With ViVE on the doorstep, a new survey finds that healthcare decision-makers are looking for technology that addresses workforce shortages, prepares the health system for a recession and improves data management.
Healthcare executives looking to make technology deals at next week's ViVE conference are looking for solutions that address clinician and staff burnout or help the health system weather a potential recession, a new survey reports.
The survey of some 300 decision-makers in healthcare, conducted by Intelligent Medical Objects, also puts data storage and analysis tools at the top of the shopping list, while AI tools aren't yet worth all the flashy marketing.
According to the survey, 94% say they plan to invest in technology that either addresses workforce issues or prepares the health system for a recession.
“Hospital providers face a lot of uphill battles, from data integration to clinician burnout, and this survey shined a light on how data integration can have a positive impact on patient care and day-to-day operations,” Ann Barnes, the company's CEO, said in a press release accompanying the survey. “It’s helpful to understand the most pressing needs as US provider organizations are making bold changes to improve patient care and are adapting their strategies faster than ever before.”
The survey comes as healthcare CIOs and chief digital health officers converge in Nashville next week for the ViVE 2023 conference, and as they and other decision-makers prepare for the Healthcare Information and Management Systems Society's (HIMSS) annual conference next month in Chicago. Both events are expected to feature discussion on a wide range of critical healthcare issues, including staff and clinician shortages brought on by burnout and stress, the upcoming end of the COVID-19 Public Health Emergency, new technologies and programs like telehealth, remote patient monitoring, Hospital-at-Home, digital therapeutics and AI, and federal efforts to improve privacy and security, enforce prior authorization rules and improve interoperability and data sharing.
Data will likely figure in a lot of conversations, according to the IMO survey.
Almost all of the decision-makers surveyed say their organizations must improve the way it uses data to improve healthcare delivery and operations, and 90% said they've had moments in the past where they lost or leaked revenue due to inefficient practices.
The survey shows similar results from other surveys and reports that list workforce management as the top priority of healthcare organizations, many of which are struggling to retain clinicians and field a good IT department. Many are also worried about the economy, with hospital margins at or perilously close to the red and a recent report indicating more than 60 hospitals are at risk of closure.
According to the survey, 71% cited maintaining or improving clinical care quality as the most important internal risk. Some 65% percent cited problems with clinician burnout, while half cited administrative burnout and 45% cited data issues.
The survey also pointed out a continuing issue for healthcare organizations looking to stay on top of the latest technologies while facing staffing issues. Some 84% of those surveyed said their health system is working with more then 20 vendors. Almost a third said software integration was their biggest problem with vendors, while 29% cited inadequate training provided by vendors and 17% reported long implementation timelines.
And that's a problem. With the economy struggling, many healthcare organizations are taking a hard look at new purchases and technologies, and requiring solid proof of ROI before they consider any new purchases. Health systems aren't going to invest in anything new if they don't see immediate and lasting value, and they certainly won't be interested in products that take a long time to install.
Finally, healthcare leaders are interested in AI technology, and both this and another recent survey pointed out that they're using the technology to address back-end operational and workforce management issues. But at the same time, many of those surveyed said the hype currently outweighs the value.
“For technology to have a positive impact on providers, it has to get out of the way and integrate seamlessly into clinical workflows,” Steven Rube, MD, IMO's chief clinical officer, said in the press release. “This survey validated an assumption that … providers needed assistance to seamlessly integrate relevant clinical data in the care of their patients. The pandemic unleashed a torrent of investment in new healthcare software solutions, and provider organizations have struggled to understand which types of software will present the best ROI."
The Rhode Island School of Design's Center for Complexity has developed a new tool that helps non-English patients accurately describe their pain for emergency care providers.
Among the many societal barriers to clinical outcomes is communication. If you don’t speak the same language as your healthcare provider, important things will be lost in translation.
That's especially true in crisis situations such as the Emergency Department, where studies have found that non-English speaking patients have higher morbidity and mortality rates. To tackle that problem, the University of Rhode Island School of Design's Center for Complexity (CfC) is developing technology aimed at translating pain.
