The health system is using a $100,000 grant from Intel to purchase 70 new cameras and microphones, which will be placed in rooms in hospitals throughout Utah and allow care providers in Salt Lake City to monitor and communicate with patients.
Intermountain Healthcare is using a $100,000 grant from Intel to expand a remote patient monitoring program inside its hospitals.
The Salt Lake City-based health system is using the money to purchase 70 camera and microphone units, which will be posted in in-patient rooms in Intermountain hospitals throughout the state. The video feed is monitored by clinical staff in Salt Lake City, giving those smaller, rural hospital an extra set of eyes and ears and an on-demand link to providers in an emergency.
The Patient Safety Monitoring (PSM) program was launched in 2017, with a goal of remotely monitoring patients and helping smaller hospitals facing staffing issues. The program has helped the health system monitor more than 9,500 patients for more than 1.4 million hours.
Aside from monitoring for falls and other emergencies, the program enables patients to communicate with care providers on-demand. It proved especially useful during the pandemic, allowing providers to monitor patients in isolation and reducing room visits. The platform allows one clinical staff member to monitor a dozen rooms at the same time.
“While this pandemic has been taxing on both parties, it is gratifying that there are ways to help alleviate the burdens of the pandemic one way or another to these populations,” Andrew Davis, project lead for Patient Safety Monitoring at Intermountain Healthcare, said in a press release. “We are always strategizing and finding ways to improve safety and this grant helps fulfill that.”
While some healthcare organizations were using RPM and telemedicine technology prior to the pandemic, COVID-19 created a surge of intertest in in-patient virtual care platforms, including audio-visual communications and digital health devices that capture patient information and send it to care providers in another location, such as the nurses’ station.
Healthcare leaders are now looking to adapt those platforms for use after the pandemic, with new tools and technology that increase monitoring and communications capabilities and allow providers to keep a better eye on patients in the hospital.
The Fayetteville, NC healthcare provider recently opened the Dorothea Dix Care for Adolescents to improve access to care and expand treatment to include the whole family.
With one in four children experiencing depression and one in five struggling with anxiety as a result of the pandemic, healthcare organizations are scrambling to develop new ways of addressing the mental health crisis. And they’re finding that treatment works best if it extends to the family.
Cape Fear Valley Health in Fayetteville, NC, recently opened the new Dorothea Dix Care Unit for Adolescents with that strategy in mind. The new facility also addresses an acute need for access in the Fayetteville-Cumberland County area, where families either have to visit the local hospital ER or drive more than an hour for mental healthcare services.
HealthLeaders recently chatted by e-mail with John Bigger, Cape Fear Valley Health’s corporate director of clinical services, about this new facility, and how it improves upon traditional healthcare services for children and adolescents.
Q.What services will the Dorothea Dix Care Unit for Adolescents offer?
JB: The Dorothea Dix Care Unit (DDC Unit) at Cape Fear Valley Health System (CFVH) will be designed specifically to provide help to adolescents from ages 12-17 and their families during periods of acutely exacerbated psychiatric illness in the CFVH system service area. During their short-term stay, youth will participate in individual, group, and/or family counseling with a focus on evidence based adaptive skill building as a foundation for successful reintegration into the community. An individualized treatment plan is developed with the youth and their family that will address and problem-solve around the issue(s) that may have contributed to the current crisis.
A secondary goal of the DDC Unit is to assist the youth and/or their families with accessing support services that will continue to help the adolescent in improving overall functioning within their home or community setting. Having this unit in Cumberland County, NC allows this for a much easier transition for the youth. This unit will likely serve adolescents that utilize resources at a higher level than most when seeking services.
Q.Will you be featuring any digital health tools or platforms? How does digital health figure into your treatment strategy, both now and in the future?
JB: Digital health tools will be utilized to provide psychoeducation through streaming programs related to self-care, education regarding mental illness, and so on. In addition, video components will be utilized to provide opportunities for role playing healthy activities and communication strategies.
In the future, we see digital health as increasing in both capacity and content, which will be utilized to assist patients in adaptive coping skills and learning. As technology improves, digital health will have a positive impact on helping with emotional regulation, biofeedback, access to telecare, and so on.
Q. How do mental health services for adolescents differ from services for adults?
JB: Adolescents are in a unique phase of life where they are trying to establish psychosocially independent functioning through distancing from parents and integration into various peer groups. This presents significant challenges as the adolescent navigates through emotional connection to the family and the push-pull relationships. In addition, the emotional and physical maturity of adulthood has not been established yet, causing significant challenges as well. Mental health services for adolescents need to be delivered through consideration of these unique life challenges and programming will need to be developed which incorporates these elements into the daily treatment.
