Healthcare Technology

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Risk Taking Doesn’t Have to Be Scary

Taking risk is an important part of being human, in order for us to succeed or get what we want out of life, we have to take a path towards uncertainty. Minimizing risk or simply feeling more prepared, can be obtained through resourcefulness and can help us gain a level of confidence in order to take the next step. In the recent article written by our CEO Anne Weiler, she describes the pillars to her own decision making and how she has applied them to starting a healthcare technology company. Anne uses a simple analogy for risk evaluation; rock-climbing. How can this analogy help you with your next big decision?

Please read Anne’s article here and post any comments below. Are you evaluating taking a risk right now? We would love to hear your thoughts!

Posted in: Healthcare Technology

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Patient Engagement Goes Mainstream: 5 Observations from HIMSS 2016

A walk through the trade show floor, and a glance at some of the sessions at HIMSS, quickly indicates that patient engagement is everywhere, which is great because an empowered patient is key to improving outcomes and lowering costs of care. There is still a lot of noise in this space however, with anything from wayfinding applications to billing services being billed as patient engagement. Let me set the record straight: making sense of things that are very confusing and often poorly designed, like hospitals and healthcare billing is not patient engagement, it’s explanation. That said, there are many innovative companies and healthcare organizations who are taking patient engagement seriously.

Here are 5 impressions or things heard at HIMSS about patient engagement and the state of healthcare IT:

  1. There are a lot of solutions in this space/competition is good. While there may be companies that have joined the space because patient engagement is a hot topic, real competition shows a real need and market.
  2. Clinical workflow does not equal patient engagement. True patient engagement solutions are designed around the needs of the patient.
  3. Engagement does not equal alignment. While this was said about physicians it’s also applicable to patients. A surgical patient can’t help but be engaged, but are the patient and physician aligned on the patient’s goals.
  4. Healthcare IT is emerging from the EMR era. Meaningful use drove widespread adoption of EMRs and monopolized IT resources for the past X years. IT is now ready to take a seat at the table and proactively suggest solutions to the clinical side of the house.
  5. People are asking how a solution is different rather than why they need a solution. This is a huge shift: at our booth we spent a lot less time explaining what we do and how we do it.

We’re looking forward to what the next year will bring. It seems like we’re at the starting blocks for some real value-based implementations of patient engagement solutions.

Patient Engagement Hits The Mainstream

Posted in: Healthcare Disruption, Healthcare Technology, M-health, Outcomes, patient engagement

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Did HIMSS deliver on its Charter? Transforming Health through IT

HIMSS Annual Conference
February 29-March 4, 2016

Another HIMSS has come and gone for me. I will not brag about how many times I have attended this conference, but I will brag about it being the first time with Wellpepper. Overall, the level of activity exceeded our expectations and validated the need for innovative patient engagement technologies like ours.

Being with a new company gave me a whole new perspective on the HIMSS annual event. Reflecting back, years of HIMSS events can blur together and it can seem like the same old same old. This year was different: the healthcare ecosystem is going through a profound change and the providers and payers know this. Health systems are beginning to understand that the model is moving away from a passive engagement with the patient, to a model where the patient is taking more initiative to include their own wants/needs to participate in their care delivery.

With that, comes a whole new set of demands from the patient consumer and that I believe is where HIMSS is trying to make the transformation.  For the second year, HIMSS has partnered with HX360’s Innovation Pavilion to showcase pioneering health IT solutions that are addressing these challenges. As a start-up company, we can often get lost in the maze of vendors at a large conference such as HIMSS (estimates suggest more than 1200 exhibitors). The HX360 Innovation Pavilion provides an opportunity for entrepreneurial health IT companies to shine… and that we did.

Along with this venue, HX360 sponsors an Executive Program that runs concurrent with HIMSS. These educational sessions attract leaders such as Chief Innovation Officers, Nursing Informatics Officers and Vice Presidents of Digital Health who are looking for innovative solutions from companies like Wellpepper. Because of this venue and opportunity, we were able to have meaningful conversations with IT and executives that are looking to get a head of the curve and provide innovative solutions for their patients and systems.

Upon my travels home, I felt optimistic this shift to value-based healthcare will really drive innovation and allow companies like Wellpepper to part of the conversation and solution. The future appears to be bright and full of opportunity.  It is an exciting time for both the healthcare community and the consumer.

So, did HIMSS hit their mark? In part, yes. HIMSS is making great strides to keep up with the changing landscape of healthcare. No longer is it just about the EMR, servers, networks and storage in the IT back room. It’s about patient facing solutions that provide ownership and accountability for the patient while securing that brand loyalty for the provider.

The transformation of healthcare is now. Healthcare does not take to change lightly. But, companies like Wellpepper will continue to pave the way to innovation and the industry will take notice.

Posted in: Healthcare Technology, Healthcare transformation, M-health, patient engagement, Telemedicine

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Flexible Care for Independent Aging: Don’t Dumb It Down!

I had the pleasure of participating on a panel on technology for aging, along with Honor founder Seth Sternberg and CareTicker founder Chiara Bell during the HX360 event at HIMSS 2016. (HX360 is a “conference within a conference” focused on innovation and C-suite leadership.) The panel was hosted by Jeff Makowka, Director of Market Innovation for AARP, and ranged from topics on entrepreneurship and whether there is a venture rush to technology for aging now to approaches for delivering care for aging in place.

Interestingly, all three panelists were inspired by personal experiences to found our companies. For me, it was poor discharge instructions and lack of continuity of care when my mom was released from 6 months in a long-term care facility. For Seth and Chiara, it was trying to figure out how to enable their parents to age at home. It’s a classic entrepreneurial model to experience a problem and try to find a solution to it, provided the market is big enough, and this market certainly is based only on demographics of the aging baby boomers. Seth and I both made the leap from technology, Seth from Google, and me from Microsoft, and Chiara from a long history in healthcare and homecare.

We were much sharper in real life.

We were much sharper in real life.

Honor’s $20M in funding lead by Andressen Horowitz is proof that Silicon Valley is paying attention to homecare, which can be viewed as important from two aspects: first we need innovative and new thinking to approach these challenges, and second these solutions could require a lot of money. (Although I would posit that we need patient capital in this space, something that Silicon Valley is not always known for. Interestingly, the same week as the panel Dave Chase and Andrey Ostrovsky posted a piece on why Silicon Valley does not belong in homecare. Maybe they should be on next year’s panel.)

