– 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.
During a panel discussion at the J.P. Morgan Healthcare Conference, three physicians from Stanford Medicine discussed the investment opportunities that can help accelerate innovation in healthcare in the coming year.
In a wide-ranging discussion at J.P. Morgan’s Annual Healthcare Conference, former CMS Administrator Andy Slavitt talked about the future of the ACA, telehealth and Medicare Advantage with a Democrat-led House, Senate and presidency.
Roughly a third of adults had a telehealth visit in the first 6 months of the pandemic, according to a new survey conducted by the Urban Institute. But not everyone who wanted a telehealth visit was able to access it, leaving some adults with unmet care needs.
In an increasingly crowded landscape, digital health startups must figure out what sets them apart. Three startup leaders shared what differentiates their companies from the competition at this year’s J.P. Morgan Healthcare Conference.
– Nuance Communications, Inc. launched an AI-powered
patient engagement virtual assistant platform to transform omnichannel digital
experiences for patients.
–Healthcare provider organizations can now deploy
a single, common cloud-based platform to support their entire patient journey
across engagement channels using Nuance’s market-leading Intelligent Engagement
– The launch comes as patients increasingly expect the
same level of engaging experiences from healthcare organizations that they have
with consumer brands.
Communications, Inc., today launched an AI-powered patient
engagement virtual assistant platform to transform voice and digital
experiences across the patient journey. The platform combines Nuance’s decades
of healthcare expertise and its award-winning AI technology trusted by consumer
brands like H&M, Rakuten and Best Buy. It works by integrating and
extending Nuance’s EHR, CRM and Patient Access Center systems to enable
healthcare provider organizations to modernize their “digital front door” and
improve clinical care experiences.
Holistic Approach to Healthcare’s New Digital Front Door
Patients are demanding the same conveniences from healthcare
organizations that they enjoy from major consumer brands. A recent survey reveals that consumers are ready for
digital changes such as telemedicine options (44%), digital forms and
communication (41%), and touchless check-in (37%). What’s more, 68% value a
customized patient experience. In fact, a poor digital health experience caused
more than a quarter of patients to change medical providers in 2020 — up 40
percent from 2019.
“Our new omnichannel Patient Engagement Virtual
Assistant Platform takes a holistic approach to powering healthcare’s new
digital front door, overcoming the shortcomings and inconsistencies of partial
point solutions,” said Peter Durlach, Senior Vice President, Strategy
and New Business Development, Nuance. “By marrying the capabilities of our
healthcare experience and the proven omnichannel customer engagement technology
trusted by Fortune 100 companies worldwide, we can help address the
urgent need of providers and patients alike to transform access to, and
delivery of, care in the modern age of digital medicine.”
– Telehealth adoption for behavioral health services
jumped sharply during the first months of the COVID-19 pandemic shutdown,
according to a new RAND Corporation study.
Telehealth adoption increased sharply during the first
months of the COVID-19 pandemic shutdown, with the approach being used more
often for behavioral health services than for
medical care, according to a new RAND Corporation study. Prior to the pandemic, patients
frequently were reluctant to use telehealth because it often meant seeing a provider
other than their own physician. According to researchers, sustaining the
ability to see one’s own doctor through telehealth may be critical to making
telehealth a permanent part of routine healthcare.
The study conducted between mid-March and
early May 2020 reveals telehealth was used by more than 40% of patients with a
chronic physical health condition and by more
than 50% of those with a behavioral health condition,
according to findings published in the Journal of General Internal Medicine. Overall,
almost half of the people who were undergoing treatment when the pandemic
shutdown began reported using some form of telemedicine.
RAND researchers examined
the increase in telehealth by surveying 2,052 adults who are a part of the RAND
American Life Panel, a nationally representative internet panel. The
questions about use of telehealth were part of a larger survey about life
during the pandemic that was fielded between May 1 and May 6.
Researchers found that the use of telehealth
for behavioral health conditions was lower
among women and among people over the age of 60. Use of telehealth also was
lower among Non-Hispanic Whites relative to Non-Hispanic Blacks and was lower
among those with less than a high school education relative to those with a
When the pandemic began, nearly 40% of the Americans
surveyed were being treated for a chronic physical health condition, while 15%
were being treated for a behavioral health condition. Since the pandemic
started, 16% had considered seeking care for a new or recurrent condition.
The study found that among patients who were receiving
care when the pandemic began, 11% had
used telehealth that included video conferencing from the middle of March to
early May, a period of less than two months. In contrast, a survey conducted
with the same panel in 2019 found that fewer than 4% had ever used video
conferencing with a doctor.
Among people who used telehealth services, researchers
found that the use of video telehealth was less common for physical health care
(14% of patients) than for behavioral health care (30% of patients).
Lack of insurance was associated with lower telehealth
use for new conditions, while use of telehealth was more common in the
Northeast than other parts of the nation.
“While the increased use of telehealth was widespread, some groups of Americans reported using the services less often than others,” said Dr. Shira H. Fischer, the study’s lead author and a physician researcher at RAND, a nonprofit research organization. “If telehealth use is going to remain high, we need to ensure equity of access, particularly for behavioral health care where education, age and gender were all associated with levels of use.”
“There is a wide expectation that telehealth will continue after the pandemic ends. Lessons from the use of telehealth during this period should inform policy for the post-COVID-19 era,” Fischer said.
In response to the spike in demand for virtual care services amid the Covid-19 pandemic, UCLA Health developed telehealth-specific triage protocols to ensure their patients are getting care through the appropriate medium — whether in person or via a video visit. Here’s how they did it.
– TigerConnect has announced an expansion in their suite
through the acquisition of Critical Alert, a leading provider of
enterprise-grade middleware for hospitals and health systems.
– For the hundreds of thousands of nurses that currently
use TigerConnect, these new capabilities will deliver real-time, contextual
information to their mobile device or desktop to allow them to work smarter,
prioritize responses, and efficiently coordinate care, all within the same
reliable TigerConnect platform they use every day for enterprise messaging.
a care team collaboration solution, today announced the acquisition
of Critical Alert, a Jacksonville,
FL-based leading provider of enterprise-grade middleware for hospitals and
health systems. Critical Alert’s product suite consists of a middleware suite
of products as well as traditional nurse call hardware servicing over 200
hospitals in North America. Financial details of the acquisition were not
Real-Time Care Team Collaboration for Hospitals
Founded in 1983, Cloud-native and mobile-first, Critical
Alert’s middleware solution enables any health system to combine nurse call,
alarm and event management, medical device interoperability, and clinical
workflow analytics. TigerConnect will integrate Critical
Alert’s middleware stack into its platform to power a wide range of alert types
and alarm management enhancements for TigerConnect’s customers. Critical
Alert’s Nurse Call hardware business will continue to operate under its
namesake as a standalone business unit.
When combined with Critical Alert’s middleware, TigerConnect dramatically
enhances the value proposition to nursing, IT leadership, and end-users. This ‘dream
suite’ of capabilities comes at a time when nurse burnout is at a record high
and chronic nurse shortages are severely challenging organizations’ ability to
deliver the best quality care.
“We see the Critical Alert acquisition as highly strategic and
a natural evolution of our already-robust collaboration
platform,” said Brad Brooks, CEO and co-founder of TigerConnect. “For the
hundreds of thousands of nurses that currently use TigerConnect, these new
capabilities will deliver real-time, contextual information to their mobile
device or desktop to allow them to work smarter, prioritize responses, and
efficiently coordinate care, all within the same reliable TigerConnect platform
they use every day for enterprise messaging.”
Joining TigerConnect is Critical Alert CEO John
Elms, who will assume the role as TigerConnect Chief Product Officer,
guiding the integration of the two companies’ technologies and leading the
development of all future product offerings. Wil Lukens, currently VP of Sales
for Critical Alert, will assume the role of General Manager of Critical Alert’s
traditional Nurse Call hardware unit.
“The timing of the deal and the fit of these two companies aligned perfectly,” said John Elms, CEO of Critical Alert. “Two best-in-class, highly complementary solutions coming together to solve some of the chronic challenges—alarm fatigue, response prioritization, resource optimization—that have driven nurse teams to the brink. Together, these unified technologies will make care professionals’ lives easier, not harder, and I couldn’t be more excited to lead the TigerConnect product organization into this next chapter.”
Critical Alert Integration with TigerConnect Plans
TigerConnect’s robust product suite, which includes care
team collaboration (TigerFlow®), on-call scheduling (TigerSchedule®), virtual
care/telemedicine (TigerTouch®), and now virtualized nurse call and
alerts/alarm management (Critical Alert middleware), will help transform
hospitals and healthcare organizations into the real-time health systems of the
Hardware-free Middleware Forms the Foundation
With a shared cloud-native approach, Critical Alert’s
advanced middleware seamlessly fuses TigerConnect’s care team
collaboration with alarm management and event notifications. Deep
enterprise-level integrations with hospital systems enable the centralization
of clinical workflow management and real-time analytics. Integrating these
systems will have a sizable impact on customer organizations’ productivity and
Next Generation Nurse Call
Critical Alert’s nurse call solution brings a modern, badly
needed upgrade to legacy systems, extending both their life and feature-set. A
single mobile- or desktop-enabled user-interface brings vital contextual
information about requests while allowing for centralized answering of nurse
call alerts and management of workflows and assignments. These streamlined
workflows reduce noise and clinical interruptions while improving
Physiological Monitoring – Less Noise, More Signal
The FDA-cleared offering intelligently routes context-rich
alarm notifications from clinical systems to TigerFlow+. An easy-to-use
workflow builder ensures alerts are prioritized accordingly and are routed to
the appropriate caregiver, suppressing unnecessary noise. The filtering,
mobilization, and escalation of alerts pairs with TigerConnect Teams,
allowing for prompt responses in critical situations.
Smart Bed Alarms for Enhanced Patient Safety
Integrations with popular smart bed systems provide remote
monitoring of bed status details, informing nurses whether they should walk or
run to a patient’s room. Staff can review and adjust bed compliance settings
from their mobile device and receive fall prevention notifications if safe-bed
configuration is compromised.
Real-time Location System (RTLS) Measures What Matters
The integration of RTLS with a deployed nurse call
application greatly enhances the data available to clinical leadership. The
combined TigerConnect/Critical Alert offering enables real-time tracking
of staff location (presence) and time spent on tasks, providing deeper insights
into resource planning, workflow effectiveness and ongoing process improvement
Advanced Analytics for Deeper Workflow Insights
A better understanding of patient behavior and workflows
helps reveal areas for optimization that can lead to improved patient care and
staff efficacy. The new combined platform capabilities centralize the
collection and tracking of patient event data and nurse task efficiency,
turning insights into action. Advanced analytics also allow for identifying,
documenting, and benchmarking responsiveness, compliance, resource allocation,
and patient throughput across the health system.
This new integrated functionality is expected to be
available to TigerConnect customers in Q1 of 2021.
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.
COLUMBIA, Mo. — A memory haunts Christina Fuhrman: the image of her toddler Pearl lying pale and listless in a hospital bed, tethered to an IV to keep her hydrated as she struggled against a superbug infection.
“She survived by the grace of God,” Fuhrman said of the illness that struck her oldest child in this central Missouri city almost five years ago. “She could’ve gone septic fast. Her condition was near critical.”
Pearl was fighting Clostridium difficile, or C. diff, a type of antibiotic-resistant bacteria known as a superbug. A growing body of research shows that overuse and misuse of antibiotics in children’s hospitals — which health experts and patients say should know better — helps fuel these dangerous bacteria that attack adults and, increasingly, children. Doctors worry that the covid pandemic will only lead to more overprescribing.
A study published in the journal Clinical Infectious Diseases in January found that 1 in 4 children given antibiotics in U.S. children’s hospitals are prescribed the drugs inappropriately — the wrong types, or for too long, or when they’re not necessary.
Dr. Jason Newland, a pediatrics professor at Washington University in St. Louis who co-authored the study, said that’s likely an underestimate because the research involved 32 children’s hospitals already working together on proper antibiotic use. Newland said the nation’s 250-plus children’s hospitals need to do better.
“It’s irresponsible,” Fuhrman added. Coupled with parents begging for antibiotics in pediatricians’ offices, it’s “just creating a monster.”
Using antibiotics when they’re not needed is a long-standing problem, and the pandemic “has thrown a little bit of gas on the fire,” said Dr. Mark Schleiss, a pediatrics professor at the University of Minnesota Medical School.
Although fears of covid-19 mean fewer parents are taking their children to doctors’ offices and some have skipped routine visits for their kids, children are still getting antibiotics through telemedicine visits that don’t allow for in-person exams. And research shows more than 5,000 children infected with the coronavirus were hospitalized between late May and late September. If symptoms point toward a bacterial infection on top of the coronavirus, Schleiss said, doctors sometimes prescribe antibiotics, which don’t work on viruses, until tests rule out bacteria.
At the same time, Newland said, the demands of caring for covid patients take time away from what are known as “stewardship” programs aimed at measuring and improving how antibiotics are prescribed. Often such efforts involve continuing education courses for health care professionals on how to use antibiotics safely, but the pandemic has made those more difficult to host.
“There’s no doubt: We’ve seen some extra use of antibiotics,” Newland said. “The impact of the pandemic on antibiotic use will be significant.”
Habits Drive Superbug Growth
Antibiotic resistance occurs through random mutation and natural selection. Those bacteria most susceptible to an antibiotic die quickly, but surviving germs can pass on resistant features, then spread. The process is driven by prescribing habits that lead to high levels of antibiotic use.
A March study in the journal Infection Control & Hospital Epidemiology found that the rates of antibiotic use on patients at 51 children’s hospitals ranged from 22% to 52%. Some of those medications treated actual bacterial infections, but others were given in hopes of preventing infections or when doctors didn’t know what was causing a problem.
“I hear a lot about antibiotic use for the ‘just in case’ scenarios,” said Dr. Joshua Watson, director of the antimicrobial stewardship program at Nationwide Children’s Hospital in Ohio. “We underestimate the downsides.”
Newland said each specialty in medicine has its own culture around antibiotic use. Many surgeons, for example, routinely use antibiotics to prevent infection after operations.
Outside of hospitals, doctors have long been criticized for prescribing antibiotics too often for ailments such as ear infections, which can sometimes go away on their own or can be caused by viruses that antibiotics won’t counter.
Dr. Shannon Ross, an associate professor of pediatrics and microbiology at the University of Alabama at Birmingham, said not all doctors have been taught how to use antibiotics correctly.
“Many of us don’t realize we’re doing it,” she said of overuse. “It’s sort of not knowing what you’re doing until someone tells you.”
All this drives the growth of numerous superbugs in the very population served by these hospitals. Numerous studies, including one published in the Journal of Pediatrics in March, cite the rise among kids of C. diff, which causes gastrointestinal problems. A 2017 study in the Journal of the Pediatric Infectious Diseases Society found that cases of a certain type of multidrug-resistant Enterobacteriaceae rose 700% in American children in just eight years. And a steady stream of research points to the stubborn prevalence in kids of the better-known MRSA, or methicillin-resistant Staphylococcus aureus.
Superbug infections can be extremely difficult — and sometimes impossible — to treat. Doctors often must turn to strong medicines with side effects or give drugs intravenously.
“It’s getting more and more worrisome,” Ross said. “We have had patients we have not been able to treat because we’ve had no antibiotics available” that could kill the germs.
Doctors say the world is nearing a “post-antibiotic era,” when antibiotics no longer work and common infections can kill.
A Monster Unleashed
Superbugs spawned by antibiotic overuse put everyone at risk.
Like her daughter, Fuhrman also suffered through a C. diff infection, getting sick after taking antibiotics following a root canal in 2012. While killing harmful germs, antibiotics can also destroy those that protect against infection. Fuhrman cycled in and out of the hospital for months. When she finally got better, she tried to avoid using antibiotics and never gave them to her daughter.
That’s because antibiotics affect your microbiome by wiping out bad germs and the good germs that protect your body against infections.
Pearl’s first symptoms of C. diff arose about three years later, at around 20 months old. Fuhrman noticed her daughter was having lots of bowel movements. The mom eventually found pus and blood in her daughter’s stools. One day, Pearl was so pale and weak that Fuhrman took her to the emergency room. She was discharged, then spiked a fever and returned to the hospital.
Doctors treated Pearl with Flagyl, a broad-spectrum antibiotic. But two days after the last dose, she went downhill. The infection had returned. She recovered only after going to the Mayo Clinic in Rochester, Minnesota, for a fecal microbiota transplantation, in which she received healthy donor stool from her dad through a colonoscopy.
Since her family’s ordeal, Fuhrman has been trying to raise awareness of superbugs and antibiotic overuse. She serves on the board of the Peggy Lillis Foundation, a C. diff education and advocacy organization, and has testified before a presidential advisory committee in Washington, D.C., about superbugs and antibiotic stewardship.
In March, the Centers for Medicare & Medicaid Services began requiring all hospitals to document that they have antibiotic stewardship programs.
One approach, Schleiss said, is to restrict antibiotics by “saving our most magic bullets for the most desperate situations.” Another is to stop antibiotics at, say, 72 hours, after reassessing whether patients need them. Meanwhile, doctors are calling for more research into antibiotic use in children.
Fuhrman said hospitals must do all they can to stop superbug infections. The stakes are enormous, she said, pointing toward Pearl, now a 7-year-old first grader who likes to wear a pink hair bow and paint her tiny fingernails a rainbow of pastel colors.
“Antibiotics are great, but they have to be used wisely,” Fuhrman said. “The problem of superbugs is here. It’s in our backyard now, and it’s just getting worse.”
The combination of Teladoc Health and Livongo creates a
global leader in consumer-centered virtual care. The combined company is
positioned to execute quantified opportunities to drive revenue synergies of
$100 million by the end of the second year following the close, reaching $500
million on a run-rate basis by 2025.
Price: $18.5B in value based on each share of Livongo
will be exchanged for 0.5920x shares of Teladoc Health plus cash consideration
of $11.33 for each Livongo share.
Siemens Healthineers Acquires Varian Medical
On August 2nd, Siemens Healthineers acquired
Varian Medical for $16.4B, with the deal expected to close in 2021. Varian is a
global specialist in the field of cancer care, providing solutions especially
in radiation oncology and related software, including technologies such as
artificial intelligence, machine learning and data analysis. In fiscal year 2019,
the company generated $3.2 billion in revenues with an adjusted operating
margin of about 17%. The company currently has about 10,000 employees
Price: $16.4 billion in an all-cash transaction.
Gainwell to Acquire HMS for $3.4B in Cash
Veritas Capital (“Veritas”)-backed Gainwell Technologies (“Gainwell”),
a leading provider of solutions that are vital to the administration and
operations of health and human services programs, today announced that they
have entered into a definitive agreement whereby Gainwell will acquire HMS, a technology, analytics and engagement
solutions provider helping organizations reduce costs and improve health
Price: $3.4 billion in cash.
Philips Acquires Remote Cardiac Monitoring BioTelemetry for $2.8B
Philips acquires BioTelemetry, a U.S. provider of remote
cardiac diagnostics and monitoring for $72.00 per share for an implied
enterprise value of $2.8 billion (approx. EUR 2.3 billion). With $439M in
revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients
remotely; its portfolio includes wearable heart monitors, AI-based data
analytics, and services.
Price: $2.8B ($72 per share), to be paid in cash upon
Hims & Hers Merges with Oaktree Acquisition Corp to Go Public on NYSE
Telehealth company Hims & Hers and Oaktree Acquisition Corp., a special purpose acquisition company (SPAC) merge to go public on the New York Stock Exchange (NYSE) under the symbol “HIMS.” The merger will enable further investment in growth and new product categories that will accelerate Hims & Hers’ plan to become the digital front door to the healthcare system
Price: The business combination values the combined
company at an enterprise value of approximately $1.6 billion and is expected to
deliver up to $280 million of cash to the combined company through the
contribution of up to $205 million of cash.
SPAC Merges with 2 Telehealth Companies to Form Public
Digital Health Company in $1.35B Deal
Blank check acquisition company GigCapital2 agreed to merge with Cloudbreak Health, LLC, a unified telemedicine and video medical interpretation solutions provider, and UpHealth Holdings, Inc., one of the largest national and international digital healthcare providers to form a combined digital health company.
Price: The merger deal is worth $1.35 billion, including
WellSky Acquires CarePort Health from Allscripts for
Price: $1.35 billion represents a multiple of greater
than 13 times CarePort’s revenue over the trailing 12 months, and approximately
21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12 months.
Waystar Acquires Medicare RCM Company eSolutions
On September 13th, revenue cycle management
provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue
cycle management, workflow automation, and data analytics tools. The
acquisition creates the first unified healthcare payments platform with both
commercial and government payer connectivity, resulting in greater value for
Radiology Partners (RP), a radiology practice in the U.S., announced a definitive agreement to acquire MEDNAX Radiology Solutions, a division of MEDNAX, Inc. for an enterprise value of approximately $885 million. The acquisition is expected to add more than 800 radiologists to RP’s existing practice of 1,600 radiologists. MEDNAX Radiology Solutions consists of more than 300 onsite radiologists, who primarily serve patients in Connecticut, Florida, Nevada, Tennessee, and Texas, and more than 500 teleradiologists, who serve patients in all 50 states.