Finally, parent and family involvement tend to be at a higher level of investment for adolescents so that family therapy is more enhanced.
Q. It sounds as if family and/or caregivers figure prominently in treatment plans. How will this new facility address family and/or caregivers?
JB: Family and caregivers are essential in adolescent care. Oftentimes, mental illness has impacted the entire family, not just the adolescent receiving care. Our psychotherapists in Fayetteville will meet with family members to not only assess functioning within the family dynamic, but to also focus on developing strong aftercare plans, which incorporate ongoing care of the family and the adolescent. This can be achieved through family therapy during aftercare in conjunction with individual and/or group therapy for the adolescent.
Q. The pandemic has certainly brought the need for these services into the spotlight. What lessons have you learned during the pandemic that will affect how you treat adolescents or how you designed this new facility?
JB: The pandemic has presented significant challenges with adolescent mental health care across the country. Social distancing has impacted the ability to identify and establish appropriate social integration and social groups. School isolation and limited extracurricular activities have limited the ability for people to interact. In addition, social media has become a social norm, and this is fraught with its own challenges in relation to fitting in, social bullying, and so on.
The lessons we have learned play a key role in how we approach treatment. We will have more face-to-face sessions while at the same time utilizing the digital learning platforms listed earlier to help guide adolescents through establishing appropriate interactions with others, both interpersonally and through social media platforms. We will also work with the adolescents to focus on challenges they face through the pandemic and how we can help to address them on an individual basis.
Q. What are the biggest challenges you face in providing mental health care for adolescents?
JB: The biggest challenges we face are related to simply finding the right resources for adolescents upon discharge from our facility. Simply put, we need more outpatient providers that support adolescents through evidence-based practices. We do not have enough in our community, and the need is there. In addition, challenges remain regarding how to navigate the journey into adulthood while dealing with the pressures of peer groups, social media, and the like.
Having a strong support group/system becomes critical for adolescents facing the stage of life. The Dorothea Dix Care Unit is a step in the right direction for the Fayetteville-Cumberland County region, allowing patients to work with board certified psychiatrists, and for local families to be more involved in the treatment process. The unit opens the doors for better access, meaning children in crisis can get immediate care, rather than waiting for a bed elsewhere while spending longer periods of time in the Emergency Department.
Q. What new technology or services would you to use in the future? What’s out there that you’re excited about trying out?
JB: As mentioned earlier, digital technology development will have a dramatic impact in the future, where adolescents will be able to reach out for help through various platforms. It would be great for an adolescent to be able to use an app so they can check in with a therapist, access breathing techniques, have biometric information on their phones they can utilize to provide biofeedback, and so on. Other future things involve checking medication levels remotely, utilizing technology to learn about one’s body, and so on.
Q. How will these services or this facility evolve?
JB: I think research leads this area. While there are a tremendous number of ideas regarding technology, there needs to be development into functional realms prior to implementation. Then, once the functionality of an idea is developed, it needs to be researched through evidence-based research to ensure that it works, and works the way it’s supposed to.
Finally, parameters need to be put into place to ensure the new technology is not able to be used in a harmful way. As an academic/teaching hospital we’ll be able to establish cutting edge techniques to help our patients.
Health systems like Magnolia Regional Health Center are boosting patient engagement and reducing wasted prescriptions with new services at the point of care.
Medication adherence is a significant pain point for healthcare providers, contributing to wasteful expenses, physician stress, and reduced clinical outcomes. Some health systems are turning to digital health technology not only to help patients take prescribed medications, but to make sure those drugs are the most appropriate and economical.
At Magnolia Regional Health Center in Corinth, Mississippi, clinicians are using a digital tool developed by DrFirst within their Meditech EHR to identify prescription benefits and therapeutic alternatives (ranging from other treatments to lower-priced generic medications) with patients at the point of care. The myBenefitCheck tool enables clinicians to reduce the chances of a patient deciding not to fill a prescription or follow dosing instructions.
"We've had some challenges over the years," says Brian Davis, CHCIO, the hospital's chief information officer.
A 2017 study estimated that 69% of patients with at least $250 in annual medication costs are abandoning their medications, a percentage that had risen steadily due to rising out-of-pocket costs, and undoubtedly has gotten worse because of the pandemic. Health systems like Magnolia are now using new tools to address that issue at the point of care.
