless costs. Moreover, documents – whether printed or stored on a workstation or server – still require manual data entry into EHRs and practice management systems. The tasks are tedious, prone to error, and negatively impact workflow, staff efficiency, physicians, and patients, and may lead to the following:
– Patient record errors, including filing or documenting information in the wrong patient file, and data entry errors;
– Poorly documented or lost test results; and
– Gaps in communication during transitions of care from one healthcare provider or setting to another.
In addition to these areas of concern that threaten patient safety, inbound documents often contain a lot of information on clinical, administrative, and financial matters that aren’t necessarily relevant to an intended recipient. That means a recipient must review all pages of the document and separate needed information from extraneous ones, which can further delay processing and patient transitions of care.
Smarter, faster document processing with AI
Healthcare providers need a document exchange and processing strategy that enables fully digital, secure, and efficient communication among numerous, highly customized EHRs, each with its own workflows and document processing preferences.
Such a strategy needs to include moving away from paper to fully digital documents. Healthcare organizations can accomplish this easily and without the need to overhaul the entire existing health IT infrastructure. The two main ways of transitioning from paper to digital are using digital fax instead of traditional fax and document imaging when documents are simply scanned into the system. In many cases, the resulting document format will be a TIFF image; and while it is not machine-readable, it enables paperless filing of clinical documents to the EHR.
Alternatively, converting the document into a readable format, such as a searchable PDF, will allow the healthcare organization to add value in document processing at every subsequent step. Making the document readable enables automatic identification of the type of document, data extraction, including patient name, medical record, date of birth, and physician name, as well as more effective management of the overall lifecycle of the document.
This step requires the utilization of AI and natural language processing techniques. Automatic extraction of data replaces the human labor required to manually index the information, which streamlines the triaging of documents to correct systems, teams, or recipients.
For example, if a digital document is clearly labeled as a discharge summary for John Harrison, a staff member can process it much easier and faster than when she has to open and read it to understand the type of the document and the identity of the patient. By mostly automating the receiving, reading, classifying, and triaging of medical documentation, providers are able to save time and ensure information is received and processed quickly by the right person, which typically means that the patient can be better served.
The COVID-19 pandemic has only driven home the need for seamless, 100%-digital exchange of patient information. If healthcare administrators depend on the physical fax machine to do their jobs, they won’t be able to work remotely. Most people don’t have fax machines at home, and especially fax machines routed to the hospital’s number, to be able to print information and then manually scan and enter that information into the patient’s health record. A fully digital document processing approach enables agility and flexibility necessary in the modern healthcare environment.
Moreover, recent ransomware attacks in the form of malware embedded into email attachments sent to users in hospitals lead to providers blocking inbound email attachments altogether. That means providers could not access their own patient data, let alone data from other institutions. As a result, emergency patients may have to be taken to other hospitals, and surgeries and other procedures delayed. Cloud-based platforms enable users to securely access patient information outside of the hospital’s network.
Small steps lead to big results
It’s essential from both a patient safety perspective and provider efficiency perspective that the exchange and processing of medical documentation be digitized. The benefits of digital document processing are significant, enabling fluid information exchange among all stakeholders.
By transitioning to fully digital document exchange, providers can significantly streamline administrative and clinical processes. The key to realizing the benefits of this approach is to take the first step by moving away from paper and then build on that by harnessing the power of AI to fully support the daily work of clinicians and administrators. Outbound and inbound documents can be prioritized, addressed, processed, and delivered appropriately, facilitating timely information exchange for processing prescriptions, medical orders, billing, reporting, analytics, research, and much more.
About John Harrison
As Chief Commercial Officer at Concord Technologies, John is responsible for the company’s revenue growth and brand development, ensuring Concord continues to create the right products to meet the needs of its customers. John brings more than 25 years of document communication and automation experience to the team. Prior to joining Concord, John held executive management positions at OpenText, Captaris, and Goaldata, overseeing business operations across multiple continents.
– In partnership with JP Morgan Chase; United Way; top
healthcare organizations including Anthem, Centene, One Medical and Epic; and
other non-profit and community partners, Lyft’s goal is to facilitate 60M safe
rides to vaccination sites.
– Lyft’s vaccine access campaign will help the communities who need it most safely travel to receive the vaccine. These rides will be facilitated through its business segment, Lyft Healthcare, and social impact initiative LyftUp.
Inc. announced the launch of a nationwide campaign to support universal
access to the COVID-19
vaccine. The goal of this effort is to provide 60 million rides to and from
vaccination sites for low-income, uninsured, and at-risk communities, when the
vaccine becomes available.
Corporate partners JP Morgan Chase and Anthem Inc. and community partner United Way will be working alongside Lyft to lead the effort, with many other businesses, healthcare, and technology partners preparing to join the campaign as vaccines become available in the coming weeks.
Additional program partners signing on to launch the effort include Epic, Centene Corporation, Modern Health, One Medical, National Hispanic Council on Aging, National Asian Pacific Center on Aging, National Urban League, and the National Action Network.
Lack of Transportation Could Prevent Millions of People
from Being Vaccinated
Lyft’s on-demand transportation network provides critical
access to healthcare services for at-risk communities disproportionately
affected by COVID-19, including non-emergency medical transport for home-bound
seniors, people living with disabilities, and dialysis patients. Many of these
patients belong to vulnerable populations who will be prioritized for early
vaccine distribution, and Lyft’s healthcare transportation services will play a
critical role in transporting them to and from vaccination sites.
“Access to reliable transportation represents a major barrier to care for millions of Americans across the country,” said Megan Callahan, MPH, VP of Lyft Healthcare. “In fact, lack of transportation is one of the top reasons people miss medical appointments. The COVID-19 pandemic has exacerbated this problem, creating a huge challenge in making sure vulnerable populations have access to the vaccine — especially for seniors living alone, low income workers, and parents with young children. We estimate that 15 million Americans will face transportation issues trying to get to vaccination sites. That’s where Lyft can make a difference.”
LyftUp Initiative to Serve Underserved Communities
The universal vaccine access campaign is part of the
company’s LyftUp initiative, a partnership of companies, community
organizations and individuals working together to make sure everyone has access
to affordable, reliable transportation to get where they need to go. Working
together using Lyft’s transportation platform, companies and social impact
organizations will help underserved communities access vaccination appointments
by providing subsidized rides for employees and members, and free or discounted
rides for those in need.
In addition to directly funding rides, corporate partners
will leverage their customers and member networks to promote individual
contributions to the campaign as well as provide social media and marketing
resources to connect people in need with community partners. Community
partners will then route ride credits to those in need.
– Vida’s diabetes management program
achieves lasting results for participants. Because chronic conditions like diabetes,
obesity, and hypertension often occur simultaneously, Vida’s unique program was
built from the ground up to treat multiple conditions at the same time.
– The new partnership, which will launch in
January of 2021, allows eligible individuals access to Vida’s group diabetes
coaching, in-app peer group support, digital therapeutics for diabetes and
co-occurring chronic conditions, and more to help them manage their diabetes
and their whole health.
– Kentucky has the seventh highest prevalence of diabetes of any state with 13.7% of the
adult population reporting having the disease, well above the U.S. average of
10.9%. The percent of Kentuckians with diabetes has more than doubled since
2000 when only 6.5% of the population reported having been diagnosed.
Additionally, about two thirds of adult Kentuckians are considered overweight or obese
which increases the risk of Type II Diabetes among other chronic illnesses.
– The mobile-first experience is uniquely
personalized to each user through a combination of provider expertise and
machine learning algorithms that utilize data from 100+ app and device
integrations, as well as biometric data, and more to personalize the program
and content. The program addresses the root causes behind an individual’s
diabetes, and, using the power of human connection, psychology, and nutritional
expertise, Vida drives long-term behaviors that shift the course of the
– Philips and BioIntelliSense has been selected by the
U.S. Army Medical Research and Development Command (USAMRDC) to receive nearly $2.8M
from the U.S. Department of Defense (DoD) to validate BioIntelliSense’s
FDA-cleared BioSticker device for the early detection of COVID-19 symptoms.
– Working with the University of Colorado Anschutz
Medical Campus, the clinical study will consist of 2,500 eligible participants
with a recent, known COVID-19 exposure and/or a person experiencing early
Philips and BioIntelliSense,
Inc., a continuous health monitoring and clinical intelligence company, today
announced they have been selected by the U.S. Army Medical Research and
Development Command (USAMRDC) to receive nearly $2.8M from the U.S. Department
of Defense (DoD) through a Medical Technology Enterprise Consortium (MTEC)
award to validate BioIntelliSense’s FDA-cleared BioSticker device for the early
detection of COVID-19
symptoms. The goal of the award is to accelerate the use of wearable
diagnostics for the benefit of military and public health through the early
identification and containment of pre-symptomatic COVID-19 cases.
Medical-Grade Wearable for Early COVID-19 Detection
As millions of individuals have been screened and tested, the emerging research on traditional screening methods is revealing how challenging it is to detect the risk of COVID-19 infections early. Temperature checks have proven to be unreliable and even amplified testing (PCR) has proven to be ineffective in identifying the virus in the early days of infection.
The FDA-cleared BioSticker is an advanced on-body sensor
that allows for effortless continuous monitoring of temperature and vital signs
combined with advanced analytics, enables the BioSticker to identify
statistically meaningful trends and screen for early potential COVID-19
“The medical-grade BioSticker wearable, combined with advanced diagnostic algorithms, may serve as the basis for identifying pre- and very early symptomatic COVID-19 cases, allow for earlier treatment for infected individuals, as well as reduce the spread of the virus to others,” said James Mault, MD, Founder and CEO of BioIntelliSense.
Clinical Trial Details
Working with the University of Colorado Anschutz Medical Campus, the
clinical study will consist of 2,500 eligible participants with a recent, known
COVID-19 exposure and/or a person experiencing early COVID-19 symptoms.
Individuals may learn more about the study eligibility and enroll online
The research will focus on the validation of BioIntelliSense’s BioSticker for
early detection of COVID-like symptoms, as well as assessment of scalability,
reliability, software interface, and user environment testing.
Turning Data into Actionable Insights
While previous studies have shown potential using consumer wearables in relation to COVID-19, this study will leverage BioIntelliSense’s medical-grade wearable, the BioSticker, which enables continuous multi-parameter vital signs monitoring for 30 days and captures data across a broad set of vital signs, physiological biometrics and symptomatic events, including those directly associated with COVID-19. With its integration into Philips’ remote patient monitoring offerings, this is another example of how cloud-based data collection takes place seamlessly, across multiple settings, from the hospital to the home. Allowing data to be turned into actionable insights and care interventions, while providing connected, patient-centered care across the health continuum.
Dr. Vik Bebarta, the Founder and Director of the CU Center for COMBAT Research and Professor of Emergency Medicine on the CU Anschutz Medical Campus added: “The University of Colorado School of Medicine and the CU Center for COMBAT Research in the Department of Emergency Medicine are excited to be a lead in this effort that will change how we care for our service members in garrison and our civilians in our communities. The COMBAT Center aims to solve the DoD’s toughest clinical challenges, and the pandemic is certainly one example. With this progressive solution, we aim to detect COVID in the pre-symptomatic or early symptomatic phase to reduce the spread and initiate early treatment. This trusted military-academic-industry partnership is our strength, as we optimize military readiness and reduce this COVID burden in our community and with frontline healthcare workers.”
Shelter-in-place orders related to the COVID-19 pandemic have exaggerated the social exclusion and loneliness of many elderly and vulnerable individuals, thereby increasing their chances of experiencing critical health complications. This trend—combined with societal shifts including reduced inter-generational living, greater geographical mobility, and less cohesive communities—has placed the elderly at heightened risk of being isolated and, consequently, in harm’s way.
Fortunately for senior citizens quarantined or living alone, technology can help detect and alert caregivers, healthcare professionals or family members to elderly persons’ changes in behavior—which can prevent serious issues.
Of the solutions available, the IoT is uniquely positioned to enable caregivers to support the well-being of those at risk when others cannot be at their side. By tracking key health indicators such as dehydration and malnutrition and behavioral changes like decreased mobility, IoT-enabled monitors reduce emergency hospital admissions and allow elders to stay in their homes longer safely.
Preventive fall detection
Falling, which becomes more prevalent with age, is the second leading cause of accidental or unintentional injury deaths worldwide. Therefore, actions for preventing falls must be taken both at home and in care facilities. Recording incidents, identifying risk factors (individual and environmental), and highlighting the preventive and corrective measures are critical steps in fall prevention, prediction, and detection. And they can all be accomplished with the IoT.
With conventional fall-detection technologies, a person must wear or carry the device and press a button upon falling. If the person is unwell but does not fall, nothing is reported, which is why it is important to monitor discomfort by other means, such as an algorithm that detects a change in the patient’s general wellbeing.
Using IoT sensors for this purpose, healthcare providers are able to track progress over longer periods of time (days or months) and determine whether an individual’s health is deteriorating, thereby placing them at future risk of falling. With this knowledge, caregivers can intervene and provide increased care before any injury occurs.
Keeping elders in their homes longer
When used in conjunction with tele-assistance services, IoT solutions can also help reassure families their loved ones are safe living on their own by transmitting critical information indicative of deteriorating health so that early warning signs don’t go unnoticed.
Companies such as SeniorAdom and Vitalbase have already developed remote assistance solutions based on IoT technology, including various motion detection sensors, geolocation pendants, and wrist bands. These solutions are designed to automatically detect any potential behavioral changes due to a fall, physical weakness, or cognitive deterioration (e.g., Alzheimer’s disease).
These innovative solutions make it possible to better protect elderly populations by anticipating risks and acting quickly in the event of an emergency. With a self-learning algorithm and an intelligent box wirelessly connected to sensors installed in the home, SeniorAdom can detect a potentially critical or abnormal situation and warn caregivers or relatives. SeniorAdom’s motion sensors and door open/close sensors learn the daily activities of the monitored individual to “get smart” on their everyday habits. As a result, the sensors can detect and send alerts about any changes in activities, which might indicate a problem.
How the sensors work
Operating on a 0G network—which is optimized to frequently transmit small amounts of information over a large distance—IoT-enabled sensors detect conditions and movement from connected devices, and never pick up personal information. Additionally, these devices consume minimal energy on a 0G network and therefore support communications at a very low cost. This means families can receive effective care without a hefty price tag.
Devices that run on other networks, like cellular, can also use a 0G network as a backup to ensure device users have constant supervision and those vulnerable individuals are able to communicate their health needs immediately. For example, Vitalbase’s Vibby OAK, an automatic fall detector worn on the wrist or neck, connects to a cellular mobile device but uses a 0G network when there is no primary connectivity, either because the user is not near a phone, or there’s no cellular network connectivity. At healthcare facilities, the device can interface with all existing nurse call systems to alert medical staff when an issue arises.
By optimizing automatic and intuitive fall-detection devices with the IoT, older adults can live more independently and maintain autonomy. The ability to remotely monitor seniors, receive alerts in case of emergencies, predict issues based on early warning signs, and intervene proactively offers peace of mind to both healthcare providers and families of senior citizens.
About Ajay Rane
Ajay Rane is the VP of Global Ecosystem Development at Sigfox, the initiator of the 0G network and the world’s leading IoT (Internet of Things) service provider. Its global network, available in 60 countries with 1 billion people covered, allows billions of devices to connect to the Internet, in a straightforward way, while consuming as little energy as possible.
A recent Advisory Board briefing examined the annual Centers for Medicare & Medicaid Services (CMS) Readmission penalties. Of the 3,080 hospitals CMS evaluated, 83% received a penalty for payments to be made in 2021, based on expected outcomes for a wide variety of treated conditions. While CMS indicated that some of these penalties might be waived or delayed due to the impacts of the Covid pandemic on hospital procedure volumes and revenue, they are indicative of a much larger issue.
For too long, patients discharged from the hospital have been handed a stack of papers to fill prescriptions, seek follow-up care, or take other steps in their journey from treatment to recovery. More recently, the patient is given access to an Electronic Health Record (EHR) portal to view their records, and a care coordinator may call in a few days to check-in. These are positive steps, but is it enough? Although some readmissions cannot be avoided due to unforeseen complications, many are due to missed follow-up visits, poor medication adherence, or inadequate post-discharge care.
Probably because communication with outside providers has never worked reliably, almost all hospitals have interpreted ‘care coordination’ to mean staffing a local team to help patients with a call center-style approach. Wouldn’t it be much better if the hospital could directly engage and enable the Primary Care Physician (PCP) to know the current issues and follow-up directly with their patient?
We believe there is still a real opportunity to hold the patient’s hand and do far more to guide them through to recovery while reducing the friction for the entire patient care team.
Strengthening Care Coordination for a Better Tomorrow
Coordinating and collaborating with primary care, outpatient clinics, mental health professionals, public health, or social services plays a crucial role in mitigating readmissions and other bumps along the road to recovery. Real care coordination requires three related communication capabilities:
1. Notification of the PCP or other physicians and caregivers when events such as ED visits or Hospitalization occur.
2. Easy, searchable, medical record sharing allows the PCP to learn important issues without wading through hundreds of administrative paperwork.
3. Secure Messaging allows both clinicians and office staff to ask the other providers questions, clarify issues, and simplify working together.
There are some significant hurdles to improve the flow of patient data, and industry efforts have long been underway to plug the gaps. EHR vendors, Health Information Exchanges (HIEs), and a myriad of vendors and collaboratives have attempted to tackle these issues. In the past few decades, government compliance efforts have helped drive medical record sharing through the Direct Messaging protocol and CCDAs through Meaningful Use/Promoting Interoperability requirements for “electronic referral loops.” Kudos to the CMS for recognizing that notifications need to improve from hospitals to primary care—this is the key driver behind the latest CMS Final Rule (CMS-9115-F) mandating Admission, Discharge, and Transfer (ADT) Event Notifications. (By March 2021, CMS Conditions of Participation (CoPs) will require most hospitals to make a “reasonable effort” to send electronic event notifications to “all” Primary Care Providers (PCPs) or their practice.)
However, to date, the real world falls far short of these ideals: for a host of technical and implementation reasons, the majority of PCPs still don’t receive digital medical records sent by hospitals, and the required notifications are either far too simple, provide no context or relevant encounter data, rarely include patient demographic and contact information, and almost never include a method for bi-directional communications or messaging.
Delivering What the Recipient Needs
PCPs want what doctors call the “bullet” about their patient’s recent hospitalization. They don’t want pages of minutia, much of it repetitively cut and pasted. They don’t want to scan through dozens or hundreds of pages looking for the important things. They don’t want “CYA” legalistic nonsense. Not to mention, they learn very little from information focused on patient education.
An outside practitioner typically doesn’t have access to the hospital EHR, and when they do, it can be too cumbersome or time-consuming to chase down the important details of a recent visit. But for many patients—especially those with serious health issues—the doctor needs the bullet: key items such as the current medication list, what changed, and why.
Let’s look at an example of a patient with Congestive Heart Failure (CHF), which is a condition assessed in the above-mentioned CMS Readmission penalties. For CHF, the “bullet” might include timely and relevant details such as:
– What triggered the decompensation? Was it a simple thing, such as a salty meal? Or missed medication?
– What was the cardiac Ejection Fraction?
– What were the last few BUN and Creatinine levels and the most recent weight?
– Was this left- or right-sided heart failure?
– What medications and doses were prescribed for the patient?
– Is she tending toward too dry or too wet?
– Has she been postural, dizzy, hypotensive?
Ideally, the PCP would receive a quick, readable page that includes the name of the treating physician at the hospital, as well as 3-4 sentences about key concerns and findings. Having the whole hospital record is not important for 90 percent of patients, but receiving the “bullet” and being able to quickly search or request the records for more details, would be ideal.
Similar issues hold true for administrative staff and care coordinators. No one should play “telephone tag” to get chart information, clarify which patients should be seen quickly, or find demographic information about a discharged patient so they can proactively contact them to schedule follow-up.
Building a Sustainable, Long-Term Solution
Having struggled mightily to build effective communications in the past is no excuse for the often simplistic and manual processes we consider care coordination today.
Let’s use innovative capabilities to get high-quality notifications and transitions of care to all PCPs, not continue with multi-step processes that yield empty, cryptic data. The clinician needs clinically dense, salient summaries of hospital care, with the ability to quickly get answers—as easy as a Google search—for the two or three most important questions, without waiting for a scheduled phone call with the hospitalist. X-Rays, Lab results, EKGs, and other tests should also be available for easy review, not just the report. After all, if the PCP needs to order a new chest x-ray or EKG how can they compare it with the last one if they don’t have access to it?
Clerical staff needs demographic information at their fingertips to “take the baton” and ensure quick and appropriate appointment scheduling. They need to be able to retrieve more information from the sender, ask questions, and never use a telephone. Additionally, both the doctor and the office staff should be able to fire off a short note and get an answer to anyone in the extended care team.
That is proper care coordination. And that is where we hope the industry is collectively headed in 2021.
About Peter Tippett MD, PhD: Founder and CEO, careMESH
Dr. Peter S. Tippett is a physician, scientist, business leader and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
About Catherine Thomas: Co-Founder and VP, Customer Engagement, careMESH
Catherine Thomas is Co-Founder & VP of Customer Engagement for careMESH, and a seasoned marketing executive with extensive experience in healthcare, telecommunications and the Federal Government sectors. As co-founder of careMESH, she brings 20+ years in Strategic Marketing and Planning; Communications & Change Management; Analyst & Media Relations; Channel Strategy & Development; and Staff & Project Leadership.
Although most organizations have now provided WFH employees with secure computers using endpoint detection and response (EDR) solutions or mandated the use of virtual private networks (VPNs), this does not fully solve the security problem.
These solutions may protect the user and network from future attacks, but if network infiltration has already occurred, threats in the form of advanced persistent threats (APTs) may be lying dormant for weeks, months, or maybe even years, on an apparently secure network. To respond to these threats, a network detection and response (NDR) capability is required. This capability looks for activity or patterns of behavior from users or network servers that indicate attacks may be in progress may have taken place or may be developing.
Ideally, EDR and NDR need to be integrated and used together to provide end-to-end network visibility and security.
Cybercriminals and other bad actors were quick to exploit the COVID-19 pandemic with, for example, phishing attacks. These exploited the fears of healthcare consumers and healthcare workers who, in the early days of WFH, were often accessing corporate networks on secured mobile phones and personal computers from their home networks.
This led to a variety of security issues; for example, Mirai botnet–type attacks that exploited WFH practices to infect healthcare organizations’ networks or dropper-based attacks that loaded malware to steal users’ credentials and ultimately lead to ransomware attacks. While these attacks still continue, most healthcare organizations have taken the measures necessary to secure their networks and their patient and organizations’ data.
A Spike in State-Sponsored Attacks
Beyond threats from financially motivated cybercriminals looms the threat from highly sophisticated and well-resourced state-sponsored attackers. As widely reported in the media, there has been a spike in state-sponsored security attacks on lab and research facilities working on COVID-19 treatments. For example, the Wall Street Journal cited U.S. officials as suggesting that Chinese and Iranian hackers are targeting universities and pharmaceutical and other healthcare firms that are working to find a vaccine for COVID-19, in an attempt to disrupt this research and slow its development.
In addition to direct attacks on research institutions, software vendors that develop the tools used by these institutions are also at risk. Security is becoming a “supply chain” issue that touches not only all of the network users and assets but also all the precursors to these assets, including the network carriers and software vendors on which network users rely.
Lack of Trust
Who can you trust in this expanded threat environment? To take proper precautions, nobody. As healthcare consumers and the workforce want or need to operate on an “access anywhere, anytime” model, adopting what’s called a Zero Trust security architecture not only makes sense, it is close to an imperative for healthcare organizations.
Zero Trust means that, because the network is under constant attack from a huge array of external and internal threats, all users, devices, applications, and resources on the network must be treated as being hostile. These users and devices need to be rigorously and continuously authenticated, while patient, research, and other data and network assets need to be protected at a much granular level than traditional perimeter-based security models allow.
The Rise of IoMT Devices
Healthcare organizations must also find new, more cost-effective ways to deliver high-quality healthcare to their increasingly tech-savvy consumers – and the use of Internet of Medical Things (IoMT) devices is critical to this process. IoMT devices, ranging from simple telehealth and remote patient monitoring to surgical robots and augmented reality technologies, can reduce operating costs and increase the quality of patient care.
COVID-19 has accelerated the adoption of IoMT technology, a process that will further accelerate with the availability of 5G networks over the coming one to three years. Many of the simpler IoMT devices don’t support traditional security models, so their adoption poses significant new threats unless healthcare institutions act to enhance security by, for example, ensuring that their network detection and response tools are ready for this challenge.
Looking ahead, it’s clear that the world is evolving towards a new normal, which will pose more threats and concerns for the healthcare industry. Recognizing this and preparing for the threats discussed, will create a better game plan for what’s to come and allow for necessary growth within healthcare infrastructure.
About Matyn Crew Martyn Crew is Director of Solutions Marketing at Gigamon. He brings a 30-year background in all aspects of enterprise IT to his role where he focuses on a number of initiatives and products including Gigamon’s Application Visibility and Intelligence solutions.
An in-depth look at twelve recently released COVID-19 vaccine management solutions as COVID-19 vaccines are being distributed nationwide.
