Dual lawsuits allege ads were tailored to patients based on their health information
Two lawsuits allege that Facebook parent company Meta Platforms, Inc. partnered with health systems to serve up ads based on patient medical information collected from the portals of the health systems' web sites.
Meta Pixel is a tool allowing third-party web sites to measure and grow audiences for ad campaigns. The suits allege that this tool was employed by these health systems to collect personally identifiable information based on patient visits to those web sites.
"When Meta Pixel is incorporated, unbeknownst to users and without their consent, Meta gains the ability to surreptitiously gather every user interaction with the website ranging from what a user clicks on to the personal information entered on a website," states a July 25 suit filed in the Northern District of California on behalf of patient Jane Doe. "Meta aggregates this data against all websites. Meta benefits from this information because it improves its advertising network, including its machine-learning algorithms and its ability to identify and target users."
The tool allowed data collected about the patient via UCSF Medical Center and Dignity Health patient portals to enable Meta to send her targeted advertising related to her medical conditions, the suit alleges.
In an earlier June 17 suit, filed in the same court on behalf of patient John Doe, a patient of the Medstar Health System in Baltimore accused Meta of harvesting similar data from the patient portal, without obtaining authorizations for sharing of personally identifiable information, therefore violating HIPAA.
"Facebook knowingly receives patient data—including patient portal usage information— from hundreds medical providers in the United States that have deployed the Facebook Pixel on their web properties," according to the June 17 suit. "To date, through experts, plaintiffs have identified at least 664 hospital systems or medical provider web properties where Facebook has received patient data via the Facebook Pixel."
The court will have to decide if the suits can be considered with class action status, as requested by the filing attorneys.
A team of researchers in Texas has developed a tattoo that can reportedly measure blood pressure continuously and more comfortably than a smartwatch.
Researchers at the University of Texas at Austin and Texas A&M University have created an electronic tattoo that can be worn on the wrist comfortably for hours while providing accurate, continuous blood pressure measurements.
“Blood pressure is the most important vital sign you can measure, but the methods to do it outside of the clinic passively without a cuff, are very limited,” Deji Akinwande, a professor in the department of electrical and computer engineering at UT Austin and one of the co-leaders of the project, said in a press release.
The project is documented in a new paper published recently in Nature Nanotechnology.
Left untreated, high blood pressure can lead to serious heart ailments. Traditional blood pressure checks only measure brief moments in time, while continuous measurements can provide greater insights.
“Taking infrequent blood pressure measurements has many limitations, and it does not provide insight into exactly how our body is functioning,” Roozbeh Jafari, a professor of biomedical engineering, computer science and electrical engineering at Texas A&M and co-leader of the project, said in the press release.
One of the more talked-about possibilities for continuous blood pressure monitoring in recent years has been smartwatches. But the Texas researchers found that smartwatches are not ready for the task.
"The watches slide around on the wrist and might be far from arteries, making it hard to deliver accurate readings," the press release noted. "The light-based measurements can falter in people with darker skin tones and/or larger wrists."
The key ingredient in e-tattoo is graphene, described as one of the strongest and thinnest materials in existence. It's similar to graphite contained in pencils, but the atoms are precisely arranged in thin layers.
The e-tattoos consist of a sticky, stretchy material containing the sensors, which can be comfortably worn for long periods without sliding around.
The device measures blood pressure by injecting electrical current into the skin and analyzing the body's response, a phenomenon known as bioimpedance. Researchers used a machine learning model to obtain and analyze blood pressure readings.
The research was supported by grants from the Office of Naval Research, the National Science Foundation and the National Institutes of Health.
The six-hospital health system in New Orleans has transitioned from six different EHRs to one, saving money and setting the stage for more tech initiatives.
LCMC Health is saving money by consolidating all of its hospitals onto a single platform based on the Epic electronic health record, and now the New Orleans-based, six-hospital health system has its sights set on tech-based initiatives to improve patient care.
The achievement caps the four-year project to migrate LCMC Health's hospitals from six different EHRs to Epic, coming at a time when the health system is in a growth and acquisition phase.