PointClickCare Acquires Collective Medical
PointClickCare Technologies, a leader in senior care technology with a network of more than 21,000 skilled nursing facilities, senior living communities, and home health agencies, today announced its intent to acquireCollective Medical, a Salt Lake City, a UT-based leading network-enabled platform for real-time cross-continuum care coordination for $650M. Together, PointClickCare and Collective Medical will provide diverse care teams across the continuum of acute, ambulatory, and post-acute care with point-of-care access to deep, real-time patient insights at any stage of a patient’s healthcare journey, enabling better decision making and improved clinical outcomes at a lower cost.
Teladoc Health Acquires Virtual Care Platform InTouch
Teladoc Health acquires InTouch Health, the leading provider of enterprise telehealth solutions for hospitals and health systems for $600M. The acquisition establishes Teladoc Health as the only virtual care provider covering the full range of acuity – from critical to chronic to everyday care – through a single solution across all sites of care including home, pharmacy, retail, physician office, ambulance, and more.
Price: $600M consisting of approximately $150 million
in cash and $450 million of Teladoc Health common stock.
AMN Healthcare Acquires VRI Provider Stratus Video
AMN Healthcare Services, Inc. acquires Stratus Video, a leading provider of video remote language interpretation services for the healthcare industry. The acquisition will help AMN Healthcare expand in the virtual workforce, patient care arena, and quality medical interpretation services delivered through a secure communications platform.
CarepathRx Acquires Pharmacy Operations of Chartwell from
CarepathRx, a leader in pharmacy and medication management
solutions for vulnerable and chronically ill patients, announced today a
partnership with UPMC’s Chartwell subsidiary that will expand patient access to
innovative specialty pharmacy and home infusion services. Under the $400M
landmark agreement, CarepathRx will acquire the
management services organization responsible for the operational and strategic
management of Chartwell while UPMC becomes a strategic investor in CarepathRx.
Cerner to Acquire Health Division of Kantar for $375M in
Cerner announces it will acquire Kantar Health, a leading
data, analytics, and real-world evidence and commercial research consultancy
serving the life science and health care industry.
This acquisition is expected to allow Cerner’s Learning
Health Network client consortium and health systems with more opportunities to
directly engage with life sciences for funded research studies. The acquisition
is expected to close during the first half of 2021.
Cerner Sells Off Parts of Healthcare IT Business in
Germany and Spain
Cerner sells off parts of healthcare IT business in Germany and Spain to Germany company CompuGroup Medical, reflecting the company-wide transformation focused on improved operating efficiencies, enhanced client focus, a refined growth strategy, and a sharpened approach to portfolio management.
Price: EUR 225 million ($247.5M USD)
CompuGroup Medical Acquires eMDs for $240M
CompuGroup Medical (CGM) acquires eMDs, Inc. (eMDs), a
leading provider of healthcare IT with a focus on doctors’ practices in the US,
reaching an attractive size in the biggest healthcare market worldwide. With
this acquisition, the US subsidiary of CGM significantly broadens its position
and will become the top 4 providers in the market for Ambulatory Information
Systems in the US.
Price: $240M (equal to approx. EUR 203 million)
Change Healthcare Buys Back Pharmacy Network
back pharmacy unit eRx Network
(“eRx”), a leading provider of comprehensive, innovative, and secure
data-driven solutions for pharmacies. eRx generated approximately $67M in
annual revenue for the twelve-month period ended February 29, 2020. The
transaction supports Change Healthcare’s commitment to focus on and invest in
core aspects of the business to fuel long-term growth and advance innovation.
Walmart acquires CareZone, a San Francisco, CA-based smartphone
service for managing chronic health conditions for reportedly $200M. By
working with a network of pharmacy partners, CareZone’s concierge services
assist consumers in getting their prescription medications organized and
delivered to their doorstep, making pharmacies more accessible to individuals
and families who may be homebound or reside in rural locations.
Verisk, a data
analytics provider, announced today that it has acquiredFranco Signor, a Medicare Secondary Payer
(MSP) service provider to America’s largest insurance carriers and employers.
As part of the acquisition, Franco Signor will become part of Verisk’s Claims
Partners business, a leading provider of MSP compliance and other analytic
claim services. Claims Partners and Franco Signor will be combining forces to
provide the single best resource for Medicare compliance.
Rubicon Technology Partners Acquires Central Logic
Private equity firm Rubicon Technology Partners acquires
Central Logic, a provider of patient orchestration and tools to accelerate
access to care for healthcare organizations. Rubicon will be aggressively driving Central Logic’s
growth with additional cash investments into the business, with a focus
on product innovation, sales expansion, delivery and customer support, and
the pursuit of acquisition opportunities.
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
In a wide-ranging interview with MedCity News, Cerner CommunityWorks President Mitchell Clark discussed the healthcare challenges facing rural communities amid the Covid-19 pandemic and the company’s new free offering that aims to support rural telehealth.
EverCommerce, a provider of solutions for businesses in the service sector, has added Updox to its roster of health services companies. Updox offers a variety of virtual care, patient engagement and office productivity solutions.
Reviewing 2019’s key digital health stories last year I suggested that, while big strides continued to be made, any definitive ‘coming of age’ moment for the sector was unlikely.
But that was before the first reports emerged of a highly contagious coronavirus and 2020 will be forever associated with COVID-19 and the global devastation and disruption it has wrought.
Now, after a year that feels like it had many more than the usual 12 months, ‘digital’ has most certainly come of age across all aspects of our lives, including communication, commerce, working life and, yes, health.
So, what were the standout changes for digital health, and digital pharma for that matter, in this most unusual of years?
I suppose I could just answer ‘COVID’ and be done with it.
In fact, preparing for our year in review articles, we decided in our editorial meeting to have at least one look at medical progress away from COVID.
Nevertheless, the pandemic was clearly the biggest change-agent for digital health and digital pharma in 2020.
1. Digital transformation moved front and centre
COVID-19 brought rapid, deep and likely lasting changes to healthcare and the pharmaceutical sector, as both scrambled to respond to unprecedented demands.
Consequently, what might previously have looked upon as a 3, 5 or even 10 year plan suddenly required progress within just days or weeks.
As I noted earlier this year, healthcare companies went from being lost in a ‘digitalisation jungle’ in 2019, to this year making huge progress thanks to the ‘digital accelerant’ of COVID, with many channels being used for the first time as a result of the pandemic.
2. Telehealth reached a tipping point
The rapid digitalisation of life during COVID-19’s acute phase also had a huge impact on healthcare delivery.
If you, or someone you know, has had to see a doctor since March, the chances are the health service tried to avoid an in-person visit to limit the spread of the coronavirus. Here in the UK, as elsewhere, directives from the top made adopting telehealth a vital part of the pandemic response.
Questions certainly remain about how far the use of telemedicine will return to pre-COVID times, but the sustained focus on changing healthcare models this year looks to have put in place a lasting transformation.
3. AI made historical progress
Moving away from COVID, up to a point, and artificial intelligence (AI) in pharma and healthcare looked to be everywhere this year, having already made significant moves towards centre stage in 2019.
Google’s AI company DeepMind grabbed many headlines in November when it solved the 50-year-‘protein folding problem’, but there was less theoretical progress made too with the announcement in Nature Medicine of new standards for clinical trials that involve AI.
The CONSORT-AI reporting guideline should help determine the difference between hype and useful data when AI is used in medical studies – a small, but growing area.
Meanwhile, just one of the big pharma companies expanding its focus on AI was GlaxoSmithKline, which opened a new AI hub in London in September and hopes to end 2020 with a nearly 100-strong AI team.
4. The FDA took a strategic approach to digital health
Although a few years in the making, the new centre should accelerate the FDA’s responses to new mobile health devices, software as a medical device, wearables and a range of other types of health tech, particularly when coupled with the September update to its digital health pre-certification programme.
It wasn’t the only major body taking steps to advance digital health this year, with the WHO publishing in February its draft global strategy on digital health for the next five years, in which it noted:
“Digital technologies are an essential component and an enabler of sustainable health systems and universal health coverage. To realise their potential, digital health initiatives must be part of the wider health needs and the digital health ecosystem and guided by a robust strategy that integrates leadership, financial, organisational, human and technological resources.”
5. Record-breaking digital health investments
Investor interest in digital health has been running high for some time but, with all of the above going on this year, 2020 is looking like being a banner year for deals.
With fragmentation still an issue in the sector, further consolidation is expected if the current lack of scale among some companies is to be overcome, and well-placed observers see large amounts of private equity waiting in the wings to support this.
Looking back on this year, we can see digital health increasingly becoming a necessity for ensuring patients have the best outcomes.
Consequently, the advances seen in 2020 should provide solid foundations for pharma companies – and others in the digital health ecosystem – to continue to make further progress in the new year, and beyond.
About the author
Dominic Tyer is a journalist and editor specialising in the pharmaceutical and healthcare industries. He is currently pharmaphorum’s interim managing editor and is also creative and editorial director at the company’s specialist healthcare content consultancy pharmaphorum connect.
The academic medical center collaborated with GE Healthcare to set up the first virtual intensive care unit program in the state, which will help the organization extend its critical care expertise across rural areas and manage bed capacity amid climbing Covid-19 cases.
once an intriguing proposition struggling to reach its potential, became an
absolute necessity in 2020. In the early days of COVID-19, as medical centers
labored to deal with an influx of patients while also trying to mitigate
coronavirus spread, telemedicine was urgently needed as an option for providing
healthcare to others at a safe distance. In the U.S., the government and
providers quickly started to take measures to facilitate its use during the
crisis of the pandemic.
In some ways it’s
hard to understand why telemedicine wasn’t already in widespread use,
though, considering that people are increasingly preferring to do everything
from banking to grocery shopping online. Why not healthcare as well?
A new webinar, Emerging Trends in Telemedicine, offers some insight. Moderated by Elsevier’s Ann Gabriel, the webinar includes an international panel featuring Dr. Amol Navathe (Philadelphia VA Medical Center, University of Pennsylvania), Dr. Heather Ross (Toronto General Hospital, University of Toronto), and Dr. Robin Ohannessian (Public Health specialist, Director of Télémédecine 360).
In this fascinating
discussion, the panelists talk about the many challenges of telemedicine, which
include hurdles like regulatory standards, privacy and security concerns, the
need for political buy-in, insurance coverage and pricing for telemedicine
visits, and technology requirements. These issues and more have contributed to
the relatively sluggish rate of adoption of telemedicine prior to the pandemic.
The good news is
that is changing – and while those hurdles are still high, they are hardly
insurmountable. The panelists reveal some of the ways that they have seen
governments, doctors, patients and the healthcare system as a whole start to
embrace telemedicine and they offer some thoughts as to how it can be most
The webinar also
includes the presentation of some fascinating data and polling results that
offer further insight into the latest trends around telemedicine and its
As 2020 draws to a close, healthcare providers are strategizing for the new year and the new normal. Providers will need to retool their telehealth efforts and prepare to meet a burgeoning mental crisis, among other issues.
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.
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
– Publicly traded logistics company ArcBest announced its
deal with Doctor On Demand to introduce its virtual-first health plan to its
13,000 employees, who are largely “essential workers” as long-haul
– Employees appreciated the convenience and safety of 24/7 virtual care – from their homes, from the road – and ArcBest is now doubling down on virtual care for 2021 – and offering a holistic, virtual-first primary care health plan – one where patients see the same PCP time and time again virtually and can receive many of the same services virtually that they’d typically receive in-person.
On Demand, the nation’s leading virtual care provider,
and ArcBest, a
multibillion-dollar leader in supply chain logistics, announced a partnership
to offer a new Virtual Primary Care health plan benefit to its employees and
their dependents nationwide. The partnership expands on the existing urgent
care and behavioral health services that Doctor On Demand has been providing to
ArcBest since 2017.
Virtual Primary Care Benefit
ArcBest is getting creative in how they deliver healthcare benefits to their thousands of field employees – many of whom are on the road or reside in rural areas throughout the country. As the pandemic hit, it became increasingly difficult or unsafe to seek in-person medical or mental health care, so ArcBest promoted the use of its telemedicine offering of urgent care and mental healthcare.
The new Virtual Primary Care benefit will be available to all 8,000 members who are covered under ArcBest’s medical plan starting December 1st. This benefit comes at a critical time as COVID-19 cases are spiking again, and as the country simultaneously heads into cold and flu season. As a provider of essential freight and logistics services, ArcBest has a large field employee population that operates 24/7, making it challenging to access routine in-person care.
Virtual Primary Care Improves Access to Care
ArcBest believes that investing in this new virtual health
plan upfront will have a major impact on employees’ health long term –
promoting preventative healthcare and driving down long-term costs associated
with employees waiting until their chronic back pain or chronic disease
warrants more costly interventions.
“At ArcBest, we have a unique set of healthcare benefit needs, and Doctor On Demand’s existing urgent and behavioral health care services have been invaluable, especially this year,” said Rich Krutsch, Vice President, People Services at ArcBest. “The pandemic has also prompted us to double-down on our investments in virtual care, and we’re excited to expand our program with Doctor On Demand to include much more holistic, integrated virtual care for our employees.”
Employees Can Select Primary Care Doctor Through Doctor
Eligible ArcBest employees and their dependents will now be able to select a primary care provider through Doctor On Demand and access a comprehensive set of services to support whole-person health, including preventive wellness check-ups, vaccination referrals, nutrition consultations, chronic condition management, and more. Additionally, members are able to continue to see the same physician over time, allowing them to build a consistent, trusted relationship via video.
Telehealth and virtual care are not brand-new phenomena suddenly cobbled together as a rapid response to the onset of the COVID-19 pandemic, but the average US patient could be forgiven for thinking that it is. Indeed, virtual visits to care providers and remote patient monitoring have been available for quite some time, delivering two key benefits:
– Providing a platform to address cost-efficiencies and accessibility to quality healthcare for the populace at large
– Playing a key role in managing a growing population of chronically ill seniors.
Prior to 2020, however, the rules of reimbursement and implementation for associated telehealth services were difficult to navigate, wildly differing at the state and federal level with a host of regulations further complicating matters. Federal reimbursement policies are centered on Medicare, via the Centers for Medicare and Medicaid Services (CMS) – the single largest payer for seniors and chronically ill patients. Additionally, compliance with the Health Insurance Portability and Accountability Act (HIPAA) dictated rigorous standards for direct and monitoring communications between care providers and patients. Complicating matters further, US states offered a patchwork of individual telehealth laws dictating separate Medicaid policies.
The result was a lack of clarity of how healthcare providers could overcome regulatory and financial reimbursement barriers to implement effective telehealth programs as well as a lack of parity in coverage services and payments for patients. To address this at the federal level, CMS released new guidance in 2020 to relax reimbursement restrictions for providers. Now, we’re at the cusp of a new era of telemedicine where providers could widely offer:
– Virtual office visits that address traditionally in-person services such as primary care, behavioral health, and specialty care (e.g. pulmonary or cardiac health rehabilitation)
– On-demand virtual urgent care to address pressing concerns and urgently needed consultations
– Virtual broader home health services such as remote patient monitoring, outpatient disease management, and various forms of therapy (e.g. physical, speech)
– Tech-enabled home medication administration helping patients receive injectable or consumable medication via monitored self-administration
This is all, of course, dependent upon the mobile technology (e.g. tablets, wearables, etc.) and associated services that telehealth providers will rely upon to make these services happen at parity and scale for their patients. Even more importantly, virtual care programs being scaled up to cover a larger percentage of patients will fall apart if providers don’t have the resources to offer robust support and maintenance options for these devices and services. Quality of virtual care is highly dependent on persistent device and service availability and dependability.
Whether providers have already begun purchasing the mobile devices needed or are still struggling with the choice of what devices and services they need and/or can afford, however, they now face a different quandary: How to stand up these virtual care services at scale in a sustainable way that works within current budget resources and doesn’t pass on ballooning costs to your patients?
One way to make complex mobile technology deployments financially manageable is opting for a mobile device as a service (mDaaS) model which allows you to shift from a CapEx-based spending model to an OpEx spending model for purchasing hardware and allows telehealth providers to bundle or roll up a range of devices, accessories, services, maintenance and support into a single, predictable monthly per-device price. With mobile device technology rapidly evolving, telemedicine providers will need the operational agility to pivot to different solutions and quick technology refreshes as the need arises.
When done with the right third-party partner, it offers the additional advantages of outsourcing end-to-end support and lifecycle management to highly trained agents, who can free up precious IT resources. Most importantly, it creates a level of control over technology and spend that makes standing up virtual care programs convenient and stress-free.
There are many options to consider when expanding telemedicine services rapidly to larger patient bases, whether during disruptive events such as the COVID-19 pandemic or in the years to come. The key to making these services sustainable is finding a financing model that will free up internal resources, offer greater spending flexibility, and offer end-to-end support for your healthcare mobile technology ecosystem.
About Don Godbee Senior Mobile Solutions Architect at Stratix
Don brings a unique perspective to mobility in the Healthcare Vertical with over 25 years of consulting and delivery of critical solutions. Don has delivered various solutions from OEM integration of sensors in medical devices to mobile point of care solutions and services with major EHR software solution providers such as Epic, Cerner, GE Healthcare, Allscripts, and McKesson.
– Pear Therapeutics today announced that it has
successfully closed an $80 million Series D financing led by SoftBank Vision
– Pear is the
leader in prescription digital therapeutics and the first company to receive
FDA authorization for a prescription digital therapeutic (PDT) to treat
– Pear currently has three FDA authorized therapies, reSET, reSET-O and Somryst, for substance use disorder, opioid use disorder, and chronic insomnia, respectively.
Inc., (“Pear” or the “Company”) today announced that it has successfully
closed an $80 million Series D financing led by SoftBank Vision Fund 21 with
participation from existing investors including Temasek, 5AM Ventures,
Arboretum Ventures, JAZZ Venture Partners, Novartis, CrimsoNox, and EDBI, and
new investors, Forth Management, Pilot House, Sarissa Capital, Shanda Group,
and QUAD Investment Management.
What are PDTs?
PDTs are a new therapeutic class that uses software to treat
disease. Just like traditional medicines, prescription digital therapeutics are
prescribed by a physician and backed by clinical data that has been validated
by the FDA. As a new method of care, they offer patients a wide variety of
benefits, including: increased access to therapies, improved engagement and
adherence compared to face-to-face therapies.
Pear’s FDA Authorized Products
Pear’s products reSET®
and reSET-O® for the treatment
of substance use disorder and opioid use disorder, respectively, are the first
two PDTs to receive market authorization to treat disease from FDA. Pear
recently launched Somryst,
for the treatment of chronic insomnia, its third FDA-authorized PDT and the
third PDT to receive market authorization from FDA. Pear also recently launched
its end-to-end virtual care experience combining virtual doctor visit(s) via
telemedicine provider with PearConnect, the industry’s first patient service
center for PDTs.
The Company’s three FDA-authorized products address large
market opportunities with more than 20 million patients suffering from
substance and opioid use disorders and more than 30 million from chronic
insomnia, in the U.S. alone. These diseases are on the rise as the pandemic has
exacerbated the country’s mental health crises.
Pear plans to use the latest round of funding to accelerate
reimbursement coverage for its three commercial products, creating the first
market access pathway in the PDT industry. The Company collaborates with
innovators to build a broad and deep pipeline that has the potential to
redefine standard of care in a range of therapeutic areas, including specialty
psychiatry, specialty neurology, and a host of other non-CNS diseases. Pear has
built the first scalable platform infrastructure to discover, develop, and
deliver PDTs to patients.
“Pear is pleased to welcome our new investors and our new board members. SoftBank Investment Advisers represents an ideal partner to support Pear as we build the digital therapeutics industry,” said Corey McCann, M.D., Ph.D., President and CEO of Pear Therapeutics. “This oversubscribed round of funding will allow us to continue to invest in the launches of our three commercial products to accelerate revenue growth, which we intend to reinvest in our robust pipeline and platform.”
Tom Stanis, Verily’s co-founder and former head of software, left the Alphabet subsidiary in February to found a new healthcare startup. Called Story Health, his new startup is focused on providing care in the gaps between specialty visits.
– CommonHealth has connected to 230
health systems in the United States, allowing patients to gather, manage and
share their health and test data, including COVID test and vaccination status. By
the end of this month, CommonHealth will connect to more than 340 health
– CommonHealth extends the health data
portability and interoperability model pioneered by Apple Health to the 55
percent of Americans with Android devices (85 percent globally)
The Commons Project, a nonprofit public trust established to build digital platforms and services for the public good, today announced that the CommonHealth app has now connected to 230 health systems in the United States, allowing patients using those health systems to gather, manage and share personal health information – including COVID test and vaccine status – on Android devices for free. CommonHealth enables broader and more equitable participation in remote consultations with doctors, telemedicine, innovative care models, next-generation health services, and research.