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.
Accenture recently rolled out a comprehensive vaccine management solution to help government and healthcare organizations rapidly and effectively plan and develop COVID-19 vaccination programs and related distribution and communication initiatives. Expanding on Accenture’s contact tracing capability that leverages Salesforce’s manual contact tracing solution, the platform is rapidly deployable and designed to securely track a resident’s vaccination journey, from registration and appointment scheduling to final vaccine administration and symptom follow-ups.
VigiLanz, a clinical surveillance company launched their new mass vaccination support software, VigiLanz Vaccinate provides end-to-end management of the entire vaccination process, enabling hospitals to maximize the success of mass vaccination events for healthcare workers. VigiLanz Vaccinate streamlines vaccine administration and management by making it easy for staff to register and provide consent while automating workflows for program administrators. Its real-time insights into volume needs to reduce vaccine waste, while analytics give visibility into vaccination and immunity rates at the individual, department, hospital, and system-level.
UCHealth recently deployed BioIntelliSense BioButton™ Vaccine
Monitoring Solution, an FDA-cleared medical-grade wearable for continuous
vital sign monitoring for up to 90-days (based on configuration) to healthcare
workers receiving COVID-19 vaccine UCHealth’s staff and providers will wear the
BioButton device for two days prior and seven days following a COVID-19 vaccine dose
to detect potential adverse vital sign trends. Together with a daily
vaccination health survey and data insights, the wearer may be alerted of signs
and symptoms to guide appropriate follow-up actions and further medical management.
VaxAtlas launches a
digital platform to support the COVID-19 vaccination process making it easy for
anyone to schedule and manage their vaccinations. Through a comprehensive suite
of on-demand tools, VaxAtlas manages the process of getting COVID vaccinations
from beginning to end. The platform provides access to a national certified
pharmacy network for local appointment scheduling, recall alerts, second dose
reminders, as well as QR clearance passes for vaccine validation. VaxAtlas
alleviates the complexity associated with vaccine logistics and helps to get
people back to work and back to living their lives.
DocASAP launches COVID-19
Vaccination Coordination Solution to help healthcare providers and payers meet
the urgent demand for vaccinating the nation. DocASAP’s COVID-19 Vaccination
Coordination Solution will help providers and payers guide people through the
vaccination process with pre-appointment engagement, online appointment scheduling
and reminders, and post-appointment wellness tracking. This will help reduce
the burden on staff and call centers to manage the sheer volume and complexity
of these appointments, and better coordinate the influx so providers can
effectively deliver the needed care. DocASAP will support the phased approach
to rolling out vaccinations, beginning with front-line healthcare staff.
7. Allied Identity
Allied Identity announced the launch of Vaxtrac, comprehensive vaccination management and credentialing platform designed to aid in the local, national and international response to COVID-19 and other communicable diseases. Vaxtrac uses SICPA’s proprietary CERTUS™ service in order to ensure the security of vaccination records and credentials.
8. Net Health
Net Health has developed a proprietary web-based Mobile Immunization Tracking platform to more efficiently manage on-site
immunizations. To ensure compliance, Net Health’s Mobile Immunization
Tracking platform tracks verification and enables employee consent forms to be
electronically recorded. Immunization data and the Vaccine Information Sheet
(VIS) are pulled directly from the Centers for Disease Control (CDC) database
and fields are auto-populated so clinicians do not have to manually enter data.
This ensures information in the employee record is accurate and saves time as
the clinician moves from one employee to the next.
9. Traction on Demand
Vancouver tech company, Traction on Demand,
has developed a COVID-19 Vaccine Clinic Accelerator. The accelerator helps
health authorities track all the critical details of their clinics including
type, location, staff members, and cold storage units available on-site and
applies CDC’s COVID-19 Temporary Clinic Best Practices to a
Salesforce-based mobile app, providing organizations with a digitized CDC
checklist, auditable clinic administration including a permanent auditable
record of all vaccination clinics an organization holds, critical risk
identification, and shift tracking.
10. MTX Group
MTX Group launches a
comprehensive end-to-end COVID-19 vaccine administration, management, and
distribution Solution for state and local public health agencies built on
Salesforce. The MTX vaccine management solution brings together the various
components of a COVID-19 vaccination program, including vaccine administration
and inventory management. MTX also works with public health departments to
identify necessary steps to promote vaccination adoption within a community.
The vaccine management solution is secure, portable, interoperable, and
provides data-driven vaccination program management capabilities.
Vaccination Management (IVM) Salesforce Solution is an end-to-end offering
for automating tasks, integrating data sources, and delivering a seamless
vaccination program that offers supply chain visibility and future demand
forecasting. Disparate systems won’t work for this unprecedented health crisis.
Phresia provides an end-to-end COVID-19 vaccine management solution for outreach, intake, reminder, and recall tools to increase vaccine uptake. Key features include communicating with patients about vaccine availability, send appointment reminders and boost recall, manage your waitlist, automate patient intake for vaccine visits, including consents, questionnaires, and patient education, and screen patients for vaccine hesitancy and maximize uptake by delivering personalized messaging based on those survey results.
– Data analytics and digital health company MDClone
announced a partnership with the Department of Veterans Affairs’ (VA) VHA
Innovation Ecosystem to democratize data and provide better, smarter, faster
healthcare to U.S Veterans.
– By leveraging MDClone’s data platform, the VHA is able to tackle this massive problem by securely accessing, organizing, and analyzing the critical health data of Veterans with the use of synthetic data – a breakthrough method pioneered by MDClone.
a digital health
company, and the VHA Innovation Ecosystem, a division of the United States
Department of Veterans Affairs (VA) today announced a partnership to
democratize data at the Veterans Health Administration (VHA). The partnership
will provide unprecedented, secure access to clinical data to better understand
and improve the health of the more than nine million veterans it serves.
The VHA Innovation Ecosystem aims to empower a wider network of VHA clinical and operational staff to explore data and discover insights that can be used to impact the lives of veterans nationwide. MDClone worked closely on this initiative with Dr. Amanda Purnell, Senior Innovation Fellow at the VHA Innovation Ecosystem, who is part of the Care & Transformational Initiatives (CTI) in the VHA Innovation Ecosystem. This program is specifically focused on testing and refining innovative care models and transformational initiatives that can be meaningfully scaled to impact Veteran care.
Improving Healthcare for Veterans with Synthetic Data
It’s no secret that Veterans have historically had a difficult time adjusting to normal life following service, which leads to many mental health issues that go unnoticed and un-treated – often leading to homelessness and the tragic loss of lives. By leveraging MDClone’s data platform, the VHA is able to tackle this massive problem by securely accessing, organizing, and analyzing the critical health data of Veterans with the use of synthetic data – a breakthrough method pioneered by MDClone. Synthetic data sets are virtually identical to the original patient data, so there’s no identifying information that can be traced back to individual patients. Synthetic data also has the potential to help the VHA collaborate with external agencies, healthcare providers, and the industry.
Non-technical users can quickly ask important questions, find answers, and take action – dramatically shortening timelines for quality improvement, innovation, and grassroots clinical research. The initial collaboration with MDClone will center around suicide prevention, chronic disease management, precision medicine, health equity, and COVID-19. For example, practitioners can tackle issues like suicide by identifying leading indicators and proactively intervening with patients most at risk.
“The VHA has long been at the forefront of healthcare informatics and the use of data to improve patient outcomes and drive operational improvements,” said Ziv Ofek, Founder and CEO, MDClone. “The selection of MDClone’s unique platform builds upon this tradition. With one of the largest medical databases in the world, the VHA requires enterprise-scale tools to explore data, innovate, and improve patient care. MDClone’s dynamic environment will help VA staff deliver on their mission to provide the best healthcare services to Veterans across the U.S.”
– CybelAngel tools scanned approximately 4.3 billion IP addresses and detected more than 45 million unique medical images left exposed on over 2,140 unprotected servers across 67 countries including the US, UK, and Germany.
– The report highlights the security risks of publicly accessible images containing highly personal information including ransomware and blackmail.
The analyst team at CybelAngel, a global leader in digital risk protection, has discovered that more than 45 million medical imaging files – including X-rays and CT scans – are freely accessible on unprotected servers, in a new research report.
Medical Device Data Leaks
The report “Full Body
Exposure” is the result of a six-month investigation into Network Attached
Storage (NAS) and Digital Imaging and Communications in Medicine (DICOM), the
de facto standard used by healthcare professionals to send and receive medical
data. The analysts discovered millions of sensitive images, including personal
healthcare information (PHI), were available unencrypted and without password
CybelAngel tools scanned approximately 4.3 billion IP addresses and detected more than 45 million unique medical images left exposed on over 2,140 unprotected servers across 67 countries including the US, UK, and Germany.
The analysts found that openly available medical images, including up to 200 lines of metadata per record which included PII (personally identifiable information; name, birth date, address, etc.) and PHI (height, weight, diagnosis, etc.), could be accessed without the need for a username or password. In some instances, login portals accepted blank usernames and passwords.
“The fact that we did not use any hacking tools throughout our research highlights the ease with which we were able to discover and access these files,” says David Sygula, Senior Cybersecurity Analyst at CybelAngel and author of the report. “This is a concerning discovery and proves that more stringent security processes must be put in place to protect how sensitive medical data is shared and stored by healthcare professionals. A balance between security and accessibility is imperative to prevent leaks from becoming a major data breach.”
3 Steps to Safeguard The Way Providers Share & Store
CybelAngel advises there are simple steps that healthcare facilities can take to safeguard the way they share and store data including:
– Determine if pandemic response exceeds your security policies: Ad hoc NAS devices, file-sharing apps, and contractors may take data beyond your ability to enforce access controls
– Ensure proper network segmentation of connected medical
imaging equipment: Minimize any exposure critical diagnostic equipment and
supporting systems have to wider business or public networks
– Conduct real-world audit of third-party partners: Assess
which parties may be unmanaged or not in compliance with required policies and
– CybelAngel provides a complimentary, comprehensive 30-day
data exposure assessment healthcare and other organizations use to measure
their risk and uncover priority issues.
– Artificial intelligence algorithms can predict outcomes
of COVID-19 patients with mild symptoms in emergency rooms, according to recent
research findings published in Radiology: Artificial Intelligence journal.
– Researchers trained the algorithm from data on 338
positive COVID-19 patients between the ages of 21 and 50 by using diverse
patient data from emergency departments within Mount Sinai Health System
hospitals (The Mount Sinai Hospital in Manhattan, Mount Sinai Queens, and Mount
Sinai Brooklyn) between March 10 and March 26.
Mount Sinai researchers have developed an artificial intelligence algorithm to rapidly predict outcomes of COVID-19 patients in the emergency room based on test and imaging results. Published in the journal, Radiology: Artificial Intelligence, the research reveals that if the AI algorithms were implemented in the clinical setting, hospital doctors can identify patients at high risk of developing severe cases of COVID-19 based on the severity score. This can lead to closer observation and more aggressive and quicker treatment.
They trained the algorithm using electronic medical records (EMRs) of patients between 21 and 50 years old and combined their lab tests and chest X-rays to create this deep learning model. Investigators came up with a severity score to determine who is at the highest risk of intubation or death within 30 days of arriving at the hospital. If applied in a clinical setting, this deep learning model could help emergency room staff better identify which patients may become sicker and lead to closer observation and quicker triage, and could expedite treatment before hospital admission.
Led by Fred Kwon, Ph.D., Biomedical Sciences at the Icahn School of Medicine at Mount Sinai, researchers trained the algorithm from data on 338 positive COVID-19 patients between the ages of 21 and 50 by using diverse patient data from emergency departments within Mount Sinai Health System hospitals (The Mount Sinai Hospital in Manhattan, Mount Sinai Queens, and Mount Sinai Brooklyn) between March 10 and March 26. Data from the emergency room including chest X-rays, bloodwork (basic metabolic panel, complete blood counts), and blood pressure were used to develop a severity score and predict the disease course of COVID-19.
Patients with a higher severity score would require
closer observation. The researchers then tested the algorithm using patient data on other patients in all adult age groups and
ethnicities. The algorithm has an 82 percent sensitivity to predict intubation and death within 30 days of
arriving at the hospital.
Many patients with COVID-19, especially younger ones, may show non-specific symptoms when they arrive at the emergency room, including cough, fever, and
respiratory issues that don’t provide any indication of disease severity. As a
result, clinicians cannot easily identify patients who get worse quickly. This algorithm can provide the probability that a patient may
require intubation before they get worse. That way clinicians can make more accurate decisions for appropriate
Algorithms that predict outcomes of patients with COVID-19 do exist, but they are used in admitted patients who have already developed more severe symptoms and have additional imaging and laboratory
data taken after hospital admission. This algorithm is different since it predicts outcomes in COVID-19 patients while they’re in the emergency room—even in those with mild symptoms. It only uses information from the initial
patient encounter in the hospital emergency department.
“Our algorithm demonstrates that initial imaging and laboratory tests contain sufficient information to predict outcomes of patients with COVID-19. The algorithm can help clinicians anticipate acute worsening (decompensation) of patients, even those who present without any symptoms, to make sure resources are appropriately allocated,” explains Dr. Kwon. “We are working to incorporate this algorithm-generated severity score into the clinical workflow to inform treatment decisions and flag high-risk patients in the future.”
– Innovaccer partners with SyTrue to uncover powerful insights
and accelerate its efforts to drive healthcare’s digital transformation.
– The integration of SyTrue’s proprietary NLP OS with
Innovaccer’s FHIR-enabled Data Activation Platform will empower healthcare
organizations to identify diagnosis codes and Hierarchical Condition Categories
(HCC) from patient care progress notes and other unstructured texts.
Innovaccer, Inc., a San
Francisco, CA-based healthcare
technology company, announces its partnership with SyTrue, a leading provider of clinical data
extraction, to generate robust, actionable insights from healthcare data. The
partnership allows Innovaccer to leverage healthcare’s most-advanced Natural
Language Processing Operating System, NLP OSTM, and dive deep into clinical
data, extracting valuable details about patient health journeys.
Empowering Healthcare Organizations to Improve Patient
The integration of SyTrue’s proprietary NLP OS with
Innovaccer’s FHIR-enabled Data Activation Platform will empower healthcare
organizations to identify diagnosis codes and Hierarchical Condition Categories
(HCC) from patient care progress notes and other unstructured texts. With the
ability to gain insights from the unstructured datasets, providers can improve
the accuracy of patient risk scores.
SyTrue’s NLP OS will empower Innovaccer’s data platform to
semantically search, identify, and discover key elements from medical records
across the organization, delivering relevant, actionable insights at the moment
of care. NLP OS will allow Innovaccer to help its clients extract details about
lab records, medications, vital signs, diagnoses, and other elements from
structured and unstructured sources to successfully meet quality requirements.
The partnership will allow Innovaccer’s customer provider organizations to understand their patients’ medical records in a more comprehensive manner and optimize reimbursement through advanced coding, smart cohort identification, and unstructured data normalization.
“Creating a longitudinal record is paramount to enabling an intelligent journey throughout our complex healthcare system. Too often, crucial patient data is not included as part of the complete medical record because it is locked in faxes, portable document formats (PDFs) and other unstructured documentation. To unlock the insights contained within these files is expensive and time-consuming,” says Kyle Silvestro, CEO at SyTrue. “Our partnership with Innovaccer will reduce the time and cost to create intelligent and comprehensive insights which will significantly enhance the patient journey.”
As 170 research teams race to develop a vaccine for COVID-19, some that are in late-stage approvals have seen recent progress, but it is still not yet clear when a vaccine will become widely available. Until then, healthcare organizations continue to rely heavily on data analytics to try to improve COVID-19 outcomes and public health.
Since the novel coronavirus became widespread in the U.S., healthcare data scientists have leveraged clinical and claims data to pinpoint which underlying conditions put patients at higher risk of complications from COVID-19. Health systems are mining clinical data to predict surges in COVID-19 cases and looking at key factors—including increases in hospital website traffic, such as searches for emergency department (ED) wait times and physician page clicks—to understand how COVID-19 is ramping up locally in real-time. Meanwhile, risk-based modeling has helped health plans address social determinants of health that could impede recovery.
Now, providers and health plans are refining their approach. The more they learn, the greater the benefit to public health and long-term outcomes. Three evolving use cases for using claims and clinical data to combat COVID-19 stand out.
Reduce disparities in care. Early in the pandemic, lack of complete information around patient demographics prevented the identification of members in communities that were most vulnerable to COVID-19 infection. The impact: severe differences in mortality rates. In Chicago, the rate of mortality among Black residents was alarmingly high—70% of COVID-19 deaths—even though these residents comprise just 29% of the city’s population. Meanwhile, Spanish-speaking residents account for 18.3% of the nation’s population, yet comprise 34.3% of coronavirus cases.
One of the reasons demographic data was often missing from COVID-19 lab tests is that laboratory and hospital staff were too overwhelmed with cases to have time to input all of a patient’s non-clinical information. Today, data scientists are working to fill in the gaps using clinical history and medical claims. With these analyses, healthcare organizations are closing gaps in care, such as by expanding access to COVID-19 testing for the nation’s most vulnerable populations and increasing access to professional interpreters to more effectively gather key patient details. They are also addressing social determinants of health that heighten risks, such as food insecurity and lack of access to prescription medications.
Alleviate reliance on spotty testing. Not everyone who contracts COVID-19 has a healthcare encounter. For instance, if one member of the household tests positive for the coronavirus, other members may decide not to undergo testing if their symptoms are mild. These are instances where analyses of clinical and claims information already in the system—both emerging and historical data—can help spot unconfirmed cases of COVID-19. Such analyses give public health officials the information they need to contact, test,s and quarantine individuals that have contracted the virus, helping to limit the spread of the disease.
On a wider scale, data analysis can also provide early warning surveillance of potential COVID-19 cases, strengthening the pandemic response. For example, by observing increases in medical claims for telemedicine, rapid flu tests, and chest X-rays, data scientists can detect patterns in claims that suggest a COVID-19 outbreak is likely to occur. From there, they can forecast demand for hospital care up to 10 days in advance, ensuring that facilities have sufficient staff, supplies, and beds available to meet their community’s needs. Similarly, disruptions to seasonal flu trends, which remain fairly consistent within a region year over year, could alert public health officials to a potential COVID-19 outbreak.
Avoid preventable deaths. Information regarding patients’ underlying medical conditions can be hard to come by during a public health crisis as overwhelming and widespread as the current pandemic. In fact, just 5.8% of medical records for patients hospitalized with COVID-19 in Q1 2020 had data available related to their underlying health conditions and other risk factors. Today, it is known that certain chronic conditions raise the patient’s risk for severe complications from COVID-19—and that list of conditions is growing. The insight gained from these analyses not only informs how healthcare providers treat an individual’s illness, but also gives those with chronic disease the ability to make informed decisions based on their risk level for infection.
Moreover, the availability of actionable, real-time intelligence to improve health can set the stage for increased care collaboration. During COVID-19, healthcare providers across geographies are sharing their knowledge, especially regarding treatment protocols. Such learnings include the value of using high-flow nasal oxygen in treating severe cases of COVID-19. Early results show that this technique has a positive impact on patients with mild to moderate respiratory failure. It also reduces intubation rates and improves clinical prognosis for patients with acute respiratory failure. By sharing data-driven insights, organizations can work together to improve COVID-19 outcomes and reduce avoidable deaths.
Improving Outcomes and Reducing Risk
Clinical and claims data analysis helps healthcare organizations respond proactively to COVID-19. With the race toward a COVID-19 vaccine well underway, these analyses will help identify which populations should receive the vaccine first, assess reactions to the vaccine by demographic group and spot trends that could affect vaccination protocols. They also give healthcare organizations up-to-date contact information to engage patients, which will be critical to clinical efficacy if a second dose of the vaccine must be administered. In 2020 and beyond, continued focus on clinical and claims data analysis will be key to facilitating a robust response that enhances outcomes and saves lives.
About Emad Rizk, M.D.
Emad Rizk, M.D., is President and CEO of Cotiviti and brings a 30-year, well-documented track record of delivering improved quality and financial performance to healthcare organizations through forward-thinking leadership, business acumen, and clinical expertise.
– 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
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.
A global health crisis has thrust us into a scenario in which lives quite literally depend on the ability to virtually connect. Telehealth has rapidly emerged as a vital tool, enabling continuity of care, allowing vulnerable individuals to access their physician from home, and freeing up resources for providers to treat the most critical patients. The acceptance of telehealth and expansion of covered services for the senior population demonstrate that this technology will endure long after COVID-19 subsides.
Prior to the pandemic, just 11% of Americans utilized telehealth compared to 46% so far this year, and virtual healthcare interactions are expected to top 1 billion by year’s end. While the technology has been a life-saver for many, usage depends heavily on the availability of audio-video capabilities, internet access, and technological prowess – potentially leaving vulnerable patients behind.
Seniors Face Physical, Technical and Socioeconomic Barriers to Telehealth
Despite telehealth’s surge, there is growing concern that the rapid shift to digitally delivered care is leaving seniors behind. Telehealth is not inherently accessible for all and with many practices transitioning appointments online, it threatens to cut older adults off from receiving crucial medical care. This is a significant concern, considering older adults account for one-quarter of physician office visits in the United States and often manage multiple conditions and medications, and have a higher rate of disability. This puts an already vulnerable population at a higher risk of severe complications from COVID-19.
Research published recently in JAMA Internal Medicine found that more than a third of adults over age 65 face potential difficulties accessing their doctor through telehealth. Obstacles include familiarity using mobile devices, troubleshooting technical issues that arise, managing hearing or vision impairments, and dealing with cognitive issues like dementia. Many of these difficulties stem from the natural aging process; it is imperative for provider organizations employing telehealth and telehealth vendors to improve offerings that consider vision, hearing, and speaking loss for this population.
While barriers associated with aging are a key factor within the senior population, perhaps the greatest challenges in accessing telehealth are socioeconomic. The rapid shift to digital delivery of care may have left marginalized populations without access to the technological tools needed to access care digitally, such as high-speed internet, a smartphone or a computer.
According to the JAMA study, low-income individuals living in remote or rural locations faced the greatest challenges in accessing telehealth. A second JAMA study, also released this summer indicated that “the proportion of Medicare beneficiaries with digital access was lower among those who were 85 or older, were widowed, had a high school education or less, were Black or Hispanic, received Medicaid, or had a disability.”
These socioeconomic factors are systemic issues that existed prior to the pandemic, and the crisis-driven acceleration of telehealth has magnified these pre-existing challenges and widened racial and class-based disparities. Recent initiatives at the federal level, such as the FCC’s rural telehealth expansion task force, are a step in the right direction, though more sustained action is needed to address additional socioeconomic challenges that are deeply rooted within the healthcare system.
Fortunately, Telehealth Hurdles Can Be Overcome
Recognizing that telehealth isn’t a “one-size fits all” solution is the first step towards addressing the barriers that disproportionately impact seniors and work is needed on multiple levels. Telemedicine consults are impossible without access to the internet, so the first step is to provide and expand access to broadband and internet-connected devices. With more than 15% of the country’s population living in rural areas, expanding broadband access for these individuals is especially crucial. In addition, older adults in community-based living environments need greater access to public wi-fi networks.
Access to mobile and other internet-connected devices is also essential. Products designed with large fonts and icons, closed captioning, and easy set-up procedures may be easier for older adults to use. For example, GrandPad is a tablet designed specifically for seniors and has an intuitive interface that includes basic video calling, enabling seniors to virtually connect with their caregivers.
To address affordability, the Centers for Medicaid and Medicare Services (CMS) allowed for mid-year benefit changes in 2020 to allow for payment or provision of mobile devices for telehealth. Many Medicare Advantage organizations are enhancing plans’ provisions of telehealth coverage and devices for 2021.
In addition to increasing access to broadband and internet-connected devices, providing seniors with proper educational resources is another crucial step. Even if older adults are open to using technology for telehealth visits, many will need additional training. Healthcare organizations may want to connect older patients with community-based technology training programs. Some programs take a multi-generational approach, pairing younger instructors with older students.
For example, Papa is an on-demand service that pairs older adults with younger ‘Papa Pals’ who provide companionship and assistance with tasks such as setting up a new smartphone or tablet.
From a socioeconomic perspective, careful consideration is needed to address the concerns that telehealth may reinforce systemic biases and widen health disparities. Providers may be less conscious of systemic bias toward patients based on race, ethnicity, or educational status.
In turn, providers must address implicit bias head-on, such as offering workplace training and incorporating evidence-based tools to adequately measure and address health disparities. This includes pushing for policies that enable widespread broadband access funding to better connect communities in need.
Health plans can support expanded access to care through benefit design, reducing costs for plan members. To match members and patients with the right resources and assistance, health plans and providers should launch outreach campaigns that are segmented by demographic group. Outreach initiatives could include assessments to determine each person’s ability and comfort level with telehealth.
The Path Forward
Without question, telehealth is playing a central role in delivering care during the current pandemic, and many of its long-touted benefits have been accentuated by the current demand. Telehealth, along with other digital monitoring technologies, have the potential to address several barriers to care for seniors and other vulnerable populations for whom access to in-person care may not be viable, such as those based in remote locations or with mobility issues.
