DHW Q&A: Bridging Gaps in Remote Care With Clear Arch Health

With Robert Flippo
MobileHelp / Clear Arch Health, CEO

In this Digital Health Wire Q&A, we sat down with MobileHelp CEO Robert Flippo to discuss the shifting remote patient monitoring landscape and how new technologies are enabling more people to age independently.

Clear Arch Health is MobileHelp’s healthcare division, which integrates RPM and personal emergency response systems (PERS) into a turnkey solution that’s easy to implement for both patients and providers.

Can you give us a quick introduction to Clear Arch Health and your overall strategy?

Our overarching goal from the very beginning has really been to improve people’s ability to age independently, starting with our consumer-facing MobileHelp personal emergency response business, and also with our Clear Arch Health remote patient monitoring platform.

To enable people to age wherever they want, which is usually in the home, you need a platform that’s both flexible and proactive. There’s the actual clinical monitoring component, where clinicians are managing patients, keeping track of vitals, checking on medications, etc. Then there’s also all the data that results from that.

A lot of people think about RPM as devices, but there’s a whole system behind those devices that’s analyzing that data to more effectively manage patients. Controlling that entire tech stack is what lets us help people age independently, and that’s the real mission here.

The longer people can remain independent, the happier they’re going to be.

How does your experience in PERS support the remote patient monitoring aspect of your business, and what sort of capabilities do you unlock by combining the two?

There’s a couple of pieces to it. First and foremost, the patients who are typically in need of PERS are also more likely to need chronic disease management using remote patient monitoring. So for the consumer, combining the two really simplifies the experience.

That’s hugely important when you think about this demographic. One of the major lessons we’ve learned from working with this population for over 15 years now is the importance of having a seamless platform that’s intuitive for someone that might be over the age of 75.

It’s easy for a lot of companies to get caught up with the shiniest tech and all of its bells and whistles, but the patients that we’re working with usually want the exact opposite.

This fundamental understanding of our customer base drives the design of everything from our hardware and installation to our customer service and manual. It’s powerful in its simplicity and fully turnkey. You plug our products in, and they work.

Can you give an overview of that hardware and the other components of the platform that you layer on top of it?

I’d say that a lot of people think of the hardware as the whole solution. It’s an important part, and it needs to be safe and reliable and all of those things, but at the end of the day it is just one component, like you said.

The flagship product for our remote patient monitoring service is a custom tablet solution that we’ve developed and manufactured for both RPM and personal emergency response. It’s purpose-built for our customers with loud speakers, sensitive microphones, and easy connectivity – but it’s also highly configurable.

Depending on the program that’s being developed, we can provide unique content for education, or a direct connection to nursing staff for video visits, but all of it is integrated with the EMR so that care teams can also have a seamless experience and access to the data.

When we deploy a program with a new client, the set-up, the training, and the ability to interact with patients directly are all just as important as the hardware. There’s at least as much service in this industry as there is technology. 

There’s recently been a major shift to RPM and home health in general. What are some of the biggest changes that you’ve seen over the last few years?

One of the biggest changes has been the willingness of CMS or Medicare to actually reimburse remote patient monitoring for chronic disease management.

Up until recently, home health agencies were tasked with taking care of patients after they were discharged from the hospital, and one of their primary incentives was to try and prevent readmissions – yet there wasn’t a specific line item that covered remote patient monitoring. RPM has now been proven to prevent readmissions, and reimbursement is following.

The other major change has been the flood of new entrants into the space, both from small startups and larger companies more at scale like we are. In my view, that’s actually created a lot of noise in the market, and it’s now more difficult than ever to separate out who the real players are and how they might be able to help.

What are the biggest trends you’re seeing in the aging in place segment that might not be getting the attention they deserve?

I don’t think that it’s so much a specific trend that people are overlooking, as much as the fact that we’re only just starting to see the beginning of what the possibilities are. At a certain point, these programs are generating so much data that the real challenge becomes getting the value out of it.