CommonHealth App Development Background
Developed in collaboration with UCSF, Cornell Tech, and Sage Bionetworks with a team of clinicians, public health experts, technologists, scientists and privacy advocates, CommonHealth is operated by The Commons Project. CommonHealth was first deployed at UCSF Health and underwent substantial testing and user experience research in multiple diverse populations in San Francisco. CommonHealth is the first and only platform designed to allow users of the Android operating system to collect and manage their health data on their mobile devices in a similar way that Apple Health Record operates on iOS.
Already integrated with LabCorp, which
operates one of the largest clinical laboratory networks in the world,
CommonHealth allows individuals to store their COVID test results and vaccination
status, in addition to any health record. CommonHealth plans to integrate with
an additional 110 health systems in December, connecting to more than 340
health systems before the year ends.
Earlier this year, the Center for Medicare and Medicaid (CMS) rolled out new patient health record sharing rules that will require hospitals and physician offices to send standardized medical information, such as lab test results, vaccination records, and imaging tests, directly to third-party apps, like CommonHealth, by July 2021.
Why It Matters
“The COVID pandemic has accelerated the need for the safe sharing of health data as medical consultations go online and individuals are required to demonstrate COVID test and vaccination status in order to travel, work, study and undertake other social activities,” said JP Pollak, co-founder and chief architect at The Commons Project. “CommonHealth extends the privacy-centered data portability and interoperability model pioneered by Apple Health to the 55 percent of Americans who have Android devices.”
Providing care for chronic disease patients during a one-in-a-century pandemic is full of challenges, but health systems like Jefferson Health are finding ways — with help from technology — to make sure their patients are getting the care they need.
The dominant presence of COVID-19 has not meant the absence of cancer, ear infections, heart attacks, chronic pain, or other illnesses that need attention and care. Physicians have continued treatment for all types of maladies, and physician training has continued as well. But this treatment and this training look much different these days. Despite the challenges that came with major COVID shutdowns and changing requirements, the healthcare system and patients have been both creative and resilient in finding robust “temporary” solutions to these challenges. It is now looking like some of these COVID-era transitional steps will be preserved and play a lasting role in the future of medical education and telemedicine. What must be sacrificed to reap the benefits of these new protocols?
The rapid adoption of technology and virtual engagement tools has been both impressive and interesting to watch – Zoom meetings between medical association boards of directors, FaceTime calls between isolated patients and their family members at home, telehealth phone appointments with family practice physicians, or virtual medical conferences through Webex – the increasing reliance on these tools has pushed boundaries and exposed both opportunities and challenges with technology use for the future of healthcare.
As COVID-19 has significantly accelerated the feasibility and acceptance of telehealth care by physicians, patients, and payors, we now see healthcare systems navigating in real-time the complex issues with cybersecurity and patient privacy. Due to waivers, everyday technologies can be utilized right now, including FaceTime, Skype, Facebook Messenger video chat, Google Hangouts, and Zoom, but new regulatory guidance may be needed to develop safe, secure, and patient-friendly telehealth applications for the future. Cyber-security, already an important priority in the healthcare information space, is going to become that much more essential as doctor’s offices and clinics implement even more telehealth protocols faster than they ever would have normally planned or budgeted for.
These changes in practice and patient care have also impacted how controlled substances are prescribed. The Drug Enforcement Agency has modified policies to allow for the remote prescribing of controlled substances during the pandemic. Online counseling, informed consent, and follow-up with patients can be done in a virtual setting. Pill counts can be done in a video call and patients can still have their questions answered regarding their pain therapy, although it is likely that after the crisis, prescribing certain controlled substances may return to in-person visits. It is important that the regulatory climate continues to evolve at the pace needed to address the changing needs and realities of telehealth in the time of COVID.
While we have all become more comfortable on telehealth platforms, there continues to be an important role for in-person visits. Patients may appreciate the convenience of telemedicine; however, they must understand that it can limit a physician’s ability to perform a thorough examination and possibly reduce the chances of a physician detecting an unexpected complication or condition.
Moving forward, I expect there will be much greater reliance on telehealth strategies even post-COVID, but it will always have to be balanced with old-fashioned office visits.
Residency training has also experienced a profound shift this year. Conventional teaching approaches have either been cut back or have been canceled due to COVID risks, and reduced access to personal protective equipment (PPE) has limited the amount of time spent with patients being cared for during residency and fellowship programs. But we can’t stop training for the next generation of physicians or providing quality Continuing Medical Education (CME) for practicing physicians. E-learning techniques, such as webinars and online skills training, certainly play a role – and these may offer ways to actually enhance cross-departmental or multidisciplinary collaborative educational sessions. E-learning may be more cost-effective and easier to participate in than traveling to conferences or symposia, but the hands-on learning and deep discussions that can occur in breakout sessions or clinical training modules will need to be replaced somehow. And there must be careful vetting of online content in order to avoid a proliferation of commercially biased information, plagiarized materials, or simply false information. As we all adjust to new settings and styles for learning, there must be purposeful strategies to ensure online lectures are still supported with opportunities for learning from direct patient contact and collegial support.
Despite these concerns and challenges, new models for CME activities actually pose a great opportunity for increased access, cost-effectiveness, and practicality for busy clinicians.
Even before the first case of COVID-19 was diagnosed, technological innovation had already begun to change education, healthcare, and even social relationships. The COVID-19 crisis has simply accelerated the drive and interest in these new tools. But while the technological tools and platforms to a large extent existed years before COVID-19, they have never been used as purposefully, as rapidly, or with such intentionality as they are being used now.
I am sure the shift toward technology and virtual engagement in medicine will not go away when we finally get past the COVID-19 crisis. There will likely be lasting changes with the reliance on distance-medicine techniques for both patient care and physician training. But we must keep a close eye on regulatory frameworks that need to be updated, and make extra efforts to build and maintain patient-physician relationships.
About Shalini Shah, MD
Shalini Shah, MD is Vice-Chair and Associate Professor, Department of Anesthesiology & Perioperative Care, and Enterprise Director of Pain Services, UC Irvine Health. Dr. Shah completed her residency in Anesthesiology from NYP-Cornell University and a combined fellowship in Adult and Pediatric Chronic Pain at Brigham and Women’s Hospital, Beth Israel Deaconess and Children’s Hospital of Boston, Harvard Medical School.
– 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.
The US government has introduced a scheme to allow hospitals to reduce the number of inpatients they see through a telehealth platform that would helps deliver acute care at home.
The move comes as the number of new cases of COVID-19 have been climbing to around 180,000 a day, with deaths since the start of the pandemic now rising above 260,000, and concerns that some hospitals could become overwhelmed over the winter months.
The Centres for Medicare & Medicaid Services (CMS) announced the plans as part of broad plan to free up hospital capacity amid the COVID-19 surge, although it stressed patients won’t have to use the service unless they want to, and the first assessment by a physician must take place in person.
It said that treatment for more than 60 different acute conditions, including asthma, heart failure, pneumonia and chronic obstructive pulmonary disease (COPD), can be carried out “appropriately and safely in home settings with proper monitoring and treatment protocols.”
The new telehealth scheme applies to patients with conditions that require at least daily visits by a physician and ongoing medical team monitoring.
Six health systems across the country have already been approved to participate in the programme, getting the necessary Medicare waivers to allow them to treat patients at home.
They are Brigham and Women’s Hospital in Massachusetts, Massachusetts General Hospital, Huntsman Cancer Institute in Utah, Mount Sinai Health System in New York City, Presbyterian Healthcare Services in New Mexico, and Iowa’s UnityPoint Health.
Participating hospitals must have screening protocols in place before care at home begins, to assess that patients have access to working utilities, ensure there are no other physical barriers to care, and rule out welfare concerns such as a risk of domestic violence.
The US healthcare system has rapidly adopted telehealth and remote patient monitoring during the response to the coronavirus pandemic, with some suggesting it will transform the future of health care delivery, although there are dissenting voices.
In March 13, President Trump made an emergency declaration that empowered the CMS to issue waivers to Medicare programme requirements to support healthcare providers and patients during the crisis.
Since then, the CMS has added dozens of services to the list of telehealth services it will reimburse during the public health emergency, including emergency department visits, initial nursing facility and discharge consultations, home visits, and physical, occupational and speech therapy services.
Some of the changes have found their way into the proposed 2021 Physician Fee Schedule, which will make reimbursement for some telehealth and digital services permanent.
“We’re at a new level of crisis response with COVID-19 and CMS is leveraging the latest innovations and technology to help healthcare systems that are facing significant challenges to increase their capacity to make sure patients get the care they need,” said CMS Administrator Seema Verma.
“With new areas across the country experiencing significant challenges to the capacity of their health care systems, our job is to make sure that CMS regulations are not standing in the way of patient care for COVID-19 and beyond,” she added.
Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest costs. Cost-sharing and insurance premiums are rising consistently since the last decade for employer plans, which covers nearly half of the country’s population. Plan members are shouldering a part of the healthcare cost burden, so they want to keep it as low as possible. At the same time, they want maximum value for their money with access to quality care.
CMS identified this as an opportunity and issued the Final Interoperability and Patient Access rule. The rule allows patients to access electronic health data through any third-party application of their choice. The rule intends to allow patients to take control of their data and determine who can see which data. It will also make transferring data from provider to provider easier. So that patients can be ensured that their provider is fully aware of their medical history.
The Challenge of Providing Members Access to Healthcare Data
The biggest challenge that health plans will face is to extract data from multiple sources in-house, clean and scrub it, and ensure it is in the appropriate format as required by the Centers for Medicare and Medicaid Services (CMS). Some health plans have been in business for a really long time. Patient data has been accumulating through these years in legacy systems. Providing access to that data through certified third-party applications will require a lot of effort on the part of health plans. The health plans also have to ensure tight authentication standards so that only the people requested by the members have access to their healthcare data.
In addition, there are multiple problems associated with provider data. Incorrect data in the provider database costs close to $3 billion annually. CMS has also issued warnings for inaccurate provider directories, high claim-reprocessing volumes, and substantial encounter-data rejection rates. Payers have been addressing the data issues with short term solutions. But now they have to resolve the provider data problems for good and make health data readily available to the members.
The COVID Crisis Upended The Payer Compliance Initiatives
Payers are in solidarity with providers and patients in this time of crisis. While providers work tirelessly to help an increased number of patients access the required care, payers are providing support through fast track reimbursements and reduced utilization management.
Many health plans are focused on ensuring that their members have access to resources to fight COVID, which is why CMS extended the deadline for the Final Interoperability rule. Utilization patterns are witnessing a significant change. Many members are not receiving scheduled care as some elective surgeries are rescheduled and some provider offices are shut down. There has been a drop in certain kinds of utilization. Conversely, there has been a dramatic surge in telehealth office visits and behavioral health services.
The Road Ahead for Health Plans
Healthcare payers have endured significant claims-based, economic, and operational challenges during the pandemic. While they battle those bottlenecks, they also have to ascertain and prepare for the future and devise ways to ensure that their members have access to quality care.
Health plans will have to try to anticipate what utilization patterns will look like in the future, especially in the next year. Telehealth utilization will not be the same as it was pre-COVID. They will also have to ensure that members have access to care. They will have to reach out to members, especially those who are the most vulnerable. They will have to make sure members are not suffering from social isolation, they are taking their medication and they have access to transportation to get to the doctor.
Provider Alliance for CMS Compliance
CMS is handing over the reins of the care journey to the patients to improve care delivery through the Interoperability rule. Providers will play a key role in enabling access to healthcare data to patients by streamlining data and closing coding gaps. Payers must assist providers with their data needs to ensure compliance with the CMS rules.
As the pandemic ends and CMS comes out with more definitive long term rules and coverages, it is going to be important to ensure that providers are on the same page with payers. Health plans can partner with providers to educate them about the acceptable telehealth codes and what type of services are to be performed using those codes. Providers want to take care of their patients and they want to do it well. They want to leverage technology to ensure patient access to care and ensure their safety, especially for patients who suffer from multiple comorbidities.
About Elizabeth Bierbower
Elizabeth Bierbower is a strategic leader with more than thirty years of executive experience in the health insurance industry. She has experience scaling cost-effective and profitable growth strategies through internal innovation, and a reputation as being one of the industry’s most fiscally responsible and progressive leaders. Bierbower currently serves on the Boards of Iora Health, the American Telemedicine Association, and is on Innovaccer’s Strategic Advisory.
Previously Beth was a member of Humana’s Executive Management Team and held various roles including Segment President, Group and Specialty Benefits, and was an Enterprise Vice President leading Humana’s Product Development and Innovation teams.
A merger involving two US digital health specialists and a blank cheque company has created a telemedicine player, called UpHealth, that is valued at more than $1.3 billion.
The three-way deal combines UpHealth – which provides patient care management, telemedicine and digital pharmacy services and gives its name to the new group – with CloudBreak, which provides a video consultation platform for doctors and patients.
The blank cheque company or ‘special purpose acquisition company’ (SPAC) that provides funding is GigCapital2, which raised $150 million in its public offering in June 2019.
The merger is expected to be completed in the first quarter of 2021, subject to the usual closing conditions. Once completed, UpHealth will continue to be listed on the NYSE but with a new ticker symbol (UPH).
The combined company will cover a broad swathe of the digital health landscape, bringing together population health software, telehealth services, digital pharmacy delivering compounded and manufactured medicines, and tech enabled behavioural health services for people with mental health and substance abuse issues.
It will have pro forma 2020 revenues of around $115 million, rising to $194 million next year, coming from established contracts with health providers, insurers and payors from all 50 states in the US as well as nine international markets, according to the prospectus for the merger.
The new UpHealth will have two co-chief executives – Al Gatmaitan and Ramesh Balakrishnan – with Chirinjeev Kathuria of UpHealth and Avi Katz of GigCapital2 serving as co-chairman.
The elements of its digital health portfolio included integrated care management unit Thrasys – whose SyntraNet health information exchange platform is used to organise patient health records and workflows.
Telehealth will be split into a US division – consisting mainly of CloudBreak – and an international division centred on Glocal Healthcare Systems that is operating in India, Southeast Asia, and Africa.
The digital pharmacy business will be provided by MedQuest, which is licensed in all 50 states and pre-packages and ships medicines direct to patients, serving a network of 13,000 providers.
Finally, behavioural health will be provided by two subsidiaries – TTC Healthcare and Behavioural Health Services – which provide both onsite and telehealth services.
The increased reliance on telemedicine services during the coronavirus pandemic has sparked a flurry of M&A and fundraising activity among providers trying to broaden and expand their businesses.
The largest by far was the $18.5 billion merger between Teladoc and Livongo to create a digital health giant with pro forma sales of $1.3 billion, which came shortly after Teladoc bought InTRouch Health for $600 million.
Other sizeable deals include Veritas Capital’s acquisition of the health and human services assets of DXC Technology for $5 billion, Align Technology’s buyout of digital dentistry specialist exocad for $417 million, and Google’s $100 million investment in telehealth player Amwell on the same day the Boston-based company announced its IPO.
– GigCapital2 Inc has agreed to merge with UpHealth Holdings Inc and Cloudbreak Health LLC to create a public digital healthcare company valued at $1.35 billion, including debt, the blankcheck acquisition company said on Monday.
– The combined company will be named UpHealth, Inc. and
will continue to be listed on the NYSE under the new ticker symbol “UPH”.
Blank check acquisition
company GigCapital2 agreed to merge
with Cloudbreak Health, LLC, a unified telemedicine and video medical
interpretation solutions provider and UpHealth
Holdings, Inc., one of the largest national and international digital
healthcare providers to form a combined digital health company. The deal is valued
at $1.35 billion, including debt. the combined company will be named UpHealth, Inc. and will continue to be
listed on the NYSE under the new ticker symbol “UPH”.
Following the merger, UpHealth will be a leading global
digital healthcare company serving an entire spectrum of healthcare needs and
will be established in fast growing sectors of the digital health industry.
With its combinations, UpHealth is positioned to reshape healthcare across the
continuum of care by providing a single, integrated platform of best-in-class
technologies and tech-enabled services essential to personalized, affordable,
and effective care. UpHealth’s multifaceted and integrated platform provides
health systems, payors, and patients with a frictionless digital front door
that connects evidence-based care, workflows, and services.
“We are excited to partner with UpHealth and Cloudbreak through our Private-to-Public Equity (PPE)™ platform. The combined UpHealth has all the hallmarks we look for in a successful partnership, including a world-class executive team and an exceptional business model with scale, strong growth, and profitability margins in the digital healthcare industry. We are particularly excited about the opportunity to provide our Mentor-Investor™ discipline in partnership with an exceptional global leadership team, as well as participate in a high-tech integrated platform that comprises a variety of cutting edge disciplines, such as the Artificial Intelligence platform being developed by Global Telehealth in conjunction with the tech-enabled Behavioral Health divisions. We are confident UpHealth is at the inflection point and positioned for accelerated growth.” – Dr. Avi Katz – Founder and Executive Chairman of GigCapital2
Combined Company Offerings
Upon closing the pending mergers and the combination with Cloudbreak, UpHealth will be organized across four capabilities at the intersection of population health management and telehealth:
1. Integrated Care Management: Thrasys Inc. (“Thrasys”) has reinvested $100M of customer revenue to
develop its innovative SyntraNet Integrated Care technology platform. The
platform integrates and organizes information, provides advanced
population-based analytics and predictive models, and automates workflows
across health plans, health systems, government agencies, and community
organizations. The platform plans to add at least 40 million lives to UpHealth
in the next 3 years to support global initiatives to transform healthcare.
2. Global Telehealth: will consist of a U.S. division and an international division
that, together, are anticipated to grow revenues by an additional $47 million
The U.S. division of
Global Telehealth following the combination, Cloudbreak, is a leading unified
telemedicine platform performing more than 100,000 encounters per month on over
14,000 video endpoints at over 1,800 healthcare venues nationwide. The
Cloudbreak Platform offers telepsychiatry, telestroke, tele-urology, and other
specialties, all with integrated language services for Limited English Proficient
and Deaf/Hard-of-Hearing patients. Cloudbreak’s innovative, secure platform
removes both distance and language barriers to improve patient care,
satisfaction, and outcomes.
division of Global Telehealth following the combination, Glocal Healthcare
Systems Pvt. Ltd (“Glocal”), is a global provider of virtual consultations and
local care spanning the care continuum. It has designed proven, affordable and
accessible solutions for the delivery of healthcare services globally. The
platform provides a full suite of primary and acute care services, including an
app-based telemedicine suite, digital dispensaries, and hospital centers. The
platform has signed several country-wide contracts with government ministries
across India, Southeast Asia, and Africa.
3. Digital Pharmacy: MedQuest Pharmacy (“MedQuest”) is a leading full-service manufactured and compounded pharmacy licensed in all 50 states that pre-packages and ships medications direct to patients. The company also offers lab services and testing, nutraceuticals, nutritional supplements, education for medical practitioners, and training for organizations, associations, and groups. MedQuest serves an established network of 13,000 providers. The MedQuest platform is poised for strong growth via targeted product expansion and expansive eCommerce capabilities for the entire provider network. UpHealth and MedQuest have mutually executed a merger agreement, the closing of which is awaiting regulatory approval for the transfer of licenses expected by the end of 2020 or early 2021.
4. Tech-enabled Behavioral Health: TTC Healthcare, Inc. (“TTC Healthcare”) and
Behavioral Health Services LLC (“BHS”) offer comprehensive services
specializing in acute and chronic outpatient behavioral health, rehabilitation
and substance abuse, both onsite and via telehealth. UpHealth’s Behavioral
Health capabilities have dramatically expanded use of telehealth for medical
and clinical services and are leveraging UpHealth’s platform to increase
volumes across its services. UpHealth and TTC Healthcare have mutually executed
a merger agreement, the closing of which is awaiting regulatory approval for
the transfer of licenses expected prior to the end of 2020.
Global Financial Impact and Reach
UpHealth will have agreements
to deliver digital healthcare in more than 10 countries globally. These various
companies are expected to generate approximately $115 million in revenue and
over $13 million of EBITDA in 2020 and following the combination, UpHealth
expects to generate over $190 million in revenue and $24 million in EBITDA in
Earlier this spring, the Webex UX Research team conducted an extensive qualitative study with healthcare providers and patients who use telehealth services. The study unearthed the challenges, opportunities and patterns of behavior when using video in healthcare settings. It also served as the foundation for developing healthcare personas, among the first industry-specific personas to be created and used at Webex.
In the world of product development, personas are a common tool to help surface deep research findings and build alignment across multiple teams. While personas used to be synonymous with stereotypes, the practice has transitioned towards more behavioral, “psychographic” personas. The Webex UX Research team builds personas directly from qualitative research and these artifacts are referenced across the entire product organization to build more clinically relevant voice and video tools.
The initial research study was made up of one-hour interviews (with each participant being interviewed over Webex Meetings), which produced an enormous amount of data. By identifying patterns across this massive amount of data, we developed personas for both providers and patients.
Instead of devolving into typical demographics, the personas center on specific patterns of behaviors and beliefs to understand the telemedicine landscape. For example, healthcare providers tended to be time-strapped and juggled multiple technology platforms. They often used video to help alleviate a patient’s concern, and their main priority was providing relief to patients. Providers chose very easy to use video platforms, ideally ones that their patients had used before and didn’t require downloads. Providers tended to complain about technical shortcomings during telehealth appointments, like pixelation or poor audio, making it difficult to consult with patients.
