Tag: value-based care

Health IT Industry Outlook Survey Reveals Six Key Leadership Trends for 2019

In the seventh annual Health IT Industry Outlook Survey conducted by Stoltenberg Consulting Inc., 42 percent of health IT leaders rate updating technology to improve the patient experience as the top objective for 2019, followed by measuring improvement in patient care (33 percent).

Coinciding with this pivotal focus on empowering the patient care journey, 45 percent of respondents identify value-based care as the most significant, pressing topic in healthcare this year, followed by artificial intelligence (26 percent) and cybersecurity (20 percent). Meanwhile, leveraging meaningful patient data (32 percent) serves as the largest overall hurdle for health IT teams in 2019, followed closely by ineffective IT or EHR operations (29 percent).

In the push to gain true value in value-based care initiatives, lack of system interoperability stands as the biggest operational burden for healthcare organizations (54 percent), followed by rising overhead and staff costs (17 percent), financial reimbursements (15 percent) and EHR burnout or reporting burden (14 percent).

Dan O’Connor

“Thanks to the continuing industry push for healthcare interoperability, significant progress is starting to come to fruition,” said Dan O’Connor, vice president of client relations at Stoltenberg Consulting. “We’re now seeing a clearer picture of how different players across the care spectrum will be held accountable to drive more transparent, engaged patient care journeys, which in turn will help healthcare providers meet their organizational goals.”

Other key survey findings indicate that despite nearly universal initial adoption across the country, EHR and application implementation support (34 percent) remains the top 2019 IT outsourcing request, followed by optimization work (27 percent), legacy system support (22 percent) and help desk support (17 percent). Yet, with current IT training offered, 63 percent of respondents say they feel “unprepared” or “very unprepared” to manage and execute effective IT operations within their healthcare facilities.

Stoltenberg conducted the survey at the 2019 Health Information and Management Systems Society (HIMSS) annual conference in Orlando. More than 300 survey participants represented a comprehensive spectrum of provider facilities, including health systems, standalone hospitals, physician practices and other ambulatory care facilities. Clinical IT professionals led survey participation (38 percent), while executive/C-suite leaders followed closely behind (36 percent).

For a complete look at the 2019 survey results and analysis, visit www.stoltenberg.com.

Impact of Value-Based Care On How Community Oncologists Think About Treatment Choices

New data on the state of value-based care in oncology has found that while community oncologists are optimistic about the beneficial potential of value-based care, they see a conflict between the need to decrease episode costs and the rising prices of the most innovative novel therapies.

In an effort to dig deeper into current attitudes toward new value-based reimbursement models and novel therapies in cancer care, Integra Connect surveyed leaders and decision-makers in oncology practices. Respondents represented practices with approximately 530 community oncologists, all of whom are participating in value-based care programs.

The survey results yield useful insights into how oncologists are dealing with rising drug costs in the era of value-based care, which makes practices financially accountable for improving the quality of patient care while also lowering the overall costs of cancer episodes. As drug prices continue to increase to new levels, driven in part by groundbreaking therapies, respondents indicated that it is becoming increasingly difficult to keep costs below value-based care program targets.

Other key themes surfaced by the survey include: expectations for the future of value-based cancer care; how drug costs are affecting treatment behaviors; what oncologists need from pharmaceutical manufacturers; the influence and effect of care pathways; and the value of and vision for precision medicine.

The number one challenge for making value-based care work: Rising drug costs

When asked about the number one challenge for making value-based care succeed in oncology, the majority of respondents (57 percent) cited managing the rising cost of drugs, including promising but expensive novel therapies. Beyond the context of value-based care, 93 percent of oncologists describe increasing drug costs as a priority issue impacting the overall well-being of their practices.

Value-based care is driving changes in cancer treatment choices

With oncologists increasingly accountable for the cost of entire episodes of care, a full 87 percent of survey respondents said that value-based care is causing them to think differently about drug choices, compared to their approaches during the fee-for-service era. When it comes to the choice of drug for an individual patient’s treatment regimen, oncologists assert that they remain as committed as ever to delivering the best clinical outcomes, regardless of impact on episode cost.

Nonetheless, more than three-quarters of oncologists indicated that they are making changes to how they and their practices choose treatment regimens under value-based care programs. A sizeable group (38 percent) says that it may change drug choices and opt for lower-cost therapies, but only when efficacy and toxicity remain the same. An equal percentage of oncologists voiced a desire to develop a deeper understanding of drug value, not just cost, that helps them understand the patient impact of therapies on an individualized level.

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Keep Your Eye On 4 Trends Revealed At HIMSS19

By Sheri Stoltenberg, CEO, Stoltenberg Consulting.

