We covered a wide range of hospital innovation stories in Q1 2017, as hospitals continued to explore digital health interventions in patient engagement, remote patient monitoring, and even artificial intelligence and virtual reality. It was also a big quarter for the UK’s National Health Service and also boasted some digital health news for US government actors. Read on for a roundup of notable Q1 provider stories.
Patient Engagement
At MobiHealthNews’s Personal and Digital Connected Health event at HIMSS this quarter, a few different hospital executives spoke about their recent efforts in patient engagement. Cleveland Clinic Chief Experience Officer Dr. Adrienne Boissy discussed the hospital’s efforts around physician reviews, patient satisfaction scores, and interactive technology like smart TVs. And Chanin Wendling, Geisinger Health System’s AVP of Informatics talked about how Geisinger used customer relationship management software to personalize the care that patients at the hospital receive.
Also during the quarter, Charleston Area Medical Center in West Virginia reported that a patient education initiative led to reduced readmission rates for several chronic conditions. What led to the reductions was health information for patients and workflow integration for hospital staff via SmarTigr, TeleHealth Services’s interactive patient education and engagement platform that offers videos designed to educate patients about their care and medication.
Other initiatives focused on different ways to make patients feel welcome during their stay. Saint Luke's Health System, a 10-hospital system serving patients in and around Kansas City, Missouri, teamed up with VenueNext to build a new, comprehensive mobile app for patients and visitors. As well as integrating Saint Luke's existing patient portal, telehealth, and appointment scheduling systems, the new app will add informational and educational content from the health system's website. But where VenueNext's nonhealthcare experience shines (the company has mostly worked in the sports and entertainment sectors) is in additive services like wayfinding, proximity notifications, and food and beverage ordering.
UCHealth in Denver tested CareLoop’s real-time social feed of information and messages and found that 96 percent of patients responded well to the experience. The feed, which is akin to Facebook for emergency departments, delivers messages from caregivers, questions from patients, test results, explanation of care delivered, what to expect next and more. This way, patients have a live feed giving them everything they need to know about their care and family members can read up and see what’s happening with their loved ones. Further, physicians, nurses and other caregivers can have more touch-points with patients without having to perform another face-to-face visit.
And interactive patient engagement and education company GetWellNetwork added a new client to its roster: Children’s Mercy, in Kansas City, Missouri is now one of about 40 pediatric hospitals in the country to deploy GetWellNetwork’s platform, which is rooted in putting patients at the center of care by equipping them with digital tools and information to be an active participant in their treatment and condition management. By providing tools for both patients and staff, the GetWellNetwork platform is designed to help hospitals guide patients and their families through self-management of their conditions, pre- and post-admission care, and overall health education while also improving hospitals’ outcome goals.
Philadelphia-based Jefferson Health, a large health system affiliated with Thomas Jefferson University, launched a new telemedicine platform to reach out to patients. The platform is live for Jefferson’s network of outpatient and inpatient care, which is comprised of six colleges, nine hospitals, and 34 outpatient and urgent care locations -- serving over 2.6 million patients annually. The Teladoc-powered platform will be white-labeled under the name JeffConnect, and will cover inpatient, outpatient and care transition periods. Patients can access the platform through their smartphone, tablet or computer.
Finally, a few patient engagement initiatives were focused on post-discharge care. The Indiana University Center for Aging Research used a $3.2 million grant from the National Institutes of Health’s National Heart, Lung, and Blood Institute to advance the development and evaluation of a mobile Critical Care Recovery Program. The goal is to provide post-ICU patients the rehabilitation they need after being discharged from intensive care units. And Yale New Haven Hospital tapped Reflexion Health for its virtual physical therapy platform as part of a new program aimed at helping patients recover from joint replacement surgery. The platform will be introduced to patients before surgery and concurrently installed in their homes, and they will begin using it while still in the hospital before moving onto their homes.
