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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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In the last several months, we have seen a drastic boom in telehealth usage due to the circumstances created by the COVID-19 pandemic. If the current state of telehealth is any indicator for the future, we may see utilization of all digital care technology expand beyond the traditional four walls. Has health consumer behavior truly changed enough to continue this trend even past the pandemic or will they revert to old ways? Also, what do we do when telemedicine simply is not enough? This past July, Wellframe hosted a HLTH GoLIVE webinar, Filling the Gaps of Telemedicine, with BlueCross Blue Shield of Tennessee, Blue Cross Blue Shield of Massachusetts and Oliver Wyman.  During the webinar, the panelists discussed how a unique combination of digital capabilities can help close previous gaps in care. We followed up with the panelists to share their biggest takeaways. Jacob Sattelmair, Co-founder and CEO, Wellframe “Telemedicine solves a lot in terms of convenience and accessibility, but [doctor’s visits] are still a 13-minute encounter where 99.9% of someone’s life is in between. We do think that as more people are trained to use digital and virtual channels to access care, and more solutions are coming out to fill in some of those gaps, people will be acclimated to look to digital as a way of getting support, not just when they’re talking to a physician, but in between. And I think those are some exciting opportunities that we see for our partners.” Andrea Willis, SVP and Chief Medical Officer, BlueCross BlueShield of Tennessee “We are mostly a rural state. And for the most part, we did see that access was improved because of this rapid expansion [of virtual health]. But it also shone a spotlight on where there were disparate areas as well. We decided that we did not want to miss this moment to actually be a part of true public health. So we gave a grant to the Tennessee Department of Health, for example, to improve access in some rural areas, and we joined with other companies to increase broadband access... what this has done is brought all the right stakeholders to the table for us to go in collectively to support increased access for everybody.” Sukanya Soderland, Chief Strategy Officer and SVP, Blue Cross Blue Shield of Massachusetts “What we&#39;re starting to see is some of the expectations that consumers have had outside of healthcare, where our lives are run off of our phones, are starting to infiltrate into healthcare. That means a lot of health plans will need to raise the bar, and it&#39;s upped the ante for all of us. As far as telehealth is concerned, a lot of the initial responses that I&#39;ve seen in some of the survey work have demonstrated that consumers have been pretty satisfied with the virtual options that they have in light of COVID. But, I don&#39;t think that&#39;s something we can rest our laurels on at this stage because again, the expectations will continue to rise. We’re going to have to bring a deeper discipline to our offerings moving forward.” Marcia Macphearson, Partner, Health and Life Sciences, Oliver Wyman “COVID-19 created a powerful force accelerator for telehealth adoption by providers, patients and payers that has exposed a much wider set of stakeholders to a substantially different experience of healthcare; if this adoption rate persists it holds the promise to materially shift consumer healthcare behavior which has been long promised but not previously delivered upon. Maintaining telehealth adoption momentum is now a key objective for stakeholders across the industry but will require continued efforts across capability enablement, addressing digital inequity across populations, and reimbursement and policy reforms.”

Filling the Gaps of Telemedicine

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Head of US Digital Health Strategy