Sheri Stolenberg

The 2019 HIMSS Annual Conference may be over, but that doesn’t mean an end to the pressing challenges and trends discussed at Orlando’s Orange County Convention Center. More than 42,500 people attended the conference — the majority of whom were C-suite executives and HIT professionals taking full advantage of the healthcare IT industry’s largest opportunity for networking, product promotions, continuing education and major announcements.

As always, there were a few subjects during HIMSS19 that generated significant buzz. Here are four of those trends that will remain key topics throughout the next year:

Healthcare data exchange

The release of two long-anticipated proposed rules on information blocking came just as HIMSS19 convened. The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) unveiled proposals that would require healthcare providers and plans to implement open data sharing technologies to support transitions of care. The first focuses on standardized application programming interfaces (APIs) and carries forward provisions from the 21st Century Cures Act.

Those associated with Medicaid, the Children’s Health Insurance Program (CHIP), Medicare Advantage and Qualified Health Plans in the federally-facilitated exchanges would have to provide patients with immediate electronic access to medical claims and other health information by 2020. Under a latter proposal, health information exchanges (HIEs), health IT developers and health information networks (HINs) can be penalized up to $1 million per information blocking violation, but providers are not subject to fines.

The goal of the proposals is to consider care across the entire continuum, giving patients greater control and understanding of their health journeys. This is interesting, given that HIMSS attendees who responded to Stoltenberg Consulting’s seventh annual HIT Industry Outlook Survey noted “lack of system interoperability” as one of their biggest operational burdens, and “leveraging meaningful patient data” as the IT team’s most significant hurdle this year. Thus, overcoming these challenges to meet the newly proposed mandates will likely dominate discussions during the remainder of 2019.

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Interoperability: The Key To Enhanced Care and Becoming A Preferred Provider

By B.J. Boyle, vice president of product management, PointClickCare.

B.J. Boyle
B.J. Boyle

Interoperability, as it was envisioned, should be built on transparency and connectivity, allowing a patient’s critical health information to be easily accessible, regardless of where treatment is being administered. By creating an infrastructure that supports the sharing of patient data along the care continuum, hospitals, skilled nursing facilities (SNF) and long-term post-acute care (LTPAC) facilities can offer the best care possible. As a result, organizations that participate in interoperability best practices are positioned to become preferred providers.

Unfortunately, interoperability is still a work in progress for many organizations. While more than 95 percent of hospitals and 90 percent of office-based physicians are now utilizing electronic health record (EHR) platforms, many struggle with — or have reservations around — sharing information outside of their facility. As such, silos represent a great barrier to realizing a fully implemented state of interoperability.

The current data gap can drastically impact care. For example, a patient experiences a serious medical incident — such as a fall or stroke — and arrives at the hospital where staff may not have access to existing patient data which could inform the best delivery of care. Or perhaps they’re able to access that data, but not right away. Care is now delayed, which can be additionally concerning depending on the time-sensitivity of the patient’s condition.

Taking this example a step further, let’s explore what happens after care at the hospital has concluded. The patient requires rehabilitation, and a continuation of care document (CCD) is issued to a post-acute care facility. From there, the patient’s information is transferred by less-than-foolproof methods such as fax, for example. A glitch as simple as a jammed paper feed could prevent critical information from reaching the appropriate caregiver.

As value-based care and payment-care models are moving toward the forefront, blind handoffs of patient information are no longer viable, as they drastically increase the financial risks hospitals and payer groups are subject to — not to mention the clear detriment the system has on delivery of care.

Closing the gap

The larger question is how does the industry get from Point A to Point B? The easy answer is to liberate the data through a cloud-based infrastructure that supports an efficient, easy-to-access data exchange between all caregivers. An integrated solution would connect stakeholders across the care continuum, providing accurate insights when needed, eliminating data silos between care partners, and enabling more confident decision-making.

These systems would promote:

Overcoming concerns

The concept of interoperability, in some ways, seems contradictory to traditional best practices. Healthcare organizations are charged with protecting patient data at all costs, and the idea of sharing data in a way that opens access to a wider group of stakeholders could give pause. Regulatory infractions for data loss in the healthcare industry can be steep, and the number of well-publicized data breaches in recent years reinforces how valuable health records are to both the organizations who keep them and those who try to steal them.

So, it should go without saying that an EHR “superhighway” must be developed with security in its DNA, taking stringent regulatory requirements into account. The good news is that the newest breed of information exchange platforms is being built with security roles in mind, drastically reducing the possibility of data loss.

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In Need of Repair: Not-for-Profit Hospitals’ Finances

By Ken Perez, VP of healthcare policy, Omnicell, Inc.