"We are relatively young as a hospital system," says Sherri Mills, LCMC Health's chief nursing informatics officer. The EHR migration was a key factor, she says, in LCMC Health's efforts to coalesce.
"We know the HIMSS methodology helps organizations take a good look at how they're leveraging technology for patient safety and quality," she says.
The investment in the Epic transition cost the health system tens of millions of dollars, Mills says, but LCMC Health is coming out ahead financially compared to EHR expenses prior to consolidating.
"Through good application rationalization and consolidation, we actually are saving money," she says.
Children's Hospital New Orleans, for example, was actually documenting patient charts on paper before Epic was installed.
"They did have a way to do order management [electronically], but documentation was still on paper," Mills says.
Among the tasks that had to be satisfied to achieve the HIMSS EMRAM rating, LCMC Health had to demonstrate that its systems were secure, have a downtime contingency plan, and perform failover exercises to that plan. Requirements for the certification also include site visits by an executive from HIMSS Analytics and former or current chief information officers to ensure an unbiased evaluation of the Stage 7 environments.
High compliance over six months required
The HIMSS rating evaluates such aspects of EHRs as barcode scanning of patients and specimens to enhance patient safety and computerized physician order entry (CPOE), and requires hospitals to achieve at least 90% to 95% compliance with those measures over a six-month period.
"In addition to that, they just asked a lot of questions around quality and the interactivity between your systems," Mills says.
She says LCMC Health physicians transitioning onto Epic from other EHRs found order entry to be more complex and a bit more rigid, but the physician notes contained more functionality.
"Physicians have had a more enriched and fulfilling experience because everything is on one database," she says.
Like other health systems, LCMC Health continues to grapple with note bloat.
"It just varies on the particular clinician," Mills says. "We struggle with [messaging], too. How do we make sure that the messages that the doctor receives are particular to the doctor?"
One tactic: route some of those in-basket messages to groups that can handle matters extraneous to physicians, she says.
Coming out of the HIMSS attestation, LCMC Health is focusing on increasing nurse happiness through its Project Joy.
"Daily cares is a nursing flow sheet, everything that you can't figure out where to put it in the chart," Mills says. "We are going through that daily care flow sheet and trying to figure out, should this live here? Should we document this? Is this just extra clicks for the nurse? Is this meaningful documentation? Is it driving a decision?"
This includes going back to the principles of charting by exception, she says.
"A great example is having to answer the question, is a security officer present?" she says. "It had yes and no. People answered no to that question over 100,000 times in a month. Why do we even have no? It's just taking a step back and looking at how we can make things better with fewer clicks."
One challenge during the migration was the need to make training virtual to adapt to conditions during the pandemic.
"We created self-learning modules for all disciplines, every single class," Mills says. "It definitely forced us to develop that a lot more quickly."
Some in-classroom training is now being reintroduced, due to limitations of the virtual modules, she says.
One lesson learned, Mills says, is to find a good partner to help with EHR migration and consolidation.
"Hyland helped us navigate the process," she says of the enterprise content services and management company. "We focused on our projects. What is our story to tell? What is something good that our organization has done, that we would want to broadcast to our community? When you can get clinicians on board to talk about how we're leveraging our technology for better patient quality and safety, and they understand the importance of why we're doing that and celebrating that, that's the key thing."
Also under consideration: Having some of the remaining hospitals attest to Stage 7, or possibly looking instead at alternate HIMSS attestations for ambulatory settings.
"We've struggled a little bit more with measures like CPOE in some of our clinics," Mills says. "It's a good way for us to challenge ourselves to make sure we're using our [EHR] to its highest functionality."
Cloud Security Alliance guide describes risks to everything from patient privacy to an organization's reputation.
Healthcare organizations looking for guidance on managing third-party vendor security risks have a new resource, thanks to the Cloud Security Alliance (CSA).
Third-Party Vendor Risk Management in Healthcare gives an overview of these security risks, and offers guidance on identifying, assessing, and mitigating third-party vendor risks going forward.
