The Iowa health system has launched a subscription-based program, with help from Fitbit, to not only encourage people to improve their health and wellness, but share that information with the care providers.
Healthcare organizations are looking to the consumer wearables space to promote health and wellness, with the goal of improving patient engagement and clinical outcomes.
The latest to do so is MercyOne, which has launched a subscription-based wellness platform aimed at helping consumers improve their lifestyles through digital health.
The Iowa-based health system is making its Circle+ powered by MercyOne platform available to anyone, whether or not they’re a patient. Participants can sign up and complete an assessment to gain access to a suite of virtual resources and mHealth apps, at a charge of $19.99 per month.
The program, unveiled this past March, combines the benefits of the consumer-facing digital health market with the support of a healthcare organization, which can curate and recommend specific resources and products. Surveys have shown that consumers will embrace health and wellness ideas more readily if they’re supported or recommended by a healthcare provider.
The health system is partnering with Fitbit on the program, which gives members a free Inspire 2 fitness tracker or preferred pricing on a more expensive wearable, as well as a Fitbit Premium membership. Other benefits include access to apps like Navigate Wellbeing, Total Brain, and Fringe.
“MercyOne has embraced consumer-facing digital health overall including remote patient monitoring, virtual nursing, [and] virtual triage, as well as virtual visits for primary and specialty care and more,” MercyOne President and CEO Bob Ritz said in an e-mail interview with HealthLeaders. “This partnership with Fitbit is just one of the ways we are continuing to offer care anywhere and connect with consumers in new ways.”
“Our mission calls us to transform the health of our communities, and our vision is to set the standard for a personalized and radically convenient system of health services,” he added. “Ultimately with Circle+ powered by MercyOne, we want to connect with people before they are sick to keep them well. We develop comprehensive business plans to support our innovation initiatives, which include return on investment assessments.”
Officials say the program will not only drive interest in preventative care, but support the health system’s clinical services as well. They want people in the program to not only pay more attention to their health, but share that data with their care providers, who in turn can guide them and improve care management.
“We plan to evolve our … program to support clinical pathways,” Janell Pittman, MercyOne’s chief marketing and digital strategy officer, said in the e-mail exchange. “MercyOne has long been a believer in the impact social influencers of health have on health outcomes and has employed community health workers, health coaches and more to impact health outcomes by addressing loneliness, transportation, prescription access and food security to name just a few. We will continue to transform the health of our communities by supplementing analog approaches with digital with expanded use of remote patient monitoring, expanded connections to patients via asynchronous and synchronous care, hospital at home and more.”
“We do encourage members to download critical pieces of [the program] to share with their provider,” added Try Cook, the health system’s division director of business solutions. “These items include the results of wearable tracking, health risk assessment summary, health coaching goals, and other results-oriented metrics. Each member is provided specific instructions on how to download and provide this info to their providers. Our providers and care managers will use this data and member input to provide personalized care.”
The Children's Community Health Plan is using a digital therapeutic to improve patient engagement and give members dealing with panic disorder an alternative to medication or emergency in-person treatment.
Healthcare providers and payers often look for alternatives to medication in treating chronic conditions, especially those experienced by children. One increasingly popular example is digital therapeutics, which can be delivered virtually, though an mHealth app, when and where needed.
The Children's Community Health Plan (CCHP) is seeing success with one such treatment for members dealing with PTSD and panic disorder. The Milwaukee-based health management organization, an affiliate of Children's Wisconsin, recently made a digital health platform developed by Freespira available for free to its 150,000 members, roughly 60% of which are children, and saw success in roughly 70% of the people who used the platform.
"We've been pleasantly surprised by the number of members who have engaged in treatment," says Mark Rakowski, the health plan's president.
The key word is "engaged," and it's one that healthcare organizations like CCHP have long struggled with in chronic care management. People often have a difficult time sticking with a treatment over a lengthy period of time—and with chronic conditions that time might be a lifetime. Patients get tired, lose interest, the treatments fall off, and the chances of negative health outcomes shoot upward.
A Digital Health Alternative to Drugs
Digital therapeutics, defined by the Digital Therapeutics Alliance as "medical interventions delivered directly to patients through evidence-based, clinically evaluated software," takes aim at the patient engagement dilemma. Advocates say these treatments, delivered via mHealth apps, devices, even video games, have the potential to hold patients' attention longer and make them more inclined to manage their healthcare.