Where clinical decision support tools originally allowed care providers to research symptoms and identify treatments, new technology taps into the EHR and other databases to expand that palette. Providers can now access the entire patient record, including claims data, to better understand how a specific patient might react to a specific treatment (including whether a patient can afford that treatment) and collaborate with the patient on treatments that would work.
To study the tool's effectiveness, Magnolia Regional analyzed medication adherence and prescription fill rates for 417 patients living with congestive heart failure (CHF) between July 2020 and September 2021. They found that first-fill prescription abandonment rates for expensive antithrombotics was higher for patients readmitted to the hospital (50%) than for patients who didn't have to return (35%), while there was little difference between the two groups when less expensive anticoagulants were prescribed. The evidence indicated that patients were not filling their prescriptions or not following doctor's orders when cost was a factor.
Brian Davis, chief information officer for Magnolia Regional Health Center. Photo courtesy MRHC.
Davis says these tools allow doctors to talk with patients at their most vulnerable moment—when they're being diagnosed and given a course of treatment. That's when clinicians may have the best chance of ensuring long-term care management.
"If providers had access … at the point of care, they could have better conversations," he says. "This allows our care providers to get in front of medication adherence."
Magnolia Regional's experience is one example of how innovative technologies and strategies are being used to improve medication management. Some providers use digital pill boxes, telehealth platforms, or mHealth apps to track medication adherence at home, while others are deploying technology to give clinicians the resources to discuss adherence with patients as they're being treated.
The advances extend to eprescribing as well. At the recent HIMSS22 conference in Orlando, First Databank (FDB) unveiled FDB Vela, a cloud-based platform that integrates with the EHR and, according to its makers, "enables the seamless flow of critical medication prescription information, benefits verification, and clinical decision support between prescribers, payers, pharmacies, and other constituents."
"Drug information needs to be integrated into the EHR" to give clinicians tools at the point of care, says Robert Katter, FDB's president.
Katter says much of the innovation these days is tied to patient-centered care. Consumers are asking for that information, he says, when they meet with care providers, so that they can make informed decisions about their care.
The new technology and strategies address several concerns in care management. Aside from aiming to reduce the amount of wasted or unused prescriptions, care providers want to know whether the treatments they're prescribing are working, and that only happens if the patient is following doctor's orders. Pharmaceutical companies would also like to know that information, which they could use to design more effective medications.
Then there are the clinical outcomes. If a patient doesn't follow treatment, the condition might worsen, perhaps leading to more treatments and even hospitalization. The same outcomes might be seen in a patient that is taking the wrong medications, or not taking the right doses.
Davis says that care providers have the opportunity to talk with patients not only about the different types of treatments available, but the varying degrees of effectiveness. One drug may be more expensive than a generic alternative, but it's more likely that the first drug is more effective, while the generic drug may get the job done but over more time. The doctor might also find more information in the patient's medical record on the potential for side effects.
Branded, higher-cost medications "do tend to show better outcomes," says Davis. But that doesn't mean a generic medication isn't effective. And if a patient can afford only the less expensive drug, there's a much better chance that he or she will fill the prescription and follow doctor's orders.
"It has led to several changes in medications," he says.
These tools also affect patient engagement, or activation. A clinician who has more specific information at the point of care stands a better chance of having a meaningful conversation with the patient, one that gets the patient involved in his or her care. A more engaged patient would then most likely follow the care management plan, or be more inclined to work with the clinician to make sure the course of treatment is effective.
Davis sees these new tools and strategies as the first step in a more comprehensive care management program, particularly for patients with chronic conditions. And they point to the need for a robust EHR that includes a patient's complete medication history and integration with both the health plan and the pharmacy.
Beyond that, there's an opportunity on these platforms to identify social determinants of health, such as why a specific patient won't take certain medications or can't afford them. A clinician who has insight into a patient's home and family life, financial concerns, and other pressures would then be able to design an appropriate care management plan that offers a better chance of being followed.
"There's some work there in balancing these things out," he says.
Against the backdrop of the war in Ukraine, two senators have unveiled the Healthcare Cybersecurity Act of 2022, which would bring federal resources to bear on the top technological threat to healthcare organizations.
Congress is taking on healthcare privacy and security.
Senators Jacky Rosen (D-NV) and Bill Cassidy (R-LA) have introduced the Healthcare Cybersecurity Act of 2022, which aims to bring the federal government in to help healthcare organizations protect their resources against hackers.