The three panelist companies took similar approaches in using technology to scale and empower the people in the process, both patients and caregivers. For Wellpepper it’s about empowering the patient to follow their care plans and get remote support from the healthcare team. Honor and Careticker are more focused on the patient and their homecare team, whether that is professionals or family members. What was similar in the approach was providing information in real-time to the people who need it, and treating everyone in the process with respect. Honor does this by ensuring homecare workers are paid a living wage. Careticker does this by recognizing for people to age in place, the family caregivers need the right information and supports and Wellpepper does this with patient-centered and highly-usable software that is not dumbed down for the aging.

We were perhaps the outlier on this panel as our solution is not aimed specifically at the elderly. However, you could say we are the most representative of the way we need to approach the challenge: we need solutions that are designed with empathy, putting the patient first, and are not categorizing people into “young” and “old.” Well designed solutions and products should can address a broad spectrum of users, and we need to treat those aging in our population as another audience in this spectrum.

Posted in: Aging, Behavior Change, Healthcare Disruption, Healthcare motivation, Healthcare Technology, Healthcare transformation, M-health, Managing Chronic Disease, Patient Satisfaction

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Wellpepper goes to Vegas for HIMSS16!

Screen Shot 2016-02-24 at 4.03.54 PM

 

Sunny and 70’s all week,Vegas here we come! We will try to bring some sun back with us.Vegas Weather HIMSS Blog

We will be in booth #5 @ the HX360. Let us know if you’ll be attending HIMSS16 by sending us a tweet @wellpepper.

Contact us, to set up a meeting with Anne Weiler CEO or Robin VP of Business Development 

The annual HIMSS conference is almost here! A few tips.  Wear comfortable shoes and your Fitbit, you will be walking miles. With over 43K in attendance at HIMSS15, the lines for coffee and food were long.  Bring a few snacks and get your morning coffee before you get to the conference!

So many interesting and inspiring education sessions, so little time! Between walking and navigating the crowds, it can take up to 10-15 minutes to get where you are going so take some time to plan out your education sessions. Get to the sessions early if you want a seat, many sessions end up being standing room only. 

Stop by to see Wellpepper CEO Anne Weiler on this panel which is part of the HX360 Innovation Leaders Program

Date: Monday, February 29, 2016: [Time: 2:30 PM – 3:15 PM]

Session Title: Flexible Care to Fit the Second Half of Life: from Independent Aging to Acute & Long Term Care

Session Description:  How can technology support flexible, high quality, cost-efficient care delivery that meets patients’ needs in the second half of life? Where are the most egregious gaps in care for older patients? These are the questions that will be explored by our panel, covering topics ranging from aging independently to rehabilitation, home care support, family caregiving and honoring end-of-life wishes.

Here are some of our  education session picks.

Connected Health

March 1, 2016 — 08:45AM – 09:45AM : Trends & Resources in Connected Health: Harnessing the power of mobile for research 

Clinical and Business Intelligence                                                                

March 1, 2016 — 10:00AM – 11:00AM: Actionable Analytics: From Predictive Modeling to Workflows

March 3, 2016 — 02:30PM – 03:00PM: Getting to Big Data Insights in Healthcare

Consumer and Patient Engagement

March 2, 2016 — 10:00AM – 11:00AM: Patient Engagement – The Next Chapter

March 4, 2016 — 12:00PM – 01:00PM: Patient Engagement Beyond Patient Portal-Strategic Approach

Care Coordination and Population Health

March 1, 2016 — 10:00AM – 11:00AM: Too Many Patient Portals – What Can You Do About It?

March 1, 2016 — 01:00PM – 02:00PM: Coordinated Health: The Experience You Should Expect

March 1, 2016 — 03:15PM – 03:45PM: mHealth solution for remote patient engagement

March 1, 2016 — 04:45PM – 05:15PM: Rethinking patient engagement and provider workflow

Clinical Informatics and Clinician Engagement

March 1, 2016 — 04:00PM – 05:00PM: Enhancing Patient Outcomes with Big Data: Two Case Studies

March 2, 2016 — 10:00AM – 11:00AM: Taking Plans of Care from Clinician to Patient-Centric

March 2, 2016 — 01:00PM – 02:00PM: Seven Essentials in Clinical Information Technology Adoption

 

Posted in: Healthcare Research, Healthcare Technology, Healthcare transformation, M-health, Outcomes, Patient Satisfaction, Uncategorized

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mHealth and big data will bring meaning and value to patient-reported outcomes

Anne Weiler
Wellpepper, Inc., Seattle, WA, USA
Correspondence to: Anne Weiler. CEO, Wellpepper, Inc., Seattle, WA, USA.
Email: anne@wellpepper.com
Abstract: The intersection of widespread mobile adoption, cloud computing and healthcare will enable patient-reported outcomes to be used to personalize care, draw insights and shorten the cycle from research to clinical implementation. Today, patient-reported outcomes are largely collected as part of a regulatory shift to value-based or bundled care. When patients are able to record their experiences in real-time and combine them with passive data collection from sensors and mobile devices, this information can inform better care for each patient and contribute to the growing body of health data that can be used to draw insights for all patients. This paper explores the current limitations of patient reported outcomes and how mobile health and big data analysis unlocks their potential as a valuable tool to deliver care.

Link to full article can be found here

Posted in: Adherence, Healthcare Technology, M-health, Telemedicine

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APTA Combined Sections Meeting Wrap Up

Walking the floor at APTA CSM 2016 Anaheim, CA

Last week, I attended the American Physical Therapy Association Combined Sections Meeting (APTA CSM) in Anaheim, CA. The show was well attended by about 18,000 Physical Therapists and professionals in related roles. The packed house meant lots of energy, a few full sessions, and long lines for coffee at the two overwhelmed Starbucks kiosks in the nearby hotels. Wellpepper started out in physical rehabilitation, so it was great to be back in the company of many talented ‘movement system experts’ and associates working together to gain knowledge in order to achieve best practices for healthcare systems, patients and/or caregivers.

