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Our partner 4sight Health compiled an <a href="https://a.storyblok.com/f/98928/x/39a29a250c/htlh2021_4sightreport_v01.pdf" target="_blank">executive summary</a> of our HLTH 2021 conference, detailing how we returned with gusto to in-person programming following a two-year hiatus with only virtual events and delivered, as always, by staying true to our mission of community, connection and engagement.  HLTH was officially back! Despite extensive COVID safety precautions offered to ensure everyone’s safety, much of the HLTH 2021 experience remained unchanged. We created a unique, action-oriented “marketplace” that advanced dialogue, confronted hard truths and explored solutions to healthcare’s most pressing issues. Everything was still BIG! <ul><li>Attendance was massive with 6,500+ in-person attendees</li><li>Content was rich and sprawling, consisting of 300+ speakers</li><li>Technology remained unmatched</li><li>Entertainment was world-class, featuring famous singer Michelle Williams from the hit R&amp;B girl group Destiny’s Child</li><li>The exhibit floor was enormous, spanning 600+ sponsors and exhibitors</li><li>Networking was nonstop</li></ul> <a href="https://a.storyblok.com/f/98928/x/39a29a250c/htlh2021_4sightreport_v01.pdf" target="_blank">Read and download the full report here</a>.

HLTH 2021 Executive Summary

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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. Long before COVID-19 was part of our reality, my Co-Founder Taylor Justice and I set out to design a system that would bridge the gaps between social care and healthcare, an infrastructure to ensure that people’s needs were met holistically across communities–not in a siloed, fragmented way. We initially created Unite Us in 2013 to help veterans and their families transition back to civilian life, simplifying care coordination and service delivery for providers and ultimately the people seeking those services. Since then, our community-driven work has organically expanded into the healthcare industry, working with partners all over the country to address critical social needs so that people’s health improves. Little did we know then how relevant and critical this integrated model would support communities around the country respond to the pandemic and ensure that the most underserved, vulnerable people do not slip through the cracks. Unite Us was built for this.  The COVID-19 crisis has laid bare an undeniable fact: the people hardest hit are those who already lacked resources, had limited access to quality social and clinical care, and in some cases are one paycheck(or worse) away from putting food on the table or paying the rent. <a href="https://www.pewsocialtrends.org/2020/04/21/about-half-of-lower-income-americans-report-household-job-or-wage-loss-due-to-covid-19/?utm_campaign=2020-04-" target="_blank">Study</a> after study show that the people who are suffering the most both medically and economically during the pandemic are the ones who were underserved before it hit.  In the past several weeks, <a href="https://www.cnbc.com/2020/04/30/us-weekly-jobless-claims.html" target="_blank">more than 30 million people</a> filed unemployment claims. Many Americans are turning to safety net benefits programs like Supplemental Nutrition Assistance Program (SNAP), which was already servicing 36 million Americans by the end of 2019. With a limited supply of providers and services to meet this record volume of applications, more Americans will suffer. Prior to the COVID-19 crisis, about 44 million Americans had no health insurance, and over 38 million people were <a href="https://www.census.gov/library/publications/2019/demo/p60-266.html" target="_blank">living in poverty</a>. These numbers will continue to climb as the unemployment rate skyrockets.  The fact is, the fight against this virus is not only happening in hospitals, but throughout individual communities across the country. Americans are strongly urged to physically distance themselves from others at a time where they need to be connected more than ever, especially to health and social care providers for the essential services they need.  