Researchers at the center have partnered with Seattle-based "human experience design" company WongDoody to develop Say Your Pain: The Universal Pain Translator, a digital health tool that enables users to describe pain symptoms to care providers. The platform pairs dozens of common pain symptoms, such as throbbing, cramping, burning, and piercing, with animations, enabling care providers to gain a better understanding of a patient's condition and plan care accordingly.
“Humans are complex social organisms whose health is shaped more by the environments they live in and the people they care for than the clinical services they receive," Justin Cook, founding director of the CfC, said in a press release. "The frontier of improving human health is connecting the dots between our biology, our environment and our social lives. This is a complex challenge that demands a creative solution.”
To develop the platform, researchers worked with animators who are experiences in semiotics, or the study of signs and symbols and their use in interpretation, along with more than 30 clinicians. They've designed the tool to be used on most connected devices and, initially, in three core languages: Spanish, Mandarin, and Ukrainian (due to the fact that many Ukrainian refugees are now seeking care from American and Canadian providers).
Cook sees this project as a means of addressing one of the biggest social drivers of health (SDOH) and a key aspect of improving health outcomes for underserved populations.
“Our aim, starting with pain, is to dive directly into the cultural, social and environmental factors that are at the core of human health and develop solutions that make good health and wellbeing available to everyone," he said. "This is critical work in our efforts to achieve health equity.”
It also addresses a considerable challenge in emergency healthcare: Understanding a patient's condition and being able to design a quick and effective care plan.
“Justin and the team at the CfC are committed to bringing humanity back to healthcare," added Grace Francis, WongDoody's global chief creative and design officer, in the press release. "From their deep research and understanding, we were able to spot a design opportunity that can help patients advocate for themselves in medical situations. We hope it will help doctors diagnose faster and more accurately when there’s a language barrier. This has the potential to save lives and could make ER visits less traumatic for patients who don’t speak English."
With the nation's maternal mortality rate rising, hospitals are turning to text messages to make a connection with at-risk mothers.
With recent news that the maternal death rate rose significantly in 2021, healthcare leaders are looking for innovative and effective ways to connect with at-risk mothers-to-be and collaborate on better care management and outcomes.
In Dallas, the spotlight is on the Preterm Birth Prevention Program launched in 2018 by Parkland Hospital and the Parkland Center for Clinical Innovation (PCCI). The program, which affects some 13,000 mothers-to-be a year, uses data on social drivers of health (SDOH) to identify at-risk women and develop targeted interventions aimed at improving care.
"Healthcare itself only accounts for 15% to 20% of health outcomes," says Yolande Pengetnze, MD, a pediatrics specialist and PCCI's vice president of clinical leadership. "True health … comes outside of the health system. That's where we need to be."
The program is one of many being deployed by health systems and payers across the country to tackle the high maternal mortality rate, especially among underserved populations. Many of these efforts are looking outside the typical boundaries of clinical treatment to community and cultural factors that affect healthcare, including employment, housing, transportation, education, daycare, welfare, cultural biases, and other factors that affect healthcare access.
Parkland's program tracks socioeconomic and demographic factors and clinical data to identify pregnant women at risk of preterm delivery. The data also helps providers at Parkland design personalized care plans that meet both the care team's needs and the patient's preferences.
"An informed patient is the best patient in healthcare," says Pengetnze, who notes that prior to using this technology, "we'd wait for them to come to the doctor."
Yolande Pengetnze, MD, vice president of clinical leadership, Parkland Center for Clinical Innovation. Photo courtesy PCCI.
The program is run through a health plan, which uses its database to screen for social drivers of health (SDOH) and make that first connection to patients through their care managers and text messaging. From that point, the patient is directed to a wide range of care management resources, and are even connected to a social worker if needed. In addition, a care team at Parkland is brought in to manage clinical interventions.
"We're trying to create some sort of continuum of care for these patients and be proactive," Pengetnze says. "We want to be able to identify these problems before they come to the doctor."
The program uses personalized text messages like the following:
Remember to take your prenatal vitamins every day! Prenatal vitamins help you and baby get all of the vitamins and minerals you need for healthy growth.
Doctor's visits are a great time to ask all your questions about pregnancy! Bring a list of anything you want to know.
In the third month, baby will be the size of a peach!