I attended a number of sessions, mostly focused on the shift to value-based payment, and outcome measurement. The healthcare value equation has penetrated deep in this community. I saw the same basic slide in at least 3 talks:

* This formula has been widely discussed by Michael Porter and others.

I attended two presentations on outcome measurements by Beth Israel Deaconess Medical Center (BIDMC) and Johns Hopkins. Both organizations spoke about the task of adopting outcome measurements in an acute settingand their thoughtful deliberate steps to take research-based measurement techniques and apply them into clinical practice;BIDMC’s applied the Knowledge Translation framework, and Hopkins’ applied the Translating Knowledge Into Practice (TRIP) initiative. There were many similarities that both organizations encapsulated in their task of adopting outcome measurements; both organizations had to fight against “don’t give me more documentation work” attitudes, worked cross-functionally with PTs, nurses, physicians and administrators to gain support for their plans. And both adopted process measurements to observe the rollout of outcome measurement tools and practices. Furthermore both had some crossover in the specific measurement tools they used (e.g. AM-PAC / 6 clicks).Another common thread I believe important to note was the development of practical tips and tricks for how to make it easy to capture data into their EMRs that weren’t always designed to capture this kind of data (real nuts-and-bolts stuff like how to copy and paste boilerplate text).

Finally, armed with data on patient functional outcomes, Johns Hopkins shared some of the work they were doing on risk-stratifying patients to help control costs. In a world where Post-Acute Care costs represent one of the largest and most variable cost centers for many procedures, this is critical. The quantity and richness of this data is something I hadn’t seen presented at this conference before. Here is real objective data on how real patients progress through their care journeys that can be used to at the individual level to have an informed conversation with the patient and provides fantastic optics into the most important work product of the healthcare system: making people better.

I was struck that both presentations concluded that measuring outcomes was less of a technical feat than an organizational one. It is, as Michael Friedman a presenter from Johns Hopkins articulated, “About culture change more than anything.”

Throughout the conference, there were also mentions of Patient-Reported Outcomes (Oswestry, HOOS, KOOS were frequently mentioned – thankfully ones that Wellpepper supports!) My sense was that these are still not as widely deployed and not as consistently measured to have made their way into any of the mainstream presentations. As Wellpepper and other companies keep pushing to measure (and improve!) the patient journey with patient reported outcomes, I expect this will change in the coming years.

The one disappointment I had from the conference was that the excellent session on the Patient Experience was not better attended. Jerry Durham (a minor celebrity in the PT world!) introduced a panel of 2 patients to present on their experiences and lamented that often the Triple-Aim objectives are reduced to a Double Aim, ignoring the patient experience. So we had the excellent chance to learn and hear real patients talk. Both patients were both doing great thanks to their Physical Therapists, but both talked about the significant failings they’d seen in their medical practitioners (of all stripes). In a string of wrenching, quotable sound bites, one said “I couldn’t have gotten this bad without the help of PT”. It’s a shame that despite the healthcare rhetoric about putting patients first that more attendees didn’t put this into practice and take the opportunity to learn from some honest patient-driven conversation.

All told, this was a good conference, notable for the increasing use of patient data to measure and improve. If the attendance for CSM 2017 in San Antonio is anything like this one, let’s hope for more coffee and more chairs!

Posted in: Adherence, Healthcare Disruption, Healthcare Technology, M-health, Telemedicine

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EvergreenHealth Selects Wellpepper as Mobile Patient Engagement Solution for Total Joint Replacement

SEATTLEJan. 20, 2016 /PRNewswire/ — Wellpepper, Inc., a clinically validated platform for patient engagement, today announced that EvergreenHealth, an integrated health care system that serves nearly 850,000 residents in northern King and southern Snohomishcounties in Washington State, has selected Wellpepper as the mobile engagement solution for all total joint replacement and musculoskeletal care plans. The project was made possible at EvergreenHealth with a generous donation from The Schultz Family Foundation, a private not-for-profit foundation founded by Howard Schultz, CEO of Starbucks Corporation, and his wife Sheri.

Patients with musculoskeletal issues that require surgery or rehabilitation will use Wellpepper on their mobile devices to track their outcomes and adhere to their care plans. This information will enable patients, physicians, and other healthcare providers to track progress and patient-reported outcomes in real-time to improve care. Wellpepper enables health systems to implement their own care instructions on its task-based platform and makes it easy for patients to understand and adhere to their care instructions.

“Across our organization, we strive to be a trusted source for innovative care solutions for our patients and families, and our partnership with Wellpepper helps us deliver on that commitment,” said EvergreenHealth CEO Bob Malte. “Since we began using Wellpepper in 2014, we’ve seen how the solution enhances the interaction between patients and providers and ultimately leads to optimal recovery and the best possible outcomes for our patients.”

The Wellpepper remote care management solution is designed to be easy-to-use and highly engaging for patients while being flexible and easily customizable for use in clinical practice. It is clinically-proven to improve patient adherence and outcomes with over 70 percent patient engagement.

Health systems are increasingly looking for solutions to enhance patient care while reducing costs, and this is particularly true in total joint and musculoskeletal scenarios. The new Comprehensive Care Model for Total Joint replacement announced by the Centers for Medicare and Medicaid aims to reduce the cost and quality variability of procedures.

“We are seeing a lot of interest in using the Wellpepper platform in orthopedic and total joint replacement scenarios,” said Anne Weiler, co-founder and CEO of Wellpepper. “Interest and adoption are largely being driven by our ability to customize the care plans based on the health system’s own protocols, personalize the plans for each patient and collect the standardized outcomes required as part of the new Center for Medicare and Medicaid requirements.”

The Wellpepper platform doesn’t dictate care plans; instead it provides a set of task-based building blocks that health systems and providers can customize to reflect their own methodologies and practices. The patient interface is simple and straightforward, so patients get only the tasks and questions they need on a given day.

For more information about Wellpepper or to find out how the Wellpepper patient engagement solution can support value-based payment models, please visit wellpepper.wpengine.com or email info@wellpepper.com.

