Category Archives: Health Technology

Remote patient monitoring cuts hospital admissions, ER visits, report finds

Doctor conferring with patient and on-screen specialist for article, Remote patient monitoring cuts hospital admissions, ER visits, report findsDive Brief:

  • One-fourth of healthcare organizations say remote patient monitoring reduces emergency room visits and hospital readmissions, while 38% say the technology results in fewer inpatient admissions, according to a new KLAS Research report.
  • The industry-backed American Telemedicine Association and the research group looked at how RPM is impacting providers and payers, talking with 25 organizations that used RPM products from seven different vendors.
  • The key use cases for remote patient monitoring were heart disease and chronic obstructive pulmonary disease, though interest in using RPM for other conditions like diabetes and hypertension is starting to pick up. RPM is also seeing some limited use in mental health, surgical recovery, dementia and cancer.

Dive Insight:

Remote patient monitoring is a growing sector in the digital health space, with an aging population and the opportunity to better manage chronic conditions. There is a potential windfall for companies with the right idea and clinical evidence to back it up, and investors are lining up to get a piece of the action. Disease monitoring was among the top-funded value propositions in last quarter, with $781 million across 38 deals, according to Rock Health.

RPM also holds potential to improve health outcomes. In a 2017 study, breast reconstruction patients with access to a mobile app that allowed them to submit photos and report information to their doctors had fewer post-surgery follow-up appointments than patients without the app. Patients using the app also rated their follow-up care higher on convenience.

Payers are recognizing its benefits and incentivizing its use, too. In its physician fee schedule final rule  for 2018, CMS unbundled a code for RPM, allowing physicians to seek reimbursement for collecting and interpreting health data generated remotely by patients, digitally stored and sent to providers, with a minimum of 30 minutes.

The move marked a “huge win” for RPM and a “big step forward for Medicare’s ability to deal with chronic conditions,” Gary Capistrant, the ATA’s chief policy officer, told Healthcare Dive earlier this year. He noted that several years ago when Medicare covered a code for chronic care but didn’t cover remote monitoring, the result was a tepid uptake.

Use of RPM is growing across all use cases, but is particularly robust for hypertension, mental health and cancer, where there is a lot of room for growth, according to KLAS.

According to the report:

  • 13% of organizations report RPM improves medication compliance;
  • 8% say it lowered A1c levels, an indication of how the body is maintaining blood glucose levels;
  • 13% say it improved patient health;
  • 25% report greater patient satisfaction; and
  • 17% cite quantified cost reductions.

    [SEE FULL STORY HERE]

New blood pressure app

September 7, 2018
Source: Michigan State University

Summary: Researchers have invented a proof-of-concept blood pressure app that can give accurate readings using an iPhone — with no special equipment.Michigan State University has invented a proof-of-concept blood pressure app that can give accurate readings using an iPhone — with no special equipment.

smartphone app screen for article, New blood pressure appThe discovery, featured in the current issue of Scientific Reports, was made by a team of scientists led by Ramakrishna Mukkamala, MSU electrical and computer engineering professor.

“By leveraging optical and force sensors already in smartphones for taking ‘selfies’ and employing ‘peek and pop,’ we’ve invented a practical tool to keep tabs on blood pressure,” he said. “Such ubiquitous blood pressure monitoring may improve hypertension awareness and control rates, and thereby help reduce the incidence of cardiovascular disease and mortality.”

In a publication in Science Translational Medicine earlier this year, Mukkamala’s team had proposed the concept with the invention of a blood pressure app and hardware. With the combination of a smartphone and add-on optical and force sensors, the team produced a device that rivaled arm-cuff readings, the standard in most medical settings.

With advances in smartphones, the add-on optical and force sensors may no longer be needed. Peek and pop, available to users looking to open functions and apps with a simple push of their finger, is now standard on many iPhones and included in some Android models.

If things keep moving along at the current pace, an app could be available in late 2019, Mukkamala added.

“Like our original device, the application still needs to be validated in a standard regulatory test,” he said. “But because no additional hardware is needed, we believe that the app could reach society faster.”