With CCHP, the motivation to use this treatment stems from a statistic from the Centers for Disease Control and Prevention (CDC) that nearly 3 million children have been diagnosed with a serious emotional or behavioral health condition during the pandemic, and that roughly 6% of children ages 6–17 now experience those health issues.
Children's Community Health Plan President Mark Rakowski. Photo courtesy CCHP.
"We needed another tool in our toolbelt," says Rakowski. "This is an alternative treatment to traditional psychotherapy or pharmacology, which can sometimes have side effects. This gives us a chance to try something new."
The Freespira platform addresses panic disorder through breathing, based on the theory that the underlying physiological cause is tied to breathing irregularities and a hypersensitivity to carbon dioxide. Through a breathing sensor, tablet, and customized app, users undergo two 17-minute treatments a day to normalize breathing patterns for a 28-day period.
After one year of use, CCHP officials reported that 68% of the nearly 250 people who used the digital therapeutic experienced "clinically significant" reductions in symptoms associated with PTSD and panic disorder.
This, in turn, means less of a reliance on prescription medications, fewer visits to the doctor's office or the hospital to treat emergencies like panic attacks, and an improvement in quality of life, which carries with it a number of downhill benefits. For payers, the ROI is seen in reduced healthcare costs and better clinical outcomes.
Finding a Path to Sustainability
Rakowski says CCHP reviewed the data before agreeing to support the Freespira platform, "and that was really the key." But the health plan is going to need its own data to scale up and sustain the program.
While CCHP is initially providing the Freespira digital therapeutic free of charge, that won't last forever. Because a large percentage of the health plan's member base is on Medicaid, they'd like the Centers for Medicare & Medicaid Services (CMS) to offer reimbursement. That, in turn, would convince more care providers to either prescribe or recommend the treatment to their patients.
"We can cover the cost for now because we are seeing ROI," Rakowski points out. "But will that remain over time? Our future payments are based on claim utilization … and we're going to need longitudinal data to prove that."
And long-term sustainability, he says, will be tied to patient engagement.
An important aspect of this treatment is provider buy-in. Having a doctor prescribe or recommend this treatment (as opposed to having a health plan suggest or recommend it) goes a long way toward improved patient engagement. Patients trust their doctors and will listen to them, Rakowski says, and they'll be more inclined to stay in touch with their doctors about the treatment.
"We don't want to get in the way of that relationship," he says.
And like CMS, doctors need to see the proof that a digital therapeutic will work for their patients before supporting it. And that value can work both ways.
"They want to make sure that the technology itself has that level of scrutiny," Rakowski says.
Rakowski says these home-based treatments—CCHP also works with Propeller Health, a digital health company focused on breathing problems like asthma and COPD—offer benefits to care providers as well, in that they can manage their patients more easily on a digital health platform. Doctors not only gain a link to the patient's life between scheduled visits to the office, but they get data that helps them see how the patient is doing, how the current treatment plan is or isn't working, and what daily events or stressors might be bringing on panic attacks and other worrisome outcomes.
That's especially important in dealing with a behavioral health concern. Rakowski says that patients living with these health issues are still stigmatized and are less inclined to visit a doctor when they need one. They may also have difficulties opening up to a doctor about their mental health or describing what they're feeling or how they're acting.
"Just getting people to pick up their phone [and call] is a challenge," Rakowski says.
A digital therapeutic must not only be functional, but easy and attractive enough that someone will want to use it and continue using it when needed. A treatment like Freespira's fits that bill, while also helping patients become more comfortable with managing their health.
Rakowski says CCHP has plans to boost the number of members using the Freespira platform, and he's hoping the numbers continue to look good. They've had good and bad luck with digital health so far, but the success of both Freespira and Propeller Health is giving administrators ideas on what other treatments to try. They'd love to find an mHealth app, he says, that will help new and expectant mothers with maternity care.
"Implementation is time-consuming," he says, "but for us as a health plan, we see what we've done with this so far and the difference we're making. We're changing people's lives."
