Population and Public Health

Hospital is looking to the public to nominate one of three initiatives: a patient identification shield, a surgery blood loss manager, or a bioprinter to produce living tissue replacement.

With estimates that such programs can reduce costs by $3.27 for every dollar spent and building wellness centers can bring a 10 percent return, more and more providers and payers are getting into the wellness game.

Pieces Technologies announced $21.6 million in its first round of funding to advance its cloud-based population health management tools. The Pieces platform provides integrated monitoring, prediction, workflow optimization and organizational learning services specifically for hospitals, health systems. Its cloud-based software is also designed to connect to hospitals’ information systems to provide a holistic view of patients and their healthcare needs. [Also: Hospitals driving population health with data analytics, mobile apps, telehealth tools] The goal is to identify and prevent adverse events, such as avoidable mortality and hospital readmission for chronic diseases and illnesses, according to Pieces CEO and founder Ruben Amarasingham, MD. “Pieces Tech’s solutions are helping us redesign and transform our healthcare delivery models for better population health management,” Fred Cerise, MD, Parkland Health and Hospital System’s president and CEO, said in a prepared statement. Parkland’s non-profit research and development arm, Parkland Center for Clinical Innovation, served as an incubator for the platform. [Also: Healthcare IT startups to watch in 2016; Running list of big news]  “While many purport to have solutions for population health, over the last several years the team has stealthily built and validated a robust healthcare IT and clinical services platform that has clinically proven to truly bend the cost curve on quality and care across diverse constituencies,” added Garrett Vygantas, MD, Partner at Jump Capital. Jump Capital and Pacific Advantage Capital led the funding, along with participation from Children’s Health in Dallas, Order of Saint Francis Healthcare System in Peoria, Ill, PCCI, select Dallas investors and others. Twitter: @HealthITNews

A new report from the President’s Council of Advisors on Science and Technology claims technologies such as telehealth and wearable sensors should be put to work to help more elderly Americans stay healthy and connected as they age. The report by PCAST, an advisory group of scientists and engineers appointed by President Barack Obama to make policy recommendations related to technology and science, found these types of technologies can help elderly Americans face challenges tied to social connectivity, emotional health and cognitive and physical ability. "With many Americans wishing to live in their homes and communities for as long as possible, technology such as prosthetics, wearable sensors, and other tools for daily living can make that possible," said PCAST members Christine Cassel and Ed Penhoet. [Also: Mobile apps emerging as essential population health tools] As of 2014, an unprecedented 15 percent of the U.S. population was over the age of 65, according to the Census Bureau, and many of them remain active. Recommendations also include creating better access to the Internet as something essential to health, social engagement and well-being, and offering more education and training for seniors in online technologies. PCAST also suggests greater efforts by technology providers to develop monitoring tools for frail and vulnerable elders. But the report also calls on a federal agencies to make changes. Specifically it pointed to telehealth as something with clear benefits for seniors living remotely or with limited mobility – but said the government needed to update regulation and payment policies to reflect recent innovation in the space. For another example, the Federal Trade Commission should continue to enforce regulatory review and guidelines for commercial cognitive training products, PCAST said. [Like Healthcare IT News on Facebook] And the group called upon an array of federal agencies – from the National Institutes of Health to the Defense Advanced Research Projects Agency, or DARPA – to expand research on projects such as robotics and advanced mobility technology. It also recommended that Centers for Medicare and Medicaid Services payment policies should be adapted to increase seniors' access to those next-generation tools. "Technology has played an important role in increasing life expectancy, but it also has an important role to play in increasing the quality of life by maximizing Americans’ ability to function in their later years," PCAST Chairs John Holdren and Eric Lander wrote in a letter to President Obama. Twitter: @MikeMiliardHITN

Eran Bellin, MD, of Montefiore Medical Center, discusses the tools and methods the organization implemented to track and use information for driving better population health outcomes.

HIMSS16 provided countless hours of must-see video content for Healthcare IT News, from fascinating interviews with thought leaders and speakers at the conference to in-depth panel discussions and show floor highlights throughout the week. We have compiled the top 5 videos to date for you to watch in case you missed them.