Examples of risks, use cases, and tools for managing these risks are included in this toolkit. Different types of risk are described, including cybersecurity, reputational, compliance, privacy, operational, strategic, and financial.
“Healthcare delivery organizations entrust the protection of their sensitive data, reputation, finances, and more to third-party vendors," James Angle, the paper’s lead author and co-chair of CSA's Health Information Management Working Group, said in a press release. "Given the importance of this critical, sensitive data, combined with regulatory and compliance requirements, it is crucial to identify, assess, and reduce third-party cyber risks. These risks are even more prevalent in the healthcare industry due to the lack of automation and the proliferation of digital applications and medical devices used, time-consuming and costly vendor risk assessment procedures, and the lack of fully deployed critical vendor management controls."
Health systems that use third-party technology vendors create an expanded attack surface, giving attackers an opportunity to breach those vendor-based systems, steal data from them, or use those systems to gain access to IT platforms.
And yet, use of third-party technology is projected to continue, said Michael Roza, a contributor to the paper, particularly as health systems focus their limited resources on core objectives and outsource support services to third-party suppliers.
The objective of the CSA Health Information Management Working Group is to advise health information service providers on how to deliver secure cloud solutions, including services, transport, applications, and storage, to their clients, and to increase cloud awareness among all aspects of healthcare and related industries.
CSA invites individuals interested in participating in its research and initiatives to join the working group.
Mental health and cardiac care research get a combined $258 million boost.
New federal funding will support 26 research studies to fill gaps in care and improve decision-making for a range of diagnoses, including asthma, bone fractures, migraines, intellectual and developmental disabilities, and sinus infections.
The $258 million in funding was announced by the Patient-Centered Outcomes Research Institute (PCORI). The institute also announced an additional $3.9 million for two projects to promote wider and faster clinical adoption of useful findings from completed PCORI clinical effectiveness research (CER) studies.
“Reflecting priorities encapsulated in PCORI’s recently adopted Strategic Plan, today’s funding approvals are an important step in advancing PCORI’s work to generate and disseminate information that improves the quality and relevance of evidence available to help patients and all stakeholders make better-informed decisions about their health," said PCORI Executive Director Nakela L. Cook, MD, MPH, said in a press release. “Facing a complex healthcare system and many care options, patients need reliable information to help them understand which care options will work best for them in their particular circumstances.”
Among the mental health studies funded:
Nearly $25 million will be devoted to study pharmacologic treatment of bipolar disorder accompanied by a major depressive episode. The study aims to enroll 2,800 adults at 38 academic medical centers and community health sites.
A second study will evaluate the benefits and harms of electroconvulsive therapy and intravenous ketamine for treating acute suicidal depression, aiming to enroll 1,500 adults at 10 to 13 sites in the US.
A third study aims to increase outpatient addiction treatment for adults with opioid use disorder after being discharged from an emergency department by using text-messaging telehealth services and financial incentives.
PCORI also earmarked $52 million on research to determine the effectiveness of different cardiac healthcare options for adults. One study will compare alternative therapies to restore normal heartbeats suffering both heart failure and reduced ejection fraction, while another will compare blood pressure outcomes among a diverse population with high blood pressure who receive care either through a telehealth platform with a pharmacist or traditional care with a telehealth-enabled blood pressure monitoring platform.
The two CER-based projects will focus on promoting informed decision-making between antibiotics and surgery for patients with appendicitis at 15 hospitals across the country, and one incorporating an mHealth program into routine care at three community mental health agencies to help those with mental illness manage their symptoms.
Doylestown Health is using a platform developed by XSOLIS to help nurses stay on top of fast-changing patient conditions and ensure each patient is properly classified and cared for.
For all their advantages, EHRs aren't so good at detecting changes in patient status that separate those being observed and those who end up admitted. Nursing staff are often left to comb and click through records in an endless game of catch-up.
But at Doylestown Health, AI and algorithmic technology are delivering this in a more efficient manner.