Patients, on the other hand, demonstrated different beliefs and behavior. They often expressed trepidation prior to using telemedicine services for the first time and were more likely than doctors to describe themselves as not very tech savvy. However, after their initial video appointment, patients had an overwhelmingly positive view of telemedicine. This was especially true for people who had encountered difficulties in the past to make it to an in-person appointment due to factors like illness or injury, traffic or distance, and extreme weather events.
These personas have been used across the Webex organization to help our own teams reach alignment on the needs of this critical industry, during an especially critical time. The healthcare personas provided an essential window into our user’s world, building empathy and keeping their needs front and center. With this data, our teams have been able to continue to make improvements in our Webex technology, helping to provide a better virtual care experience for patients and providers alike.
– Amwell just announced some new offerings Amwell Now, Touchpoint
Tablet software, and C500 to help increase doctor-to-patient virtual
connections as patient and doctor preferences change in light of the pandemic.
– The new solutions (a quick-to-deploy video visit offering, new tablet software, and a telemedicine cart) are designed to be easy-to-use but fully integrated in the provider’s systems and secure.
leader, today announced new connectivity, device and cart offerings, all
tailored to meet the evolving needs of care teams and patients. Spurred by the
impact of the COVID-19 pandemic, Amwell is introducing Amwell Now,
Tablet software, and the C500
telemedicine cart to help health systems and other healthcare organizations
easily leverage telehealth as a safe, quality care option.
and Amwell’s latest Carepoint tablets and carts are designed to make it easier
for providers to quickly onboard patients and use virtual care. These tools can
be integrated within and scaled across organizations’ current systems and
devices, making it simple to embed and launch telehealth across various
specialties and serve an entire care organization. New offerings include:
enables a simple connectivity experience for patients and providers,
streamlining entry to the Amwell platform, which is purposefully designed for
healthcare interactions. Amwell Now addresses physicians’ needs for easy, fast
video visits, all on Amwell’s HIPAA compliant, clinically tailored platform. It
delivers simple reporting functionality and the ability for organizations to
put forward their own brand versus that of Amwell. Providers can deploy Amwell
Now with only a few clicks, invite patients by text or email, launch an instant
video connection, and experience an adaptable video visit workflow that is easy
for both themselves and their patients.
Touchpoint Tablet Software
Amwell’s Touchpoint Tablet software offers a new and simple
way to connect remote providers to on-site patients and providers. With it,
health systems can use (existing or new) iPads to facilitate bedside video
connectivity and collaboration in a secure, reliable, HIPAA-compliant way. The
Touchpoint Tablet software is integrated with Amwell Fleet Monitoring, enabling
health systems to track their tablets as part of their Carepoint fleet.
C500: Lightweight Telemedicine Cart
is Amwell’s latest-generation, lightweight telemedicine cart that empowers providers
to conduct efficient, high-quality remote exams across a variety of
specialties. Featuring an embedded 4K camera that responds immediately to user
commands and smart sensors that make the cart environment-aware, the C500
provides a seamless care experience that is fully integrated with the Amwell
Why It Matters
“Amid COVID-19, healthcare organizations’ needs for and expectations surrounding telehealth have fundamentally changed,” said Ido Schoenberg, Chairman and Co-CEO, Amwell. “Increasingly, virtual care is being used as core to all types of care delivery, whether it’s to safeguard care teams, limit unnecessary exposure for patients, or to prioritize the home as a go-to care setting. Our latest offerings are responsive to industry calls for simplicity, integration, and quality, and in service to the evolving landscape of healthcare and our lives overall.”
The company, which makes a digital stethoscope and electrocardiogram, raised $65 million in series C funding. It plans to use the funds to build out a telehealth platform and at-home monitoring program for cardiopulmonary patients.
KLAS recently issued a Spotlight on Zoom for healthcare. KLAS Spotlights are first looks at new and emerging technology. Everyone knows Zoom, but how well does the solution perform for healthcare organizations looking to handle the immediate demands created by COVID-19 as well as develop long-term strategic initiatives? In this Spotlight, KLAS examines the early outcomes and satisfaction of some of Zoom’s healthcare customers.
Zoom Key Strengths & Challenges for Healthcare
– Works as promoted
– Clients see value
in the solution
– Quick implementations, easy initial setup
– Phone/web support less responsive due to extreme growth
– Lacks some bells and whistles other telemedicine products
– Security is a concern for some
KLAS outlines four key points to ponder for healthcare
organizations considering Zoom:
1. The Solution’s Long-Term Viability in Healthcare
In order to remain competitive in healthcare, Zoom will need
to improve the solution’s integration with EHRs and medical devices and also
make it easier for patients to connect to a telehealth session.
2. Impacts and Tradeoffs of the Underlying Technology
Zoom recently adopted Oracle Cloud and also maintains the
use of AWS and Azure cloud services. The mobile apps are developed in Java
(Android) and Swift (iOS). The Zoom environment accommodates both failover and
load-balancing services to support effective and reliable service response
Governance is a key factor in driving success with both
telehealth and teleconference capabilities. Guidance for how these capabilities
will be used internally and externally will need to be established.
4. Telehealth vs. Teleconference
Healthcare organizations require both telehealth and teleconference capabilities to effectively communicate with their staff and patients. Zoom must improve its enterprise application integration and medical device connectivity to compete in the exploding telehealth market.
Abbott recently released global research on vascular patient care, designed to shine a light on the vascular patient journey. The report called “Beyond Intervention” uncovers the universal challenges faced by physicians who deliver vascular care, their patients, and the hospital administrators who support them. It also explores how the right use of technology and data could potentially enable more precise diagnoses and better treatment strategies to ensure the best possible patient outcomes.
To establish what the state of vascular care looks like around the world today, Abbott surveyed over 1,400 patients, physicians, and health system administrators from nine countries.
The research revealed how important personalized care is for patients. This was a sentiment that came through loud and clear from all the patients surveyed, regardless of geography. Patients desire more of a “tailored for me” approach from their physicians. This includes more face-to-face interaction and time with their doctor, with the ability to have all of their questions addressed.
Likewise, doctors sighted a scarcity of time spent with their patients as well as their limited visibility into patient adherence to treatment and lifestyle changes and challenges with other key factors that influence the quality of care they can provide.
What exactly does more personalized care look like? Here are some of the ideas that resonated with the vascular patients who responded to the survey:
– A consultative, two-way patient-doctor relationship, with the patient playing an active role in informed decision-making
– An individualized treatment plan based on the doctor’s ability to review relevant data pertaining to successes achieved with similar patients (“How did patients like me get better?”)
– Effective and seamless information-sharing among the primary care provider, hospital specialists, and healthcare systems, as well as with individual patients themselves via computer or smart applications.
– The ability for the doctor to monitor the patient’s progress remotely and provide information to verify that the personalized treatment is working, and to pick up early warning signs of relapse or deterioration
If more personalized care is what patients desire, then how can the use of technology and data enable this? We already see signs of this in the form of telemedicine and personalized care plans used to treat patients with chronic disease. We have also seen remote patient monitoring become a necessity and, in the age of COVID-19, a new standard of care, keeping patients “connected” with their physicians. This suggests that health care is moving in the right direction. Rather than simply treating the patient at a point in time for an illness, technology has the potential to harness the power of data to optimize care across the entire patient journey – before, during, and after the intervention. By focusing on the whole patient, and by placing him or her at the center of the healthcare world, providers can see beyond the intervention alone.
The survey also revealed that hospital administrators’ top priority focused on patient satisfaction; successful outcomes that boost the number of satisfied and healthy patients while reducing hospital readmissions and costs. The results showed that administrators place a greater priority on plugging data gaps pertaining to outcomes than the total cost of care.
If the intention is to build data-driven technological solutions that see the whole patient, that could shift the focus from illness and intervention to wellness and prevention, potentially lightening the burden on providers, and delivering a higher quality of life for patients, also at a lower cost.
The existing model of care is clearly not working to its full potential, to the detriment of everyone who must navigate it. But overhauling a healthcare system that is so entrenched in structure and institutional practices is not something that can happen overnight. Change will happen incrementally with the input of all stakeholders. It is up to us in the world of medical devices and technology to take our cues from the medical community, patient advocates, and healthcare systems big and small.
The research motivates us to continuously improve upon what we have already delivered and ask ourselves how we can make our products even better. Without knowledge of their pain points or insights into the challenges they face daily, we would not be able to effectively meet patients’ needs. This research also reinforces what Abbott is consistently striving to achieve: building life-changing technologies to improve the patient’s quality of life and help them live their best lives.
Access to mental healthcare continues to be a hurdle amid the Covid-19 pandemic, prompting Aetna and telehealth provider Inpathy to expand their existing mental health partnership to include three more states.
Lark Health, which offers AI-powered digital care platforms for chronic diseases, has raised $70 million in new funds, which it plans to use to expand its relationship with Anthem and eventually deepen partnerships with other payers and telehealth providers.
According to this recent PwC Pulse Survey, 90% of healthcare executives are prioritizing changing workplace safety measures and requirements as their employees transition back into the clinical space. 67% plan to make remote work a permanent option for roles that allow it, and 70% are actively working to improve the remote work experience.
Healthcare organizations are managing the acceleration of existing trends such as overnight increases in remote workforce, increased security concerns and exponential growth in telehealth and virtual care.
Couple that with the appearance of new dynamics such as prioritization of worker safety and wellness in the care facility, patient consumerism, shifts in care delivery sites and disruption of business and patient-care models, and organizations have a lot to consider when it comes to balancing acceleration and disruption to become future ready.
With these massive shifts in prioritizes, webelieve it’s time to look beyond “normal” or even the “new normal” and embrace the ever-changing reality of our future with new levels of resilience. Not to just recover and adjust in the face of change, but to thrive.
This is where Cisco makes a difference. You need secure, healthcare solutions designed and built for change at scale across your organization.
With unmatched healthcare expertise that spans networking, security, cloud, data center and collaboration, Cisco and our ecosystem of partners can deliver a complete healthcare solution that empowers your workforce to triage and care for patients remotely and allows administrative staff to work from home.
We’d love to hear what you think. Comment below and stay tuned for the next blog in our #HealthcareNow series.
Most of the digital health experts we spoke to for this issue of Deep Dive made one thing clear – no one can really say what the future holds for digital tech in the pharma and healthcare industries.
But this isn’t necessarily a bad thing – our interviewees also stressed that if companies can remain adaptable and innovative, there are myriad opportunities to thrive during and after COVID-19. In this issue we hone in on some of the tech that is set to change healthcare forever – including VR, AI and digital therapeutics – and look at how pharma can best harness themWe also examine how the pandemic is affecting digital sales, patient support programmes and HCP consultations, and speak to some exciting digital start-ups that are bringing new ways of managing health into systems like the NHS.
A “pivotal moment” for digital health adoption
Former chief digital officer for the NHS, Juliet Bauer, is now applying her experience to the private sector through video consultation firm Livi. She shares her thoughts on how well the NHS is integrating digital health and what the public and private sectors can do to further boost adoption
Navigating the NHS as a digital start-up
We speak to finalists from the Greater Manchester Future of Health accelerator to find out how digital start-ups can overcome the challenges small companies face in bringing their technologies into the NHS
pharmaphorum’s digital magazine Deep Dive provides objective, issue-driven views, analysis, high-level interviews and unique research for pharmaceutical companies, biotech firms and the wider healthcare sector.
In 2020 Deep Dive will have special focuses on disruptive technologies in pharma, R&D innovation, market access and commercialisation, oncology, sales & marketing innovation, digital health and patient engagement. Subscribe to future issues of Deep Dive.
– Mayo Clinic announced a collaboration with Vocalis
Health to to research and develop new voice-based tools for screening, detecting
and monitoring patient health, beginning with a study to identify vocal
biomarkers to detect pulmonary hypertension (PH).
– The clinical validation study will utilize Vocalis
Health’s proprietary software, which can operate on any connected voice
platform (mobile, computer, tablet, etc.) to analyze patients’ health based on
– Following this initial phase, researchers will work to
identify vocal biomarkers targeting additional diseases, symptoms and
Mayo Clinic and Vocalis Health, Inc., a company
vocal biomarkers for use in healthcare, today announced a collaboration to
research and develop new voice-based tools for screening, detecting and
monitoring patient health. The collaboration will begin with a study to
identify vocal biomarkers for pulmonary hypertension (PH) which could help
physicians detect and treat PH in their patients.
Impact of Pulmonary Hypertension
Pulmonary hypertension is a severe condition causing high blood pressure in the lungs, but
as the symptoms are similar to other heart and lung conditions, it is often not
detected in routine physical exams. While traditional blood tests can sometimes
detect pulmonary hypertension, it frequently goes undiagnosed. This
strategic collaboration aims to provide an
alternative and highly scalable method to check patients for PH, using only a recording of the patient’s voice, to understand their health and the progression of the disease.
Study Establishes Relationship Between Certain Vocal Biomarkers
& Pulmonary Hypertension
In a previous trial with Vocalis Health, the Mayo research
team established a relationship between certain vocal characteristics and PH.
In this new collaboration, Mayo will conduct a prospective clinical validation
study to further develop PH vocal biomarkers. The clinical validation study
will utilize Vocalis Health’s proprietary software, which can operate on any
connected voice platform (mobile, computer, tablet, etc.) to analyze patients’
health based on voice recordings. Following this initial phase, researchers
will work to identify vocal biomarkers targeting additional diseases, symptoms
Vocalis Health Background
Vocalis Health is an AI healthtech company pioneering the
development of vocal biomarkers – where health-related information is derived
from analysis of people’s voice recordings – to screen, detect, monitor and
predict health symptoms, conditions and diseases. Vocalis Health is currently focused on
screening users for COVID-19 and on monitoring patients with chronic diseases
such as COPD.
“We have seen the clinical benefits of voice analysis for patient screening throughout the COVID-19 pandemic, and this collaboration presents an opportunity for us to continue broadening our research, beginning with pulmonary hypertension,” said Tal Wenderow, CEO of Vocalis Health. “Voice analysis has the potential to help physicians make more informed decisions about their patients in a non-invasive, cost-effective manner. We believe this technology could have important clinical implications for telemedicine and remote patient monitoring in the very near future. We are excited to work with Mayo Clinic and have already started planning clinical trials for additional indications.”
– Fern Health will reveal a
first-of-its-kind collaboration with Mass General Hospital where it will inform
existing and future digitally-delivered pain management programs through the
marriage of AI + predictive analytics with 10 million de-identified Mass
General patient records.
– MGH will validate emerging Fern Health products and pilot new products in clinical environments, setting the stage for Fern expansion into all aspects of non-invasive multimodal pain management.
Fern Health’s relationship with MGH, formed 18 months ago, will now broaden to entail a multi-year collaboration in which MGH will validate emerging Fern Health product lines, pilot new products in a clinical setting, and investigate new scientific approaches to pain management.
The expansion supports Fern Health’s long-term vision of democratizing access to non-invasive multimodal pain management. Fern Health’s current product suite, which includes an evidence-based, digitally delivered musculoskeletal (MSK) pain management program, was originally developed with experts from within Mass General, in consultation with their clinical collaborators at the world-renowned Spaulding Rehabilitation Network. Fern’s biopsychosocial pain management solution was validated with the clinical rigor of MGH’s renowned hospital-based research enterprise.
“There are a multitude of gaps in the U.S. healthcare system that unfortunately fail our patients with chronic pain, from lack of access to high-quality pain care to the proliferation of costly and often ineffective treatments,” said Mihir M. Kamdar, MD, MGH Pain Physician and Digital Health Advisor. “Evidence-based models of care are still rare in digital health solutions even though they have the potential to address these gaps and give clinicians innovative and effective care options for their patients.”
Leverage Data-Driven Insights from De-Identified Patient Data
Fern Health will leverage clinical validation and implementation science, clinical protocol development, access to data-driven insights derived from de-identified patient data, third-party corroboration for peer-review publications, and FDA approval processes.
“By evaluating digital health tools in a real-world clinical setting, we can provide distinctive insights, understand user preferences, and validate clinical protocols for optimal implementation and outcomes,” added Joseph C. Kvedar, MD, Senior Advisor, Virtual Care, Mass General Brigham; Professor of Dermatology, Harvard Medical School; and Senior Advisor, MGH Center for Innovation in Digital HealthCare. “This collaboration is designed to help advance pain management through digitally-delivered personalized exercise therapy, education, and health coaching—which early results suggest is occurring.” Dr. Kvedar is also President of the American Telemedicine Association (ATA).
Expansion into All Aspects of Non-Invasive Multimodal Pain Management
The collaboration also gives Fern Health substantial clinical and scientific data to expand into the broader ecosystem of digitally-delivered pain management platforms:
– The Fern user experience will replicate how a patient might experience evidence-based, personalized treatment at a hospital-based pain management clinic. Rather than delivered in-person, treatment is delivered digitally and is accessible from anywhere.
– Informed by predictive analytics and an expansive MGH data set of 10 million de-identified patient records, personalized, evidence-based Fern patient treatment plans will leapfrog the performance of “one-size-fits-all” pain management platforms that are limited to publicly available data or their own user data.
– The collaboration will form the foundation from which Fern will launch new products and services rooted in collaborative care aimed at treating the whole person across physical, emotional, and behavioral considerations.
Why It Matters
One out of every two people suffer from MSK pain and the U.S. spends $380 billion on MSK conditions each year, contributing to MSK pain being the top driver of employer healthcare costs. Fern Health eases the burden on employers who face daunting pain management treatment economics. Provided as a benefits add-on for self-insured employers, Fern Health offers a biopsychosocial approach to pain management, including personalized restorative therapy, pain neuroscience education and virtual 1:1 health coaching. The company is currently engaged in pilot programs with several mid-size and large employers spanning the professional services, manufacturing and transportation sectors.
“At least half of the population suffers from physical pain and its cascade of effects across social, mental and emotional well-being,” said Travis Bond, CEO, Fern Health. “This initiative marries science, clinical rigor, artificial intelligence and incredibly rich historical patient data sets with digital care delivery. It’s a huge first step into a better future for pain management science and for the millions of people living with musculoskeletal pain today.”
Teladoc Health has sued competitor American Well for patent infringement. The company is seeking unspecified damages and a ruling that would prevent AmWell from using the telemedicine cart technology that Teladoc claims to hold the patents for.
As COVID-19 took hold in March, U.S. doctors limited in-person appointments — and many patients avoided them — for fear of infection. The result was a huge increase in the volume of remote medical and behavioral health visits.
Doctors, hospitals and mental health providers across the country reported a 50- to 175-fold rise in the number of virtual visits, according to a report released in May by the consulting firm McKinsey & Co.
The COVID-fueled surge has tapered off as patients venture back to doctors’ offices. But medical professionals and health experts predict that when the pandemic is over, telehealth will still play a much larger role than before.
“There are still a few doubting Thomases, but now that we’ve run our practices this way for three months, people have learned that it’s pretty useful,” says Dr. Joseph Kvedar, president of the American Telemedicine Association and a practicing dermatologist who teaches at Harvard Medical School in Boston.
For patients, the advantages of telemedicine are clear: You typically can get an appointment sooner, in the safety of your own home or workplace, saving time and money on gas and parking — in some cases, even avoiding a loss in wages for missing work.
James Wolfrom, a 69-year-old retired postal executive in San Francisco, has had mostly virtual health care appointments since the pandemic started. He particularly appreciates the video visits.
“It’s just like I’m in the room with the doctor, with all of the benefits and none of the disadvantages of having to haul my body over to the facility,” says Wolfrom, who has Type 2 diabetes. “Even after the pandemic, I’m going to prefer doing the video conferencing over having to go there.”
Telemedicine also provides care for people in rural areas who live far from medical facilities.
The growth of virtual care has been facilitated by Medicare rule changes for the COVID-19 emergency, including one that reimburses doctors for telemedicine at the same rate as in-person care for an expanded list of services. State regulators and commercial health plans also loosened their telehealth policies.
In California, the Department of Managed Health Care, which regulates health plans covering the vast majority of the state’s insured residents, requires commercial plans and most Medi-Cal managed care plans during the pandemic to pay providers for telehealth at parity with regular appointments and limit cost sharing by patients to no more than what they would pay for in-person visits. Starting Jan. 1, a state law — AB-744 — will make that permanent for commercial plans.
Five other states — Delaware, Georgia, Hawaii, Minnesota and New Mexico — have pay-parity laws already in effect, according to Mei Wa Kwong, executive director of the Center for Connected Health Policy. Washington state has one that also will begin Jan. 1.
If you are planning a telehealth appointment, be sure to ask your health plan if it is covered and how much the copay or coinsurance will be. The appointment may be through your in-network provider or a telehealth company your insurer contracts with, such as Teladoc, Doctor On Demand or MD Live.
You can also contact one of those companies directly for a medical consultation if you don’t have insurance, and pay between $75 and $82 for a regular doctor visit.
