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Chief Executive Officer

In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates.

COVID-19 Discussion with Jon Cohen, MD

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MD, MPH, Chief Medical Officer

As the healthcare industry battles workforce burnout, financial pressures, the transition from fee-for-service, and harnessing the mountain of data now at providers’ fingertips, high-value data, insights, analytics, and augmented intelligence (AI) are key tools that can help drive efficiencies, cost savings, and provider and patient satisfaction.  How Digital Care Technology Can Alleviate Provider Burnout  A lack of workforce support within the industry was an already mounting pressure that was further exacerbated by the pandemic–when responding to COVID-19, some organizations were able to <a href="https://www.healthcatalyst.com/success_stories/digital-care-technology" target="_blank">successfully reduce</a> this pressure by using digital care technology.  Healthcare provider burnout is negatively impacting the recruitment and retention of key professionals, resulting in long-tail consequences for organizations. The industry is still seeing elevated turnover with prolonged pressure as healthcare employment is still below pre-COVID levels.  According to a <a href="https://www.medscape.com/slideshow/2022-lifestyle-burnout-6014664?reg=1" target="_blank">2022 Physician Burnout &amp; Depression Report from Medscape</a>, the two specialties that report the highest burnout are Critical Care and Emergency Medicine, with 56 percent and 60 percent of surveyed physicians reporting burnout, respectively. AI support and automated patient engagement technology solutions can help stave off caregiver burnout, as the top contributor <a href="https://www.medscape.com/slideshow/2022-lifestyle-burnout-6014664?reg=1#2" target="_blank">reported by physicians</a> was too many bureaucratic tasks (paperwork, charting, etc.).  One example of how digital care technology can alleviate mounting healthcare needs is seen in a March 2022 case study. <a href="https://www.healthcatalyst.com/success_stories/digital-care-technology" target="_blank">A large healthcare system</a> identified the need for robust telehealth-based efforts in response to the COVID-19 pandemic. The organization deployed a new patient engagement platform and was able to rapidly expand care capacity to meet increasing demand, ensuring that more than 38,000 patients were supported through COVID-19 screening, testing, treatment, and monitoring. The technology enabled the organization to quickly centralize support for COVID-19 screening, testing, and monitoring for a large population. Your data is not only an asset when managing new and rapidly changing situations but also ongoing pressures of staffing shortages and charting. As burnout continues to mount, turning to data and digital care technology can help provide insights and solutions that can reduce that stress. How Data Can Reduce Financial Pressures by Predicting Labor Spending Another healthcare trend that data can help remedy is the growing financial pressures accelerated by COVID-19 and inflation. During COVID, the financial margins between cost-of-care and incoming revenue shrunk. Financial pressures remain, suggesting that we have a long way to go to see a reset to the pre-COVID revenue baseline, in addition to rising costs.  While changes in acuity, increasing outpatient volume, and easing costs are helping, margin recovery has been slow, driving financial discomfort for C-suite and investors in the first and second quarters this year. One of the major drivers of healthcare operating expenses is labor management, as an <a href="https://www.kaufmanhall.com/sites/default/files/2022-08/KH_NHFR_2022-08.pdf" target="_blank">August Kaufman Hall National Hospital Flash Report</a> shows labor spend has increased over 9 percent from 2021, after a 16.4 percent increase year-over-year from 2020. Technology solutions can help by predicting labor spending. According to a June 2022 case study, <a href="https://www.healthcatalyst.com/success_stories/healthcare-labor-management-hawaii-pacific-health" target="_blank">Hawai‘i Pacific Health (HPH)</a> used a data platform