If you’ve ever watched a person go through the first stages of coping with type 2 diabetes – and with the disease at epidemic levels, many of us have a close friend or relative with the disease – you’ve seen them struggle to put into practice all the information, advice and strategies they are given.
This is true of most people with newly diagnosed chronic diseases, not just diabetes. To avoid complications, and the huge costs in both suffering and money that come with them, they have to learn a new way of living. Medication and other treatments can’t take the place of lifestyle changes. And despite their best efforts, many people are defeated by the challenge.
We now spend 70 percent of our healthcare dollars on chronic disease care, much of it to treat complications that lifestyle changes could avert. All that money isn’t really helping. People continue to suffer and to lose years of productive life. If we could find a way to help these people improve their health, we could dramatically reduce both suffering and costs.
Chronic disease patients need tech support
One thing we’ve learned here at Dell is that in helping hospitals implement an electronic health record (EMR), at-the-elbow tech support makes a big difference. And learning to use a new EMR has many of the same challenges as learning to live with diabetes.
To go live with a new EMR, doctors and nurses have to learn a new way of working. It’s more than just a software change. It’s changing everyday habits that have kept the operation running for years. That’s why it is crucial to have someone to guide the caregivers through the first days and weeks. The right support lowers users’ frustration, increases their confidence and makes the difference between a quick, smooth transition and a drawn-out, rocky transition.
That kind of tech support could also help patients with diabetes and other chronic diseases learn a new set of habits. For diabetics, even a simple thing like breakfast can be a challenge. If you can’t pick up your usual donut, what’s the alternative? Friendships can be harder. “No, sorry, I can’t go to happy hour for chips and a margarita,” isn’t what your friends want to hear. Add in blood sugar checks, medication and a new exercise routine, and it can be overwhelming. None of it is fun, and all of it distances you from friends and daily comforts.
Diabetes education classes can help, just as training classes for doctors and nurses can help them learn a new EMR. But patients also need the same at-the-elbow tech support for their new life that caregivers need for their new EMR. They need a knowledgeable, friendly healthcare tech support agent who can suggest a happy hour walk with your friends or what to drink instead of a sugar-loaded margarita. Or tell you about a healthy breakfast sandwich that is right on your way to work. Or how to tell your mom that you won’t be eating her famous pancakes at Sunday brunch. Someone to boost your confidence and make you feel like you can succeed at this new life.
New technology makes at-the-elbow support possible for patients
Sadly, most of patients are pretty much on their own. The result is confusion, loss of confidence and a sense that it is all just too hard. And that means expensive complications and more suffering.
The good news is that new telehealth technology can bring at-the-elbow support to patients at home, at a price that is affordable. While support can’t be literally at a patient’s elbow, secure video conferencing can give patients access to doctors, nurses and health coaches who can answer questions, give advice on medications, food, exercise and how to lose the unhealthy foods without losing the relationships that are tied to them. And most patients already have the technology needed – a smartphone, tablet or computer.
GenoSpace has built a comprehensive platform for genomic and other biomedical data. Its serves research, clinical development, pathology and clinical care customers who work with high-dimensional genomic and other biomedical data.
Elevator pitch
At GenoSpace, we are digital architects of genomic medicine. GenoSpace has built a comprehensive platform for precision medicine to enable interpretation, analysis, reporting and collaboration on high-dimensional genomic and other biomedical data. With specific applications supporting research, development, pathology and clinical care, many of the most advanced precision medicine organizations are powered by GenoSpace.
Product/service description
GenoSpace has built a comprehensive software platform for genomic medicine. The company leverages a single storage and security platform to deliver a variety of applications and services including reporting, population analytics, clinical trial matching, interactive physician and patient portals, and patient communities. GenoSpace specializes in data integration, modeling, analysis, interpretation, visualization and collaboration. GenoSpace applications serve users at laboratories, health systems, and organizations engaged in research and clinical development, as well as patients.
Founders’ story
John Quackenbush
GenoSpace was founded by John Quackenbush and Mick Correll in 2012 after they realized existing platforms for analyzing genomic information could be greatly improved. John is board chair and Mick is chief executive officer.