[SEE FULL STORY HERE]

90% of Americans use digital health tools, survey shows

Author:  Aug. 29, 2018

Dive Brief:
Consumers continue to embrace digital health tools, with 90% of respondents in a new Rock Health survey using at least one last year, up from 80% in 2016.
photo of person with a smart watch, smart phone and health apps for article, 90% of Americans use digital health tools, survey showsThe greatest adoption is occurring around online health information (79% vs. 72%) and online provider reviews (58% vs. 51%). A slower uptick was seen in mobile tracking (24% vs. 22%), while wearables held steady at 24% and live video televisits slipped three percentage points to 19%.
But while 77% of people prefer in-person doctor visits to telehealth, most who used video visits were satisfied with the experience. Among those who paid for their virtual encounter, 91% said they were satisfied. That number dropped to 62% when someone else paid.

Dive Insight:
Likewise, while not everyone is jumping at the idea of wearables, those who use them report progress meeting personal health goals. The chief reasons people use wearables are to track physical activity, lose weight, improve sleep and manage stress.

The tools for doing so are proliferating, with mobile operating systems and various apps offering to track the information. Fitibit has been upping the ante, and recently launched a product line update that includes detection of blood oxygen levels, goal-based exercise modes and a sleep tracking beta.

[SEE REST OF THE STORY HERE]

How Facebook — yes, Facebook — might make MRIs faster

Facebook’s artificial intelligence lab is working with New York University’s medical school to make MRI exams 10 times faster, which, if successful, would allow radiologists to complete a test in minutes.

  @mattmcfarlandAugust 20, 2018: 11:14 AM ET

Doctors use MRI — shorthand for magnetic resonance imaging — to get a closer look at organs, tissues and bones without exposing patients to harmful radiation. The image quality makes them especially helpful in spotting soft tissue damage, too. The problem is, tests can take as long as an hour. Anyone with even a hint of claustrophobia can struggle to remain perfectly still in the tube-like machine that long. Tying up a machine for that long also drives up costs by limiting the number of exams a hospital can perform each day.

photo of high speed MRI machine for article, How Facebook -- yes, Facebook -- might make MRIs fasterComputer scientists at Facebook (FB) think they can use machine learning to make things a lot faster. To that end, NYU is providing an anonymous dataset of 10,000 MRI exams, a trove that will include as many as three million images of knees, brains and livers.

Researchers will use the data to train an algorithm, using a method called deep learning, to recognize the arrangement of bones, muscles, ligaments, and other things that make up the human body. Building this knowledge into the software that powers an MRI machine will allow the AI to create a portion of the image, saving time.

“You could be in and out in five minutes. It would be a real game-changer.” Daniel Sodickson, vice chair for research in radiology at NYU School of Medicine, told CNNMoney.

{SEE FULL ARTICLE HERE}

UCSF to Use Dignity Health Digital Platform to Increase Health Access

Partnership Puts Information in the Hands of Patients to Transform their Health Care Journeys

Dignity Health and UCSF Health are collaborating to develop a state-of-the-art digital engagement platform that will provide information and access to patients when and where they need it as they navigate primary and preventive care, as well as more acute or specialty care.

The platform, which ultimately aims to serve as a model for health systems nationwide, will be hosted by Dignity Health. The two health care organizations will leverage technological expertise and cloud-based infrastructure that Dignity Health has developed for its 40 hospitals. As one of the nation’s top-ranked academic medical centers, UCSF Health will contribute its extensive knowledge of the patient experience in specialty care.

The two health care organizations will develop a trusted path of digital access across the patient journey using the proprietary cloud-based platform of Dignity Health, one of the nation’s largest health systems.

“Our collaboration with Dignity Health will empower patients and their families with digital health care and connectivity, while simplifying the provider experience,” said Shelby Decosta, senior vice president and chief strategy officer for UCSF Health. “Together, with Dignity Health, we are opening new pathways for health care organizations to create a superior experience for their own patients and ultimately, for patients nationwide.”