ATA2022, taking place next week in Boston, will give the organization an opportunity to plan the evolution of telehealth beyond the pandemic, and to talk about bringing virtual care to an 'inspirational level.'
Healthcare organizations are experimenting with new and innovative technologies and services as they move away from the pandemic and closer to value-based care, and a lot of those cool new ideas will be front at center at next week’s ATA2022 American Telemedicine Association conference in Boston.
Meeting in person for the first time in more then two years, telehealth advocates will have the chance to chat up what some are calling “Healthcare 3.0.” It describes an ecosystem based on lessons learned from the rapid uptake of virtual care during the COVID-19 emergency, the fast-moving field of consumer healthcare, and new advances in mobile technologies, including smart devices, sensors, and wearables.
This year’s theme is “Now what? Creating an Opportunity in a Time of Uncertainty.”
“It’s more than all of us asking, ‘What do we do now?’” says ATA CEO Ann Mond Johnson. “People want to make sure that telehealth wasn’t just a pandemic-only tool.”
Indeed, as ATA2022 convenes next Sunday through Tuesday at the Boston Convention Center in the city’s trendy Seaport District, much of the talk is still centered on how to continue the momentum beyond COVID-19. The public health emergency caused by the pandemic is expected to end before the close of 2022, putting an end to many federal and state measures enacted during the PHE to improve access to and coverage of telehealth services. The ATA is among many organizations lobbying the federal government to extend or even make permanent those measures, but in the meanwhile providers and payers are uncertain as to how to chart a long-term telehealth strategy.
Johnson says the shift from in-person to virtual care during the pandemic – and the gradual shift back to a hybrid platform that combines the two – has proven that telehealth is viable, either as a supplement to improve in-person care or an alternative when barriers exist. Providers, she says, are now learning to “bake it into the process,” or integrate virtual and in-person services.
That’s especially apparent in the growth of remote patient monitoring programs that allow providers to monitor and communicate with patients at home, and in hospital-at-home concepts that allow hospitals to shift some acute care and ICU services to the home by combining RPM platforms and tools with in-person care.
More than one panel will discuss the RPM and Hospital at Home concept, with one focusing on the payer perspective and another on innovations in delivery and strategy. Other hot-button topics include telemental health, VC support for innovative start-ups, virtual care strategies for critical and emergency care, senior and pediatric care programs and policy issues such as cross-state licensing.
The ATA will also shine the spotlight on start-ups with its Telehealth Innovators Challenge, which enables nine “virtual care visionaries” in three categories – in-patient care solutions, the patient experience, and tools that deliver care – to showcase their ideas before a panel of judges.
Mond hopes the conference continues the evolution of telehealth. What once was considered a nice idea worthy of a pilot project is now a standard of care in many places, existing alongside or integrated with in-person care. Now, she says, the industry needs to bring it to an “inspirational level,” taking on the social determinants of health and addressing disparities in care.
And in that she hopes the industry will lead by example.
“This boils down to change management,” she says. “It’s time to take that next step.”
Researchers at the Medical University of South Carolina are using mice models to design better treatments for babies born with low birthweight who suffer a germinal matrix hemorrhage (GMH).
Thousands of children are born with very low birthweight in the US every year, and many are at high risk of suffering a brain hemorrhage, called a germinal matrix hemorrhage (GMH), shortly after birth, causing severe long-term health effects or death.
Researchers at the Medical University of South Carolina (MUSC) are turning to mice to develop new strategies for diagnosing and treating the condition, an effort that could greatly improve the birth rate and reduce the number of birth defects.
“We were just having to wait for bad things to happen,” Ramin Eskandari, MD, a pediatric neurosurgeon at MUSC Children’s Health, said in a recent press release. “And then we had to react to them. We have no treatment for the actual hemorrhage or for preventing the stroke or hydrocephalus that comes after.”
Eskandari said he came upon research by Stephen Tomlinson, PhD, vice chair of the Department of Microbiology and Immunology at MUSC, who was focusing on a part of the immune system called the complement system. Thinking that work could have applications for infants, the two collaborated with Mohammed Alshareef, MD, a senior neurosurgery resident at MUSC, to create a mouse model to stand in for premature infants with very low birthweight.