Remote Patient Monitoring
Several hospitals shared news this quarter about remote patient monitoring initiatives. At the Digital and Personal Connected Health event at HIMSS, Carolinas HealthCare System Vice President of Information and Analytics Services Pamela Landis revisited the ongoing MyCarolinas tracker program and shared data and results from some small pilots at the hospital. In addition to MyCarolinas Tracker, Landis shared data from a new remote monitoring app the health system recently launched called MigraineRx. The objective of the app is to use the phone's passive sensors to collect as much data as possible about when patients' headaches occur.
At the same event, Julie Hall-Barrow, the vice president of virtual health and innovation at Children’s Health in Dallas, Texas, detailed her hospital’s experience using the Proteus Discover system (which tracks medication adherence via an ingestible sensor) in a population of adolescent transplant patients, a use case where she said the novel technology has great promise.
Northwell Health in New York shared a couple of different pieces of news in this space this quarter. In February, through a partnership with health technology company Health Recovery Solutions, Northwell gave its clients the opportunity to use Bluetooth-enabled tablets to transfer vital signs and facilitate videoconferencing with their clinicians. Northwell also shared details of an inhouse program that helps the hospital track when patients leave the hospital and when they’re readmitted.
Care Coordination
A lot of hospitals are using digital technology to doctors, patients, and caregivers to one another within the hospital.
In the lead up to HIMSS Media’s Pop Health Forum, Jennifer Laffey, supervisor and nurse practitioner, at Northwell Health Solutions, spoke to us about a care coordination tool Northwell uses to track patients in their transitional program. Laffey described it as a “LoJack” for patients, informing the hospital when patients are discharged and when they’re admitted to another facility. The tool also allows caregivers to indicate information for other team members; and it pulls parts of the medical record, such as history and physicals, vital signs, and radiology studies, to offer caregivers a snapshot of the patient without needing the full chart from the hospital.
Catholic Health Services of Long Island, a 1,928-bed, six-hospital health system, tapped Uniphy Health for a physician communication and collaboration app that will be rolled out across the whole system. As the name implies, Uniphy has created an app intended to bring together many different workflow needs for physicians. It supports secure messaging, secure image sharing, and group announcements as well as a physician directory. The app also facilitates referrals, helping to keep them in network, and interfaces with two databases: the hospital's EHR and the New York State Health Information Exchange (HIE). This allows physicians who are on some kind of value-based compensation such as bundled payments or shared risk arrangements to be notified when their patients show up at the emergency room.
Lurie Children’s Hospital of Chicago selected healthcare communication company MD Interconnect to provide its cloud-based, mobile messaging platform called RapidConnect to the hospital. Developed by doctors, the RapidConnect messaging system works for both smartphones and desktop computers to replace paging systems and their companion devices in hospitals to provide faster, more secure and more coordinated communication for care teams.
Finally, Mount Sinai Health System in New York is using technology to connect not just caregivers within the hospital, but community organizations as well. Mount Sinai is using Salesforce’s CRM platform to coordinate and manage care of Medicaid members within its Performing Provider System, which was formed in 2015 along with the overhaul of Medicaid. The Mount Sinai PPS covers more than 350,000 Medicaid members across the New York Metro area, and the collaboration with Salesforce will allow the health system to connect every provider and organization across the ecosystem and easily transfer information between each in order to better understand patient needs and provide personalized care.
Population Health
Another areas that has seen a lot of innovation this quarter is population health. Several hospitals partnered with big companies like Philips and Microsoft on population health initiatives.
Valhalla, New York-based Bon Secours Charity Health System, part of the Westchester Medical Center Health Network, forged a $180 million population health initiative with technology giant Philips to improve quality of patient care. The agreement will make Philips solutions available to BSCHS in support of its goal to transform the delivery of healthcare to the residents of New York’s Hudson Valley. The initiative includes population health programs aimed at improving care and helping build healthier communities.