In the first phase of the digital collaboration, UCSF is redesigning the user experience of its web and mobile properties and leveraging Dignity Health’s technical expertise to re-envision how the medical center delivers information to patients. The personalized, mobile-responsive infrastructure is supported by rich analytics and machine learning. In later phases, UCSF’s Center for Digital Health Innovation and Dignity Health will map out the multiple pathways that patients follow in moving from primary and secondary care to more acute care services, to create a robust digital system that connects patients and providers, while providing patients with the information they need throughout the process.

Continue reading UCSF to Use Dignity Health Digital Platform to Increase Health Access

QuitMedKit: An Essential Guide to Tobacco Cessation App

Douglas Maurer, DO/MPH/FAAFP | 

Tobacco use remains the #1 preventable cause of morbidity and mortality in the United States and worldwide. Overall, cigarette smoking among U.S. adults (aged ≥18 years) declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still, nearly 38 million American adults smoked cigarettes in 2016, according to the Centers for Disease Control and Prevention (CDC).

Screenshot of app for article, QuitMedKit: An Essential Guide to Tobacco Cessation App
And it’s FREE!

Smoking remains the leading cause of cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD). Efforts to promote tobacco cessation are encouraged at the national, state, local, and individual practice level. The CDC reports only California and Alaska spend the recommended amount on tobacco cessation.

National efforts have included tobacco taxes and smoking bans which have both proven effective. Efforts to prevent the initiation of tobacco use in youths include Tar Wars from the AAFP. More recently, the prescribing of apps for cessation has been utilized and shown to be effective. I have studied the Smartquit app myself via a randomized controlled trial in the military population (unpublished data) served by our residency program. What are the options for providers just wanting to counsel patients outside of a research study and/or paying for a smoking cessation app to prescribe?

The University of Texas MD Anderson Cancer Center has just released a new app called QuitMedGuide. The app was developed by Alexander V. Prokhorov, MD, PhD and Mario Luca, MS, at MD Anderson. The app is intended to assist healthcare providers in counseling and treatment of tobacco dependence. The app includes the evidence-based 5As approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

Evidence-based medicine

Developed by the University of Texas MD Anderson Cancer Center, QuitMedKit uses the current 2008 US Department of Health and Human Services Clinical Practice Guideline for tobacco cessation. The app includes detailed information on the proven 5As approach to cessation, tips on motivational interviewing, and current FDA-approved medications for tobacco cessation.

Who would benefit from this App?

Medical students, primary care physicians, midlevels, hospital medicine physicians, nurses, pharmacists, or any provider who counsels patients on tobacco cessation.

[SEE ORIGINAL STORY HERE]

California online community college announces first health care pathway

APRIL 25, 2018 BY ED COGHLAN

California’s health care providers have a workforce challenge. The state is going to need 11,000 medical coders between now and 2024—that’s about 1,600 job openings a year.

keyboard graphic for article, California online community college announces first health care pathwayThe proposed California online community college has announced its first partnership to establish a program pathway in the health care industry to meet needs like more coders.

The California Community Colleges Chancellor’s Office and the Service Employees International Union-United Healthcare West & Joint Employer Education Fund met with reporters Tuesday to discuss the agreement.

The statewide online community college has been proposed by Governor Brown to help California’s stranded workers, those who lack job credentials and skills because they are unable to attend colleges because of family and work responsibilities.

If approved by the Legislature this summer, the college is expected to be activated by 2019.

Medical coders start at $30 per hour and can make as much as $50 per hour. Their task includes reviewing medical charts and assigning codes for insurance billing.

“These are attractive jobs to enter the health care industry,” said Rebecca Hanson of the SEIU UHW-West & Joint Employer Education Fund.

Lorraine Maisonet of Elk Grove, California was on the conference call. She works for Dignity Health and commutes two hours to work every day. She doesn’t have time to go to school but indicated that an online college would let her learn at her own speed when she could.

Alma Hernandez is the executive director of SEIU California, which represents more than 700,000 members. She said that many workers are stuck in dead-end jobs and don’t have access to the education opportunities that are already available. She also pointed out that the for-profit colleges that offer similar certificate programs are expensive and often result in workers being in debt.