In a study recently published in the International Journal of Molecular Sciences, the team found that they could inhibit the complement system in the brain immediately after a hemorrhage, reducing and possibly even preventing temporary and permanent damage that accompany these types of strokes. By using a complement inhibitor called CR2Cry, they found improve not only survival but weight gain, reduce brain injury and incidents of hydrocephalus, an improve motor and cognitive performance in adolescence.
The new treatment could have a profound effect on the survival rate and long-term health for babies born with very low birthweight, who made up about 1% of infants born in the US in 2020, or roughly 48,500 births. And those numbers are rising as healthcare providers use new technology and treatments to treat newborns.
“We’re seeing younger and younger babies viable,” Eskandari said in the press release. “I remember when a 23-week-old baby wasn’t viable, and even in the last eight years since my residency, we’re now seeing babies at 20 weeks not only be viable but live full lives and attend school.”
The process that Eskandari and his colleagues developed is unique in the more than 100 clinical trials currently running, because it targets a specific part of the brain. But focusing on the point where the pathology begins, they can avoid affecting the complement system for the entire body, thus reducing the chance of infection and other immune disorders.
Eskandari and his colleagues say their research will not only help infants born with brain hemorrhages, but those dealing with other types of brain injury as well.
“These babies are a really good overall model of how all brain injury could potentially be helped,” he said, adding that he hopes to launch a clinical trial soon at MUSC. “Having a hemorrhage that leads to stroke and hydrocephalus checks a lot of boxes that we see in many patients.”
The vulnerabilities were found in the Aethon TUG smart autonomous robot, which is used by hundreds of health systems to ferry medications and other supplies throughout the hospital.
An autonomous robot commonly used in hospitals to transport medication and other supplies from room to room could be hacked and used to spy on patients and staff, according to a New York-based healthcare IoT security company.
Cynerio announced earlier this month that its researchers had discovered five vulnerabilities in the innards of the Aethon TUG smart autonomous robot, which is sued in hundreds of healthcare sites around the world.
Robots like the Aethon TUG are used by hospitals to do light housekeeping and ferry items from one place to another, relying on radio waves, sensors and other technology to open doors, take elevators and maneuver through hallways without hitting anything. More advanced telepresence robots are being used to connect care providers in other locations with patients in their rooms or the Emergency Department and even perform some guided surgeries.
Collectively called the JekyllBot:5, the malware was found in the TUG Homebase Server’s JavaScript and API platforms, as well as a WebSocket that is used to relay commands from the server to the robot. According to a Cynerio press release, these vulnerabilities could:
Disrupt or impede the timely delivery of medications and lab samples;
Shut down or obstruct hospital elevators and door locking systems;
Monitor or even take videos and pictures of patients, staff, and hospital interiors, as well as sensitive patient medical records;
Control the robots to allow them to access restricted areas, interact with patients or crash into staff, visitors, and equipment; and
Hijack administrative user sessions in the robots’ online portal and inject malware through their browser to enable future cyberattacks on IT and security team members at healthcare facilities.
Cynerio has reportedly been working closely with Aethon to send patches to its customers to apply to the robots and has updated firewalls at some hospitals so that their IP addresses can’t be used to access the robots.
“These zero-day vulnerabilities required a very low skill set for exploitation, no special privileges, and no user interaction to be successfully leveraged in an attack,“ Asher Brass, Cynerio’s lead researcher on the JekyllBot:5 vulnerabilities and head of cyber network analysis, said in the press release. “If attackers were able to exploit JekyllBot:5, they could have completely taken over system control, gained access to real-time camera feeds and device data, and wreaked havoc and destruction at hospitals using the robots.”
And the concerns aren’t limited to accessing sensitive and valuable data through web portals or e-mail scams. Robots and smart devices both within the hospital setting and outside the campus that can remotely access healthcare operations are at risk of being accessed and controlled. Experts have warned that these vulnerabilities can not only expose data but put lives at risk.
“Hospitals need solutions that go beyond mere healthcare IoT device inventory checks to proactively mitigate risks and apply immediate remediation for any detected attacks or malicious activity,” Cynerio founder and CEO Leon Lerman said in the press release. “Any less is a disservice to patients and the devices they depend on for optimal healthcare outcomes.”