The introduction of new AI tools is giving us the ability to analyze that data in real time, which will let more people age independently by allowing us to pick up on situations that might be difficult to spot by a human looking at the raw data.

The reality is that there aren’t enough caregivers to take care of the population that’s going to be aging in place over the next 10 to 20 years, so if we don’t figure out how to use this technology to more effectively manage patients, we’re going to be in a tough spot. In my opinion, it’s not really an option that we succeed here, it’s a necessity.

Is there any advice that you would give to a provider organization or health system thinking about implementing their own remote patient monitoring strategy?

When you really dig into it, remote patient monitoring is probably more complicated than you’d originally think. The key to overcoming that is finding the right partner for your situation.

If you’ve seen one remote patient monitoring solution, you’ve seen one remote patient monitoring solution. Everybody’s situation is different, even within health systems. They’re generally solving for the same problem, but they all have unique requirements and capabilities, so finding a partner that can help navigate to the right solution and that’s flexible enough to implement it will give you a much higher probability of success.

For more on Clear Arch Health’s RPM platform, head over to their website.

DHW Q&A: More Care, Less Friction With Medallion

With Derek Lo
CEO, Medallion

In this Digital Health Wire Q&A, we sat down with Medallion CEO Derek Lo to discuss the emergence of virtual care and how to overcome the friction it brought with it.

Derek founded Medallion in 2020 to help healthcare companies automate credentialing, licensing, and compliance for their provider networks. He’s since helped scale Medallion into one of the largest provider network management companies in the US, with over 300 customers and $85M in funding.

Let’s kick things off with some background on Medallion. Can you share a little about the company and your platform?

First and foremost, Medallion exists to improve access for patients – to allow them to receive care where they want it and in the most cost effective way. Virtual care is here to stay, tons of studies are showing that both physicians and patients support it, but with that comes a whole new problem set.

A major component of that is licensing and making sure that telehealth providers can operate efficiently, but the second piece is insurance.

The multi-payor system in the US creates immense complexity, whether it’s claims and the entire revenue cycle industry, or more in our world: credentialing, enrollment, contracting, negotiation. All of these processes are wrapped around taking insurance as a provider.

That’s really what we’re trying to cut down on. We’re aiming to remove as many of these friction points as possible.

To fill in some more color on the platform, what are some of the ways that you remove this friction?

Like I mentioned, Medallion’s main goal is to automate away all of these operational and regulatory compliance tasks that companies have to do just to run their business. That starts with creating a system record for their provider data, so we’ve built our own CRM from the ground up.

What that’s allowed us to do is build different product lines on top of that, automations that tackle various operational pain points in those two main buckets of licensing and insurance.

On the licensing side, that includes things like getting new state licenses, maintaining and renewing licenses, continuing education tracking – all to help with network operations. On the insurance side, that’s where we’re removing friction by helping establish contracts with new payors, followed typically by enrollment, or in some cases, delegated credentialing.

There’s also a huge need for ongoing support with things like roster management, where provider groups have to share their rosters so everyone can track who’s in-network. That’s still a very manual process that a lot of companies are doing with spreadsheets, same goes for sanctions monitoring and compliance. That’s where we come in.

Looking at Medallion’s growth, it seems like plenty of companies share those pain points. How do you guide the direction of a company that’s growing so quickly?

I think a big part of leadership is finding a way to focus on the top one or two problems at any given moment, and being able to drill down on those problems that are right in front of you.

In one way, building a company is just a long sequence of decisions that plays out over many years. It’s the quality of those decisions, in aggregate, that ultimately decides how successful the company is.

There are obviously external factors – a great example being the SVB crisis – but even those are just another decision along the way. It’s our job to make sure that we get those decisions correct and back them with execution.

What’s a misconception that people have above provider management or credentialing?

At the end of the day, if you talk to any healthcare CEO, these functions are a cost center for their organization. They’re a strategic priority, but only because they’re a key gateway to revenue. Yet for that reason alone, people understand that they’re super important to get right.

