With every sector of the economy feeling the effects of ever-increasing healthcare costs and no relief in sight, it’s no wonder household names outside of traditional healthcare are stepping in and attempting to improve what could only be characterized as a problematic system.
Industry outsiders take an interest in “solving” healthcare
This year began with three modern-day titans of industry declaring they are ready to disrupt healthcare. Jeff Bezos of Amazon, Warren E. Buffett of Berkshire Hathaway, and Jamie Dimon of JP Morgan Chase announced they were forming an independent healthcare company for their employees. By June they named a CEO for this venture: Dr. Atul Gawande. A Harvard surgeon, author, and executive director for Ariadne Labs, Dr. Gawande has built his career on examining how medicine is practiced in the US.
Industry outsiders see data as a key leverage point
What is noticeably apparent with this surge in “healthcare outsiders” is that none of these big players are attempting to remake all of healthcare. To remake a system as vast and complex as the US healthcare system is more than any one company or consortium can reasonably hope to do.
However, they all do seem to be focused on data as the key point of leverage for disrupting and remaking a segment of healthcare. Gathering and processing data into diagnostic, predictive, or operational information is seen as the leverage point for ultimately making healthcare more efficient and effective.
Some of these industry outsiders are focusing their efforts directly on finding and exploiting opportunities for cost savings. Here are some examples.
Optimizing the pharmacy purchasing experience
Making the patient purchasing experience for pharmaceuticals, medical devices, and medical supplies seamless and reliable has drawn the attention of Amazon.
For the patient ordering and refilling prescriptions, the process could be automated and culminate in same-day delivery to the patient’s door. To some extent, patients will be able to comparison shop for non-prescription items and bundle purchases. For the seller inventories and distribution can be centralized and possibly some operational savings can be realized.
Finding a more efficient way of selling and delivering medical supplies will increase convenience for patients. But patients rarely pay the full cost of their prescriptions, so the cost drivers present in optimizing retail sales aren’t present at the pharmacy.
By Poornima Venkatesan, senior consultant, Virtusa.
Poornima Venkatesan
In today’s value-based care environment, patient engagement is a vital key to success in clinical outcomes. This is especially true for chronic diseases such as arthritis, where continuous care is necessary because of the disease’s physical, emotional and economic impact on patients. Although the advent of specialty drugs in the past decade has made disease control possible, clinicians still face challenges in patient care because patients’ preferences about therapy aren’t often considered.
Understanding patient goals and expectations
While a clinician’s goal is to achieve remission, a patient’s goal could be clinical or nonclinical and varies depending on their individual characteristics and demographics.
Patients from low-income countries such as Morocco expect access to primary care (never mind rheumatologists), support services and education about the disease. The high expenses related to rheumatoid arthritis (RA) in such countries result in poor treatment compliance, school absenteeism in children and deterioration in quality of life. Comparatively, even with excellent health insurance systems in the United States, one in six adults with RA reduce their medication use because of high out-of-pocket costs. Most patients expect cost-effective care. In wealthier countries like the United Kingdom, patients expect increased social connectedness and family support.
Elderly patients expect reduced pain, fatigue and side effects, whereas young adults expect independence and normalcy from their treatments. Women, who are most affected by RA, might expect a lesser impact on family life and childrearing.
If such multidimensional expectations are not met, patients tend to discontinue their treatment. As new biologics and non-biological complex drugs (NBCDs) are developed, patient adherence is essential in determining both therapeutic and potential adverse effects. Studies reveal that frustration towards the method of drug administration (like self-injection) also impacts adherence. In the U.S alone, the total cost of non-adherence is estimated between $100 billion and $289 billion annually.
Therefore, it is important for the patient and the physician to trust each other and have open discussions about treatment strategies and expectations to ensure better alignment and cooperation.
Measuring patient engagement
The first step towards patient engagement is awareness of their current engagement levels. The patient activation measure (PAM) tool is helpful here. PAM measures the attitude and knowledge of patients about the disease and treatments. Studies have proven that highly activated patients have better outcomes via increased medication adherence, resulting in lower healthcare costs through fewer ED visits, hospital admissions and re-admissions. By continuously monitoring activation levels, providers can measure sustained changes in patient behavior and personalize their care programs.
We can also measure engagement levels by taking advantage of data. Data derived from direct [electronic health records (EHR), claims] and indirect sources (wearables) provide a holistic view of an individual patient. Simple analytics applied to population data can predict patient behavior. For example, analytics can help providers know which patients are likely to miss their appointments, which patients will fill their prescriptions on time, and so on. Detailed patient-based data could also lead to better and more accurate diagnoses and treatments.
