This article is part of a series powered by HLTH and CHIME to highlight key insights and perspectives from leading executives speaking at ViVE.
This ViVE Conference Last week’s meeting in Miami Beach provided a useful roadmap for progress on interoperability, health equity and value-based care, as well as the work that remains to be done.
Micky Tripathi, national coordinator for health information technology at the U.S. Department of Health and Human Services, noted that the adoption of electronic medical records has changed dramatically over the past decade, largely due to the HITECH Act designed to incentivize hospitals to switch to electronic medical records. He noted that in 2010 about 10 percent of hospitals used EHRs, compared to 95 percent today.
His presence lays the groundwork for the next chapter of interoperability, as illustrated by the Trusted Exchange Framework and Common Agreement (TEFCA) and CommonWell’s drive to interconnect networks of suppliers, payers, labs and others and Carequality, to EHR-centric networks like Epic and Cerner, and public and private health information exchanges.
Digital health implementation matures, less futurism
ViVE provides an excellent stage for healthcare executives and their partners to discuss the consequences of the widespread adoption and expansion of virtual health and other forms of health technology in the past few years since the start of the Covid-19 pandemic influence. We have gone far beyond the point where these are merely abstract concepts or insights gained from a series of pilots limited to large academic medical centers. UnitedHealthcare and Providence’s are also broadly committed to health equity in many forms Working to improve health outcomes for pregnant women arrive RubiconMD’s efforts Addressing access to experts in underserved rural communities.
Digital Health Pilot: “Reject” Faster
Part of the goal of drug development is to find out early whether a drug is working. The sooner a drug is identified as a failure in a particular indication, the better it is for the company, from saving money to understanding what isn’t working and, if possible, why. Health systems appear to be on a similar path when evaluating the value of digital health tools. For pilot studies to be successful, they must have a baseline of expectations. Neal Patel, chief information officer at Vanderbilt University Medical Center, said during the ROI panel that he focused on “Scalability and Adoption: Did the Pilot Solve the Problem?” Nashville, where De Bilt University is located, is a relatively small ecosystem where people will tell you if you did well or badly.
Big Tech and Retail Health Continue to Raise Healthcare Ambitions
The Bloomberg Scoop Last week, Aaron Martin, the health system’s outspoken digital officer who played a leadership role in building the venture fund, will move back to Amazon in a stunning development that not only underscores the tech giant’s continued presence in healthcare expansion. But it also illustrates a trend showcased at ViVE — Amazon, CVS Health and Google are exerting influence as part of a push to transform healthcare.Before Martin, Amazon hired Providence head of innovation Sunita Mishra, MD, in 2020 as medical director of Amazon Care Medical, Amazon’s clinical delivery team [You can check out her interview with MedCity editor in chief Arundhati Parmar here]. The road between the big healthcare system and big tech companies like Google and Apple is getting older and looks set to continue as providers seek to improve the patient experience and user interface for tasks like scheduling appointments, checking in to appointments, etc. . Access patient data between appointments as medical and retail health companies seek/continue to deepen their healthcare knowledge base.
Expert and Value-Based Care: Incremental Progress
While primary care physicians are on the front lines of the transition to value-based care, specialty medicine is lagging behind in the shift away from fee-for-service, which, as one speaker observed, accounts for 90% of the cost of specialty care. “at the end Today, there must be incentives for specialists to move to value-based care,” He said.
In a panel discussion, a group of medtech companies shared some insights on how they are collaborating with experts and are tackling the challenge of reducing healthcare costs while improving patient outcomes.
Octave Biological Sciences focus on According to its website, it quantitatively measures subclinical disease activity in multiple sclerosis and detects relapse to identify suboptimal responses to current interventions by combining patient responses to routine health inquiries and imaging analyses.
Mike Edgeworth, Octave’s chief population health officer and neurologist, noted that many MS treatments are known as disease-modifying therapies (DMTs), which drive up the cost of MS. The cost per patient is approximately $5 million. Of the $80 billion spent on MS in 2019, 70% went to DMT.
“We know that in the treatment of MS, getting patients on the right medication quickly is our best way to prevent relapse. Half of people with MS will be disabled within 12 years [after diagnosis],” Edgeworth said. “Although pharmaceutical companies are developing some complex drugs to treat the disease, it can take 12-18 months for doctors to determine whether a drug will work for a patient. “
The company helps patients share feedback and self-assessments between appointments about disease symptoms and medication side effects, on a variety of sensitive issues that patients may be reluctant to share with their doctor in person, such as bladder dysfunction and sexual dysfunction. These are summarized in the report and shared with neurologists prior to their visit.
He points out that if neurologists have data insights, they can determine from the outset what the phenotype of a patient’s disease is — whether it’s a mild or severe case — and inform them early on whether the drug is working for the patient or needs to be replaced with another A – it may improve patient outcomes.
Cardiovascular direct care costs reached $320 billion in 2016. According to Dan Blumental, it is expected to more than double to $800 billion by 2023, Novocadia founder. His company is focused on developing a heart failure program that covers remote patient monitoring, algorithmic approaches to direct medical treatment, and shifting care away from high-cost settings like hospitals, which Blumenthal describes. Risk-taking entities, especially payers and primary care groups, have expressed interest.
Sema4, a spin-off from Mount Sinai Health System that went public through a SPAC, was led by CEO Eric Schand also participated in the discussion. It generates and aggregates patient-centric big data to provide insights into medical conditions and interventions that can help prevent or treat patients. The company combines genomic and clinical information and applies analytics to gain precision health insights. In its quarterly earnings highlights this week, Sema4 revealed that it had signed three new health system partnerships with North Shore University Health System, AdventHealth and Avera Health. The acquisition of GeneDx earlier this year will help it develop one of the largest data generation engines in clinical genomics.
Schadt said at ViVE that its platform can be used to conduct virtual clinical trials.
“youUltimately, that’s what drives data – testing and patient engagement. It’s a growth hacking engine that helps us get the right scale of data to build the best model. “
Trusted Exchange Framework and Mutual Agreement
new buzzwords
There are a lot of buzzwords to match the hype around some aspects of health tech, As Politico’s health tech reporter pointed out. While AI isn’t one of them in the discussions I’ve heard, “seamless integration” definitely is.
If TEFCA gains the traction the ONC hopes, the Qualified Health Information Network, or QHIN, will enter more conversations this year. QHIN agrees to a trusted exchange framework and governance framework principles supported by a mutual agreement. In return, QHINs receive technical certificates that allow them to communicate with each other and access a directory of endpoints. Carequality is managing the QHIN application and onboarding process. Health Gorilla is positioned as the first QHIN.
Challenges that remain
Despite all the hurdles in improving data sharing and data availability, there is still a huge amount of unstructured patient data that cannot be shared productively outside any clinical setting.
Accurately matching patient records across organizational boundaries is another challenge.In an interview prior to her appearance on ViVE, Project Sequoia CEO Mariann Yeager shared some of the inherent challenges in making it happen.
“It’s one of the core competencies that you really need, whether it’s for treatment or research, or if you need information, you have to make sure that the patient records the provider is requesting the information from are the exact same people that were in your system before you released it .. so these are fairly common issues. It’s on our radar. We did a White papers from a few years ago. This is one of those chronic problems.
“We talk a lot about unique health IDs that have always been the focus. If you have secondary identifiers, like social security numbers or other membership IDs, you can get up to 99.9% of the metrics. And then there are other ways. We improved the identity transaction definition, and maintain consistency to raise standards.”
