Fresh off a busy March for health tech conferences, Reuters recently hosted its Digital Health 2022 event in the sunny city of San Diego, with an agenda hyper-focused on sharing the technology and practices that are enabling providers to deliver high quality care.
One of the keynotes that stood out was a conversation featuring Bon Secours Mercy Health CDO Jason Szczuka and Providence Health’s newly appointed CDO Sara Veazy, who each shared pearls of wisdom surrounding streamlining clinical workflows and reaching key executives at large health systems.
BSMH’s Jason Szczuka explored strategies that vendors can use to influence decision makers when presenting their solutions, and how this usually involves taking a different approach with each stakeholder.
- Szczuka stressed the importance of knowing the entire landscape of individuals at each organization, then communicating the value of solutions appropriately for each one. The way to sway a data ops team looks much different than convincing a clinical team.
- He also shared his “jobs-to-be-done approach” to assessing potential solutions. Given that patients need to complete a series of “jobs” from intake to discharge while simultaneously facing difficult health challenges, it’s the responsibility of health systems to make these tasks as easy as possible. New technologies get looked at through this lense.
Providence’s Sara Vaezy, who was appointed to the CDO role just earlier this month, fielded a handful of questions about the types of solutions that are a priority for adoption, including technologies that help flexibly match supply and demand for care.
- Vaezy shared how the solutions that streamline workflows for clinicians are often disguised as patient-facing changes, such as enabling self service for patients in order to open up provider bandwidth.
- She also discussed how new solutions must align with all three dimensions of Providence’s services: 1) the business model; 2) the operating model from a network perspective; 3) the technology layer.
While many of the themes at Reuters Digital Health 2022 had a familiar ring to them, one overarching message rang louder than the rest. Whether you’re a provider looking to deliver the best care possible or a vendor introducing a new solution to make that happen, technology is just a tool to help whoever is wielding it. Healthcare is still all about the people.
At a time when patients are expecting more from their healthcare experiences and providers are looking for new ways to rise to the challenge, NexHealth announced the close of $125M in Series C funding to help create the infrastructure needed for frictionless care interactions.
The funding arrives less than a year after the company’s $31M Series B round, pushing its total valuation to an even $1 billion.
NexHealth’s 29-year-old CEO Alamin Uddin first caught a glimpse of the technical barriers preventing seamless patient management while working as a medical receptionist during his time as a pre-med undergrad.
- The experience led Uddin to found NexHealth in 2017 with the ambitious mission of accelerating innovation in healthcare through the creation of a “Universal API” that enables developers to quickly build useful services.
- NexHealth’s Universal API integrates data from EHR systems to break down the silos that have traditionally slowed the pace of healthtech innovation, eliminating the need for developers to integrate with individual EHRs and reducing the time required to deploy new products.
- Uddin compares the service to fintech company Stripe’s back-end credit processing platform, which allows companies to easily plug-in and start interacting with different vendors.
The fresh financing will be used to drive strategic talent acquisitions and develop new doctor-facing features for NexHealth’s patient experience platform that leverages the Universal API to streamline practice management with features like online scheduling, automatic reminders, and two-way messaging.
- The platform currently manages over 68M patient records, and the recent capital raise should help bring on more large enterprises by adding functionality for one-click booking and integrated forms.
NexHealth is looking to establish itself as a way to provide frictionless patient experiences during a period when that’s exactly what the market is calling for. As the healthcare industry continues to lumber its way through the adoption of standards like HL7 and FHIR, NexHealth’s Universal API promises a simpler alternative that’s easier to implement, and the investor attention that it’s attracting appears to be validation that the approach has merit.
“The Telehealth Era Is Just Beginning” is a fitting title for the bullish stance on virtual care featured in this month’s issue of the Harvard Business Review. Although we cover plenty of articles outlining the benefits of telehealth, this piece was penned by a pair of especially qualified authors: former chief executive of the Permanente Medical Group, Robert Pearl, and Intermountain Healthcare’s executive director of telehealth services, Brian Wayling.
Pearl and Wayling shared an extensive deep dive on several key areas where telehealth can have a positive impact. It’s worth the read if you have 30 minutes and a big cup of coffee, but the key points are outlined here for those in search of the condensed takeaways.
Reducing unnecessary trips to the ER was the first focus area, due in large part to the heightened medical risks created by ER physicians frequently lacking access to patient EHR data and the low likelihood of follow-up care.
- Kaiser Permanente addresses these issues by providing members with a telehealth center with physicians that can solve the problem and coordinate any follow-ups in 60% of cases, preventing unnecessary ER visits.
Reversing the chronic disease crisis was the second use case highlighted, with telehealth providing a better way to serve the 50% of US hypertension patients living with an elevated risk of complications due to poor management of the condition.