The suburban Philadelphia healthcare network, centered around an independent 270-bed hospital, is using predictive analytics technology from XSOLIS to improve medical utilization management. In the first six months of use, officials say they've improved observation rates by 20% and observation to inpatient conversion rates by 37%. And three years later, the initial return on investment of 4.6x has now improved to 7.3x.
Mary Beth Mitchell, MSN, RN, CPHQ, CCM, SSBB, senior executive director of care transformation strategies at Doylestown Health, oversaw this transformation, as well as hospice/palliative care and clinical documentation improvement, while heading the hospital's case management department.
Mary Beth Mitchell, MSN, RN, CPHQ, CCM, SSBB, senior executive director of care transformation strategies at Doylestown Health. Photo courtesy Doylestown Health.
Mitchell says hospitals would like to be able to admit all presenting patients, but payers insist on observation status as a less-costly alternative based on how sick the patient is. That usually does not last more than 48 hours.
"We are required contractually to review and assure that we have the patient in the appropriate status, so that when we bill the insurer, we're billing appropriate," she says.
Utilization review (UR) nurses must review every patient who comes in and is placed in a bed, whether they're on observation status or inpatient status, to be sure they are in the right status, Mitchell says. These nurses create patient synopses that are sent to the payer, who then can agree or disagree with the status assigned to the patient by the hospital.
Prior to adopting the XSOLIS technology platform, those nurses would, on a daily basis, start at one end of the 270-patient roster, either by payer or by floor, and work their way through to the other end, one chart at a time, to look for changes in patient status that rise to the threshold of changing status from observation to inpatient or vice versa, Mitchell says.
"I could look at a chart in the morning, and the patient looks appropriate for observation," she says. "But during the course of the day, lots of stuff happens to patients. But [UR nurses] are not going to look at that chart again till the next day, because this is a manual process."
Some hospitals start with certain diagnoses, but they're still guessing what they will find in those particular charts, Mitchell says.
The technology platform "assigns a severity for us, and through their AI platform [we] are able to use that severity to predict that the patient should be inpatient or observation status," she says.
The technology continually combs through each chart, looking for events entered by clinicians and notifying UR nurses when those events rise to the level of suggesting a change in status, Mitchell says.
"It's almost like an assistant, re-reviewing your charts constantly," she says.
Since UR nurses typically work on a Monday-through-Friday schedule, the technology is particularly useful in catching changes in patient status late on Fridays, also alerting those nurses about changes over the weekend when they arrive Monday morning, she says.
Unlike the presentation of data in EHRs, where less relevant data is often a distracting presence for UR nurses, the technology highlights key measures.
"When I'm going through an EHR, I have to click in and out of every tab," Mitchell says. "I have to look at every medication the patient is on. I really don't want to sift through things that aren't meaningful. [The technology] boils that down. For the medication lists, we only see what's considered notable meds."
The XSOLIS platform presents synopses of the recommended status changes to UR nurses, who can snip them and send them to payers via electronic fax or other means, Mitchell says.
The technology also accounts for traditional Medicare's standards for admissions and the fact that most private payers use one of two criteria – Milliman or Interqual.
One drawback is that this process can reduce the UR nurse's role to being a box-checker Mitchell says. But using the right technology can restore their ability to practice to the top of their license by allowing them to consider multiple diagnoses for a patient.
"The nursing staff loves this, because they're getting to use their clinical skills," she says. "It's more fulfilling to do their job."
Mitchell says healthcare organizations should thoroughly examine and test the technology platform before putting it into use. Different vendors and products offer different pathways and goals, making it vital to ensure that one platform can fit seamlessly into a health system's workflow and meet the needs of administrators and staff.
"We asked for data," she says. "We asked to speak with other hospitals. Were they actually seeing this make a difference? How are they utilizing it? By the time we made the decision, we felt pretty comfortable this was going to help us accomplish what we needed it to accomplish."