Ask your doctor about the signs of labor at your next doctor's visit. It is helpful to know the signs of labor to know when to start preparing.
Stay Safe! Make sure to wear your seatbelt under your belly and over your hips, NOT over your belly. Also try not to drive more than 5 to 6 hours a day.
Pengetnze says the messages are sent two to three times a week, sometimes more often for women deemed at high risk.
And this method has worked. According to officials at Parkland, the interventions have helped to reduce the preterm delivery rate by 20%, boosted prenatal visits to the doctor by some 8%, and reduced costs by 6%. A survey of those taking part in the program, meanwhile, found that almost three-quarters said they felt better prepared to take care of themselves and their new family members.
Those percentages are particularly important to the Medicaid population, which sees a higher rate of preterm deliveries and complications due to access issues. Surveys have shown that socioeconomic factors contribute to stress and depression, which in turn affect preterm health.
The challenge lies in reaching those underserved populations and identifying who needs help. Pengetnze says HIPAA (Health Insurance Portability and Accountability Act) guidelines can hinder how providers use data and connect with patients, while providers often can't locate or access the socioeconomic data they need because patients are reluctant to provide that information. And since text messages aren't secure communications, the program needs consent from the patient before sending them.
"Some women don't even want it known that they are pregnant," she points out. "With SDOH, some data elements are sorely missing in the system. The EHR is a good platform, but we need technology that can collect that type of data and standardize it."
Noting the success with at-risk pregnant women, Pengetnze says the platform can be used to target other populations and health concerns.
"The [text messaging] platform is good because it's simple, and that's what we need to reach out to these populations," she says. "We need to make it simple for them [to connect], and then we'll do the complex part. Any additional step in that process increases the risk of losing that patient along the way."
A new survey from The Health Management Academy finds that healthcare leaders are bullish on AI technology, especially if it can make back office operations easier and help with burgeoning workforce management issues.
A new survey on the use of AI in healthcare finds that roughly half of the health systems surveyed are using the technology for back-office operations and workforce issues—especially nursing--and there's a lot of interest in conversational applications.
The survey of 40 leading healthcare executives, conducted by The Health Management Academy, sees growing support for AI "to fill gaps and improve productivity," according to a press release accompanying the report. And that growth is coming fast: Almost 85% of those now using AI for workforce issues expect a moderate to significant increase in one to three years.
Healthcare organizations are embracing AI at a fast pace, with executives seeing the technology as a means of improving the quality and accuracy of business tasks, reducing manual labor and improving clinical and staff workflows. Some have argued that the industry may be embracing automation too quickly, at risk of fraying the "human element" of healthcare.
Much of the early adoption of AI is driven by the workforce crisis in healthcare, a combination of a shortage of skilled workers and rising labor costs during a sour economy. With health systems struggling to stay in the black, executives are turning to technology.
According to the HMA survey, 47.5% of executives are now using AI for workforce issues, and the rest are "currently evaluating or considering AI solutions for the workforce." Most health systems start with AI in the back office (78% say they're using or evaluating AI for revenue cycle management tasks, while human resources and supply chain management are also popular), where they see "quick financial wins through cost savings." Then they'll move on the clinical operations, then clinical care.
One area of growth is in nursing. According to the survey, only 15% of executives are now using the technology to support their nurses, but 82.5% say they're evaluating AI for that department. And 65% are exploring AI applications for other clinical staff, including call center, administrative, and financial staff.
"Historically, nursing and other clinical staff have been overlooked for technology investments," the report noted. "However, as competition for labor escalates, health systems are seeking new ways to attract and retain talent and ensure staff work efficiently and effectively at the top of their license. Executives recognize that technology plays a big role and are ready to make the investments."
As for what's on the horizon, healthcare executives are intrigued by conversational AI. Just 27.5% are using that technology now, most often in chatbots, while the other 72.5% is evaluating how they might put AI to use.
"Conversational AI incorporates advanced automation, artificial intelligence, and natural language processing to make machines capable of understanding and responding to human language," the report says. "When asked whether their health system uses conversational AI, most executives answer, 'yes, we have chatbots.' While chatbots have gained traction, it is important to acknowledge they are only one of many use cases for conversational AI."