We’ve observed our healthcare systems lament not being better prepared for this crisis. But this medical crisis foreshadows what we’ve known since we launched Unite Us: we need national, comprehensive public health infrastructure that sufficiently serves both medical and social needs. We also need sufficient and sustainable funding for community organizations, nonprofits, and other agencies who are on the frontlines meeting people’s social needs, just as the doctors, nurses and healthcare workers in the hospitals are on the frontlines meeting their medical ones. In short, we must elevate social care to the same priority level as health care.  Fortunately, Unite Us was able to seamlessly adapt to remote work, continuing to engage at a deep level with both our health and social service partners, identifying what they needed from us and adjusting to provide solutions, even while physically distant.  Here’s a high-level view of what we’ve been up to: <ul><li>We are building Rapid Response Networks that we stand up in shorter periods of time. In just a few weeks, we launched <a href="https://nyc.uniteus.com/" target="_blank">Unite NYC</a> in collaboration with <a href="https://www.healthsolutions.org/" target="_blank">Public Health Solutions</a> and <a href="https://www.air-nyc.org/" target="_blank">AIRnyc</a> that includes CBOs from all over New York City to help those hardest hit by the pandemic. That grassroots community network is growing daily. </li><li>We’ve added COVID-19 screening tools into our existing partners’ workflow, so that they can readily assess and address social needs arising directly from the pandemic. </li><li>We’ve also added a COVID-19 exposure assessment that allows our partners to appropriately direct people to the care they need, helping to redirect people away from hospitals and to the proper local resource if in fact they’ve been exposed, but aren’t critically ill. </li><li>We have accelerated the growth of our networks while ensuring that we support every organization’s adjustment to their service offerings throughout the crisis. </li></ul>While the need for an immediate response to COVID-19 is crucial in the short term, we also need to think about what a post-pandemic world will look like - and execute on that now.   Here are some action steps we can take: <ul><li>Direct stimulus and relief funding equitably to the non-profit sector, to CBOs who are struggling to keep their doors open in the very communities who need the most help. </li><li>Develop a national, comprehensive public health infrastructure that brings together partners from ALL sectors–non-profit, healthcare, insurance, government and business–who can work collaboratively towards a service delivery system that is inclusive, fair and sustainable for the long haul. </li><li>Shift mindsets to recognize that social care must be valued equally to healthcare if we are ever to truly build healthier communities across this country. </li></ul>For over seven years, Unite Us has been strategically building the technological infrastructure to allow for secure information sharing between community network providers, enabling them to send and receive electronic referrals, and track outcomes together to ensure people are getting the care they need. Sending people into a service black hole without accountability will never transform care delivery, nor lead to healthier people and communities. Only when we can track outcomes, identify gaps in services and direct funding to where it’s needed most, will we start to see impactful, systemic change.  We will be dealing with COVID-19’s impact for the foreseeable future. We know--and have always known--that the power of a connected community and care coordination is absolutely critical for immediate recovery efforts, the ability to stabilize, regroup and heal, and finally, to be prepared for inevitable future health crises. As a nation, we need to invest in communities to ensure that people can get back on their feet. A far-reaching infrastructure needs to be part of that investment. About Dan Brillman: Dan Brillman, CEO and Co-Founder of Unite Us, graduated from Yale University in 2006 and worked in finance and consulting before joining the Air Force Reserves as a combat pilot, where he still serves today. After earning his MBA from Columbia Business School in 2012, Dan worked in venture capital in NYC, where he focused on investing and technological innovation until co-founding Unite Us in 2013. He is a recipient of the Jefferson Award for Public Service and was recently added to Business Insider’s “30 People Under 40 Changing Healthcare.”