The COVID-19 global pandemic caused massive disruption and exposed existing gaps in the US healthcare system. Such inefficiencies posed urgent risks to people living with chronic diseases, forcing healthcare providers to quickly adopt new models of care, access and delivery. The evolution to prioritize digitalization has accelerated! The need for rapidly evolving digital technology and remote care supports a larger, more patient-centric approach— “portable health”. Portable health is an ecosystem of connected, location-independent healthcare services and solutions, accessible wherever and however patients decide. Today, we overwhelmingly opt for more personalized lifestyle approaches that fit into our busy lives, and healthcare is no exception. Through intelligent digital solutions, we can better individualize care while improving utilization and outcomes for a broad range of patients. At its core, portable health is about integrating care seamlessly into people’s lives, regardless of where they live, what they do or who they are.  Here’s why portable health is here to stay: <ul><li>Safety: Remote care is a requisite in today’s climate. With 35% of Americans still delaying medical care due to COVID-19,1 we need to develop solutions to better serve these shifting healthcare needs. The move to more patient-centric healthcare provides a virtual opportunity for patients and caregivers to minimize physical contact while remaining safe and hands-on in the ongoing management of patient health. </li><li>Convenience: The number of Americans aged 65+ is projected to nearly double from 52 million in 2018 to 95 million by 2060.2 As this population ages, the flexibility of healthcare at home will become imperative to those whose physical abilities may be declining, or who have multiple chronic conditions requiring care from various specialists. Convenience is a critical factor for people younger than 65, too. With the recent COVID-19 lockdown restrictions along with current surge, we’re spending an increasing number of hours per day working while also managing family needs (e.g., home schooling). This has required telecommuting for many.3 With intensified schedules and work-life environment imbalance, decreasing the amount of time spent traveling to visit a doctor while continuing efficient care needed will progressively be essential to so many.  </li><li>Enhanced care: In addition to the safety and convenience of portable health, the customized patient-driven nature provides a benefit to healthcare that many people crave. Certain treatments can now be implemented at the time and place a patient chooses. Through innovative technologies that are now available, treatment plans can be better tailored to a specific person, rather than a population or a disease state. Additionally, innovations in digital health – mobile and voice tech, chat bots, wearable devices and more – can further accelerate improvements in patient experiences through data and analytics. </li></ul>The beauty and value of portable health is using digitally-focused solutions to provide practical, meaningful support and therapeutic guidance for patients outside the doctor’s office and within the context of their daily lives as a mom, dad, police officer, teacher, etc.—not as a “patient”. Through an interconnected web of customized care and innovative technologies, an individual can receive support and healthcare providers can receive better data informed by real-world observations. With analytics, patients and doctors have data at their fingertips to better encourage adherence and management of chronic diseases, like diabetes. In addition to healthcare providers, pharmaceutical companies play an important role in seamlessly integrating the portable health ecosystem into the lives of patients. As a partner in the healthcare community, Novo Nordisk aims to diversify holistic digital health interventions and support offerings to improve engagement and medication adherence among patients. We’re committed to making strides in digital health to better support people with chronic metabolic disease through safe, convenient and customized care. By actively leveraging the latest technology and partnerships, we can facilitate care delivery with greater efficiency. The existing gaps in our healthcare system will continue to be exacerbated as the COVID-19 pandemic progresses, threatening the health of those patients who struggle with and manage chronic diseases every day. However, as these problems are uncovered, I’m confident that solutions will be found. The healthcare industry is revolutionizing new and innovative ways to accelerate care and appropriate interventions for the millions of people living with chronic diseases. Enhancing and individualizing patient experiences is essential to providing sustainable care for those who need it most. Today’s problems call for advanced solutions beyond traditional protocols and pharmacotherapy, leveraging digital, technology and data. There is no time like the present to make this happen. References <ol><li>Centers for Disease Control and Prevention. Reduced Access to Care: Household Pulse Survey. Available at: https://www.cdc.gov/nchs/covid19/pulse/reduced-access-to-care.htm. Last accessed: September 2020. </li><li>Population Reference Bureau. Fact Sheet: Aging in the United States. Available at: https://www.prb.org/aging-unitedstates-fact-sheet/. Last accessed: September 2020. </li><li>National Bureau of Economic Research. Collaborating During Coronavirus: The Impact of COVID-19 on the Nature of Work. https://www.nber.org/system/files/working_papers/w27612/w27612.pdf. Last accessed: October 2020.</li></ol>