to forecast its workforce needs and effectively manage staff schedules—two changes that led to $2.2 million in savings in just 16 months, while maintaining high-quality outcomes. As health systems face immense pressure to improve efficiency and reduce costs, leveraging technology solutions and high-value data can help drive financial improvements. High-Value Data Clears the Path to Value-Based Care  The necessary transition away from fee-for-service (FFS) to value-based care (VBC) is another industry challenge that data can help healthcare organizations rise to meet. While medical economic forces are driving the transition to VBC, the migration has been slower than expected or predicted; in 2016, 65 percent of health systems leaders said VBC would be the standard payment model by 2021, according to a report from the <a href="https://www.fiercehealthcare.com/providers/value-based-outcomes-and-measures-medical-practices-2022-mgma-report" target="_blank">Medical Group Management Association (MGMA)</a>. While small, nimble market disruptors are migrating to VBC faster, 75 percent of total revenue for large organizations still comes from FFS, according to an updated report. High-value data can support predictive technology models that elucidate the risk/reward ratio, ultimately presenting a glide path for faster adoption. A willingness in organizations to make large shifts in financial infrastructure to support population-based payments will also accelerate the shift.  This winning combination of high-value data and a willingness to innovate can be seen in the successful transformation made by UC San Diego Health to value-based care. <a href="https://www.healthcatalyst.com/success_stories/reducing-pmpm-uc-san-diego-health" target="_blank">UC San Diego Health</a> sought to transform its organization, expanding beyond fee-for-service, transitioning to value-based care, and improving the health of its patient population by forming its Medicare Shared Savings Program (MSSP) ACO. The organization’s leaders realized they needed a better understanding of their organizational strengths, opportunities for improvement, and actionable, timely data that would enable them to improve outcomes, reduce waste, and succeed in value-based care. The organization leveraged an analytics platform to give insight into performance and improvement opportunities, educating and engaging ACO providers. In addition to supporting VBC efforts, UC San Diego Health’s data-informed improvements have lowered waste and decreased costs, including $883K in cost avoidance, the result of a reduction in per member per month. While questions remain about what will drive a faster, greater shift to value-based payment models and factors behind the slow migration from FFS to value-based payment models, diving into the data will give us better insights into what is working and what is getting in the way.  Integrating Data, Analytics, and AI into Provider Workflows and Executive Decisions Finally, many healthcare providers feel they’re drowning in a tsunami of data, but an incomplete understanding and adoption of data, analytics, and applied AI technology are preventing their optimal use of that data for point-of-care solutions.  Executive use of AI and high-value data insights in decision-making needs improvement and multiplying these problems is a mismatch between providers’ and executives’ perceptions and the reality of their data intelligence. While we are still a long way from optimizing the use of data intelligence to solve our industry problems, enabling strategies using analytics and technology is critical to reducing costs and optimizing care outcomes.  To accomplish this, we need to increase providers&#39; trust in the quality and validity of the data and educate them on the use of high-value data and analytics applications. If we can shift organizational perspectives on the value of data, analytics, and AI-engineered solutions, we can leverage the use of advanced tools and AI in decision making to reframe AI as a tool to help providers work better–not replace–human judgment. Informed decision-making, combined with AI adoption, will enable streamlined, scalable care decisions that can effectively address many of the trends impacting the industry today.