Expanding on the success of connected healthcare pilot programs originally launched in 2013, Arizona-based health system Banner Health and Royal Philips announced a 15-year partnership to go forward with their collaborative efforts to leverage telehealth and other integrated solutions in healthcare. With the expanded partnership, Banner and Philips will leverage Philips’ research in connected care and population health management and Banner’s clinical and operational capabilities to develop integrated solutions for Banner’s patient population. Banner will also have access to many Philips offerings, such as their radiology practice management toolset, and the two companies will look for ways to take a more connected approach on certain areas, like cardiology, by incorporating advanced imaging, genomics, digital pathology and data analytics.
Additionally, Microsoft and UPMC partnered to improve healthcare delivery through a series of projects. The health system will work on Microsoft's Healthcare NExT Initiative, which will focus on clinician empowerment and productivity with AI, officials said. The companies will work together to develop new tools that will first be implemented at UPMC before it hits the market. The partnership will focus on products to empower patients and providers, while advancing UPMC's immunology research.
Smartphone-based research
We reported on several Apple ResearchKit efforts during the quarter.
Stanford University and BioTime subsidiary LifeMap Solutions made available a new version of MyHeartCounts, one of the original ResearchKit apps. The app measures activity from any wearable device linked to the Apple Health app and takes each user's cholesterol and blood pressure results to offer a risk assessment for future heart attack or stroke, and the updated version now offers coaching. The coaching module assigns users one of five available profiles based on their activity patterns, then sends tailored prompts to encourage them to take their activity to the next level if they are able.
Some of the first published research from a ResearchKit study also came out this quarter. In an article in the journal Nature Biotechnology, researchers show how they used the Apple ResearchKit framework to develop an iOS app to study how asthma affects the every day life of different people, as well as how they are managing their condition over time. They launched the Asthma Mobile Health Study in March 2015, and interest was immediately evident: within six months, 50,000 iPhone users had downloaded the app, which featured surveys to assess symptoms, medication adherence and other factors about the condition.
Finally, Penn Medicine launched a new ResearchKit app aimed at people with a rare condition called sarcoidosis, which is characterized by inflammation to one or multiple parts of the body including eyes, skin, lungs, heart, brain and other organs. Called simply Sarcoidosis, the app combines patient resources with research, providing people with sarcoidosis with links to disease information, advocacy groups and specialists in their region (via their smartphone’s GPS).
AI, VR, and More
AI and VR were two of the biggest buzzwords this quarter and we wrote about a few initiatives using that technology. We expect more as the year goes on.
At Cedars Sinai in Los Angeles, Dr. Brennan Spiegel is leading a team experimenting with virtual reality to help patients manage pain, depression, and anxiety without drugs and to help them virtually leave the "bio-psycho-social jail cell" of the hospital. Using a library of different software programs from partner vendor Applied VR, patients can virtually explore different environments. Recent experiences sending 360 degree cameras home with patients' families have even allowed to them to visit familiar locations as well as exotic ones.
On the AI side, Intermountain Healthcare is working with Zebra Medical Vision, a deep learning imaging analytics company, based in Israel to integrate machine learning in medical imaging analysis. Zebra-Med’s analytics engine will receive imaging data and analyze findings indicative of cardiovascular, pulmonary, metabolic and bone health. Intermountain will use the results to identify patients at risk. As Zebra-Med’s engine grows with new insights it will be able to provide increasingly comprehensive reports that will lead to more accurate, cost effective patient treatment.
Additionally, Jupiter Medical Center, a not-for-profit 327-bed regional medical center in Jupiter, Florida, will employ cognitive computing platform IBM Watson for Oncology. Jupiter is the first US community hospital to adopt the technology. The goal is to provide insights to physicians to help them deliver personalized, evidence-based cancer treatment.
And in more general innovation news, the Stanford University School of Medicine launched a Center for Digital Health which will help support greater efficacy data for digital health tools by providing Silicon Valley companies with opportunities to develop, test, and implement new tools in collaboration with the university. To kick off the launch, Stanford is currently accepting proposals for programs seeking to use the Apple Watch in a healthcare context. Stanford is offering 1,000 Apple Watches and $10,000 in grant funding to the winning proposal.
US & UK Government news
We saw a lot of digital health moves from both the UK’s National Health Service and various entities in the US government.
