The Combined Forces of VRI and Higi Power Modivcare’s Monitoring Platform

Modivcare is a provider of innovative community and home monitoring solutions that leverage devices, digital tools, non-clinical, and clinical resources to efficiently and effectively engage populations in their care. The platform brings together two leaders in the monitoring space, combining the unique assets of each to create one powerful platform. VRI offers personal emergency response systems (PERS), vitals monitoring, and data-driven patient engagement solutions. While Higi brings forward its community network of Smart Health Stations and its telehealth-enabled Health Station model, digital engagement tools, and a national clinical network that powers its clinician-led home monitoring solution. This integrative solution suite offers a risk-appropriate service that evolves with the member over time to meet each member’s health and social related needs.

The combination of these two assets provides a glimpse into the company’s transformative vision and commitment to delivering meaningful engagement, data-driven insights, and compassionate care.

With proven outcomes aligned to member satisfaction, gap closure, and reduction in total cost of care, Modivcare’s monitoring platform proactively removes barriers to enable access for vulnerable populations by engaging with members in the ways that matter to them.

Modivcare’s Vision

Modivcare’s approach brings forward a new modality to support both rural and underserved populations who may lack access to traditional care settings, and who are more likely to suffer from adverse outcomes. The community screening platform can shorten the distance to healthcare, offering self-service vitals monitoring, risk assessment tools, and a platform to engage in virtual care. As risks and care needs are identified, home-based programs support a regular cadence of data collection, proactive monitoring of biometrics, clinical guidance via the clinical network, and access to support at the press of a button through PERS, text, or phone call.

The combined platforms offer an ideal complement to propel Modivcare’s vision forward. VRI’s incredible strength and legacy in PERS and vitals monitoring brings a strong history routed in outcomes tied to core customer objectives like driving member satisfaction, closing HEDIS care gaps, and reducing total cost of care, especially for the costliest members. Higi adds its clinical network to further strengthen the organization’s capabilities in alignment to its customers – a vision realized by Modivcare’s President and CEO L. Heath Sampson.

“We acquired Higi both for its Smart Health Station technology and network and its clinical network that serves as a backbone to care delivery offered by the newly imagined combined organization. Our strategy is to broaden our reach and deepen engagement with our members to meet their diverse needs,” Sampson says.

Mr. Sampson finds immense opportunity in rethinking how benefits historically considered to be supplemental can move the needle on important clinical measures that impact health plan outcomes, quality measures, and member satisfaction. Before becoming CEO, Sampson served as Modivcare’s CFO and led the business to focus on innovative healthcare offerings – specifically supportive care services.

Modivcare’s monitoring services are accessible to state agencies, Managed Care Organizations, Medicare Advantage Plans and care partners, with a special focus on helping its customers address vulnerable and underserved populations. The leadership team’s efforts to simplify healthcare for these communities through non-emergency medical transportation solutions (NEMT), in-home personal care, virtual and remote care, and integrated supportive care services are designed to positively impact their physical, emotional, and social wellbeing.

Member-Centered Care

Core to this vision is E3, another unique feature of the platform designed to enhance connections to care by prompting actionable steps and removing barriers for members. It fosters active participation by providing dynamic education tailored to each member’s health needs. By identifying individual needs and challenges, E3 empowers members to take control of their health.

The E3 platform evolves with members, adapting to changes in their health status and care requirements with continuous data collection that allows for proactive management and timely interventions. By integrating technology with personalized guidance, E3 sets a new standard in member-centered care, effectively prompting action and addressing barriers to health.

Impacting Members, Caregivers, and Healthcare Partners

The Modivcare monitoring team is consistently inspired by its mission to provide access to the care that matters for those who need it most. From digital experiences to human-touch, every interaction is a cause for inspiration that keeps teammates engaged in their work.

VRI’s in-home Vitals Monitoring Program serves as a powerful tool that provides a more complete picture of a member’s health and social needs, leading the provider to treat the patient more effectively resulting in better outcomes. In a study completed by Modivcare spanning 10 years of data, members with hypertension received an in-home blood pressure cuff that was monitored by VRI’s Care Center. The program included daily blood pressure monitoring, reminders for missed readings, 24/7 triaging for abnormal readings, and escalation reports to providers as appropriate. Results showed 52% of initially uncontrolled participants were within HEDIS control in six months.

Modivcare’s clinician-led service that collaborates with a member’s primary care provider, in partnership with the Michigan Center for Rural Health and three rural, critical access hospitals in Michigan, provided virtual care over the course of 18 months. Through clinician-led in-home monitoring and coaching with a dedicated nurse care manager, the number of individuals with controlled blood pressure readings doubled, increasing from 39% at the start to 78% by the end of the pilot period. Patients with previously uncontrolled hypertension experienced an average reduction of 27 mmHg systolic and 11 mmHg diastolic, achieving blood pressure readings in the normal range. In addition, many participating patients also improved their blood glucose and weight.

Modivcare’s self-guided monitoring services empower users with timely access to tools and information that makes a tangible difference. From the pregnant user who accessed a publicly available Higi Station to measure her vitals when something didn’t feel right – following the digital prompts to get to care immediately and ultimately crediting the platform with saving her baby’s life – to the platform user living alone who found comfort and reassurance in being able to regularly monitor their health, having access to self-screen and following actionable digital navigation made all the difference.

Modivcare remains deeply committed to its mission of delivering care that makes a tangible difference in the lives of those who need it most. By blending cutting-edge digital tools with compassionate human touch, Modivcare’s monitoring services empower individuals to take control of their health while fostering meaningful connections that inspire both patients and care providers. Each success story fuels Modivcare’s drive to expand access to care and redefine healthcare delivery for all.

The post Modivcare Monitoring: VRI PERS & Vitals Monitoring Plus Higi’s Community Platform & Clinical Network appeared first on HealthTech Magazines.

By Debbie Welle-Powell, Chief Population Health Officer, Essentia Health

Digital Care is here to stay. 