“In light of the threat of Russian cyberattacks, we must take proactive steps to enhance the cybersecurity of our healthcare and public health entities,” Rosen said in a press release. “Hospitals and health centers are part of our critical infrastructure and increasingly the targets of malicious cyberattacks, which can result in data breaches, the cost of care being driven up, and negative patient health outcomes. This bipartisan bill will help strengthen cybersecurity protections and protect lives.”
The bill has three components. If passed into law, it would:
Require the Cybersecurity and Infrastructure Security Agency (CISA) and Department of Health and Human Services (HHS) to collaborate on improving cybersecurity in the healthcare and public health sectors, as defined by the CISA;
Authorize cybersecurity training for healthcare organizations on cybersecurity risks and ways to mitigate them; and
Require the CISA to conduct a detailed study on specific cybersecurity risks facing the healthcare industry, including an analysis of how cybersecurity risks specifically impact healthcare assets, an evaluation of the challenges that these organizations face in securing updated information systems, and an assessment of relevant cybersecurity workforce shortages.
In January, the ECRI Institute listed the threat of cybersecurity attacks as this year’s top technological threat to healthcare organizations.
“The question is not whether a given facility will be attacked, but when,” Marcus Schabacker, MD, PhD, the ECRIs’ president and chief executive officer, said in a press release accompanying the Top 10 Health Technology Hazards for 2022. “Responding to these risks requires not only a robust security program to prevent attacks from reaching critical devices and systems, but also a plan for maintaining patient care when they do.”
Nearly 50 million people saw their personal health data accessed illegally in 2021, a threefold increase over the past three years, according to Politico. And hacking accounted for three-quarters of those data breaches, more than double the 35% figure reported in 2016.
“Unfortunately, the industry is pretty much easy pickings, and they’re hitting it because they’re getting paid,” s Mac McMillan, CEO of cybersecurity company CynergisTek, told Politico. “It’s [not] gonna slow down until we either get more serious about stopping it, or blocking it, or being more effective at it. From the cybercriminals’ perspective, they’re being successful, they’re getting paid, why would they stop?”
Researchers used an AI tool to detect heart problems in the voice recordings of patients, while the health system unveiled a new program for new companies looking to develop AI platforms.
Researchers at the Mayo Clinic have developed an AI tool that can screen a patient’s voice recording for evidence of coronary artery disease (CAD).
According to a study published in Mayo Clinic Proceedings, researchers led by Jaskanwal Deep Singh Sara, MD, a cardiology fellow at the Mayo Clinic, developed a smartphone app for AI voice analysis that is able to accurately predict which patients have clogged arteries, which can cause heart attacks. The study builds on earlier work that had identified vocal biomarker components in voice samples.
“Telemedicine is non-invasive, cost-effective and efficient and has become increasingly important during the pandemic,” Sara said in a press release issued by the American Cardiology Association. “We’re not suggesting that voice analysis technology would replace doctors or replace existing methods of health care delivery, but we think there’s a huge opportunity for voice technology to act as an adjunct to existing strategies. Providing a voice sample is very intuitive and even enjoyable for patients, and it could become a scalable means for us to enhance patient management.”
Researchers found that a patient with a high voice biomarker score was 2.6 times more likely to suffer major problems associated with CAD and three times more likely to show evidence of plaque buildup. It reportedly is the first study of its kind to use voice analysis technology to predict CAD outcomes.
According to the ACA press release, the Vocalis Health algorithm has been trained to analyze more than 80 features of voice recordings, including frequency, amplitude, pitch, and cadence, based on a training set of more than 10,000 voice samples collected in Israel. Researchers had identified six features that were highly correlated with CAD and combined them into a single score, expressed as a number between -1 and 1 for each individual. One-third of patients were categorized as having a high score and two-thirds had a low score.
Sara said researchers haven’t determined why certain vocal features indicate a prevalence for CAD, but they’re looking closely at the autonomic nervous system, which regulates the voice box, many parts of the cardiovascular system and other bodily functions that aren’t under conscious control.
In addition, the study focused on English speaking patients in the Midwest, using software developed in Israel. More studies will be needed to determine if the platform works in other languages and dialects, and whether the platform can be scaled to address other chronic conditions.
The news follows a report just last week that researchers at Cedars-Sinai have developed an AI tool that can analyze plaque buildup in a patient’s arteries to predict if he or she will likely have a heart attack within five years.
And it comes alongside the Mayo Clinic’s launch of an incubator for AI platforms, joining a growing number of health systems looking to develop innovative home-grown services.