If you are one of the 13 million Californians enrolled in Medi-Cal, the state’s Medicaid program, you can get telehealth services at little to no cost.
Large medical offices and health systems usually have their own telemedicine platforms. In other cases, your provider may use a publicly available platform such as FaceTime, Skype or Zoom. Either way, you will need access to a laptop, tablet or smartphone — though, for a phone conversation, a landline or simple cellphone will suffice.
Smartphones with good cameras can be particularly useful in telemedicine because high-resolution photos can help doctors see certain medical problems more clearly. For example, a photo from a good smartphone camera usually provides enough detail for a dermatologist to determine whether a mole requires further attention, Kvedar said.
Relatively inexpensive apps and at-home tools enable you to measure your own blood pressure, pulse rate, oxygen saturation level and blood sugar. It’s a good idea to monitor your vitals and have the numbers ready before you start a virtual visit.
Be aware that a remote visit is not right for every situation. In the case of serious injury, severe chest pain or a drug overdose, for example, you should call 911 or get to the ER as quickly as possible.
Virtual visits also are not recommended in other cases for which the doctor needs to lay hands on you.
Wolfrom has had only a few in-person health visits this year, one of them with a podiatrist who checks his feet every six to 12 months for diabetes-related neuropathy. “That can only be done when you are in the room and the podiatrist is touching and feeling your feet,” Wolfrom says.
Face-to-face visits are generally better for young children. Kids often require vaccinations, and it’s easier for doctors to monitor their growth and development in person, says Dr. Dan Vostrejs, a pediatrician at Santa Clara Valley Medical Center in San Jose.
In general, telemedicine is effective in cases that would typically send you to an urgent care clinic, such as minor injuries or flu-like symptoms, including fever, cough and sore throat.
It is also increasingly used for post-surgical follow-ups. Telemedicine can be a godsend for geriatric or disabled patients with reduced mobility. And it’s a no-brainer for mental health care, which is mostly talking anyway.
Among the top telehealth adopters are medical specialists who treat chronic illnesses such as diabetes, hypertension, cardiovascular disease and asthma, says Dr. Peter Alperin, a San Francisco internist and vice president of product at Doximity, a kind of LinkedIn for medical professionals.
Providers can monitor patients’ vitals remotely and discuss lab results, diet, medications and any symptoms in a video chat or a phone conversation. “If you happen to see something that’s awry, you can bring them into your office,” Alperin says, adding it’s “a better form of triage.”
But telemedicine has some serious disadvantages. For one thing, the less formal setting can allow some routine medical practices to slip through the cracks.
In the second quarter of this year, blood pressure was recorded in 70% of doctor office visits compared with about 10% of telemedicine visits, according to a study published early this month.
Elsa Pearson, a resident of Dedham, Massachusetts, had a medical appointment scheduled in March, which was switched to a telephone call because of the pandemic-induced lockdown.
“It was honestly the most efficient appointment I’ve had in my life,” says Pearson, 30. But, “I must admit, without the push of having the labs right there when you leave the appointment, I’ve yet to get them done.”
Perhaps the biggest pitfall in telehealth is the loss of a more intimate and valuable doctor-patient relationship.
In a recent essay, Dr. Paul Hyman, a Maine physician, reflected on the times when an unexpected discovery during an in-person examination had possibly saved a patient’s life: “A discovery of an irregular mole, a soft tissue mass, or a new murmur — I do not forget these cases, and I do not think the patients do either.”
Healthcare consumers want the same level of ease when scheduling a health check-up as they have when booking an Uber, and younger generations of Americans are increasingly hinging their care selection preferences on facilities that offer a user-friendly digital front door, a new report shows.
– ARC Innovation brings new technologies into the hospital
and community healthcare ecosystem to further improve patient care. It enables
data fluidity and integration amongst innovators; scientists; startups;
high-level developers; large and small companies; investors; and academia all
under one roof.
– ARC includes six medical tracks, with a senior Sheba
physician leading each: telemedicine, precision medicine, digital innovation
focusing on big data and artificial intelligence, augmented and virtual
reality, rehabilitation and surgical innovation.
– “Working in tandem with Sheba will enable us to participate in an open collaboration with world leaders in global healthcare innovation, all of us working together to find new and innovative ways to deliver patient care,” said Holy Name Medical Center, President & CEO Michael Maron in a statement.
– 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.”
Remote patient monitoring has emerged as the next significant challenge for virtual healthcare and that challenge is creating significant opportunities for many companies largely outside of the traditional healthcare technology marketplace. In particular, it is potentially setting up an opportunity for Big Tech companies like Apple, Google, and Amazon, to revolutionize telemedicine and healthcare similar to what those companies have accomplished in mobile phones, Internet search, and retail.
Next Generation Remote Health Monitoring
Next generation remote healthcare monitoring will likely look much different than anything done before. What is emerging today is the potential for the broad adoption of remote health monitoring devices and systems that leverage consumer wearables, smart home communication systems, and big data to produce holistic views specifically for healthcare providers. The pandemic has thrust telemedicine solutions forward by years if not a decade or more in the short span of three to six months. This is creating an opportunity for remote patient monitoring to provide even better visibility into patients beyond what can be accomplished with basic video conferencing.
But while telemedicine is now becoming more firmly established, remote monitoring seems to still have a long way to go. This is evident in a new report by KLAS Research (a healthcare industry research firm) published on August 27th, where they interviewed 19 executives from 18 healthcare organizations regarding their challenges and solutions during the outbreak of the pandemic. Not surprisingly, telemedicine was the top challenge with 32% of the executives. Overall, though, 84% of the executives indicated that the telemedicine issues were already solved and the remining 16% indicated that the solutions were in progress. However, remote patient monitoring ranked as the second most significant challenge with 26% of the respondents. But furthermore, only 22% of the executives indicated the remote monitoring challenges were solved, with 33% saying it was in progress, and 45% indicating it was completely unsolved. So, a clear opportunity exists.
Big Tech’s Virtual Healthcare Market Leverage
For Big Tech, the leverage into virtual health comes from the ability to offer remote monitoring solutions across wearables, ambient sensors, and smart home communication devices, as well as the capability to apply big data, AI, and machine learning to the information from those devices. Big Tech is even combining these technology solutions with healthcare specific services like telemedicine, prescription drug delivery, and medical testing. Market evidence suggests that Big Tech is already putting these pieces together and using this leverage to expand into the broader healthcare market.
Wearables and Ambient Sensors
Wearables and ambient sensors, and particularly consumer-oriented versions of these products, are a key enabler of next generation remote healthcare monitoring by serving as the principle connection with the individual. Over just the last few years the overall market for wearables has increased significantly and the market demarcations are blurring between traditional medical wearables and consumer health and fitness wearables.
Apple leads the overall wearables market with its Watch, Beats, and AirPod products. Across those product lines the company shipped 29+ million units in Q2 2020 and holds an approximate 30% market share, which is nearly three times the size of its nearest competitor. In addition, the Apple Watch is aggressively pushing into classical medical applications with its ability to measure blood oxygenation levels, its electrocardiogram (ECG) capability, and its ability to detect atrial fibrillation (AFib) as well as other cardiovascular conditions. (5)
Smart home communication devices such as smart speakers and home control systems will also be a key component of next generation virtual healthcare. These systems can serve as communication access points to the Internet for lower power wearables and ambient sensors, and also enable intelligent personal assistant capabilities, such as reminders to take medications, and help in monitoring exercise and other behavioral health aspects.
Amazon is the dominant market leader in smart home communication devices with its Echo Alexa personal assistant, which has estimated 50%+ market share as of January 2020. Amazon was first-to-market with its smart speaker system and continues to augment its capabilities with an ever-expanding array of interactive skills. This includes skills to integrate Amazon’s Ring home security and control system, its portfolio of Alexa wearable devices, and numerous third-party products.
Google has the second position in the smart home communications device market with an approximate 30% market share for its Nest smart speaker products. (8) Recently the company make a $450 million investment in ADT, Inc. with the aim of growing its Nest deployments specifically in the home security market. Google also has a relationship with the Cleveland Clinic that has recently materialized into a capability for its Nest smart speakers that allow users to ask for Cleveland Clinic health tips. This is a perfect example of the virtual healthcare synergies that can be accomplished with smart home communication devices.
Apple is behind the competition in the smart home communications market. The company’s HomePod smart speaker is a distant 4th in market share at only 2.8%. So, while Apple’s Siri assistant has been an integral part of its iPhone for quite some time, the company has yet to make an impact in combining Siri and HomePod for the home market.
The big data processing of medical information will become increasingly important as virtual healthcare remote monitoring grows. The ability to analyze the vast amounts of real-time, streaming data to produce trends, correlations, and medical diagnoses can potentially transform how healthcare is applied at both an individual and societal level. Big Tech is uniquely positioned with shear corporate size and technology assets to pursue remote monitoring big data. In addition, Big Tech is already pursuing healthcare data relationships with significant healthcare providers and can leverage those projects into new applications processing remote monitoring data.
In 2019 Google made waves in establishing relationships with both Ascension Health and the Mayo Clinic to partner on the development of digital tools that integrate healthcare data into new patient care models. While the Ascension deal, in particular, raised concerns about patient data privacy, the two relationships will provide Google valuable experience in processing healthcare data that can be leveraged into future remote monitoring data applications.
Apple is leveraging its iPhone and wearables products in its health data initiatives. In 2018 the company introduced a health records app for the iPhone where Apple partners with healthcare providers to deliver a patient’s records to their mobile phone. In addition, Apple has established a variety of research relationships with organization such as Harvard’s T.H. Chan School of Public Health, Brigham and Women’s Hospital, University of Michigan, and others, that focus on cardiovascular projects related to the Apple Watch and hearing projects related to the AirPod earbuds.
Amazon’s principle relationship for health data is with Cerner Corporation, which has an approximate 25% share for electronic health records systems across the entire healthcare marketplace. In 2019, Cerner chose Amazon Web Services as its preferred cloud provider for its healthcare patient data. More recently the companies announced a further collaboration where consumers using Amazon’s Halo wearable can opt-in to share their activity and health data and allow that information to be stored in their patient record in Cerner’s systems. The patient’s healthcare provider can then access and evaluate that information directly in the patient’s records. This is another example of virtual health synergies accomplished via the integrated capabilities of a consumer wearable, health data systems, and a patient’s healthcare provider.
As the most straight-forward initiatives toward revolutionize healthcare, Big Tech is also directly entering the healthcare provider and services market, which at a minimum provides a convenient platform to leverage its healthcare technology and data solutions.
Last September Amazon introduced its pilot telemedicine program, Amazon Care, for its employees in Seattle. This service includes virtual primary care as well as home consultations and prescription drug services via Amazon’s PillPack division, a virtual pharmacy Amazon acquired in 2018.
Google’s most recent activity takes a different approach where on August 24th it announced it was investing $100 million in telemedicine provider Amwell. The synergies mentioned in the deal specifically focused on Google’s cloud computing services, but the intersection extends into its data processing and machine learning expertise and can potentially tap into its home personal assistant products for remote monitoring capabilities.
Challenges and Opportunities Ahead
When Big Tech pursues business growth, the companies must think big and look for markets that are ripe to be thoroughly transformed. With the global healthcare market size at more than $8 trillion and new technologies poised to transform how healthcare is executed, a prime opportunity exists. But significant questions remain in terms of the technological solutions, the market competitive and relationship dynamics, and of course, concerns about regulatory and information privacy.
Despite the market positions of Big Tech in wearables, smart home communications, and big data, there continues to be significant venture capital and start-up activity in the technological areas of virtual health that tend to focus on opportunities that Big Tech hasn’t yet pursued. The companies that achieve some degree of success will likely experience a very attractive market to be acquired by not only Big Tech competitors like Apple, Amazon, and Google, but also the leading telemedicine companies like Teladoc Health, Amwell, MDLIve, and SOC Telemed as well as technology-oriented insurers like UnitedHealth Group. From a Big Tech product portfolio perspective, two of the more significant gaps pertain to Apple’s position in smart home communications and Amazon’s position in wearables. In the smart speaker market, Apple’s 4th place position behind Sonos Inc. has led to speculation that Apple might buy Sonos purely to increase its market share. This is very unlikely to happen given Apple’s reluctance to large M&A deals and, more importantly, its recent announcement that it is will stop selling Sonos products in the Apple Store. So, for the moment, Apple looks to be preparing to grow its market share on its own. For Amazon in the wearables market, the situation is similar. There doesn’t look to be any wearable or smartwatch companies that help Amazon’s market position. Even if Amazon were to acquire a company like Garmin, it would only improve its market share by a few percentage points.
The competitive and relationship dynamics of the virtual healthcare market will continue to be very active as broad industry solutions come together. Ultimately, this market is a non-trivial combination of technology, information systems, and healthcare providers. Big Tech has significant positions in many key markets, but lacks considerable exposure to others, most notably in the healthcare provider area. The first six months of the Covid-19 pandemic has thrust telemedicine providers like Teladoc Health, Amwell, MDLive, and SOC Telemed to the forefront and positions them as key parts of future virtual health solutions. Teladoc just recently announced an $18.5 billion deal to acquire Livongo, a company focused on remote monitoring and virtual health services for diabetes and related health issues. Amwell, MDLive, and SOC Telemed are all accessing the public markets to shore up access to capital and the ability to leverage stock as an acquisition currency. So, watch for all these companies to be active acquirers. But for Big Tech there are many more private telemedicine companies that could be acquisition targets to improve Big Tech’s connection to the healthcare provider market. These include companies such as Doctor on Demand, Crossover Health, 98point6, and HealthTap. In fact, Amazon just recently announced a partnership with Crossover Health to provide health services to its employees and health centers near its fulfillment and operations facilities. This could potentially be a precursor to a more significant acquisition opportunity.
Last, but certainly not least, are the concerns over regulatory issues and information privacy. For Big Tech, under the current environment, any initiatives to capture significant portions of the next generation virtual healthcare market are likely to attract even more scrutiny regarding antitrust issues and the companies’ abilities to keep patient information private. But even these challenges are unlikely to deter Big Tech’s pursuit of healthcare. The market opportunity is just too attractive.
Jim Moeller provides business intelligence data analytics consulting services into projects involving strategic planning, competitive analysis, technology assessment, and intellectual property research.
Nice Healthcare, a Minnesota-based startup that offers telemedicine and primary care services, raised $5 million in seed funding. The company plans to use the funds to bring its benefits to businesses in more states.
Donella Pogue has trouble finding dentists in her rural area willing to accommodate her 21-year-old son, Justin, who is 6 feet, 8 inches tall, is on the autism spectrum and has difficulty sitting still when touched.
And this summer, he had a cavity and his face swelled. Pogue, of Bristol, New York, reached out to the Eastman Institute for Oral Health in Rochester, which offers teledentistry.
Dr. Adela Planerova looked into his mouth from 28 miles away as Pogue pointed her laptop’s camera into her son’s mouth. Planerova determined they did not need to make an emergency one-hour drive to her clinic. Instead, the dentist prescribed antibiotics and anti-inflammatory drugs, and weeks later he had surgery.
Teledentistry allows dental professionals like Planerova to remotely review records and diagnose patients over video. Some smile about its promise, seeing it as a way to become more efficient, to reach the one-third of U.S. adults who federal figures from 2017 estimate hadn’t seen a dentist in the previous year and to practice more safely during the pandemic.
But others see it as lesser-quality care that’s cheaper for dental professionals to provide, allowing them to make more money. At the same time, widespread adoption is hindered by issues such as spotty internet and insurance companies unwilling to reimburse for teledentistry procedures.
Dr. Christina Carter, an orthodontist in Morristown, New Jersey, said teledentistry has its place but shouldn’t replace time in the dental chair.
“It cannot be used for a full diagnosis because we need other tools, like X-rays,” she said. “We have all tried to see things on our phone or even on a Zoom call, and there is still just a different feel.”
Still, as the pandemic curbs in-person visits and reduces dentists’ revenue, more dentists are seeking guidance from Dr. Nathan Suter, a leading teledentistry advocate who owns the consulting company Access Teledentistry. Since March, he said, he’s done webinars for about 9,000 dental professionals, up from fewer than 1,000 in the three years before the pandemic.
Teledentistry providers trace the practice to 1994, when the Army launched a pilot program in which health care providers used an intra-oral camera to take photos of a patient’s mouth at a fort in Georgia and then sent them over the internet to a dental clinic at a fort 120 miles away.
Over the next two decades, dentists in upstate New York and the San Francisco Bay Area led teledentistry pilot programs for underserved children, some of whom were in preschool and already had cavities. The number of children who completed the prescribed dental treatment rose significantly.
Supporters say teledentistry can help reach the 43% of rural Americans who lack access to dental care. Medicaid and the Children’s Health Insurance Program will pay for many dental procedures for those enrolled in those programs, but only 38% of dentists participate in those programs, according to the American Dental Association. One reason: Medicaid typically reimburses at a significantly lower rate than those of private insurance plans.
Teledentistry could help dentists treat more patients and make more money a number of ways. If dentists remotely review data captured by hygienists, they can see more patients. Because video appointments save them time, dentists then have room for the people “who need the more expensive services” while also focusing on preventive care, said Kirill Zaydenman, vice president of innovation for DentaQuest, an administrator of dental insurance and oral health care provider.
But dentists have not widely adopted teledentistry — mainly because they’ve had difficulty getting insurers to pay for it, said Dr. Dorota Kopycka-Kedzierawski, a Rochester dentist. That’s partly because of insurers’ concerns about fraud. Dr. Paul Glassman, who started the Virtual Dental Home project to reach underserved preschool children in the Bay Area, considers those fears “completely incorrect.”
“If you want to bill for something you didn’t do,” he said, “you can do that just as easily in an in-person environment as you can using teledentistry.”
Since March, as the pandemic descended, most, if not all, private dental plans have been reimbursing for teledentistry, said Tom Meyers, vice president of public policy for America’s Health Insurance Plans, a trade organization. And all state Medicaid programs now reimburse for teledentistry in some form, Glassman said, though policies differ by state and some practices may not be covered in some places.
But teledentistry isn’t reimbursable under Medicare. (Most dentistry isn’t.) Another obstacle to widespread adoption: Some dentists and lawmakers connect teledentistry to companies offering at-home teeth aligners with little or no in-person contact with a dentist. Glassman has promoted teledentistry throughout the United States and reviewed proposed legislation or regulations in states such as Idaho, Massachusetts and Texas. He said he hears concerns from dentists about the lack of an in-person exam during which X-rays are taken. Such concerns are reflected in some legislation.
SmileDirectClub, an at-home teeth-aligner company, has argued in statehouse testimony that in-person care is not always needed. The company opposed a 2019 bill in Texas that aimed to improve access to dentistry in rural areas because it included a number of restrictions on teledentistry, including one that would have required an in-person dentist’s examination if a teledentistry provider treated that patient for more than 12 months.
SmileDirect’s attorney argued at a hearing the rule “could interrupt the course of a patient’s treatment.”
The measure failed.
Proponents argue teledentistry isn’t just about making more money. Pogue, the New York woman, said it was the best option for her son with special needs.
“He is really afraid of dentistry, so when he goes to see someone, he is really tense and really jumpy, so that’s another reason the teledentistry was nice was because he was in my bedroom doing it, so he was really comfortable,” said Pogue, 53, whose son is covered by Medicaid.
A few weeks later, Justin did have to have surgery, which went “perfect,” his mom said.
Some dentists say teledentistry faces particular stumbling blocks in rural areas. Dr. Mack Taylor, 36, a dentist who grew up in the small town of Dexter, Missouri, now practices in a health center just down the road. Twenty years ago, he said, Dexter had eight dentists. Now there are only three.
Technology is a major obstacle for local residents, many of whom lack reliable internet service. Taylor recently applied for a U.S. Department of Agriculture grant that would give him $26,500 to buy equipment so that, for example, a hygienist can take photos inside the mouths of nursing home residents and send them to Taylor to review.
“It’s not like medicine where you can discuss someone’s ailments and have a good idea what’s going on,” Taylor said. “Maybe all you can tell me is ‘I have a broken tooth,’ but I can’t physically see what’s going on and prescribe the right treatment.”
– On-demand text-based primary care platform 98point6
raises $118M in Series E funding to further invest in research and development
and expand its robust medical practice.
– 98point6 offers patients easy access to primary care in the same way they’ve grown accustomed to receiving the majority of services today—on their schedule and via a mobile app.
98point6, an on-demand digital primary care service that delivers personalized consultation, diagnosis, and treatment to patients across the country, today announced a $118 million Series E fundraising round to further invest in its success. Funding was led by L Catterton and Activant Capital, with additional investment from new and returning investors, including Goldman Sachs.
Get-Text-Based Primary Care Anywhere
Primary care is a necessity for all, serving as the front
line for healthcare and disease prevention. However, seeing a doctor is
increasingly difficult with an average wait time of 24 days just for an
appointment. 98point6 offers patients easy access to primary care in the same
way they’ve grown accustomed to receiving the majority of services today—on
their schedule and via a mobile app. Pairing artificial
intelligence (AI) and machine learning with the expertise of
board-certified physicians, its patient-focused and technology-augmented
solution makes primary care more accessible and affordable, leading to better
health and total cost-of-care savings.