Finally, healthcare executives say they'll be focusing on using AI technology that integrates with other technology and shows ROI. According to the survey, executives list the five most important factors of AI products as interoperability with the EHR, privacy and security, ability to augment EHR capabilities, anticipated return on investment, and expected value (hard and soft) across three or more years.
The Delaware-based health system is jumping into the direct-to-consumer telehealth space with a new service that emphasizes personalized virtual care.
ChristianaCare is launching a direct-to-consumer telehealth program for residents in Delaware, Pennsylvania, Maryland, and New Jersey.
Executives at the Delaware-based health system say Virtual Primary Care challenges the popular DTC telehealth strategy by matching patients with a care team, rather than assigning care requests to the next available provider.
"We offer a personalized approach in which patients have the attention of their care team who are all focused on their specific needs and health goals," Sarah Schenck, MD, FACP, the health system's medical director for virtualist medicine, said in a press release. "Each care team knows their patients and is actively working to help them reach their personal health goals. And when patients need specialized care or services, our providers have access to ChristianaCare’s network and the ability to refer to the trusted services and specialists a patient might need outside of primary care.”
“We are reimagining healthcare by making it radically convenient and accessible, and by creating a unique and personal experience,” added Sharon Anderson, RN, MS, FACHE, the health system's chief virtual health officer and president of ChristianaCare’s Center for Virtual Health, which is overseeing the new program. “The Virtual Primary Care practice goes beyond simply offering video visits to patients. We’ve transformed care so it no longer revolves around waiting for an appointment — it’s immediate, coordinated, continuous. Patients can now access virtual primary care 24/7 as well as a host of other health services — all through their computer, tablet, or smartphone.”
The health if offering subscriptions on a monthly, quarterly and yearly basis, starting at $35 per month, with access to primary care services and text-messaging. Emergency room visits, labs, imaging and specialist referrals are not included in the subscription price.
With this program ChristianaCare is taking on the growing DTC telehealth market and an increasingly competitive primary care marketplace that includes healthcare organizations, telehealth companies, health plans and retail companies like Amazon, Walmart, CVS Health and Walgreens.
While many of these programs are designed to put consumers in front of the first available provider, some health systems are pushing back against that strategy by focusing on personalized care, or care teams that follow the patient's healthcare journey.
"When individuals sign up, they’ll choose their care team of experts including a primary care provider, nurse, and a patient digital ambassador (PDA)," the health system says in the press release. "The patient digital ambassador serves as a personal health guide to assist individuals with registration and technology set-up for their virtual visits. As a care team member, the PDA is available as a personal health guide, while the primary care provider supports patients with their clinical care needs."
Digital health tools that allow providers to electronically prescribe controlled medications can improve care management and curb drug misuse if they're used correctly.
Digital health technology has been hailed as an important tool for healthcare providers in prescribing medications, but those tools can be used for harm as well as good. That's why federal regulators are very strict in regulating digital prescribing, or e-prescribing.
The Centers for Medicare & Medicaid Services (CMS) established new rules at the beginning of 2023 for Electronic Prescribing for Controlled Substances (EPCS), focusing on Schedule II, III, IV, and V controlled substances (including prescription opioids) covered under Medicare Part D. This mandate requires providers to use secure prescribing practices aimed at preventing drug diversion, including multi-factor authentication and comprehensive reporting that tracks prescription events as they occur.
The mandate can be tricky to understand, but it also gives providers an avenue to e-prescribing that can improve care management and outcomes. HealthLeaders recently sat down, virtually, with Dan Fabbri, senior vice president and chief data scientist at Imprivata and an assistant professor at Vanderbilt University, to explain the new mandate.
Q. Under current regulations, what must healthcare providers do to virtually (electronically) prescribe medications?
Fabbri: The federal Electronic Prescribing for Controlled Substances (EPCS) mandate that went into effect at the beginning of 2023 includes two main requirements for healthcare organizations: Multi-Factor Authentication (MFA) and comprehensive reporting to track prescription events. MFA verifies the physician's identity and ensures they have authorization to prescribe a particular medication, while the reporting requirement creates an extensive record of medication prescriptions in order to detect any anomalous activity, such as drug diversion. These requirements apply to all Schedule II, III, IV, and V controlled substances covered under Medicare Part D. To meet the DEA requirements for EPCS, healthcare organizations must have a detailed, highly collaborative cross-functional project plan that outlines the five key phases: assessment, preparation, testing, enrollment, and transition.