The COVID-19 pandemic accelerated change to a new model of care; a virtual (digital) model built to deliver care at the right time, all in the comfort of the patient’s home.

Health care systems, including Essentia Health, were challenged by the pandemic to deliver necessary care differently. Prior to COVID, we offered limited retail E-Visits and remote patient monitoring (RPM) only to high acuity chronic heart failure patients. When the pandemic hit, we took a quantum leap forward, resourced our change management capability and fast-tracked the adoption of digital technology. With the technology platform in place (built), we were able to move quickly to direct-to-consumer services that kept our patients safely in their homes. This technology also kept our providers and staff safe by limiting the number of patients on campus and reducing viral transmission in the community. Today our direct-to-consumer digital programming includes on-demand video visits, retail E-Visits, RPM, and our newly approved CMS Hospital at Home waiver program. 

A shift in mindset is occurring with our clinicians. They are trusting the technology to deliver timely and safe care.

This new model of care is generating higher patient satisfaction scores, showing we are truly improving the patients’ experience.

Essentia Health’s Story and the Impact of Virtual Care

1. The Numbers. Essentia led other health systems in Minnesota with well over 604,000 telehealth visits since the pandemic started. Our expanded RPM Program prevented 102 hospital admissions and prevented 67 emergency department visits. This work generated savings of approximately $2.5 M across Medicare, Medicaid and commercial populations. Essentia holds thirteen total cost of care contract agreements totaling 180,000 at-risk lives. When we appropriately reduce utilization, these earnings are reinvested in chronic care programs, enhanced technology applications and analytical tools. Negotiating value-based, risk contracts has been a key to our success as an integrated health system and Level 3 NCQA Accredited ACO because we are able to measure the impact of closing gaps in care and quantify making health care more affordable.   
   
   
2. Screening Social Determinants of Health (SDOH) and Social Needs. The COVID-19 pandemic placed a great deal of strain on our communities. At the beginning of 2020, we were just piloting a social needs screening program asking our patients about food insecurity, transportation and financial strain. In April 2020, we rapidly scaled up social needs screening to ensure our 75 primary care and pediatric clinics were offering this screening to all of our patients. To date, we’ve offered this screening to more than one million patients, with 46% (420,330) of patients responding. We found that a significant increase in requests for social needs (particularly food) was reported. As a result, more community health workers were hired, and our relationships with community partners were expanded. We’ve been able to successfully connect more than 2,000 patients with the community resources they needed.
   
   
   In April 2021,  building on our work, we launched RESOURCEFUL, a free, online, public resource directory, through a partnership with Aunt Bertha. Its name “RESOURCEFUL,” reflects our desire to bring community assets to our patients. The program makes it easy for patients to identify resources close to them, empowering them to seek needed information to help themselves. We are widely promoting this to our patients and community. The process has truly been collaborative in nature, with our community partner organizations helping us name, brand and promote the site.
   
   
3. Evolving New Care Team. As our care models evolve, so too must the care team. With the successes in implementation and growth of virtual visits and RPM for both COVID and chronic care patients, we recently approved a permanent Essentia 24/7 Telehealth Care Team. It is  essentially backup to primary care services, however, performed remotely with digital technology. Now, on a 24/7 basis, we provide on-demand care to our patients, along with annual wellness visits and advance care planning. A shift in mindset is occurring with our clinicians. They are trusting the technology to deliver timely and safe care. With RPM devices, we are seeing our emergency medicine physicians, cardiologists, and hospitalist coming to us and asking if we can deploy the devices in the patient’s home. RPM is becoming a standard of care for patients with conditions such as diabetes, enabling them to manage their diet and blood sugar levels with wearable push/pull devices.
   
   
   Our hospitalists, paramedics, pharmacists, social workers, and nurses are developing clinical competencies to provide care in a different environment with our hospital-at-home program. We can see that the care team of the future is going to be heavily influenced by digital technology and the data it produces. Care team members must have skills on how to integrate technology and data into their care of the patient, and we must expand our definition of the “Team”, as we will see the patient and his/her devices become more of an active member in the plan of care, in this virtual world.

The Challenges of Virtual Care. There are still many challenges and barriers with telehealth to overcome. From parity in reimbursement, and state licensure, to the technological challenge of broadband connectivity and integrity, we must assume the virtual/digital care model will continue to evolve. There is also the need to cut through the noise and distractions, help make the data timely and more meaningful, and provide ongoing education to our clinicians. In addition, there are new, non-traditional stakeholders in the health care ecosystems too, such as regulators, financiers and intermediaries who will shape the future. As is the constant, this too will change.

In Summary

The disruptive nature of the COVID pandemic forced us to re-think the care delivery model and optimize the digital and virtual delivery system. It continues to force us to evolve, to adopt and to expand upon the new care model. Consumers are increasingly willing to share their personal data through “wearable” technology and bluetooth-enabled devices. Additionally, this new virtual model of care is empowering consumers to take control of their well-being in ways that were impossible just a few short months ago. Health systems and clinicians with deep roots in care delivery must ask themselves how to best use this new technology, and its data, to transform what well-being and virtual care delivery means in the future. The future is not as far off as it seems. In fact, it’s at your very finger tips. 

The post The Future of Integrated Virtual Care… appeared first on HealthTech Magazines.

One positive thing we have learned from the global pandemic is that Revenue Cycle teammates and work can be very effectively accomplished in a remote work environment. I believe it is here to stay in one form or another. Some organizations will stay fully remote, some will have a hybrid model, and still, others will come back fully into the office.

To continue to be effective in a remote work environment, we need to strengthen our methods of communicating and keeping our teammates connected and fully engaged. The isolation factor and not being as connected to your teammates can lead to teammate depression, which will negatively affect one’s productivity. Regular video conferencing can help. This is helpful for keeping everyone up to date with changes in focus or new training and allowing some time to socialize. Catching up with your teammates as you do in the breakroom will make everyone feel more connected. I call it “water cooler time”. 