About EvergreenHealth
EvergreenHealth is an integrated health care system that serves nearly 850,000 residents in King and Snohomish counties and offers a breadth of services and programs that is among the most comprehensive in the region. More than 950 physicians provide clinical excellence in over 80 specialties, including heart and vascular care, oncology, surgical care, orthopedics, neurosciences, women’s and children’s services, pulmonary care and home care and hospice services. Formed as a public hospital district in 1972, EvergreenHealth includes a 318-bed acute care medical center in Kirkland, a network of 10 primary care practices, two urgent care centers, over two dozen specialty care practices and 24/7 emergency care at its Kirkland campus, Monroe campus and at a freestanding center in Redmond. In 2015, the system expanded to include EvergreenHealth Monroe – an accredited, full-service 72-bed public hospital district, established in 1960 in Monroe, Washington. EvergreenHealth has clinical and strategic partnerships with several health care entities, including Virginia Mason, Seattle Cancer Care Alliance and dozens of independent practices that are part of the clinically integrated EvergreenHealth Partners network. In addition to clinical care, EvergreenHealth offers extensive community health outreach and education programs, anchored by the 24/7 EvergreenHealth Nurse Navigator & Healthline. For more information, visit www.evergreenhealth.com.

About The Schultz Family Foundation
The Schultz Family Foundation, established in 1996 by Howard and Sheri Schultz, creates pathways of opportunity for populations facing barriers to success. The Foundation invests in innovative solutions and partnerships that unlock people’s potential, and strengthen our businesses, our communities, and our nation. For more information about the Foundation and its work: schultzfamilyfoundation.org.

About Wellpepper
Wellpepper is a healthcare technology company that provides a clinically validated platform for digital treatment plans delivered via mobile devices. The Wellpepper patient engagement solution improves patient adherence and outcomes with its patent-pending adaptive notification system and just-in-time, task-based instructions and by fostering communication between healthcare providers and patients. Wellpepper is used by major health systems that are moving to an accountable care organization model and need to track and improve patient outcomes while lowering costs. Wellpepper was founded in 2012 to help healthcare organizations lower costs, improve outcomes and improve patient satisfaction. The company is headquartered in Seattle, Washington.

Media Contact:
Jennifer Allen Newton
Bluehouse Consulting Group, Inc.
503-805-7540
jennifer (at) bluehousecg (dot) com

SOURCE Wellpepper

RELATED LINKS
http://wellpepper.wpengine.com


Posted in: Healthcare Technology, Healthcare transformation, Interoperability, M-health, Outcomes, Physical Therapy, Prehabilitation, Press Release, Rehabilitation Business

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2016: The Year of Telehealth

Judging by the freezing rain hitting my window pane and the darkness that comes at 430 pm, it is evident we are coming to the year’s end here in Seattle. As always the approach of a new year brings a great number of predictions and I don’t mean the kind that are derived just out of hope, but out of reality. A quick Internet search produces many real 2016 telehealth predictions; some are witty, honest and steadfast, others more conservative. However one common thread not to ignore is the ever increasing benefits of telehealth and the great strives by the US Congress to regulate and support such. For instance there are 17 telehealth bills pending in the Senate and 21 in the House; from excise tax on medical devices to the “VETS Act to improve the ability of health care professionals to treat veterans via telehealth…” The 114th Congress ends in January 2017 so the progressive reality of telehealth to have a presence in your healthcare entity is undeniable and if such already exists it will be more palatable.

Another common thread in my searches is the statement: 2016 will be the Year of Telehealth. It is easy to believe this statement without any gullibility especially after experiencing first hand the steadfast innovation of telehealth over the last few months of 2015. Coupled with the readmission penalties, competitive advantage, telehealth parity laws, quality reporting outcomes incentives, and transformation of rural care it is no surprise that this statement is used liberally. Furthermore every year it is becoming increasingly more difficult to find skeptics of telehealth, the list of benefits are always increasing and scrutiny of our healthcare system forces many to find solutions. Telehealth is on that strong progression towards not just being an added bonus to way we provide care to our patients, but in some cases the only way we provide care.

I would never claim to be an elite expert in the field of healthcare innovation and policy, so I do not want to go into what I think will happen in 2016, but one cannot help feel the buzz in our Wellpepper office in Fremont, Seattle, WA. Our group serves has an example of what is going on in the mhealth field; we have grown in leaps and bounds just over the last 6 months in order to keep up with the demands of the industry. I cannot believe how incredibly lucky I am to be part of such great innovative team of professionals that have one goal of many in mind that brings my sentiment home, to make healthcare better for all of us.

Happy New Year!

Posted in: Healthcare Policy, Healthcare Technology, Healthcare transformation, M-health, Seattle, Telemedicine

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Digital Health and the Influence on Healthcare: Wearables, Telehealth, & Treatment

Things are looking up in the world of digital health at least this was the view from “Digital Health and the Influence on Healthcare: Wearables, Telehealth, & Treatment.” The WBBA held their last event of the season with a panel on digital health, hosted by Russell Benaroya, CEO of Everymove, and featuring Dr. John Scott, Director of Telemedicine at UW Medicine, Davide Vigano CEO and co-founder of Sensoria, Mike Blume, independent healthcare consultant, and myself. I’d characterize the overall event as being optimistic and realistic, both from the panel and the attendees.

Digital health event

It was a dark and stormy night

No one said that the road to digital health was easy or fast, but the consensus that things like moving to the cloud, and the acceptance and adoption of patient-driven digital care is reaching a turning point.

Both Sensoria and Wellpepper’s business models are made possible by the cloud. For Sensoria this was the ability to process millions of datapoints coming from their wearable technology. For Wellpepper, this is our ability to rapidly implement solutions working with department heads facing a particular challenge in patient engagement and outcome tracking and improvement. Dr. Scott remarked on the dramatic drop in the cost of telemedicine solutions over the years he’s been an advocate and solutions due to both Moore’s Law and cloud computing over his tenure running telemedicine at UW.

Sensoria's Quantified Socks

Sensoria’s Quantified Socks

As well, although Dr. Scott highlighted how telemedicine was limited by arcane reimbursement models that did not allow for patients to receive telemedicine consults in their homes, he and other panelists discussed that they were not waiting for billing codes to do the right things in using technology to deliver better care. As usual, the Affordable Care Act was seen as a big driver as patient-centered and digital care.