Q. How do these regulations reduce the chance of misuse or drug diversion?
Fabbri: Implementing MFA and comprehensive reporting required by the federal EPCS mandate has the potential to prevent and mitigate drug diversion by asking healthcare organizations to create a record of what medications are being prescribed, why they are being prescribed, when they are being administered, and who is prescribing and administering them. MFA confirms a physician's identity and their right to prescribe a particular medication, while the reporting allows auditors to search for abnormal activity such as drug diversion.
While these requirements are much-needed steps in the right direction, they are only as strong as the degree to which they’re implemented. Healthcare organizations must now navigate technology tools to meet compliance requirements while also being careful to not slow down workflows and compromise patient care.
By using the proper tools to ensure only valid physicians are prescribing via MFA and create a digital audit trail of prescription activity to give greater visibility into drug diversion events, healthcare organizations can reduce medication errors, improve patient outcomes, and reduce the number of patient visits, while combating the opioid abuse epidemic. Overall, EPCS enhances accountability and creates room for improvement in prescribing, allowing providers to make better-informed decisions and reducing the chance of addiction.
Q. How do they affect telehealth and digital health programs?
Fabbri: There are Drug Enforcement Administration (DEA) compliant tools that allow for quicker and safer prescribing of controlled substances, even when the provider is not at the hospital. This technology enables patients to get medication as soon as they need it without inconveniencing clinicians.
EPCS has also been a critical component of continuing patient care through telehealth during the COVID-19 pandemic, as practitioners were able to serve patients through approved real-time video platforms while limiting the potential of community spread, due to an exception to the Controlled Substances Act. Proposals have recently been announced to close this telemedicine exemption and require in-person prescribing visits with potentially greater clinician and patient burden.
Q. How can healthcare providers use technology (cyber solutions) to make this process safer and easier?
Fabbri: By using digital identity solutions, healthcare organizations can comply with DEA standards quickly and efficiently while improving visibility into who has been prescribed what, when, and why. By implementing technologies and applications that integrate with their current electronic medical record (EMR) systems, healthcare organizations can achieve EPCS compliance without creating additional burdens on healthcare professionals or IT teams. Digital identity tools can help providers prescribe medication faster and safer without limiting the effectiveness, efficiency, and performance of nursing and physician staff.
For example, healthcare organizations often use multi-factor authentication (MFA). With the latest digital identity technology, doctors can efficiently and securely prescribe needed medications when they are away from the hospital while still complying with EPCS rules. New digital identity tools provide users with a variety of ways to enforce MFA, custom-built for the fast-paced provider workflow. There are several DEA-compliant options providers can choose from - hands-free authentication, push token notifications, fingerprint or facial biometrics, or conventional hardware and software tokens. These options make the authentication process less tedious and time-consuming than typing in a password each time, allowing patients to get their medication without unnecessary delays.
Additionally, AI-powered drug diversion platforms enable healthcare organizations to flag suspicious behavior, such as an unusual number of pills being pulled from a cabinet. This technology also detects less nefarious behavior that raises the risk of drug diversion, like leaving a cabinet open to avoid slowdowns in care. By utilizing MFA and single sign-on solutions in tandem with AI monitoring, healthcare organizations can have better visibility over all prescribing activity in the organizations, also reducing drug diversion.
These solutions empower healthcare organizations to prevent fraudulent actors from obtaining and abusing opioids, while making the EPCS process safer and more manageable for staff. Overall, leveraging these innovative cybersecurity tools can help healthcare organizations ensure compliance with EPCS regulations, and expand their capabilities for detecting, preventing, and remediating drug diversion - all improving patient care.
Q. What are the challenges or barriers that providers have to overcome to use this technology?
Fabbri: While the benefits of EPCS compliance are clear, the complexity of the DEA requirements and certification process can make it a daunting task. The implementation of EPCS also requires a significant number of tactical steps involving various departments such as IT, clinical leadership, pharmacy, application/EHR teams, and compliance/credentialing. Successfully navigating DEA compliance while providing streamlined workflows for clinicians can be difficult, requiring careful planning and coordination between different departments within a healthcare organization.