In the post-pandemic era, telehealth can provide greater access and convenience, but if not implemented carefully, the permanent expansion of telehealth may worsen health disparities. Careful consideration and collaboration will be essential in embracing the value of telehealth while mitigating its inherent risks.
If implemented correctly, telehealth can provide continued access to care for our vulnerable aging population and can significantly improve care as well. Enhancing the ability to connect with healthcare providers anytime, anywhere can give seniors the freedom to gracefully age in place.
About Anne Davis
Anne Davis is the Director of Quality Programs & Medicare Strategy at HMS, a healthcare technology, analytics, and engagement solutions company, where she’s focused on the company’s Population Health Management product portfolio.
– DispatchHealth launches Clinic Without Walls, a new service line offering patients a telemedicine visit with in-person assistance for more complex medical visits.
– The initial service line will be available in a pilot to MultiCare patients in the Tacoma and Spokane areas in an effort to its senior patients’ alternative visits during the pandemic.
DispatchHealth, a provider of in-home high-acuity medical care, today announced
the launch of Clinic Without Walls. The new service line expands access to care
for vulnerable patients by offering enhanced virtual visits with hands-on
support. Clinic Without Walls is initially being offered to MultiCare patients
in the Tacoma and Spokane areas.
Meeting the Growing Needs of In-Home Medical Care Options
visits have become an increasingly popular option to help decrease a patient’s
risk of exposure to COVID-19. More
advanced capabilities are often required for vulnerable patients who are facing
chronic disease or require medically complex care. The Clinic Without Walls
model offers these patients hands-on support with an emergency medical
technician (EMT) to help guide them through a telemedicine presentation and
connect them with a physician.
“The pandemic has highlighted the need for more in-home medical care options during the pandemic and beyond,” said Dr. Mark Prather, chief executive officer and co-founder of DispatchHealth. “Our unique model continues to expand and meet the growing needs of patients, payers, and provider partners. We are excited to continue to grow our partnership with MultiCare to help their most vulnerable patients by treating medically complex issues through hands-on support and tele-presentation.”
How It Works
During a Clinic Without Walls visit, an EMT from DispatchHealth will visit a patient where they live. The EMT comes equipped with a handheld, telehealth exam kit developed by TytoCare, manufacturer of the hand-held telehealth device DispatchHealth uses. The kit allows them to assist a guided medical exam including assessment of the lungs, ears, throat, skin, and abdomen. In addition, comprehensive vital signs, social determinants of health intervention, and moderate-complexity lab work are available in the home. If additional lab work or imaging is required, the service will be coordinated by DispatchHealth.
“The goal of this program is to keep MultiCare’s vulnerable patients safe and healthy”, said Christi McCarren, senior vice president of retail health and community based care at MultiCare. “Many of these patients have been deferring care due to the fear of contracting COVID-19. Additionally, this program helps patients facing significant mobility and transportation issues receive the care they need.”
Clinical Without Models Care Model
DispatchHealth’s Clinic Without Walls model complements the organization’s additional service lines, which include Advanced Care, Extended Care, and Acute Care. Combined, DispatchHealth is able to reduce avoidable ER visits, hospital admissions, or a stay at a skilled nursing facility. The company has experienced a period of rapid expansion and record growth and has more than doubled its national footprint in 2020, with services available in 28 cities across the United States. DispatchHealth is open seven days a week, 365 days a year, including holidays. For more information, including market hours and areas of service, visit DispatchHealth.com
– Cityblock Health, a transformative, value-based healthcare provider focused on improving healthcare outcomes for marginalized communities, today announced a $160M Series C round, bringing its total raised to $300M.
– Cityblock is a care delivery trailblazer working to right the injustices of a healthcare system that cycles vulnerable communities through frequent ER visits and hospital stays. Its tech-enabled model delivers primary care, behavioral care, and social services, virtually and in-person, to the Medicaid and lower-income Medicare beneficiary communities.
– Cityblock provides social services that address core
aspects of poverty in order to improve health outcomes, including access to
nutritious food and support to safely care for oneself.
Health, a Brooklyn, NY-based healthcare provider for lower-income
communities, announced today the completion of a $160 million Series C funding
round and a valuation of over $1 billion. New Cityblock investor General Catalyst
led the round, with participation from crossover investor Wellington Management
and support from major existing investors, including Kinnevik AB, Maverick
Ventures, Thrive Capital, Redpoint Ventures, and more. The investment round
brings Cityblock’s total equity funding to $300 million, as they look to grow
their footprint to democratize access to community-based integrated care in a
more than $1.3 trillion market.
Care That Meets You Where You Are
Spun out of Sidewalk Labs, an Alphabet Company in 2017 and anchored in a first partnership with EmblemHealth, Cityblock is a transformative, value-based healthcare provider focused on improving outcomes for Medicaid and lower-income Medicare beneficiaries. The company provides medical care (both primary care and complex specialty services), behavioral health, and social services to its members virtually, in their homes, in the community, and in its neighborhood hubs. Their model reflects an underlying philosophy that improving health outcomes and minimizing systemic healthcare inequities requires fundamentals that address the root effects of poverty, like having access to nutritious food or the ability to safely care for yourself and others.
Value-Based Care Model
Cityblock leverages a value-based model, instead of a
fee-for-service basis, like most healthcare providers. Cityblock splits the
cost savings that come from better outcomes with the healthcare payer. Cityblock’s
financial structure squarely aligns the health needs of its members to continuously
deliver patient-centric care.
Cityblock is powered by Commons a groundbreaking care delivery platform that brings together distributed community-based care teams, care delivery workflows, data feeds, and multimodal member interactions. It allows social workers, pharmacists, doctors, paramedics, and our virtual care teams to all come together on the same page in real-time. With each new market we enter, our technology reinforces our care model, allowing us to serve more members while ensuring consistently high quality, empathetic, and effective care.
Integrated Care Team
Cityblock’s integrated care teams include doctors, nurses,
advanced practice clinicians, behavioral health specialists, licensed clinical
social workers, and community health partners, and leverage close partnerships
with existing healthcare providers and community-based social services
Today, Cityblock provides care to 70,000 members in Connecticut,
New York, Massachusetts, and Washington D.C., with high member engagement and
NPS scores of high 80s to 90s across its markets. Over the past year, Cityblock
members have seen reductions in in-patient hospital admission rates and
improvements in quality outcomes, keeping people healthier and driving down
costs across the board, while more than doubling membership and revenue,
The Impact of COVID Has Magnified Health Disparities
According to Cityblock, the COVID-19 pandemic has
significantly magnified health disparities highlighting three fundamental
– Inequity of
America’s social infrastructure, including the legacy of systemic racism, has
created unacceptably disparate health outcomes
– Healthcare’s volume-based, fee-for-service payment model contributes
poor outcomes, especially for marginalized communities
– The models that
have to-date addressed key components of these challenges have not successfully
Story of Cityblock Member Sonia
The story of Sonia, a Cityblock member, is featured in the blog post announcing the raise. Counted out and considered
a ‘nuisance’ by the healthcare system, Sonia was visiting the emergency room
several times a week for care and services, resulting in poor outcomes for the
health system and for herself. Cityblock enrolled Sonia in their high-risk
short-term housing program, placing her into a hotel during the peak of her
community’s Covid-19’s outbreak. As her trust in Cityblock grew, Sonia worked
with Cityblock and its community partners to secure permanent housing. Over the
course of two years, Sonia saw a 21% reduction in hospital use and a 24%
reduction in monthly costs, and has had zero ER visits since April 2020.
“The devastating impact of COVID-19 has been a painful
reminder of the vulnerability of lower-income communities and communities of
color,” said Iyah Romm, Cityblock Health co-founder and CEO. “We cannot turn a
blind eye to a healthcare system that cycles vulnerable communities through
frequent ER visits and hospital stays. We believe that new models of care
delivery, rooted in preventative care and augmented with social services, are
one major path forward to righting the injustices of our healthcare system.
This starts with listening to our members, extends through changing payment
models to create sustainability for primary care providers and building
technology to democratize access to the care models that we are building.”
– Virtual maternity care platform Babyscripts announced a
new round of investments from Banner Health, CU Healthcare Innovation Fund, The
Froedtert & Medical College of Wisconsin Health Network, and WellSpan
– Using internet-connected devices for remote monitoring,
Babyscripts offers risk-specific experiences to allow providers to manage up to
90% of pregnancies virtually, allowing doctors to detect risk more quickly and
automate elements of care.
the leading virtual care
platform for managing obstetrics, today announced a new round of
investments through their Strategic Partners Program,
a unique investment bloc composed of health systems interested in
forwarding Babyscripts’ cutting-edge digital solutions for pregnant
populations. Partners include Phoenix-based Banner Health, one of the largest
nonprofit health care systems in the country; the CU Healthcare Innovation Fund, located on
the University of Colorado Anschutz Medical Campus in Aurora, Colorado; the Froedtert & the Medical College of
Wisconsin health network, an integrated health care system based in
Wisconsin; and WellSpan Health, an
integrated health system serving central Pennsylvania and northern
This investment round is structured to leverage the input
and support of clinical and health system partners, ensuring that Babyscripts’
product development and future roadmap aligns with customer needs.
Babyscripts has spent the last six years building a
clinically-validated, virtual care platform to allow OBGYNs to deliver a new
model of prenatal care. Using internet-connected devices for remote monitoring,
Babyscripts offers risk-specific experiences to allow providers to manage up to
90% of pregnancies virtually, allowing doctors to detect risk more quickly and
automate elements of care.
3-Tier Approach Virtual Maternity Care
Babyscripts’ three-tiered approach to virtual maternity care
allows providers to deliver risk-specific care to pregnant mothers at any time,
in any place, through a mobile app and internet-connected monitoring devices:
Maternal Digital Education: Virtually connect with expectant and new mothers between visits with a custom mobile app.
Maternal Health Monitoring: Virtual management of
pregnant patients through remote monitoring for blood pressure, weight, blood
sugar, social determinants of health (SDOH)
Maternal Population Health: Improve patient/member
care through a unique collaboration between the care team and the payer.
The solution is powered by a robust set of vetted user
experiences, integrations, workflows, and best practices.
“From the beginning, we’ve set ourselves apart from other tech companies by partnering with physicians to make sure that we’re developing solutions that will actually be useful and improve outcomes, not just look and feel ‘cutting-edge’,” said Juan Pablo Segura, co-founder and President of Babyscripts. “This investment is validation that health systems see the value of our solution — and they’re willing to put their money on it.
– Google announces the launch of its Google Health
Studies App with the first study focused on respiratory illness in partnership
with Harvard Medical School & Boston Children’s Hospital.
– Google Health Studies aims to create opportunities for
more people to participate in health research. By contributing, you’ll
represent your community and start improving the future of health for everyone.
To make it easier for leading research institutions to
connect with potential study participants, Google has announced the launch of
the Google Health Studies app with the first study focused
on respiratory illness. The app allows anyone with an Android phone to participate
in health studies by answering survey questions and contributing relevant data.
Google Health Studies provides a platform for researchers to reach a large and
diverse population so they can better understand human health, while providing
the public with greater opportunities to contribute to medical research.
Help Scientists Better Understand Respiratory Diseases
For the first study, Google has partnered with researchers
from Harvard Medical School and Boston Children’s Hospital, which will help
scientists and public health communities better understand respiratory
illnesses, including influenza and COVID-19. The study utilizes federated learning and analytics—a privacy technology that
keeps a person’s data stored on the device, while allowing researchers to
discover aggregate insights based on encrypted, combined updates from many
devices. The technology examine trends
to understand the link between mobility (such as the number of daily trips a
person makes outside the home) and the spread of COVID-19, This same
approach powers typing predictions on Gboard, without Google seeing
what individuals type.
Help Researchers Make Advancements in Medicine and Healthcare
Respiratory Health Study is open to adults in the U.S. and
will focus on identifying how types of respiratory illnesses evolve in
communities and differ across risk factors such as age, and activities such as
travel. Study participants will use the Google Health Studies app to regularly
self-report how they feel, what symptoms they may be experiencing, any
preventative measures they’ve taken, and additional information such as
COVID-19 or influenza test results. By taking part in this study, volunteers
can represent their community in medical research, and contribute to global
efforts to combat the COVID-19 pandemic.
“With COVID-19 emerging alongside seasonal respiratory pathogens, research is now needed more than ever to develop more effective treatments and mitigation strategies,” says Dr. John Brownstein, professor at Harvard Medical School and Chief Innovation Officer of Boston Children’s Hospital. “Google Health Studies provides people with a secure and easy way to take part in medical research, while letting researchers discover novel epidemiological insights into respiratory diseases.”
PointClickCare announces its intent to acquire Collective Medical to create the
largest combined acute and post-acute care network in North America for $650M.
Collective Medical’s platform connects more than 1,300 hospitals, thousands of
ambulatory practices and long-term post-acute care (LTPAC) providers, as well
as accountable care organizations (ACOs) and every national health plan in the
country, across a 39-state network.
– With the acquisition of Collective Medical, PointClickCare will solidify its position as a high-growth, cloud-based SaaS leader, serving a large, diversified customer base across the acute, ambulatory, post-acute, and payer spectrum.
Technologies, a leader in senior care technology with a network of more
than 21,000 skilled nursing facilities, senior living communities, and home
health agencies, today announced its intent to acquire Collective Medical, a Salt Lake
City, UT-based leading network-enabled platform for real-time cross-continuum
care coordination for $650M. Together, PointClickCare and Collective Medical
will provide diverse care teams across the continuum of acute, ambulatory, and
post-acute care with point-of-care access to deep, real-time patient insights
at any stage of a patient’s healthcare journey, enabling better decision making
and improved clinical outcomes at lower cost.
The acquisition follows a partnership, created between the
companies in August 2019, which streamlined the integration of Collective
Medical’s solution for care transitions with PointClickCare’s leading
cloud-based software platform. Hundreds of PointClickCare customers are already
leveraging this connection to the Collective platform to coordinate seamless
care transitions and influence decisions at the point of care.
COVID-19 Underscores Barriers to Care Coordination
Currently, hospitals, ACOs and health plans
lack the data and tools to effectively coordinate with LTPAC providers and
other disparate points of care – an issue spotlighted further by the COVID-19 pandemic.
And despite the healthcare system’s ongoing move to value-based payment
models, barriers to care coordination
persist, especially for seniors and other complex patient populations. Through
this acquisition, the company will be uniquely positioned to address these
PointClickCare supports a network of more than 21,000
skilled nursing facilities, senior living communities and home health agencies.
In the United States, 97 percent of all hospitals discharge patients to skilled
nursing facilities using PointClickCare. Founded in 2005, Collective Medical’s
platform connects more than 1,300 hospitals, thousands of ambulatory practices
and long-term post-acute care (LTPAC) providers, as well as accountable care
organizations (ACOs) and every national health plan in the country, across a
These providers come together via the Collective platform to
support patients suffering from a variety of complex conditions, including
substance use disorder, mental and behavioral health issues, and other care
needs requiring multiple interventions and transitions across disparate care
settings. The combination of PointClickCare and Collective Medical will enable
care to be more seamlessly delivered for the most complex (high-cost,
high-needs) patients, including the rapidly growing aging population.
The acquisition will connect care teams, post-acute
providers, hospitals and health plans with better data about their patients,
ultimately reducing administrative burdens and bringing down the high costs of
complex care. Providers and health plans will be empowered as they work to
solve the complexities around the senior patient population by leveraging
increased information across diagnoses groups and unprecedented access to drive
behavior change at the point of care.
Acquisition Establishes PointClickCare As Leader in Acute and Post-Acute
With the acquisition of Collective Medical, PointClickCare
will solidify its position as a high growth, cloud-based SaaS leader, serving a
large, diversified customer base across the acute, ambulatory, post-acute, and
payer spectrum. As the shift to value-based care fuels growing market demand
for intelligence and collaboration tools, the company will be best positioned
to provide the most fully integrated set of real-time care coordination tools
across the entire continuum of care, powered by the largest network of its kind
in the U.S.
“The healthcare ecosystem is a mix of disconnected providers, systems, plans, processes and data. Healthcare costs and risk are on the rise, while patient care and provider-to-provider coordination are inconsistent. Our mission is to improve the lives of seniors, and we believe the best way to meaningfully advance this goal is by connecting disparate points of care,” says Mike Wessinger, founder and chief executive officer of PointClickCare Technologies. “Collective Medical offers the right fit of people and technology and together we will initiate a new era of data-enriched collaboration across the continuum that radically transforms how data and people are empowered to liberate health.”
The acquisition is subject to receiving regulatory
approvals, including from The Committee on Foreign Investment in the United
States (CFIUS), and other customary closing conditions, and is expected to be
completed by the end of December 2020.
Highmark, one of the largest Blues plans, has chosen Lark Health for its
chronic disease prevention and management platform.
Members will have access to Lark’s 24/7 AI-based coaching and programs to
manage diabetes, hypertension, and prevent chronic conditions.
Highmark Inc., America’s fourth-largest overall Blue Cross Blue Shield-affiliated organization, announced a growing collaboration with Lark Health, virtual chronic disease prevention and management platform giving select Highmark members access to Lark’s 24/7 health coaching to prevent and manage conditions like hypertension and diabetes and to stay healthy through weight management and stress reduction programs.
Costly Impact of Chronic Diseases
Chronic conditions are widespread and costly, and Lark’s
programs are aimed at providing personalized health coaching to address them at
scale. Six in 10 U.S. adults have a chronic disease, while 4 in 10 have two or
more. Diabetes affects an estimated 30 million Americans, and is a risk factor
for complications such as neuropathy, hypertension, stroke, heart disease, and
kidney disease. Diabetes costs the nation an estimated $327 billion annually in
direct medical costs and indirect costs, such as lost productivity. Nearly 1 in
3 adults have hypertension, which is an underlying cause of over 1,000 deaths
each day in the U.S. Hypertension costs the country over $48 billion each year.
Nearly 2 out of 3 individuals with diabetes also have hypertension.
Expansion of 2-Year Collaboration
Highmark’s vision is to deliver tech-enabled
and consumer-friendly solutions that meet members where they are and allow them
to more easily manage their health with highly personalized coaching. Since
beginning the two-year collaboration, member enrollment in Lark has been
Highmark’s employer group customers in Pennsylvania, Delaware, and West Virginia, as well as commercial National group customers, are able to access Lark’s unlimited 24/7 personal counseling in real-time through an easy-to-use, text message-like modality.
Lark and Highmark have worked together throughout the collaboration to identify and reach out to individuals at risk of developing chronic conditions, increasing awareness of the virtual care offerings through social media advertising, direct mail, email, and text campaigns.
Virtual Care Platform that Addresses Health Plans’ Costliest
Powered by conversational AI, the platform seamlessly addresses the whole person, with counseling for diabetes, cardiovascular disease, prediabetes, smoking cessation, stress, anxiety, and weight management, and it incorporates smart connected devices, like scales, that sync with the program to help remotely monitor conditions. When an emergent situation or complex question arises, Lark escalates the concern to a live interaction telephonically or provides a recommended next step.
“Preventing and managing chronic conditions is time-consuming, costly, and inconvenient. We need solutions that are scalable and meet people where they are, especially for individuals who might have comorbid conditions,” said Lark CEO and co-founder Julia Hu. “We are thrilled that Highmark members are choosing and embracing Lark to help them stay healthy, and we look forward to continuing our work with Highmark to offer engaging health coaching to more people.”
The COVID-19 pandemic has shed light on the shortcomings of today’s hospital and healthcare IT infrastructure, with many healthcare organizations quickly adopting the latest and greatest technology to support remote operations. However, in the scramble to adapt, many IT leaders did not ensure that the acquired technology integrated well with legacy systems – resulting in underused components and wasted costs. As we enter into a new era in healthcare, it is paramount that these organizations adopt technologies that support overall digital transformation and are fiscally responsible. The IT acquisition journey has taken us from focusing on the speed of components to the speed of the cloud, but we must work to innovate further. To adopt infrastructure that works at the speed of the business, healthcare IT providers must evaluate legacy IT acquisition efforts, the current models, and how they can evolve in the future.
The historic view of acquiring healthcare IT has been to move at the speed of the components. This lifecycle management approach was born out of the perception that acquiring new IT systems were too expensive for the return on investment. The focus was on the management of equipment, licenses, and contracts, causing IT leaders to spend the majority of their time patching and updating existing systems. The inability to predict a system’s capacity for computing, storage, and data meant less time spent on security, which left health systems vulnerable to outside threats.
Today’s Operating Model
Today, the focus has shifted to ensuring IT infrastructure moves at the speed of the cloud. Many hospitals and healthcare organizations have adopted an on-premise cloud and consolidated their licenses, equipment, and contracts to streamline service and reduce maintenance interruptions. This allows IT departments to proactively manage infrastructure capacity while also gaining security hardened systems. The technology management approach provides application-based cost management for healthcare organizations that require a variety of different needs, adjusting the perception of IT to that of service providers. Healthcare organizations that embrace this model are able to move and house their applications based on need, rather than pre-existing equipment constraints, which was unattainable before.
The Future of IT Acquisition
Looking ahead, there is no doubt that hospitals and healthcare organizations need to continue to evolve to maintain seamless operations. With COVID-19 highlighting infrastructure vulnerabilities, it is paramount that IT adjusts for increased technology, network traffic, and security weaknesses. Healthcare organizations that are working through issues with tools, cloud skills, and other obstacles that impede hybrid cloud adoption believe these problems will soon be resolved. With that in mind, it is likely that within the next decade there will be aggressive hybrid cloud adoption across the healthcare industry.
Additionally, in response to shifting priorities, subscription and consumption-based service models are growing in popularity because of their ability to flex up or down to optimize costs and efficiencies. In the future, healthcare organizations must move at the speed of the business as well as meeting community needs, like COVID-19 data reporting and analytics.
Instead of investing in legacy solutions that have proven difficult to manage, healthcare organizations looking to adjust their IT infrastructure can consider adopting numerous “as-a-service” models. For organizations that have specific software, application management, and full system infrastructure needs, Software-as-a-service (SaaS), Platform-as-a-service (PaaS), and Infrastructure-as-a-service (IaaS) are top considerations. Some organizations may only need access to software for a set number of users, rather than full support for the entire system, pointing them to subscription-based software instead of the as-a-service options. Conversely, consumption-based software models are growing in popularity.
Organizations that prefer to pay for applications or devices based on actual usage of the product may prefer this model because it often implies the user pays a certain amount in advance and then draws down against the pre-payment based on their use (“consumption”) of the application. This option allows systems to better budget from the onset, rather than determining costs as the year progresses.
Historically, projects and supporting product offerings are based on yearly budget and funding allotments. That is until the product offerings changed. Software subscriptions, software-as-a-service (anything-as-a-service), and consumption-based services are dramatically impacting the way that IT is purchased, which helps reduce costs.
When looking at healthcare IT spending more broadly, organizations allocate millions of dollars each year, even though they often have mixed experiences in the success of implementations. Since companies usually pay based on project implementation milestones, there are rarely performance clauses. With this in mind, organizations need to hold vendors accountable for successful implementations and first-year operations. In the future, many healthcare organizations will pursue shared risk cost models as they allow the provider to develop system improvements while mitigating costs for the organization.
The COVID-19 pandemic has forever changed how health systems assess and acquire IT infrastructure. With unprecedented amounts of network traffic, telehealth needs, and sensitive patient data, organizations need to prioritize IT planning and acquisition to avoid procurement delays and exorbitant costs. As 2021 budgets are being determined, hospital decision-makers should consider adopting subscription and consumption-based models to help them the best support and protect their data and meet the demands of tomorrow.
About Cheryl Rodenfels
Cheryl Rodenfels is the Healthcare Strategist for Nutanix. She is a seasoned technology executive, responsible for improving customer success and experience across the entire portfolio of Nutanix products and services. Cheryl’s responsibilities include developing the healthcare practice at Nutanix by identifying market opportunities, creating industry-specific training and documentation, enabling sales, and improving technology adoption and solution delivery. Cheryl can be found on LinkedIn.
– Today, CVS Health was selected by HHS, as part of
Operation Warp Speed, to pilot the administration of a limited supply of
bamlanivimab, a monoclonal antibody therapy, with eligible COVID-19 patients
at-risk of severe infection or complications resulting from the virus.
– Under this pilot, Coram, the specialty pharmacy and
infusion care business of CVS Health, will administer the intravenous therapy
in patients’ homes or long-term care facilities to help meet the growing demand
for these new treatments.
– The pilot will be available in Boston, Chicago,
Cleveland, Los Angeles, Milwaukee, Minneapolis and Tampa, and their surrounding
communities starting Thursday, December 3.
CVS Health was selected today by the U.S. Department of Health and Human Services (HHS), as part of Operation Warp Speed, to pilot the administration of a limited supply of bamlanivimab, a monoclonal antibody therapy, with eligible COVID-19 patients at risk of severe infection or complications resulting from the virus. The selection underscores the role of CVS Health as a diversified health services company and expands work underway with HHS and Operation Warp Speed as CVS Health also prepares to administer COVID-19 vaccines
COVID-19 Therapy Pilot Details
Under this pilot, Coram, the specialty pharmacy and infusion
care business of CVS Health, will administer the intravenous therapy in
patients’ homes or long-term care facilities to help meet the growing demand
for these new treatments. Coram and its more than 800 certified and highly
trained nurses across the country are a prime example of how CVS Health offers
diversified health services to transform health and meet people where they are
– whether in normal times or during the ongoing pandemic.