Researchers at the University of Michigan have developed algorithms that allow them to track the progress of the virus through a smartwatch, and hope to expand that platform to monitor other health concerns.
Researchers at the University of Michigan have created a protocol for tracking COVID-19 symptoms through a smartwatch, and say the process could eventually be used to detect other health issues, such as the flu.
In a study recently published in Cell Reports Medicine, the research team traced six factors derived from heart rate data collected by a smartwatch that determine when a user is infected by the virus and how sick they become. They found that those living with the virus experienced an increase in their heart rate per step once the symptoms were detected, and those dealing with a cough experienced a much higher heart rate per step than those who didn’t have a cough.
“We found that COVID dampened biological timekeeping signals, changed how your heart rate responds to activity, altered basal heart rate and caused stress signals,” Daniel Forger, a professor of mathematics and research professor of computational medicine and bioinformatics at the University of Michigan and part of the research team, said in a press release issued by the university. “What we realized was knowledge of physiology, how the body works and mathematics can help us get more information from these wearables.”
The research adds to the growing body of evidence that mHealth wearables can be used to detect and monitor COVID-19 in patients at home, enabling healthcare organizations to treat them through remote patient monitoring programs rather than putting them in a hospital.
It also expands the opportunities for RPM programs to track and treat other health concerns at home instead of the hospital, clinic or doctor’s office. In time, wearables and sensor-embedded clothing could be used to detect and monitor a wide range of health concerns, from viruses like the flu to chronic conditions like diabetes, asthma, cardiac failure and cancer.
In Michigan, researchers focused on data from patients in the Intern Health Study, a multi-site study that followed physicians in several locations across their first year of residency, as well as the Roadmap College Student Data Set, which tracked student health during the 2020-21 school year through Fitbit wearables, self-reported COVID-19 diagnoses and symptom information and publicly available data. In all, they tracked the health of 43 medical interns and 72 students.
Using an algorithm developed to estimate daily circadian phase from heart rate and step data taken from a wearable, they found that:
Heart rate increase per step, a measure of cardiopulmonary dysfunction, increased after symptom onset.
Heart rate per step was significantly higher in participants who reported a cough.
Circadian phase uncertainty, the body’s inability to time daily events, increased around COVID symptom onset. Because this measure relates to the strength and consistency of the circadian component of the heart rate rhythm, this uncertainty may correspond to early signs of infection.
Daily basal heart rate tended to increase on or before symptom onset. The researchers hypothesize this was because of fever or heightened anxiety.
Heart rate tended to be more correlated around symptom onset, which could indicate the effects of the stress-related hormone adenosine.
The research team said they were able to create new algorithms that can be used to study how an illness impacts heart rate physiology – and which could be used to expand the use of wearables in healthcare.
“There’s been some previous work on understanding disease through wearable heart rate data, but I think we really take a different approach by focusing on decomposing the heart rate signal into multiple different components to take a multidimensional view of heart rate,” Caleb Mayer, a doctoral student in mathematics, said in the press release. “All of these components are based on different physiological systems. This really gives us additional information about disease progression and understanding how disease impacts these different physiological systems over time.”
Healthcare organizations are using digital patient questionnaires to gather real-time data from patients, allowing clinicians to adjust care management when and where needed.
Healthcare organizations are using digital health tools to gather more data about their patients, but the challenge has always been how to use that information.
At Ascension Illinois, care providers are using Measurement-Based Care (MBC) to improve outcomes in behavioral health treatment. The strategy is based on collecting information throughout treatment to assess outcomes, then modifying care management plans to improve treatment.
Chris Novak, vice president and chief operating officer for Ascension Illinois' behavioral medicine service line, says the process of gathering data to support treatment benefits not only the provider but also the patient. The health system uses a digital health platform developed by Owl to create a baseline assessment for each patient, then uses ongoing virtual questionnaires to demonstrate patient progress, giving providers the evidence they need to measure and then improve treatment.
The digital platform is important. It has allowed health systems like Ascension Illinois to move from paper-based questionnaires and subjective observations during visits to data collection at the point of care, saving valuable clinician time. It allows the provider to gain a better idea of what the patient is experiencing, and to collaborate with the patient on care management.