Your Data Can Find the Answers

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Chief Executive Officer and Co-Founder

In the United States, we spend significantly more of our GDP on healthcare than our peer nations. Yet, we rank at the bottom when comparing the quality and efficiency of healthcare delivery in our country – we all can agree that this is a problem that must be addressed. And it could be partially to blame for why one in five healthcare workers are walking away from the profession. One silver lining of the COVID-19 pandemic has been the added visibility given to alternative methods of healthcare delivery and sites of care. By reconsidering how we deliver care, namely the superior efficacy of care in the home, we are finally on the cusp of transforming the stifling cost of medicine in our country, while addressing our nation&#39;s overall health and well-being.  In Washington state, the epicenter of the U.S. coronavirus outbreak, the state&#39;s largest community-based non-profit health system MultiCare, partnered with DispatchHealth to address COVID-19 related surges in hospital capacity and fear-based deferral of health care. We worked collaboratively to meet the changing needs of the community by launching two pivotal programs, Hospital at Home and Clinic Without Walls. Two different Hospital at Home models launched: one under the CMS Waiver Program where patients were admitted from the hospital ER and one through DispatchHealth’s &quot;Advanced Care&quot; offering where patients were admitted through Dispatch’s on-demand, in-home mobile ER services. Clinic Without Walls addressed patients deferring treatment out of fear or inability to leave home by bringing the care to them. These patients were typically inappropriate for a simple video visit due to memory impairment or the complexity of their medical conditions. Leveraging technology and an enhanced video visit facilitated by an in-person, highly trained medical technician, the strategy allowed providers to remotely complete a more complex exam on those patients with chronic disease and comorbidities without the patient ever leaving home. An early snapshot of data revealed unprecedented patient satisfaction in both programs with an NPS score of +98. The partnership enabled MultiCare, a health system with more than a centuries-long legacy of excellence, to quickly right-size its care model while still focusing on a superior patient experience and the high-quality care its community expects.    In the United States, our healthcare system spends an unsustainable four trillion dollars (17% GDP). Research and experience back an estimation that 60% of patients in the emergency room setting, 25% of inpatient admissions and 20% of skilled nursing facility stays, roughly $340 billion of our annual spend, qualify for substitutive care in the home, where costs are 20% to 40% lower on average. Imagine the ability to use those dollars for issues like homelessness, hunger, and education.    To say the COVID-19 pandemic sparked a boom in complex home-based healthcare is like calling the musician who has worked years at mastering their craft an overnight success –DispatchHealth has been perfecting the practice of high acuity healthcare in the home for almost a decade and that work was built on the shoulders of maverick clinician-pioneers who came before DispatchHealth. And globally, we&#39;re late to this party! For example, every metropolitan and regional hospital in Victoria, Australia, has a hospital at home program. What the pandemic has done is raise broader awareness of care outside the four walls, as well as the inequity of care for some of our homebound and access-challenged populations. We&#39;ve witnessed hundreds of thousands of patients use telemedicine for the first time or have their first house call in the case of DispatchHealth. ER utilization hasn&#39;t rebounded to pre-COVID levels. I suspect that those patients got a taste of a more convenient personalized care solution that costs a lot less.    For executive leaders managing health systems, meeting the changing demands of patients is time sensitive. The value of partnering to scale complimentary service lines that enable fewer avoidable emergency room visits, hospital admissions, or stays at skilled nursing facilities using an evolved hospital-like setting without walls. This enhanced approach to care empowers clinicians to go beyond traditional clinical treatment settings and meet patients where they are, with the type of convenient care they are growing to expect.

We're Late to the Party and Don't Even Know It: An Immediate Fix for America’s Ailing Healthcare Delivery System