The 21st century has seen a massive change in the way people live their lives. It is now the digital era, and almost everything is online or made available in electronic form. There are now jobs online. Elections are now run in many countries so that people can submit votes electronically. Hotel bookings and other travel accommodations can be done online. Even bank transactions are done over the web.
One of the most consequential manual-to-digital revolutions is the US government’s drive to create electronic health records (EHRs) from the mountains of filed information for patients. The main aim is to make medical information available to all concerned parties whenever needed. The long term goal is making healthcare significantly more effective.
This policy direction delivered a jolt to the medical IT industry, inspiring hospitals all over the US to start looking for digitalization partners. It has also pushed clinics and hospitals to standardize their functions, especially those that relate to drug formulas.
Because of the scale and promise of these standardization efforts, health and pharmaceutical leaders and administrators are wondering how to best respond and take advantage of the EHR frenzy. Here are some of the ways that pharma companies can plan for the future…
Intensify efforts to get empirical support for product effectiveness.
The digitization of almost everything has bestowed on people the power of more effective insight. The mountains of data that is being digitized can be searched for trends, such as the effectiveness of one prescription over another. Informative resources that allow anyone to immediately refer to them for help in making crucial decisions regarding health are now on the horizon.
To make their products appealing to doctors and patients, pharmaceutical companies can focus on getting empirical support for their claims. They can conduct many forms of scientific analysis on the use and effectiveness of their drugs.
However, be careful not to interpret with the results just so they project only a positive image. Bear in mind that the main purpose of testing is to understand the actual mechanisms at play and eventually get ideas on how to improve. Tests should never be aimed at getting marketing support points, though those are going to be very welcome bonuses if that is what the study uncovers.
CarePort Health provides post-acute care management solutions for hospitals, payers, ACOs and post-acute providers to better manage patient care across the continuum.
Elevator pitch
CarePort Health bridges the data gap between acute and post-acute care to help improve patient outcomes.
Founders’ story
Lissy Hu
Since CEO and co-founder Dr. Lissy Hu immigrated from China to the U.S. at seven years old, Hu has been immersed in the healthcare landscape. Her mother worked as a home health aide helping vulnerable populations so, at an early age, Hu learned the compassion and hard work that went into helping patients. It was through her family’s influence that Hu decided to dedicate her career to helping underserved and vulnerable patient populations. After completing her pre-med at Columbia University, Hu did a healthcare fellowship where she worked with 3,000 high-cost Medicare patients in the Bronx. It was here that she was exposed to the gaps between acute and post-acute care – ultimately, there was no way to know how her patients were doing once they left the hospital setting. This black hole her patients were going into once discharged left Hu perplexed, but also motivated to do something about it. After her fellowship, Hu pursued a joint MD/MBA from Harvard. During that time, she developed the idea that is now CarePort, launching the company after winning a business plan competition in 2012. In 2016, CarePort Health was acquired by Allscripts, one of the largest EHR solutions providers. The company’s Boston-based team recently moved into a new, larger office space to accommodate its expanding team.
Marketing/promotion strategy
CarePort Health partners with hospitals, payers, accountable care organizations (ACOs) and post-acute providers to give access to its suite of solutions including CarePort Guide, CarePort Connect and CarePort Insight. The shift to value-based care has motivated healthcare organizations and their providers to have a heightened lens on patient health beyond the hospital, and CarePort is one solution that provides that level of visibility.
Market opportunity
CarePort’s customers are primarily hospitals, payers, ACOs and post-acute providers like skilled nursing facilities. One-in-five patients are admitted to post-acute care after being discharged from the hospital – nearly 8 million patients annually. With an aging population, this number is set to increase. Today, most patients that need post-acute care are handed a piece of paper by the nurse or physician that includes a list of names and addresses – no other context. Not only is this a confusing time for the patient, but also their families. Having to decide where they receive care next based off a list of names does not provide proper guidance into the type of care they will receive. By leveraging CarePort Health’s suite of solutions, providers and their patients can look deeper into the facilities being suggested and make a more informed clinical decision.
The CarePort platform consists of three tools to improve post-acute outcomes:
CarePort Guide: Simplifies post-acute provider selection to make it as informed and intuitive as booking a hotel.
CarePort Connect: Empowers providers across the continuum – hospitals, payers, ACOs, and post-acute providers – to coordinate care through real-time information sharing. Intuitive and web-based, CarePort Connect breaks down silos of patient information to connect previously disparate providers with shared patients through real-time, actionable data sharing.
CarePort Insight: Provides organizations with real-time analytical reports that are easily generated with multiple drill-down options and filters for provider, patient type and/or condition.