Chris Novak, vice president and chief operating officer for Ascension Illinois' behavioral medicine service line. Photo courtesy Ascension Illinois.
"It helps us to demonstrate to our patients in real time the improvements that we're seeing," he says. And in doing so, it allows clinicians to personalize patient care.
Data is often considered the cornerstone to improving clinical care, and innovations like digital health and telehealth have proven both beneficial and problematic. They allow healthcare providers to collect much more data than before, about patients as well as their home environment and daily habits, but that data must be sorted and analyzed. Without processing tools, providers are overwhelmed by data, unable to determine what information they can use.
"The field is evolving," says Novak, who sees home-based digital health platforms and wearables as the next evolution of MBC. The information contained in those platforms, he says, can greatly affect care management if used correctly. A care provider who can see into a patient's daily lifestyle can pinpoint activities or habits that affect health, and design care plans that reinforce good habits and steer the patient away from bad ones.
With the MBC platform used by Ascension Illinois, Novak and his colleagues gain insights from clinically validated assessments, offering objective data on a patient's care plan. The patient answers questionnaires electronically and submits the information to the care provider. For patients living with thought disorders or who might have problems answering questionnaires, the provider can administer those questionnaires with the patient during a session.
Those assessments give care providers the real-time information they need to improve care, and thus become the basis for value-based care.
"Across a wide range of treatment settings, there is a substantial gap between the outcomes achieved in randomized controlled trials and in routine mental health care," the study noted. "One of the main contributors to enhanced outcomes in randomized controlled trials is that treatment protocols include systematic measurement of symptom severity, followed by algorithm-based treatment adjustments when patients are not responding to care."
"Although there are numerous brief, validated symptom rating scales that reliably measure change in severity of symptoms over time, only 17.9% of psychiatrists and 11.1% of psychologists in the United States routinely administer symptom rating scales to their patients," the researchers continued. "On the basis of clinical judgment alone, mental health providers detect deterioration for only 21.4% of their patients who experience increased symptom severity. Detection rates are even worse for patients whose symptoms are not deteriorating but who also are not improving as expected. The failure to detect patients who are not responding to treatment contributes to clinical inertia (defined as not changing the treatment plan despite a lack of substantial improvement in symptom severity.) The use of symptom rating scales to monitor outcomes helps prompt clinicians to overcome treatment inertia and change the treatment plan when patients are not responding to treatment."
That study concluded that because behavioral healthcare providers weren't demonstrating the value of their treatments, payers weren't supporting the programs, leading to "chronic underfunding of mental health services." It argued that MBC could prove that value.
Then came the pandemic.
Novak says MBC proved its mettle during the pandemic, when most health systems shifted from an in-person model of care to a virtual platform to reduce the spread of the virus and enable care providers to treat patients in their homes. Through the platform, providers were not only defining the effectiveness of their treatments but also comparing the value of an in-person treatment program against a virtual program, or one that combines both virtual and in-person care.
It also allowed them to gain support from payers, who typically want to see proof that a new service will reduce costs and/or improve outcomes before they reimburse providers.
"Our discussions with payers have been positive," Novak says. MBC "quantitatively [demonstrates] that improvements are being made in a virtual setting, which is on par with in-person care."
The challenge, of course, lies in synching the data to the electronic health record (EHR), a process often complicated, if not hindered, by different platforms that store data in silos. Novak notes his health system currently works with four different EHRs, so it's easier right now to keep that data separate and integrate it later, when they move to one EHR.
That's where he sees this platform evolving. As the technology improves and systemwide integration is made easier, MBC will become a standard of care, with automated and adaptive testing that allows care providers to see the results in real time, adjust care management on the fly, and modify future assessments and tests to be more personalized.
"Behavioral health horizontally intersects all areas of medicine," he says, "and demonstrating the impact of effective care is critical."
Ballad Health and the East Tennessee State University Research Corporation are launching the Appalachian Highlands Rural Innovation and Entrepreneurship Alliance, which aims to combine healthcare research and innovation with community resources
A new collaboration in the Appalachian Highlands is integrating healthcare innovation with the local economy, thereby making the path forward a community endeavor.