“This is responding to the needs of California workers,” she said.

Community Colleges Chancellor Eloy Ortiz Oakley indicated that the system is working on other pathways as the system focuses on how to help California workers improve their economic mobility and rebuild the state’s middle class.

[SEE FULL STORY HERE]

How Apple’s Health Records Could Reshape Patient Engagement

Dignity Health’s chief digital officer explains why he thinks Apple can succeed for population health and precision medicine efforts where other PHR launches have not.

By Mike Miliard     April 18, 2018     09:46 AM

As a longtime collaborator with Apple – since before it even beta-tested its Health Records project, live now at 39 hospitals – San Francisco-based Dignity Health is in sync with the iPhone developer’s vision, said Shez Partovi, MD.

screensnap of Apple's personal health record feature with iOS 11.3.
A screensnap of Apple’s personal health record feature with iOS 11.3.

“We had been working with Apple prior to their initial announcement for some time,” said Partovi, chief digital officer and senior vice president of digital transformation at Dignity Health. “We’d been working with them for a while because we’re aligned in our philosophies of empowering patients by giving them their data.”

As part of the Health Records launch, Dignity will leverage HL7’s FHIR standard to securely move patients’ health data from own electronic health record system to the iPhones of patients using iOS 11.3 – enabling them manage meds, labs, allergies, conditions and more, and notifying them when the health system makes changes to their health information.

[Also: Apple reveals 39 hospitals to launch Apple Health Records]

“When you think of personalized medicine, you can think about caring for yourself in two dimensions,” said Partovi. “There’s care management, where a health system or physician or team is managing your care, and there’s self-management.”

For those patients managing an illness or a chronic condition, “a big part of your life is self-managing that condition,” he said.

Luckily, nowadays there are “more and more tools out there that will be enhanced if they have your data.” A tool like Apple’s Health Records, that puts valuable EHR data right onto a person’s smartphone, can only be a boon.

“That, for us, has always been the philosophy,” said Partovi. “We recognize that a lot of care happens outside the four walls of a health system. And we believe that for healthy populations we need to give patients their data.”

Picking up where Google left off

The idea of personal health record is nothing new, of course. Most providers offer at least a basic patient portal that can be accessed via computer or smartphone, although utilization of them remains underwhelming.

[SEE FULL STORY HERE]

Can An mHealth Kit Improve Outcomes in Workers Comp Treatment?

Cedars-Sinai will be testing a digital pain reduction kit, which includes VR glasses and mHealth wearables, to see if mobile health technology can replace opioids for people recovering from workplace injuries.

 By Eric Wicklund

 – Cedars-Sinai Medical Center is participating in a study to determine whether an mHealth kit containing wearables and a pair of virtual reality glasses can help people suffering from work-related injuries recover more quickly and without the use of opioids.

patient in hospital wearing VR glasses for article, Can An mHealth Kit Improve Outcomes in Workers Comp Treatment?

Researchers at the Los Angeles hospital are partnering with Samsung Electronics America, Bayer, appliedVR and The Travelers Companies for the 16-mointh study, which will put the “digital pain-reduction kit” in the hands of between 90 and 140 participants.

“Workplace injuries that lead to chronic pain can cause ongoing issues, as an injured employee may mask pain with opioids or other drugs,” Dr. Melissa Burke, Travelers’ National Pharmacy Director, said in a press release. “

Identifying new, non-pharmacologic alternatives for pain reduction  can help an injured employee avoid chronic pain, lower the chances that they will develop a dangerous opioid addiction and reduce medical costs.”

Led by Brennan Spiegel, MD, MSHS, Director of Health Services Research for Cedars-Sinai and a professor of medicine and public health at UCLA, Cedars-Sinai has been one of the leadersin studying the application of virtual reality tools and other mHealth devices in healthcare, focusing particularly on digital therapeutics.

Continue reading Can An mHealth Kit Improve Outcomes in Workers Comp Treatment?