Ken Perez
Ken Perez

Decreasing inpatient admission volumes, shifts in the re-imbursement mix from higher-margin commercial payers to lower-margin public payers, and pressures resulting from value-based care have been solid trends during the past several years. Thus, it was not surprising that a Moody’s Investors Service report released in August portrayed the current condition of finances for not-for-profit hospitals as troubling.

According to Moody’s, the median annual expense growth rate slowed from 7.1 percent in 2016 to 5.7 percent in 2017 because of hospitals’ continued control of labor and supply costs. But annual revenue growth fell faster, from 6.1 percent in 2016 to 4.6 percent in 2017, the second straight year that expense growth exceeded revenue growth, a trend that is expected to continue through 2019. Moody’s concluded that not-for-profit hospitals are on an “unsustainable path.”

Consequently, median operating margins dropped to an all-time low of 1.6 percent in 2017. More than 28 percent of hospitals posted operating losses last year, up from 16.5 percent in 2016. Of course, operating losses cannot be sustained forever. If they are sustained for multiple years, closure of the hospital frequently results. Earlier this year, Morgan Stanley concluded that 18 percent of U.S. hospitals are at risk of closure or are weak financially, with approximately 8 percent of hospitals (roughly 450 facilities) presently at risk of closing. To put that figure in perspective, during the past five years, only 2.5 percent (150 hospitals) have closed. Also, Morgan Stanley found that 10 percent of hospitals suffer from weak finances.

Various factors account for not-for-profit hospitals’ financial difficulties.

Because the vast majority of net patient revenue came from fee-for-service based payment models—such as DRG payment, fee schedule, percentage of the chargemaster, or list price—overall reduced payment rates adversely impacted revenue in 2017. To be clear, nominal payment rates did not decline—e.g., Medicare’s Inpatient Prospective Payment System and Outpatient Prospective Payment System both incorporated nominal year-to-year increases in 2017—but the revenue mix for hospitals did shift from higher-margin commercial payers to lower-margin public payers. Median Medicare and Medicaid payments as a percentage of gross revenue rose to 45.6 percent and 15.5 percent, respectively, in 2017. Furthermore, continuing a five-year trend, public payers’ share of hospital revenue is projected to increase for the foreseeable future, as more of the baby boomers—an obviously large demographic group—reach retirement age and an increasing number of them incur the sizable costs of the last year of life.

In addition, hospital finances were adversely impacted by the continued shift from inpatient to outpatient care, a trend driven by greater competition from ambulatory facilities, such as physician offices and ambulatory surgery centers. Moody’s reported that median outpatient growth rates exceeded inpatient growth rates for the fifth straight year. In her July 25 address to the Commonwealth Club, Seema Verma, administrator of the Centers for Medicare & Medicaid Services, supported the inpatient-to-outpatient shift, stating that Medicare is seeking to avoid “downstream” expenses, such as emergency department (ED) visits and hospital admissions.

Faced with these financial challenges, not-for-profit hospitals have pursued a number of approaches.

Most commonly, they have tried to improve their management of labor and supply costs. However, this strategy—while certainly logical—may be reaching a point of diminishing returns. Lyndean Brick, president and CEO of the Advis Group, a healthcare consulting firm, has concluded: “This is no longer solely about expense reduction. If not-for-profits just focus on that, they will be out of business in the next few years” (Modern Healthcare, Aug. 29, 2018).

Another strategic response has been consolidation—in which small hospitals join a larger health system—to gain more leverage with payers, to accomplish greater economies of scale, to get access to lower-cost capital, and to enhance access to talent.

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Patient Engagement: The Catalyst to Care

By Poornima Venkatesan, senior consultant, Virtusa.

Poornima Venkatesan
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.

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The Health Data Life Cycle: 7 Key Stages To Success In Value-Based Care

By Richard A. Royer, chief executive officer, Primaris.

Richard Royer
Richard Royer

Back in the day – the late 1960s, when social norms and the face of America was rapidly changing – a familiar public service announcement began preceding the nightly news cast. “It’s 10 p.m. Do you know where your children are?”

Today, as the healthcare landscape changes rapidly with a seismic shift from the fee-for-service payment model to value-based care models, there’s a similar but new clarion call for quality healthcare: “It’s 2018. Do you know where your data is?”

Compliance with the increasingly complex alphabet soup of quality reporting and reimbursement rules – indeed, the fuel for the engine driving value-based car – is strongly dependent on data. The promising benefits of the age of digital health, from electronic health records (EHRs) to wearable technology and other bells and whistles, will occur only as the result of accurate, reliable, actionable data. Providers and healthcare systems that master the data and then use it to improve quality of care for better population health and at less cost will benefit from financial incentives. Those who do not connect their data to quality improvement will suffer the consequences.