Details of the pilot include:
– Coram will begin administering 1,000 doses of monoclonal
antibody therapies for the treatment of COVID-19.
– The pilot will be available in Boston, Chicago, Cleveland,
Los Angeles, Milwaukee, Minneapolis and Tampa, and their surrounding
communities starting Thursday, December 3. Following the pilot, Coram will
scale this solution to additional markets in areas of greatest need.
– To be eligible, and in accordance with the therapy’s
Emergency Use Authorization (EUA), patients must not be hospitalized, be within
10 days of symptom onset, at least 12 years of age or older, weighing at least
40 kilograms (or 88.2 pounds), and at high risk for progressing to severe
disease and/or hospitalization.
– There is no out-of-pocket cost to the patient for this
Why It Matters
As COVID-19 rates surge in many parts of the country, Coram
also has worked to help keep patients out of inpatient and hospital settings
altogether, alleviating pressure on the health care system and preserving
important hospital resources for the most critical patients. Since early
in the pandemic, Coram has partnered with hospitals to safely
transition eligible infusion patients home to help ensure hospital bed capacity
to treat COVID-19 patients. Importantly, today’s announcement also expands the
integral role of CVS Health on the front lines in the fight against COVID-19.
This includes work underway with HHS and Operation Warp Speed to administer
COVID-19 vaccines when available, as well as a national COVID-19 testing
infrastructure, which has enabled the company to perform more than eight
million tests across more than 4,300 retail testing locations and onsite at
workplaces and campuses around the country since the start of the
“Patients can rest assured they are receiving the best care possible through Coram in the safety and comfort of their own home or long-term care facility, and Coram is poised to continue to meet shifting health care demands as the importance and value of home-based care will undoubtedly outlive the pandemic,” added Prem Shah, Pharm.D., Executive Vice President of CVS Specialty and Product Innovation. “This established and experienced clinical service further demonstrates CVS Health’s unique ability to touch all aspects of a person’s health to make their experience more accessible and affordable.”
– DAS Health Ventures acquires healthcare
and managed IT company Randall Technology Services (RandallTech).
– This acquisition adds Allscripts® PM
and EHR solutions to the DAS portfolio of supported products, and DAS Health
has now added additional staff in Texas that will create opportunities for
greater regional support of its entire solutions portfolio.
DAS Health Ventures, Inc., an industry leader in health IT and management, announced today it completed the acquisition of Randall Technology Services, LLC (RandallTech) healthcare and managed IT company based in Amarillo, TX. As part of DAS’ growth strategy, this most recent expansion further strengthens its position in the US healthcare technology space.
Acquisition Enhances DAS Health Market Reach
DAS Health actively serves more than 1,800 clients, and
nearly 3,500 clinicians and 20,000 users nationwide, with offices in Florida,
Nevada, New Hampshire and Texas, and a significant employee presence in 14 key
states. This acquisition adds Allscripts® PM and EHR solutions to the DAS
portfolio of supported products, and DAS Health has now added additional staff
in Texas that will create opportunities for greater regional support of its
entire solutions portfolio.
Increased Support for Existing RandallTech Clients
Randall Technology’s clients will gain an increased depth of support, and a substantially improved value proposition, as DAS Health’s award-winning offerings are robust, including managed IT / MSP services, practice management, and EHR software sales, training, support and hosting, revenue cycle management (RCM), security risk assessments (SRA), cybersecurity, MIPS/MACRA reporting & consulting, mental & behavioral health screenings, chronic care management, telemedicine, and other value-based and patient engagement solutions.
Financial details of the acquisition were not disclosed.
– Zebra Medical Vision, the deep-learning medical imaging analytics company, and Scottish digital transformation consultancy Storm ID were chosen to co-develop new AI-based osteoporosis prevention solutions under EUREKA intergovernmental network.
– The UK-Israel research and development grant will be
co-developed with clinical teams from NHS Greater Glasgow and Clyde and Assuta
Medical Centers in Israel.
Scottish digital transformation consultancy Storm ID and Israeli AI
start-up Zebra Medical Vision have
won a UK-Israel research and development competition with a proposal for a
revolutionary, machine learning-driven model for early detection and prevention
of osteoporosis to improve patient care and reduce healthcare costs. The
collaboration will involve close engagement with clinical teams in NHS Greater Glasgow and Clyde and Assuta Medical Centers. The project is
co-funded in part by the UK and Israel under the EUREKA framework to foster
industrial research collaboration between the UK and Israel.
Early Detection of Osteoporosis Through AI-Based Models
For the next two years, an international, multidisciplinary
team of clinicians, data scientists and computer scientists will develop a
machine learning-driven model for early detection and prevention of
osteoporosis to improve patient care and reduce healthcare costs. The solution
will analyze medical imaging data and patient records to help clinical teams
identify and treat people with risk of fractures before they happen.
“We are pleased to partner on the development of this innovative new service for osteoporosis patients through the expertise of the West of Scotland Innovation Hub. This is another example of a successful collaboration between industry and the NHS to move forward innovative healthcare. Our clinical teams at NHS Greater Glasgow and Clyde will support the aim of this project to ultimately identify and treat patients with increased risk of bone breakage before it happens,” said David Lowe, Emergency Consultant, NHS Greater Glasgow and Clyde, and Clinical Lead, West of Scotland Innovation Hub.
As you read this, doctors are on the frontlines fighting a global pandemic. Lives depend on their skills and expertise, but what often gets overlooked is the fact that doctors are still prone to stress. Sure enough, according to a report by Medscape, more than 42% of physicians across various specialties say they are burned out.
Burnout is still a common occurrence among physicians and it’s a matter that practitioners and healthcare institutions should take seriously. After all, doctors are human like us and they deserve a break from their daily challenges. The issue of stress and burnout in the medical field continues to be a critical topic in the midst of the COVID-19 pandemic, so it’s important to explore the options that are currently available to people in the medical field. Here are a few key solutions:
1. Creating a culture of collaboration
At the organizational level, administrators will need to establish a robust program for engaging the needs of physicians and specialists. Initiatives such as mental health interventions and counseling not only encourages productivity but improves personnel retention. These should also involve physicians in the decision-making mechanisms of the organization.
Not all policies are reflective of what’s happening on the ground, so giving physicians a place in “higher up” conversations creates a culture of trust and collaboration. This, in turn, simplifies complex processes and leads to better outcomes for the whole organization.
2. Training for bigger roles
Indeed, much of the occupational stress that doctors experience stems from a lack of professional support. When you have multiple specialists doing the same tasks without giving them an opportunity to expand their horizons, you risk creating an avenue where job dissatisfaction is rampant. One way to correct this is to invest in job enrichment and build an environment where constant learning is emphasized.
This keeps the organization from thinning itself out with only a few specialists capable of handling certain tasks such as administering anesthesia or handling data security. In addition, providing doctors with enough autonomy to apply newly-acquired skills helps enhance productivity and bring innovation to the fore. Through skill development programs and participation in workshops, conferences, and team-building should be considered along these lines.
3. Developing a stress engagement program
Work stress interventions are critical to any organization, and that goes for hospitals and clinics. There is always a need to draft a game plan for knowing how to keep physicians and other practitioners engaged and prevent the onset of stress.
There are a number of ways you can go about this. For one, you may opt for a more workable shift-rotation scheme. Psycho-physiological needs should also be met, so if your organization is based in Washington, you may recommend a Seattle pain relief clinic or pain management center that’s capable of addressing stress-induced conditions such as fibromyalgia.
Stress is rampant in the medical field because practitioners are committed to providing quality life-saving services. Organizations will only need to confront the reality that doctors, nurses, attendants and everyone else down the line require enough support, especially now as healthcare systems are met by unprecedented challenges.
Senior isolation is a health risk that affects at least a quarter of seniors over 65. It has become recognized over the past decade as a risk factor for poor aging outcomes including cognitive decline, depression, anxiety, Alzheimer’s disease, obesity, hypertension, heart disease, impaired immune function, and even death.
Physical limitations, lack of transportation, and inadequate health literacy, among other social determinants of health (SDOH), further impair access to medical and mental health treatment and preventive care for older adults. These factors combine to increase the impact of chronic comorbidities and acute issues in our nation’s senior population.
COVID-19 exacerbates the negative impacts of social isolation. The consequent need for social distancing and reduced use of the healthcare system due to the risk of potential SARS-CoV-2 exposure are both important factors for seniors. Without timely medical attention, a minor illness or injury quickly deteriorates into a life-threatening situation. And without case management, chronic medical conditions worsen.
Among Medicare beneficiaries alone, social isolation is the source of $6.7 billion in additional healthcare costs annually. Preventing and addressing loneliness and social isolation are critically important goals for healthcare systems, communities, and national policy.
Organizations across the healthcare spectrum are taking a more holistic view of patients and the approaches used to connect the most vulnerable populations to the healthcare and community resources they need. To support that effort, technology is now available to facilitate analysis of the socioeconomic and environmental circumstances that adversely affect patient health and mitigate the negative impacts of social isolation.
Addressing Chronic Health Issues and SDOH
When we think about addressing chronic health issues and SDOH in older adults, it is usually after the fact, not focused on prevention. By the time a person has reached 65 years of age, they may already be suffering from the long-term effects of chronic diseases such as diabetes, hypertension or heart disease. Access points to healthcare for older adults are often in the setting of post-acute care with limited attention to SDOH. The focus is almost wholly limited to the treatment and management of complications versus preventive measures.
Preventive outreach for older adults begins by focusing on health disparities and targeting patients at the highest risk. Attention must shift to care quality, utilization, and health outcomes through better care coordination and stronger data analytics. Population health management technology is the vehicle to drive this change.
Bimodal Outreach: Prevention and Follow-Up Interventions
Preventive care includes the identification of high-risk individuals. Once identified, essential steps of contact, outreach, assessment, determination, referral, and follow-up must occur. Actions are performed seamlessly within an organization’s workflows, with automated interventions and triggered alerts. And to establish a true community health record, available healthcare and community resources must be integrated to support these actions.
Social Support and Outreach through Technology
Though older adults are moving toward more digitally connected lives, many still face unique barriers to using and adopting new technologies. So how can we use technology to address the issues?
Provide education and trainingto improve health literacy and access, knowledge of care resources, and access points. Many hospitals and health systems offer day programs that teach seniors how to use a smartphone or tablet to access information and engage in preventive services. For example, connecting home monitoring devices such as digital blood pressure reading helps to keep people out of the ED.
Use population health and data analyticsto identify high-risk patients. Determining which patients are at higher risk requires stratification at specific levels. According to the Centers for Disease Control and Prevention, COVID-19 hospitalizations rise with age, from approximately 12 per 100,000 people among those 65 to 74 years old, to 17 per 100,000 for those over 85. And those who recover often have difficulty returning to the same level of physical and mental ability. Predictive analytics tools can target various risk factors including:
– Recent ED visits or hospitalizations
– Presence of multiple chronic conditions
– Food insecurity, housing instability, lack of transportation, and other SDOH
– Frailty indices such as fall risk
With the capability to identify the top 10% or the top 1% of patients at highest risk, care management becomes more efficient and effective using integrated care coordination platforms to assist staff in conducting outreach and assessments. Efforts to support care coordination workflows are essential, especially with staffing cutbacks, COVID restrictions, and related factors.
Optimal Use of Care Coordination Tools
Training and education of the healthcare workforce is necessary to maximize the utility of care coordination tools. Users must understand all the capabilities and how to make the most of them. Care coordination technology simplifies workflows, allowing care managers to:
– Risk-stratify patient populations, identify gaps in care, and develop customized care coordination strategies by taking a holistic view of patient care.
– Target high-cost, high-risk patients for intervention and ensure that each patient receives the right level of care, at the right time and in the right setting.
– Emphasize prevention, patient self-management, continuity of care and communication between primary care providers, specialists and patients.
This approach helps to identify the resources needed to create community connections that older adults require. Data alone is insufficient. The most effective solution requires a combination of data analytics to identify patients at highest risk, business intelligence to generate interventions and alerts, and care management workflows to support outreach and interventions.
About Dr. Jenifer Leaf Jaeger
Dr. Jenifer Leaf Jaeger serves as the Senior Medical Director for HealthEC, a Best in KLAS population health and data analytics company. Jenifer provides clinical oversight to HealthEC’s population health management programs, now with a major focus on COVID-19. She functions at the intersection of healthcare policy, clinical care, and data analytics, translating knowledge into actionable insights for healthcare organizations to improve patient care and health outcomes at a reduced cost.
Prior to HealthEC, Jenifer served as Director, Infectious Disease Bureau and Population Health for the Boston Public Health Commission. She has previously held executive-level and advisory positions at the Massachusetts Department of Public Health, New York City Department of Health and Mental Hygiene, Centers for Disease Control and Prevention, as well as academic positions at Harvard Medical School, Boston University School of Medicine, and the Warren Alpert Medical School of Brown University.
Signify Health, a leading provider of technology-enabled healthcare solutions designed to keep people healthy and happy at home has acquiredPatientBlox, an Atlanta-based technology company with deep expertise in applying distributed ledger technology in healthcare. The acquisition accelerates Signify’s prospective provider payment capabilities for episodes of care, supporting the company’s commitment to advance value-based care through novel payment and risk arrangements. Financial details of the acquisition were not disclosed.
Acquisition Will Accelerate Prospective Episode of Care
The addition of blockchain technology enables a further shift away from traditional fee-for-service models. By making payments to providers at the start of the episode, providers are incentivized to drive care redesign because there is shared measurement and accountability at every step of the process, which results in improved care coordination, outcomes, and cost savings.
An episode of care is a healthcare event — a condition or a treatment — that is marked by a sequence of interactions between a patient and providers. The blockchain can capture each of those interactions and the patient’s care milestones that trigger payments. The PatientBlox platform is designed to manage these transactions without relying on fee-for-service claims.
PatientBlox Integration Offers Payers/Providers Array of Payment Options
As part of the acquisition, Signify will integrate the
PatientBlox technology into its already robust and scalable value-based care
platform, which supports $6B in healthcare spend annually associated with
the federal government’s bundled payment program, BPCI-A, and episodes of care
payment programs by health plans and employers.
The proprietary PatientBlox technology is built-for-purpose and highly-secure, enabling functionality that facilitates contract and payment administration under a prospective payment model. Under its expanded platform, Signify will offer payers and providers a diverse array of payment options to meet them where they are in their value-based care journey.
“We combined our team’s healthcare, fintech, and supply chain experience with machine-learning and Distributed Ledger Technology (DLT) to build the PatientBlox platform for administration and management of prospective bundles,” said PatientBlox Co-Founder and CEO Rahul Sharma. “Our DLT based platform enables collaboration between Healthcare Payers and Providers and provides real time data synchronization across entities thus enabling rapid scaling of prospective bundled payment programs. We are excited to work with Kyle and the Signify team and are proud to have the novel technology developed by the PatientBlox team be part of Signify’s leading platform, which is already driving real change in the healthcare industry.”
Razor-thin operational margins coupled with substantial and ongoing losses related to COVID-19 are culminating in a perfect storm of bottom-line issues for U.S. hospitals and health systems. A study commissioned by the American Hospital Association (AHA) found that the median hospital margin overall was just 3.5% pre-pandemic, and projected margins will stay in the red for at least half of the nation’s hospitals for the remainder of 2020.
The reality is that an increase in COVID-19 cases will not overcome the pandemic’s devasting financial impact. An internal analysis found that, in the first half of 2020, client organizations documented more than 1.2 million COVID-19 related cases. At least one study suggests that $2,500 will be lost per case–despite a 20% Medicare payment increase. And notably, a positive test result is now required for the increased inpatient payment.
The healthcare industry must face its own “new normal” as the current path is unsustainable, and the future stability of hospitals in communities across the nations is uncertain. If financial leaders do not act now to implement systems and embrace sound revenue integrity practices, they will face unavoidable revenue cycle bottlenecks and limit their ability to capitalize on all appropriate reimbursement opportunities.
The COVID-19 Effect: A Bird’s Eye View
The financial impact of COVID-19 is far-reaching, impacting multiple angles of operations from supply chain costs to lost billing opportunities and compliance issues. Findings from a Physician’s Foundation report released in August suggest that U.S. healthcare spending dropped by 18% during the first quarter of 2020, the steepest decline since 1959.
Already vulnerable 2020 Q1 budgets were met with substantial losses when elective procedures—a sizeable part of income for most health systems—were halted for more than a month in many cases. Many hospitals continue to lose notable revenue associated with emergency care and ancillary testing as patients choose to avoid public settings amid ongoing public safety efforts.
Outpatient visits also dropped a whopping 60% in the wake of the pandemic. While a recent Harvard report suggests that numbers are back on track, the reality is that a resurgence of cases could make consumers wary of both doctor visits and elective procedures again.
In addition, the supply chain quickly became a cost risk for health systems by Q2 2020 as the ability to acquire drugs and medical supplies came at a premium. Meeting cost-containment goals flew out the window as did the ability to create value in purchasing power.
Further exacerbating the situation is an expected increase in denials as healthcare organizations navigate a fluid regulatory environment and learn how to interpret new guidance around coding and billing for COVID-19 related care. For example, while telehealth has proved a game-changer for care continuity across the U.S., reimbursement for these visits remains largely untested. History confirms that in times of rapid change, billing errors increase—and so do claims denials.
While there is little that can be done to minimize the impact of revenue losses and supply chain challenges, healthcare organizations can take proactive steps to identify all revenue opportunities and minimize compliance issues that will undoubtedly surface when auditors come knocking to ensure the appropriate use of COVID-19 stimulus dollars.
Holistically Addressing Revenue
Getting ahead of the current and evolving revenue storm will require healthcare organizations to elevate revenue integrity strategies. Hospitals and health systems should take four steps to get their billing and compliance house in order by addressing:
1. People: Build a cross-functional steering committee that will drive revenue integrity goals through better collaboration between billing and compliance teams.
2. Processes: Strategies that combine the strengths of both retrospective and prospective auditing will identify the root cause of errors and educate stakeholders to ensure clean, timely filed claims from the start.
3. Metrics: Best practice key performance indexes are available and should be used. Clean claim submission, denial rate, bad debt reduction and days in AR are a few to consider.
4. Technology: The role of emerging technologies that use artificial intelligence cannot be understated. Their ability to speed identification of risks, perform targeted audits, identify and address root causes and most importantly, monitor the impact of process improvements is changing current dynamics. For one large pediatric health system in the Southwest, technology-enabled coding and compliance processes resulted in $230 million in reduced COVID-related denials and a financial impact of $2.3 million.
Current manual processes used by many healthcare organizations to assess denials and manage revenue cycle will not provide the transparency needed to both get ahead of problems and identify areas for process improvement and corrective action in today’s complex environment.
About Vasilios Nassiopoulos
Vasilios Nassiopoulosis the Vice President of Platform Strategy and Innovation at Hayes, a healthcare technology provider that partners with the nation’s premier healthcare organizations to improve revenue, mitigate risk and streamline operations to succeed in an evolving healthcare landscape. Vasilios has over 25 years of healthcare experience with extensive knowledge of EHR systems and PMS software from Epic, Cerner, GE Centricity and Meditech. Prior to joining Hayes, Vasilios served Associate Principal at The Chartis Group.
American businesses and their leadership are at a crossroads. COVID-19 has forced us all to re-evaluate how we work and live, while the current protest movements have placed a spotlight on the systemic injustices non-white workers face both in and out of the office. Given that communities of color have been disproportionately impacted by COVID-19, companies serious about doing right by their employees need to act decisively and clearly or risk becoming complicit in the racial and social inequities we so desperately need to correct.
The mass lay-offs and furloughs, erratic work schedules, limited sick leave benefits, and low wages have become a testament of how employers can play a role in the financial fragility and hardship of their employees. Throughout my career as a researcher and educator, I’ve seen institutions successfully make progress around racial/ethnic health disparities. In these instances, leadership has taken decisive action to review how policies and employee regulations—both explicit and implicit—have contributed to the disparities. This process needs to be ongoing, requiring company leadership to have the courage to commit to social change.
In the wake of the current social justice movement, many companies have put out statements of support for the protest movement, highlighting how they are working to address racial injustice. But these statements have been met with skepticism, especially from former and current Black employees, many of whom experienced circumstances where they did voice concerns to managers or leadership, but those concerns were ignored or left in limbo.
We’re seeing this buildup of lack of trust in workplaces across the country, especially in light of the pandemic. Consider this through the lens of reopening. The first step in determining how to open safely for all employees is listening to employees and their unique concerns. If employers truly want to reopen safely, they need to be open to receiving feedback, even when it might be tough to hear.
Once employers have employee opinion and advice, they must devise a plan for addressing their concerns, identifying what arsenal of expertise and partnerships are needed to make sustainable social change and protect employee health. Each company will have a different reopening plan depending on their needs, location, and available resources and will have to use their creativity as employers deal with the pain of serious financial losses while still committing to safeguarding employee health.
Crucially, leadership should evaluate health insurance coverage at every level of the company, as equitable access to healthcare and healthcare information via employers can go a long way in addressing a company’s racial inequalities. Further, access and information are powerful tools for alleviating anxiety, encouraging trust, and diminishing uncertainty, such as:
– Are all your employees covered for medical benefits?
– Do they know what COVID-19 related procedures and treatments are covered under their current plans?
– Can these be expanded to be ready for the next pandemic?
Trust also requires employers to regularly and critically evaluate the solutions they have put into place for employees, especially digital solutions. Digital health evaluations and AI health screening tools can appear to simplify the burden of addressing health or racial concerns. But, these tools also have faced their own issues around racial and gender bias. The guidance provided by these tools is only as good as the data that informs the platform. Employers must ask hard questions about how comfortable employees are disclosing health information, in addition to interrogating what data is informing their guidance and how confidential is the disclosed information. AI and other digital platforms are not band-aids for companies that are looking to reopen, they are part of a larger action plan that must be informed by employees’ needs and the latest expert guidance around how to prevent the spread of COVID-19.
Regardless of the pandemic, companies, and institutions that have historically made any progress around racial diversity and inclusion have actively incorporated social justice into their mission. In the midst of a pandemic, that commitment is even more critical.
The process of addressing disparities can be painful, but if companies are serious about reopening safely, they must face these realities head-on. If the commitment is real, the company evolves to a place with better employee loyalty and a stronger reputation. In today’s world, this progress will literally save lives.
The globalization of the pharmaceutical industry has forced pharma companies to outsource, increasing their reliance on third-party vendors and suppliers. As this supply chain grows in complexity, companies find themselves grappling with a growing amount of cyber risk.
A data breach in the pharmaceutical industry can cost companies upwards of $5 million and costs can rise significantly if a third-party vendor or supplier is the cause of a data breach. For this reason, organizations must ensure the third-parties that exist within their supply chain remain secure.
Challenges in the Pharmaceutical Supply Chain
There are innumerable logistical, compliance, and cost-related issues that organizations must consider as they add third-parties and vendors to their supply chain.
From a logistics view, a growing number of touchpoints between production and consumers, shipments that require refrigeration, packaging coordination, and shipment delays related to third-parties all may increase risk.
This risk is compounded by compliance-related issues. The highly-regulated pharmaceutical industry must comply with a number of healthcare-related regulations, like HIPAA, and must also be sure that their third-party suppliers abide by rules set by supply regulations like Good Distribution Practice (GDP). If these companies and their third-parties do not comply, the organization becomes subject to costly fines – which can range between $10 million and $1 billion depending on various factors.
Pharmaceutical businesses must protect their organizations in this challenging risk environment by working to mitigate third-party cyber risk as they also work to limit their own.
Why Third-Party Risk Management is Critical for Pharma
Due to the high value of the intellectual property they house, pharmaceutical companies are subject to a high-level of cybercrime. In fact, according to a study conducted by Deloitte, the pharmaceutical industry has become the number one target of cybercriminals at a global level, especially in relation to IP theft.
For a pharma organization, data breaches can be devastating, costing companies grief over lost or stolen data and large sums of money to remedy any business hindrances caused by the breach. According to Ponemon’s Cost of a Data Breach report, data breaches cost pharmaceutical companies an average of $5.2 million. When a third-party supplier or vendor causes a breach, the average cost rises by $370,000.
In order to protect drug production and patient well-being, the industry must take care to minimize its cyber risk, specifically when it comes to third-parties.
Best Practices for Third-Party Risk Management in the Pharmaceutical Industry
It is crucial that pharmaceutical organizations work to limit the third-party risk that may stem from vendors and suppliers. Use the following seven best practices for developing your third-party risk management (TPRM) strategy:
1. Identify Your Suppliers
Pharmaceutical companies have a large, outsourced supply chain and it is imperative to understand exactly who your suppliers are at all points on the chain. Cyber risk can stem from any size or type of vendor, so make sure to list each third-party you work with – from small vendors who may work with only one department, to large vendors who develop drug labels and bottle caps.