Possibly because there were two ex-Microsoftees on the panel (Davide and me) a cloud-based platform approach was touted as the best way to both collect, analyze, and sort the data that came in directly from patients. In the case of Sensoria and Davide, this was to look for trends and patterns coming from sensor-integrated clothing, and in the case of Wellpepper it was to collect patient outcomes in the context of care and compare these across patients, procedures, and healthcare organizations.

This view led to a discussion about the proliferation of data, and everyone agreed that digital health has the ability to overwhelm health systems with data that they are currently not prepared for. EMRs are not set up to include sensor or patient-reported data, and as Dr. Scott pointed out, physicians are not looking for every data point on a patient, only the anomalies, like glucose out of range.

One audience member asked about whether healthcare organizations had an overall data strategy, and whether digital health data should be collected as part of that. It’s an interesting idea to consider but it seems like it’s still a long way off in healthcare. Does your organization or CIO have an overall data strategy? It seems that quality measures and the need for patient reported outcomes are introducing new requirements for data, but this is at the departmental or initiative level. Grappling with questions like this will be important as connected devices, digital, health, and patient reported outcomes enter the mainstream.

Posted in: Health Regulations, Healthcare Disruption, Healthcare Policy, Healthcare Research, Healthcare Technology, Healthcare transformation, M-health, Outcomes, Telemedicine

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Reverse Innovation: What We Can Learn From Global M-Health

Whenever possible at conferences, I try to attend at least one session that is outside my particular area of focus and expertise. While almost everything at the recent HIMSS M-Health was relevant, global health is a bit outside the target for Wellpepper right now. Attending a few sessions on M-Health got me thinking about similarities between some of these initiatives and the situation at home.

Global M-HealthWhen we started Wellpepper, we got a lot of feedback on our mobile first strategy, not all of it positive. We believe that people have an emotional connection with their mobile devices and that when people’s mobile devices ask them to do something they generally do it which is why we optimize our patient experience for mobile. Concerns were that people of lower socio-economic backgrounds or older people would not be able to use the technology.

We and other startups have found this to be untrue, and given the success of mobile programs in the developing world, it seems that this is a red herring of an argument as m-health initiatives are successful with people with widely varying literacy levels and for whom this is often their only connection with technology. Basically if people with low tech literacy can engage in their health through mobile devices in the developing world, we’re pretty sure everyone can in the US as well. In the developing world, mobile infrastructure has leapt over landline infrastructure. A similar thing has happened for lower income people in the US: they are more likely to only have Internet access through a smart phone than through a computer and home Internet connection.

The session “Innovative Content & Mobile Delivery Tools: Driving Healthcare Utilization & Coordinating Care” covered a number of private and public partnerships to bring culturally relevant and timely information health issues related to childbirth to women, caregivers, and families in Africa. There were a number of similar initiatives involving different players in different countries both not-for-profits and telecommunications companies. Rather than recapping one initiative this post is a survey of some of the learning and best practices from a few different ones.

Most projects were either focused on preventing unwanted pregnancies and also reducing child mortality. Really two sides of the same coin: making sure women and families had the information and resources they needed to care for their children. Information needed to be localized to the needs of the audiences that included mothers, mothers-to-be, midwives, and others caring for pregnant women, and their spouses. Customized content was key, for example, nutrition advice needed to address what was available in each country, and medical advice for the types of caregivers that were in the area, not always licensed medical professionals.

While the projects were shown to work, sustainability was key. There needed to be benefits to the telecommunciations companies that were providing free texting between expectant and new mothers and providers, and access to video content. There are definitely benefits for the telecommunications companies, which included:

  • Customer loyalty. By supporting women and families in this crucial time, the telcos were able to let them know that they would be with them through thick and thin and supporting them in important life events.
  • While the phones were provided for this particular educational program, people started using them for other activities which provided a revenue stream for the telecommunication companies.
  • Lack of churn. Many women were repeat users of the program when they had their second child.

Content for Global M-HealthChallenges of the programs mostly revolved around content. Creating and managing content was a big cost for the non-profits involved. Video content was seen to be best as it didn’t require a high-level of literacy, but keeping content both culturally-relevant and up-to-date was a challenge. As a result, one organization provides a free content library for front-line health workers.

In addition to the similarities of access to information, the content problem is also one we see here. However, the difference is an abundance of content for patient treatment plans. Each organization has their own content and best practices. During the session, I thought that donating care plans and instructions to some of these not-for-profit might be an interesting way to solve this problem, collect more feedback on care plans and accessibility, as well as give back.

Posted in: Healthcare Disruption, Healthcare motivation, Healthcare Research, Healthcare Technology, Healthcare transformation, M-health

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Help Wellpepper! My headache is agonizing

I remember when I was a kid walking into my grandmothers bedroom while she was in bed tending to, what I know now was, a headache. It was the middle of a busy summer day, but yet the room was dark, cool and completely silent, well except for me gasping; she wore these thick black eye masks that always scared me. Now as an adult I frequent this same scenario, except I have more than just aspirin to help me cope with my migraines, and very soon a useful device, my smartphone.

If you suffer from migraines, the thought of getting in the car, driving to the doctor, sitting in a busy clinic and being away from your cool dark room, is daunting. Honestly I don’t go to the doctor until sometimes days after, and by then I tend to block out that terrible afternoon I spent in bed. As a patient being able to record the effects in real time and communicate remotely with a helathcare professional is so much better than considering that trip. The new Wellpepper app will enable migraine sufferers to connect with their neurologist in real time, noting the severity of their headache, side effects, triggers and any medication taken. I cannot express how awesome it would be to roll out of bed for a minute, answer a few simple questions on my smartphone and go back to bed. This would save me money, a trip to the doctor after the fact (because let’s face it I am not driving to the ER in that state) and yet another session with my doctor that entails just getting out the prescription pad.

I have used great apps like Migraine eDiary and My Migraine Triggers, but they always left something to be desired, that connection to a human being that can help. Doctors are nurturers and when you are in as much pain as some of these headaches can be it is so reassuring to know that your doctor is on the other side of the Wellpepper app doing whatever they can to help. I know apps will never replace our clinicans, that much is evident, but if apps can be used as a tool to help us function better especially in times of distress, I couldn’t be happier.