As for the alphabet soup? For starters, we’re as familiar now with these acronyms as we are with our own birth dates: MACRA (the Medicare Access and CHIP Reauthorization Act of 2015), which created the QPP (Quality Payment Program), which birthed MIPS (Merit-based Incentive Payment System).

The colorful acronyms are deeply rooted in data. As a result, understanding the data life cycle of quality reporting for MACRA and MIPS, along with myriad registries, core measures, and others, is crucial for both compliance and optimal reimbursement. There is a lot at stake. For example, the Hospital Readmissions Reduction Program (HRRP) is an example of a program that has changed how hospitals manage their patients. For the 2017 fiscal year, around half of the hospitals in the United States were dinged with readmission penalties. Those penalties resulted in hospitals losing an estimated $528 million for fiscal year 2017.

The key to achieving new financial incentives (with red-ink consequences increasingly in play) is data that is reliable, accurate and actionable. Now, more than ever, it is crucial to understand the data life cycle and how it affects healthcare organizations. The list below varies slightly in order and emphasis compared with other data life cycle charts.

One additional stage, which is a combination of several, is secure, manage and maintain the data.

Find the data. Where is it located? Paper charts? Electronic health records (EHRs)? Claims systems? Revenue cycle systems? And how many different EHRs are used by providers — from radiology to labs to primary care or specialists’ offices to others providing care? This step is even more crucial now as providers locate the sources of data required for quality and other reporting.

Capture the data. Some data will be available electronically, some can be acquired electronically, but some will require manual abstraction. If a provider, health system or accountable care organization (ACO) outsources that important work, it is imperative that the abstraction partner understand how to get into each EHR or paper-recording system.

And there is structured and unstructured data. A structured item in the EHR like a check box or treatment/diagnosis code can be captured electronically, but a qualitative clinician note must be abstracted manually. A patient presenting with frequent headaches will have details noted on a chart that might be digitally extracted, but the clinician’s note, “Patient was tense because of job situation,” requires manual retrieval.

Normalize the data. Normalization ensures the data can be more than a number or a note but meaningful data that can form the basis for action. One simple example of normalizing data is reconciling formats of the data. For example, a reconciling a form that lists patients’ last names first with a chart that lists the patients’ first name first. Are we abstracting data for “Doe, John O.” or “John O. Doe?” Different EHR and other systems will have different ways of recording that information.

 Normalization ensures that information is used in the same way. The accuracy and reliability that results from normalization is of paramount importance. Normalization makes the information unambiguous.

Aggregate the data. This step is crucial for value-based care because it consolidates the data from individual patients to groups or pools of patients. For example, if there is a pool of 100,000 lives, we can list ages, diagnosis, tests, clinical protocols and outcomes for each patient. Aggregating the data is necessary before healthcare providers can analyze the overall impact and performance of the whole pool.

 If a healthcare organization has quality and cost responsibilities for a pool of patients, they must be able to closely identify the patients that will affect the patient pool’s risks. Aggregation and analyzing provides that opportunity.

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Health IT Leaders Taking Tentative Steps Toward Implementing AI

By Ben Flock, chief healthcare strategist, TEKsystems.

Ben Flock

As technology advances, so does the healthcare industry, with technological breakthroughs increasing the ability of healthcare professionals to serve their patients, record and transfer patient data and more efficiently complete other tasks necessary to keep the industry moving. IT services provider TEKsystems recently released the results of a survey that polled almost 200 healthcare IT leaders (e.g., IT directors, chief information officers, IT vice presidents and IT hiring managers) in late 2017/early 2018 on a range of key issues, including technology maturity, workforce planning, critical roles and the top trends shaping healthcare IT today.

The results revealed a shifting focus from IT leaders: healthcare is behind the curve on initiatives that have the potential to shape the industry going forward, including artificial intelligence (AI).

Business demand is driving both the interests of IT leaders and the prioritization of AI in healthcare.  Value-based care, regulatory mandates and the consumer push for precision/personalized care are driving the business prioritization of AI. These results indicate that while IT leaders know AI in healthcare is the future, they are currently taking a cautious approach to utilizing the technology. This is very likely rooted in security concerns, as there are federal, state and even local mandates dictating the protection and privacy of patient data.

Although cautious, healthcare organizations are actually proceeding on the AI front. As evidence, survey data shows a high percentage of healthcare organizations are in the implementation, evaluation or refining stage with respect to specific technology applications that leverage AI – digital health systems (75 percent) and telemedicine (51 percent). This pragmatic approach to AI will continue, and healthcare organizations will address this emerging industry imperative by providing IT resources, as well as enabling platform technologies and repeatable solutions capabilities in secure applications and solutions that leverage artificial intelligence.