2. Understand and Qualify Potential Cyber Risks
Each third-party has the potential to introduce numerous risks that must be identified at the start of your business relationship. Make note of the types of software, networks, devices, and data that each of your third-parties access. Then, develop a risk inventory and map them against a standardized risk taxonomy, estimate the likelihood and severity of each risk, and rank each third-party in order of potential risk.
3. Determine a Risk Rating
Once each third-party has been analyzed from a risk-perspective, assign a risk rating to each. Risk ratings generally range from low to high, meaning high-risk vendors receive the most attention when prioritizing risk monitoring strategies and determining your risk appetite.
4. Define Controls
It’s important to make sure that third-parties have the same level of risk tolerance as your organization. When developing a TPRM policy, you need to define the types of controls your third-parties should be using like encryption, regular security patching, and data segregation. If possible, these controls should be worked into your business contracts.
5. Measure Third-Party Compliance
After setting controls, you must set metrics to measure third-party compliance. These metrics may include time to risk detection, time to risk remediation, or time to risk recovery. Monitoring third-party compliance regularly requires a review of security questionnaires or self-audits provided by the third-party.
6. Align with a Risk Management Framework
In order to properly manage third-party risk, pharmaceutical organizations must develop a third-party risk management framework. Common frameworks like NIST and ISO help to identify which third-party vendors pose the greatest risk and require an immediate response.
7. Continuously Monitor Third-Parties
In order to ensure security, pharmaceutical companies must continuously monitor their third-party business partners. Many organizations incorporate platforms that can monitor ecosystem risk, providing real-time visibility into the complex IT risks associated with the rapidly expanding pharmaceutical attack surface.
The supply chain for the pharmaceutical industry is increasing in regulatory complexity, logistics, and costs. Globalization has expanded the threat landscape, leaving many companies forced to upgrade their risk-management capabilities. Now is the time to adopt the best practices highlighted above to protect drug IP and patient lives.
About Dr. Aleksandr Yampolskiy, CEO of SecurityScorecard
Dr.Aleksandr Yampolskiy is a globally recognized cybersecurity innovator, leader, and expert. He is co-founder and chief executive officer of SecurityScorecard and strives to create a new language for cybersecurity by enabling people to work collaboratively across the enterprise and with external parties to build a more secure ecosystem.
Blockchain technology has somewhat infamously been described as “a solution in search of a problem,” but as the healthcare industry responds to the demands of the pandemic, several valuable use cases have surfaced that could benefit from employing the emerging technology.
Due in large part due to its ability to promote trust, transparency, and privacy, blockchain has emerged as today’s best technology-based option for accomplishing the important objective of delivering real-time access to critical information that is presented in a consistent format from trusted sources.
False positives, duplicate records, and privacy issues make it very difficult to derive actionable intelligence with confidence from the current data-sharing infrastructure that exists in the healthcare industry. Further, lack of trust represents another challenge that hinders the formation of greater transparency, as much of the healthcare industry remains reluctant to pervasively share data due to privacy and competitive barriers.
By design, blockchain allows for competing organizations to come together to share data about their patients in a completely auditable way, while maintaining their competitive independence and privacy concerns. It is these fundamental qualities that have helped blockchain emerge as a viable solution for a number of critical healthcare functions whose importance has grown during the COVID-19 pandemic, such as contact tracing, provider credentialing, and patient records-sharing.
Blockchain: The basics Before delving into the specifics of what blockchain can do for healthcare during the pandemic, it is important to establish a general understanding of blockchain’s basics. By no means is it necessary for most healthcare executives to develop a deep knowledge of the technology, but familiarity with its essential elements will enable business leaders to speak roughly the same language as healthcare technology experts as blockchain continues to gain prominence.
Blockchain is a distributed ledger technology that enables users to share trusted and verified information in a decentralized manner. Combined with security and cryptography technology, blockchain can protect the privacy of users who contribute data while also sharing the provenance of the data, enhancing trust.
Blockchain technology provides a safe, effective way to accurately document, maintain, store, and move data – from health records to financial transactions. With blockchain, people can directly engage with others to receive services, transfer money, and perform other common daily tasks we do in business today.
Blockchain use cases The biggest benefits offered by blockchain are associated with greater trust and privacy due to the technology’s ability to enable better data accuracy and verification. At its most basic level, blockchain changes ownership and control of data from one centralized source to multiple sources that contribute data. Following are three COVID-19-related use cases for blockchain in healthcare.
Contact tracing: To follow the potential transmission of the novel coronavirus, many governments have embarked upon contact tracing, in which infected individuals are asked to list all other people they’ve come into contact with over a certain period of time. Decentralization of data helps facilitate critical healthcare operations such as contact tracing because the process is reliant on using granular, sensitive data to inform public health officials of who may be at risk of exposure based on their movements and contacts. In contract tracing, maintaining individuals’ privacy is critical. Earlier this year, blockchain platform Nodle launched a contact-tracing app called “Coalition,” which emphasized user privacy.
Patient-record sharing: Another valuable use case for blockchain as it relates to COVID-19 is the aggregation of patient records during a crisis or disaster to create a “light” electronic health records system, which disparate groups of providers can use to share patient records while treating unfamiliar patients during the pandemic or other crises and natural disasters. Such a platform will allow providers to work with patients who may not have access to their usual provider, but still receive the full range of needed services and prescriptions. The main concept of the solution is that patients’ electronic health records follow them wherever they go. In other words, regardless of where the patient stays during a disaster, there is always access to their personal medical information and they are able to receive required medical services. This patient data can be delivered through a blockchain digital wallet, providing access, security, and integrity of data.
Provider credentialing: Provider credentialing — which is the process of verifying providers’ skills, training and education — is an often-tedious, time-consuming process for both providers and payers that can lead to delays in care that contribute to poor health outcomes. By using blockchain for the process, providers can maintain control of their own data and give health systems, payers and other authorities access to their credentials as they like. Earlier this year, five organizations announced plans to use a new blockchain credentialing system from ProCredEx with the aim of using distributed ledger technology to reduce time and costs associated with the traditional approach to credentialing.
The right technology at the right time It is important to note that blockchain technology requires a cultural and paradigm shift toward broader collaboration across traditionally disparate and potentially competitive entities. The technology facilitates a framework that allows organizations to contribute to joint efforts without risking their intellectual property or proprietary information. However, it will still require an intentional change in behavior to successfully work across different business interests toward a common goal. Nonetheless, to surmount the challenges posed by healthcare’s manual, time-consuming processes for contact tracing, patient record-sharing, and provider credentialing, blockchain represents the right technology at the right time.
About Brett Furst
A senior executive with nearly three decades of experience in selling and managing technology solutions within the manufacturing, CPG, and healthcare industries, Brett Furst serves as president of HHS Technology Group, a software and solutions company serving the needs of commercial enterprises and government agencies.
– White house coronavirus task force doubles down on rapid testing strategy to fight the coronavirus as some states say they don’t have the supplies to comply with the federal government’s advice.
– This article was originally published by the Center for Public Integrity, a nonprofit investigative news organization based in Washington, D.C.
The White House coronavirus task force is doubling down on part of its strategy for halting the spread of the virus: widespread use of rapid tests.
As COVID-19 cases and hospitalizations reached record highs, the task force last week issued advice to a number of governors: Begin using rapid tests on all young people, even those without COVID-19 symptoms, in counties with exploding numbers of cases.
The guidance came as state officials and some scientists express doubt about rapid testing strategies. The rapid tests, known as antigen tests, give results faster but are more likely to return false negatives than lab-based polymerase chain reaction (PCR) tests, and the Food and Drug Administration has not yet approved the rapid tests for use in patients who show no symptoms.
But the nation’s testing czar, Adm. Brett Giroir, who also sits on the task force, gave a robust defense of the strategy in emailed responses to questions from the Center for Public Integrity.
“The testing of asymptomatic individuals with rapid antigen tests is vital,” Giroir wrote. “The data are really to a point that those who argue against asymptomatic testing … are more influenced by politics, financial self-interest of their industry, or lack of knowledge, than they are by the evidence of how to support control of the pandemic.”
The task force previously urged states to use the rapid tests to screen certain groups, such as teachers or health-care workers. The federal government is distributing to states 150 million antigen tests made by Abbott Laboratories.
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In his email Giroir pushed back on comments from another member of the task force, Dr. Scott Atlas, who told The New York Times last month that testing asymptomatic people would amount to “destroying the workforce.” Atlas, a favorite adviser of President Donald Trump, holds views repudiated by many scientists studying the pandemic and has been the source of rifts within the task force.
“No credible public health expert would suggest that it is good practice to allow an infectious person — whether symptomatic or asymptomatic — into the community or workforce,” Giroir wrote. “The best way to keep America working and Americans in school and employed is to control the spread of the virus.”
But it’s not clear that states can keep up with the federal advice to deploy rapid tests more broadly.
Of the 16 states that responded to questions from Public Integrity, 11 said they were using rapid tests to screen special populations, such as nursing-home residents or health-care workers, but only four indicated plans to use them on broader populations. Several said they didn’t have enough tests to screen the general public.
“We do not have enough supplies to use for general population testing,” said Taylor Gage, spokesman for Nebraska Gov. Pete Ricketts. “The state is using all the tests — we do not have a reserve or backlog on hand.”
Manpower is another dilemma. Some states don’t have enough school nurses to deploy antigen test screening in schools, let alone the general population, said Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials.
“Nobody’s against that but some of it is just pure logistics. If you want us to do that, where are the tests?” Plescia said. “It’s just there are sort of on-the-ground challenges to rolling some of the stuff out with the speed that the administration would like.”
Another hurdle to testing 18-40-year-olds: the millennials themselves. Young people so far have not responded well to efforts such as contact tracing, said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials.
“Getting them to test frequently, if this is the population we’re targeting, will require more than just putting the tests out there,” she said. “It requires, really, a campaign to change public sentiment around the disease.”Preview mode is not supported for related articles. Please change to Edit mode by clicking the pencil icon in the toolbar above.
That’s something the White House has not done. The president lately has been mostly silent about coronavirus testing, after weeks of falsely blaming high case counts on increased testing. And the task force’s recent endorsements of antigen testing are contained in reports to governors that the White House does not make public.
“We’re hearing some of the right words, the right public health tactics, the right strategies emerging from the White House task force behind the scenes, but we really have to turn that internal to an external, public-facing messaging campaign,” Tremmel Freeman said. “Nobody really knows what the strategy is or why it’s important.”
In addition to concerns about “how,” some states are hung up on whether they should use rapid tests on asymptomatic people when the FDA has not approved them for that use.
Several states still have official health guidance that contradicts the White House view of rapid tests — Virginia policy, for example, says PCR testing should be used whenever possible. At least three states have discouraged the antigen tests’ use in nursing homes. The federal government has shipped more than 13 million rapid tests to nursing homes, but a Kaiser Health News investigation found that roughly 38% of the nation’s nursing homes have yet to use them.
“There’s quite a bit of uncertainty and things we’re sorting out that have caused most of us to move forward with some caution,” Plescia said. The health officials in his organization “just have some anxieties around the accuracy of the test.”
But several scientists who spoke to Public Integrity said the administration’s push to test more asymptomatic young people using antigen tests is a good idea.
“We have to do more to break these chains of transmission,” said Gigi Gronvall, an immunologist at the Johns Hopkins Center for Health Security. “You could be saving somebody by testing them and getting them to isolate.”
Some cautioned that jurisdictions who deploy the tests more broadly need to have clear plans to ensure positive people isolate — which may be a challenge for those who need to show up to jobs or risk losing them.
“Advocating for [antigen tests’] use really broadly without a plan for what to do with the results is going to create problems,” said Susan Butler-Wu, an associate professor of clinical pathology at the University of Southern California’s medical school. “You have to have a plan for what to do when it’s positive, and you have to have a lot of education around what to do if it’s negative.”
Giroir said states must figure out how exactly to test wide swaths of their populations, though he said weekly testing at universities has shown the best results.
“States and counties need to employ strategies specific to their populations including education and resources,” he wrote.
Over the past few months, primarily as a result of the COVID-19 pandemic, telehealth has gone from a “nice-to-have” to a “must-have” for healthcare providers. The surge of COVID-19 patients in the spring, coupled with “stay-at-home” orders in many states, meant that many patients in need of care for chronic conditions and other non-emergent health issues were unable to visit their providers face-to-face.
Telehealth became the emergency solution, aided by relaxation of government regulations and improved reimbursement from health payers, led by the U.S. Centers for Medicare and Medicaid Services (CMS). But then a funny thing happened.
As COVID-19 restrictions eased, many patients and providers found they liked telehealth and wanted to keep it around. Patients liked it because they didn’t have to take hours out of their day to travel to an appointment, go through COVID-19 protocols, wait to be called, wait to see their provider, then travel home again.
Providers liked it because they could work more efficiently and, if they were incorporating remote patient monitoring, obtain a more complete view of their patients’ day-to-day health. Both sides also liked telehealth because, quite frankly, it helped them reduce their risk of contracting a highly contagious virus.
While we are not out of the woods yet – many experts are predicting a fall and winter surge that will make the spring surge look like a warm-up act – there are already discussions about whether telehealth was simply a stopgap measure in a crisis or should be viewed as a standard option for care going forward. In order to make telehealth permanent, however, healthcare organizations will want to know exactly what it can contribute once it’s safe to venture to the office once again.
Advanced analytics can help. They can show what worked, and what didn’t, so providers can make data-driven decisions about where, how, and whether to continue using telehealth. The following are eight ways analytics can contribute to present and future telehealth success.
1. Find the patients for whom telehealth visits offer the greatest benefits. Normally, these will be patients who can be diagnosed or assessed without direct laying-on of hands. They may have a condition such as a rash that can be inspected visually or may be able to use consumer-grade devices to take and report biometric readings. Advanced analytics can help discover them, enabling providers to close care gaps while improving Star ratings and HEDIS scores.
2. Prioritize patients by need. Analytics can help identify patients who are most at-risk of deterioration if they do not follow-up after preventive or elective procedures or are not closely monitored. They can also help providers make the appropriate adjustments to those priorities as patient health changes.
3. Get ready for additional surges. The next surge has already begun, and there are likely to be others before the pandemic is fully behind us. Providers need to have measures in place to keep staff safe and avoid the risk of more lockdowns or other changes that will disrupt their operations. Analytics can help them determine how much to invest in additional telehealth equipment and training to ensure uninterrupted service to their patients.
4. Measure telehealth’s impact on patient outcomes and reimbursement. Telehealth is so new, and the pandemic has caused so many shifts in reimbursement, that it can be difficult to determine exactly what effect it has had on outcomes and revenue. Analytics can uncover which changes have been positive and should be continued, and which should either be discontinued or adjusted to produce better health and/or financial result.
5. Uncover and rectify possible coding errors. As the pandemic took hold in March, CMS launched its “patients over paperwork” initiative. The goal was to ensure providers focused on care rather than worrying about coding accuracy, especially as the path to telehealth opened up. At some point, however, accurate coding will again be required. Analytics can help providers uncover and rectify any coding issues to ensure claims are paid fairly and completely.
6. Enable more effective remote patient monitoring. The presence of a global pandemic doesn’t halt chronic or other conditions affecting patient health. These conditions must continue to be managed to prevent them from deteriorating, which will place more of a health burden on patients while increasing long-term costs. Remote patient monitoring delivers the day-to-day data on these conditions. Analytics use that data to spot trends and update providers on the condition of all those patients, making it easier to ensure successful treatment for all of them.
7. Manage timed events more effectively. Risk-adjustment capture of previously documented conditions, which comes through CMS sweeps, retrospective reviews, and other means, can be disruptive to provider operations. Analytics can take the burden off an already exhausted staff by automating and simplifying the process.
8. Use trend and outcome data to inform the future. There is still much we don’t know about the effectiveness – and cost-effectiveness – of telehealth. This type of forward-looking analysis can be used to deliver policy and regulatory guidance for permanent reimbursement and best practices for telehealth-related visits.
As we continue to battle the global pandemic, telehealth does more each day to demonstrate its value. But what happens when the battle is finally won? Should it go back to the background or become fully integrated into a healthcare organization’s standard offerings?
Advanced analytics can be used to answer these questions and many others, helping providers make the decision that best fits their organization.
About Prasad Dindigal Prasad Dindigal serves as Vice President, Healthcare & Life Sciences, with EXL, a leading operations management and analytics company that helps our clients build and grow sustainable businesses.
– Omada’s diabetes prevention program will be available
to Intermountain’s at-risk patient population as part of a limited engagement
in 2020 and 2021.
– Omada’s diabetes prevention program is personalized to
meet each participant’s unique needs as they evolve, ranging from diabetes
prevention, type 2 diabetes management, hypertension, behavioral health, and
Deepening a collaboration that began in 2016, Omada Health
Healthcare announced the availability of Omada’s Prevention Program as a covered
benefit to patients with prediabetes seen by Intermountain Medical Group
providers at Intermountain primary care facilities. As in-person healthcare
systems seek to integrate proven digital care and coaching for at-risk
patients, this new offering creates a roadmap for large health systems across
the country. Omada’s prevention program will be available to Intermountain’s
at-risk patient population as part of a limited engagement in 2020 and 2021
that launched at the end of August.
Omada’s diabetes prevention program is personalized to meet
each participant’s unique needs as they evolve, ranging from diabetes
prevention, type 2 diabetes management, hypertension, behavioral health, and
musculoskeletal issues. Omada combines professional health coaching, connected
health devices, real-time data and personalized feedback to deliver clinically
Expansion Builds on Previous Successful Collaborations
This announcement builds on a series of milestones between
Intermountain Healthcare and Omada. In 2016, the two companies launched an
innovative partnership in conjunction with the American Medical Association to
deliver digital diabetes prevention services via physician referral. In 2019,
the Omada Program became a covered benefit for Intermountain employees and
their adult dependents, followed by an investment from
Intermountain Ventures, the strategic investment arm of Intermountain
“Intermountain is focused on ensuring all patients receive the care and information they need – where, when, and how they want it – with seamless coordination across the system,” said Elizabeth Joy, M.D., M.P.H., Intermountain’s Medical Director for the Office of Health Promotion and Wellness under Community Based Care and Nutrition Services. “We’ve enrolled nearly 2,000 participants to date from our caregiver population, and we anticipate that access to the Omada program will enhance patient engagement and improve health outcomes in a time when patients are seeking deeply human digital care.”
Why It Matters
“By expanding the Omada diabetes prevention program to our at-risk patients, digital coaches will help encourage and teach patients to proactively manage and improve their overall health and prevent a potentially deadly disease. This is one of the many ways Intermountain Healthcare is moving toward value-based care, which aims to improve patient outcomes and reduce healthcare costs, not just for patients, but entire communities,” said Rajesh Shrestha, VP and COO, community-based care at Intermountain and president and CEO of Castell, an Intermountain company focused on elevating value-based care capabilities.
We’ve all experienced crises in our lives. They may be personal in nature (e.g., involving our interpersonal relationships), organizational (e.g., relating to our employment or retirement income), or nature-made (e.g., floods, tornados, or the COVID-19 pandemic). When crises hit our communities, the impacts can be widespread and far-reaching. Healthcare providers and community-based organizations (CBOs) are called upon to provide more rapid and extensive care and support to the community than is otherwise the norm. A well-established and highly functioning Connected Community of Care (CCC), as is the case here in Dallas, Texas, can provide a tremendous strategic and tactical advantage over non-connected peers.
Since 2014, the Parkland Center for Clinical Innovation (PCCI) has led an effort to bring together several large healthcare systems and a number of regional social-service organizations such as food banks, homeless assistance associations, and transportation service vendors, along with over 100 smaller CBOs (i.e., neighborhood food pantries, crisis centers, utility assistance centers) and area faith-based organizations to form the Dallas CCC. Over time, civic organizations, such as the Community Council of Greater Dallas, Dallas County Health and Human Services (DCHHS), and select academic institutions have begun to participate in various community-wide projects under the Dallas CCC umbrella.
Central to the success of the Dallas CCC are the partnerships that have been formed between the CBOs and a number of local healthcare systems (Parkland Health & Hospital System [Parkland], Baylor Scott & White Health, Children’s Medical Center, Methodist Health System, and Metrocare Services), clinical practices, and other ancillary healthcare providers serving the Dallas metroplex. These partnerships have proved essential in building a truly comprehensive and functional network aimed at improving both the health and well-being of Dallas residents.
Connecting these various entities and forming a two-way communication pathway is an electronic information exchange platform termed Pieces™ Connect, which allows for real-time, two-way sharing of information pertaining to an individual’s social and healthcare needs, history, and preferences. The information exchange platform is the glue that holds the physical network together and provides one of the mechanisms to disseminate information from public health and healthcare entities to social service providers in the community. It allows the individual community resident, via the CBO, to become better informed about important health issues, such as routine vaccinations or preventive care, such as social distancing and proper mask usage during a pandemic.
Until recently, the primary mission of the Dallas CCC focused on addressing residents’ social determinants of health (SDOH) issues through providing community resources (e.g., food assistance, housing, transportation) to improve the lives of Dallas County residents. While this mission has become even more critical during the COVID-19 pandemic, the work of the Dallas CCChas also evolved to include identifying COVID-19 sites within the County and directing community outreach efforts to help stem the rapid spread of the virus.
The Dallas CCC has provided an innovative model of community governance and cooperation to impact the consequences of the COVID-19 outbreak. From the first days of the pandemic, PCCI has been working with Parkland and DCHHS to help reliably identify and quantify the geographic location and incidence rates of positive COVID-19 cases within Dallas County. This problem is especially challenging when considering vulnerable populations and the transitory nature of these residents in inner-city communities.
Working with data provided by DCHHS, the Dallas-Fort Worth Hospital Council, and CBOs, PCCI built a series of dynamic geo-maps that were able to identify, at the neighborhood and block level, the location of hotspots of positive COVID-19 cases as well as attendant mortality rates. In addition to flagging at-risk patients and populations, the model continues to be used by public health and civic leaders to establish locations for testing sites within the city of Dallas based on COVID-19 incidence and community needs.
With the establishment of the hot-spotting, the next step was to get that information, along with general infection prevention protocols, in the hands of local CBOs to help raise awareness and slow the spread of the virus. With the aforementioned information in hand, public health workers have been able to develop targeted communications and tactical strategies to improve containment efforts through community-wide awareness and educational messaging.
By connecting local CBOs and faith-based organizations with public health workers and clinicians, the Dallas CCC is facilitating effective contact tracing and the implementation of care plans for high-risk individuals in a more efficient and scalable manner.
The value of the CCC communication network linking healthcare providers and CBOs cannot be underestimated, as it represents a highly effective and efficient mechanism to disseminate leading practice information aimed directly at high-risk populations. We have seen first-hand that communications delivered to community residents through familiar food pantries, homeless shelters, and places of worship are much more effective than community-wide public information campaigns broadcast via radio or television.
This increased effectiveness is based on the fact that many of these at-risk individuals frequent the CBOs on a regular basis for essential services and these individuals know and trust the CBO staff delivering the information. From one-on-one conversations to displaying infographic posters and take-away educational leaflets, CBOs provide a ready avenue to communicate with at-risk individuals in the communities they serve.
As mentioned, early work in Dallas County is beginning to demonstrate the value of CCC in facilitating contact tracing. In this case, the challenge is not simply identifying the location of positive COVID-19 cases but having the ability to connect those cases to other individuals within the neighborhood or community who may have come in contact with the infected individual, all while working in an environment where individuals frequently move from one location to another. Having a well-established communication system at the local neighborhood level can be extremely helpful in identifying contacts and potential contacts.
It is well-known that many individuals in impoverished, underserved neighborhoods are reluctant to speak with individuals they don’t know or trust, especially if those individuals are affiliated with government agencies, no matter how well-intentioned the agency personnel may be. Staff members at local faith-based organizations and CBOs frequented by these vulnerable residents are a highly effective resource for identifying inter-personal relationships and connecting with those individuals, which is something that has proved challenging for public health staff when working outside of a CCC environment. In Dallas, CBOs, public health, and civic staffers, as well as medical student volunteers have all been partnering to help facilitate the contact tracing process with positive results.
CCC’s can materially improve the health and well-being of a community’s residents, especially in times of crisis. The take-away lesson is clear. If you already have a CCC, lean on it to help you through crises impacting your community. If you don’t have a CCC, now is the time to begin the process of establishing one in your community. Even with the challenges that the current pandemic is generating, it is possible to begin building your CCC. Start small and gradually increase the CCC’s scope and scale; don’t be in a rush to grow. The most important thing is to take the plunge and begin the journey!
the leader in technology-enabled behavioral health integration, is now
available to healthcare providers through Epic’s App
Orchard marketplace. NeuroFlow combines provider workflow augmentation
solutions, clinical care dashboards, and a patient-facing application to create
a clinical feedback loop centered around behavioral health.
– Patient generated data including validated assessment
scores, mood and sleep ratings, and journal responses are fed into NeuroFlow’s
provider-facing web platform, which leverages a combination of machine learning
and natural language processing (NLP) from patient journal entries to risk
stratify patients and enhance care coordination efforts.
– The NeuroFlow integration with Epic will
help organizations accelerate their efforts toward integrated care by
facilitating reimbursement for collaborative care codes and optimizing value-based contracts.