There are many different technologies available to track both productivity and quality electronically. Most systems will provide reporting or scorecards to the teammate as well as management in real-time.

There are several policies and processes to put into place for any version of how your organization utilizes a remote workforce. The first and foremost is to create a document outlining all requirements and expectations, for both the employer and employee, when working remotely. Let’s face it. Remote working is very different than being in the office.   Here are a few things to keep in mind (this is not an exhaustive list by any means):

1. Workspace Requirements
2. Equipment
3. Internet
4. Productivity and Monitoring
5. Onsite Requirements

Workspace Requirements – What will be defined as an acceptable workspace? It is not always a straight yes or no answer. Each individual circumstance may be different. Whatever is approved needs to be adequate to get the job done and provide any needed protection of all patient privacy due to HIPPA. Some employers may require a space that is secure from others in the home. Ergonomic considerations should be addressed to ensure a comfortable and safe work environment.

Equipment – Who provides the equipment? If the organization provides the equipment, a log of all equipment should be kept by an individual, and there should be signoffs of both parties. The terms for the return of equipment upon termination of employment should be spelled out in the agreement. Who services the equipment, and how is that managed? 

Internet – Obviously, the teammate must have access to the internet. There needs to be a requirement around who is responsible for the internet service and who pays for it. Maybe more important is a minimum requirement on internet speeds to ensure the job is efficiently and timely performed. Information systems should verify those minimums prior to the teammate being approved for working remotely. 

Productivity and Monitoring – We have requirements or expectations for a certain level of work performance already. Is it the same if you are remotely working? Expectations should be documented, so everyone is accountable for completing the expected workload. There are many different technologies available to track both productivity and quality electronically. Most systems will provide reporting or scorecards to the teammate as well as management in real-time. What happens if productivity drops below expectations? Should the teammate be required to come in for refresher training or return to onsite work until productivity is back to acceptable levels? These types of potential issues should also be spelled out in the remote work documentation.

What about working hours for the remote workforce? Does it matter if it is the traditional 8 am to 5 pm? There are a lot of roles where you don’t have to interact with the patient or payors. For example, Medical Record Coders. If they can access all their tools, does it really matter what time of the day or night they code? You do want to ensure required work is completed in a designated time frame. The same argument can be made for most back-end roles. This gives employers a lot of flexibility with staffing needs. You may see a pickup in productivity when the teammates have a more flexible work schedule. On-site staff may have to take time off for doctors’ appointments or child issues, but if they have the flexibility to complete work off traditional work hours, the employer does not have lost productivity time, not to mention happier teammates. Leadership will have to balance and keep track of these things, so patient needs are still addressed timely and during regular work hours.    

Onsite requirements – I believe some offices still have teammates that the role requires them to be onsite and some just rather come in for personal reasons, or they don’t have a conducive area to do remote work at home. One option is to have your teammates switch off week to week so everyone  can have remote time as well as on-site time. This is where a hybrid model can work well. This also saves on space and allows the organization to reduce the footprint and possibly the cost of real estate. You may want your entire team onsite for meetings or training and need to ensure you can still handle the entire team in one location.

One nice thing about remote workforces is they can be anywhere and work. You may be able to attract teammates that are in a different city setting or even another state. This gives you a lot more opportunities to attract a robust and dedicated workforce. For those in a more rural area, this option can have a significant impact on the staffing you can attract.

The post The Remote Revenue Cycle appeared first on HealthTech Magazines.

March 11, 2020 is when the World Health Organization (WHO) classified the coronavirus outbreak as a pandemic. Since that time, we have witnessed and watched as one of the most resilient sectors of the world kick itself into high gear performing well beyond the normal asks and put oneself-last and others first. In such, Digital Health has been adopted at a rate shocking to most. What used to be a lackluster approach to innovation in healthcare, barriers have been removed, allowing for the thoughtful implementation of digital health tools that completed the necessary business continuity and resiliency needed to fight a pandemic and the complexity of healthcare.

Now, I am not slight to the fact that not all were as bad as the previous statements make it seem, although the comments from the collective healthcare industry are appropriate and the perspective valid. At the base level, not all providers of the healthcare community had a telehealth program for a myriad of reasons. Not all funding reimbursed Telehealth visits and subsequently, in many instances, the Information Systems infrastructures were not ready for such, to name a few of the challenges. 

The USFDA defines Digital Health as the broad scope to include categories such as mobile health (mHealth), HIT, wearable devices, telehealth and telemedicine, and personalized medicine.

It further states that Digital health tools have the vast potential to improve our ability to diagnose and treat disease accurately and enhance the delivery of health care for the individual.

In this Digital Health shift, it’s exciting to fathom this in the reality of Information Systems (IS) because the patient choice has pushed healthcare to reimagine delivery and close the widening tech gap, particularly in the primary care sector.

In this Digital Health shift, it’s exciting to fathom this in the reality of Information Systems (IS) because the patient choice has pushed healthcare to reimagine delivery and close the widening tech gap, particularly in the primary care sector.

I get it! I understand that primary care is the “contact” aspect of medicine that has been the bedrock first point of entry for the healthcare wheel by all patients. Even by definition by the American Academy of Family Physicians (AAFP) define Primary Care as care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern.

It continues with the diagnosis and treatment of acute and chronic illnesses in various health care settings (e.g., office, inpatient, long-term care, home care, etc.)

Primary care is performed and managed by a personal physician, often collaborating with other health professionals and utilizing consultation or referral as appropriate. Primary care provides patient advocacy in the health care system to accomplish cost-effective care by coordinating health care services.

Primary Care physicians are trained in the idea of in-office patient care settings for obvious reasons but add a pandemic and the notion that in-office isn’t ideal for care relative to curbing virus spread, we must start to re-think, how we deliver such care. I am not articulating that once we are back to normalcy, we continue to disregard in-office care, but what I am challenging is that patient choice matters even after the pandemic, and we must provide IS solutions that promote a balance of patient choice and quality care. A delicate balance is achievable with a strategic approach starting with Telehealth and Remote Patient Monitoring.