We talk to companies all the time where things aren’t running optimally, so they’re worried about leaving revenue on the table because they aren’t getting credentialed fast enough, or claims are getting kicked back because enrollment wasn’t done correctly, and so forth.

It’s really important to tackle these problems, not only because of the missed revenue, but because solving them truly makes an impact in terms of growing efficiently, seeing more patients, and ultimately providing better care.

If Medallion had a secret sauce that you could share with other founders, what would that be?

I don’t think there’s necessarily a magic ingredient, but the biggest thing would have to be the execution component we were talking about earlier. That involves doing deep thinking on the market, and really focusing on the customer above all else

What does the customer need? What are their business problems? How are those problems being solved today? How could they be solved in an optimal scenario?

Every day we try to be as thoughtful as possible about how those answers align with what we’re doing and how we’re trying to serve those needs. We also have a fantastic team, so if we can keep focusing on what I just mentioned, in literally as many decisions as possible, then we’ll get a lot of decisions right in the long run. 

For more on Medallion, head over to their website or swing by booth #1831 at HIMSS.

DHW Q&A: Hospital Tech With Steward CEO

With Dr. Ralph de la Torre
Steward Health Care System, Founding Chairman and CEO

In this Digital Health Wire Q&A, we sat down with the founding Chairman and CEO of Steward Health Care System, Dr. Ralph de la Torre, to discuss the challenges facing US health systems and the technologies needed to overcome them. 

Prior to founding Steward, Dr. de la Torre was CEO of Caritas Christi Health Care, as well as the Chief of Cardiac Surgery at Beth Israel Deaconess, where he was widely recognized as one of the top cardiac surgeons in the nation. He’s since guided Steward’s expansion from a six-hospital system to the largest private for-profit hospital operator in the country.

Let’s start with some background on Steward. Can you share a little bit about the overall strategy and your original vision?

The premise of Steward has always been to create a truly integrated system where all of the providers, the hospitals, the care, and the patient are all completely coordinated and unified from a data perspective.

The goal is to understand the patient journey no matter where it takes place – whether at the hospital, the ASC, or the primary care office – and to have anything that comes out of those encounters captured in a central location so that everybody can use it to deliver better care.

Unifying all of that data under one roof is easier said than done. What are some of the technologies that Steward’s been using to make that vision a reality?

One of the biggest has been our enterprise data warehouse, where we collect all of our data in Massachusetts, and can then query a patient across all of their encounters. That’s a tremendous population health tool.

If you think about what payors do, more often than not they use claims data to make predictions and ascertain what needs to be done to keep a patient healthy. Our strategy involves actually using care data, which reveals problems much sooner.

By the time you get a claim, the problem’s already happened. But if you have the right stack of data coming from the providers, you can get out in front of those problems much sooner, and ideally prevent them from happening.

When you’re evaluating new digital health solutions for Steward, what separates the standout solutions from the rest? 

Easy. It’s the return on investment. Whether we’re integrating a new tool or investing in one, we need to know whether it’s a 1-year, 5-year, or 10-year return. The other thing is that it needs to be real. Having a new app that relies heavily on a highly trained workforce almost defeats the purpose of the app itself.

To add to that – one of the biggest problems as hospitals are coming under cost pressure is balancing Best-in-Breed versus Best-in-Suite solutions. Many of us have a suite of applications, whether it’s Epic or MEDITECH or something else, and sometimes these applications provide an element that’s “B” grade.

You might see a new solution outside of your suite with an element that’s an “A”, but is it worth the incremental cost? As cost pressures increase, more and more of these decisions are Best-in-Breed versus Best-in-Suite. If you’re going to go with Best-in-Breed, that automatically raises the threshold of how good the tech has to be.

Are there any areas in healthcare where you think startup founders should dedicate more attention to creating new products and services?

I think as a general rule of thumb in medicine, the United States gets more excited about the latest cutting edge therapy for a small subset of patients than about ordinary care for everyone. US healthcare isn’t lacking in high technology, it’s lacking in the basics. We don’t have basic wellness, we don’t have basic nutrition, we don’t have enough primary care visits.