– The launch is an encouraging development for health
systems seeking to practice any of a range of collaborative care models, a
clinical approach integrating both the physical and mental health of
patients. Hospitals and health systems using Epic can deploy NeuroFlow to
streamline clinical workflows and scale existing initiatives for measuring and
treating patients’ mental health symptoms.
Health authorities need to prioritize delivery and the repurposing of mobile point-of-care ultrasound machines which have proven to be reliable, affordable, and effective in saving the lives of coronavirus patients.
Most Americans are familiar with ultrasound technology from the scans done to check on the status of the fetus during pregnancy.
But far fewer are aware of how valuable mobile versions of these units have also become in America’s emergency rooms where they almost instantly detect and record everything from internal bleeding, abdominal pain to life-threatening infections.
We now need to raise the status of these life-saving diagnostic machines, finding and rushing them to the frontlines of hospitals where coronavirus patients are triaged and cared for.
Even before the COVID-19 pandemic, there had been elevated global demand for these mobile – called “point of care” – units that can be brought to the bedside. Some are small handheld devices that instantly connect to a smartphone.
International relief organizations and national health authorities have issued urgent calls to manufacturers in the last few days for any surplus or underutilized ultrasound equipment capable of performing lung scans. They are also seeking point-of-care ultrasound units that are underutilized or are in “retired” inventory at clinics and hospitals around the world, units that can be adapted for use in lung ultrasound (LU) diagnosis.
Sales and maintenance records from manufacturers may also be used to track down operational LU machines that are already in-country and can be drafted into urgent service during the pandemic.
Because the most desired devices are mobile and move from patient to patient, very strict hygienic procedures must be carefully monitored and managed.
As with so many technical innovations over the past half-century, taking the technology mobile was originally funded by one of the smallest but most consequential units in our U.S. military arsenal: Defense Advanced Research Projects Agency (DARPA).
DARPA didn’t invent ultrasound, but it did help shrink the technology to mobile size so that frontline military physicians could take the technology closer to the battlefield and save the lives of wounded warriors. These mobile units, now ubiquitous in ICUs and in emergency rooms around the world, are much cheaper and lower risk than radiography (x-ray) units which are difficult to maneuver to the bedside of the critically ill especially with diseases as transmittable as a coronavirus.
It turns out that these popular mobile units provide particularly precise views of distressed lungs – important tools to have when doctors need to see the exact progression of the COVID-19 virus in infected patients who are quarantined and unable to be safely moved to a remote radiology suite. COVID-19 often presents as a respiratory invader that causes acute inflammation in the lungs, primarily as a patchy, interstitial infiltrate – a condition recognized with ultrasound imaging.
A small but important study was just published in Radiology by the Radiological Society of North America (RSNA) on March 13 which comes from other doctors also on the coronavirus frontlines in Italy.
That report – covering the records of emergency physicians at Ospedale Guglielmo da Saliceto in Piacenza, Italy – claims a “strong correlation” between lung ultrasound and CT findings in patients with COVID-19 pneumonia, leading the investigators to “strongly recommend the use of bedside [ultrasound] for the early diagnosis of COVID-19 patients who present to the emergency department.”
Pneumonia and respiratory failure are a principal cause of death among COVID-19 patients. What we can assess in a lung ultrasound right now in these patients is the involvement of both lungs with basically patchy findings. Distinctive to the disease is typically ultrasonographic B lines – wide bands of hyperechoic artifacts that are often compared to the beam of a flashlight being swung back and forth.
If there is a significant consolidation, diagnostics may also capture imagery of hepatization of the lung. This information is critical to monitoring, addressing, and curing pneumonia.
For these patients and hospitals in crisis, mobile lung-ultrasound units are also scanning far more patients in a short period of time than more elaborate diagnostic imaging technologies, while delivering an accurate, actionable answer on the presence and degree of infection.
Lung ultrasound is a critical application of the point-of-care mobile units in the emergency rooms battling COVID-19 around the world, but these patients very sick with COVID-19 may also need venous access under ultrasound guidance to administer fluids and medications. Or they may be in shock and need a shock assessment, for which point-of-care ultrasound in COVID-19 resuscitation bays and ICUs are also very useful.
The COVID-19 pandemic is expected to get worse in the U.S. before it gets better. New York, California, and the State of Washington have set up military-style hospitals – 250-bed infirmaries that will be fully functional hospitals for COVID-19 patients – and will be placing point-of-care ultrasound there and elsewhere where it would be much more difficult to put a CT scanner.
The challenge in meeting that urgent goal is whether we can find and deploy enough functional lung ultrasound devices to COVID-19 responders in the next several weeks to save lives that are already in danger and restore COVID-19 patients alive and well to families desperate for medical rescue. I believe we can and will.
About Diku Mandavia, M.D.
Diku Mandavia, M.D. is the Senior Vice President, Chief Medical Officer, at FUJIFILM Sonosite Inc., and FUJIFILM Medical Systems U.S.A., Inc. He completed his residency in emergency medicine at LAC+USC Medical Center in Los Angeles where he still practices part-time. He is a Clinical Associate Professor of Emergency Medicine at the University of Southern California.
Today, hospitals and insurance companies are increasingly
investing in digital health innovations like Buoy to solve problems related to
accessing the healthcare system and helping patients to get to the right care
setting on the first attempt. By
addressing the problem that happens when people attempt to search their
Founded in 2014 by a team of doctors and computer scientists working at the
Harvard Innovation Laboratory, Buoy Health uses AI technology to provide
personalized clinical support the moment an individual has a health concern. Buoy
navigates people through the healthcare system intelligently, delivering triage
at scale, and connecting them with the right care endpoints at the right time
based on self-reported symptoms.
Buoy will use the proceeds to further build out its IP with respect to artificial intelligence and other technologies, as well as grow the Buoy team. The fundraise will advance Buoy’s clinical and insurance-based navigation capabilities to help move the individual to a more consumer-friendly healthcare journey.
As of the Series C close, Buoy has helped nearly one million
Americans assess symptoms and locate the best places for them to seek care in
their community during the COVID-19 pandemic. As one of the first digital
health companies in the U.S. to respond to the pandemic, Buoy was an early
leader in connecting individuals to care at the right time, saving more than
29,764 medical professionals’ hours, or 1,240 days.
Buoy also launched Back With Care, an employer platform that
provides health resource navigation, risk assessment and personalized guidance
for the transition back into the workplace for employers and employees across
the country. With numerous tech companies and large healthcare organizations launching
consumer-centric offerings to tackle this issue, Buoy remains committed to
humanizing the healthcare journey and assessing the COVID-19 risk in connection
with getting back to physical offices.
“We are honored by the continued support and commitment in Buoy from many of the industry’s most influential insurers and are proud to be working with a group of investors that truly believe in our mission to make healthcare more personalized and convenient,” said Andrew Le, MD, CEO and co-founder of Buoy Health.
Le continued, “Buoy was founded on the idea that turning to the internet for answers when you are sick can be overwhelming, confusing, and inefficient. I’m proud of the work we’ve done to help more than 9 million individuals make more informed decisions for their health, and the tools we have built to help consumers and employers navigate COVID-19. From the moment an individual has questions about their health, to ensuring they get the support they need as they seek care, Buoy will serve as the sidewalk to every possible front door of care, navigating the individual through their healthcare journey.”
– Cleveland Clinic develops the COVID-19 risk prediction model through Epic MyChart that is now available to health systems around the world.
– Healthcare organizations can present the clinically
validated model to patients in MyChart to assess their risk of having COVID-19.
Cleveland Clinic researchers have developed a COVID-19 risk prediction model that uses information from the patient’s comprehensive health records combined with patient-centered information in Epic’s patient-facing app, MyChart, to show an individual’s likelihood of testing positive for COVID-19. The COVID-19 risk prediction model is now available to health systems around the world through Epic.
Predicting positive COVID-19 tests could help direct limited healthcare resources, encourage those who are likely to have the virus to get tested, and tailor decision-making about care. Cleveland Clinic’s model was developed and validated using retrospective patient data from more than 11k patients tested for COVID-19 at Cleveland Clinic locations in Northeast Ohio and Florida. Data scientists used statistical algorithms to transform data from patients’ electronic medical records into the first-of-its-kind risk-prediction model. All data collected was housed in a secure database.
How It Works
Patients complete a short self-assessment in MyChart,
documenting information like symptoms they are experiencing and potential
exposure to COVID-19. The model uses that information, as well as clinical and
demographic data already in their electronic chart, to calculate their score.
Patients with high risk for having COVID-19 are advised to receive a test, and
their care team members can be automatically notified of a high-risk score.
Other healthcare providers around the country also have
developed risk prediction models, which they can integrate with Epic. For
organizations that want to use an existing model rather than developing their
own, they can quickly turn on the model designed, developed, and tested–and now
being shared–by Cleveland Clinic researchers.
“We have developed the first validated prediction model that can forecast an individual’s risk for testing positive with COVID-19 and then simplified this tool while retaining exceptional accuracy for easy adoption,” said Lara Jehi, M.D., Chief Research Information Officer at Cleveland Clinic. “We are excited to make this tool available to the 250 million patients around the world who have a record in Epic. The ability to accurately predict which patients are likely to test positive will be paramount in effectively managing a patient’s care as well as allocating our resources.”
A risk prediction model for Covid-19, developed by researchers at Cleveland Clinic, is now available to all health systems worldwide that use the Epic MyChart patient portal. The model will help clinicians estimate the likelihood of a patient testing positive for the disease.
– Centene Corporation acquires AI healthcare analytics platform
Apixio to additional data and AI capability to technology portfolio.
– Apixio will remain an operationally independent entity
as part of Centene’s Health Care Enterprises group to continue bringing value
to its clients and the industry.
Centene Corporation, today
announced it has signed a definitive agreement to acquire
Apixio Inc., a AI healthcare analytics company offering Artificial
Intelligence (AI) technology solutions. The transaction is subject to
regulatory approvals and is expected to close by the end of 2020.
Better Data. Better Healthcare
More than 1.2 billion clinical documents are generated each year in the U.S., but there is very little analysis of that unstructured information. Founded in 2009. Apixio helps organizations use their data for knowledge about patient health. This ultimately translates into more effective care delivery, lower costs and streamlined processes. Apixio’s machine learning and deep learning algorithms analyze unstructured data embedded in electronic health records, scanned notes, facsimiles, and handwritten notes to produce high-quality predictions for measurement, care, and discovery.
The Apixio Platform
The Apixio Platform can mine textual data and combine its generated insights with available structured data to craft computable individual health profiles or phenotypes. We analyze our assembled phenotypes in real-time using a flexible rules engine. This automates the execution of clinical guidelines, quality and risk measures, payment or reimbursement policies, and other operational and administrative rules, to support critical healthcare activities.
Acquisition Complements Centene’s Existing Data Analytics
“Centene is committed to accelerating innovation, modernization and digitization across the enterprise and solidify its position as a technology company focused on healthcare. Apixio’s capabilities are closely aligned with our plans to digitize the administration of healthcare and to leverage comprehensive data to help improve the lives of our members,” said Michael F. Neidorff, Chairman, President and Chief Executive Officer for Centene. “Apixio’s technology will complement existing data analytics products including Interpreta, creating a differentiated platform to broaden support for value-based healthcare payment and delivery with actionable intelligence.”
As part of the acquisition, Apixio will remain an
operationally independent entity as part of Centene’s Health Care Enterprises
group to continue bringing value to its clients and the industry, while also
realizing the benefits of enhanced scale with Centene. Financial details of the
acquisition were not disclosed.
– The Veterans Health Administration has selected Ontrak
in collaboration with Harvard Medical School and Brown University to transform
suicide prevention care for veterans.
– Leveraging AI developed by a Harvard Medical School
professor and the core analytics of the Ontrak platform, the three-year study
will look at the effect of intensive care coaching in addition to the standard
of care for veterans at high risk of suicide after inpatient hospitalization at
a psychiatric hospital. The trial will include 850 patients at six VA
– Suicide prevention is a focus for the military as well
as for the population as a whole as the U.S. grapples with the COVID-19
Ontrak, Inc., an AI-powered
virtualized healthcare company, announced a cooperative research and
development agreement with the Veterans Health Administration (VHA) to conduct
a 3-year research study on the effect of intensive care coaching in addition to
the standard of care for Veterans at high risk of suicide-related behaviors
after psychiatric hospital.
Research Study Details
The study will leverage AI developed by Dr. Ronald Kessler
of the Harvard Medical School, as well as the core analytics of the Ontrak
platform. Dr. Kessler is the McNeil Family Professor of Health Care Policy at
Harvard Medical School and a principal in the STARRS Longitudinal Study of
suicide prevention among US Army soldiers. “We are excited to have Ontrak
helping us evaluate the effects of an intensive intervention to prevent
suicidal behaviors among Veterans at very high risk,” stated Dr. Kessler.
Why It Matters
Suicidal ideation has been elevated since the pandemic and
the CDC reported on August 14 that a survey of U.S. adults in June 2020
indicated that 11% had seriously considered suicide in the past 30 days, which
was twice as high as in the previous 12 month period.
Addressing Veteran suicide is a top VHA priority and Ontrak is proud to apply their AI and virtual care coaching model in a trial of 850 patients at 6 VHA hospitals selected from a total of 98 in the country. This study has the potential to not only reduce suicide risk but also to produce secondary reductions in risk through interventions that address co-occurring medical conditions.
Dr. Judy Feld, Medical Director of Ontrak, stated, “Suicide is the 10th leading cause of death in the U.S. with rates steadily increasing over the past decade and worsening during the Covid-19 pandemic. We know that individuals with behavioral health conditions such as depression, substance use disorder, and post-traumatic stress disorder are at higher risk for suicidal ideation or attempt. Importantly, the rate of suicide among our country’s military Vets is double that of non-Veterans. As a pioneer in the development of evidence-based interventions for engaging individuals in care for anxiety, depression, and substance use disorders, Ontrak is honored to partner with the VHA healthcare system and collaborators from Harvard Medical School and Brown University to advance the medical community’s understanding of the most impactful case management for Veterans at high risk of suicide after inpatient hospitalization.”
– As the buying wave of healthcare IoT solutions
continues, strong technology offerings and numerous new wins in the last year
have established Medigate and Ordr as leaders in the growing market.
– KLAS finds that the adoption of security solutions for the healthcare internet of things (IoT) continues to grow as healthcare organizations look for ways to understand and manage the risk associated with connected devices.
The adoption of security solutions for the healthcare internet of things (IoT) continues to grow as healthcare organizations look for ways to understand and manage the risk associated with connected devices. In most deployments, the focus has shifted from securing mainly medical devices to covering both medical devices and the broader IoT devices found in healthcare settings.
KLAS Data Insights Report
As the market matures, organizations are also beginning to
look beyond core capabilities—where most solutions are comparable—to factors like
cost, ROI, expertise, and vendor culture when making buying decisions. With
many strong options in the market, the bar for vendors is high. In the
latest KLAS Data Insights report, KLAS spoke with 51 healthcare
organizations to understand which vendors are being selected and why and to
glean early insights into customer satisfaction. Data insights for this report
comes from KLAS Decision Insights data and KLAS performance data.
Medigate, Ordr Emerge as Leaders in Growing Healthcare
As the buying wave of healthcare IoT solutions continues,
strong technology offerings and numerous new wins in the last year have
established Medigate and Ordr as leaders in the growing market. KLAS finds that
Medigate’s is picking up steam and showing rapid growth since last year. Medigate’s
technology delivers detailed information to customers through
Healthcare organizations that have recently selected Medgate
point to the vendor’s expanded IoT capabilities as an added plus in comparison
to being traditionally selected solely for medical devices. Healthcare organizations
that did not select Medigate cited concerns over price or challenges during the
Customers who recently chose Ordr, whose market share has
consistently grown year over year, were drawn to the breadth and number of
devices Ordr can detect and the highly granular visibility the solution
provides. Feedback on the user experience is mixed, though customers say that
once users are properly trained, the tool drives deep insights. Ordr’s culture
of flexibility and willingness to partner stand out as reasons they are
selected. Prospective customers that did not select Order, cited other vendors as
having a deeper knowledge of medical devices.
Other key findings of the KLAS report include:
Palo Alto Acquisition of Zingbox Creates Uncertainty
– Zingbox—acquired by Palo Alto Networks in fall
2019— was the early market leader as they continue to be considered in most
decisions, but a majority of prospective clients select other vendors, in large
part due to uncertainty about Zingbox’s future under Palo Alto Networks.
Concerns about Armis’ Technology Abilities Driven by
– KLAS validated very few organizations that selected Armis. Cross-industry vendor Armis is increasingly considered in healthcare IoT security decisions; today, their traction in the healthcare industry is average.
Asimily and Up-and-Coming Sensato Leverage Healthcare
Expertise for Early Traction
– Asimily has continued to grow and acquire customers in the last year as current customers see Asimily’s networking and healthcare expertise as differentiators. Healthcare organizations that select Asimily appreciate the vendor’s honesty about what they will and won’t do and how development requests fit into the product road map.
CyberMDX and Cynerio See Overall Slow Market Traction
– KLAS-validated considerations and new wins of
healthcare-focused vendors CyberMDX and Cynerio have been much lower than that
of most other commonly considered vendors.
Interoperability in healthcare is a national disgrace. After more than three decades of effort, billions of dollars in incentives and investments, State and Federal regulations, and tens of thousands of articles and studies on making all of this work — we are only slightly better off than we were in 2000.
Decades of failed promises and dozens of technical, organizational, behavioral, financial, regulatory, privacy, and business barriers have prevented significant progress and the costs are enormous. The Institute of Medicine and other groups put the national financial impact somewhere between tens and hundreds of billions of dollars annually. Without pervasive and interoperable secure communications, healthcare is missing the productivity gains that every other industry achieved during their internet, mobile, and cloud revolutions.
The Human Toll — On Both Patients and Clinicians
Too many families have a story to tell about the dismay or disaster wrought by missing or incomplete paper medical records, or frustration by the lack of communications between their healthcare providers. In an era where we carry around more computing power in our pockets than what sent Americans to the moon, it is mystifying that we can’t get our doctors digitally communicating.
I am one of the many doctors who are outraged that the promised benefits of Electronic Medical Records (EHRs) and Health Information Exchanges (HIEs) don’t help me understand what the previous doctor did for our mutual patient. These costly systems still often require that I get the ‘bullet’ from another doctor the same way as my mentors did in the 1970s.
This digital friction also has a profoundly negative impact on medical research, clinical trials, analytics, AI, precision medicine, and the rest of health science. The scanned PDF of a fax of a patient’s EKG and a phone call may be enough for me to get the pre-op done, but faxes and phone calls can’t drive computers, predictive engines, multivariate analysis, public health surveillance programs, or real-time alerting needed to truly enable care.
Solving the Surround
Many companies and government initiatives have attempted to solve specific components of interoperability, but this has only led to a piecemeal approach that has thus far been overwhelmed by market forces. Healthcare interoperability needs an innovation strategy that I call “Solving the Surround.” It is one of the least understood and most potent strategies to succeed at disruptive innovation at scale in complex markets.
“Solving the Surround” is about understanding and addressing multiple market barriers in unison. To explain the concept, let’s consider the most recent disruption of the music industry — the success of Apple’s iPod.
The iPod itself did not win the market and drive industry disruption because it was from Apple or due to its great design. Other behemoths like Microsoft and Philips, with huge budgets and marketing machines, built powerful MP3 players without market impact. Apple succeeded because they also ‘solved the surround’ — they identified and addressed numerous other barriers to overcome mass adoption.
Among other contributions, they:
– Made software available for both the PC and Mac
– Delivered an easy (and legal) way for users to “rip” their old CD collection and use the possession of music on a fixed medium that proved legal “ownership”
– Built an online store with a massive library of music
– Allowed users to purchase individual tracks
– Created new artist packaging, distribution, licensing, and payment models
– Addressed legalities and multiple licensing issues
– Designed a way to synchronize and backup music across devices
In other words, Apple broke down most of these barriers all at once to enable the broad adoption of both their device and platform. By “Solving the Surround,” Apple was the one to successfully disrupt the music industry (and make way for their iPhone).
The Revolution that Missed Healthcare
Disruption doesn’t happen in a vacuum. The market needs to be “ready” to replace the old way of doing things or accept a much better model. In the iPod case, the market first required the internet, online payment systems, pervasive home computers, and much more. What Apple did to make the iPod successful wasn’t to build all of the things required for the market to be ready, but they identified and conquered the “surround problems” within their control to accelerate and disrupt the otherwise-ready market.
Together, the PC, internet, and mobile revolutions led to the most significant workforce productivity expansion since WWII. Productivity in nearly all industries soared. The biggest exception was in the healthcare sector, which did not participate in that productivity revolution or did not realize the same rapid improvements. The cost of healthcare continued its inexorable rise, while prices (in constant dollars) leveled off or declined in most other sectors. Healthcare mostly followed IT-centric, local, customized models.
Solving the Surround for Healthcare Interoperability
‘Solving the Surround’ in healthcare means tackling many convoluted and complex challenges.
Here are the nine things that we need to conquer:
1. Simplicity — All of the basics of every other successful technology disruptor are needed for Health communications and Interoperability. Nothing succeeds at a disruption unless it is perceived by the users to be simple, natural, intuitive, and comfortable; very few behavioral or process changes should be required for user adoption.
Simplicity must not be limited to the doctor, nurse, or clerical users. It must extend to the technical implementation of the disruptive system. Ideally, the new would seamlessly complement current systems without a heavy lift. By implication, this means that the disruptive system would embrace technologies, workflows, protocols, and practices that are already in place.
2. Ubiquity — For anything to work at scale, it must also be ubiquitous — meaning it works for all potential players across the US (or global) marketplace. Interoperability means communicating with ease with other systems. Healthcare’s next interoperability disruptor must work for all healthcare staff, organizations, and practices, regardless of their level of technological sophistication. It must tie together systems and vendors who naturally avoid collaboration today, or we are setting ourselves up for failure.
3. Privacy & Security — Healthcare demands best-in-class privacy and security. Compliance with government regulations or industry standards is not enough. Any new disruptive, interoperable communications system should address the needs of different use cases, markets, and users. It must dynamically provide the right user permissions and access and adapt as new needs arise. This rigor protects both patients from unnecessary or illegal sharing of their health records and healthcare organizations in meeting privacy requirements and complying with state and federal laws.
4. Directory — It’s impossible to imagine ubiquitous national communications without a directory. It is a crucial component for a new disruptive system to connect existing technologies and disparate people, organizations, workflows, and use cases. This directory should maintain current locations, personnel, process knowledge, workflows, technologies, keys, addresses, protocols, and individual and organizational preferences. It must be comprehensive at a national level and learn and improve with each communication and incorporate each new user’s preferences at both ends of any communication. Above all, it must be complete and reliable — nothing less than a sub-1% failure rate.
5. Delivery — Via the directory, we know to whom (or to what location) we want to send a notification, message, fetch request or record, but how will it get there? With literally hundreds of different EHR products in use and as many interoperability challenges, it is clear that a disruptive national solution must accommodate multiple technologies depending on sender and recipient capabilities. Until now, the only delivery “technology” that has ensured reliable delivery rates is the mighty fax machine.
With the potential of a large hospital at one end and a remote single-doctor practice at the other, it would be unreasonable to take a one size fits all approach. The system should also serve as a useful “middleman” to help different parties move to the model (in much the same way that ripping CDs or iTunes gave a helping hand to new MP3 owners). Such a delivery “middleman” should automatically adapt communications to each end of the communication’s technology capabilities, needs, and preferences..
6. Embracing Push — To be honest, I think we got complacent in healthcare about how we designed our technologies. Most interoperability attempts are “fetch” oriented, relying on someone pulling data from a big repository such as an EHR portal or an HIE. Then we set up triggers (such as ADTs) to tell someone to get it. These have not worked at scale in 30+ years of trying. Among other reasons, it has been common for even hospitals to be reluctant to participate fully, fearing a competitive disadvantage if they make data available for all of their patients.
My vision for a disruptive and innovative interoperability system reduces the current reliance on fetch. Why not enable reliable, proactive pushing of the right information in a timely fashion on a patient-by-patient basis? The ideal system would be driven by push, but include fetch when needed. Leverage the excellent deployment of the Direct Trust protocol already in place, supplement it with a directory and delivery service, add a new digital “middleman,” and complement it with an excellent fetch capability to fill in any gaps and enable bi-directional flows.
7. Patient Records and Messages — We need both data sharing and messaging in the same system, so we can embrace and effortlessly enable both clinical summaries and notes. There must be no practical limits on the size or types of files that can easily be shared. We need to help people solve problems together and drive everyday workflows. These are all variations of the same problem, and the disruptor needs to solve it all.
8. Compliance — The disruptor must also be compliant with a range of security, privacy, identity, interoperability, data type, API, and many other standards and work within several national data sharing frameworks. Compliance is often showcased through government and vendor certification programs. These programs are designed to ensure that users will be able to meet requirements under incentive programs such as those from CMS/ONC (e.g., Promoting Interoperability) or the forthcoming CMS “Final Rule” Condition of Participation (CoP/PEN), and others. We also must enable incentive programs based on the transition to value-based and quality-based care and other risk-based models.