Mayo Clinic Platform_Accelerate recently launched its first 20-week program, with four start-ups in the first class. The companies will work with Mayo Clinic researchers as well as experts from Google and Epic to develop, test and eventually market new technologies.
"Health tech startups are critical contributors to the cycle of innovation," John Halamka, MD, president of the health system’s Mayo Clinic Platform initiative, said in a recent press release. "We are excited to collaborate with these innovators to solve some of the most complex problems in medicine today."
With interest in AI soaring – and some critics saying the hype has far outpaced practical applications – health systems are looking to cut through the static by developing their own platforms. They’re using incubators to attract promising start-ups, then guiding the companies’ growth with the goal of fine-tuning their products before they go to market.
"We are helping participants take a crucial step in their growth trajectory by providing startups with a disciplined focus on model validation and clinical readiness to show product value," Eric Harnisch, vice president of partner programs for Mayo Clinic Platform, said in the press release. "The program is integral to our Mayo Clinic Platform mission to enable new knowledge, new solutions and new technologies that improve patients' lives worldwide."
The four startups chosen for the Mayo Clinic program are:
Cliexa, based in Denver, which “aims to transform patient-centered data into actionable insights for people with cardiovascular conditions and multiple chronic diseases such as diabetes;”
Quadrant Health, based in New York, which “will analyze electronic health record and patient messaging data to triage messages and predict patient harm before it occurs;”
ScienceIO, based in Boston and New York, which “will develop tools for organizing data to help streamline care and reduce the administrative burden for physicians;” and
Seer Medical, based in Melbourne, Australia, which “will use data to refine and test its home-based epilepsy diagnostics and management models, as well as look for digital biomarkers to predict seizures.”
The Workgroup for Electronic Data Interchange and the Confidentiality Coalition have written a letter to federal officials calling for more protections for patient information accessed through third-party mHealth apps.
Two organizations focused on protecting patient data are urging federal officials to take several steps to protect that data from unsafe third part mHealth apps.
The Workgroup for Electronic Data Interchange (WEDI) and Confidentiality Coalition have written a letter to Health and Human Services Secretary Xavier Becerra and Commerce Secretary Gina Raimondo offering five recommendations for protecting patient information on third party apps, much of which isn’t covered by the Health Insurance Portability and Accountability Act (HIPAA).
“Some CEs, including health plans, physician practices and inpatient facilities have already built or have contracted with business associates to develop patient access APIs and apps and are actively promoting their use,” the letter points out. “Specifically, these apps deployed by providers and health plans are typically covered under HIPAA and therefore the individual’s accessing data have assurances that their information is being kept private and secure. We are concerned, however, regarding the lack of robust privacy standards applicable to the large percentage of third-party app developers not associated with CEs and therefore not covered under HIPAA and the fact that there currently is no federally recognized certification or accreditation for these apps.”
“The potential exists for PHI gained via the apps to be inappropriately disclosed to the detriment of patients and their families,” the letter states. “While we strongly support patient access to their PHI via apps, we assert that a national framework is required to ensure that health care data obtained by third-party apps is held to high privacy and security standards.”
In response, the two groups are urging Becerra and Raimondo to:
Release additional guidance on the types of third-party app security and privacy verification that will be permitted and allow CEs themselves to undertake an appropriate level of review of a third-party app before permitting it to connect to their APIs;
Require entities that are not HIPAA CEs or business associates to clearly stipulate to the individual the purposes for which they collect, use, and disclose identifiable health information and require that these individuals be given clear, succinct notice concerning the collection, use, disclosure, and protection of individually identifiable health information that is not subject to HIPAA;
Work with the private sector in the development of a privacy and security accreditation or certification framework for third-party apps seeking to connect to APIs of certified health IT. Once established, CEs should be permitted to limit the use of their APIs to third-party apps that have agreed to abide by the framework. Such a program would not only foster innovation, but also establish improved assurance to patients of the security of their information;
Apply similar security requirements in the private sector as CMS applies to its Blue Button 2.0 and DPC initiatives, requiring all third-party apps seeking to access PHI via provider or health plan APIs to prove adherence to a strict set of privacy and security guidelines or successfully complete a CMS-approved security certification; and
Partner with groups like the Confidentiality Coalition, WEDI and other professional associations in the development and deployment of education aimed at a wide range of consumers and CEs. Enhanced consumer and CE education will lead to significant improvement in the ability of the consumer and the CE to understand their rights and responsibilities under the law.
According to the two groups, recent evidence indicates mHealth third-party apps are vulnerable to unauthorized access and use. They applaud efforts to update HIPAA to account for new technologies and tactics, but say more needs to be done now.