One of the main challenges for on-the-floor providers to meet EPCS compliance is ensuring that the requirements don’t slow down workflows and negatively impact patient care. To avoid this impact, it will be crucial for healthcare organizations to strategically choose technology that meets compliance mandates while simultaneously improving workflows and patient care.
Q. Can these technologies/processes improve medication adherence and clinical outcomes?
Fabbri: Aided by technology, electronic prescribing ensures that prescriptions are accurately and efficiently transmitted to pharmacies without the potential for mistakes that can occur with handwritten paper-based systems, such as medication errors due to illegibility, incomplete or incorrect information, and fraud due to stolen prescription pads.
By automating the prescription process and integrating AI tools, providers can reduce the potential for human error, and electronic systems can be cross-referenced with clinical decision support tools to alert providers of potential drug interactions or contradictions.
The use of AI and analytics-based cybersecurity tools help healthcare organizations detect suspicious trends and outliers that may impact patient care and improve clinical outcomes by providing valuable insights into prescribing patterns. For example, these technologies can analyze PHI, including EHRs and prescription histories, to identify patients who have been prescribed opioids for an extended period or at high doses, or who have a history of substance abuse. By identifying these patients, healthcare providers can take proactive measures to prevent overprescribing, which in turn reduces healthcare costs, and mitigates legal and reputational risks.
Q. Is there a need or a desire among telehealth advocates to improve the regulations or change them to make the process easier?
Fabbri: Despite a boom in telemedicine, patchwork laws and insurance coverage in the US has hindered telehealth access for years. A repeal of policy that protects telemedicine will limit advancements in providing care through mobile devices and impact patient outcomes.
Q. How should this process evolve? What's on the horizon for electronic prescribing of medications?
Fabbri: The EPCS process is likely to evolve in a direction that requires electronic prescribing of all controlled substances, regardless of payer status. At the federal level, EPCS is only required for controlled substances under Medicare Part D. However, many states already have mandates that require electronic prescribing for all controlled substances, and the trend is likely to trickle up all the way to the federal government. In fact, a new EPCS bill is making its way through Congress that would expand the kind of controlled substances subject to EPCS regulations.
To ensure that EPCS continues to meet the needs of the healthcare industry, healthcare organizations will need to collaborate with regulators and technology vendors to focus on improving the technology and tools used for electronic prescribing, as well as addressing issues related to privacy, security, and interoperability. Overall, the nationwide move towards EPCS is a positive step for improving medication adherence and clinical outcomes—including tackling the country’s opioid crisis— and as the healthcare industry continues to evolve, it will likely become an increasingly important tool for healthcare organizations.
The FDIC take-over of the Silicon Valley Bank this weekend will hit the healthcare technology market hard, affecting not only digital health startups but health systems looking to plan their innovation strategies.
The collapse of the Silicon Valley Bank last week sent a shudder through the healthcare industry, and could have an impact on the digital health ecosystem for some time.
SVB, the 16th largest bank in the country, reportedly had almost $80 billion in deposit and investments—many from healthcare technology companies and venture capital firms—when a run on withdrawals Thursday forced the bank to shut down. Its total assets, according to federal regulators, stood at roughly $209 billion, with some reports saying more than 97% of that was uninsured.
That run was caused by an announcement on Wednesday by the bank, which said it needed money to address a $1.8 billion hole caused by the sale of a $21 billion loss-making bond portfolio consisting mainly of US Treasuries.
This, in turn, created turmoil in the banking sector, with several banks reporting rapidly declining stocks. By the end of the day Thursday, more than $80 billion in stock market value from 18 of the world's biggest banks had disappeared.
The Federal Deposit Insurance Corporation (FDIC) stepped in on Friday and seized the bank, transferring insured deposits to the Deposit Insurance National Bank of Santa Clara. Over the weekend the FDIC announced that insured depositors would have access to their money on Monday morning, while uninsured depositors would have access to at least an advance dividend and a receivership dividend.
Social media was filled with stories of digital health startups scrambling to determine whether they could make payroll, or even remain in business.