Care Management – A complete Acute Case Management, Discharge Planning and Utilization Review workflow tool with a built-in network of more than 20,000 providers.
Referral Management – An intake, referral management and discharge planning tool for post-acute care providers.
Who are your competitors?
CarePort Health has designed tools unique to the market and, therefore, does not have direct competitors. There are a few companies in the market that have similar tools. However, CarePort Health is the only company that utilizes rich data sets to provide a much more comprehensive look into post-acute care settings for each patient.
How does your company differentiate itself from the competition and what differentiates CarePort Health?
CarePort Health is the only company that has developed three unified tools to help providers and their patients make more informed decisions for post-acute care management. Patients are no longer making decisions based off a flat list of names and addresses. CarePort’s technology allows them to look at the full spectrum of the care being offered by each facility and how it can meet their healthcare needs.
By Zachary Blunt, manager of product management population health, Greenway Health
Zachary Blunt
Electronic health records (EHRs) were expected to revolutionize healthcare practices, making them more efficient, reducing costs and enabling them to provide more coordinated care.
But ask healthcare providers about the EHRs they’ve deployed, and the results are far from what was expected.
In fact, more than 60 percent of healthcare professionals rank their return on investment (ROI) for EHR systems as “terrible” or “poor,” according to a recent survey from Health Catalyst. Another study, published in the Journal of the American Medical Association, estimated the costs of billing and insurance-related activities using EHRs ranged from $20 for each primary care visit to $215 for inpatient surgery, totaling 3 percent to 25 percent of professional revenue.
So, why aren’t EHRs living up to the hype and delivering the promised investment? In many cases, it has to do with these systems not being used to their highest potential.
Here’s a look at five steps healthcare practices can take to address challenges resulting from EHR implementation and maximize their ROI.
Get Buy-In Across the Board — from IT to Finance to Front Office Staff
Adopting EHRs to manage clinical activities impacts many revenue cycle-related functions, such as patient registration, insurance eligibility, scheduling and the services/treatments a patient received during each clinical encounter. To achieve ROI, EHRs must be able to improve several operations of a practice and streamline the workflows of different departments. It’s best practice for all clinicians and staff to weigh in before installing new systems or technologies.
Provide Strong Leadership, Communication and Training
Changes in common practices during EHR implementation can result in significant resistance from users or a longer learning curve that hampers efficiency and adds to the cost of the system. To achieve results, healthcare leaders should clearly articulate the EHR implementation plan, prepare themselves for a transition period and develop a training protocol so all users understand their roles in using the system. In addition, users should have a solid background and understanding on how their roles factor into the overall success of the system and the practice at large.
Improve Staffing Efficiency While Improving Operating Margins
Labor costs can account for nearly half of a healthcare provider’s operating costs. But providers often fail to take a strategic look at how adjusting staffing can improve the bottom line. Often, providers use historical averages to determine staffing levels at their practices, resulting in an outlay of overtime pay outside the planned budget when unexpected staffing demands occur. Data from EHR solutions, as well as enterprise resource planning (ERP) sources, can be analyzed to gain a better understanding of historical staffing trends. Accenture estimates that by getting insights from EHR and ERP data, U.S. healthcare providers could save more than $77 billion over the next five years by reducing overtime and overall labor costs.
With the increasingly “on the go” nature of technology and communication, information is accessible from the palm of a user’s hand in the form of mobile devices. Subsequently, the success of modern EHR software lies in the moment accessibility on mobile devices like smartphones and tablets.
The addition of mobile functionality for EHR systems is driving the adoption of electronic health record systems and software in the industry and contributing to meaningful use for patients and physicians alike. Patients benefit from doctors and staff who can make informed decisions by easily accessing their medical records from an easy-to-use mobile interface. Mobile EHRs allow practice staff and physicians to access valuable and crucial patient records, while increasing communication between healthcare facilities in a more efficient, secure manner.
This is incredibly useful in critical care or emergency situations; allowing physicians and other care staff to quickly, securely and accurately view patient information on the fly is a major advantage when emergency surgery or care has to be administered. With the continued scourge of the opioid epidemic requiring investments in patient and physician safety and with continued staffing shortages in the industry leading to further implementation of AI and technology based solutions, mobile EHR will be a critical tool in a healthcare staff’s arsenal, allowing the relaying and accessing of accurate information in a constantly evolving environment.
In addition, the internet, office tools and desktop computers are no longer necessary for effective documentation; mobile EHR allows offline record populating whenever and wherever it’s necessary, increasing the accuracy and timeliness of documentation. By allowing physicians and staff to accurately and conveniently exchange documentation and patient records through a secure, mobile platform, informed decisions can be made 24/7. This drives meaningful use by improving quality, safety, efficiency and care coordination for public health.