These two digital health modalities are sufficient beginning stages towards gap closing. In patient’s reality, time is one of the most valuable things that cannot be wasted. Patients are more than a medical record number, rather they are humans in the midst of everyday life and the healthcare industry should not present itself as a barrier to such. A parent(s) of children trying to live a healthy life individually and collectively can have as many as 20 healthcare appointments in a year for a family of four (multiple factors applied i.e., age, gender, and health disparities.) For elderly patient(s), this number increases accordingly. This is time off from work, taken away from vacation/sick days, not recoverable until the next allotment. Humans value such time away as it is needed for some semblance of work-life balance. To impede on that should not be taken lightly. This is where we have watched patient choice become one of the deciding factors as patients are searching for primary care physicians hospitals and referring specialists.

Enter in Telehealth and Remote Patient Monitoring. Having the ability to have a Virtual Visit that incorporates the traditional visit adding the device readings is the best of both worlds. The ability to take BMI’s and such on a device and be able to calculate readings and simultaneously drop this data into the medical chart while the provider is on the call is, in my opinion, a holy grail of hybrid compromise. Does this negate the visits that truly need to be in the office; no! Does it provide patients with the ability to manage their time and still walk the journey of whole person health; yes! Does it help minimize stress on the healthcare system from reducing no show rates and provider double booking; yes! Does this complete the Quadruple AIM; yes!  As we begin to round the corner on the coronavirus, the wins we have achieved as an industry need to be celebrated, but we also must look into the new normal and say to ourselves, what’s the goal of our system? To provide quality care at an affordable cost that reduces the burden on both the patient and the provider. Opening our four walls to Digital Health is one way Information Systems departments can continue to play a critical role in the strategic decisions for business resiliency. It’s how we as healthcare drop the mask and bridge the human gap into our system that we are all a part of while we are at work ourselves.

The post Drop the wires, but don’t leave the patient behind appeared first on HealthTech Magazines.

By Richard Zane, M.D., Chief Innovation Officer, Sarah Wendel, M.D., Administration, Operations, and Quality Fellow & Adeel A. Faruki M.D., Operations, Executive Leadership, and Innovation Fellow, University of Colorado Anschutz Medical Campus

When healthcare professionals at the University of Colorado Anschutz Hospital lined up to receive the Pfizer-BioNTech COVID-19 vaccine in December and January, some were wearing one of the newest approaches to wearable technology — a coin-sized device affixed with medical-grade adhesive to their upper left chests.

The low-cost medical grade device was the BioButton^TM, an FDA-cleared device that provides continuous vital sign monitoring of skin temperature, respiratory rate, and heart rate at rest. It was developed by BioIntelliSense, a clinical intelligence company based in Golden, Colo., and has been utilized as a scalable and cost-effective solution for health screening and COVID-19 symptom monitoring.

As vaccines became available to healthcare professionals starting in December 2020, our CARE Innovation Center, along with CU Innovations and UCHealth, partnered with BioIntelliSense. The goal was to explore the clinical applications of the BioButton^TM for monitoring vaccination as a foundational step in developing a scalable post-vaccine monitoring program that could be deployed broadly.

Healthcare workers at the University of Colorado Hospital on the Anschutz Medical Campus were offered BioButton^TM as an operational pilot designed to evaluate the logistics of deployment, operational feasibility, and interest in wearable technology for post-vaccine symptoms self-monitoring.

They were provided a BioButton^TM at no cost, and interested individuals were asked to wear the device 2 days before and 7 days after receiving the vaccine. Upon activation of the device, participants were surveyed to assess ease of applicability of the device and if the wearable technology made them feel more comfortable with COVID vaccination. In addition, voluntary daily health surveys assisted participants in monitoring signs and symptoms that may require further assessment. The operational pilot was performed in two phases. The first phase had volunteers assisting with device setup and activation. The second phase allowed participants to obtain the device and a setup guide from various pick-up locations.

We learned many lessons during our operational pilot, including discovering that participants can obtain the BioButton^TM wearable, place the device, and complete setup without direct assistance. But we also determined that allowing individuals to obtain devices from pick-up locations free of cost resulted in a significant number of devices being obtained and never activated.

The participation of our frontline healthcare workers in this vaccine monitoring program serves as a key operational milestone in our ability to scale the program for the larger populations. We believe it will be essential to assist participants through the activation and setup process to improve device utilization during the expansion of this pilot to other populations.

As COVID-19 vaccines become more available, BioButton^TM or other wearable technology could help improve vaccine acceptance by enabling individuals to monitor themselves for side effects.

As supplies of COVID-19 vaccines become more available, BioButton^TM or other wearable technology could help improve vaccine acceptance by enabling individuals to monitor themselves for side effects. Nearly 134 million in the U.S. have been fully vaccinated against COVID-19 as of May 29, 2021, and almost 167 million have received at least one dose. If wearable devices enable more of the world’s population to be vaccinated, we fully support expanding the use of this type of technology to other individuals.

At the UCHealth CARE Innovation Center, located on the University of Colorado Anschutz Medical Campus, we continually explore the ever-changing healthcare landscape with the goal of working alongside leading industry and start-up partners to revolutionize healthcare. We emphasize entrepreneurial, quick-to-market innovations that eschew bureaucratic red tape.

Established in 2016, the UCHealth CARE Innovation Center focuses on designing innovation platforms to cut through the predictable obstacles that encumber other large organizations so our partners and people around the world, can benefit.

Development of the COVID-19 vaccine has proven to be a significant clinical achievement in addressing the global pandemic. Wearable devices like the BioButton^TM are a promising step in addressing this worldwide crisis.

BioIntelliSense’s strategic partnership with CU Innovations, UCHealth, and its CARE Innovation Center explores the clinical applications of the company’s wearable medical devices and medical-grade services. The alliance is committed to developing and validating new models of data-driven care that are patient-centered and built for scale. We aspire to bring technological advancements into the hands of our patients and providers to improve outcomes and change the practice of medicine.