- Pearl reported that KP consistently achieves a blood pressure control rate above 90% by replacing traditional office visits with EHR-connected blood pressure cuffs and virtual check-ins, enabling more frequent disease measurement and timeliness of treatment.
Other interesting examples revolved around improving access to specialty care and reducing geographical barriers to treatment, which help eliminate misdiagnosis and long wait times for patients with rare conditions.
- Wayling laid out how Intermountain’s Neuro Fast Access Clinical Team virtual platform allows low-acuity patients to receive remote migraine treatment from an expert, which opens up clinical time for patients who require in-person care.
How to Spur Adoption
While these case studies are useful for anyone looking to replicate the success of KP and Intermountain at their own health systems, the article saves its most valuable information for last, exploring two changes required to usher in “the telehealth era.”
- Integration – The organizations that consistently rank highest on quality are large multispecialty medical groups that leverage technology to coordinate care. As more doctors opt to work within health systems, they’ll be able to take advantage of shared EHRs, cross-specialty communication, and virtual care to help patients in ways unavailable to physicians in solo practice.
- Value-Based Care – Doctors who are incentivized based on the quantity of services they provide will logically resist models that reduce specialty referrals and hospital admissions. It’s easier for KP and Intermountain to say this, but telehealth’s full benefits will only be realized after more organizations adopt value-based structures that promote the use of virtual care to create superior outcomes.
For best results, Pearl and Wayling suggest implementing value-based models within integrated organizations, driving the point home with a final example of how two large health systems (good luck guessing which ones) are finding success with this strategy.
With much of the pandemic-driven adoption of virtual mental health services looking like it’s here to stay, Iris Telehealth recently closed $40M in Series B funding to help its telepsychiatry services keep up with a demand that’s “grown exponentially” over the past two years.
Iris’ telepsychiatry platform is designed to help US health systems and community health centers improve outcomes for patients with serious mental illness by intelligently pairing them with its staff of board-certified psychiatrists.
- The company identifies best-fit providers for each unique organization based on practice philosophy, long term goals, and scheduling availability, then ensures a long-term commitment to addressing their partners’ needs.
- These partnerships support healthcare organizations in creating their own sustainable telepsychiatry department by providing ongoing support, care model optimization, and triage assistance to help match patients to providers with appropriate licenses.
The latest funding will accelerate the scaling of Iris’ clinical operations team and the go-to-market strategy for expanding beyond its 200 current partner organizations.
- Iris made it clear that developing long-term relationships will remain a priority throughout the expansion, and a core pillar of making this happen will be to extend the length of its contracts, which already average a four year duration.
- The long term contracts are made to support what Iris reports is the number one need of its partners, which is the ability to optimize their throughput across the entire continuum between the primary care referral to discharge follow-up.
Even as health tech funding cools off into the second quarter, mental health has remained the most resilient clinical area, with Rock Health reporting that the sector brought in a leading $1B during Q1 2022. The investor attention has catalyzed the creation of plenty of solutions targeting conditions such as anxiety or depression, and now Iris is looking to establish itself as the “escalation team” for when these situations require one.
When your target market is growing quickly, it takes funding to keep up, which is why Vytalize Health recently closed a $53M Series B round to help bring value-based care to Medicare enrollees and their primary care physicians.
The latest funding brings Vytalize’s total raise to just over $75M as it looks to enter new partnerships within a Medicare market that’s projected to double in size over the next decade.
Vytalize got its start as a Medicare-focused primary care practice in 2014, but has since developed a vertically integrated platform that combines a risk-bearing entity with an in-home clinic model to help other practices transition to value-based care.
- As an ACO, Vytalize connects physicians and specialists to wrap care around the Medicare population, aiming to improve preventive health services while reducing avoidable hospitalizations.
- The company doubled its patient base to 130k seniors over the past year, and is now partnered with 280 primary care practices across 16 states that account for a combined $2B in annual care delivery.
To help manage high-risk populations, Vytalize equips its clients with a virtual in-home clinic that helps practices deliver better care in the white space between appointments, a task made easier due to the acquisition of patient communication company MedPilot in 2021.
- The influx of capital will help Vytalize integrate a wider network downstream from its primary care partners (hospitals, specialty networks, ancillary providers), while also establishing relationships with more Medicare Advantage and commercial plans.
The Medicare population is one of the hottest corners of the healthcare market, and many startups have sprung up to help providers transition away from volume-based reimbursement.
These companies are making big moves to gain an edge – just look at Devoted Health’s hefty $1.15B Series D round or One Medical’s acquisition of Iora Health for some recent examples – but Vytalize’s latest funding could help it carve out a niche as a novel type of ACO focused on helping strengthening patient-provider relationships through value-based primary care.