To ensure IT employees are aware of the need to be cautious when implementing AI initiatives, organizations must ensure adequate onboarding and ongoing risk and compliance (R&C) training is provided. An annual “check the box,” activity, R&C training isn’t enough to help employees and third parties manage risk appropriately. The best strategy is to implement a risk-based approach by focusing on higher risk functional areas with direct access to consumers and/or protected health information (PHI), and creating targeted training. Simple education and awareness tactics can dramatically improve compliance when employees and third parties understand how to apply teachings to their area.

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Value-Based Care: What Happened, What’s Next

By Matthew Fusan, director of customer experience, SA Ignite.

Matthew Fusan
Matthew Fusan

Although the Quality Payment Program (QPP) has been in effect for a year, there continues to be a lot of change in the program as CMS continues to evolve. The new year creates an ideal time to reflect back on what changes we have experienced to date as well as look forward and examine what could happen in 2018 and beyond.

2017: A Year of Regulatory Confusion

As the QPP rolled out, confusion still reigned supreme at both the CMS and HHS levels:

2018: More Focus, More Models

While some programs are being cut/reduced, there is still pressure on CMS to accelerate new Advanced Alternative Payment Models (APMs) so they are exploring options during 2018.

While these models are all under consideration/in development, it will be interesting to see if the CMMI RFI will drive additional choice or will the changes proposed consume CMMI for 2018 and reduce the capacity to introduce new models. Either way, CMMI will look very different in 2018 and beyond.

2019: Change is Mandated

In 2019, critical components of MIPS are mandated, including:

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3 Skills Developers Need Today to Modernize Healthcare

Joanna Gorovoy, senior director product and solutions marketing, Axway.

Joanna Gorovoy
Joanna Gorovoy

To accelerate the shift toward value-based care – organizations across the healthcare ecosystem must find new ways to unlock value from an ever-expanding array of data sources to create data-rich digital services and experiences that improve patient engagement, enable delivery of more personalized healthcare services, and increase clinical collaboration and care coordination across the patient journey. Developers play a key role in accelerating innovation that will shape the future of healthcare and positively impact patient outcomes. But innovating at the speed of digital is challenging in an industry that has long been plagued by interoperability challenges, a prevalence of legacy, siloed systems and applications, and heightened data privacy and security requirements which hinder digital projects. As a result, there are a few key things developers should keep in mind when designing for today’s healthcare market.

You can’t spell interoperability without A-P-I

The frustrations associated with sharing information have burdened the healthcare industry’s digitization efforts for many years. With application programming interfaces (APIs) taking hold, however, data exchange is now easier to accomplish. APIs are revolutionizing data sharing by making it possible to bridge legacy IT systems of record, such as electronic heath records (EHRs), with modern systems of digital engagement, such as mobile apps. Healthcare developers must take an API-first approach and will need to gain knowledge of the latest healthcare interoperability standards – such as FHIR. FHIR (Fast Healthcare Interoperability Resources) is an HL7 standard that simplifies the exchange of healthcare information and promotes the use of APIs to support light-weight integration, facilitating secure data access and interoperability. As healthcare developers increasingly leverage APIs to move beyond some of the challenges associated with secure data sharing and opening up proprietary EHR systems, this will result in faster time to market for innovative digital services and experiences.

Create a sound security strategy

Security must always be top of mind for healthcare developers. Before writing a single line of code, healthcare developers should familiarize themselves with HIPAA regulations that protect all personal health data transactions and impose hefty penalties for violations. As developers design apps that leverage patient health data from a variety of sources, they need to take the time to understand how this law works and must be mindful of how to mitigate security concerns. Adopting a full lifecycle API management solution enables developers to secure and manage FHIR and other healthcare APIs in a unified way across projects and communities, ensure data security and streamline compliance and help reduce the data security burden by using built in, configurable audit trails and reporting.

Inviting external innovation

Healthcare organizations are increasingly looking to invite open innovation into their organizations as they struggle to keep pace with digital transformation. Organizations such as Kaiser Permanente, Johnson and Johnson and Stanford, for example, have hosted developer challenges and hackathons to stimulate innovation and bring in fresh perspectives from developers outside of their organization/industry to help tackle big problems such as healthcare access and affordability. As the industry struggles with IT modernization challenges, developers who have experience working across multiple industries can provide a fresh point of view and can contribute skills and approaches they have gained developing applications for other industries/use cases to provide value to healthcare.

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