The post UCHealth CARE Innovation Partnership Drives Innovation in Wearable Technology appeared first on HealthTech Magazines.

Before 2020 there had been forward-thinking discussions on the consumerism of medicine, but the pandemic forced providers to focus on patient-centric care through telehealth, chatbots, remote consults, remote patient monitoring, and rich digital engagement tools. Fortunately, all stratifications of health care (payer, Medicare, and Medicaid) have benefited from this transformation. Some health systems saw up to 80% of ambulatory visits delivered by telephonic / telehealth encounters, but how do we ensure that all community members receive the care they need? 

According to the Centers for Disease Control (CDC), health equity is achieved when every person has the opportunity to “attain his or her full health potential,” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.” Health inequities are reflected in differences in length of life, quality of life, disease rates, disability, death, the severity of disease, and access to treatment. Telehealth can improve health outcomes, reduce reliance on emergency room visits for episodic care, and reduce hospitalizations – all of which help meet health care’s quadruple aim – reduce cost, improve patient experience, improve quality and physician joy of practice. 

To determine how vulnerable a community is, we employ the Center for Disease Control (CDC) / Agency for Toxic Substance and Disease Registry (ATSDR), Social Vulnerability Index (CDC/ATSDR/SVI) tool that uses census data to determine the social vulnerability of every census tract. At AltaMed, by leveraging the CDC/ATSDR/SVI for social determinants of health (SDOH), we service and focus on the communities in the most vulnerable quartiles and overlay the SVI census track, and then geo-target by quartile of vulnerability. In April 2020, AltaMed Health Services started offering HIPAA compliant telehealth visits and they were not integrated with the Epic EMR. Today, we have full integration that allows the clinician to view the patient during the visit and invite in a translation service if needed. The incorporation of language services reduces language barriers is a key step toward health equity.

From May through December 2020, over 80,000 telehealth visits were completed. When it came time to vaccinate our patients, we used text messaging, email, and phone campaigns that leveraged the demographic data within our EMR to prioritize delivery aligned to CDC tier definitions. Furthermore, we broadly opened our vaccination slots to the community, so that everyone who wanted a COVID-19 vaccine could get one.

As we approach the midpoint of 2021, we look to broaden and continue extending our tele-footprint, including remote patient monitoring for Congestive Heart Failure (CHF). We enrolled a cohort of patients in January and have had promising results. We provide the patients with Bluetooth-enabled devices (weight scale, pulse oximeter, and BP cuff) and are taking daily measurements that are transmitted back to our virtual care team, where we can monitor changes in the patient and have a clinician intervene early. Daily rolling measurements are tracked and alerts are provided to the care team, enabling them to intervene versus having the patient go to the emergency room. Soon, we will be expanding this for Chronic obstructive pulmonary disease (COPD) and maternal-child/postpartum support for women.

Looking ahead from a care delivery perspective, with telehealth, we should have improved workflow, adoptions, and the technology should be easier to use for both providers and patients.

Looking ahead from a care delivery perspective, with telehealth, we should have improved workflow, adoptions, and the technology should be easier to use for both providers and patients. Primary care will see video specialty care, broader adoption for behavioral health, and routine care/nurse visits will become more prevalent. Quality outcomes will improve with advancements in remote patient monitoring that focus on the patient-centric home for those with chronic conditions.

We need to be careful that we do not revert to all our traditional care delivery models, maintain the focus to continue to strive and deliver patient-centric care that is consistent for all patients, and not lose the valuable legacy of learning from the pandemic.

Key Findings and Implications for the Future

1. Telehealth must be patient-centric, intuitive, and as simple as clicking a link. 
   
   
2. Insignificant broadband coverage can result in the patient defaulting to telephonic visits versus full video. We need to eliminate the digital desert that exists in socially disadvantaged communities that include urban cities and rural communities. Fortunately, there are national and state bills pending legislation review: 1) Life America Act for Health Infrastructure and 2) Broadband and Investments in America’s Health Infrastructure.

Providers should have the ability to work from anywhere and launch the tele encounter from a mobile device or laptop. Exam rooms may need to be altered to optimize telehealth visits and creation of telehealth centers of excellence is recommended.

The post Health Equity and Telehealth appeared first on HealthTech Magazines.

This happened almost overnight: The federal Centers for Disease Control reported a 154% increase in telehealth visits during the last week of March 2020, compared to the same period in 2019. With hospitals overwhelmed and patients in lockdown, the pandemic flipped the switch to activate a movement that had been building for years.

As innovative tools and technology continue to enhance the virtual experience, healthcare systems face new questions. How can we leverage these advances and growing acceptance by patients? How can we take virtual care to the next level, particularly as the pandemic continues?

Designing the program was a multidisciplinary effort that focused on the dual objectives of Metro Health’s digital health strategy.”COVID-19 has accelerated widespread transformations in healthcare delivery and technology, perhaps nowhere more dramatically than telehealth adoption.

Although the recent expansion of telehealth has emphasized primary-care visits, we also have the opportunity to address the challenges of the pandemic itself by mitigating its burden on our health systems and at the same time, improving patient outcomes.

Home-based monitoring of select COVID-19 patients, paired with telehealth, offers just such an opportunity.

Serving patients where they want to be

On Nov. 30, in the wake of the pandemic’s second U.S. wave, Metro Health – University of Michigan Health launched a 24/7 home-monitoring program for ambulatory COVID-19 patients at our 208-bed hospital in Wyoming, Mich.

By discharging certain patients to recover at home, where they are most comfortable and heal best, we have been able to keep more beds available and limit exposure and workload for staff. In the first month of operation, 33 patients enrolled, saving more than 300 hospital stays.

When an attending physician clears an ambulatory COVID-19 patient for home recovery, we equip the patient with an internet-connected tablet and Bluetooth-synched peripherals: thermometer, blood pressure cuff, pulse oximeter, and scale. We teach them how to use the equipment and we send them home.