Ballad Health and the East Tennessee State University Research Corporation are launching the Appalachian Highlands Rural Innovation and Entrepreneurship Alliance, which will “coordinate multiple local and national areas of research and idea development, particularly impacting the delivery of healthcare, through surveilling efforts, accelerating early-stage development, translating research into business opportunities and identifying scalable opportunities for investment, ultimately reshaping the overall economy, health and well-being of the region.”
Ballad Health’s network includes 21 hospitals, post-acute care and behavioral health facilities and a large multi-specialty group practice covering 29 counties across parts of Tennessee, Virginia, Nort Carolina, and Kentucky.
“When we created Ballad Health, we made a commitment that this new organization would leverage the regional strength of the Appalachian Highlands, reaching across all our communities in Northeast Tennessee and Southwest Virginia to enhance opportunities to turn good ideas into thriving businesses and economic opportunity,” Ballad Health Chairman and Chief Executive Officer Alan Levine said in a press release. “This center will not only leverage good local ideas into business opportunities for the region, but it will attract ideas from all over the world, which will support the enhancement of healthcare delivery and innovation, while also creating an ecosystem for those transformative ideas to grow and be put into practice all over the world.”
The partnership takes the typical digital health incubator one step further, so that healthcare innovation and delivery are integrated with the community.
It also builds on an existing relationship between the health system and the schools that has seen the launch of the Center for Rural Health and Research at ETSU, the Ballad Health Strong BRAIN Institute and Center for Trauma Informed Care, and the Appalachian Highlands Center for Nursing Advancement.
“Ultimately, the Appalachian Highlands Rural Innovation and Entrepreneurship Alliance will result in an interactive rural cooperative, and as the alliance grows, we expect new companies to anchor their operations in the Appalachian Highlands as they take advantage of the unique environment to create life- and industry-changing equipment, systems and technologies,” Tony Keck, executive vice president of system transformation at Ballad Health, said in the release. “The resulting economic benefit will support the multiple regional efforts to grow the economy, while providing an investment return for those in the region who believe in investing in the region.”
The program also speaks to the challenges faced by health systems across the country in competing for both patients and staff in a much larger ecosystem, which includes telehealth vendors, retailers like Amazon and Google, and even payers that offer their own healthcare services.
“The reality of our situation right now, is that regional employers aren’t just competing with each other for top workforce talent – we’re competing with businesses all over the United States,” added Bo Wilkes, managing director of the Ballad Health Innovation Center and president of Ballad Ventures. “We have a rich culture and history, excellent schools and healthcare and low cost of living, and now, we’re going to have the entrepreneurial alliance that draws in some of the best minds in the country. By all rights, the Appalachian Highlands should be a top destination for workers and families.”
Researchers have found that a digital therapeutic platform using gaming concepts can help adults diagnosed with major depressive disorder (MDD) improve their cognitive function
Researchers from Duke University and Stanford have found that a digital therapeutic video game can help people living with major depressive disorder (MDD).
In a study recently published in the American Journal of Psychiatry, adults diagnosed with MDD and taking antidepressant medication “significantly improved sustained attention” while playing the AKL-T03 game developed by Boston-based Akili Interactive. The mHealth game is designed to address cognitive challenges, including difficulties concentrating, decision making, slowed thinking, and forgetfulness, in people living with MDD.
“Society is facing a growing mental health crisis, with depression rates in the US increasing about 20% during the pandemic,” Richard Keefe, PhD, a professor of psychiatry at Duke University Medical Center and primary investigator of the study, said in a press release. “While mood symptoms are most often associated with MDD, equally concerning are the frequent associated cognitive impairments.”
“More than ever, we need safe and effective ways to support these patients – new tools that can be easily and broadly accessed,” he added. “Based on the results of this study, AKL-T03 has the potential to play a meaningful role in the treatment of MDD patients.”
Digital health companies like Akili have been developing mHealth games for several years to address a variety of health concerns, from behavioral health treatment to chronic care management for conditions ranging from diabetes and asthma to cancer. Many of the products have been tailored for children and young adults, who respond well to games and gaming concepts.
Digital health platforms are especially attractive to care providers because they can be administered at home, in a more comfortable environment for patients, rather than a clinic or doctor’s office, and they can be used when appropriate for the patient.