While mobile apps are new enough on the care delivery scene that many providers have only begun dabbling, consumers are sending a strong message that forward-thinking hospital executives can translate into an opportunity for improving population health management programs. Northwestern University's Feinberg School of Medicine is conducting clinical trials that use mobile health apps to do much more than just communicate with patients — the software teaches mental health patients cognitive behavioral therapy, or CBT, techniques designed to improve population health and reduce mental healthcare costs. This story is part of a reporting package on the rise of population in health in healthcare IT management. Stories include our analysis of health system strategies, an overview of the work done by Essentia Health and a look at how mobile apps are supporting initiatives. Designed by Northwestern's Center for Behavioral Intervention Technologies, the ThinkFeelDo website (a responsive design site built to render effectively on any device) and the IntelliCare suite of mobile apps (available in the Google Play store for Android devices, with Apple iOS apps in the works) break up the various CBT techniques into separate modules to make learning the techniques and applying them in situations an easier task. The modules include text, animation and video. Caregiver coaches, on the other end of the mobile site and apps, review patient progress and can intervene during lessons to help patients with any challenges or issues and to provide encouragement. "Costs can be saved by giving depressed patients these kinds of tools, decreasing overall health care utilization for an individual," said Kenneth R. Weingardt, scientific director at the Center for Behavioral Intervention Technologies. Weingardt also is a licensed psychologist. "We are now saving more money because the cost of the app is much lower than the cost of face-to-face. For some folks who are fairly well-functioning and can go it alone, these types of technology may provide them with what they need so they do not have a long depressive episode that impacts their health and costs a health plan money." ThinkFeelDo and IntelliCare are still in clinical trials at Northwestern, though CBITs is in discussions with Kaiser about deploying IntelliCare through its patient portal. "Mobile interventions have much farther reach than individual providers can have," Weingardt said. "They can reach many more people beyond those we can see in our clinic. And a health system that adopts these kinds of tools can improve their bandwidth and their ability to address these problems beyond the capacity of their workforce.” [Like Healthcare IT News on Facebook] In the Northwestern’s clinical trials, Weingardt added, that means giving participants tools to get symptoms under control and making it less likely they will come back with complaints. Providers such as Northwestern and other simply cannot ignore the trend toward mobile tools any longer, said population health management vendor Enli Health Intelligence chief medical officer Joseph Siemienczuk, MD. "We have to follow the communication preferences of the community and and it is clear that their communication preferences have moved to mobile technology,” Siemienczuk said. "As we pursue effectiveness, moving patient engagement activities to mobile technology is an imperative." Twitter: @SiwickiHealthIT

As 67 percent of healthcare organizations have population health management programs in place, experts say information technology is key in making them work.

First-mover health systems are already using telehealth services to successfully manage patient populations and lower healthcare costs. Take Essentia Health, for instance. The 16-hospital and 68-clinic system uses an Epic EHR and telehealth technology from Medtronic to focus on improving the health of congestive heart failure patients and enhancing the care surrounding this chronic health problem. This story is part of a reporting package on the rise of population in health in healthcare IT management. Stories include our analysis of health system strategies, an overview of the work done by Essentia Health and a look at how mobile apps are supporting initiatives. Whereas 25 percent of congestive heart failure patients in the U.S. are readmitted to the hospital within 30 days, according the Agency for Healthcare Research and Quality, Essentia said that less than 2 percent of those participating in its telehealth program return in that same timeframe. Indeed, telemedicine technologies at Essentia and other tech-savvy hospitals can help fill in care gaps, monitor at-risk patients and extend services to patients who might not otherwise receive them. Essentia, for its part, started the telemedicine work in 1998 and then instituted a formal population health management program several years ago. Today, of the 2,500 patients in Essentia's congestive heart failure program, about 300 who meet certain clinical criteria have been given tele-scales. The electronic scales digitally report via landline or cellular phone service a patient’s weight every day as well as how that person responds to questions the scale literally asks aloud. Tele-scales cost between $70-$110 per month to lease. Physician assistants and registered nurses, in turn, can deliver telehealth care under the guidance of cardiologists. "Weighing every day helps you identify the real problems," said Denise Buxbaum, heart failure program manager at Essentia Health. "When these patients actually come into the hospital, most of the times they outspend their diagnosis-related group, anyway. Now we have contracts, we are an accountable care organization. BCBS of Minnesota did one study and with this technology we saved them $1.25 million." Buxbaum said the combination of regular monitoring and the patient education that comes with it lead to improved patient health and, as a result, lower costs. "Patients need to understand the consequences of their lifestyle choices, and by showing them – when they see it with their own eyes – they are more likely to make a better choice the next time when they learn from ongoing education," she said. "With telemedicine, we are catching things early before patients have to visit an emergency room." [Like Healthcare IT News on Facebook] Additionally, Essentia Health built an interface between the telemedicine system and its EHR so patient data that congestive heart failure nurses see can be readily available to all members of a care team. "Our EHR allows caregivers to review the patient medical record to see what other care coordinators or providers have done when caring for our patients," Buxbaum explained. "This allows for a more seamless, higher level of quality care when we all know what the rest of the health care team is doing." Twitter: @SiwickiHealthIT

The technology pioneer offered his thoughts on funding new projects and keeping up with change at his HIMSS16 keynote earlier this month. Here are seven takeaways.