In America, we don’t really take care of ourselves, but we’re great at keeping ourselves alive once we get sick. I think going back to the basics and building tools that help with basic nutrition, wellness, and population health will have a larger macroeconomic effect than tailoring the latest molecule for a small cohort.

Another area I think people have forgotten a little bit about is the business intelligence tools that make hospitals and physicians more efficient. We’re keeping a close eye on products that can help us improve our efficiency. You have to realize that in the long run, hospitals are cost centers, not revenue centers – so these are the tools that are going to move the needle for value-based systems and providers.

If you could push a magic button to create the perfect business intelligence tool for Steward, what would that look like?

It would be a tool that integrates everything together. It would be able to tell me what each component of care delivery costs in detail, then help proactively guide me to minimize the cost per unit, whether it’s a device or an hour of labor.

As an example, if we have too much staff on a Friday, that’s a huge expense. The tool would need to be able to look at something like OR cases and scheduling, then predict exactly what operating room utilization will be, so that we can move OR cases around to make sure our staff and supplies are there when we need them, and not there when we don’t.

What Steward initiatives are you most excited about right now?

I’m really excited about our Medicare Advantage play, particularly everything we’re doing with CareMax. Steward has an absolutely massive amount of Medicare patients, and we decided that we want to approach them with a complete managed care platform.

We quickly realized that it would take years to build that ourselves, so we went out and looked at the different models that were already out there. We thought that CareMax had the best IT and patient platforms for Medicare Advantage, and so we ended up doing a huge partnership with them.

The way I see it is that Steward has the largest ACO in the nation, and we’re great at managing care behind the scenes. CareMax has what we think is the best Medicare Advantage patient interface, and delivers a great experience at that level. Now we’ve united the two.

I think that the market is underestimating the massive value that uniting these two components really brings, and I think this combination has the potential to be the next big thing in healthcare.

Digital Health Wire Q&A: Zoom’s Healthcare Transformation

With Heidi West
Zoom, Head of Healthcare

As the role of digital health continues to grow, new use cases are emerging and enabling communication between patients and physicians. The rapid adoption of telehealth solutions over the past year and a half has led to a boom in innovation that has expanded the scope of the technology well beyond the “virtual visit.”

In this Digital Health Wire Q&A we sat down with Zoom’s Head of Healthcare, Heidi West, to discuss the role of telehealth today and how the technology is evolving to meet the needs of consumers in a post-pandemic world.

Since the start of the pandemic, Zoom has enabled everything from remote schooling to virtual healthcare visits. How has Zoom’s healthcare business changed over the course of the past two years?

When the pandemic happened, there was a very abrupt shift from in-person visits to telehealth. At the beginning of the pandemic, telehealth was all about the virtual visit, and figuring out ways to engage the patient and provider. Throughout the course of the last year and a half, through the creativity and innovation of nurses and doctors and administrators, it started to focus more on all the ways that we can break down the communication barriers throughout healthcare.

It also served as a family connection point in many ways, helping patients that were isolated and vulnerable during the pandemic. As Zoom for Healthcare’s platform continues to evolve, the focus will be on augmenting or enhancing the communication experience along the entire continuum.

What are Zoom for Healthcare’s top priorities in this space?

Our number one goal is to continue to provide a simple and frictionless experience within healthcare communication. Whether it’s virtual visits, telehealth, or even internal communication between the business and the clinical side, we are looking at all of those strategic communication points and finding ways to simplify and tie more of a ubiquitous familiar experience across healthcare.

There’s a lot of passion in what we do, and a tremendous responsibility to clients and patients. A patient’s health and wellness conversations with their doctor are some of their most private communications, and that’s not lost on us.

A recent survey listed Zoom as the the most used telehealth platform, with 34% of physicians using the service. Why are so many physicians already choosing Zoom over other healthcare-focused platforms?

There’s a couple of reasons. It’s the simplicity, quality, and you’re not becoming tech support when you engage in a telehealth visit. There are niche products that are just telehealth, but many miss the business-to-consumer piece of the puzzle. Zoom is really uniquely positioned to bridge that gap.