Rather than having doctors ask administrative questions, gather patient history, or chart information, 98point6’s AI technology does it for them. Patient profiles are automatically built and the 98point6 system learns from each visit, avoiding redundancy.
In just the past year, the company has grown 274 percent and serves more than three million members through more than 240 commercial partnerships with brands like Premera, Banner|Aetna, Boeing, Circle K, Sam’s Club, and others. The platform continues to see usage across age groups: pediatrics ages 1–17 (7%), 18–35 (47%), 36–50 (28%) and 50+ (18%), and 90% of patients surveyed say they would use the service again.
On average, 98point6’s commercial partners report 8x higher utilization than traditional telemedicine solutions as more people are choosing the convenience of on-demand care over higher-cost options like urgent care or the emergency room—or delaying care altogether. The round allows 98point6 to further invest in research and development and expand its robust medical practice. Last month the company announced a national rollout of its platform available to every Sam’s Club member.
“We’ve created an experience that patients use and love,” said Robbie Cape, chief executive officer and co-founder of 98point6. “98point6 has experienced accelerated growth over the last year, due in part to the pandemic, as more organizations recognized the existing and undeniable desire for on-demand, digitally enabled care. The increased interest in 98point6 put us in a unique position to serve many in a time of need. Our approach to care replaces the high cost and complexities of navigating the healthcare system while meeting the expectations and preferences of today’s healthcare consumer. This investment is a testament to the strength of our platform, and I am confident we will benefit from the deep expertise of both the L Catterton and Activant teams.”
As you read this, over 200,000 American deaths have been attributed to the virus. The influx of cases continues, while state and local economies are experiencing hardship, children are shuttered in their homes learning remotely, grown children are moving back home and the “new normal” disrupts nearly all of life’s plans.
Yet, these issues don’t reveal all the traumas that Americans are experiencing 10 months into the pandemic. The pandemic’s impact continues to be swift and brutal, showing little sign of slowing down. Loneliness and isolation are gripping many American adults, as the nation settles in for a long fall/winter.
Growing evidence supports the notion that this virus is spread through aerosols, that is, person-to-person transmission by means of inhalation of infectious particles. With the onset of colder weather and the approaching holiday season, conditions are rife for spreading the virus. Flu season is imminent and COVID-19 cases are increasing.
While the safest choice is to isolate until the widespread availability of a vaccine arrives (within the next 6-12 months), this is an unwelcome option for some already suffering from “pandemic fatigue” and not really an option at all for others (like those who work outside the home).
Either way, America’s mental health is at risk. According to the CDC, reports of mental health conditions (anxiety, trauma, substance abuse, suicide) have considerably increased during the pandemic with more than 40% of American adults reporting mental health struggles. Frontline healthcare workers are particularly affected, and over 71% have experienced psychiatric symptoms, including depression, anxiety, insomnia, and distress. Even run-of-the-mill loneliness and isolation contribute to substance misuse and disorders, which, by the way, contribute to an increased risk for COVID-19.
Key Ways Mental Health Providers Can Help
Because mental health threats are now part and parcel of living amid the COVID-19 pandemic, it is important to routinely gauge the health of those close to you, (and this is paramount for those recovering from COVID-19, frontline workers, and first responders.) Consider consulting a mental health provider if you notice any of these characteristics in yourself or someone you know:
– Engaging in high-risk activities, such as heavy drinking, illicit drug use, or self-destructive behavior;
– Exhibiting feelings of overwhelming sadness, hopelessness, grief, or worthlessness
Nearly every American is impacted mentally, financially, and emotionally by the pandemic, and even the fortunate few who aren’t already personally affected are feeling the stress of an uncertain future. Mental health providers aim to improve coping skills, relationships, and self-care regimens to reduce anxiety, depression, or other mental illness. From generalized anxiety to neuropsychology related to recovery from COVID-19, behavioral health specialists are equipped to help in a myriad of ways such as these:
1. Building resilience by introducing coping and stress tolerance activities, such as mindfulness and meditation, or a simple shift in perspective
2. Shoring up social connections and relationships to serve as a layer of protection and diffusion from life stress
3. Ensuring self-care activities, such as adequate sleep, diet, exercise, and more to sustain mood and self-esteem
4. Delivering grief and loss counseling for those who have suffered acute human losses during the crisis
5. Counseling for substance abuse and addiction
6. Initiating a short intervention using cognitive behavioral therapy techniques
Those with pre-existing mental health issues, including depression, PTSD, social anxiety, agoraphobia, generalized anxiety and major depression, may benefit from an increased intensity in treatment, by frequency or duration.
For survivors of COVID-19 who have had significant cardiac and respiratory complications including prolonged periods of dyspnea (shortness of breath), hypoxemia (decreased blood oxygen levels), and hypoxia (decreased oxygenation of organs), neurocognitive screening and ongoing monitoring of mental status will be helpful.
Advances in Telemedicine
Recent advances in computer-administered neurocognitive testing have allowed
clinicians to administer psychological and neurocognitive assessment instruments by telemedicine, and there are now many more neurocognitive assessment batteries available to aid in the detection and quantification of neuropsychological functional deficits.
Historically, psychologists, psychiatrists, and L.C.S.W.s have not done virtual sessions with patients, but COVID is changing that, and increasingly insurers are receptive to this practice. The technology, capability, and compliance aspects of virtual appointments were available prior to 2020, but COVID has brought “distance meeting” into the American vernacular. Medical doctors now treat patients via telehealth in numerous instances, and mental health patients can be treated using similar meeting applications.
Telebehavioral health could not be more timely. In the fight against isolation, virtual technology allows human beings to check on one another and meaningfully connect, at the same time allowing people seeking mental health services to receive treatment safely without risking infection from a devastating disease.
Even as the pandemic presents a common threat like none other we have faced in recent years, it also offers us the opportunity to reach out and check on one another. Everyone is affected in some way by COVID-19, be it the disease itself or simply disruption to our routines and mass anxiety. It’s definitely time to take mental health seriously. Our technology ensures that we do not have to be alone in isolation, and relief may be just a call away. Through mutual understanding and effort, we can focus on the unifying experience of overcoming this crisis.
About Dr. Lazarovic
Dr. Lazarovic, M.D., F.A.A.F.P., has nearly 40 years of medical administration/managed care experience, including 18 years as Chief Medical Officer at Broadspire/CRAWFORD, a global third-party administrator of workers’ compensation, disability, auto and medical product liability claims. Experienced in clinical guidelines, medical cost control and strategic planning, Dr. Lazarovic has conducted and published original research and analytics and presented at multiple industry conferences. Dr. Lazarovic is currently the CMO responsible for the development of advanced, evidence-based clinical applications at MyAbilities Technologies, a medical software and services company in the workers’ compensation and disability sector.
– Press Ganey advances the healthcare consumerism movement with acquisitions of Doctor.com and a majority stake in Binary Fountain.
– Expanded technology platform enables industry-leading
management of providers’ online brand and seamless Web-wide patient acquisition
and loyalty strategies.
Press Ganey today
announced the expansion of its market-leading health care consumerism platform
with the acquisitions
of Doctor.com and a majority equity stake
in Binary Fountain. These acquisitions create the largest health care
consumerism platform in the industry that offers an unmatched opportunity for
health systems and providers to drive digital patient acquisition, retention,
and reputation management strategies that will deliver new levels of growth and
Set Up Your Virtual Practice in 5 Minutes or Less with
Doctor.com’s Turnkey Solution
Founded in 2013, Doctor.com provides the critical
infrastructure and integrations necessary to enable modern digital experiences
for patients. Doctor.com clients benefit from best-in-class provider data,
robust physician and patient engagement tools, and seamless integrations with
the most prominent health care directories, search engines, social media
platforms, and EHR/PM systems. As a result, thousands of clients, including
200+ leading hospitals and health systems, 30,000+ private practices, and
leading brands in the life sciences industry, have been empowered by Doctor.com
to enhance their digital presence and credibility, increase patient trust, and
grow their business.
Why It Matters
The COVID-19 crisis radically disrupted the health care
industry and altered consumer behavior. The result was massive growth in
telehealth services, with Press Ganey administering more than 15 million
telemedicine surveys year to date. Coupled with more than 71% of patients
seeking physician reviews online and 70,000 health-related Google searches each
minute, these fundamental shifts have escalated the need for health care
providers to enhance and streamline the online healthcare customer experience.
“This acquisition is game-changing for the industry. By pairing data and insights from Press Ganey’s 472 million consumer surveys a year with next-generation technology, health care organizations can finally unite their patient experience and patient acquisition efforts within one powerful platform. This unified solution drives performance improvement, accelerates transparency initiatives, and improves the patient experience,” said Andrei Zimiles, co-founder and CEO, Doctor.com. “As patients continue to ‘shop’ for care in increasingly competitive digital channels, this groundbreaking new platform from three pioneers in the consumerism space gives health care organizations the edge they’ve been looking for.”
Financial details of the acquisition were not disclosed.
– UAB Medicine has announced a large-scale, strategic
telemedicine partnership with Advanced ICU Care that will encompass the entire
health system, one of the top three largest public hospital facilities in the
– The relationship initiates the development of a new
tele-ICU care operations center and envisions serving up to 750 ICU beds in
Alabama and surrounding states.
UAB Medicine, a nationally recognized leader in patient care, research and training and Advanced ICU Care, a provider of high-acuity telemedicine services, announced a large strategic telemedicine partnership with the technology, operations, and care partnership encompass the entire UAB Health System including the University of Alabama at Birmingham Hospital, the third-largest public hospital facility in the U.S. The relationship initiates with the development of a new tele-ICU operations center in Birmingham and envisions serving up to 750 ICU beds in Alabama and surrounding states.
Tele-ICU Supports Critically Ill Patients Throughout UAB Health
As the nation’s leading provider of high-acuity telemedicine
services, Advanced ICU Care’s proprietary HUB workflow management software
platform uniquely addresses the challenges associated with the customized
delivery of acute patient care at high volumes across multiple care venues. In
addition, the company’s technical, operational, and clinical expertise draw
upon its care of over a half million tele-ICU patients and care partnerships
with more than 100 hospitals nationwide. UAB Medicine brings to the
collaborative relationship additional clinical expertise as a national leader
in pulmonary and critical care medicine.
“Advanced ICU Care’s clinical and operational expertise and proprietary HUB workflow management software are assets that are well aligned with UAB’s vision for our tele-ICU programs,” said Reid Jones, CEO of UAB Medicine. “Telehealth and tele-ICU have become increasingly important vehicles for healthcare delivery, and we look forward to leveraging Advanced ICU Care’s assets to deliver high-acuity telemedicine to patients across Alabama and beyond.”
Cleveland Clinic’s top clinicians and researchers present the top 10 medical innovations transforming medical advancements and new awards to recognize healthcare innovation.
The list of breakthrough technologies was selected by a committee of Cleveland Clinic subject matter experts, led by Will Morris, M.D., executive medical director for Cleveland Clinic Innovations, and Akhil Saklecha, M.D., managing director of Cleveland Clinic Ventures.
Health systems should embrace an omni-channel strategy that includes asynchronous virtual visit capabilities to better meet consumer needs, improve provider capacity, and enable more robust virtual care models.
Network launched its next-gen ultrasound product, the new Butterfly iQ+
featuring the world’s only Ultrasound-on Chip™ technology and announced a
landmark collaboration with the American College of Cardiology (ACC).
Inc., today announced the launch of its next-gen ultrasound product, the
new Butterfly iQ+, the world’s only single-probe, whole-body
ultrasound system that connects to a mobile device and features an integrated
telemedicine platform. Butterfly iQ+ offers new capabilities, such as
faster frame rates, Needle VizTMtechnology, a longer battery life and
Ultrasound reinvented again
Butterfly iQ+ features an optimized manufacturing
process in partnership with TSMC, the largest and most advanced dedicated IC
foundry in the world. TSMC’s MEMS (microelectromechanical systems)
manufacturing technology enables the ultrasound transducer to seamlessly integrate
with CMOS (complementary metal-oxide semiconductor) technology. In addition,
TSMC possesses manufacturing capacity that can scale to realize Butterfly’s
vision of making an ultrasound device as ubiquitous as the stethoscope for the
world’s 40 million healthcare providers.
Butterfly’s innovative product has been shown to be a
particularly useful tool during the global COVID-19 pandemic due to its lung imaging
capabilities, portability and ease of cleaning, as infection control has become
increasingly important. Butterfly iQ+ brings a suite of new
capabilities that make it even easier to make fast decisions at the bedside.
Faster, sharp imaging
With patented on-chip digital micro-beamforming enabling 15%
faster frame rates and 60% faster pulse repetition frequency, healthcare
providers can see image details in the heart, lungs and bladder with optimized
clarity. High-performance shallow imaging capabilities help support fast,
confident interventional decision-making, while deep imaging capabilities in
the lung and deep cardiac presets allow for sharp details. The Butterfly iQ+ can
help healthcare providers save time in their diagnosis and treatment of
patients, improving overall patient outcomes.
State-of-the-art technology for new levels of control
The cutting-edge Needle VizTM technology available
on Butterfly iQ+ can provide healthcare professionals with an
enhanced ability to see a needle—improving confidence for central line
placements, regional nerve blocks and other guided procedures. Additionally, in
just four seconds, clinicians can calculate bladder volume automatically using
the AI-based Auto Bladder Volume tool, allowing faster decisions at the
More power and durability
The Butterfly iQ+ extends battery life by 20%
and scanning time by 100% to help healthcare providers get through their shift.
With its durable, anodized aluminum body and replaceable compression- and
stomp-tested cable, the Butterfly iQ+ offers military-grade
durability to withstand tough shifts, and has been tested to withstand an
industry-leading 4-foot drop. This next-generation device has gone through
rigorous testing to ensure shock resistance and protection from dust and water
Pricing & Availability
Putting ultrasound on a chip, Butterfly was able
to define a new precedent of affordability by providing a whole-body ultrasound
device at $1,999, plus membership. Today, as it reinvents ultrasound
again, Butterfly iQ+ will be available for the same affordable
“Two years ago, Butterfly introduced the world’s first handheld, single-probe, whole-body ultrasound system. Since then, the device has been used by tens of thousands of medical professionals across the globe with significant clinical, economic and societal impact,” said Laurent Faracci, Butterfly Network’s Chief Executive Officer. “We have collaborated with the Butterfly community of users to define our innovation path. The first result in that journey is the new Butterfly iQ+, a big step forward for point-of-care ultrasound, with our most advanced chip ever and a number of amazing innovations and improvements that our talented team and partners developed.”
– Augmedix closes $25 million in private placement
funding and completion of a reverse merger transaction with Malo Holdings Corp.
– Following the transaction, the merged entity will be
named “Augmedix, Inc.”, and will continue the historic and innovative
business of Augmedix.
Augmedix, a company
specializing in providing remote medical documentation and live clinical
support services, today announced the closing of a $25 million private
placement financing and completion of a reverse merger with Malo Holdings Corp.
In connection with the financing, current investors Redmile Group, DCM, and
McKesson Ventures invested alongside new investors. Financial advisory firms, Stifel, Nicolaus
& Company, Incorporated, B. Riley Securities, Inc., and GP Nurmenkari, Inc.
(as consulted by Intuitive Venture Partners) acted as placement agents for the
private placement. Montrose Capital
Partners was the sponsor for this transaction.
Reverse Merger Details
Augmedix further announced the completion of a reverse
merger transaction with Malo Holdings Corp., an SEC-reporting public Delaware
corporation. Following the transaction, the merged entity will be named
“Augmedix, Inc.”, and will continue the historic and innovative
business of Augmedix. In connection with
the financing and merger, Augmedix agreed to cause its common stock to be
quoted on the OTC Markets QB tier, subject to certain terms and conditions.
Remote Medical Documentation & Live Clinical Support
Founded in 2012, Augmedix converts natural clinician-patient
conversation into medical documentation and provides live support, including
referrals, orders, and reminders, so clinicians can focus on what matters most:
patient care. The Augmedix platform is powered by a combination of proprietary
automation modules and human-expert assistants operating in HIPAA-secure
locations to generate accurate, comprehensive, and timely-delivered medical
Augmedix services are compatible with over 35 specialties
and are trusted by over one dozen American health systems supporting
telemedicine, medical offices, clinics, and hospitals. We estimate that our solution saves
clinicians 2–3 hours per day, increases productivity by as much as 20%, and
increases certain clinicians’ satisfaction with work-life balance by 49%
Manny Krakaris, Augmedix Chief Executive Officer, said, “We’re thrilled to complete this financing, which we believe puts Augmedix on the path of accelerated expansion, and will enable us to broaden our operational capabilities, accelerate our technology research and product development, and strengthen our marketing and sales.” Krakaris noted that the COVID-19 pandemic has accelerated the growth of telemedicine and enabled Augmedix to showcase its competitive advantages in the medical documentation market. “Because the Augmedix service is accessed through mobile devices and is telemedicine application-agnostic, our innovative technology allows clinicians access to medical note documentation, regardless of their location,” Krakaris said.
– Intermountain Healthcare announced it will scale
Notable’s AI-driven platform across the health system’s clinically integrated
network to support thousands of providers, automate administrative workflows,
streamline the check-in experience for patients, and simplify provider
– The Notable Platform uses intelligent automation to identify and engage more patients in need of care and enables staff and clinicians to better serve patients by eliminating manual, administrative tasks like registration, documentation, and billing.
Healthcare, today announced it is partnering with Notable Health to reimagine the
manual, repetitive administrative aspects of patient intake and post-visit
follow-up into a fully automated, intuitive digital experience across the
health system’s clinically integrated network (CIN).
Empowering Digital Transformation from Check-In Through Collections
Intermountain is harnessing Notable Health’s platform to
digitally transform ambulatory check-ins through mobile registration and
virtual clinical intake for both in-person and telemedicine appointments.
Available within general internal medicine groups in the Salt Lake City region,
over 55 percent of patients from these clinics are now completing their entire
digital check-in prior to their office visit, decreasing check-in time by 25
percent. Intermountain reports an industry-leading 94 percent patient
satisfaction rating for their digital check-in and registration experience,
including 86 percent for patients 65 and older.
Notable extends the capabilities of My Health+, Intermountain’s health app, with digital assistants that automate administrative workflows for staff, streamline the check-in experience for patients and simplify follow-up for providers. Following an initial deployment that went live in under one month and results realized across over 100 providers, Intermountain will scale the Notable Platform to support thousands of providers within additional specialties and states across the clinically integrated network in the coming months.
Initial Notable Deployment Outcomes/Results for Intermountain
Intermountain patients benefit from a digital intake process
that assists with registration, verifies insurance eligibility, and prompts
patients to enter symptoms and medications directly from their smartphone through
dynamic questionnaires customized for an individual’s medical history. The
platform enables patients to complete their entire check-in before their visit
for a touchless, paper-free experience. This reduces the number of people in
waiting rooms, and patients can be offered virtual visit options when
Today’s announcement comes after general internal medicine
groups in the Salt Lake City region generated significant results across 100+
· By automating clinical documentation through the Notable
Platform, Intermountain medical assistants save 30 minutes of charting time per
· More than half of patients now complete their entire
digital check-in prior to their office visit, decreasing check-in time by 25%;
· Patient satisfaction ratings for digital check-in and
registration have topped 94%, including 86% for patients 65 and older.
“Creating a more seamless and empowered consumer experience is critical to meeting evolving patient expectations. This starts with digitally transforming the complex process of accessing and registering for care,” said Kevan Mabbutt, senior vice president and chief consumer officer at Intermountain. “By engaging patients to provide information through My Health+ about their health before their visit, we can better address what type of care our patients need, and where and when they can receive it across the care delivery continuum.”
While payers and policymakers took a more narrow-minded perspective on innovation value in 2020, the year 2021 will bring an increased focus on a treatment’s societal value, how innovation interacts with digital technologies, and whether new innovations are able to reduce existing health outcome inequalities.
Digital healthcare means using communications and information technologies in medicine to diagnose, predict, treat, and monitor diseases. It is also widely used for prognosis, rehabilitation, behavioral health, and public health. Indians have witnessed a surge of smartphone and internet use since the last decade. This had led to an easier delivery of smart digital solutions. Known inequalities in access to healthcare, lack of trained professionals, outdated infrastructure, and low healthcare budget are some of the problems in India. Modern healthcare technology and innovation is the solution to improve the health status of the country. Similarly, the healthcare system is continuously being transformed with the latest technology. It is believed that in the coming decade, all pharmaceutical companies will leverage available technology to improve clinical outcomes. India`s healthcare industry has grown from $100 Billion (2015) to $280 Billion (2020) and is rapidly surging at a CAGR of 18.3%
Amidst Covid-19, there is a fortunate surge in innovation and locally made technology in India. The government is enthusiastic about digital solutions for rapid diagnostic methods among other innovations. Technology should be consumer-friendly, efficacious, and affordable. India is not far behind in terms of innovation.
The objectives of digital health products and services are:
To improve clinical outcomes
To improve the patient experience
To be consumer-friendly
To improve the physician provider experience.