"It's really important in this day and age for hospitals to learn to leverage technology to their advantage," Mitchell adds. "Any time you do something manually, somebody's going to miss something. We leverage the technology to help us."
Patients are increasingly concerned about who has access to their confidential health information and how that data is being used, according to a survey commissioned by the American Medical Association.
Patients are increasingly concerned about eroding security and the confidentiality of personal health information in digital form, according to a survey recently authorized by the American Medical Association (AMA).
More than 92% of patients say privacy is a right and their health data should not be available for purchase, the survey finds.
Savvy Cooperative surveyed 1,000 patients at the start of 2022 for the AMA, and found that they are worried about data privacy protections and confused about who can access personal health information.
Almost 75% of those surveyed are concerned about protecting the privacy of personal health data. Only 20% of patients said they know how many companies and individuals have access to their data. The recent U.S. Supreme Court ruling over abortion rights is heightening these concerns, the AMA says, since a lack of data privacy may put patients and physicians in legal jeopardy where states are restricting reproductive health services.
In the survey, patients indicated they are most comfortable with physicians and hospitals having access to personal health data and least comfortable with social media sites, employers and technology companies having access to this data.
“Patients trust that physicians are committed to protecting patient privacy - a crucial element for honest health discussions,” AMA President Jack Resneck Jr., MD said in a press release “Many digital health technologies, however, lack even basic privacy safeguards."
"More must be done by policymakers and developers to protect patients’ health information," he added. "Most health apps are either unregulated or underregulated, requiring near and long-term policy initiatives and robust enforcement by federal and state regulators. Patient confidence in data privacy is undermined as technology companies and data brokers gain access to indelible health data without patient knowledge or consent and share this information with third parties, including law enforcement.”
Accord to the survey 94% of respondents say companies should be held legally accountable for uses of their health data. A similar majority of patients (93%) want app developers to be transparent about how their products use and share personal health data.
In addition, nearly 80% of patients want to be able to opt out of sharing some or all their health data with companies.
Approximately three out of five patients (59%) expressed concern with personal health data being used against them or loved ones. Patients surveyed say they are “very” or “extremely” concerned about discriminatory uses of personal health data to exclude them from insurance coverage (64%), employment (56%), or healthcare opportunities (59%).
Physicians and their hospitals should have the technology and capability to review apps for privacy and security protections, say patients responding to the survey. Almost nine out of 10 (88%) patients believe that their doctor or hospital should be able to review and verify the security of health apps before those apps gain access to their health data.
According to the AMA, federal regulations prevent providers and even electronic health record (EHR) systems from conducting necessary privacy and security reviews of apps.
The AMA has published its Privacy Principles, describing five key aspects of a national privacy framework—individual rights, equity, entity responsibility, applicability, and enforcement. The AMA also says it has developed a guide to help app developers build privacy-forward technologies.
In this interview with HealthLeaders, Purohit describes ways to evaluate organizational information technology and clinical readiness for strategic precision medicine programs, moving genetic information from tests to the lab to the EHR and then to the patient. This interview has been edited for brevity and clarity.
HealthLeaders: What kind of problem will this solve?
Purohit: Precision medicine is about using large sets of data to understand pathophysiology solutions, diagnoses, and treatments, and how they affect the patient. We have a lot of potential, where nearly everybody is on electronic records of some type, in converting that data to knowledge and using that, with the hope of improving care for patients. How did each individual do? Did the individual have side effects? Did the individual get the same level of improvement as somebody else? Those are questions that research studies couldn't answer because they're done on a population level.
HL: When you set out to get this genetic data, do you go for an opt-in approach from patients? Do you go for an opt-out approach? Are there pros and cons to either approach?
Purohit: Our approach is opt-in at UH right now. The provider will have that discussion with the patient. If it makes sense, they'll opt in for getting a genetic test. It would be nice if we get to a world where it is opt-out. I say that not with the intent of making somebody do something they don't want to, but I want to get to a place where we feel comfortable with genetic testing and what that means and what the implications are.
Maulik Purohit, MD, associate chief medical information officer at University Hospitals Cleveland. Photo courtesy UH Cleveland.