To address an older population, Akili modified its AKL-T01 digital therapeutic, branded as EndeavorRx and cleared by the US Food and Drug Administration to treat attention symptoms in children ages 8-12 diagnosed with ADHD. The company’s AKL-T03 is an investigational medical device not yet cleared by the FDA and designed on the same technology platform.
“Addressing cognitive impairments associated with depression has been an area of interest from healthcare professionals and companies over recent years, yet options remain limited for patients,” Anil S. Jina MD, Chief Medical Officer of Akili, said in the press release. “Akili’s technology is designed to target specific neural networks related to attention function and this study demonstrates the important role it could play in the treatment of patients with cognitive dysfunction in depression.”
In the study, titled the Software Treatment for Actively Reducing the Severity of Cognitive Deficits in Major Depressive Disorder (STARS-MDD), Keefe and Amit Etkin, MD, PhD, of the Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute at Stanford, working with Elena Cañadas, PhD, and Deborah Farlow, PhD, both from Akili, tested the platform on some 80 adults over a six-week time span.
“The results in this randomized controlled trial of an at-home digital intervention for cognitive impairment in patients diagnosed with major depressive disorder indicate that the active intervention, AKL-T03, significantly improved performance on the primary outcome measure of sustained attention compared with the control condition in adults 25–55 years old,” they concluded in the study. “Across a range of secondary and exploratory outcome measures targeting a variety of cognitive domains, including working memory, processing speed, task switching (e.g., letter-number sequencing, symbol coding test), depressive symptoms, and subjective cognitive symptoms (e.g., HAM-D, PHQ, and CPFQ) and quality of life (e.g., WSAS and Q-LES-Q), the benefit of AKL-T03 was not superior to the control intervention.”
“In summary, compared with a control condition, AKL-T03 demonstrated significant improvement on the primary objective measure of cognition in patients with major depression,” they added. “The intervention was well tolerated and presented minimal adverse events. The digital nature of the intervention could help to increase access for patients who otherwise might not find a solution for their depression-related cognitive difficulties.”
The New York health system has launched Ascertain, an incubator backed with $100 million in seed funding to help innovative start-ups develop and commercialize AI platforms
Northwell Health has joined the growing number of health systems to launch an incubator for innovative start-ups.
New York’s largest healthcare organization is partnering with start-up studio Aegis Ventures to unveil Ascertain, a “joint company creation platform” aimed at developing and commercializing promising AI platforms. The new venture includes $100 million in seed-stage capital.
“Ascertain brings a unique structure, an innovative approach, and a compelling vision to create breakthrough healthcare AI companies that are set up for success,” Michael Dowling, Northwell Health’s president and CEO, said in a press release issued during the health system’s first-ever Healthcare AI Innovation Summit this week. “We are all driven by the idea that everyone deserves access to high-quality, affordable healthcare. Our aim is clear: to find new, cost-efficient ways to create and accelerate companies that deliver real, equitable solutions.”
And they’ve already started. One of the first projects, in collaboration with Northwell’s newly launched Center for Maternal Health, will focus on detecting and managing serious complications for pregnant mothers and babies, including preeclampsia, which disproportionately affects Black mothers.
“Existing approaches to the detection of preeclampsia often occur too late in pregnancy, once the condition has begun to manifest,” Burt Rochelson, MD, Northwell Health’s chief of maternal hedicine, said in the press release. “An important enabler for a solution to this challenge is predictive analytics, applying available knowledge of a patient's history to enable action far earlier with simple, yet life-saving, clinical interventions. We believe the AI solution Ascertain is currently developing will enable this.”
Northwell Health has joined a number of large health systems taking innovation into their own hands with programs aimed at developing home-grown technology that can be tested in-house before being offered to the healthcare industry. Organizations like the Cleveland Clinic, Providence Health and Penn Medicine have been fostering new companies for years.
And one of the more popular areas for innovation these days is AI, or machine learning, a topic that grabbed a lot of attention at the HIMSS22 conference and exhibition last month in Orlando. In March, the Mayo Clinic launched Platform_Accelerate, a 20-week program that allows innovative start-ups to collaborate with the health system on new projects.
"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 a 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."
Northwell health officials say Ascertain will launch several companies during its first year that will focus not only on AI and maternal health, but also chronic disease detections and care management.