9. On-Ramp — The iPod has become the mobile phone. We may use one device initially for phone or email, but soon come to love navigation, music, or collaboration tools. As we adopt more features, we see how it adds value we never envisioned before — perhaps because we never dreamed it was possible. The healthcare communications disruptor will deliver an “On-Ramp” that works at both a personal and organizational scale. Organizations need to start with a simple, driving use case, get early and definitive success, then use the same platform to expand to more and more use cases and values — and delight in each of them.
So here we are, decades past the PC revolution, with a combination of industry standards, regulations, clinician and consumer demand, and even tens of billions in EHR incentives. Still, we have neither a ‘killer app’ nor ubiquitous medical communications. As a result, we don’t have the efficiency nor ease-of-use benefits from our EHRs, nor do we have repeatable examples of improved quality or lower errors — and definitively, no evidence for lower costs.
I am confident that we don’t have a market readiness problem. We have more than ample electricity, distributed computing platforms, ubiquitous broadband communications, and consumer and clinician demand. We have robust security, legal, privacy, compliance, data format, interoperability, and related standards to move forward. So, I contend that our biggest innovation inhibitor is our collective misunderstanding about “Solving the Surround.”
Once we do that, we will unleash market disruption and transform healthcare for the next generation of patient care.
About Peter S. Tippett
Dr. Peter Tippett is a physician, scientist, business leader, and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
He was a member of the President’s Information Technology Advisory Committee (PITAC) under G.W. Bush, and served with both the Clinton Health Matters and NIH Precision Medicine initiatives. Throughout his career, Tippett has been recognized with numerous awards and recognitions — including E&Y Entrepreneur of the Year, the U.S. Chamber of Commerce “Leadership in Health Care Award”, and was named one of the 25 most influential CTOs by InfoWorld.
Tippett is board certified in internal medicine and has decades of experience in the ER. As a scientist, he created the first synthetic immunoglobulin in the lab of Nobel Laureate Bruce Merrifield at Rockefeller University.
The COVID-19 Kidney Care
Challenge seeks to identify replicable solutions from providers, staff,
patients, and caregivers and share them across healthcare communities. KidneyX
is particularly interested in demonstrated solutions that consider the patient
experience and could be implemented without requiring significant effort,
expertise, money, or other resources.
These solutions may be
applied in a range of settings — such as dialysis centers, clinics, hospitals, homes,
and transport. Solutions may address, but are not limited to:
– Data collection and
– Patient management and
– Education, training, and
– Supply chain and
– Care setting logistics.
KidneyX is particularly
interested in solutions that consider the patient experience and could be
implemented without requiring significant time, expertise, money, or other
resources. Solutions that reduce the impact of the COVID-19
pandemic on communities facing existing health disparities are encouraged.
“COVID-19’s heavy impact will be felt for decades to come, drastically intensifying inequities within the American healthcare system,” said KidneyX Steering Committee Chair Dr. John Sedor. “The COVID-19 Kidney Care Challenge, alongside KidneyX’s ongoing work, offers us a way to potentially improve outcomes for patients in the near term — as well as help set innovation roadmaps for the health challenges of the future.”
The judging panel will
assign up to five points for each of the criteria below, for a maximum of 20
Impact: The confidence in the solution to reduce
SARS-CoV-2 transmission among people with kidney disease and/or reduce the risk
of kidney injury/disease among people who contract COVID-19.
Feasibility: The ease with which the solution could be
implemented, considering factors such as time, expertise, money, or other
Adaptability: The extent to which the solution could be
adapted for other people or used in other care settings and/or geographies.
Ingenuity: The degree to which the submission offers a new
solution, demonstrates an improvement on an existing solution, or applies an
existing solution in new ways.
Entrants are invited to submit their solutions via an online
submission form. The submission form asks entrants to provide an overview
of the solution; available data to demonstrate the solution has, or could have,
a positive impact; and additional information to assess how the solution may be
implemented in other settings.
Round 1 of the challenge
is now accepting solutions until December 4, 2020. Round 2 will be open to
eligible entrants from Round 1, as well as new eligible entrants who did not
enter the first round; the second round will accept solutions from December 9,
2020 to January 20, 2021. The judging panel will recommend winners from both
rounds to receive $20,000 each in recognition of their solutions.
COVID-19 terms such as quarantine, flatten the curve, social distance, and personal protective equipment (PPE) have dominated headlines in recent months, but what hasn’t been discussed in length are the hidden costs of COVID-19 as it relates to patient adherence.
The coronavirus pandemic has amplified this long-standing issue in healthcare as patients are delaying routine preventative and ongoing care for ailments such as mental health and chronic disease. Emergency care is also suffering at alarming rates. Studies show a 42 percent decline in emergency department visits, measuring the volume of 2.1 million visits per week between March and April 2019 to 1.2 million visits per week between March and April 2020. Patients are not seeking the treatment they need – and at what cost?
When the SARS outbreak occurred in 2002, particularly in Taiwan, there was a marked reduction in inpatient care and utilization as well as ambulatory care. Chronic-care hospitalizations for long-term conditions like diabetes plummeted during the SARS crisis but skyrocketed afterward. Similar to the 2002 epidemic, people are currently not venturing en masse to emergency rooms or hospitals, but if history repeats itself, hospital and ER visits will happen at an influx and create a new strain on the healthcare system.
So, if patients aren’t going to the ER or visiting their doctors regularly, where have they gone? They are staying at home. According to reports from the Kaiser Family Foundation, 28 percent of Americans polled said they or a family member delayed medical care due to the pandemic, and 11 percent indicated that their condition worsened as a result of the delayed care. Of note, 70 percent of consumers are concerned or very concerned about contracting COVID-19 when visiting healthcare facilities to receive care unrelated to the virus. There is a growing concern that patients will either see a relapse in their illness or will experience new complications when the pandemic subsides.
Rather than brace for a tidal wave of patients, healthcare systems should proactively take steps (or act now) to drive patient access, action, and adherence.
1. Identify Who Needs to Care The Most
Healthcare providers should consider risk stratifying patients. High-risk people, such as an 80-year-old male with comorbidities and recent cardiac bypass surgery, may require a hands-on and frequent outreach effort. A 20-year-old female, however, who comes in annually for her physical but is healthy, may not require that level of engagement. Understanding which patients are at risk for the potential for chronic conditions to become acute or patients who have a hard time staying on their care plan may need prioritized attention and a more thorough engagement effort.
For example, patients with a history of mental health issues may lack motivation or momentum to seek care. Their disposition to be disengaged may require greater input to push past their disengagement.
Especially important is the ability to educate and guide patients to the appropriate venue of care (ER, telehealth visit, in-person primary care visit, or urgent care) based on their self-reported symptoms. Allowing patients to self-triage while scheduling appointments helps them make more informed decisions about their care while reducing the burden on over-utilized emergency departments.
2. Capture The Attention of The Intended Audience and Induce Action
Once you’ve identified who needs care the most, how do you break through the “information clutter” to ensure healthcare messages resonate with the intended audience? The more data points, the better. It is important to understand the age of the patient, their preferred communication channel, and the intended message for the recipient, but effective communication exceeds those three data points. Consider factors like the presence of mental health conditions, comorbidities, or health literacies. Then, think beyond the patient’s channel of choice and select the appropriate channel of communication (text, phone call, email, paid social media advertisement, etc.), that will most likely induce action. As an organization, also consider running A/B tests to detect and analyze behavior. As you collect more data, determine what exactly is inducing patient action.
Of note, don’t underestimate the power of repetition. Patients may need to be reminded of the intended action a few times in a few different ways before moving forward with seeking the care they need. Repetition is also shown to decrease no-show rates, a critical metric. Proactive, prescriptive, and tailored communication will help increase engagement. Moving past the channel of choice and toward the channel of action is key.
3. Engage Patients Through Personalized and Tailored Communication
In addition to identifying the right communication channel, it’s also important to ensure you deliver an effective message. Communication with patients should be relevant to their particular medical needs while paying close attention to where each person is in their healthcare journey. Connecting with patients on both an emotional and rational level is also important. For example, sending a positive communication via phone, email, or text to lay the foundation for the interaction shows interest in the patient’s wellbeing.
A “Hey, here’s why you need to come in” note makes a connection in a direct and personalized way. At the same time, and in a very pointed manner, sharing ways providers and health systems are keeping patients safe (e.g., telehealth, virtual waiting rooms, separate entrances, and mandating masks), also provides comfort to skittish patients. Additionally, consider all demographic information when tailoring communications. And don’t forget to analyze if changes in content impact no-show rates. Low overall literacy may impact health literacy and may require simpler and more positive words to positively impact adherence.
It may sound daunting, especially for individual health systems, to personalize patient communication efforts, but the use of today’s data tools and technological advancements can relieve the burden and streamline efforts for an effective communication approach.
4. Use Technology to Your Advantage (With Caution)
Once you have developed your communication strategy, don’t stop there. Consider all aspects of the patient journey to drive action. A virtual waiting room strategy, for example, can help ease patient concerns and encourage them to resume their care. Health systems can help patients make reservations, space out their arrival times, and safeguard social distancing measures—all while alleviating patient fears. Ideally, the patient would be able to seamlessly book an appointment and receive a specific arrival time, allowing ER staff to prepare for the patient’s arrival while minimizing onsite wait time.
When implemented properly, telehealth visits can also improve continuity of care, enhance provider efficiency, attract and retain patients who are seeking convenience, as well as appeal to those who would prefer not to travel to their healthcare facility for their visit. Providers need to determine which appointments can successfully be resolved virtually. Additionally, some patients might not have the means for a successful telehealth visit due to a lack of internet access, a language barrier, or a safe space to talk freely.
To ensure all patients receive quality care, health systems should make plans to serve patients who lack the technology or bandwidth to participate in video visits in an alternative manner. For example, monitor patients remotely by asking them to self-report basic information such as blood sugar levels, weight, and medication compliance via short message service (SMS). This gives providers the ability to continuously monitor their patients while enhancing patient safety, increasing positive outcomes, and enabling real-time escalation whenever clinical intervention is needed.
It is important we ensure all patients stay on track with their health, despite uncertain and fearful times. Health systems can enhance patient adherence and induce action through the implementation of tools that increase patient engagement and alleviate the impending strain on the healthcare system.
About Matt Dickson
Matt Dickson is Vice President of Product, Strategy, and General Manager of Stericycle Communication Solutions, a patient engagement platform that seamlessly combines both voice and digital channels to provide the modern experience healthcare consumers want while solving complex challenges to patient access, action, and adherence. . He is a versatile leader with strong operational management experience and expertise providing IT, product, and process solutions in the healthcare industry for nearly 25 years. Find him on LinkedIn.
The approval is based on P-III THALES study involves assessing Brilinta (180mg as a loading dose followed by 90mg, bid) + aspirin vs aspirin as monothx. in 11,000 patients with non-cardioembolic acute ischaemic stroke or high-risk TIA for 30days
Results demonstrated a reduction in the rate of the composite 1EP of stroke & death by 17%, risk of severe bleeding events (0.5% vs 0.1%). Regulatory submissions to expand the approved indication are under regulatory review in China and the EU
Brilinta (ticagrelor) is an oral, reversible, direct-acting P2Y12 receptor antagonist that works by inhibiting platelet activation. The approval follows the US FDA’s PR designation granted in Jul’2020
Click here to read full press release/ article | Ref: AstraZeneca | Image: Pinterest
While most of the public’s attention is focused on the horse race for an approved COVID-19 vaccine, another major hurdle lies just around the corner: the distribution of hundreds of millions of vaccine doses. In today’s highly complex and disconnected health data landscape, technologies like AI, Machine Learning, and robotic process automation (RPA) will be essential to making sure that the highest-risk patients receive the vaccine first.
Why identifying at-risk patients is incredibly difficult
Once a vaccine is approved, it will take months or years to produce and distribute enough doses for the U.S.’ 330 million residents. Hospital systems, primary care physicians (PCPs), and provider networks will inevitably need to prioritize administration to at-risk patients, potentially focusing on those with underlying conditions and comorbidities. That will require an unimaginable amount of work by healthcare employees to identify patient cohorts, understand each patient’s individual priority level, and communicate pre- and post-visit instructions. The volume of coordination required between healthcare systems and the pressing need to get the vaccine to high risks groups makes the situation uniquely different than other nationally distributed vaccinations, like the flu.
One key challenge is that there’s no existing infrastructure to facilitate this process – all of the data necessary to do so is locked away in disparate information silos. Many states have legacy information systems or rely on fax for information sharing, which will substantially hamper efforts to identify at-risk patients. Consider, in contrast, the data available in the U.S. regarding earthquake risk– you can simply open up a federal geological map and see whether you’re in a seismic hazard zone. All the information is in one place and can be sorted through quickly, but that’s just not the case with our healthcare system due to its fragmentation as well as HIPAA and patient privacy laws.
There are several multidimensional barriers that make it nearly impossible for healthcare workers employed by providers and state healthcare organizations to compile patient cohorts manually:
– Providers will need to follow CDC guidelines on prioritization factors, which based on current guidelines for those with increased risk could potentially include specific conditions, ethnicities, age groups, pregnancy, geographies, living situations (such as multigenerational homes), and disabilities. Identifying patients with these factors will require intelligent analysis of patient profiles from existing electronic health record data (EHR) used by a multitude of providers.
– Some hospital networks use multiple EHR and care management systems that have a limited ability to share and correlate data. These information silos will prevent providers from viewing all information about patient population health data.
– Data on out-of-network care that could require prioritization, like an emergency room visit, is often locked away in payer data systems and is difficult to access by hospital systems and PCPs. That means payer data systems must be analyzed as well to effectively prioritize patients.
– All information must be shared and analyzed in accordance with HIPAA laws, and the mountain of scheduling communications and pre- and post-visit guidance shared with patients must also follow federal guidelines.
– Patients with certain conditions, like heart disease, may need additional procedures or tests (such as a blood pressure reading) before the vaccine can be administered safely. Guidelines for each patient must be identified and clearly communicated to their care team.
– Providers may not have the capacity to distribute vaccines to all of their priority patients, so providers will need to coordinate care and potentially send patients to third-party sites like Walgreens, Costco, etc.
All of these factors create a situation in which it’s extremely difficult – and time-consuming – for healthcare workers to roll out the vaccine to at-risk patients at scale. If the entire process to analyze, identify, and administer the vaccine takes only two hours per patient in the U.S., that’s 660 million hours of healthcare workers’ time. A combination of analytics, AI, and machine learning could be a solution that’s leveraged by healthcare workers and chief medical officers in identifying the priority of patients supplemented with CDC norms.
How RPA can automate administration to high-risk patients
Technology is uniquely poised to enable health workers to get vaccines into the hands of those who need them most far faster than would be possible using humans alone. Robotic process automation (RPA) in the form of artificial intelligence-powered digital health workers can substantially reduce the time spent prioritizing and communicating with at-risk patients. These digital health workers can intelligently analyze patient records and send communications 24 hours a day, reducing the time needed per patient from hours to minutes.
Consider, a hypothetical situation in which the CDC prioritizes certain risk profiles, which would put patients with diabetes among those likely to receive the vaccine first. In this scenario, RPA offers significant benefits in the form of its ability to:
Analyze EHR and population health data:
Thousands of intelligent digital health workers could prepare patient data for analysis and then separate patients into different cohorts based on hemoglobin levels. These digital health workers could then intelligently review documents to cross-reference hemoglobin levels with other CDC prioritization factors (like recent emergency room admittance or additional pre-existing or chronic conditions ), COVID-19 testing and antibody tests data to identify those most at risk, then identify a local provider with appointment availability.
Automate patient engagement, communications and scheduling:
After patients with diabetes are identified and prioritized, communications will be essential to quickly schedule those at most risk and prepare them for their appointments, including making them feel comfortable and informed. For example, digital health workers could communicate with diabetes patients about the protocol they should follow before and after their appointment – should they eat before the visit, what they should expect during their visit, and is it safe for them to return to work after. It’s also highly likely that widespread vaccine administration will require a far greater amount of information than with other health communications, given that one in three Americans say they would be unwilling to be vaccinated if a vaccine were available today. At scale, communications and scheduling will take potentially millions of hours in total, and all of that time takes healthcare employees away from actually providing care.
While the timeline for approval of a COVID-19 vaccine is unclear, now is the time for hospitals to prepare their technology and operations for the rollout. By adopting RPA, state healthcare organizations and providers can set themselves up for success and ensure that the patients most critically in need of a vaccine receive it first.
About Ram Sathia
Ram Sathia is Vice President of Intelligent Automation at PK. Ram has nearly 20 years of experience helping clients condense time-to-market, improve quality, and drive efficiency through transformative RPA, AI, machine learning, DevOps, and automation.
– The FDA just extended its research collaboration
agreement (RCA) with COTA, specifically looking at how COVID-19 is affecting
– With this expanded agreement, COTA and the FDA will use real-world data to explore the impact of COVID-19 and the pandemic on cancer treatment, with the opportunity to expand into other oncology questions in the future.
COTA, Inc., a healthcare technology
company that uses real-world data to bring clarity to cancer care, today
announced it has extended its Research Collaboration Agreement (RCA) with the
U.S. Food and Drug Administration (FDA) for an additional three years. This
renewed RCA will expand on the objective to explore the applications of
real-world data in oncology, including the impact of COVID-19 and the
pandemic on cancer treatment. As the project advances, the research will
broaden to study other oncology care delivery questions.
Real-world data can provide critical insights into the
delivery of cancer treatment in the routine practice setting, as well as
potential long-term effects post-COVID-19 recovery. The expanded focus of this
RCA will enable the exploration of important research questions to help support
FDA’s understanding of how the COVID-19 pandemic continues to impact patients
Why It Matters
With over 8 million cases of COVID-19 in the United States,
there is a significant need to understand the pandemic’s impact on oncology
care. Additionally, an increasing body
of research has shown that oncology patients may be particularly
susceptible to harm during this pandemic – both in contracting the
condition itself or experiencing care delays.
Cancer patients are particularly at risk of severe complications with COVID-19, and there is currently no understanding of how this can affect their oncology care or progression. Through real-world data, we can begin to understand if COVID-19 should be considered as comorbidity – particularly around clinical trial criteria.
– Cardiac patients and their cardiologists are
experiencing a high number of false positives with remote patient monitoring
devices as a result of signal artifact providing inaccurate data, which can
lead to many complications—other than medical, such as unnecessary tests and
increased medical costs.
– Ambulatory cardiac monitoring provider InfoBionic has devised a way to decrease false positives and increase efficiency.
Remote cardiac monitoring’s false positives—especially on atrial fibrillation (Afib)—hurt everyone, from the patient to the boss who will have to go without an employee when he or she has to go in for unnecessary tests. An estimated 12.1 million people in the United States will have Afib by 2030; Afib increases the risk of stroke, heart failure, and death, and is one of the few cardiac conditions that continue to rise.(1) “We must give the clinician more effective diagnoses, while at the same time increasing confidence in our healthcare technology systems with respect to the accuracy of the same patient data,” expressed Stuart Long, CEO of InfoBionic, a provider of ambulatory cardiac monitoring services.
Impact of Remote
Patient Monitoring on Afib
Afib is a “fluttering feeling that can point to a quivering heart muscle, a notable skipped beat as the mark of a palpitation, and a racing heart rate that sparks other discomforts.” (2) With the rise of remote patient monitoring (RPM) as an effective and economical modality to treat and monitor patients, false positives continue to rise to generate a lack of confidence in the accurate clinical data captured through RPM. False positives can overwhelm the clinician and result in the increased use of resources and downstream costs, and false negatives could have detrimental clinical consequences.(3)
Without a reliable RPM supported by powerful AI solutions, healthcare payers experience higher costs. Heart disease takes an economic toll, as well, costing the nation’s healthcare system $214 billion per year and consuming $138 billion in lost productivity on the job. (4) The cascading effect of false positives run the gamut of the human experience—from the physical and emotional health of the patient to the added out-of-pocket expenses of unnecessary and avoidable tests.
The increased risks of hospital readmissions at a time when healthcare systems are overtaxed and understaffed adds another factor of what could have been an unneeded situation. “InfoBionic AI has all but eliminated the need for physicians to deal with false positives. In fact, 100% of Atrial Fibrillation events longer than 30 seconds are detected accurately (true positive) by InfoBionic’s AI system(6),” said Long.
leveraging cloud computing with continuous arrhythmia monitoring to create a
reliable platform with accurate data collection, an ambulatory cardiac monitor,
such as the MoMe® Kardia device, optimizes AI solutions,
allowing for consistency in the treatment. Integrated sensor measures have been
shown to predict heart failure and might have the potential to
empower patients to participate in their own care.(5) Offering
24-hour monitoring through RPM technology that reduces false positives leads to
the patient becoming more comfortable with the RPM service, which increases the
likelihood the patient will adopt the practice of self-care well into the
future. Cardiac patients with pulmonary or electrolyte problems may need
continuous cardiac monitoring to screen for arrhythmias.
“A primary feature of our MoMe® Kardia is its ability to leverage technology in a way that makes physicians feel more confident via analysis precision that verifies detected cardiac episodes through the algorithm,” said Long. Another distinct advantage is the ability to provide 6 lead analysis instead of the 1 or 2 leads provided by other systems. This affords the physician a much better view of each heartbeat, thereby increasing physician confidence in the accuracy of diagnosis.
provides valuable clinical statistics that guide treatment with the best
patient outcomes. As the leading provider to collect every heartbeat and
transmit it to the cloud in near real time, explains Long, InfoBionic’s AI
algorithms are informed by over 15 million hours of electrocardiogram (ECG)
collected from the entire patient population. With full disclosure transmission
that allows AI algorithms to run on powerful servers in the cloud, the system
utilizes much more intensive processing than could be accomplished on other
patient-worn devices. Multiple patented algorithms are run concurrently on the
ECG stream, each with superior performance on a variety of clinical conditions.
– Ontrak acquires LifeDojo Inc, a San Francisco, CA-based
comprehensive, science-backed behavior change platform.
– The acquisition broadens Ontrak’s addressable market
and footprint to lower acuity populations enabling new interventions and remote
Ontrak, Inc., a
virtualized healthcare company, today announced that it has acquired
LifeDojo Inc, a comprehensive, science-backed behavior change platform.
Financial details of the acquisition were not disclosed.
Behavior Change Platform for Consumers and Employers
Founded in 2013, LifeDojo is a platform that makes
transformative life changes possible for members in over 16 countries.
Supported by decades of public health research, the LifeDojo approach to
member-centric behavior change delivers lasting health improvement outcomes,
high enrollment, and better engagement than traditional programs. Clients
include Fortune 500 companies and high-tech, high-growth organizations who use
LifeDojo’s 32 behavior change modules.
COVID-19 Spawns Mental Health Surge
The Journal of the American Medical Association (JAMA) this month reported accumulating evidence of a “second wave” mental health surge that will present monumental challenges for an already greatly strained mental health system and individuals at high risk for mental health disorders such as anxiety, depression, and post-traumatic stress. A June 2020 survey from the Centers for Disease Control and Prevention of 5,412 US adults found that 40.9% of respondents reported “at least one adverse mental or behavioral health condition,” including depression, anxiety, posttraumatic stress, and substance abuse, with rates that were three to four times the rates one year ago.
With the coronavirus pandemic rapidly increasing demand for
“telemental” health solutions, the acquisition of LifeDojo is expected to
advance the Ontrak growth strategy in four ways:
First, the acquisition adds a technology-first,
digital business deployed by blue chip customers in the employer space.
Second, LifeDojo enhances Ontrak’s market-leading
behavioral health engagement capabilities for new and existing customers, with
the addition of the LifeDojo digital tools that drive member value and lower
cost. The combination of behavioral health coaching and digital app-based
solutions meets accelerated payer demand for a comprehensive suite of
behavioral health services and solutions.
Third, the LifeDojo platform increases the company’s
addressable market by enabling the creation of lower cost, digital
interventions across behavioral health and chronic disease populations.
Fourth, LifeDojo’s member-facing apps enable remote
patient monitoring capabilities, initially focused on member reported data,
that will feed Ontrak AI capabilities and further personalize Ontrak’s
“As a public company and leader in virtualized healthcare, Ontrak is uniquely positioned to attract companies, products and technologies that expand our value proposition and footprint with health plan and employer partners. We will endeavor to make additional strategic purchases that expand our addressable market and maximize customer value. LifeDojo and these other intended acquisitions can possibly expand our total addressable $33.7 billion market by up to 100%,” said Mr. Terren Peizer, Chairman and CEO of Ontrak.
If you work in healthcare, chances are that the COVID-19 pandemic forced you to quickly scale up or move staff around to manage the onslaught of patients. The demand for clinicians and support staff grew alongside the spread of the virus, making organizations add clinicians or reassign employees with new or modified roles: Ambulatory nurses went down in the Emergency Department or Isolation Ward, revenue cycle folks started doing transport, and so on. In some cases, former staff or retired workers were called back to help with the surge. In the midst of these time-compressed changes, organizations remained rightly focused on their number one priority: patient care delivery. In the background, IT professionals were struggling to manage the slew of new digital identities while ensuring fast-access to new applications, workflows, and devices to accommodate remote work. Giving clinicians this access meant having to quickly provision and deprovision access during the staff ramp-up. Inevitably, access became a problem – whether to the systems or applications needed to do their jobs. In worst-case scenarios, organizations had to balance security and compliance with the delivery of healthcare services to patients. Security protocols were also compromised – a trade-off that should never have to happen.