“While we are supportive of increasing data exchange for patients via third-party apps, there is a clear potential that using these apps could result in patients having their information inappropriately disclosed,” the letter states. “We also assert that it is inappropriate to put the burden of warning the individual solely as the responsibility of the CE. CEs will typically not be experts on app data privacy and security protocols and will have little time to warn patients of the potential dangers associated with transmitting ePHI to third parties not covered by the HIPAA protections. Under current regulation, CEs are not permitted to require formal verification checks on individual third-party apps before allowing the application to connect to its API.”
“We believe that for health care data exchange to occur in an interoperable manner as called for under the 21st Century Cures legislation, there must be a consistent and high level of trust among all participants, including entities that are not legally a CE or bound by a BAA,” it concludes. “The deployment of effective federal policies is critical to assist in facilitating this trust framework.”
WEDI was formed in 1991 by then-HHS Secretary Dr. Louis Sullivan to “identify opportunities to improve the efficiency of health data exchange.” The Confidentiality Coalition is a broad group of healthcare organizations formed by the Healthcare Leadership Council to focus on advancing effective patient confidentiality protections.
Researchers at the Los Angeles health system have developed an algorithm that can reportedly predict a patient's chances of having a heart attack over the next five years by analyzing plaque deposits in coronary arteries.
Researchers at Cedars-Sinai have created an AI tool that may help care providers predict a patient’s chances of having a heart attack over the next five years.
The algorithm analyzes the amount and composition of plaque in arteries that supply blood to the heart to determine heart attack risk. In the 11-site, international SCOT-HEART study involving almost 1,611 patients from 2010 to 2019, the tool offered “excellent or good agreement” with expert reader measurements and intravascular ultrasound.
“Coronary plaque is often not measured because there is not a fully automated way to do it,” Damini Dey, PhD, director of the quantitative image analysis lab in the Biomedical Imaging Research Institute at Cedars-Sinai and senior author of the study, recently published in The Lancet, said in a press release issued by Cedards-Sinai. “When it is measured, it takes an expert at least 25 to 30 minutes, but now we can use this program to quantify plaque from CTA images in five to six seconds.”
The study is the latest effort by healthcare providers to apply AI tools to the clinical care process, and it offers a glimpse into how the technology can help healthcare providers treat their patient and improve outcomes.
“A deep learning system that rapidly and accurately quantifies coronary artery stenosis has the potential for integration into routine CCTA (coronary CT angiography) workflow, where it could function as a second reader and clinical decision support tool,” Dey and her colleagues said in the study. “By providing automated and objective results, deep learning could reduce interobserver variability and interpretative error among physicians. Deep learning-based plaque volume measurements have independent prognostic value for future cardiac events, and could enhance risk stratification in patients with stable chest pain who are undergoing CCTA.”
According to the press release, Dey and her colleagues designed an algorithm that outlines coronary arteries in 3D images, then identifies the blood and plaque deposits within them. They found that the measurements corresponded with plaque amounts seen in coronary CTAs, and also matched results with “images taken by two invasive tests considered to be highly accurate in assessing coronary artery plaque and narrowing: intravascular ultrasound and catheter-based coronary angiography.”
Using AI in healthcare was a hot topic at the recent HIMS22 conference in Orlando, but experts are divided on where the hype ends and the reality begins. Some also worried that the potential could lead researchers and providers to overlook bias in AI, or use the technology incorrectly.
In their study, Dey and her colleagues noted that they searched available databases for past research on AI, and found 26 articles exploring the use of deep learning to assess coronary lesions on CCTA. Most of those were proof-of-concept studies, they said, and none were detailed enough to provide evidence of long-term viability.
“More studies are needed, but it’s possible we may be able to predict if and how soon a person is likely to have a heart attack based on the amount and composition of the plaque imaged with this standard test,” Dey, a professor of biomedical sciences at Cedars-Sinai, said in the press release.
Amerigroup Georgia is partnering with Mom's Meals on the program, which addresses social determinants of health and aims to help reduce pregnancy and delivery complications in a medically complex and underserved population.
A Georgia-based health plan is sending two nutritionally customized meals a day to pregnant members living with diabetes in an effort to reduce delivery risks and boost clinical outcomes.
Amerigroup Georgia is partnering with Mom’s Meals on the pilot program, which gives moms-to-be an important source of nutrition for 10 straight days in a bid to reduce chances of preterm delivery and caesarean sections.