Patients take multiple readings a day and answer surveys about their wellbeing, including questions that screen for the depression commonly seen with COVID-19 cases. The readings and responses are automatically entered for remote monitoring by a team of medical professionals. Patients have video visits with providers – which family members can join virtually – and can ask for help via the portal.

Metro Health designed and launched the program in 10 days and we have heard nothing but rave reviews from patients.

No patient wants to be confined to a single room without visitors for any amount of time, let alone the notoriously long length of stay for COVID-19 hospitalization. Studies show patients heal better where they are most comfortable, sleeping in their own bed, eating their own food, and surrounded by the comforts of home.

Technology that enhances the patient-provider experience

Designing the program was a multidisciplinary effort that focused on the dual objectives of Metro Health’s digital health strategy.

“We always want to preserve the intimacy between patient and provider – to enhance, not get in the way of that experience,” said J. Josh Wilda, Chief Information Officer. “We also seek technology that extends when and where we can treat our patients.”

Remote patient monitoring is increasingly recognized for its potential to reduce hospital readmissions, improve outcomes and support data-based care decisions. Metro Health had been exploring expanding its home-monitoring program for cardiology patients, but the pandemic inspired a pivot.

“We are excited for how this and other digital health tools will allow us to shift the patient care model in the appropriate settings, putting more tools in the hands of the patients to be more involved in their care with their providers,” Wilda said.

Metro Health worked with Health Recovery Solutions to design and launch the program. The system integrates with our electronic health record system, Epic, and has the ability to add approved family members to the patient portal for virtual visits.

A robust clinical role

Deploying technology is only part of the equation. At Metro Health, we knew a successful launch would require collaboration across the board, from IT, case management, hospital staff, and importantly, our medical group.

Since we do not have an established monitoring center, we leveraged employed staff across our system to check the patient portal around the clock. This involves physician assistants, nurse practitioners, nurses, medical assistants, and case managers supported by physicians and specialists.

Nurses and medical assistants check the portal at least every two hours during the day and every four hours at night. Providers monitor the portal throughout the day as they conduct virtual visits with patients. Appointments are scheduled for days one, two, four, seven, and 10.

The system also issues alerts if a patient’s readings or responses fall outside established parameters. For example, if a patient’s pulse ox reading is out of range, email and text notifications go out to multiple staff members. Nurses triage the patient, determining whether to escalate the case and bring in the nurse practitioner, physician assistant, or physician.

In addition to being popular with patients, the system has been embraced by Metro Health providers. Gerrit J. Kleyn, a primary care PA at one of our outpatient clinics and part of the team that supported this innovation, put it this way:

“Being able to assist patients while they convalesce from COVID in their own homes has been one of the most rewarding things I have been involved with. We receive daily words of appreciation from our patients and their families for the level of care we were able to provide through the virtual equipment.”

Looking beyond COVID-19

One of the hallmarks of the pandemic era has been the ability of medical organizations to adapt and develop solutions for challenging situations.

Like all good innovations, remote monitoring has potential beyond the pandemic, with opportunities to prevent hospitalizations and support post-hospital recovery. Metro Health is exploring expanding home monitoring for patients with congestive heart failure and COPD to reduce the risk and cost of readmission common with these conditions.

The goal is to provide the expert caring relationship that patients deserve in a setting that makes them happiest – at home.

The post Remote monitoring helps COVID patients at home, where they heal best appeared first on HealthTech Magazines.

The pandemic has dramatically changed where we work and how we work with one another, with our patients and their families, and with the broader community; including clinicians and researchers beyond our organizations. 

The remote monitoring approach and care delivery capabilities extend care beyond ambulatory settings or inpatient settings. Patients know they are not alone; patients know they are apart but together; patients know they can get continuous care; patients want to be engaged in their care and want more convenient access to care. Furthermore, remote patient monitoring increases patient and physician interaction assurance. It offers physicians a lot of comforts to know that when patients go home, they will be monitored remotely for critical parameters on a daily basis to know whether or not they are doing well and following their prescribed treatment. 

Remote monitoring access allows diverse experts to come together, to collaborate with one another in multi-disciplinary teams to collect patients’ data in real-time, to stay up to date, and get alerts if their patients’ condition deteriorates. It helps physicians provide improved continuity of care for patients in remote areas and of different socio-economic status. Physicians are able to maintain care and treatments despite location, distance, quarantine, lockdown, social distance, and other limitations. These capabilities have the potential to expand your impact as a physician. 

How is this possible and facilitated? The pandemic has demonstrated some of these possibilities. It may require modifying job responsibilities and a new mindset. Integrating remote care with standard office practice on an ongoing basis will require changes in workflow, new user interfaces, and a dashboard that provides relevant, real-time data. Preparing staff to monitor patients’ progress following treatment or between office visits may require training. A new workflow allows staff to collect and monitor data, monitor patients who enter data, and be in contact with clinicians so action can be taken if there is an abnormal finding or if a patient seeks help. It is important to capture this data, monitor and analyze the data for predictive analytic purposes, and ensure that you learn the most about each specific patient and to understand a specific condition. The data analytics are facilitated by connecting to the EHR system, which then allows you or your Informatics team to look at largequantities of data to make clinically important observations and do analysis that will drive better care in the future for all patients. 

Physicians are able to maintain care and treatments despite location, distance, quarantine, lockdown, social distance, and other limitations. These capabilities have the potential to expand your impact as a physician.

Let’s face this: This is a new technology- you have some quick adopters and some are slow adopters. Let’s encourage the quick adoption of this type of platform. Having the ability to be in continuous contact with the patients, both in terms of the physiology and symptoms, is very important value-added in moving toward more patient-centered care. I think it is important to understand and appreciate that you are bringing care to the patient with this type of approach instead of relying on the patient to bring their care to you.

