Telehealth

The infrastructure and consulting services can enable healthcare providers to build out telehealth strategies and design tools that address interoperability challenges and improve the patient experience. 

Patient-generated health data is proving to be critical in the shift to value-based care.

By Marc Sebes, VP of Product Management In-home clinical devices are among a number of digital health technologies that are being used to streamline clinical trial processes and enable pharmaceutical companies and contract research organizations (CROs) to monitor participants remotely. As partially or fully remote clinical trials gain market momentum, these particularly impactful devices enable the remotely collected participant data to be integrated into a clinical trial system, patient community application or engagement platform. Researchers and clinicians are then provided with access to real-time participant data at a reduced collection cost. Clinical devices are instruments, implements or machines intended for use in the diagnosis of disease or monitoring of conditions. Examples of commonly used in-home clinical devices include blood pressure cuffs, blood glucose meters, sleep tracking devices, spirometers and weight scales. Three factors have led to the increased usage of these devices in clinical trials. First, the escalating competition caused by new entrants providing in-home clinical devices has led to better usability and accuracy from all vendors. Second, as evidenced by the specialized digital health displays in retail stores like Target, consumer demand and adoption of in-home monitors is growing. Third, as data from these devices has become more accessible for clinicians, the value of utilizing these devices in trials has increased. Delving further into the increased value of real-time connectivity, the previous lack of device connectivity in the market placed a substantial burden on trial participants and researchers required to routinely collect data. Previously, patients were required to either manually record the readouts or take the device to a trial site for the data to be downloaded by a clinician. This made conducting effective remote clinical trials nearly impossible; mandating participants to self-report data multiple times a day is not only an inefficient means for data acquisition, but it also greatly heightens the risk of incomplete and inaccurate data being provided to researchers. Today, however, devices are becoming increasingly connected via Bluetooth Smart technology or application program interfaces (APIs). This growing device connectivity is enabling data to pass wirelessly in real-time from a blood pressure cuff, for example, to a smartphone and into the clinical trial’s platform or system. Unfortunately, some widely-used legacy devices remain unconnected. To bridge the gap, new data capture technologies have been developed to quickly digitize biometric readings from non-connected devices. Validic’s VitalSnap, which leverages optical character recognition (OCR) software, enables participants to capture health data via their smartphone’s camera from non-connected medical devices and automatically transfer it to a clinician. This provides researchers with the ability to access data from devices that are already clinically validated and being used in the trial.   As clinical devices continue to mature and are integrated into the connected health ecosystem, they will become an increasingly vital component for creating better results for both clinical trial participants and sponsors. Regulators expect clinical devices that generate these data to meet certain standards, therefore most are FDA-approved Class II devices that follow the 510(k) pathway. And, the data generated by these devices are generally accepted in clinical trials. In-home clinical devices are already benefiting and supporting trials today. As data is delivered in more real-time, there is less need for participants to spend time at sites. Additionally, in-home devices allow for more frequent empirical data to be collected throughout the trial. Utilizing the increased number of readings, additional correlations can be drawn from patient-reported outcomes, resulting in less uncertainty and more confident results. In summary, connected in-home clinical devices are allowing for more passive data collection that enables participants to have a more active and engaged role in clinical trials, leading to better results at a lower cost.

Practice Fusion veterans, including former chief executive Ryan Howard, on Tuesday announced a new company called iBeat. The startup is working to create a device that will continuously monitor a user’s heart activity, the company said. Howard called the emerging offering a wearable-as-a-service. The tangible device resembles a wrist-worn smartwatch capable of alerting the user as well as caregivers and emergency responders should a heart event or irregularity occur. iBeat also consists of Larry Stone as Lead Front-end Architect, Brian Boarini as Director of Product, and Kristin Tinsley as Director of Marketing and Communications. All four previously worked at Practice Fusion, which Howard founded in 2005. Stone has worked on products for Lenovo, Tesla, Disney, AT&T, Verizon and other companies, while Boarini worked on projects at Google and Tinsley worked with MySpace and TigerText. The company said it intends to double its staff by year’s end with a focus on engineering, design, growth marketing and operations.  Twitter: SullyHIT Email the writer: tom.sullivan@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Proponents of virtual care say it is the wave of the future. But while the healthcare industry might not find much disagreement with the practice in theory, it is in the potential limitations that skeptics might find flaws.

The platform has the potential to create a national virtual healthcare system, American Well chief Roy Schoenberg says. 