Posted in: Healthcare Technology, M-health, Patient Satisfaction, Telemedicine

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Press Release: Sentara Healthcare Chooses Wellpepper

Sentara Healthcare Chooses Wellpepper for Mobile Patient Engagement in Headache Care

SEATTLE, Nov. 19, 2015 /PRNewswire/ — Wellpepper, Inc. today announced that Norfolk, Va.-based Sentara Healthcare is partnering with Wellpepper to provide a mobile patient engagement solution for headache care. Wellpepper is a clinically validated patient engagement platform. Sentara is an integrated not-for-profit system of 12 hospitals and more than 100 sites of care, including a robust neurosciences program. Sentara patients who suffer from migraines and other severe headaches are able to use the Wellpepper mobile application to report their headache experiences in real time, including pain, triggers and use of over-the-counter or prescription medication. Sentara Neurologists are able to use the information collected to diagnose, treat and monitor the ongoing progress of headache patients with the goal of better outcomes, fewer office visits and lower healthcare costs.

“We believe Wellpepper can help us provide timely care for headache patients,” said Alexander Grunsfeld, MD, medical director for Sentara Neurosciences. “Sentara encourages patients to be partners with us in their care and the Wellpepper solution offers a new opportunity to achieve that goal.”

Currently, when patients are referred to a neurologist, they are asked to complete surveys and try to remember what triggered their headaches. Follow-up surveys are typically given every 3-6 months. The result is often multiple office visits and patient care is delayed until the root causes for headaches are eventually discovered.

Data collected through the Wellpepper application is presented to healthcare providers via a clinical dashboard. Neurologists can easily communicate with headache patients to alter treatment plans without the patient having to unnecessarily visit the office. Wellpepper also provides a way for patients to log pain levels using the visual analog pain scale and to record medication use and how much.

“Too often, data collection from patients is disconnected from their care plan,” said Anne Weiler, co-founder and CEO of Wellpepper. “Being able to use patients’ own smartphones and tablets to provide care plans and show results using Wellpepper is not only a way to help drive patient engagement, it is a way for healthcare providers to gather strong, real-time data and patient-reported outcomes in a way that after-the-fact surveys cannot.”

Approximately 18 percent of women and 6 percent of men between the ages of 12 and 80 suffer from migraines in the U.S. According to a study published in the Journal of General Internal Medicine, migraine cases require, on average, 2.3 more physician office visits than non-migraine controls (9.1 vs 6.8, respectively) and were significantly more likely to have been seen in an emergency department (20.7% vs 17.6%) or admitted to a hospital (4.5% vs 2.8%).

For more information about Wellpepper or to find out how the Wellpepper patient engagement solution can support value-based payment models, please visit wellpepper.wpengine.com or email info@wellpepper.com.

For information on the Sentara Neurosciences program, visit www.sentara.com/neuro

About Sentara Healthcare
Sentara Healthcare, based in Norfolk, VA, celebrates a 127 year history of innovation, compassion and community benefit.  Sentara is a not-for-profit family of 12 hospitals in Virginia and North Carolina, the Optima Health Plan, a full array of integrated services and a team 30,000 strong on a mission to improve health every day.  This mandate is pursued through a disciplined strategy to achieve Top 10% performance in key clinical measures through shared best practices, transformation of primary care and strategic growth that adds tangible value to the communities we serve. www.sentara.com

About Wellpepper
Wellpepper is a healthcare technology company that provides a clinically validated platform for digital treatment plans delivered via mobile devices. The Wellpepper patient engagement solution improves patient adherence and outcomes with its patent-pending adaptive notification system and just-in-time, task-based instructions and by fostering communication between healthcare providers and patients. Wellpepper is used by major health systems that are moving to an accountable care organization model and need to track and improve patient outcomes while lowering costs. Wellpepper was founded in 2012 to help healthcare organizations lower costs, improve outcomes and improve patient satisfaction. The company is headquartered in Seattle, Washington.

Posted in: Healthcare Technology, M-health, Press Release, Seattle, Telemedicine

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Postcards from HIMSS M-Health 2015

HIMSS M-HealthIt’s been a busy couple of weeks at Wellpepper with both the AAKHS annual conference and HIMSS M-Health Summit at the Gaylord Convention Center in National Harbor where Wellpepper was honored to have won the Venture+ Pitch along with CirrusMD. This was our second year attending the conference and we noticed that the hype for digital health is a bit lower and perhaps that represents market maturity. It could also be that organizations are in the thick of implementation and don’t have the success stories to tell yet. We believe in digital health and are rolling up our sleeves so will take this feeling that we are moving to incremental change as a positive sign.

Venture+: The Market Is Maturing

We participated in the Venture+ Pitch last year as well which was won by fellow our fellow Springboard Alumna Prima-Temp. Prima-Temp was the clear winner last year, already raising their Series B. However, there were a ton of startups with only an idea. This year the criteria was that startups have revenue before applying, and the competition was held in two parts, the first an invitation-only session where 11 startups pitched and panelists talked about the market opportunity in general, and then a final round with 4 excellent startups and really tough questions from the judges. We were a bit earlier on our journey than a couple of the other startups in the final pitch so were honored to be recognized along with CirrusMD.Clinic of the Past and Present

Interestingly the startup area on the tradeshow floor was almost entirely made up of a new class of startups. So, while the market for M-Health may be maturing somewhat, there are still new entrants attracted by the promise of disruption.

Incremental Progress and Show Me The Evidence

I was only able to attend Day 1 Keynotes, and I heard that the Day 2 keynotes were great, especially by Shahram Ebadollahi of IBM Watson Healthcare. On Day 1, with the exception of an excellent presentation from Dr. Wood from Mayo Center for Innovation (disclosure: as part of winning the Mayo ThinkBig challenge we have the opportunity to work with CFI for the next year), most of the presentations were quite low-key. The main problem was the voice of the patient was missing: the focus was on initiatives or technology. I timed it. 1.5 hours into the keynote and we heard the first end-user story, and it wasn’t really a patient, it was a blind runner who used FitBit.

Dr. Wood shook everyone out of complacency and called out for a faster adoption of healthcare innovation, pointing out how basic things like patient treatment rooms have not changed dramatically in the last 50 years. He asked the audience to consider going beyond patient-reported outcomes and consider the outcomes that matter to patients. What would the system look like if we paid for health rather than healthcare, and we paid based on people being able to reach their own self-defined goals? Digital health is an enabler of this new system, but really, it’s about taking a patient or people-centered approach to health and to care.