“One of the major issues with pregnant members with diabetes is managing food intake,” Dr. John Lue, Amerigroup Georgia’s obstetric medical director, who initiated the study, said in a press release. “Although we already offer nutritional counseling and a blood glucose meter, patients still become hyperglycemic and often require inpatient hospitalization to stabilize blood glucose levels. Our hope is for the provision of up to 140 medically tailored meals and improved behavior management to result in better health for expectant mothers and their developing babies.”
Amerigroup Georgia launched the statewide program in September 2021 with Iowa-based Mom’s Meals, and has so far delivered more than 6,000 meals to 74 members. The program, which runs through September 2022, will now be opening up to obstetric members in the Georgia managed care program.
The program is modeled after the Simply Healthcare Plans in Florida cost-of-care initiative, which helped to reduce both maternal hospital and neonatal intensive care unit (NICU) admissions.
“We hope that this model in Georgia can eventually become a standard benefit and expand to other states, especially those with higher rates of expectant mothers with diabetes,” Tim Conroy, national vice president of government and healthcare partnerships for Mom’s Meals, said in the press release.
Officials will measure the value of the program in the number of C-sections and other delivery complications, maternal hemoglobin A1C values and random glucose screenings, birth outcomes, and the reduction in other risks associated with diabetes during pregnancy.
Roughly 1 million Georgians, or about 12.4% percent of the state’s population, are living with Type 1, Type 2 or gestational diabetes, according to the American Diabetes Association; many others have been undiagnosed or have health factors that put them at high risk of developing the chronic disease.
Nutrition is considered one of social determinants of health, a non-clinical issue that factors, directly or indirectly, into one’s health and wellness. Many healthcare organizations, from providers to payers, are developing new programs that address those factors, the barriers they may cause to healthcare access and the effects they have on clinical outcomes.
The Department of Veterans Affairs is partnering with Evidation to allow veterans to enroll in a program that helps them monitor their heart health through a smartphone or wearable.
The Department of Veterans Affairs is launching a new program aimed at helping veterans manage their heart health through their smartphones and wearables.
The VA and the Veterans Health Administration Innovation Ecosystem (VHAIE) are partnering with California-based digital health company Evidation to enroll veterans in Heart Health on Evidation, a program co-developed with the American College of Cardiology in 2020. The program will be open to veterans regardless of whether they are living with heart disease.
“Veterans who join Heart Health can track and understand their heart health and chronic conditions outside of the doctor’s office from anywhere,” Arash Harzand, MD, a VHAIE senior innovation fellow, said in a press release. “Daily activity, sleep and mood can have a serious impact on heart health and this program gives Veterans an opportunity to measure and engage with these important personal health metrics.”
The program is one of many to use mHealth technology to expand opportunities for consumers and providers to track and manage chronic conditions outside the hospital, clinic or doctor’s office. The program is accessible through an mHealth app (it’s available via iOS and Android) on a smartphone, and participants can also connect through devices such as a smartwatch.
Programs like that offered by Evidation allow consumers to track relevant data, including activity, weight, diet, moods and symptoms, and access resources on cardiac health and wellness. Users can also get personalized reports that chart their health data over time and share that information with their care providers.
Some programs also partner with healthcare providers as a precursor to remote patient monitoring services, in which providers track patient health on devices over time and use that data to create a care management plan.
HIMSS22 returned to form last week in Orlando with a smaller yet energetic event, and a mission to reimagine health so that it works for everyone.
This year's HIMSS22 conference may have been more about improving the healthcare experience for everyone—healthcare workforce included—than patient care.
The annual get-together of HIMSS made its return to form with a weeklong event last week in Orlando, featuring a smaller but energetic exhibition hall, busy educational sessions, an inspiring closing keynote on mental health by Olympic champion Michael Phelps, and a "let's get back to business" air that recognized the challenges facing the healthcare industry.
And while the theme was "Reimagine Health," the focus was squarely on new technologies and processes that improve workflows and make it easier for providers to deliver care, thus reducing the stress on an overworked and shrinking workforce.
"They can't deliver care if you don't have healthy caregivers," one attendee said in the exhibit hall.
Caused in large part by the pandemic, the healthcare workforce in the U.S. is down to only 450,000, according to Roy Jakobs, chief business leader of connected care for Philips, which opened HIMSS22 at a virtual press briefing. That workforce is expected to be short 3.2 million by 2026, he said, forcing health systems to be creative about how they deliver health and support their employees.