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Co-founder & CEO

How digital health companies are missing the mark on equity – and how they can help bridge gaps in patient experience Memora Health CEO, Manav Sevak, discusses how digital healthcare can help heal equity gaps across the industry. Care teams perform outstanding work every day. And, in many ways, <a href="https://www.memorahealth.com" target="_blank">digital health innovations</a> have helped providers deliver – and some patients navigate – care.  Recent technological leaps have meant the difference between patients suffering from certain illnesses and getting back on their feet faster than ever before. AI-driven digital assistance helps make surgeries less invasive. Reflecting consumers in other industries, like retail and travel, people leverage online review sites to research care providers before deciding who to see. But closing the loop to provide everyone a seamless, high-quality A-to-Z patient experience – not just the advantaged few – continues to challenge our sector. And it’s one that digital health still grapples with.   Health Inequity Doesn’t Just Happen in Hospitals When we discuss healthcare inequality, many people think of disparities in hospitals. But much of what goes into staying healthy happens outside of doctor visits. Factors like family income, education, adverse childhood experiences (ACEs), and other <a href="https://health.gov/healthypeople/priority-areas/social-determinants-health" target="_blank">social determinants of health</a> significantly impact outcomes. One stand-out social determinant of health is access to care. For instance, <a href="http://www.hpoe.org/resources/ahahret-guides/3078" target="_blank">according to the American Hospital Association (AHA)</a>, an annual 3.6 million patients don’t get the care they need because they lack transportation — with rural communities particularly affected. This lack of accessibility challenging the U.S. healthcare system has exploded our health-equity crisis. Health disparities amount to over $90 billion a year in excess medical costs, placing further strain on a sector already thinned-out by a global pandemic and monumental staff shortages.  Digital Health Still Struggles to Close the Loop That’s not to say solution-providers haven’t begun addressing inequality in healthcare access. Enacting the Health Information Technology for Economic and Clinical Health <a href="https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement-interim-final-rule/index.html" target="_blank">(HITECH)</a> Act in 2009 and <a href="https://www.hhs.gov/healthcare/about-the-aca/index.html" target="_blank">ACA</a> in 2010 ushered in a decade of digital healthcare innovation. It seems as though a new care-related smartphone app springs up every day to help schedule doctor visits, view health results, or conduct telehealth appointments. But are these platforms built for everyone? How well do health apps level the playing field when it comes to accessing high-quality care? Let’s look at the numbers. Pew Research found that, while 97% of people in the U.S. had a mobile phone as of 2021, only 85% had a smartphone and just 77% had a broadband connection at home. And the same study found that 24% of the lowest-income bracket in the U.S. does not have a smartphone, mostly due to cost.  According to the <a href="https://www.healthit.gov/" target="_blank">Office of the National Coordinator for Health IT</a>, around 60% of U.S. patients were provided with a patient portal in 2020, but less than 40% of them ever logged in – some didn’t have internet access, while others experienced friction with digital app navigation. Historically marginalized and underserved populations experience digital inequity to an even greater extent. For example, <a href="https://www.npr.org/2021/10/06/1043666017/internet-access-rural-black-southerners-digital-infrastructure-divide" target="_blank">Black residents in the rural South are almost twice as likely to lack home-internet access as their white counterparts. </a> Location also plays a factor, as <a href="https://www.healthsystemtracker.org/chart-collection/how-might-internet-connectivity-affect-health-care-access/" target="_blank">13% of non-metropolitan residents lack basic broadband access for telehealth visits — </a>almost double the rate of their urban counterparts. These figures paint a troubling picture, suggesting digital health still has a long road ahead, especially when it comes to the patients who most need care. Healthtech can help providers elevate and streamline care for patients – not just for those who can afford it, but for everyone. But how do these solutions address inequity without adding extra work for our clinical staff? SMS is an Answer to Improving Patient Navigation For All One of the biggest challenges healthtech innovators face is making their advancements more accessible. That’s why <a href="http://www.memorahealth.com" target="_blank">Memora Health</a> has chosen to make meeting patients where they are a key priority. Equity is at the center of our equation – and SMS is our driver for closing the loop. You might ask, “why wouldn’t you just build your own patient-facing app?” The fact is that healthcare’s highest-risk patients usually don’t keep fitness or health apps on their home screens. But their messaging icon is always front and center. A <a href="https://www.aarp.org/research/topics/technology/info-2018/technology-use-attitudes.html" target="_blank">2018 AARP study </a>found that 86% of adults aged 50+ communicate through text, meaning SMS is a widely adopted communication channel that spans generations.  Beyond texting’s broad accessibility, it&#39;s incredibly effective. SMS health interventions have a 98% read rate – and patients actually complete and engage with over 74% of text-based interventions, according to our data.  We already witness the equity benefits of our text-based approach. <a href="https://www.memorahealth.com/resources/digital-health-as-a-tool-to-support-health-equity" target="_blank">One of the most resounding examples</a> is the work we’ve done in women’s health – keeping patients highly engaged during the postpartum period to make sure they have the high-touch support they need to manage healing at home with a newborn.  Over half of the patients in one of Memora’s postpartum programs are on public insurance and in lower socioeconomic brackets. Yet that program, which guides patients through their postpartum journeys, has yielded over 90% care-journey completion and screenings of 25% of patients at risk for postpartum depression. Engagement at this level makes a significant difference in helping care teams know who needed extra support. Most importantly, it’s made patients feel cared for when they need it most. <a href="https://www.memorahealth.com/resources/advance-health-equity-with-memora-health" target="_blank">The program boasts a 92% patient satisfaction rate</a>, with Black moms in particular scoring significantly higher than their peers.  There’s no silver bullet when it comes to addressing health inequities. But digital health can play a part. By meeting patients where they are with SMS and automating care team workflows, it’s possible to improve patient navigation, reduce the burden on providers, and minimize friction across the board.  Imagine a world where every patient leaves the doctor with a digital companion holding their hand through their entire care journey. Let’s empower patients to take control of their health – and get us one step closer to a healthcare system that is accessible, responsive, and always-on. <a href="https://www.memorahealth.com/resources/digital-health-as-a-tool-to-support-health-equity" target="_blank">Download Memora’s health-equity whitepaper to learn more about improving access to care at your organization.</a>

How Digital Health Can Help Heal Care Inequity

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