Veterans Affairs Under Secretary for Health David Shulkin said it will establish the centers this summer in South Carolina, Utah, Pennsylvania and the Pacific Northwest. 

The new deal is part of a larger initiative to transform Penn State Health into a hub of telehealth services that cater to patients in Central Pennsylvania. 

(SPONSORED) There is an unprecedented convergence occurring between healthcare and technology – and telemedicine is an increasingly important initiative in the connected health market.

Getting pharmacists involved in patient-centric activities, including being part of clinical care teams, is a little easier thanks to telepharmacy technology. When Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, needed to optimize its pharmacy workflow with the goal of improving patient care, it turned to PowergridRx, a cloud-based HIPAA–compliant telepharmacy platform from San Francisco-based PipelineRx. Starting in February, Dartmouth-Hitchcock began deploying PowerGridRx in its hospitals across New England. PowerGridRx is a software as a service platform that aggregates, manages and optimizes virtual pharmacy management for health systems. In addition, it differentiates Dartmouth-Hitchcock's telepharmacy network and manages the order verification process for current and future facilities. The interoperable technology platform is designed to improve medication administration visibility between facilities and addresses logistical and budgetary challenges that arise from managing and staffing multiple care settings. [Also: Dartmouth-Hitchcock, Harvard Pilgrim join forces on population health] Sarah Pletcher, MD, medical director and founder, Center for Telehealth at Dartmouth-Hitchcock Medical Center, said the health system uses PowerGrid Rx as a tool in the delivery of telepharmacy services across wider landscape. "Our customers are the ultimate end user in that regard," Pletcher said. After going live in six hospitals Dartmouth-Hitchcock has processed thousands of patient orders: "We have data that suggests the benefit to the hospitals in that we are allowing them to load-level staffing and optimize their in hospital team sometimes deploying them to more patient care or clinical activities," she said. Pletcher pointed out that for many smaller rural and critical access hospitals, the volumes that they see on weekends for example, aren't enough to rationalize them having an in-house pharmacist. "But we are also finding hospitals recognizing the value of having telepharmacy support for scenarios where they want to allow their pharmacists to be out on the floors helping with patient care," she said. In a cancer infusion suite for instance, Pletcher explained that oftentimes pharmacists are part of clinical team working on projects where they might be involved in an electronic medical record implementation, or working on quality or formulary projects for the hospital. "Any time we can help extend their team to allow them to optimize their in-hospital team, we're happy to be there for them," she said. From a technology perspective, Pletcher noted that there are obstacles associated with integration and with host IT systems and EMRs. She said that with anything involving multiple hospital IT departments and multiple hospital EMRs, there's always a challenge – not just the technology integration, but cultural barriers where hospitals have different levels of comfort for how much bi-directional integration they want with outside software platforms. "Because we offer so many other telemedicine services this is something we are familiar with managing – the telepharmacy is the latest service – we have six or seven other 24/7 telemedicine services to hospitals where we've had to contend with IT or EMR integration. We kind of know to expect and support those conversations." Pletcher said Dartmouth-Hitchcock is expanding its telepharmacy program to more sites and more regions. "We're excited about the opportunity to further integrate our telepharmacy solutions with other clinical services." Industry insiders contend that the demand for PowerGrid Rx-type technology is on the rise for multi-site multi-facility organizations that are growing and want to tie their pharmacy network closer and closer together. "We want to create a platform that enables them to share pharmacy labor and pharmacy resources across their whole organization, opposed to having to staff individually each hospital within their network, this enables them to tie them to together," said Brian Roberts, CEO of PipelineRx. Roberts noted that among the challenges is to work with different and multiple types of IT systems. "Some of our customers have eight to ten different types of IT systems that they work with - we integrate back with their host IT systems and bring it into one platform." The other side, according to Roberts, is that they want a system that can capture policies and procedures for each one of their individual hospitals. So for example, if they were creating a central telepharmacy center they would want that telepharmacist to have information at their fingertips. "Our tool helps consolidate and bring policies and procedures into one software offering," said Roberts who added that because PowerGrid Rx is a cloud-based piece of software – there is no hardware on each individual site. "So we use the power of the Internet to build a private cloud that can manage all that information – manage the information and store the information for the hospitals." Roberts said CIOs like that because it’s a cloud-based piece of software that doesn't require them to have to go and do updates and update hardware; that's all taken care of from the PipelineRx side.