Reimagining healthcare: The shift toward patient-centric health

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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 the most up to date facts and updates.  About Josh Golomb: Josh Golomb is CEO of Hazel Health, a healthcare company offering all children access to healthcare through in-school virtual medical clinics. Hazel partners with schools to improve student health and decrease absenteeism by providing students with instant access to a network of doctors for a speedy diagnosis and care plan. Josh is an experienced senior executive, having co-founded new healthcare enterprises and presided over several large organizations, fostering tremendous growth. As former CEO of direct primary care startup Paladina Health (acquired by NEA), he has proven success in developing forward-thinking healthcare organizations while delivering exceptional clinical and financial results. HLTH Team: How is telemedicine assisting with the COVID-19 crisis? Josh Golomb: We are seeing a complete transformation in the role of telemedicine. For years there has been a huge gap between the public’s interest in telemedicine which exceeds 60%, and actual utilization, which was typically below 10%. The COVID-19 crisis is demonstrating the value of virtual, most notably by minimizing the strain on the healthcare system by keeping those with mild cases of COVID-19 at home and out of hospitals. This approach is helping physicians identify and treat non-emergency health issues, and instruct patients to stay home when they can, in order to keep clinic and hospital resources available to those who need it most right now.  HLTH Team: How is the rapid shift toward utilizing telemedicine affecting the quality of digital health platforms? Josh Golomb: Wider adoption of telemedicine is driving primary care providers to shift toward conducting high quality virtual visits. It also provides an opportunity for everyone in the healthcare community to work together and develop the most robust protocols for care. Digital health technologies that were once faced with skepticism around their effectiveness are quickly becoming strong platforms with rigorous standards.  At Hazel, we have been recruiting experienced family practices and pediatricians to deliver care, many of whom were initially weary of telemedicine. From the beginning, we’ve approached care with the mindset that we wanted to develop the protocols and practices to have the most rigorous pediatric clinical practice. We are excited to share what we have learned with the hard working physicians that are now practicing this new form of care for the first time.   HLTH Team: How are families coping with school closures? Josh Golomb: School closures have had a monumental impact on all families as schools play a central role in communities well beyond education. Many working parents rely on schools for child care and do not have jobs that allow them to work remotely. Families also rely on schools to feed their children - The National School Lunch Program provides free meals to more than 30 million children each year. Schools are also often a crucial health resource. At Hazel, 50% of the families we work with tell us they do not have a primary care physician. These families often rely on a school nurse as their primary source of healthcare. With schools closed, many families are left without options other than the Emergency Room. For these families, school closures threaten a key lifeline of support.   Thankfully, we are seeing incredible leadership from our school partners working around the clock to ensure families receive vital services. School Districts are finding creative ways to get families the services they need - from food and supplies to wifi access and computers to enable families to connect from home. Many school nurses are still supporting families remotely, helping to ensure that their students can still get treatment for pink eye, a key medication refill, or other non-COVID-19 treatments that families still need for their kids. We are doing our part to introduce telemedicine as a healthcare resource in our communities.  Last week, one of our school nurse partners reached out to help with a family in need remotely. Their child had asthmatic symptoms, but had no primary care provider. The family was planning to head to the Emergency Room, which would put them at risk for COVID-19 transmission. We were able to connect our provider to the student and get them the care they needed. We were proud of our ability to support the family, but know that we were only able to play this role because of the deep trust that school had built with the family.   HLTH Team: How is Hazel supporting families during this time? Josh Golomb: Hazel works closely with school districts and local health authorities to ensure that families have easy access to the most up-to-date information available on COVID-19. We’re working with our school partners, families, and legislatures to offer Hazel’s services at the designated “resource outposts” they’ve made available to families at this time.  Hazel is also now allowing students and families to access medical advice and treatment by Hazel doctors from home. Students in Hazel’s partner districts are able to meet virtually with doctors, who can provide medical expertise, prescriptions, and clarification on how to stay safe. As schools close and students are forced to stay home, Hazel is enhancing our platform and responding to the call to serve families in need. We also believe that an integrated platform that supports children across school and home will be a huge support to families.   We’re proud to be doing our part to help the underserved communities being hit hardest by COVID-19, and helping to mitigate the strain on the healthcare system by keeping families out of the hospital when possible and providing them with the care they need.  HLTH Team: What are your thoughts on some state governments looking to open school back up in May? Do you think that is too soon? What are the benefits/risks?  Josh Golomb: Each state has different needs, and strategies to contain need to be made on local levels. Each state is taking the necessary precautions to do what they need, and schools have been amazing community leaders throughout these challenging times. HLTH Team: Have you noticed an increased need for mental health support for K-12 students during this time? Are there enough resources out there in regards to mental health for this age group?  Josh Golomb: Anxiety and depression have been on the rise for K-12 students since the 1950s. Now more than ever, students need mental health support as they are growing up in an uncertain time. With 11% of children diagnosed with depression by the time they are 18, schools have the ability to offer instrument support as this is where students are spending the majority of their time. We’re currently working on a mental health support offering at Hazel so that we can provide the resources school leaders need to support K-12 mental health. Our hope is that as health care evolves with telemedicine, these services can be more widely implemented for the benefit of schools and children everywhere.  HLTH Team: What advice would you give to parents with children with special health needs who may not be able to access the same level of care right now and where telehealth may not be enough?  Josh Golomb: Telehealth has proven to be a leading solution for equitable, quality care, but we recognize it is not a one-size-fits-all solution. The needs of every family are different, so there will be instances where families need to seek differing or more substantial levels of care. Our recommendation is to seek local community resources in order to access the best resources for a given situation. Schools are a great place to start, as district leaders have their finger on the pulse of what is available in each community.

COVID-19 Updates with Hazel Health: The Impact on K-12 Students

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