By utilizing EHR on mobile platforms, staff and physicians can increase their efficacy and accuracy when updating documentation or accessing patient files. By creating a friendly, innovative platform to access crucial information, EHR software that features mobile functionality is a necessity in modern EHR applications. It will continue to drive meaningful use and accessibility in the healthcare industry going forward as evidenced by the infographic featured below.
Greenlight Guru is the only quality management software designed specifically for the medical device industry.
Elevator pitch
Get to market faster with less risk and achieve true quality.
Founders’ story
Jon Speer
The seeds for Greenlight Guru were planted back in 2006 by Jon Speer, a medical device engineer turned consultant as a result of a simple observation: paper-based quality management systems are painful, risky & wildly inefficient. Commercial quality management software solutions have been available for over 20 years now, yet only about 30 percent of medical device companies that should be using them were. This observation and question led Jon Speer to team up with David DeRam to create the vision for a beautifully simple quality management software.
Marketing/promotion strategy
Greenlight Guru partners with trade publications and frequently hosts webinars to help medical device startup founders plot a clear course through the complicated regulatory environment.
Market opportunity
Quality management solutions existed, or could be engineered to work, for nearly every industry. Because of to the complicated nature of medical device regulatory compliance in the United States, Canada and the European Union one of two things was happening: 1. Systems not meant for medical devices were being rigged to work or, 2. An unorganized, not easily searched paper-based QMS was developed.
Greenlight Guru was developed to help medical device manufacturers manage documents, manage risk, perform quality management and log and address customer complaints in an easy to use cloud-based platform.
Who are your competitors?
Greenlight Guru is the only QMS system built specifically for the medical device industry. Non-industry specific QMS systems exist; however, they often have to be heavily modified to handle even the most mundane tasks in the medical device industry. As a result, Greenlight Guru helps device manufacturers spend more time on their product, and less time on paperwork.
How your company differentiates itself from the competition and what differentiates Greenlight Guru?
Greenlight Guru consists of three systems meant to help device manufacturers “GO” to market, “GROW” in the market, and “GURU” to provide regulatory expertise to device makers. This three pronged approach helps manufacturers through the full life-cycle of the product.
Business model
Greenlight Guru has a B2B business model with systems mean to help device makers “GO” to market, “GROW” in the market and “GURUs” to help stay in the market.
Current needs
Greenlight Guru is always looking for talented individuals with a willingness to work hard and improve the quality of life for our users.
Considering how far we come through technology, it’s taking massive strides in regards to managing health and creating new solutions to major health issues. Cancer is still one major topic that is always up in the air in regards to benefits it can gain from technology. There have been many ideas and solutions which have continued to grow. With such a big impact that it’s there are many ways in which digital technology can be used to contribute to the issue of cancer.
Social Media
The growth of social media appears to have benefited many sectors in more ways than one and the same goes for the healthcare sector. With accessibility that everyone has to social media it allows for millions to connect and interact with each other, meaning online support groups gather communities to discuss and access information that everyone involved can relate to. Patients can be directed for support and it’s all extremely convenient. Twitter’s TweetChat facility makes creating groups easy and accessible.
Mobile Apps
The rise of wearables and mobile health apps have increased in popularity enormously with connected care benefiting most from such technologies. With connected care patients and providers can interact with one another, monitoring patient health remotely in real-time. There are also secure email communications available for patients and their careers. It creates great convenience for both parties and keeps everyone well informed with up to date information. Some impressive connected care mobile apps are already available and the progress made in mobile app development is sure to continue with endless possibilities.
Targeted Therapies
The role of genomics has played a major role how scientists and medical professionals have been able to make treatment for cancer more specialized and specific. Because of the complexity of cancer cells, it’s required further in-depth research to understand how these can be targeted better and the development of genomics has made this possible. It enables newer drugs to be created that can help with tackling the different cancer mutations and genetic changes. Further research continues in this space the progress that’s been made, gaining further knowledge and success through technologies like genomics.
Clinical Trials
Digital technology continues to be a valuable asset in the clinic trials space. They’re becoming increasingly costly but the availability of digital technologies means patient reported outcomes can be easily monitored and reported. Being able to gather up to date information to do with side effects, unexpected reactions and outcomes of the trials will make them more reliable. Through digital technologies the mass amounts of people that are able to be recruited will also make it less costly and safer in the long run.
The 21st century has seen a massive change in the way people live their lives. It is now the digital era, and almost everything is online or made available in electronic form. There are now jobs online. Elections are now run in many countries so that people can submit votes electronically. Hotel bookings and other travel accommodations can be done online. Even bank transactions are done over the web.