Although “digital transformation” probably tops the list of commonly used healthcare buzzwords, a new report conducted by Morning Consult and commissioned by Innovaccer paints a clear picture of why the term has become so popular, as well as the barriers standing in its way.
The “Healthcare’s Data Readiness Crisis: Triage vs. Transformation” report is based on survey results from a blue ribbon panel of 75 US health system executives, which explored their current views with respect to digital transformation.
Among the highlights of the survey was the fact that 95% of respondents are focused on digital transformation, making it the number one imperative for the rest of the decade.
- 83% are aiming to have their organizations achieve full digital transformation in under five years, which might as well be a fraction of a second in healthcare time.
- To accomplish this, healthcare IT leaders are prioritizing solutions that can make a measurable difference in the near-term, such as population health (41%), hiring talent (40%), and competitive analysis (40%).
When asked about the obstacles that are stifling innovation, interoperability ranked as the leading technical challenge (41%), surpassing both implementation (25%) and data quality (23%).
- 42% said their organizations’ data is highly fragmented and siloed, and 58% didn’t believe that their EHR vendor could support their enterprise data strategy.
- Despite these hurdles, only 5% of executives are currently investing in data activation platforms that facilitate interoperability across all of their systems.
Out of all the takeaways from the report, the disconnect between healthcare’s high aspirations for digital transformation and the lack of data readiness that’s needed to support it is likely the biggest.
Across the industry, data and the insights it can reveal are trapped in disconnected siloes within each institution, yet many organizations are still tackling data optimization as a one-off project vs. a foundational capability. This results in short-term fixes to long-term problems and postpones any sort of true digital transformation.
As a result, only the health systems that crack the code on data readiness will have the foundation needed to sustain accelerated transformation over the long haul, which should create a durable competitive advantage over slower organizations while pressuring others to follow suit.
Value-based care is a common line item on the strategy whiteboards of many digital health startups, but few are executing on a real-world gameplan at the level of Clarify Health.
Less than a month after acquiring Embedded Healthcare to drive provider behavior change, Clarify is once again the top story of the week following the completion of a massive $150M Series D funding round led by Softbank Vision Fund 2.
To recap Clarify’s solutions, it builds cloud-based applications on top of its Clarify Atlas Platform, which maps over 300M patient journeys to illuminate areas that can be optimized to improve value-based performance.
- The platform links clinical performance to financial impact to boost payer-provider collaboration, while helping target behavioral nudges at the moments when they’ll be most effective.
- Clarify’s scale allows it to apply what it calls a “Moneyball-style” analytical method to healthcare, objectively assessing provider performance to identify the most efficient incentives and interventions.
Clarify’s latest investment is earmarked to accelerate the adoption of its intelligence offerings and payments technology beyond the 75 healthcare organizations it currently serves.
- Although scaling up the client roster is obviously a top priority for most companies, it’s doubly important in the value-based care space, improving the AI-driven models that allow quality care to be compensated fairly and building the provider trust that serves as the foundation of risk-based arrangements.
Clarify Health President Todd Gottula stated that the company was founded to help healthcare organizations benefit from “the big data efficiencies of the banking and consumer industries.” Clarify’s been quickly bolstering its services to make this vision a reality, and if the past year has shown us anything about the company, it’s that it won’t shy away from using its newly replenished coffers to acquire companies aligned with that goal.
Direct-to-consumer telehealth company Hims & Hers is partnering with hybrid care provider Carbon Health to give its California patients better access to in-person primary care.
The new partnership enables licensed medical professionals on the Hims & Hers platform to direct patients to Carbon Health clinics if in-person treatments are needed.
Hims & Hers has been quickly integrating its retail and virtual care offerings as it looks to create “a one-stop shop for a new generation of consumers” in search of convenient healthcare.
- The company launched in 2017 with a focus on D2C men’s health products, but has since broadened its platform to include virtual primary care and therapy services.
- These new services allow Hims & Hers to offer a wider range of care options to its growing membership base, which doubled to 609k active users in 2021.
- The Carbon Health collaboration adds another brick-and-mortar provider to Hims and Hers’ partner network, which now allows its members to access comprehensive primary care in seven states.
Carbon Health currently operates 83 clinics across 12 states, and recently raised $350M to help scale to 1,500 clinics by 2025.
- Working together with Hims & Hers should give momentum to Carbon Health’s patient acquisition efforts, and it wouldn’t be surprising to see the partnership expand to other states if successful in California.
By embracing partnerships with companies like Carbon Health, Hims & Hers can provide access to in-person care without the burden of developing its own brick-and-mortar clinics. This strengthens Hims & Hers’ value proposition to its large membership base while allowing it to serve as a referral partner for local providers, which seems like a solid approach as long as it can execute on the strategy.