Genetic data is quite sensitive, and it can reveal things we may not have intended to reveal. There are implications for that in terms of insurance coverage. But it would be nice if we could be in a world where we can get genetic data without having to worry about some of those logistical issues, because I think the potential to help somebody with their genetic data is tremendous.
HL: With clinical trials, there's a very specific kind of aim and outcome that is desired. So it's kind of easy to identify that genetic data is actionable when it's a clinical trial. But if it's a more general practice of medicine, and standard of care issue, how does one make genetic data actionable?
Purohit: There's several ways that I think are in play right now. Our team has worked on pharmacogenomics, which is when you get the genetic testing done, then it matches that genetic code to different medications. One area is for depression treatment and a class of medication called SSRIs, selective serotonin reuptake inhibitors. The standard practice has been that you pick one of the SSRIs and do sort of a trial and error. That's a very dissatisfying process for a patient. It would be nice to get a better starting point.
With pharmacogenomics, what UH has been able to do is get a genetic test, and then look at how that matches with the SSRIs that are out there. Now you have a much better starting point to achieve a good outcome of treatment for the patient. That's not to say that it's perfect, because we don't have all the information from genetic code right now. But it's a much better starting place.
HL: Is the bulk of the actionable data pharmacogenomic in nature, or are there other forms of actionable data as well?
Purohit: For example, cancer treatment. Maybe you can look at a genetic code for designing chemo treatments. There's a world of possibility. We're evolving with our knowledge of what's out there in terms of the genome.
HL: When can genomics be used to bend the cost curve of healthcare? For example, by indicating alternate remedies such as exercise instead of prescribing a drug?
Purohit: It's more of an investment than it is a return. We're not there yet in terms of bending the cost curve tremendously. But if we don't make the effort to invest in it and explore it, then we won't get where we need to go.
HL: Are there particular disease management programs that are benefitting first?
Purohit: Pharmacogenomics is the hottest one, not only for depression, but also anticoagulation, like what is the best method of blood thinning to avoid clots, which can be important for preventing heart attack and stroke, some of the most disastrous illnesses and diseases out there.
Genetic counseling is probably up there as well. And I think we're getting to a point that, even for oncology and chemotherapeutic agents, it is helpful to have that in matching the type of cancer and the specifics of that with the treatment protocol. So those are probably the three biggest, but certainly evolving on a fast pace.
HL: To what degree do you bump up against the shortcomings of EHRs as you try to integrate genetic data into them?
Purohit: A lot of labs might send back a PDF, which is great, but it's not data that can be processed within the EHR. How do you combine that with existing knowledge of genetic code and what that means, converting that raw genetic data into a decision support tool that the clinicians can use? There are many steps in the process. It's certainly not easy, but these are the challenges that all of us are working on, along with the scientific knowledge about the genome itself. We don't have the solution worked out for the majority of this, but we are working on it.
HL: To what extent are you challenged by interoperability issues, whether it be patients who go outside your system for other care or payers whose data is not transparent to you, or other issues?
Purohit: What we had to do initially was have every lab out there build an interface to have the data transfer. Each interface is resource-intensive. Now we're using 2bPrecise to solve some of these issues.
HL: You have a variety of job responsibilities as associate CMIO. Where does this genomic data initiative rank vs. the other priorities that are on your desk?
Purohit: This falls into high priority. One thing that UH is undergoing right now is converting the EMR from the existing state to a full Epic integrated suite. That is priority number one. But if we ignore the R&D component and focus simply on the current [IT] aspect, then we're not going to move ahead.
HL: The biggest criticism we hear about vendor partners is the proprietary nature of what they offer, with algorithms that aren't necessarily shared because they're trade secrets.
Purohit: I certainly understand that. If you're a company and you come up with a solution and you give it away, it's not always the best business plan. I don't need to know what the algorithm is. What I do need to know is what's the performance metric? How well does it work? What's your sensitivity, specificity, positive predictive value, negative predictive value? Those kinds of things should be public, because it's a public safety issue.