According to SVB, the bank was used by more than three-quarters of healthcare-based, VC-backed initial public offerings (IPOs) over the past three years. News reports listed some of the digital health clients as Dispatch Health, Oak Street Health—recently purchased by CVS Health--and Privia Health.
Analysts say this could affect a digital health innovation market that had been flush with cash just a few years ago, when the pandemic contributed to a surge in digital health and telehealth adoption and many banks and investment firms were eager to support these new ideas. This was also helped by federal and state actions reducing barriers to telehealth adoption and reimbursement.
The end of the pandemic, along with a struggling economy, is forcing many healthcare organizations to reassess their innovation strategies. They're pushing startups to show value and demonstrate ROI quickly.
"This is an 'extinction level event' that will set startups and innovation back by 10 years or more," Garry Tan, president and CEO of California-based startup accelerator Y Combinator, said on Twitter, adding that thousands of smaller tech companies could collapse "before the FDIC gets through its receivership process and releases the funds" that these companies need to pay bills.
The impacts of the SVB collapse might also be seen in upcoming healthcare events like ViVE and HIMSS, where innovation is a popular topic. The crisis could impact attendance and cut into the activity in the exhibit hall.
A new study from Trilliant Health finds that the number of people needing help for behavioral health issues is outpacing the healthcare industry's efforts to meet demand, and driving a need for more and better telehealth and digital health services.
The surge in demand for behavioral health services is pushing providers to embrace telehealth and digital health solutions, according to a new report.
The report, Trends Shaping the Health Economy: Behavioral Health, from analytics and market research firm Trilliant Health, finds that behavioral health visit volume has jumped 18% over pre-pandemic levels, and the percentage of virtual visits for behavioral health concerns has surged from 34.4% in 2019 to 63.8% in 2022.
This increase, the study noted, isn't driven by frequent users, but by those seeking help for the first time or occasionally: Some 66% of patients diagnosed with a mental health condition saw a care provider five or fewer times per year.
And it's driving up costs. According to the report, behavioral health issues can exacerbate other health issues, such as diabetes or hypertension, driving up cost by some 20%.
Combined with noted increases in patients seeking specialized behavioral care services and the use of prescription drugs, the study paints a picture of an industry struggling to catch up.
"While the magnitude of the national behavioral crisis is well documented, less is known about how the pandemic changed the behavioral healthcare journey for patients," Sanjula Jain, PhD, Trilliant Health's chief research officer and SVP of market strategy, said in a press release accompanying the report. "Our longitudinal analysis of how Americans accessed care and were treated for behavioral health conditions reveals that, despite increased investments in technology-enabled behavioral health services and inpatient psychiatric capacity, demand continues to outpace available supply."
“This mismatch is already resulting in fewer patients receiving specialized behavioral healthcare, increased prescription use and comorbidity risk, while also growing the total cost of care," Jain added. "These distressing trends suggest that by the laws of economics, the post-pandemic behavioral health market will likely increase the economic burden facing the US healthcare system, which is already fast approaching 20% of GDP.”
The study, compiled from claims databases, also found that the demand for and use of prescription drugs in behavioral health has grown to 21.5% of all prescriptions in 2021. One alarming trend is the prescription of Adderall or its generic equivalent for treatment of ADHD for patients age 22-44. That segment of the population saw a 58.2% increase in prescriptions from 2018 to 2022, while other age groups remained relatively consistent before and after the pandemic.
As for specific behavioral health concerns, anxiety and depressive disorders accounted for 40% of all behavioral health visits in the first half of 2021, yet the condition with the highest increase since 2019 was eating disorders (52.6%). That was followed by anxiety (47.9%), alcohol- and substance-abuse (27.4%), depression (24.4%) and bipolar disorder (12.2%).
The report also finds that those under 18 years old are in need of behavioral health services more than any other age group – with diagnoses for eating disorders more than doubling between 2018 and 2022, followed by depressive disorders (44%). And prescription for this age group jumped 35% over the same time frame.
The jump in virtual visits for behavioral health means that fewer people are seeking help at the hospital. According to the report, the overall share of behavioral health visits to the ED has decreased over the past four years.