There are many reasons for this shortage, beginning with surging rates of stress, depression, and burnout that are pushing people out of healthcare and causing many others to have second thoughts about joining the workforce. To address these challenges, HIMSS offered dozens of sessions on behavioral health access and innovation for both patients and providers, while several exhibit hall presentations and booths targeted preventive health and wellness, as well as mental health integrations (often through virtual care) with clinical services.
Beyond that, many healthcare companies sought to highlight technology that improves the clinical care process, including AI and digital health tools and platforms that reduce the administrative burden for healthcare providers and improve workflows. The theme running around the convention center was that technology should be used not only to boost clinical outcomes and improve access to care but to make the clinician's job easier.
"The pandemic has fast-tracked how we think about healthcare," said Elise Kohl-Grant, chief information officer at Innovative Management Solutions NY, whose presentation at HIMSS22 focused on how to advance "equitable interoperability" to help underserved communities access behavioral health services that address the social determinants of health.
Speaking in a bustling corridor at the Orange County Convention Center prior to her session, Kohl-Grant spoke about the structural determinants that often define healthcare access, and about how new technology, from natural language processing tools that record and summarize conversations to data-mining tools that pull out relevant information, can help care providers improve their interactions with patients. This means the providers spend less time doing administrative work and more time understanding why a patient needs care and how to better provide that care.
"Simple things like appointment reminders can make a lot of difference," she said. And while those reminders help patients remember and plan for their appointments, a digital health platform that automatically sends out those reminders reduces stress on the providers, helps them cut down on missed appointments, and boost patient engagement.
"We've learned to be more nimble and change when we need to," said Don Gerhart Jr., RPh, who works in pharmacy clinical informatics at Pennsylvania-based WellSpan Health, and led a presentation on using AI for smart data migration and EHR consolidation. Gerhart said health systems that can use new technology to fine-tune the EHR and improve clinical functions not only boost efficiency, but also make clinicians more proficient and even appreciative of the EHR.
And that makes the whole healthcare experience better.
Putting a Spotlight on Innovation
To be sure, the pandemic has changed a lot about healthcare. Beyond the staggering and still-growing toll on patients, it cast a spotlight on a health system that had to pivot quickly and become innovative to handle the surge. Hospitals that had never tried telehealth launched new services within weeks, while others saw their 10-year digital health plan accomplished in a year.
There was clear evidence in the exhibit hall, where Zoom—once considered too simplistic for healthcare—now commands a presence as one of the fastest-growing virtual health platforms. Salesforce, a relatively new entrant into the healthcare industry, highlighted services honed in the business world that aim to improve back-end operations, strengthen patient engagement, and allow care providers to spend less time on a computer and more time with their patients.
Hyland Software offered a presentation of its new connected care platform, featuring technology that pulls in and sorts unstructured data coming from outside the EHR. Get Real Health held a press conference at its booth to unveil CHBase Unify, a "digital front door app platform" that represents the evolution of the personal health record and aims to improve patient engagement. Bamboo Health—formerly Appriss Health and PatientPing—talked up care collaboration and integration at its booth, while symplr and Tegria chatted up the benefits of health systems partnering with tech companies and even outsourcing services to reduce the IT burden.
And while health systems have always had a limited presence in a venue designed to focus on vendors, Intermountain Health planted itself squarely in the middle of the floor with a large booth. The Salt Lake City–based health system has always been one of the leaders in digital health innovation, with a virtual care network spanning several states. Its participation in HIMSS22 points to the challenges that hospitals and health systems now face in increased competition from retail health providers and health plans and telehealth companies that have their own networks of providers.
"It is about patient choice now," said Michelle Machon, RN, MSN, DNP, CPHIMS, CENP, director of clinical education, practice & informatics for the Kaiser Foundation Hospitals, who was in town to anchor a presentation on how technology changed pandemic communications.
Machon said that when the pandemic started, health systems launched virtual care services using whatever they could find, including Zoom, Skype, and Google Chat, because that's what their patients wanted to use. And they were innovating in other areas as well, using baby monitors in the ICU and commercial blood glucose monitors to track patients in isolation.
"Now it's becoming the norm," she said.
Like so many others said at HIMSS, Machon says healthcare will change because the public will want it. They've seen what virtual health can do during a pandemic, and how technology has improved their travel, banking, retail, and dining experiences, and they'll demand that of their care providers or look for someone who will offer that experience.
Healthcare leaders, meanwhile, will look at soaring rates of stress and burnout and ever-shrinking workforces and conclude that a healthy workforce is an imperative, and that means not only addressing mental health needs but making it easier and more efficient for care providers to do their job.