John received his PhD in theoretical physics from UCLA in 1990. Following a physics postdoc, he was awarded a 1992 NIH Special Emphasis Research Career Award to work on the Human Genome Project. After two years at the Salk Institute and two years at Stanford University, he moved to The Institute for Genomic Research, pioneering gene expression analysis. He joined the Dana-Farber Cancer Institute and Harvard School of Public Health in 2005 and works on reconstruction of gene networks that drive the development of disease. He received a 2013 White House Open Science Champion of Change award for his work on facilitating genomic data access.
Mick Correll
Mick’s more than 15-year career has tracked the path of genomics from basic research to clinical care. Over this time he has held leadership positions in academia and industry, and has developed informatics solutions for pharma/biotech R&D, ag-bio, and academic, government and community healthcare providers. Prior to launching GenoSpace, he and partner John Quackenbush established the Center for Cancer Computational Biology at the Dana-Farber Cancer Institute. Mick began his career at Lion Bioscience Research Inc. and UK-based informatics provider InforSense. Mick earned a BS in Computer Science and BA in Molecular Biology from the University of Colorado at Boulder.
Market opportunity (in your particular space–numbers, competitors, etc. are helpful)
The market for interpreting and analyzing molecular and other biomedical data is a multi-billion dollar component of the broader molecular diagnostics and applicable life science research markets—each of which represent tens of billions of dollars per year. GenoSpace’s target customers are innovators in lab medicine, hospitals and health systems, and research and clinical development organizations. While there are several competitors for individual offerings provided by GenoSpace, the company is unmatched in its cloud-based architecture, comprehensive suite of offerings and experience delivering those offerings to real customers.
Guest post by Ken Perez, vice president of healthcare policy, Omnicell.
Since the passage of the Patient Protection and Affordable Care Act, most of the health reform activity in the Medicaid arena has primarily been about expansion of coverage. According to the Centers for Medicare and Medicaid Services (CMS), as of February 2015, 70.5 million people—more than one in every five Americans—were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP), which represents an increase of almost 40 percent from the number enrolled at the end of 2009.
However, on May 26, CMS aimed its sights on improving the quality of care delivered by Medicaid, issuing a 653-page proposed rule to “modernize the Medicaid managed care regulations,” which have not been revised in a decade. The proposed rule faces a public comment period that will continue thru July 27.
The changes presented in the proposed rule would align the regulations governing Medicaid managed care with those of other major sources of coverage, including Medicare Advantage (MA) plans and Qualified Health Plans (QHPs), which are offered thru health insurance exchanges (marketplaces). CMS has said that the proposed Medicaid measures will emphasize evaluating health outcomes and the patient experience enrollees have with private plans. In addition, the proposed rule mandates public reporting of information on quality of care, as well as the use of financial incentives to reward Medicaid managed care plans that meet quality measures, a la Medicare Advantage Star Ratings.
CMS’s announcement has been met with mostly favorable responses. “It was about time for the changes” has been a common refrain, with the revisions viewed as a natural, logical progression.
How big is the market that will be impacted by the changes? Per CMS, Medicaid managed care organizations (MCOs) have grown from handling 8 percent of Medicaid beneficiaries in 1992 to about 70 percent of the 70 million Medicaid enrollees today—almost 50 million people. That figure compares with 17.3 million MA enrollees as of January 2015.
Guest post by Chris Boone, CEO, Health Data Consortium.
Consumers are receiving more health data than ever, as evidenced by the myriad mobile apps (WeightWatchers, Mindshift, Nike+ Training Club, etc.) and wearables (FitBit, iWatch, Jawbone, etc.) now available. With health data so pervasive, health literacy has become a commonly discussed issue as it pertains to consumers’ ability to obtain and process healthcare information to make better healthcare decisions. But, with the advent of so much data, there must be a national emphasis on the importance of health data literacy, as well, to empower patients to leverage available data in a meaningful way that can improve their and their loved ones’ health outcomes.
The Health Data Literacy Landscape
There remain challenges to the health data movement – such as privacy concerns – and as a result, questions around how to improve health data literacy remain largely unexplored. The road to health data literacy starts with digital access to health information, and new technologies that seamlessly augment consumers’ daily health practices to enable better health decision-making. Interestingly enough, however, the rate at which health data entrepreneurs and innovators are producing incredible technologies may be exceeding the rate at which consumers are able to digest and use the information.