Remote patient monitoring offers several advantages:

1. Expands geographic pools, expands the potential patients to all. The physician will be able to offer treatments to their patients; knowing that there is a robust monitoring in place after they receive treatments and appropriate routine care is being provided for the folks who are further away geographically. Following treatment or between office visits, patients could be having symptoms and decline that physicians otherwise would not know about.

2.  It can give an incredible amount of reassurance and comfort knowing that a real-time data will be available to physicians daily  to monitor patient health conditions. A remote medical device is Bluetooth enabled to connect by an app to a patient’s smartphone or computer, where information is transmitted securely to the EHR platform in the medical facility. Then, the physician can pick up the values and intervene upon. This is instrumental and will be mainly picked up to detect issues. This brings comfort to both patients and physicians without face-to-face physical interaction.

3. Enables the physicians to longitudinally collect data on their patients with acute illness(s) and chronic illness(s)- objective data that is useful.

What happens when you get data science involved and you start to look at combining data from multiple sources? That is where the real power of digital remote technology starts to come together. You can start seeing the cause and effect of what treatment is working and vice versa, overtime on the same individual patient. The clinical team can see data at the individual level or at a group level that will give them a clinical snap review while interacting with multiple databases and the timeline of the treatments, which is the key in the treatment process of any illness. 

All in all, remote monitoring requires a different mindset about how physicians deliver care as it extends patient care beyond office walls or hospital walls, offering many benefits to both patients and physicians.

The post A Powerful Feature of Digital Technology Applied to Medicine appeared first on HealthTech Magazines.

What seemed like a page out of a fantasy fiction novel or sci-fi creation is now a reality. Thanks to technology, particularly in healthcare, a significant part has moved to the patients’ homes. The level of care patients receive at the convenience of their homes is escalating since the COVID-19 pandemic. Telehealth and remote patient monitoring (RPM) are not only alternatives to conventional in-person visits for care, but also have evolved into accepted norms of the mainstream practice. In very specific use cases, RPM, such as remote electrocardiogram (ECG) monitoring, are the realities that are making early detection of heart conditions of a hockey player by his coach possible and aiding cancer patients to track signs of cardiac side effects from anti-cancer drugs. Among all healthcare services, the RPM solutions have grown in relevance for demonstrating safety and effectiveness while also considering compliance and user experience as the core priorities. To keep up with the new change in medical practices, patient needs and the largesse of the new healthcare market, QT Medical pivoted their business to provide the best value in the pandemic. The company is one of the leaders in the Medical Device industry that pioneered PCA 500, an electrocardiogram (ECG) technology aimed at improving heart health. PCA 500 is QT Medical’s first product and the world’s smallest 12-lead ECG platform based on state-of-the-art technologies, including a super-compact ECG recorder, pre-positioned electrodes, apps on mobile devices, HIPAA compliant cloud management, and diagnostics powered by machine learning. 

Unlike its contemporaries, the PCA 500 recorder weighs only about 1 percent of the popular ECG devices by Philips, but offers the same level of quality. It’s patented single-use electrode strip has no lead wires that helps simplify the leads’ replacement and reduces the risk of infection. The device has been tested on several airlines and is slated to officially launch in the aviation, maritime, and remote care markets. “Before the pandemic, we were focused on selling devices. The far-reaching impact of the pandemic made us really look deep to see what value we are providing while staying relevant,” says Ruey-Kang Chang, Founder and CEO, QT Medical. The ECG solution, PCA 500, is compact, digital, mobile, and cloud-based that enables patients to do their own medical grade 12-lead ECG at home—a patient prerogative and real value during this pandemic! The 12-lead ECG offers a comprehensive look at the patients’ heart and is the standard for physicians to rely on. The device has also been tested in clinical trials involving diverse cohorts, including babies, which are the most challenging testing group to measure its user-friendliness. In a clinical trial of over 1,000 parents using PCA 500 to conduct 12-lead ECG tests on their newborns, over 90 percent of the parents were successful in completing the tests! Dr. Chang, who is a pediatric cardiologist, was already aware of the difficulties in using ECGs on pediatric patients and worked alongside the QT Medical team to reinvent the ECG machine that can best work for everyone. The innovation steered the introduction of the PCA 500 device with a holistic service that empowers patients with the tools to care for their heart health from home. “We have made it so simple, that its usage requires no additional training. Besides, the cloud management and EMR compatibility are valuable features for the practitioners,” Chang explains. “We will offer computer interpretation powered by machine learning, which will be more accurate and robust over time.”

Recently, QT Medical created and launched the Xpress ECG, a service surrounding the PCA 500 technology that offers online order, mail delivery, 12-lead ECG home tests. Since the end of 2020, the Xpress ECG has garnered approval from many satisfied healthcare providers and patients. The service’s official launch focuses on boosting the accessibility and affordability of hospital grade ECG testing for patients at home. From the care providers’ standpoint, Xpress ECG provides better workflow and higher reimbursements, allowing the doctors and care providers to focus on patient care qualities amidst the pandemic-related restrictions. “Xpress ECG has proven to be a much-needed service, and 98 percent of patients could complete their tests at home with simple instructions,” adds Chang. One of the common feedback received from QT Medical’s cardiologist clients using Xpress ECG is that they find better quality ECGs from their patients at home than that of the ECGs they get from hospitals.

The use of Xpress ECG service has also been extended to the senior population with necessary iterations on the electrodes for their easy usage and automation of the entire recording process to navigate the challenges related to lack of familiarity and usage of smartphone apps. “For patients who do not have a compatible mobile device or do not know how to download an app, we are now working on broadening the supported mobile devices, and in some cases include a Samsung phone preloaded with our app with the Xpress ECG kit,” mentions Chang. Emphasizing the plan for its large-scale adoption, Chang believes Xpress ECG is not just an alternative to ECGs in hospitals or doctor’s offices, but it’s a replacement. “Xpress ECG tests can be done before, after, or between scheduled office visits. It streamlines the workflow in the office and saves a lot of costs and resources associated with in-office ECGs.” In the current times of social distancing, Xpress ECG is beneficial in minimizing the exposure to potential infections and allows for reimbursements 3-5x times higher than an office ECG test. For example, a typical office ECG test billed under CPT code 93000 reimburses $18 only. By using the Xpress ECG service, physicians can order a complete medical grade ECG test online at the current cost of $30. Using the new RPM codes (99457 and 99458) since this ECG test is done by patients at home, plus the interpretation code 93010, physicians can be reimbursed for up to $102 for each Xpress ECG test. 