It’s the same solution that their kids are using in school. It’s the same solution and look and feel as their trivia nights, or parent-teacher conferences. Zoom serves as a familiar connectedness that we’ve all really needed over the past year and a half.

Many telehealth offerings include services such as text and email notification, payments, and file transfers. Is this indicative of the direction that telehealth is heading?

Telehealth is in no way done with just a virtual visit. With Zoom Apps, any number of those needs that you mentioned can now reside within the Zoom meeting and serve different purposes. We’ll also begin to see more functionality leveraging biometrics and enabling live vital sign monitoring during telehealth visits.

Zoom will always remain simple and easy to use, but simple does not mean non-innovative. The mobile web client is a perfect example of that. Our clients asked for it, and within a quarter we’re already in beta. I’m really proud of the fact that we are customer-driven in the way we’re building the platform.

In the same survey, top physician concerns regarding telemedicine were “technology challenges for patients”, “poor integration with other technologies”, and “new telehealth specific workflows.” How can telehealth technology be improved to address these concerns?

This goes back to the reasons why so many physicians are already using Zoom, and that’s that we have an integrated workflow. Our goal is not to create parallel workflows, but to work within the workflows that clinicians are already sitting in today.

The beauty of our open platform is that it allows our clients to build within their own workflows. Providing that level of flexibility in the way people can develop with Zoom sets us apart significantly in solving a lot of these problems. From a patient perspective, I think addressing any friction point should be the goal, which is why we launched the mobile web client to help anyone struggling with the app.

Safety and data privacy concerns are always a priority with sensitive interactions like a telemedicine visit. How does Zoom ensure patient privacy is protected and that sensitive data is never vulnerable?

First and foremost, Zoom holds privacy and security to the highest level of responsibility. We enable HIPAA compliance throughout our entire platform. We have safeguards spanning everything from end-to-end encryption data to data-at-rest, but it’s important to remember that technology only enables HIPAA compliance. It’s the responsibility of everyone involved in the conversation to protect the information.

So it’s safe to say that patients don’t have to worry about someone “zoombombing” their doctor visit?

They don’t have to worry. Protecting user privacy is Zoom’s top responsibility and something we take very seriously.

Outside of doctor/patient visits utilizing telemedicine, where else is there a role for the technology that might not be as obvious?

I look at the entire healthcare continuum, and telemedicine has a role anywhere from a well-visit, to primary care, to an acute care setting, as well as in the home. There are dozens of communication points along this continuum, and our goal is to look at them and ask if there’s a way that Zoom can improve them or remove friction. For each communication component, we ask questions like: Do you augment this with video? Do you leverage Zoom Phone? Can Zoom Rooms tie different pieces together? The entire healthcare journey needs to be the focus, not just the virtual visit.

I would almost flip the question and ask: Where wouldn’t telehealth fit? Even in just the patient’s room, there’s entertainment, education, food services. All of these can be improved through technology, but so can things like care coordination and family engagement. We’re looking at the patient room as a source of digital transformation that revolves around putting the patient at the center of all of the different communication that goes on within the room.

How do you see the telehealth space evolving over the next few years and where does Zoom fit into this picture?

The biggest thing to remember is that the landscape has changed following the pandemic. Patients have choice. Patients have flexibility. There’s a lot of competition in delivering care today. Never underestimate the consumer’s wants and needs from healthcare.

Look at all of the four hour blocks of care and say, how do I augment in-person with virtual? Do I leverage nurse practitioners? Do I leverage medical assistants? Then augment to provide that flexibility and convenience to patients. Healthcare still uses pagers and fax machines, so the chance to upgrade to a more strategic communication strategy will only continue to evolve.

The healthcare industry just saw 10 years of innovation in six months, and I think it’s made people aware that the consumers and the communities they serve will follow the innovation – and I’ll say it again: never underestimate the consumer.

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-- The Digital Health Wire team

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