But there's a catch. Of those going to the ED for treatment for depression or anxiety, almost half didn't receive follow-up care within 60 days, and 84% of patients seeking treatment for alcohol or substance abuse disorder didn't seek follow-up care at a inpatient or residential treatment center within 60 days. In fact, almost 10% of those patients returned to the ED within 30 days.
The upshot of the study is that America's healthcare industry isn't keeping up with the surge of people needing help for behavioral health issues, even as more healthcare organizations embrace digital health and telehealth to address access issues. The challenge lies not only in adding virtual care alongside in-person care but making the process as easy and intuitive as possible.
The health system is partnering with the YMCA of Northwest North Carolina to add healthcare and wellness services, including telehealth clinics, in 17 sites across seven counties.
Novant Health is expanding access to health and wellness services for underserved populations through the YMCA.
The four-state, 15-hospital health system is bolstering a long-standing partnership with the YMCA of Northwest North Carolina with a program that includes wellness resources, support for youth sports, and on-site and telehealth healthcare services in 17 locations across seven counties.
The partnership seeks to close gaps in care by offering access to services in areas where it may be difficult to connect with healthcare providers, and through community-based locations that are easy to reach. The health system will use TytoCare telemedicine technology to facilitate virtual visits.
For example, Novant Health is building a 1,500-square-foot clinic inside the Winston Lake Family YMCA, which serves the East Winston-Salem community. The first-of-its-kind clinic will offer primary care, women's and children's care, rehabilitation services and diabetes and nutrition support resources. The clinic is expected to open in 2024, and services will be provided through a mobile community care cruiser until then.
“From diabetes prevention to cancer survivorship, Novant Health and the YMCA have always offered complementary services for our communities,” Chad Setliff, senior vice president and president of Winston-Salem-based Novant Health Forsyth Medical Center, said in a press release. “Moving forward, we’ll offer a more integrated wellness experience that leverages the best of both organizations to improve health outcomes for patients and members, strengthen wellness offerings, and reduce barriers to care through a combination of digital tools and co-located clinics.”
“Now more than ever, organizations need to truly collaborate and partner together to drive systemic, meaningful change in our communities,” added Darryl Head, president and CEO of the YMCA of Northwest North Carolina. “Our strategic health and wellness partnership with Novant Health is an example of what can happen when two organizations work together to make change happen. Not only does this collaboration highlight our shared community benefit, but it will also expand our combined services, create new and innovative programming, and bring additional healthcare opportunities to East Winston, one of our most vulnerable areas, with a new, in-branch clinic.”
Health system executives said each new clinic will offer services identified through a Community Health Needs Assessment.
The hospital is launching a pilot program in which 80 patients being treated for blood cancer will use a VR platform to address behavioral health and care management issues.
Massachusetts General Hospital will be enrolling 80 patients in a trial program testing the value of a virtual reality digital therapeutic platform on behavioral health.
MGH, which is Harvard Medical School's largest teaching hospital, is partnering with Rocket VR Health on the program, which aims to improve quality of life, symptom burden, psychological distress, and self-efficacy for patients living with blood cancers who are undergoing hematopoietic set cell transplants (HCT). These patients often deal with a wide range of health concerns during their four-week hospital stay that can affect both short- and long-term health and wellness.
"The capacity to use VR to improve the physical and psychological wellbeing of patients with cancer enduring prolonged hospitalization can increase access and potential for scalability and dissemination of this supportive care platform," Areej El-Jawahri, an associate professor of medicine at Harvard Medical School, director of digital health at the Mass General Cancer Center, and a co-investigator of the study, said in a press release.
“Today, we can deliver therapeutic VR interventions on lightweight, affordable and ergonomic headsets with therapeutic experiences that are more engaging than what has been possible in the past," Rocket VR Health Co-founder and CEO Sid Desai added. "This study will guide us towards validating the efficacy of our digital therapeutic in our effort to build the go-to distress management solution for hospitalized patients.”
MGH and Rocket VR Health have been working since 2021 on a digital therapeutic platform incorporating VR technology, leveraging research on palliative care interventions for patients undergoing HCT. They've developed a four-week program that includes interactive sessions, doctor holograms and meditations in nature-based locations.