QT Medical is already witnessing great responses through its PCA 500 solution and Xpress ECG service from patients and care provider groups. To stay ahead of the curve and continue its innovation, the company is gearing for exciting developments in its pipeline. “Our pediatric electrodes are under review at the FDA and we expect to launch in the market later this year.  We have a defibrillator-proof version called PCA 1000, which we plan to launch in the EMS market next year,” expressed Chang. “We are also working on the next generation PCA 500— a 5G-connected, AI-powered, continuous 12-lead ECG monitor, that will be advantageous for monitoring patients in the hospital, ICU, ER, ambulance, as well as high-risk patients at home.”

While the company has made exceptional progress on the AI front of the ECG over the last three years, its experts believe that there are no limits with respect to AI application in ECG diagnostics. “We are now perfecting the ECG diagnostics with AI that will be on par with the accuracy of an expert cardiologist. In the next few years, our AI algorithm will be predictive—identify patients at risk, and possibly see things that have yet to happen,” says Chang. Telehealth and remote patient monitoring are the future, and QT Medical will play a crucial role in the new healthcare revolution.

The post QT Medical-Remote 12-Lead ECG: A Replacement, Not An Alternative! appeared first on HealthTech Magazines.

Healthcare has never been considered an industry easy to disrupt or willing to embrace innovation. It took a global pandemic to change healthcare as we know it today and I am certain that we are only at the beginning of this change process curve, putting one disruption point behind us and a few more to come. We have been working hard over the last few decades, moving past what once was a ‘Sick Care’ and truly focusing on ‘Healthcare’, which promotes our communities’health and well-being. Yet, we failed to prepare adequately to face this pandemic and gave a response that one would consider less than optimal for the most expensive healthcare system in the world. Without a doubt, resilience and dedication to providing quality care have allowed us to get to where we are today despite all adversities we faced.

By virtualizing care and delivering innovations at home, we are building bridges which no health system can build physically.

What needs to change moving forward?

All of us will have many different ideas and perspectives around how to navigate a path forward, but one thing is clear that ‘Status Quo’ is now less desirable than ever. I am not saying that almost all care will need to be virtual & delivered to the patient’s home, but why not aim for it? It is only when we seek dreams we are able to create tomorrow’s success today. We all know that highly complex and advanced care will always require hospitals and medical facilities where patients will have to travel, but can’t we at least work on making HealthCare a little more ‘Caring’ and ‘Healthy’? Self-care equals better patient care and bedside standard of care saves more lives than any other medical interventions. Hospitality in the context of a hospital aims to make the patient’s experience positive. By virtualizing care and delivering innovations at home, we are building bridges which no health system can build physically.

Today, I am able to coordinate a video visit with a daughter in Florida and an elderly parent in my home state Massachusetts where I practice primary care, to go over End-of-Life Planning discussion and help assess medication compliance and home environment which might  prevent next fall &/or ER visit. My care team is able to engage with patients virtually in realtime at the most vulnerable points in their care, such as post-hospital discharge through TCM (Transition Care Management) program, monitoring and preventing the adverse outcome of chronic disease through RPM (Remote Physiological Monitoring) program, & engaging patients, post Emergency Room visit to improve access to care, address gaps in care or prevent further downstream utilization thus reducing total cost of care.

Compass Medical, where I practice as a primary care physician and function as Chief Medical Information Officer, is a physician-owned and led medical organization serving over eighty thousand patients across Southeastern Massachusetts. Just like many other healthcare organizations, we also faced the crisis head-on with a steep decline in office visits, rapid deployment of Telemedicine, and process disruptions around every aspect of care delivery given new safety and infection control measures needed to implement. Patients were avoiding essential in-person care and providers were beyond overwhelmed trying to manage clinical and operational volatility.

Crisis breeds Opportunities and Success breeds Complacency.

A group of our leadership team members and clinicians came together to seek new opportunities amid this crisis and we came out with what we call today ‘Connected Care Services Model’. We doubled down on CCM (Chronic Care Management) we implemented as a centralized service since 2016 and expanded by incorporating TCM (Transition Care Management) program enabled through real-time ADT (Admission Discharge Transfer) feeds. We recruited a pool of clinical staff and providers rapidly to deploy RPM (Remote Patient Monitoring) program and post Emergency Room discharge Telehealth follow-up the program. We increased our TCM utilization by 500% and created a new services model while our peers were either doing 100% virtual care or waiting for this pandemic to be over to go back to “Old Normal”.  

Our patients started embracing these new care delivery models rapidly. They appreciated working outside the box of medical buildings we so get hyperfocused on as our sole means to provide excellent quality care. Now the care was in patients’ hands or reaching out to them in times of their most vulnerable. Remote care is not just limited to providing necessary means to take care of patients in their homes, but also should enable every care team member to provide the highest efficiency of care possible. Remote work from home enabled us to continue many essential clinical and operational processes without major gaps in the workforce due to exposure or other such needed measures. We have a set of providers currently utilizing remote scribing services, including myself which allows for greater flexibility and efficiency by reducing EMR documentation burden.

Remote care or Telemedicine is not the next big thing. I firmly believe that remote care is an opportunity, but at the core, it is just another part of a comprehensive care delivery which we need to continue to enable through data and technology. We cannot wait for the crisis to be over to pave the path forward as our most high risk and vulnerable populations need us in healthcare today more than ever to provide new ways to handle old problems and work together to find solutions to new challenges we all face together.

The post Remote Care: Turning Crisis into Opportunity appeared first on HealthTech Magazines.