So, how do we leverage the opportunities provided by greater access to health data without overwhelming the consumer?
Data Visualization and the User Experience
Once data becomes accessible to consumers, data visualization is a key component to ensuring it is understandable and actionable. Consumers must be able to comprehend and digest data to put it to work.
In addition – and like in any other industry – the user experience must be a top priority when building new technologies. We need developers to build mobile apps, wearables, websites, etc. that are simple in design with an emphasis on providing useful and easily actionable data for consumers.
On May 28, HIMSS submitted comments to the Department of Health and Human Services on the meaningful use Stage 3 proposed rule and the 2015 Edition Health IT Certification Criteria. The two letters, sent to Acting CMS administrator, Andrew Slavitt, and National Coordinator for Health IT, Dr. Karen DeSalvo, respectively, strongly urge CMS and ONC to:
Decrease the prescriptive nature of the EHR Incentive program,
Increase focus on the substantial capabilities established earlier in the program, and
Reduce complexity in the 2015 Certification Criteria.
HIMSS voiced its continued support for the meaningful use program as a tool to positively transform health and healthcare in the United States. Identifying meaningful use as a “critical tool for enabling healthcare transformation,” the response cites HIMSS Analytics data – collected annually on all non-federal US hospitals, and more than 30,000 tethered US ambulatory facilities – that “70 percent of hospitals have made a positive progression in the advancement of their EHR capabilities over the last five years, with more than 60 percent of ambulatory facilities showing similar progress in the last three years.”
HIMSS reiterated its long-standing commitment to interoperability: “HIMSS is committed to a culture in which IT is fundamental to transforming healthcare; improving quality of care, enhancing the patient experience, containing cost, improving access to care, and optimizing effectiveness of public payment.”
HIMSS remains strongly committed to making the Electronic Health Record Incentive program less prescriptive and more focused on encouraging and assisting providers to take advantage of the substantial capabilities established in Meaningful Use Stages 1 and 2, including interoperability.
HIMSS applauds a proposal in the NPRM for a single definition of Meaningful Use starting in calendar year 2018, no matter when a provider began to participate in the EHR Incentive Program.
HIMSS supports the work being done by CMS to align the EHR Incentive Program with other CMS quality reporting programs that also use certified health IT. HIMSS believes such efforts will lessen the burden on providers.
HIMSS is committed to ensuring patient safety remains paramount to the development, implementation, and wide-spread use of health IT systems.
HIMSS reiterates its long-standing assertion that 18 months is the minimum length of time needed between the final rules on Meaningful Use, certification, and standards, and the start of any stage of Meaningful Use. An 18-month timeline allows stakeholders to help educate and prepare providers on the upcoming new stage. The current timeline for transitioning to Meaningful Use, Stage 3 in 2017 and 2018 does not include 18 months.
At Health Datapalooza, the acting Centers for Medicare & Medicaid Services (CMS) Administrator, Andy Slavitt, announced a new policy that for the first time will allow innovators and entrepreneurs to access CMS data, such as Medicare claims. As part of the Administration’s commitment to use of data and information to drive transformation of the healthcare delivery system, CMS will allow innovators and entrepreneurs to conduct approved research that will ultimately improve care and provide better tools that should benefit healthcare consumers through a greater understanding of what the data says works best in health care. The data will not allow the patient’s identity to be determined, but will provide the identity of the providers of care.
CMS will begin accepting innovator research requests in September 2015.
“Data is the essential ingredient to building a better, smarter, healthier system. The announcement is aimed directly at shaking up health care innovation and setting a new standard for data transparency,” said acting CMS Administrator Andy Slavitt. “We expect a stream of new tools for beneficiaries and care providers that improve care and personalize decision-making.”
Innovators and entrepreneurs will access data via the CMS Virtual Research Data Center (VRDC), which provides access to granular CMS program data, including Medicare fee-for-service claims data, in an efficient and cost effective manner. Researchers working in the CMS VRDC have direct access to approved privacy-protected data files and are able to conduct their analysis within a secure CMS environment.
“Historically, CMS has prohibited researchers from accessing detailed CMS data if they intended to use it to develop products or tools to sell,” said Niall Brennan, CMS chief data officer and director of the Office of Enterprise and Data Analytics. “However, as the delivery system transforms from rewarding volume to value, data will play a key role. We hope that this new policy will lead to additional innovation and insights from the CMS data.”