The United States Department of Defense tapped healthcare communication company Vocera Communications to deploy San Jose, California-based Vocera’s system in the Army’s Medical Command facilities around the world. The $14 million contract – Vocera’s largest to date – will equip Army care team members with the company’s wireless, hands-free clinical communications platform in 23 facilities. The Vocera platform integrates with more than 120 clinical systems including nurse call systems, electronic health records, physiologic monitors, ventilators and real-time location systems, and enables mobile workers to connect quickly with the person, information or system they need.
Chicago-based Apervita, a health analytics and data platform provider, announced its integral role in developing the US Department of Veterans Affairs (VA) Digital Health Platform. As part of the proof-of-concept for the Digital Health Platform, Apervita acted as the analytics engine to help the VA integrate information for all patients and care providers across the VA system to improve patient care. The goal of the Digital Health Platform is to create an interoperable dashboard spanning a veteran’s complete medical record. It will integrate patient data from all electronic health record systems, wearables, connected devices and apps, then add analytics and engagement platforms to make it easier for veterans to obtain healthcare. Under the management of prime contractor Georgia Tech, Apervita worked with Salesforce and MuleSoft to build pathways and guidelines to coordinate patient data and care.
The Office of the National Coordinator released a draft of an analysis of the landscape of the role patient-generated health data has to play in clinical research and health care delivery. The white paper, written by Accenture Federal Services, is now available for public comment and is the latest development in the ONC’s two-year contract with Accenture to identify challenges and opportunities in PGHD and subsequently develop a framework for the ONC on how to collect and use the data.
Finally, for the US, the National Institute of Diabetes and Digestive and Kidney Diseases, a part of the National Institutes of Health, gave out $41 million in grants to four studies that will hopefully make the artificial pancreas – a long-sought, fully automated, closed-loop system for insulin regulation – a reality. Two of the studies are underway and two more are slotted to begin recruiting in the next two years.
Across the pond, the NHS made a number of digital health moves during the quarter, including two involving chatbots. Babylon, a UK-based telemedicine startup, will power one six-month trial in north-central London, which will include 1.2 million covered citizens. Babylon is a major telemedicine provider in its native England. The company's direct-to-consumer offering starts with an AI-powered chatbot which can escalate up to a video visit if necessary. Triage via Babylon requires about 12 text messages and takes about a minute and a half.
Additionally, through a partnership with digital and social media company Orbital Media and Innovate UK, a group of developers, data scientists and research will collaborate for 30 months to develop photo realistic avatars that will function as primary physician chatbots. People can access the service to get interactive medical information on things like coughs, colds and flu.
The NHS also expanded the rollouts for several mobile apps. The list includes GDm-health, an app for managing diabetes in pregnant women; EDGE-COPD for chronic pulmonary disorder; and SEND, a tablet app for monitoring vitals of patients in hospitals. These apps have all cleared initial trials and the Oxford University Hospitals (OUH) NHS Foundation Trust, in partnership with Oxford University, is working with a firm called Drayson Technologies to roll them out to four other NHS Trusts and, eventually, to the whole system.
UK healthcare organization Salford Royal, a part of the NHS, is working with Validic to integrate patient generated health data into their electronic health records into their system. Salford Royal serves some 220,000 UK residents across Manchester and is considered one of the NHS’s most digitally advanced trusts. The health system recently received over $12 million (10 million British pounds) to build out their digital capabilities, with a large focus on remote monitoring. Using Validic’s data connectivity platform, Salford Royal will integrate patient-generated health data from wearables, in-home medical devices and consumer health apps to identify how that data can lead to better outcomes in patient care as well as cost reductions.
Lastly, UK-based digital health company Inhealthcare is now working with Medway Community Healthcare to provide remote monitoring services to people who are self-managing cardiac health. Using Inhealthcare’s telehealth platform, Medway patients who have been prescribed the anticoagulant Warfarin for longterm use and currently self-test their blood can now manage their condition completely remotely, freeing up time they would otherwise have to spend going to the doctor as well as reducing pressure on the healthcare system.