What Patients WantAgain, maybe it’s a sign of market maturity, but the conference this year seemed more evolutionary rather than revolutionary. Themes from previous years were expanded on. For example, Judy Murphy of IBM talked about how consumer expectations expectations are fueling demand for m-health. People expect the same level of transparent and always available technology to manage their healthcare as they get from any other consumer experience.

HoneyBee and IPSOs announced the launch of the Global M-Health Survey which also pointed to ubiquity and consumer expectations and desire for M-Health. (The final survey results will be available in Q1.)

In a number of sessions Apple Research Kit was heralded as a major breakthrough for clinical trials. While the speed with which Research Kit was able to sign up study participants is certainly turning traditional research recruits on its head, the same limitations are still there: no HIPAA-compliant server infrastructure and selection-bias for those with more expensive devices. Interestingly, one of the greatest benefits for researchers seems to be the standardization of the informed consent process. (Note that Duke University will be open-sourcing the platform infrastructure they built in recognition that not all organizations have the skills and resources to build something like that.)

Interesting, how what was deemed such a major innovation at the time of release (less than a year ago), also seems a bit incremental. Again, we will take the glass-half full approach and say that we are reaching a market maturity where the gains are more incremental, although at next year’s conference we would really like to see more clinically-validated mobile health applications, and also more patient stories, preferably told by the patients themselves.

Posted in: Healthcare Disruption, Healthcare motivation, Healthcare Policy, Healthcare Research, Healthcare Technology, Healthcare transformation, M-health

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Decreasing the Patient Survey Burden for Total Joint PROs

At Wellpepper we believe strongly about the value of patient-reported outcomes, especially when they are delivered as part of the patient care plan. However, the recent trend towards collecting PROs for reimbursement, plus HCAHPS and other surveys can result in some over-surveying of patients. We were pleased to hear at AAHKS that there is a movement to decrease the number of questions for total joint replacement with a proposal of using a HoosJr and a KoosJr. Outcomes-mobile.screen3

The HOOS and KOOS surveys are standard, validated survey instruments that are commonly used for measuring hip and knee function. We’ve heard that CMS is moving towards requiring these measures for evaluating outcomes of TJAs and other surgical procedures. A group of surgeons representing the major American orthopedic associations (American Association of Hip and Knee Surgeons, the American Association of Orthopedic Surgeons, The Hip Society and The Knee Society) has recently proposed shortened version of these surveys to lower the patient data collection burden. Details were presented at the 2015 AAOS and AAHKS conferences. These shortened versions are being called HOOS Jr. and KOOS Jr. Note that these are different than the lesser-used HOOS-PS and KOOS-PS physical short form surveys. The updated surveys are designed to be used standalone or in combination with a general health survey like VR-12, or PROMIS 10 Global. The number of questions is reduced from 40 to 6 (for HOOS) and from 42 to 7 (for KOOS), while retaining reliable, responsive output scores. With a patient completion time of under 3 minutes, these shortened surveys should dramatically aid in increasing survey response rates. Wellpepper supports HOOS and KOOS today, and looks forward to supporting HOOS Jr. and KOOS Jr. as soon as scoring rules are released.

Posted in: Health Regulations, Healthcare Technology, Outcomes, Patient Satisfaction

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Value-Based Bundles for Total Joint: The Glass Is More Than Half-Full

The bundles are coming! The bundles are coming! While many health systems have been delivering care in value-based bundles for some time, the broad implementation of bundles was made a reality when the Centers for Medicare and Medicaid announced the Comprehensive Care for Total Joint proposal to go into effect in early 2016. Navigating this new world, was the focus of the session “The Business of Total Joint Replacement: Surviving and Thriving” at the American Association of Hip and Knee Surgeons annual meeting. This was one of the best sessions we’ve attended on this topic: both realistic and optimistic about the opportunity to impact patient-centered care and change. This is a long post because the session was jam-packed with information, and I was only able to attend the first part. Heads must have been reeling for those who were fortunate to attend the entire 5-hour session.

The session was kicked off by Mark I. Froimson, MD, MBA EVP and Chief Clinical Officer of Trinity Health who took questions from the audience to start the day to ensure that their needs were addressed. A survey of the room showed that roughly half of the attendees were surgeons or physicians and the rest of the audience was comprised of included administrators, nurses, and physical therapists involved in care. This was apropos as much of the theme of the conference was about how care teams will need to work together across settings in a new patient-centered model to deliver on care.

Questions fielded showed that the audience had done their homework and included concerns about business models and outcome tracking for revisions. The Baby Boomer’s desire to stay active has resulted in earlier joint replacements which means revision surgery in the future. Audience members were concerned that revisions wouldn’t have as strong outcomes and they would be penalized by that. Participants from smaller organizations asked whether there were other metric tracking schemes they could participate in to offset the Meaningful Use incentives if they weren’t able to participate. (We have an idea: how about reimbursement for engagement with digital patient treatment plans?) Complex cases were also of concern: the system needs to ensure that systems will not be penalized for complex case that may also have weaker outcomes. Without risk adjustment for complex cases which are more likely be done at large in-patient facilities rather than ambulatory surgery centers, some organizations could be unfairly penalized.

Risk-sharing

Dr. Fromison handed the session over to the extremely optimistic Kevin J. Bozic, MD, MBA, Chair of Surgery and Perioperative Care, Dell School of Medicine. While value-based the goal of bundled payments is to improve outcomes and lower costs, Dr. Bozic spoke directly to the audience about the value for them: in the current fee-for-service model, the best surgeon gets paid the same as the worst. There is no incentive for efficiency. In the new model, surgeons that can deliver better outcomes at lower costs will be rewarded accordingly.

Interestingly though, the team-based medicine approach and the focus on surgical prep and post-operative care, means that it’s not clear which physician in the team will see the benefits of performance bonus: the primary care or physiatrist, the anesthesiologist, or the surgeon. This will be interesting to watch play out. In the past some surgeons considered their work to be finished after the surgery and others stepped in for post-acute care. As well, there was discussion about how to get hourly workers in the care team on board and aligned with the new models. As we’ve talked to countless organizations and individuals about the move to value-based payments, the common theme is that the patient outcome driven approach is better for patients: perhaps this can be the rallying cry for alignment.