Guest post by Donald M. Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University; and Thanh Tran, CEO, Zoeticx, Inc.
The ECRI Institute released in May a survey outlining the top 10 safety concerns for healthcare organizations in 2015. The second highest concern is incorrect or missing data in EHRs and other health IT systems.
HIEs? The latest Black Book survey in the U.S. finds that 90 percent of hospitals and 94 percent of independent physicians don’t trust the business model of public HIEs and have concerns over how much of the cost payers will be fronting, causing a contraction in the HIE market. Even the ONC and medical industry are at odds on how to address the interoperability issue. The ONC does not even mention middleware in any of its plans.
Even HL7 does not provide the seamless connection of middleware and is only capable of connecting one medical facility to another, requiring specific end point interfaces to even do that. For every additional facility, a customized interface must be built. At the end of the day, HL7 is really a point-to-point customized interface requiring extra steps. A middleware platform does not tie developers to specific hospitals or EMRs and allows universal access.
Meanwhile, yet another survey cites the tragedy of a lack of interoperability. A new survey of nurses nationwide, taken by the Gary and Mary West Health Institute, find that some 60 percent of registered nurses say medical errors could significantly decrease if hospital medical devices were coordinated and interoperable. Also, 74 percent of these nurses agreed that it is burdensome to coordinate the data collected by medical devices and 93 percent agreed that medical devices should be able to seamlessly share data with one another automatically.
Half of them claim they actually witness medical mistakes because of lack of interoperability of these devices. Some 46 percent of RN respondents also noted that when it comes to manual transcription from one device to another, an error is “extremely” or “very likely to occur.”
From a cost perspective, West Health Institute officials estimate that a connected, fully interoperable health system could save a potential $30 billion each year by reducing transcription errors, manual data entry and redundant tests. Meanwhile physicians and surgeons struggle with interoperability on a daily basis.
According to data published on HealthIT.gov, 173 health IT vendors are supplying certified EHR products to more than 4,500 hospitals. Despite wide penetration of EHR’s in hospitals, clinics and physician offices, access to patient information between systems continues to plaque our healthcare system.
Mobile health technologies have been on the rise for quite some time, with the number of health and fitness apps doubling over the last two years, these tools are becoming a part of our daily lives. Health apps can do everything from monitoring sleep patterns to diagnosing diseases, while other evolving technologies are paving the way for a seamless patient care experience via online patient records. An expansive infographic by the Adelphi Healthcare Informatics Master’s Degree program that follows details these important technologies.
In the beginnings of 2014, almost 50 million Americans were using health and fitness apps to monitor their behaviors. Among their most important reasons for doing so are keeping track of personal goals, staying on top of health issues, and gaining motivation. The ability to track and improve eating and exercise habits has only scratched the surface; as more and more people hop on board, the technologies will continue to get better and better.
Beyond the health and wellness applications of mobile health technologies are the value of mobile diagnoses. There are mobile technologies for diagnosing issues with the eyes, for diagnosing malaria and thyroid conditions and screening for oral lesions. These and other technologies have a wide range of applications and will only become more useful as remote areas and countries gain more access to them.
Reviewing test results online, scheduling appointments and requesting medication refills are just some of the capabilities that come along with the evolution of online patient records. Being able to interact with records and doctors in real time from miles away has the potential to revolutionize the way that the healthcare industry functions. Not only does this improve communication, but it also saves time and removes barriers that can crop up along a patient’s medical journey.
The possibilities for keeping track of health and wellness, improving the ability to make diagnoses around the world, and accessing patient records from anywhere are what make mobile health technologies exciting.
At Health Datapalooza, the acting Centers for Medicare & Medicaid Services (CMS) Administrator, Andy Slavitt, announced a new policy that for the first time will allow innovators and entrepreneurs to access CMS data, such as Medicare claims. As part of the Administration’s commitment to use of data and information to drive transformation of the healthcare delivery system, CMS will allow innovators and entrepreneurs to conduct approved research that will ultimately improve care and provide better tools that should benefit healthcare consumers through a greater understanding of what the data says works best in health care. The data will not allow the patient’s identity to be determined, but will provide the identity of the providers of care.