Verily Aims to Build GPS for Patient Care

Mayo Clinic and Verily, Alphabet’s life science division, recently announced a two-year strategic partnership to develop a clinical decision support (CDS) tool that caters to a patient’s individual needs. 

Although physicians generally do not love their EHR flashing advice at them, the collaboration aims to sidestep the one-size-fits-all approach of traditional CDS tools with AI-generated recommendations relevant to the patient in the room.

  • The Partnership – Mayo Clinic will provide curated clinical content and deidentified health record data while Verily will apply advanced analytics and user-centered design to deliver insights within existing point-of-care workflows.
  • The Roadmap – The tool will initially focus on cardiovascular and cardiometabolic conditions at Mayo Clinic, but will use open standards to enable integration with multiple EHRs for possible expansion to other use cases for Verily’s health system partners.

The Takeaway

While announcing the partnership, medical director of Mayo Clinic’s Center for Digital Health Bradley Leibovich MD stated that he hopes the tool can be used as “a GPS for patient care.”

The companies cited the exponential growth in medical discovery and knowledge as making it  nearly impossible for caregivers to keep up with the latest advances in their fields, creating a need for a tool that offers clinical support. 

Verily and Mayo Clinic are betting that their combined expertise in clinical informatics and data science will be the solution to creating a patient-relevant CDS that clinicians actually want to use.

Mayo Clinic Finds Success With Remote Patient Monitoring

Mayo Clinic recently published a new study of its remote patient monitoring (RPM) program for ambulatory care of COVID-19 patients (n = 7,074), aimed at reducing acute care utilization and hospital admissions.

The program included two care-delivery models based on patient risk, enabling RPM-registered nurses to respond to technology-generated alerts and deliver standardized care for clinical assessments and patient management.

Low-Intensity Care Model (n = 2,314)

  • Patient had no risk factors for severe illness and low symptom burden
  • Mayo provided thermometer and pulse oximeter
  • Patient reported symptoms twice daily
  • 1:50 nurse to patient ratio

High-Intensity Care Model (n = 4,760)

  • Patient had 1+ risk factors for severe illness and moderate-to-high symptom burden
  • Mayo provided LTE-enabled tablet, thermometer, pulse oximeter, blood pressure monitor
  • Patient reported symptoms twice daily
  • 1:30 nurse to patient ratio

Results

Among all patients, ED visit and hospitalization rates within 30 days of enrollment were 11.4% (low-intensity) and 9.4% (high intensity), with a 30 day mortality rate of 0.4%. The RPM engagement rate was above-average at 78.9%, supporting recent changes to the CMS physician fee schedule to expand reimbursement for RPM services to patients with acute conditions.

The Takeaway

The study suggests that RPM for management of COVID-19 is associated with “excellent clinical outcomes,” especially among patients at risk for severe illness. 

Given that Mayo Clinic’s RPM program was part of a retrospective cohort study, it remains unknown how the results compare with “usual care,” but a matched case-control study is planned to evaluate the program.

Telehealth’s Payoff

A new study from MITRE Corporation and Mayo Clinic of over 2 billion claims (plus thousands of patient and provider surveys) found that telehealth was effective at delivering care across a wide variety of specialties, but providers are still worried about its limitations in the post-COVID era.

Claims Results

  • Telehealth claims represented less than 2% of total claims before the pandemic, peaking at 49% in April 2020
  • Every clinical discipline saw usage rise, with the largest spike seen in behavioral health
  • Out of state providers were responsible for 6.5% of telehealth visit claims

Provider Survey

  • 79% of providers offered telehealth following the pandemic (16% prior)
  • Highest quality of care ratings were for chronic disease mgmt (89%) and mental health (83%)
  • Lowest quality of care ratings were for acute care (62%) and perioperative care (59%)
  • Biggest telehealth barriers were low reimbursement (~80%) and patient tech challenges (~70%)
  • Zoom (34%), audio-only (29%), and Doxy.me (28%) were the most cited technologies

Patient Survey

  • An impressive 74% of patients plan to use telehealth services in the future
  • 55% of patients reported that they would have delayed care without telehealth
  • Telehealth drove patient satisfaction by removing transportation barriers (76%), removing need to take time off work (65%), and reducing costs (67%)

The Takeaway

Telehealth studies aren’t exactly hard to come by, but this one is unique given its size and intent. Mayo Clinic’s goal behind the study was to encourage more telehealth research with the hope of influencing permanent regulatory change and reimbursement approaches. The study does a great job of showcasing telehealth’s positive impact on patients and providers, highlighting the need to better understand how the technology can be improved moving forward.

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-- The Digital Health Wire team