To address health problems
Need of Digital Technology to Manage Health
A plethora of issues exist in India`s healthcare sector which are still untouched by digital technology. Antibiotic resistance, medical reimbursement, TB, malaria, diabetes should be targeted in the coming decade.
The ratio of patients to doctors is below the acceptance rate.India does not meet minimum WHO recommendations for the healthcare workforce and infrastructure.
In short, Digital healthcare is needed for the following:
To improve access to healthcare
To reduce healthcare inefficiency
To improve the quality of care
To lower the cost of healthcare
To Provide individualized health care
India is climbing the peak of the digital health revolution. The majority of healthcare professionals (HCPs) use electronic medical records (EMRs) for more efficient medical practice.
For a few years, novel digital solutions are gaining popularity with joints from private and public sectors. The government has recently launched the much needed National Digital Health Mission (NDHM). The private sector has rolled out mobile apps, telemedicine, research centers among other initiatives. Telemedicine, Artificial Intelligence (AI), mobile apps, robotics, and virtual reality (VR) are gaining popularity. Digital intervention in healthcare is expected to drive the industry at a CAGR of 23% by 2020.
India is climbing the peak of the digital health revolution. The majority of healthcare professionals (HCPs) use electronic medical records (EMRs) for more efficient medical practice.
Top 10 Digital Health Solutions
M-health: A simple mobile app that provides online video consultation and an added feature to book laboratory tests online. It has an estimated market size of 5,184 crore INR in 2020.
Remote diagnosis – These products provide point-of-care diagnostics, teleconsultation, and online prescription capabilities thus increasing access to healthcare in rural areas. For example, a wireless monitor that measures blood pressure, oxygen saturation, pulse, body temperature, blood sugar, blood cholesterol, and total hemoglobin (Hb) count with a mobile application on your smartphone. It is expected to grow at a CAGR of 20%.
Telemedicine – It is the use of digital technology for remote diagnosis, monitoring, and patient counseling. The high volume of patient load (millions) on a few doctors (thousands) may burden the whole system and reduce its efficiency. Telemedicine or Virtual consultation will enhance patient experience and engagement; fewer tests would be prescribed; the rate of hospital re-admission will be less; better medication and patient adherence would lead to desired clinical outcomes. It is a rapidly emerging sector in India and the telemedicine market in India is expected to reach $32 million by 2020
Digital Connectivity – support groups and knowledge portals for patients and digital chatting platforms for medical professionals.
Wearables – They are used to measure basic health parameters such as heart rate, number of steps, sleep pattern, etc. For example, exercise trackers, oximeters. The overall market for this is currently valued at 30 crore INR.
Big Data Analytics – Healthcare players have realized the value of combining consumer insights and internal company data to optimize their products. Advantages are a) lower rate of medication errors, b) Facilitating Preventive Care c) More Accurate.
Artificial Intelligence (AI) – It helps in automation of clinical tasks and virtual nursing assistants. AI has the capability to transform health management. It is used in precision medicine, medical imaging, drug discovery, and genomics. DeepGenix helps the user in understanding their problems based on questions and then predicts the diagnosis. It uses deep phenotyping and deep learning (a form of AI).
Electronic medical records (EMR): This should help reduce medical errors and improve health outcomes. Automated patient history has a lot of benefits. Arintra, an AI-based software incorporates branching techniques to collect and store patient history. It also helps in diagnosing and suggesting laboratory tests. It can also be used in telemedicine before the consultation.
Virtual reality – Surgeons are using virtual-reality simulations to improve their skills or to plan complicated surgeries.
Blockchain – It is proven to be effective in preventing data breaches, improving the accuracy of medical records, and reducing costs.
Digital healthcare will continue to remain an essential part of healthcare in India. Now medical tasks like analyzing radiology, pathology, or ophthalmology images are performed by computers. Telemedicine, E-pharmacy, fitness apps, wearable devices have become an integral part of the patient`s lives, especially during Covid-19.
Opportunities for the future
Electronic medical records (EMRs)
Smart health monitor
Mobile health apps
Virtual Reality (VR)
Though some innovations are still in the early stages, they look promising. For example, research on 3D-printed hearts and other organs is being carried out; doctors are using VR instead of medication to treat pain; robots are being used in surgeries; genomic analysis. The need for digital innovations has become even more urgent during the Covid-19 pandemic.
There is a significant need for digital technology to bridge healthcare gaps. India holds the potential for digital growth, given its innovation rate, identification of problems, growing population, and surging healthcare industry. Digital technology will help India achieve healthcare for all and will soon emerge as a global leader in digital health.
Since COVID-19 emerged as a major health threat, virtual care has taken off. As many as 46% of patients reported in late April that they had used telehealth to replace a canceled healthcare visit in 2020, while 48% of physicians said they had started using telehealth to treat patients.
While a shift in care models was necessary to address business continuity amid the pandemic, these trends also represent positive movements as a growing body of evidence supports the real-life benefits of telehealth. Remote models of care are connected to safe and effective consultations across many use cases, low exposure to viruses, and much-needed access to care.
Yet the fact that physician adoption isn’t higher suggests two things:
1) Physicians may be taking a ‘wait and see’ approach in the hopes that patients will want to return to in-person care as economies reopen; or
2) Some physicians haven’t yet figured out their long-term telehealth strategy. In truth, many providers are treating telehealth as a “stop-gap” — or temporary — solution until life returns to normal.
But given the increasingly positive data around telehealth as a safe alternative to in-person care, as well as its track record in successfully treating patients, it’s time for providers to reframe their thinking. In the future, practices will need a healthcare strategy that balances virtual with in-person care.
As recently as ten years ago, telehealth reimbursement was largely limited to patients in rural areas, as payers didn’t yet see the value of compensating doctors for virtual encounters.
Today, most payers and providers recognize the value of telehealth on some level amid rising demand for services and severe professional shortages. In particular, remote care models have proven their worth during the pandemic as an effective means of preventing the spread of disease. Greater acceptance of telehealth is further demonstrated by the recent decision to relax HIPAA requirements by HHS’ Office of Civil Rights (OCR), allowing more providers and patients to virtually connect through FaceTime, Zoom, or other two-way communications systems during the current pandemic.
This is an important first step, although many providers remain resistant to change for a variety of valid reasons. Some of these include discomfort with remote care models, reimbursement concerns, and the cost of deploying telehealth.
Performing medicine in a way that doesn’t align with one’s training feels unnatural, and some providers have said that virtual encounters feel less personal. The fact is that most clinicians weren’t trained to diagnose patients remotely or engage over a screen and are simply hesitant to embrace this approach to care.
Also, providers may have trepidation about not getting paid. While CMS and private payers have expanded coverage, multiple healthcare providers have reported that bills are being delayed or only partially paid by health plans.
With limited insight into the potential return on that investment, concerns over the cost of implementing telehealth are also reasonable. A physician who is consulting with patients remotely through FaceTime, for example, might wonder if the investment in a more secure, robust telehealth platform will make sense in 12 months, should a COVID-19 vaccine materialize.
Yet by not adopting a more permanent telehealth solution, providers may be hurting themselves down the road. Patients increasingly believe virtual care is highly effective, and some even prefer it. According to a SYKES consumer survey administered in March, 60% of 1,441 respondents said the COVID pandemic has increased their willingness to try telehealth.
Also, while HHS has relaxed HIPAA enforcement at the moment, there’s no indication this will continue. Healthcare organizations will need to ensure that the platform or program they’re using is designed to keep protected health information (PHI) safe.
Investing in the Future
Given the upward trajectory of telehealth, it benefits providers to thoughtfully invest in the right strategies and solutions now to extract the greatest value and return on investment down the road. Here are four steps to take, when shifting to a long-term telehealth strategy:
– Identify needs. Many primary-care practices may have seen a bump in interest in telehealth due to COVID-19, while specialty practices may see increases stay steady, even when fears of the coronavirus fade. When planning long-term, put patient needs first: In what ways can telehealth improve care delivery, going forward? Look at data, such as virtual-visit utilization patterns, to see where there are opportunities to grow telemedicine (e.g., expanding chronic care management) based on needs.
– Consider workflows. The ideal telehealth program doesn’t interrupt clinical workflows – it enhances them. If you’re using a ‘stop-gap’ video conferencing solution to provide telemedicine, is it easy to integrate practice notes with your EHR? Or, do you have to take extra steps to document patient encounters for clinical and billing departments?
–Seek supportive partners. You can use any number of technology platforms to conduct telemedicine encounters, but not all platforms are created equal. When looking at implementing a telehealth platform, consider not only ease of use, and interoperability, but also what a particular vendor is offering: How well the telehealth platform in question can accommodate the needs of a particular specialty? What are existing clients are saying about things like training, vendor support, and the patient experience?
– Proactively engage. Your patients have most likely heard of telehealth, but they may not realize that telehealth is multifaceted and can be used to diagnose conditions such as skin disorders or allergies and can be just as effective as in-person visits. Educating patients about telehealth’s benefits, and making it easy for them to try telehealth, is essential to success.
Expanding telehealth’s role in the medical practice benefits everyone, from physicians to patients to payers. Moving past the “stop-gap” mentality now will reap greater benefits in the future, regardless of whether we’re in the midst of a pandemic, or simply trying to provide excellent care on a day-to-day basis.
About Roland Therriault
is the President and Executive Vice President of Sales at InSync Healthcare Solutions, a provider
of integrated EHR and practice management software, revenue cycle management
services and medical transcription to thousands of healthcare professionals
throughout the United States. Roland Therriault manages all operations of the
company, driving its go-to-market strategy and overseeing all sales activities.
His experience in healthcare and technology includes more than 20 years of
direct and channel sales, strategic planning and business development. Prior to
joining InSync, Roland served as Vice President of Sales for MD On-Line, a
provider of acute and ambulatory clinical and practice management solutions.
The coronavirus pandemic accelerated telemedicine exponentially as patients and doctors switched from in-person visits to remote consultations. Health providers rapidly scaled virtual offerings in March and April and traffic volumes soared to unprecedented levels, with practices “seeing 50 to 175 times the number of patients by telehealth than before the outbreak,” according to McKinsey. By early August, the U.S. Department of Health and Human Services expanded the list of allowable telehealth services in Medicare and there was an executive order supporting permanent telehealth provisions for rural areas.
But the surge in telemedicine adoption comes with a host of cybersecurity risks and regulatory compliance requirements unique to the healthcare sector.
As telemedicine traffic increases, so does the volume of hacking attempts. Recent cybersecurity news indicates healthcare organizations are top targets for cyberattacks and “providers remain the most compromised segment of the healthcare sector, accounting for nearly 75 percent of reported breaches.” The consequences are chilling: “The average cost of a healthcare data breach is $7.13 million globally and $8.6 million in the United States.
Further, whenever patient information is involved, HIPAA compliance is required. While HHS temporarily suspended pursuing HIPAA penalties on providers for “good faith provision of telehealth during the COVID-19 nationwide public health emergency,” such permissiveness will not last.
Luckily, most telemedicine providers can utilize managed services and cloud infrastructure to keep pace. Here are some best practices to meet IT compliance and cybersecurity demands for telemedicine.
Telemedicine Compliance Best Practices
Compliance should be viewed as a real-time process that drives security. Telemedicine tools and technology should therefore reflect significant expertise with all healthcare regulations (HIPAA, HITRUST, HITECH), with compliance functions permeating processes. Recommended compliance best practices include:
1. Automate Remediation
Healthcare applications cannot offer high reliability if every potential compliance problem is remediated manually; there’s just too much that can go wrong and never enough staff to address it when needed. The solution is to automate everything that can be automated, and rely on people to handle exceptions or potential violations that don’t impact reliability. Cloud-based services can integrate AI and operational intelligence to automatically remediate anomalies when possible, present recommendations to operations staff for cases that cannot be resolved automatically, and present clear choices such as:
· Do Nothing: Take no action, delete ticket after [x number of days]
· Fix Now: Implement the recommended actions immediately
· Schedule: Perform the recommended actions during the next maintenance window
This approach speeds resolution and decreases service disruptions, and improves the reliability of telemedicine delivery. The automated response also plays a critical role in security (which will be discussed shortly).
2. Perform Formal Risk Assessments
Understanding the risk level and specific risk issues are critical components for an effective compliance plan. Many providers of healthcare services underestimate their level of risk, in part because it is difficult to quantify. The HHS has published guidance in its Quantitative Risk Management for Healthcare Cybersecurity, which offers insight. There are also cloud solutions that can aid the process. Cloud services providers such as Amazon Web Services (AWS), Microsoft Azure, and Google Cloud offer automated security assessment services that help improve the security and compliance of applications deployed on their cloud hosting platforms. They can generally assess applications for exposure, vulnerabilities, and deviations from best practices. A good inspection service should highlight network configurations that allow for potentially malicious access, and produces a detailed list of findings prioritized by level of severity.
3. Reduce Attack Surface
To provide secure access to sensitive information, hybrid architectures supporting telemedicine applications need a virtual private network (VPN) gateway between on-premises and cloud resources. However, developers, test engineers, remote employees, and others who need access to cloud-based protected health information (PHI) may bypass a VPN gateway by either cracking open the cloud firewall to allow direct unencrypted internet traffic or using peering connections. To prevent such potential exposures, secure desktop-as-a-service (DaaS) solutions provide an elegant way to allow cloud-based access to PHI without exposing connections or records. A DaaS is generally deployed within a VPC providing each user with access to persistent, encrypted cloud storage volumes using an encryption key management service. No user data is stored on the local device, which reduces overall risk surface area without impeding development capability.
Telemedicine Security Best Practices
While the full scope of cybersecurity strategies is beyond the scope of this article, here are three best practices that telemedicine providers can use bolster their security profile:
1. Deploy Proactive Network Security
Modern cyber threats have become steadily more sophisticated in evading traditional security measures and more devastating once they penetrate network perimeters. For that reason, telemedicine providers need a highly proactive, multilayered approach to prevent malware-based outages, theft of intellectual property, and exfiltration of protected health information (PHI).
A combination of network anti-malware, application control, and intrusion prevention systems (IPS) is recommended. Such proactive solutions are generally bundled in managed cloud services that should automatically detect suspicious system changes in real-time, isolate and quarantine affected resources, and prevent the spread of exploits by locking down any server whose configuration differs from the installed settings.
2. Encrypt Data Storage
Data encryption is the last line of cyber-defense for PHI and other critical information. Even if an attacker can penetrate the perimeter and proactive network security and exfiltrate data from the provider, those data are useless to the hacker if encrypted. It’s good practice to encrypt all web and application servers running on cloud instances using a unique master key from a key management service when creating volumes.
Encryption operations generally occur on the servers that host cloud database (DB) instances, ensuring the security of both data-at-rest and data-in-transit between an instance and its block storage. For additional protection, you can also opt to encrypt DB instances at rest, underlying storage for DB instances, its automated backups, and read replicas.
3. Harden Operating Systems
Both Microsoft Windows Server and Linux are ubiquitous operating systems in telemedicine. They are also both attractive targets for cybercriminals because they provide complex capabilities, frequently remediate vulnerabilities, and are so common (increasing attackers’ chances of finding an unpatched system). Hackers use OS-based techniques such as remote code execution and elevation of privilege to take advantage of unpatched operating system vulnerabilities. Hardened images of Windows Server and Linux virtual machines (VMs) should be used, employing default configurations recommended by the Center for Internet Security (CIS). Such hardened images make gaining OS administrative extremely difficult, and coordinate well with proactive security bundles described earlier.
While these best practices are targeted primarily at telemedicine companies, they can also be applied to a wide range of healthcare providers and organizations delivering vital services in the face of 2020’s dramatic swings in demand.
About Gerry Miller
Gerry Miller is the founder and chief executive officer at Cloudticity. He is a successful serial entrepreneur and healthcare fanatic. From starting his first company in elementary school to selling his successful technology consulting firm in 1998, Gerry has always marched to his own drummer, producing a series of successes. Gerry’s first major company was The Clarity Group, a Boston-based Internet technology firm he founded in 1992. Gerry presided over seven years of 100% aggregate annual growth and sold the company in 1998 when it had reached $10MM in revenue.
He was recruited by Microsoft to become their Central US Chief Technology Officer, eventually taking over a global business unit and growing its revenue from $20MM to over $100MM in less than three years. Gerry then joined ePrize as Chief Operating Officer, where he grew sales 38% to nearly $70MM while improving operating efficiency, quality, and both client and employee satisfaction. Gerry founded Cloudticity in 2011 with a passion for helping healthcare organizations radically reshape the industry by unlocking the full potential of the cloud.
The investigation resulted in charges against more than 345 defendants for more than $6 billion in alleged fraud losses. Roughly $4.5 billion of that was connected to telemedicine, the Department of Justice said.
Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these pernicious trends on overall mental health will take time. However, precedents like the Great Recession suggest that these trends are likely to worsen the conditions driving suicide and substance-related deaths, the “deaths of despair” that claimed 158,000 lives in 2017 and contributed to a three-year decline in US life expectancy among adults of all racial groups.
Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 2018 data showed that only 43% of adults with mental health needs, 10% of individuals with SUD, and 7% of individuals with co-occurring conditions were able to receive services for all necessary conditions.
The treatment gap is staggering, and COVID-19 is exacerbating it: an estimated 45% of adults report the pandemic has negatively impacted their mental health, to say nothing of the disruption of essential in-person care and services. In a similar vein, a recent CDC report has highlighted the staggering and “disproportionately worse mental health outcomes, [including] increased substance use, and elevated suicidal ideation” experienced by “younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.”
Consistent with the CDC report’s findings, the crisis can be felt most acutely by the very workforce that must deal with COVID-19 itself. Hospitals, health systems, and clinical practices – together with other first responders – comprise the essential front line. They bear the burden of their employees’ stress and illness, and must also cope with the many patients who present with a range of mental illnesses and substance use disorder (SUD).
But providers don’t have to face this burden alone: numerous behavioral health-focused digital solutions can support providers in meeting their most urgent needs in the era of COVID-19. Many of these solutions have made select services available for free or at a discount to healthcare providers in recognition of the immense need and challenging financial circumstances. Some solutions also help systems take advantage of favorable, albeit time-sensitive, conditions, enabling them to lay the foundation for broader behavioral health initiatives in the long term. Several of these solutions are described below, in the context of three key focus areas for health systems.
Focus Area 1: Supporting the Frontline Workforce
Health system leaders need to keep their workforces healthy, focused, and productive during this period of extreme stress, anxiety, and trauma. Providing easily accessible behavioral health resources for the healthcare workforce is therefore of paramount importance.
Health systems should consider providing immediate, free access to behavioral health services to employees and their families and consider further extending that access to first responders, other healthcare workers, and other essential services workers in the community.
Many digital product companies are granting temporary access to their services and are expanding their offerings to include new, COVID-19-specific modules, resources, and/or guidance at no cost.
Fortunately, the market is rife with solutions that have demonstrated effectiveness and an ability to scale. However, many of these rapidly-scalable solutions are oriented toward low-acuity behavioral health conditions, so it is important that health systems consider the unique needs of their populations in determining which solution(s) to adopt.
The following are several solutions to consider:
Online CBT solutions. These tools are being used to expand access to lower-acuity behavioral health services, targeting both frontline workers and the general population. MyStrength, SilverCloud and others have deployed COVID-19-specific programming.
Text-based peer support groups. Organizations are using Marigold Health to address loneliness and social isolation in group-based chat settings, one-on-one interactions between individuals and peer staff, and broader community applications.
Focus Area 2: Maintaining Continuity of Care
As the pandemic continues to ripple across the country, parts of the delivery system remain overwhelmingly focused on containing and treating COVID-19. This can and has led to the disruption of care and services, of particular significance to individuals with chronic conditions (e.g., serious mental illness (SMI) and SUD), who require longitudinal care and support. Standing up interventions — digital and otherwise — to ensure continuity of care will be critical to preventing exacerbations in patients’ conditions that could drive increased rates of ED visits and admissions at a time when hospital capacity can be in short supply.
In the absence of in-person care, many digital solutions are hosting virtual recovery meetings and providing access to virtual peer support groups. Additionally, shifts in federal and state policies are easing restrictions around critical services, including medication-assisted treatment (e.g., buprenorphine can now be prescribed via telephone), that can mitigate risky behavior and ensure ongoing access to treatment.
The use of paraprofessionals has also emerged as a promising extension of the historically undersupplied behavioral health treatment infrastructure. Capitalizing on the rapid expansion of virtual care, providers should consider leveraging digital solutions to scale programs that use peers, community health workers (CHWs), care managers, health coaches, and other paraprofessionals, to reduce inappropriate hospital utilization and ensure patients are navigated to the appropriate services.
The following are several solutions to consider:
Medication-assisted therapy (MAT) via telemedicine. These solutions provide access to professionals who can prescribe and administer MAT medications, provide addiction counseling, and conduct behavioral therapy (e.g., CBT, motivational interviewing) digitally. Solution companies providing these critical services include Eleanor Health, PursueCare, and Workit Health.