Immediate Response and Long-Term Solutions in the Face of COVID-19

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General Manager

Clinical trials are more complex than ever. Pharmaceutical companies, medical device companies, and clinical research organizations (CROs) are collecting more research data than ever. The amount of data from novel sources that support decentralized trials has also increased over the last several years. As a result, research sites and clinicians are struggling to meet sponsor deadlines for increasingly complex trials.   Technology can help solve this challenge, when it’s deployed appropriately. Here are four tips for managing clinical trial complexity:   1) Stay focused on the experience When I say experience, I mean that in a couple of different ways. First, we should focus on the experience of the user – the sponsor team designing and conducting the trial. Better workflows can make the difference between meeting and missing a critical research decision point or deadline. Second, and just as important if not more so, we should focus on patient and clinician experience. The future of trial recruitment will be heavily influenced by the patient’s expectations for a smooth digital experience and the clinician’s ability to deliver to sponsor expectations.  2) Enable direct data flow Direct data flow, meaning the ability to collect data directly at the source (i.e., the patient, clinical setting, directly from equipment or testing systems) and flow that data to the sponsor systems, has gained momentum with the COVID pandemic and the associated healthcare disruption. Direct data flow is complex, and some technologies contribute to complexity, especially if they are not connected to each other or otherwise inhibit data flow by requiring data transformations.   As an example, clients are more frequently asking how electronic health records (EHRs) can be directly integrated with electronic data capture (EDC) systems to simplify data collection for clinical trials and better integrate that into clinician workflows. There are significant differences between how healthcare data is collected in a clinician setting versus how it is collected for clinical research. As the industry identifies ways to smartly apply technology solutions and data transformation that reduce the data disparities between the use cases, the ability to connect clinical data with clinical trials data becomes a viable path forward.   3) Apply artificial intelligence (AI) and machine learning (ML) strategically When working with AI and ML technologies, it’s important to have a specific purpose and a clearly defined use case/problem statement to be solved. We were among the first to apply AI to medical coding and have had success in that area for a long time, showing that machine learning solutions embedded within workflow can significantly reduce overall effort. Because of this experience, we are working on other targeted applications of machine learning, specifically for streamlining operational workflows and improving overall quality.  4) Lean into the expertise of your technology vendor Research requires completing a host of difficult tasks in support of complex trial designs. Technology vendors should be able to help solve those challenges. They should be able to proactively advise in these cases and not just be reactive recipients of information.  For example, adaptive clinical trial design enables planned modifications to one or more aspects, which offers distinct advantages. We helped a client with adaptive trial design, so that researchers can add multiple treatment arms throughout the study lifecycle. Another client used adaptive design to enable adjustments to the randomization schedule, based on the variable or unequal probability of treatment assignment.  Complexity will continue to increase in the clinical trial space, but innovative technologies continue to help teams rise to the challenge. Applying these principles can also help future-proof clinical trial design in the years to come.  Jennifer Duff is Merative’s General Manager for Zelta. She has more than 24 years of experience in the Life Sciences industry and specializes in enabling and scaling industry-leading services and technology solutions for biopharma clients.