Pandemic Spotlights Needs for IGA In response to the identity management challenges presented by the COVID-19 pandemic, healthcare IT organizations that had and Identity Governance Administration (IGA) systems came to the rescue. Those that didn’t, well….. IGA systems provide a fast, reliable way to manage digital identities through provisioning, governance, risk and compliance, and de-provisioning for healthcare workers who need access to workstations and applications. This is even more so the case in a crisis environment. A recent study conducted by Forrester Consulting found that an automated system helps organizations manage, streamline, and secure transactions across hypercomplex ecosystems of healthcare users, locations, devices, and locations. What’s more, according to Forrester, automation also saves time and money and results in a higher quality patient experience.
Fact is, even in the normal times, healthcare organizations rarely excel at tracking personnel moves, especially the adds and changes due to the time and system constraints often involved. That leads to what I call a “stacked shares” situation. These typically involve a person with decades of experience in your organization who has worked in multiple administrative or clinical areas within the organization and has access to about 80 percent of your network shares because she/he was never deprovisioned from ANY shares. In these instances, the network shares just kept getting “stacked,” one on top of the other. That’s probably exactly what happens during the COVID-19 pandemic as people move around to adapt to the ongoing crisis.
Another unexpected challenge created by the pandemic relates to furloughs. What is your healthcare organization doing with them? Are you disabling and then re-enabling accounts? Re-provisioning when/if they come back? What if they’ve come back but in a new role? Again, the “stacked shares” situation arises. You will likely regret it if your organization doesn’t have an automated IGA system to help you keep track of these movements through an integrated GRC system.
Moving to a Remote Workforce COVID-19 forced many healthcare organizations to rapidly accommodate a remote workforce. Only a few departments worked remotely before the pandemic, so routers, network, architecting, and bandwidth all had to be upgraded. Most health systems also required additional licensing to successfully ramp up services. Above all, the priority was to prevent any serious disruptions for clinicians.
Here again, health systems faced the challenge of balancing usability with security concerns. Tools like Zoom and Microsoft Teams proved useful, but they created additional risks including diminished safety of our healthcare workers, cybersecurity intrusions, and hacks – like theft of PHI, ransomware, and more. IT staff had to ensure the security of both the devices and the platforms being used, which is also easily managed by solid IGA systems.
In these cases, IGA systems analyze login data in real-time via Login Activity reports. They weave digital identity and access management, single-sign-on capabilities, and governance into workflows to strengthen security without compromising care delivery. This includes remote identity proofing to enable electronic prescribing of controlled substances (EPCS), as well as ensure compliance with DEA regulations while avoiding in-person interactions.
We will no doubt be living in a world of both in-person and remote healthcare for some time given the COVID-19 crisis. One lesson we already learned from the big experiment we just completed is that healthcare organizations benefit from having an IGA system in place to help balance their healthcare delivery, efficiency, and safety, as well as security and compliance. Implementing an IGA strategy no doubt makes it easy for clinicians to securely and seamlessly transition between workstations and applications and have their identity follow them.
About Wes Wright
Wes Wright is the Chief Technology Officer at Imprivata and has more than 20 years of experience with healthcare providers, IT leadership, and security. Prior to joining Imprivata, Wes was the CTO at Sutter Health, where he was responsible for technical services strategies and operational activities for the 26-hospital system. Wes has been the CIO at Seattle Children’s Hospital and has served as the Chief of Staff for a three-star general in the US Air Force.
announced their Series A round (combined seed and Series A) of $12.9M led by
Sante Ventures and new innovation VC, Intuitive Ventures.
– KēlaHealth, is a surgical intelligence engine that
applies a dynamic cycle of patient-specific predictions, stratified
interventions, and outcomes tracking to reduce surgical complications
– KēlaHealth is the first investment for Intuitive
Ventures, a new innovation fund spun out of Intuitive Surgical, Inc.
a San Francisco, CA-based surgical intelligence platform that applies a dynamic
cycle of patient-specific predictions, stratified interventions, and outcomes
tracking to reduce surgical complications, today announced the closing of
a $2.9 million Seed financing and milestone-based $10 million Series
A financing led by Santé Ventures and Intuitive Ventures, and inclusive of grant
funding from the National Science Foundation Small Business Innovation Research
(SBIR) Program. These funds will accelerate the expansion of the KēlaHealth
platform to hospitals and surgical partners across the United States. KēlaHealth
is the first investment for Intuitive Ventures, a new innovation fund spun out
of Intuitive Surgical, Inc.
Learning Ecosystem to Improve Surgical Care Outcomes
Founded by Bora Chang, MD, with a goal of harnessing machine
learning algorithms to reduce patient surgical complications and improve
outcomes. KēlaHealth uses advanced artificial intelligence techniques to
deliver a cloud-based software-as-a-service solution to healthcare providers,
surgeons, and hospital systems.
In the U.S., 51 million surgeries are performed annually, with an average complication rate of 15 percent. This results in millions of patients suffering harm and loss after a procedure. Tragically, half of these complications are known to be avoidable and contribute to $77 billion in wasted healthcare costs each year
KēlaHealth helps to prevent these avoidable complications
while enhancing surgical care by delivering stratified patient risk scoring.
The company’s state-of-the-art platform uses machine learning algorithms to
match individual risk levels with graduated pathways of care that align with
the unique needs of each surgical patient.
These personalized efforts bring surgery into a new era of
precision medicine: with KēlaHealth, surgeons can match the right patient with
the right procedure with the right precautions at the right time, leading to
improved patient outcomes and significant hospital savings.
To date, KēlaHealth’s hospital partners have applied the
company’s AI-powered platform in colorectal, vascular, cardiac, and orthopedics
The company has participated in highly selective accelerator
programs such as Cedars-Sinai Techstars Accelerator, Healthbox Studio, and Plug
Dr. Chang, CEO of KēlaHealth added: “Our vision is to apply the lessons learned from millions of previous surgeries for the benefit of every patient undergoing a procedure. Patients and their families, clinicians, and hospitals deserve the assurance that the risks of any surgery will be safely navigated by surgical teams with the best information available to them at every point in the surgical journey. We are thrilled to have a stellar group of surgeons, hospital centers, investors, and advisors working with us to realize the opportunity of precision surgery.”
– Healthify in partnership with Algorex Health Technologies, announced the results of new social determinants of health (SDoH) population analysis of Excellus BlueCross BlueShield (BCBS) members.
– SDoH are non-clinical conditions that significantly
affect health outcomes. The analysis identified Excellus BCBS members who are
struggling with SDoH such as unstable housing, food insecurity and neighborhood
stress – which has enabled Excellus BCBS to develop a targeted SDoH strategy
focusing on members with the most need.
Healthify, a company that works with managed care organizations to integrate social determinants of health (SDoH) into the healthcare ecosystem, in partnership with Algorex Health Technologies, today announced the results of SDoH population analysis of Excellus BlueCross BlueShield (BCBS) members that identified high-risk members and the value of implementing SDoH initiatives. The data identified members who are struggling with unstable housing, food insecurity and neighborhood stress, which has enabled Excellus BCBS to develop a targeted SDoH strategy focusing on members with the most need.
Excellus BCBS turned to Healthify and
healthcare data analytics company Algorex Health to
provide deep analytic insights about how social determinants of health affect health quality
and cost. The SDoH data showed significant social needs
among members in Medicaid and other government sponsored programs and the value
of addressing the most prominent social determinants of health of
Healthify creates the infrastructure that drives
collaboration among community-based organizations, healthcare payers, providers
and policy makers to address social disparities with
aligned incentives and accountability. Healthify recently announced a
partnership with Algorex Health Technologies to expand its SDoH capabilities
to include SDoH predictive analytics that help health plan
and provider organizations better understand and proactively address the social needs
of vulnerable populations.
“SDoH analytics are critical for health plans that are implementing SDoH solutions,” said Manik Bhat, Founder and Chief Executive Officer of Healthify. “Analytics helps health plans build financial cases to solve for SDoH, prioritize highest-impact interventions in an accountable network and determine the right level of investment for SDoH initiatives.”
– Human API, the consumer-controlled health data platform
announced it has closed a Series C round of $20M+ this week.
– Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers.
– The platform harnesses a machine learning-powered data pipeline
that structures health data into a consistent format, making it easier for
medical researchers and scientists to use actionable data more quickly and
efficiently while ensuring that patients remain in full control of who their
personal data is being shared with.
Human API, a San
Mateo, CA-based company empowering consumers to connect and share electronic
health data with companies they trust, announced today that it has raised over
$20 million in Series C funding. The round includes participation from Samsung
Ventures, CNO Financial Group, Allianz Life Ventures, and Moneta VC, as well as
from existing investors BlueRun Ventures, SCOR Life and Health Ventures, and
Guardian Life Insurance Company.
The capital will be used to scale new products and services
that enable new product design, granular risk stratification, optimize clinical
trial recruitment, support population health management, automate patient
monitoring, and digitize chronic disease management.
The Next Generation of Health Data Exchange
Human API’s consumer-controlled platform gives users a
streamlined means of accessing and sharing their personal health records with
physicians, trusted startups and enterprises, and insurers. The platform
harnesses a machine learning-powered data pipeline that structures health data
into a consistent format, making it easier for medical researchers and
scientists to use actionable data more quickly and efficiently while ensuring
that patients remain in full control of who their personal data is being shared
However, going one step further than just solving the data
portability issue, the Human API platform offers users various options to make
their data actionable, such as:
– Sharing their information with specific researchers who can put it to good use
– Enlisting to take part in medical trials or pharma trials
– Speeding up insurance processes to less than 24 hours
– Taking part in wellness programs provided by their employers.
“By facilitating these transactions,” explains Sean Duffy,
Co-Founder & CEO at Omada Health, “Human API is bringing into being a new
consumer health ecosystem driven by consumer-centric health apps and services.”
Appoints New Chief Commercial Officer
To drive forward this period of growth, Human API has
brought on Richard Dufty as Chief Commercial Officer. Having spearheaded
AppDirect’s growth from early stage startup to Unicorn status in just 4 years,
and having led Symantec’s $1B US Consumer and Cloud business, Dufty brings
extensive experience launching and growing software ecosystems.
– Nuance Communications, Inc. announced the Kettering
Health Network has selected ED Guidance for Nuance Dragon Medical Advisor.
– This AI-powered computer-assisted physician
documentation (CAPD) solution will help reduce physicians’ administrative
burden while lowering the risk of adverse safety events, missing diagnoses, and
malpractice litigation – priorities for all physicians, especially in the ED
where the nature of care presents special challenges and risks.
Kettering Health is deploying ED Guidance for Nuance Dragon
Medical Advisor to improve patient safety, alleviate the administrative burden
on clinicians, and reduce the risk of missing diagnoses by:
– Extending the Nuance CAPD solution to physicians in its 12
full-service emergency centers through its existing use of the Nuance Dragon
Medical One HITRUST CSF-certified conversational AI platform for documenting
care in the electronic health record (EHR).
– Empowering physicians with integrated real-time,
evidence-based emergency medical guidance from The Sullivan Group.
– Supporting best-practices-based clinical decision-making
and accurate documentation of the severity of illness and acuity of each
patient at the point of care within clinician’s standard EHR workflows.
– Using Nuance conversational AI to automatically identify
and add critical details that may impact patient treatment in real-time.
Sullivan Group Outcomes/Results
The Sullivan Group’s content has been shown to decrease the
occurrence of adverse safety events and reduce diagnosis-related malpractice
claims by up to 70 percent, and with the integration into Nuance Dragon Medical
Advisor, this guidance can be delivered in real-time while the patient is still
in the ED. ED Guidance for Nuance Dragon Medical Advisor also provides powerful
analytics for assessing ED performance and improving care quality and financial
“We see Nuance Dragon Medical One and Dragon Medical Advisor as essential tools that help physicians use the EHR efficiently for delivering high-quality patient care,” said Dr. Charles Watson, DO, Chief Medical Information Officer at Kettering Health. “Patient safety and reducing the administrative burdens of documentation and compliance are priorities for all physicians, especially in the ED, where the nature of care presents special challenges and risks. The ability to add those tools and data analytics via the cloud will help us align our clinical and compliance practices with diagnostic drivers more quickly and accurately.”
The Centers for Medicare and Medicaid Innovation (CMMI) created the Direct Contracting Model to expand opportunities for more diverse providers and healthcare organizations to participate in value-based care arrangements for Medicare fee-for-service (FFS) beneficiaries.
The goal of the new model is to create the next generation of risk-sharing arrangements to improve outcomes for patients, lower costs, and ensure high-quality care. In developing the Direct Contracting model and associated payment options, CMMI decided to build on lessons learned from accountable care initiatives, in particular, the Next-Generation ACO (NGACO) Model, as well as Medicare Advantage and other innovative private payers. The new model specifically aims to attract providers new to Medicare FFS and Innovation Center models: “the payment model options appeal to a broad range of physician practices and other organizations because they are expected to reduce burden, support a focus on beneficiaries with complex, chronic conditions, and encourage participation from organizations that have not typically participated in Medicare FFS or CMS Innovation Center models.”
High risk equals high reward for the new Direct Contracting Entities (DCE). The payment model options that participants can choose from aim to (1) increase risk-sharing arrangements through capitated and partially capitated population-based payments, (2) include providers and organization new to Medicare FFS, (3) increase access and empower beneficiaries in their care, and (4) decrease provider burden by emphasizing only core quality metrics and making certain care delivery waivers available. Importantly, the model offers options for new entrant DCEs, meaning DCEs that have no or limited experience with Medicare FFS beneficiaries and associated Medicare risk-based contracts, as well as high needs DCEs that will focus specifically on high cost, high acuity beneficiaries.
The Direct Contracting model begins with an optional six-month implementation period on October 1, 2020, which is intended to support organizations that need additional time to align beneficiaries and optimize their care coordination and management functions. In light of COVID-19’s overwhelming impact on healthcare this year, CMMI announced the first Direct Contracting Model performance year will start April 1, 2021—a three-month delay from the original start date, with five performance years to follow. The second cohort of Direct Contracting participants will begin in January 2022.
The Innovation Center will initially test two risk-sharing options:
Professional – includes a 50% shared savings/shared losses provisions and Primary Care Capitation, a capitated, risk-adjusted monthly payment for enhanced primary care services that’s equal to seven percent of the total cost of care benchmark for enhanced primary care services
Global – is 100% full risk option with either Primary Care Capitation or Total Care Capitation, which is a capitated, risk-adjusted monthly payment for all services provided by Direct Contracting Participants and preferred providers.
CMS may test a third option, the Geographic Option, in the future, which would also be a 100% risk arrangement offering an opportunity for participants to assume the total cost of care risk for Medicare FFS beneficiaries in a defined region.
Achieving Success in the Direct Contracting Model:
Similar to existing accountable care models, critical elements to achieve success in the Direct Contracting model include a focus on workflows, systems, and partnerships that support care coordination activities, including connections to needed healthcare and wrap-around services, as well as supporting providers in attaining quality benchmarks while managing overall utilization. Underlying these capabilities is access to real-time actionable information to drive timely interventions and coordination activities.
Real-time information through admission, discharge, and transfer (ADT) event notifications for Emergency Department, hospital, or post-acute encounters enable care coordination teams to deploy workflows and resources to more easily and quickly support patients. Knowing when and where patients are receiving care and understanding the clinical context for their care allows providers and care teams to more seamlessly work together to provide the right care at the right time without unnecessary or duplicative interventions. It also allows care teams to identify patients at high risk for complications, including readmissions and can prompt time-sensitive outreach and connection to additional resources.
Having access to real-time information can not only improve patient outcomes and quality but will also help to maximize payment incentives for Direct Contracting participants. Coordinated care consistently leads to shorter lengths of stay, which not only has positive quality implications for patients but also financial benefits for Direct Contracting Entities.
In addition, healthcare organizations can use real-time information to continuously strengthen and refine care network partnerships and collaborations.
To effectively manage Medicare FFS patients within the Direct Contracting Model, participants will need to coordinate with other providers across care settings and deploy timely interventions that support patients’ health and well-being. Real-time information, through ADT data, will provide participants with a new level of clinical intelligence to successfully prioritize and deploy care coordination services and ensure seamless transitions of care for patients while also creating optimal opportunities to achieve shared savings.
About Vanessa Kuhn, Ph.D
Vanessa Kuhn, Ph.D., is the Director of Policy at PatientPing, a care collaboration platform that provides real-time visibility into patient care events across the continuum. PatinetPing works with hospitals, post-acutes, health plans, ACO’s and beyond, the platform connects providers across the nation to improve patient and organizational outcomes.
– Doctor On Demand and CareLinx, one of the largest professional networks for in-home care, have announced a collaboration to bring in-home virtual care services to CareLinx clients.
– At a time when seniors have been encouraged to stay home to avoid exposure to COVID, Doctor On Demand’s partnership with CareLinx will vastly improve their opportunity to receive comprehensive healthcare while remaining safe.
After being the first and only telemedicine provider to roll out medical care for Medicare Part B beneficiaries, Doctor On Demand is doubling down on their efforts to support seniors in their homes. Doctor On Demand, the nation’s leading virtual care provider, and CareLinx, a nationwide, professional network for in-home care, today announced a partnership to bring in-home virtual care services to CareLinx clients.
Supporting High-Risk Patients at Home
The partnership aims to expand CareLinx’s in-home care offerings and improve health outcomes for their clients, geriatric and high-risk patients who need support at home. Today, CareLinx tech-enabled caregivers have digital care plans on their smartphones — enabling quality delivery of everyday care services such as bathing and meal prep, as well as direct communication to a patient’s family.
Doctor On Demand will augment these existing services by connecting CareLinx clients with virtual care providers in real-time. CareLinx caregivers will support the Doctor On Demand registration process and assist with in-home follow-ups and care coordination recommended by Doctor On Demand’s board-certified physicians as well.
CareLinx Clients Receive Access to Virtual Visits, Powered by Doctor on Demand
Eligible CareLinx clients will receive initial visits with board-certified physicians through Doctor On Demand at no cost. These virtual visits can be used to treat a spectrum of health issues, including diagnosis and testing of COVID-19, typical ailments like infections, rashes, cold and flu, and ongoing chronic diseases like asthma, diabetes, high blood pressure, and thyroid issues. Doctor On Demand physicians can also fill prescriptions and order lab work, and patients can see the same physician time and time again, building a trusted, personal relationship via video.
Why It Matters
“Now more than ever, finding high-quality, in-home care is pivotal during a time when seniors and high-risk patients are being encouraged to stay at home to minimize risk and exposure to COVID-19. Our partnership with Doctor On Demand enables CareLinx to continue equipping caregivers with digital tools and technologies to make caregiving easier, more transparent, and higher quality,” said Sherwin Sheik, CEO, CareLinx. “Additionally, this partnership is helping to supplement in-home activities of daily living with a telehealth option for our clients, who may not otherwise realize they have the option to see a provider virtually for medical ailments. Combined with the in-home care they are receiving, these services can help provide an expanded continuum of care to help them stay healthy and safe where they want to be — at home.”
The COVID-19 virus is ravaging the planet at a scale not seen since the infamous Spanish Flu of the early 1900s, inflicting immense devastation as the U.S. loses more than 200,000 lives and counting. According to CDC statistics, 94% of patient mortalities associated with COVID-19 were simultaneously suffering from preexisting conditions, leaving a mere 6% of victims with COVID-19 as their sole cause of death. However, while immediate prospects for a mass vaccine might not be until 2021, there is some hope among rural hospital health information technology consultants where the pandemic has hit the hardest.
The fact that four in ten U.S. adults have two or more chronic conditions indicates that our most vulnerable members of the population are also the ones at the greatest risk of succumbing to the pandemic. From consultants laboring alongside healthcare administrators and providers, all must pay close attention to patients harboring 1 of 13 chronic conditions believed to play major roles in COVID-19 mortality, particularly chronic kidney disease, hypertension, diabetes, and COPD.
Vulnerable rural populations must be supervised due to their unique challenges. The CDC indicates 80% of older adults in remote regions have at least one chronic disease with 77% having at least two chronic diseases, significantly increasing COVID-19 mortality rates compared to their urban counterparts.
Health behaviors also play a role in rural patients who have decreased access to healthy food and physical activity while simultaneously suffering high incidences of smoking. These lifestyle choices compound with one another, leading to increased obesity, hypertension, and many other chronic illnesses. Overall, rural patients that fall ill to COVID-19 are more likely to suffer worsened prognosis compared to urban hubs, a problem only bolstered by their inability to properly access healthcare.
Virus Helping Push New Technologies
COVID-19 has shown the cracks in the U.S. healthcare technology system that must be addressed for the future. As the pandemic unfolds, it’s worth noting that not all lasting effects will be negative. Just as the adoption of the Affordable Care Act a decade ago spurred healthcare organizations to digitize their records, the COVID-19 pandemic is accelerating overdue technological shifts crucial to providing better care.
Perhaps the most prominent change has been the widespread adoption of telehealth services and technologies that connect patients with both urgent and preventive care without their having to leave home. Perhaps the most prominent change has been the widespread adoption of telehealth services and technologies that use video to connect patients with both urgent and preventive care without their having to leave home.
Even if COVID-19 were to fade away on its own, the next pandemic may not. Furthermore, seasonal influenza serves as a reminder that healthcare is not a skirmish, but a prolonged war against disease. Rather than doom future generations to suffer the same plight our generation has with the pandemic, now is the time to develop innovative IT strategies that focus on protecting our most vulnerable citizens by leveraging existing healthcare initiatives to focus on proactive responses instead of reactive responses.
On the Right Road
While some of the most vulnerable people are the elderly, rural residents, and the poor, the good news for them is that CMS has long advocated the use of preventive care initiatives such as Chronic Care Management (CCM) and Remote Physiologic Monitoring (RPM) to track these geriatric patients. To encourage innovation in this sector, CMS preventive care initiatives provide generous financial incentives to healthcare providers willing to shift from conventional reactive care strategies to a more proactive approach focused on prevention and protection. This should attract rural hospital CEOs who have been struggling even more than usual because of the virus.
These factors led to the creation of numerous patient CCM programs, allowing healthcare executives and providers to remotely track the health status of geriatric patients suffering from numerous chronic conditions. The tracking is at a rate and scope unseen previously through the use of electronic media. Interestingly enough, the patients already being monitored by CCM programs overlap heavily with populations susceptible to COVID-19. To adapt existing infrastructure for the COVID-19 pandemic is a relatively simple task for hospital CIOs.
As noted earlier, one growing CCM program that could be retrofitted to deal with the COVID-19 pandemic are the use of telehealth services in rural locations. Prior to the pandemic, telehealth services were one of the many strategies advocated by the CDC to address the overtaxed healthcare systems found in rural locations.
Better Access, Funding and User Experience for Telehealth
Today, telehealth is about creating digital touchpoints when no other contact is possible or safe. It offers the potential to expand care to people in remote areas who might have limited or nonexistent access, and it could let other health workers handle patient screening and post-care follow-up when a local facility is overwhelmed. As a study published last year in The American Journal of Emergency Medicineaffirms, virtual care can cut the cost of healthcare delivery and relieve strain on busy clinicians.
Telehealth has also gotten a boost from the $2 trillion CARES Act stimulus fund, which provides $130 billion to healthcare organizations fighting the pandemic. The effort also makes it easier for providers to bill for remote services.
The reason for the CDC and hospital administrators’ interest in telehealth was that telehealth meetings could outright remove the need for patients to travel and allow healthcare providers to monitor patients at a fraction of the time. By simply coupling existing telehealth services with CMS preventive care initiatives focused on COVID-19, rural healthcare providers could detect early warning signs of COVID-19.
Integration Key to Preemptive Detection
This integration at a faster and far greater scale could mean much greater preemptive virus detection through routine telehealth meetings. The effect of telehealth would be twofold on hospitals serving rural and urban health communities. It could slow the spread of COVID-19 to a crawl due to decreased patient travel and improved patient prognosis through early and intensive treatment for vulnerable populations with two or more chronic health conditions.
This integrated combination would shift standard reactive care to patient infections to a new monitoring methodology that proactively seeks out infected patients and rapidly administers treatment to those most at risk of mortality. This new combination of preventive care and telehealth services would not only improve patient and community health but would relieve the financial burden incurred from the pandemic due to the existing CMS initiatives subsidizing such undertakings.
In conclusion, preventative care targeting patients with pre-conditions in rural locations are severely lacking in the context of the COVID-19 pandemic. By leveraging CMS preventive care initiatives along with telehealth services, healthcare providers can achieve the following core objectives.
First, there are financial incentives with preventive care services that will relieve the burden on healthcare systems. Second, COVID-19 vulnerable populations will receive the attention and focus from healthcare providers that they deserve to slow the spread through the use of early detection systems and alerts to their primary health provider. Third, by combining with telehealth service, healthcare providers can efficiently and effectively reach out to rural populations that were once inaccessible to standard healthcare practices.