Behavioral health integration. Providing screening, therapy, and psychiatric consultations in a variety of care settings — especially primary care — will help address the increased demand. Historically, providers have had difficulty scaling such solutions due to challenging reimbursement, administrative burden, and stigma, among other concerns. Solutions like Valera Health and Concert Health were created to address these challenges and have seen success in scaling collaborative care programs.
Recovery management tools for individuals with SUD. WEConnect Health and DynamiCare Health are both offering free daily online recovery support groups.
Focus Area 3: Leveraging New Opportunities to Close the Treatment Gap
As has been widely documented, the pandemic has spurred unprecedented adoption of telehealth services, aided by new funding opportunities (offered through the CARES Act and similar channels) and the widespread easing of telehealth requirements, including the allowance of reimbursement for audio-only services and temporarily eased provider licensure requirements.
Tele-behavioral health services are no exception; the aforesaid trends ensure that what was one of the few high-growth areas in digital behavioral health before the pandemic will remain so for the foreseeable future. This is unquestionably a positive development, but there is still much work to be done to close the treatment gap. Critically, a meaningful portion of this work is beyond the reach of the virtual infrastructure that has been established to date. For example, there remains a dearth of solutions that have successfully scaled treatment models for individuals with acute illnesses, like SMI or dual BH-SUD diagnoses.
Health system leaders should continue to keep their ears to the ground for new opportunities to expand their virtual treatment infrastructure, paying particular attention to synergistic opportunities to build on investments in newly-developed assets (like workforce-focused solutions) to round out the continuum of behavioral health services.
COVID-19 has all but guaranteed that behavioral health will remain a major focus of efforts to improve healthcare delivery. Therefore, health systems that approach today’s necessary investments in behavioral health with a long-term focus will emerge from the pandemic response well ahead of their peers, having built healthier communities along the way.
About Victor Siclovan
Victor Siclovan is a Director on the Medicaid Transformation Project at AVIA where he leads work in behavioral health, chronic care, substance use disorder, and Medicaid population health strategy. Prior to AVIA, Victor spent nearly 10 years at Oliver Wyman helping large healthcare organizations navigate the transition to value-based care. He holds a BA in Economics from Northwestern.
Amwell expanded its partnership with Tyto Care, a startup that makes connected exam kits for telehealth visits. The companies will design new integrations of their technologies, and Amwell will become a reseller of Tyto Care’s devices.
Health insurer Humana has filed a lawsuit against telemedicine company QuivvyTech that it says resulted in fraudulent prescriptions worth millions of dollars being written for duped customers.
According to the complaint, QuivvyTech hired telemarketers to cold-call Humana members, whose details were obtained using “illegal means,” and encouraged them to talk about common ailments, claiming to be calling from Humana.
The script used by the telemarketers was designed to prompt members into describing medical conditions such as “pain and inflammation, acne breakouts, eczema or psoriasis episodes, cold sores, or conditions commonly treated with antifungal medications such as athlete’s foot,” it adds.
The company is accused of then passing on the call recordings and other information to physicians – some of whom are also named in the suit – who then prescribed medicines to the Humana patients without informing them “and never having met or spoken to them.”
“They designed pre-printed prescription forms with multiple options of pre-determined categories of medical conditions with the physician marking boxes for medications, often high-dollar cost topical creams and ointments,” claims Humana and its legal counsel.
The suit also mentions “co-conspirator pharmacies” which it claims were also in on the scam and billed, dispensed and shipped the medicines to patients, often numerous times via automatic refills.
The pharmacies aren’t named as defendants in the lawsuit because of “contractual arbitration provisions” between them and Humana, but are identified in the complaint.
Humana says it paid out between $590,000 and $2.3 million to reimburse drugs prescribed by the six doctors named in the lawsuit, for a total of almost $10 million.
The suit exposes the potential for fraud with telemedicine, which has come to the fore during the COVID-19 crisis at the same time as use of digital health approaches has skyrocketed, fuelled by increased reimbursement of virtual healthcare consultations though Medicaid and Medicare.
Some of the scams identified by a recent article in Fraud magazine include “fraudulent claims using false diagnoses, phantom patients, fake telemedicine appointments and insurance reimbursement for non-essential drugs and fictitious treatments.”
Needless to say, this type of activity undermines the benefits that can accrue from greater use of telehealth services, including reduced burden on healthcare practitioners and easier access to care for people living in remote areas or those who have mobility difficulties.
Follow along with our new blog series #HealthcareNow and #PublicSectorNow, where we’ll addresses healthcare innovation around the world and how to maintain business continuity in today’s health climate.
Like most healthcare organizations, they needed to pivot when stay at home orders and social distancing limited patients from coming into clinics and hospitals for preventative and chronic care.
DPH had to rapidly select a web-based technology provider that would integrate seamlessly with their existing video conferencing solutions and Cisco solutions across infrastructure, scheduling, DX units and room kits.And, they needed security built into the platformto meet strict HIPAA requirements for patient privacy. Webex was the answer.
In just three months,DPH onboarded 1,200 telehealth providers to the Webex platform. Now, they have one of the most robust telehealth programs in the nation with over 1,000 connected endpoints, allowing patients to stay safe at home while maintaining access to needed medical care.
One of the critical areas that is benefiting by the use ofWebex is the Babies Can’t Wait (BCW) program. BCW is an early intervention program that offers a variety of coordinated services for infants and toddlers with special needsand their families. The BCW program is using Webex to:
Conduct trainings and staff meetings
Administer eligibility evaluations
Provide ongoing occupational therapy, speech therapy, and physical therapy services
Provide special instruction services
Hold weekly state meetings and teletherapy provider support meetings
DPH is also able to offer patients over 50 additional telemedicine services, including dental, diabetes, infectious diseases, and pediatric care.
“… We leveraged Webex to get those providers onboarded and trained to see patients during COVID. The feedback has been amazing. Our patients are very pleased with the platform.” –Suleima Salgado, Director of Telehealth, Georgia Department of Public Health
Before the pandemic, patients and providers were hesitant to adopt telehealth, but now, patients are driving the conversation. They are pleased with the care they now receive from home, and DPH believes the demand for telehealth will continue even after in-person appointments resume in full capacity.
“Telehealth is not going anywhere…It’s going to be a standard model of care now moving forward post COVID.” – Suleima Salgado, Director of Telehealth, Georgia Department of Public Health
We’d love to hear what you think. Comment below and stay tuned for the next blog in our #HealthcareNow series.
Dynamic personnel shifts, technology embrace, and significant behavior change will allow for rapid evolution of the healthcare industry and create the opportunity for alliances across the care continuum.
Mental health startup Lyra Health raised a $110 million series D, valuing the company at $1.1 billion. The company plans to use the funds to expand its teletherapy service and develop additional mental health solutions.
It’s all go in the US telehealth sector, with Alphabet’s Google investing $100 million in Amwell on the same day the Boston-based firm unveiled plans for an initial public offering (IPO).
Google has also agreed a partnership with Amwell that makes the telehealth company its preferred partner, while Amwell in turn has agreed to switch some of its online service to Google Cloud from current provider Amazon Web Services.
The IPO aims to raise around $100 million, according to Renaissance Capital, but no pricing has been publicly disclosed yet.
Amwell is one of the larger players in the US market, providing telemedicine to more than 2,000 hospitals and 55 health plan partners with more than 36,000 employers, and recording $202 million in revenue in the 12 months ended June 30.
The coronavirus pandemic has resulted in a dramatic increase in the use of telehealth in the US and elsewhere, and in turn seems to have prompted companies to look at strategic deals to enhance their presence, and avoid falling behind the competition.
Earlier this month, Teladoc and Livongo announced an $18.5 billion merger that will create a digital health giant with pro forma sales of $1.3 billion from telehealth systems and health monitoring tools if it gets regulatory approval.
That is the largest deal ever signed in the telehealth sector, and according to analysts signals growing confidence in the continued growth of the market once the pandemic subsides. Frost & Sullivan has predicted sevenfold growth in telehealth by 2025, an annual growth rate of more than 38%.
According to data from the US Department of Health and Human Services, Medicare primary care visits delivered remotely grew from less than 1% in February of 2020 to more than 40% in April when the pandemic was starting to peak.
“The pandemic has resulted in historic telehealth utilisation, making it a priority and, in many cases, a preference for patients, providers, and health plans,” said Amwell in a statement.
“The partnership aims to make the healthcare experience much simpler and more continuously accessible to underserved populations” like seniors and patients with chronic illnesses, it added.
The partners say they plan to work together in areas such as automated waiting rooms and checkout, language translation services, and digital triage to reduce the burden on clinicians and streamline the reimbursement process.
Google Cloud’s global director of health care strategy Aashima Gupta said in a blog post that the aim is to create a future “in which your visit begins with a customised greeting and relevant information in a digital waiting room.”
A conversational chatbot would ask about symptoms and the reason for the consultation, sharing this information with a physician prior to a remote consultation. All the interactions would take place in the patient’s preferred setting with artificial intelligence (AI) providing live, translated captioning of the conversation.
Routine tasks such as filling out reimbursement forms would be automated during the visit, freeing up more time for the consultation, and the same technology could also be applied to ongoing monitoring of patients at home.
“We’ll work together to bring these solutions to market, helping expand access to virtual care among our mutual customers and the global healthcare industry,” said Gupta.
The impact of the coronavirus crisis is shining a bright light on many of the challenges facing the U.S. healthcare system.
So much more than a lack of primary care physicians and hospital beds, the all-hands-on-deck approach to combating the spread of COVID-19 has forced patients fearful of engaging with the healthcare system for needs unrelated to the virus to put elective procedures, routine care and timely treatment for chronic or critical conditions on the back burner.
Compounding these issues, fears surrounding visiting the doctor’s office have forced primary care facilities to lay off or furlough clinicians and staff, deferring or skipping clinician salaries in some cases. When it comes to epidemic illness, primary care professionals serve as the first line of defense, preventing patients from flooding emergency rooms and hospitals when they don’t actually need to be there. However, in spite of the need for access to affordable primary care, many primary care practices will not survive the pandemic.
Despite new CDC guidance showing people with underlying medical conditions like diabetes or hypertension are at increased risk for severe illness from COVID-19, most regular wellness check-ups, cancer screenings, and nonemergency procedures have been put on hold. While COVID-19 is responsible for more than 140,000 deaths in the U.S. alone, experts predict this delay in care for chronically ill patients has resulted in a “silent” death-toll — and one that continues to climb as the world waits for a vaccine.
In the meantime, what can hospitals and clinics in the U.S. do to better serve chronic care patients and ensure no one else falls through the cracks during the pandemic?
Healthcare generates a lot of data for patient records. It’s crucial that hospitals and medical clinics have the ability to analyze that data to identify and categorize vulnerable patients who are either:
– high-risk due to potential coronavirus-related complications or
– require regular check-ups because of care related to chronic illness, mental health, or addiction.
Facing the aforementioned barriers to primary care and treatments, many chronic and crisis care patients are exponentially more vulnerable to the impact of the virus. Even if these patients do not contract COVID-19, the regression that can happen when a condition is not properly managed can be equally dangerous.
Data analysis that allows healthcare providers to stratify patient population risk and engage patients based on care needs provides caretakers the information they need to create personalized treatment plans that ensure the needs of chronic and crisis care patients are not neglected.
Safe and Continuous Outreach
Healthcare clinics that traditionally rely on in-office visits are now scrambling to provide access to their patients through telemedicine and virtual visits while navigating the challenging new landscape of billing codes and payment rules for these services. Previously derided as less than effective medicine, telemedicine, and virtual visits have become necessary to reduce staff exposure, preserve personal protective equipment (PPE) and minimize the impact of patient surges on facilities.
Because systems have had to adjust the way they triage, evaluate and care for patients through the use of methods that do not depend on in-person services, telehealth, and virtual care services are helping provide necessary care to at-risk patients while minimizing the transmission risk of the virus that causes COVID-19 to healthcare personnel and other patients.
From phone calls and telemedicine appointments to apps, surveys, and regular check-ins, advances in technology empower hospitals and clinics to prioritize relationships that build the foundation enabling continuity of care, even using a new channel to communicate. Through proactive communication with patients about helpful resources and the option for virtual visits, providers can see significant success in their commitment to continued engagement with — and care for — patients.
Dedicated Patient Advocacy
Good patient-provider relationships foster better communication, which drives improved health and wellness. As such, it’s important that hospitals and clinics have ongoing and dedicated patient advocates to reach out to high-risk and chronic care patients.
By serving as the link between a patient’s care provider and the real world, patient advocates strive to ensure that patients have access to the care and resources they need. Whether that involves access to prescriptions, medical supplies, food, financial assistance, mental health programs, or workforce navigation, care coordination needs to extend beyond simple community referrals.
In the face of a global pandemic, patients often face complicated decisions concerning their health and overwhelming obstacles to receiving care. Ongoing, dedicated patient advocacy offers guidance that helps patients navigate the complicated health system, ensuring they get the care and support they need throughout the continuing COVID-19 outbreak.
Despite efforts to safely reopen businesses and get employees back to work, the virus itself has not gone away. With practitioners fearing the spread of the disease, patients afraid to keep their in-person appointments and clinicians being redirected to emergency rooms or coronavirus test sites, primary care doctors are seeing their patients far less frequently, and patients are struggling to effectively maintain their health.
That strain on the primary care system will continue. However, by moving to value-based care models, such as advanced primary care, that leverage data, and analytics to identify and categorize vulnerable patients, facilitate safe and continuous outreach to these patients through telemedicine and other virtual means and have dedicated patient advocates reaching out to high-risk and chronic care patients, hospitals and clinics can continuously serve their most vulnerable patients throughout the duration of the coronavirus crisis.
About Dr. Kayur Patel
Dr. Kayur Patel serves as Chief Medical Officer of Proactive MD. A practicing physician with extensive experience in internal and emergency medicine, his specialty lies in bringing physicians and hospital leadership together in order to convert healthcare challenges into opportunities for growth. He is a nationally-recognized authority and a national speaker on the subject of quality in healthcare.
Though the rest of 2020 is still unknown, one fact is very clear: Clinicians will need to continue to lean heavily on technology like RPM, AI and telehealth to ensure successful patient outcomes across the board.
Even relatively healthy older adults see the benefit of receiving home-based primary care, not just because of its convenience, but because patients feel safer at home now, and more unsafe than ever in ambulatory settings surrounded by other sick patients.
The UK government has said it is vital to adopt telemedicine across the NHS in response to COVID-19 – but is the health service ready to fully embrace this digital tech? Dom Tyer investigates.
The rapid digitalisation of life during COVID-19’s acute phase has had a huge impact on healthcare delivery during the pandemic, part of which has included a major shift to telemedicine across the NHS.
Mirroring the acceleration of digital transformation in pharma, many face-to-face services have quickly been provided online or via telephone to keep patients away from overstretched and potentially infectious hospitals and GP surgeries.
The country is by no means out of the woods yet, and as I write this ‘only’ 77 people who tested positive for COVID-19 died yesterday in the UK (almost all in England). Nevertheless, plans for post-COVID healthcare are underway and digital health looms large within them.
The NHS’ digital future
As I noted in my last article, the signs of digital transformation – at a societal level, as well as across pharma – are everywhere. It’s a picture that also holds true for healthcare in the UK.
Speaking about the future of healthcare at the Royal College of Physicians recently, health and social care secretary Matt Hancock said COVID-19 had provided “a moment of exposure, of stark clarity”.
“From now on, all consultations should be teleconsultations unless there’s a clinical reason not to” Matt Hancock, UK Health Secretary
“Coronavirus has tested every single part of our infrastructure, giving us a new appreciation for what works and what doesn’t.
“And we saw things change. I mean really change. I’ve lost count of the number of times someone said to me: ‘what would have taken months took minutes’.”
COVID-19 has, he said, “catalysed deep structural shifts in healthcare that were already underway”, and he cited as examples data-driven decision-making, working as a system and telemedicine.
Indeed, he noted how telemedicine had enabled care at the peak of the pandemic and that the NHS has been treating half of patients in outpatients and primary care online. The difference between healthcare delivery just a year ago is stark.
“In the four weeks leading up to 12 April this year, 71% of routine GP consultations were delivered remotely, with about 26% face-to-face. In the same period a year ago, this was reversed: 71% face-to-face and 25% remotely,” he said.
Earlier this year, on a single day in March, over 750,000 online assessments were carried out and this trend towards digital is, unsurprisingly given his penchant for technology, something the health and social care secretary wants to see continue.
“From now on, all consultations should be teleconsultations unless there’s a clinical reason not to. Of course, if there’s an emergency, the NHS will be ready and waiting to see you in person – just as it always has been.
“But if they are able to, patients should get in contact first – via the web or by calling in advance,” Hancock said.
Expanding healthcare services
Appropriate use of telemedicine also has the backing of the pharma and biotech sectors, and features in the Life Sciences Recovery Roadmap put together by industry and medical charity bodies such as the ABPI, EMIG and BIA. The publication provides an overview of the critical issues affecting the sector as it moves towards recovery and building new partnerships with the government and NHS.
“Progress on telemedicine must be maintained and enhanced, where appropriate, to reduce pressure on acute care, support patient self-management, improve choice and address health inequalities,” the Roadmap notes.
“However, further research is required to assess where telemedicine is suitable for vulnerable people, such as those with learning difficulties. It is also important that telemedicine is not allowed to create new demand or provide an alternative route for people with self-treatable conditions to access a GP consultation when they should be practicing self-care with support, if required, from a pharmacist.”
In terms of vulnerable groups, an article in The Lancet Digital Health last month concluded telemedicine had promise for prison populations, potentially improving health service access, reducing widening health inequalities and contributing to improved health outcomes.
Meanwhile, Marie Stopes saw the potential of telemedicine early on in the pandemic, launching a service for early medical abortion care in April. Its initiative, which is in-line with NICE’s abortion care guidance, includes a nurse-led telephone consultation for eligible women.
“The government and the NHS must make sure that they bring everyone with them on this journey. In a recent survey, 50% of our members told us that they didn’t have access to a webcam” Andrew Goddard, Royal College of Physicians
The charity’s medical director Jonathan Lord said at the service’s launch: “We know first-hand the stress, anxiety and desperation that many women seeking abortion care are experiencing during the COVID-19 pandemic, and we are delighted that we have been able to implement an effective telemedicine service in response to the crisis.
“This would not have happened without a huge joint effort from both the independent women’s healthcare sector and the NHS, and we look forward to working in continued partnership to deliver the best possible care.”
But questions remain…
However, telemedicine must continue to improve if it is to deliver the best possible healthcare.
There are a range of safeguarding issues to be overcome, for example in sexual health, as the British Association for Sexual Health and HIV has noted. It held a joint webinar with The Faculty of Sexual and Reproductive Healthcare, which heard that telemedicine has been a great success during lockdown – improving access, providing a more patient-centred service and reducing complications and stress for women.
However, the webinar was also told how young people might not be able to plan how they engage with such services, or may be unable to make confidential telephone calls away from their family.
Another potentially problematic issue with telemedicine for healthcare providers is how it can be used to safely offer intimate examinations.
Such a delay is entirely understandable in the fast-moving, high-pressured environment of a pandemic, but it should also be a reminder of the balance to be struck between patient care and safety when applying digital health technology to sensitive areas of healthcare at high speed.
There are potential technological issues too. In 2018, the UK’s Office for National Statistics (ONS) classified 10% of the population as “internet non-users”, meaning they’d either never gone online or hadn’t done so in the previous three months. And there’s a digital divide, or at the very least a digital gap, in healthcare too.
Responding to Hancock’s speech at the Royal College of Physicians, its president, professor Andrew Goddard, said the RCP has been arguing for using technology to transform the way in which services are provided for some time.
“But the government and the NHS must make sure that they bring everyone with them on this journey. In a recent survey, 50% of our members told us that they didn’t have access to a webcam.”
Furthermore, early signs are that the massive spike in the use of remote NHS healthcare services during lockdown can’t continue. One rheumatologist in nearby Ireland ran 90% of his consultations remotely at the height of the pandemic, but by late July telemedicine accounted for just 10% of his workload.
Where next for telemedicine in the UK?
Interest in digital health technology has been following an upward curve for some time, but the demands of COVID-19 have generated a global wave of enthusiasm for its greater use. As a case in point, telehealth in the US is very much enjoying a moment in the sun right now.
Meanwhile, in the UK there’s clearly the political will and healthcare backing for wider use of telemedicine by the NHS, despite some, as-yet not entirely resolved, technological and safety issues.
So, as the country begins the slow process of trying to keep its infection rate curve ever-flatter, while holding on to those pandemic healthcare innovations that really worked, telemedicine in the UK finds itself at a pivotal point.
The question is: just how far will it return to the ‘old normal’ of underuse?
Based on the almost overnight explosion of its use during the pandemic’s acute phase, combined with telemedicine’s advantages for some patients of accessibility and responsiveness, a wider place for it in the post-COVID future of the NHS looks assured.
About the author
Dominic Tyer is a journalist and editor specialising in the pharmaceutical and healthcare industries. He is currently pharmaphorum’s interim managing editor and is also creative and editorial director at the company’s specialist healthcare content consultancy pharmaphorum connect.