4 Tips When Using Tech to Manage Clinical Trial Complexity

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Managing Director

Chief Medical Officer

The healthcare experience and health outcomes for people who identify as LGBTQIA+, people living in poverty, veterans, racially and ethnically diverse people, people with disabilities and other groups historically marginalized by society and the healthcare system is markedly different than it should be. The impact of health inequity has been irrefutably quantified – inequities in the U.S. health system cost approximately $320 billion per year today, and that <a href="https://www2.deloitte.com/us/en/insights/industry/health-care/economic-cost-of-health-disparities.html" target="_blank">cost is expected to rise in the coming years</a>. The Covid-19 pandemic put a magnifying glass on the inequities experienced by historically vulnerable groups while also ushering in new expectations of employers whose healthcare and workplace benefits became a safety net for employees. Employers can continue to make a huge impact by removing barriers to health equity as they provide <a href="https://www.kff.org/report-section/ehbs-2022-section-2-health-benefits-offer-rates/" target="_blank">health insurance coverage for 51% of working-age Americans</a>. They can also make an impact through salary and workplace benefits such as paid time off and benefits that help employees overcome social barriers to health. Business Group on Health reports in “2023 Trends to Watch” from their <a href="https://www.businessgrouphealth.org/%20resources/2023-large-employers-health-care-strategy-survey-intro" target="_blank">Large Employer Survey</a> that 75% of large employers are concerned about health equity within their health and well-being initiatives. Many have planned this year to offer or expand benefits to support transgender and neurodiverse populations as well as inclusive family-forming benefits.   At the HLTH conference in Las Vegas last November, we presented some opportunities for employers to help remove barriers to health equity in 2023: <ul><li>Optimize current benefits and health plan offerings</li></ul>The new calendar year often means the launch of new employee benefits and health plans and is a prime time to evaluate your current plan offering through an equity lens. Does your plan provide comprehensive coverage that meets the unique requirements of your business’ different populations, such as those with chronic illnesses, special healthcare concerns or across salary bands?   <ul><li>Address Social Drivers of Health (SDOH) within your employee population and employ reporting for transparency</li></ul>Life and social factors affect people differently, and addressing the specific, non-medical barriers of your workforce is a key opportunity to support their overall health and wellbeing. To help address SDOH issues such as food insecurity and housing instability, <a href="https://news.delta.com/emergency-savings-program-fuels-employees-financial-security-and-well-being#:~:text=Beginning%20this%20month%2C%20eligible%20employees%20can%20earn%20up,program%20and%20contribute%20to%20an%20emergency%20savings%20account." target="_blank">Delta Air Lines has implemented a program</a> that lets employees earn up to $1,000 to establish a rainy day fund that can help address sudden financial needs. Your organization can explore the needs of your employees and then prioritize a manageable number of factors that could be addressable in the next twelve months.  <ul><li>Expand access to primary care and mental health support through virtual and community-based care options</li></ul>An <a href="https://www2.deloitte.com/us/en/insights/industry/health-care/alternative-sites-of-care.html" target="_blank">October 2022 national survey by Deloitte </a>of 4,545 representative consumers found that community- based health centers and retail clinics, combined with access to virtual healthcare, could bridge care delivery gaps for populations that have been historically underserved, and in many populations would be preferred.   The survey also found that 55% of racially and ethnically diverse people who were surveyed are interested in virtual care for mental health and preventive primary care. As many employers move to adopt “virtual first” models of healthcare and are evaluating solution providers, employers can apply a health equity lens to that procurement process.  Virtual care still includes humans. There are always people – doctors, nurses, therapists, clinical practitioners – on the other side of the screen. Employers should evaluate solution providers’ ability to offer care that is socially concordant (delivered by providers who share a social identity with the employee) and culturally informed.  <ul><li>Make benefits and healthcare easy to navigate</li></ul>In addition to adding a navigation service to your health and benefits plan if you don’t have one already, employers can leverage many tactics around health literacy, including how they utilize internal communication to equitably enable employees to find, understand and use benefits to make the best healthcare decisions. This can be as straightforward as using inclusive language and imagery or more programmatic, such as training managers to identify people with unmet needs and refer them to a specific benefit program with cultural humility.   Employers can also look at adding benefits beyond health and wellness to advance health equity, such as financial literacy, commuter benefits and tuition assistance. Accolade is working with an employer on a pilot to provide onsite clinical resources for employees including health education sessions and one-on-one health coaching. These are just a few examples of ways to help employees overcome barriers and make informed decisions for their health. <ul><li>Make commitments to address health equity issues alongside others</li></ul>We believe that addressing health equity is both a moral and business imperative, and each organization has an important role to play in driving health equity as an outcome. That’s why Deloitte and Accolade recently joined 37 other organizations in <a href="https://initiatives.weforum.org/global-health-equity-network/pledge" target="_blank">signing the Global Health Equity Network Zero Health Gaps Pledge</a>, a commitment to take concerted action to advance health equity globally. The pledge includes 10 key commitments all signatories have made to embed health equity principles throughout their operations, workforce and guiding philosophies. In the first century B.C., Hillel the Elder asked “If not us, then who? If not now, then when?” This question remains relevant today. Achieving health equity in the U.S. is an attainable goal and employers hold a coveted position of influence through the valuable contributions they can make when they begin removing barriers to health equity for all their employees. Please see <a href="https://protect-us.mimecast.com/s/C_mfC73yBxhn0KqXs8QZUL?domain=deloitte.com" target="_blank">www.deloitte.com/about</a> to learn more about our global network of member firms.

The Power Employers Have in Helping to Remove Barriers to Health Equity: 5 Opportunities in 2023

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