This team-based partnership is not just within an organization or care team. Since 40-50% of costs of a total joint replacement are in post-acute care, surgeons and health systems must partner with post-acute care facilities. We’ve observed this trend directly with both inpatient and outpatient rehabilitation joining health systems and creating new ACOs to share risk.

Dr. Bozic handily turned the negative connotations of risk-sharing on their heads, when he was asked whether these new models were just a measure to shift risk to the providers. His answer was a positive “Yes” and encouraged the audience that providers were really the only ones who could manage performance and appropriateness of care. Note that payers still bear the risk of who gets a disease (although with more health systems focusing on wellness this could change), while providers bear the risk for the outcomes. Because of this, Bozic recommended that a strong physician needed to lead the change and own the bundle implementation within a health system.

Outcomes, Outcomes, Outcomes

Today with the focus on outcomes it’s hard to believe that a surgeon from Massachusetts General, largely seen as the father of outcome tracking, was run out of town and eventually lost his license for suggesting that physicians should track and be accountable for the outcomes of the interventions they performed.

Refreshingly, Dr. Bozic asked the audience to go beyond standardized outcome tracking as it relates to reimbursement, and consider which outcomes matter most to patients. We’re excited about this idea as we track outcomes both based on standardized outcome measures like the HOOS and KOOS (and soon the Hoos Jr & Koos Jr) but also at the task level and soon based on the patient’s own goal.Outcomes-mobile.screen4.jpg Outcomes-mobile.screen5.jpg

Without data transparency and sharing, improvement can’t happen. Finding out where the waste is in the 100-300% variation in inpatient total joint cost is key. Dr. Bozic is suspicious of organizations that boast that they are better than average on all measures: he believes that they are actually are unaware of their flaws and not driving a culture of continuous improvement.

We’ve been at surgeon-focused conferences before, and the booths that were busiest were those promoting joints and surgical instruments. Dr. Bozic told the audience they needed to be evaluating vendors that could help them collect, measure, and act on outcomes, which was music to our ears.

Patients and Prevention

The third speaker was Dr. David Halsey, MD from Vermont, who echoed many of the themes of the previous speakers, especially in the need for outcomes, but also posited a question we haven’t heard before, Dr. Halsey asked who better to do population health for arthritis than orthopedic surgeons? In our travels, we think that both physiatrists and physical therapists might want to join in that population health management, however, if it starts with the surgeons then they would be more incented to try other approaches before surgery, which can be accomplished through preventative care. Preventative care includes patient education and shared decision making and requires new tools to involve and engage patients in their care. It also includes making the patient’s goals front and center to improve care, and understanding and managing their expectations. Today’s patients have higher expectations to have a high level of mobility post surgery, and a low level of pain. Physicians need to engage with patients both to understand and to manage their expectations.

Moving Forward

While we’ve heard some people grousing about the squeeze that is being put on orthopedics through the CCJR, this glass-half-full group sees this as an opportunity for orthopedists to lead the way and actively engage with CMS. Data collection and transparency are the way to do this, and the current tools (aka EMRs) don’t cut it. (While this is our message at Wellpepper, it came directly from the speakers: times are changing!) Expectations are that other specialties will follow the total joint guidelines, spinal surgery is considered to be next, so orthopedists have the opportunity to set the standard for how value-based bundles are implemented in their organizations, while collecting and analyzing real-time data and leading an interdisciplinary team of course. Onwards! We’re ready!

Posted in: Health Regulations, Healthcare Disruption, Healthcare Policy, Healthcare Technology, Healthcare transformation, M-health, Outcomes

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Certified Health IT provision proposed by CMS

Finding that you have to be hospitalized again has got to be frustrating enough, but learning that it could have been avoided has to spark a cocktail of emotions for all involved. It’s not rocket science that avoiding readmission is dependent on strong discharge planning practices; i.e. seamless transfer of vital information and strong communication between a hospital and post-acute care facility. Furthermore it’s hard to sidestep statistics; the cost of readmission for Medicare patients is over $26 billion a year and approximately 2.6 million seniors are readmitted within 30 days. What? As a tax payer and a friend of many Medicare patients, I am troubled… that is a lot of individuals and money!

So naturally my next question is: What is the government doing about it?! CMS published a proposed rule in the federal register last week that includes the implementation of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT) and a revision of the discharge planning requirements (IT interoperability orientated). There are 21 discharge planning data requirements; these patient centered data elements are what a certified health IT system should provide to a PAC facility in order to enable seamless transition of care. I especially like the bullet: ‘patient’s goals and preferences’; I think this is very important for many reasons… one being that after a few patient interactions, clinicians will get a good feel of what is important to the patient through discussion. It takes time to build this knowledgebase because it requires that all important human ‘touch’.

Such patient and provider experiences are now being taken advantage of, therefore the idea of patient involvement during discharge planning provides better outcomes (therefore lower readmission) is not new, but the idea of assisting patients when selecting Post-Acute Care (PAC) providers by sharing data on quality and resource use measures, is relatively. The proposed provision also puts a time frame on when to start discharge planning; discharge planning must begin within 24 hours of admission/registration and discharge plan must be completed “before the patient is discharged home or transferred to another facility”. I have faith in our system and that this quoted remark is not new, but perhaps the first time formally written by the IMPACT committee!

I think it is also important to point out here the Community-based Care Transitions Program (CCTP) that was implemented by the Affordable Care Act in February 2012 allocating $300 million in funding to reduce readmissions. An annual report of the CCTP program success can be found here. The report concludes “Only one site had a significant reduction in readmission…” but goes on to say that not all sites entered the program at the same time, therefore this information isn’t reliable. With that said, I cannot help but wonder if the certified Health IT system would have been required already to contain the 21 data elements during electronic transmission during discharge planning (for several years mind you) these 46 Community Based organizations (CBO) would of had lower readmission rates. In 2017 when the CCTP initiative is over, I hope we learn of it’s effectiveness and it helps millions of Americans.

Posted in: Healthcare Policy, Healthcare Technology, Interoperability

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