We don't need to know how the sausage is made. But we do need to know whether the sausage is safe for people. Let's see if it performs the way we expect it to. And then if it does, great, then we can use it more. And that, you know, I think is a happy medium between giving away the secrets, which nobody wants to do, but at the same time, ensuring safety for the public.
A JAMA article penned by two doctors builds upon a recent CMS final rule calling on health systems and vendors to work together to improve EHRs.
New guidelines are needed to minimize the cognitive load imposed by electronic health records, according to a physician-written proposal published last week in JAMA Network Open.
Making Electronic Health Records Both SAFER and SMARTER states that a recent final rule issued by the Centers for Medicare & Medicaid Services should stimulate shared responsibility between EHR vendors and health systems to improve EHRs by reducing the cognitive load on clinicians and making EHRs more readable.
"Cognitive attention of the clinical team is a scare resource – one that is essential for quality health care," say Kevin B. Johnson MD, MS, of the department of biostatistics, epidemiology, and informatics at the University of Pennsylvania, and William W. Stead, MD, who served as chief strategy officer for Vanderbilt University Medical Center from 2010 to 2020.
The authors state the EHR is a "complex sociotechnical infrastructure for automating clinical and administrative workflows within a healthcare facility or system," and it is "not designed primarily to capture and present a patient's record as efficiently and effectively as practical."
They recommend that health system leaders debunk myths about what clinicians must document, avoid steps or interruptions in clinical workflows unless they are time-critical, and align decision support to role and task.
Other recommendations include supporting goal-oriented searches, automating routine tasks, monitoring care decisions and suggesting alternatives, recognizing trends from idealized patient models, translating actions into documentation, and exposing contextually relevant data.
Today’s focus on interoperability opens the door to integrating novel approaches such as self-documenting clinical environments into tomorrow’s digital connectivity infrastructure, Johnson and Stead concluded.
The health system's three-year partnership with Emcara Health combines the latter's primary care model with Adventist Health clinical delivery resources.
Emcara Health, a national value-based medical group providing advanced in-home primary care for seniors and vulnerable populations, is teaming up with California-based Adventist Health to extend care into high-risk communities across California, focusing on Medi-Cal patients.
The three-year partnership is intended to close care gaps for patients with the most complex care needs by addressing social barriers, such as homelessness, that influence a patient’s health. The partnership comprises part of the broader Enhanced Care Management initiative of CalAIM, a multi-year initiative of the California Department of Health Care Services, which operates Medi-Cal.
“This innovative care delivery model reflects our deep commitment to improving the physical, mental, and spiritual well-being of our community,” Shelly Trumbo, vice president of well-being at Adventist Health, said in a press release. “Emcara Health’s decade long focus on delivering community-based care to vulnerable populations, highly experienced multi-disciplinary care teams and nimble approach to non-traditional healthcare delivery made them the right partner to successfully realize the goals of the CalAIM initiative.”
As part of the partnership, Emcara Health will deploy field-based care teams, consisting chiefly of community health workers (CHW), to meet patients on their terms, whether at home, in a homeless encampment, or in the emergency department.
CHWs, once engaged, will conduct a social determinants of health assessment to understand the social impediments that may be impacting the patient’s health, such as access to food, stress, or transportation.
As a component of the agreement, Emcara Health nurses and social workers will be connecting and coordinating preventive care and clinical treatment through Adventist Health's California network.
Emcara Health will provide wraparound support, including transitions of care, member and family assistance, and coordinating and referring patients to community and social support services.
“Adventist Health is a proven delivery system leader that embodies deep trust in the communities it serves,” Eric Galvin, chief executive of Emcara Health, said in the press release. “By working together with California residents who are most in need, this partnership has the ability to serve as a model for managed Medicaid plans and risk-bearing provider groups looking to improve health outcomes for vulnerable populations around the country.”
Emcara Health is a line of business of PopHealthCare, a company operated by Florida-based health insurer GuideWell.