Study of medication adherence with AI-supported selfies highlights potential for clinical trials

AiCure’s tool uses a form of artificial intelligence for facial recognition to confirm that patients have taken the correct medication.

A look at the evolution of the user interface in healthcare

What are the advantages of a conversational user interface over the interfaces we’ve used for decades?

74 percent of physicians believe communication improves when patients set the agenda

What happens when patients set the agenda for their appointments by entering information in the EHR? Pretty much everybody’s happier.

Biden at AACR: “What a difference a year makes”

Former U.S. Vice President Joe Biden speaks at a signing ceremony for the 21st Century Cures Act  

Former Vice President Joe Biden took the stage at the American Association for Cancer Research (AACR) annual meeting on Monday, with a speech titled ‘The Beau Biden Cancer Moonshot: Progress and Promise.

“What a difference a year makes,” he said in his opening remarks, streamed live by AACR.

Some 15 months after the Cancer Moonshot’s launch and one year after his first AACR keynote speech, there was a lot to report back to the Washington, D.C., crowd. What a difference a year makes, indeed.

There’s a movement.

Biden is not the leader of the cancer moonshot. He’s the inspiration.

“Look, I don’t have the answers,” he said. “But you all possess the potential to generate these answers.”

Trained as a lawyer, Biden educated himself about cancer after his son, Beau, was diagnosed with a brain tumor. He later passed away. That experience didn’t give him the expertise to navigate medicine’s way to a cure. It made him passionate about it, in a way that he can serve as a focal point for the necessary people to come together.

Silicon Valley showed up, politicians on both sides of the aisle, and Nobel laureates.

“I got a call from the chairman of the board of IBM,” Biden said. “Did I want Watson, the supercomputer, to partner with the department of defense and the VA?” 

With unprecedented data sharing and collaboration, the National Cancer Institutes launched the Genomic Data Commons to pool the information garnered through The Cancer Genome Atlas (TCGA), a database of 14,000 individuals’ genomic and health records. It has now expanded to 30,000 genomes.

Amazon called, Biden said, and agreed to open its cloud-computing platform for scientists using these massive databases. Since June, the data has been accessed 80 million times by researchers around the world.

Public support has been overwhelming. There is hope once again.

“You’ve lighted a fire under the public,” he said. “They’re beginning to believe again.”

There’s a cultural shift.

“For decades, we thought we could tackle cancer one discipline at a time,” Biden told the audience of cancer experts.

It’s not enough. Cancer uses every tool, system, and pathway at its disposal. The science community needs to meet each of those mechanisms head on, by uniting immunologists, virologists, geneticists, data scientists, chemical, biological and computer engineers and more. That’s happening, Biden said. The age of individual achievements in science is over.

Since its launch, the Cancer Moonshot has seeded at least 80 new collaborations. Many government-related projects have begun, he said, bringing together unlikely partnerships between the likes of NASA and the Department of Veterans Affairs.

There’s success in Washington.

In December, Congress passed the 21st Century Cures Act, which authorized an additional $6.3 billion in funding over seven years for health-related research, including $1.8 billion earmarked for cancer specifically.

Biden had the privilege to preside over the Cures Act, he said, which achieved remarkable bipartisan support.

With the passing of the Act, Republican Senator Mitch McConnell stood up to propose that the cancer initiative takes the name of Biden’s late son. The Beau Biden Cancer Moonshot.

“Those things don’t happen very much these days,” he recalled with a lot of emotion in his voice. “There is genuine, genuine bipartisan support.”

By this stage, the speech was starting to speak to something much more than the Cancer Moonshot. Late in the Obama administration, both sides had come together to pass something worthwhile.

“This is what [the American people] expect their government to do,” Biden said.

Oh, what a difference a year makes.

One year on, President Trump has taken the White House and is outlining major cuts to the NIH, the EPA — to the entire scientific field.

“The message sent out a few weeks ago in the President’s budget is counter to this hope and the progress we’ve made,” the 47th vice president of the United States told the audience.

He didn’t hold back.

“On the cusp of saving and extending lives for Americans, the President of the United States is not only not doubling-down on our investment, he’s proposing Draconian cuts.”

Funding would be set back 15 years, Biden said. By one estimate, new grant funding would be cut by 90 percent, given the multi-year commitments that the NIH has already made.

The ex-VP doesn’t believe the budget blueprint will pass Congress. However, the message it sends has already done a world of harm, communicating that science is not valued or worthy in the United States.

What a difference a year makes.

For Biden, the Cancer Moonshot was always about two things. It needed to inject urgency into the biomedical march towards a cure while also shifting the culture towards more collaboration, passion, and hope.

“You can not turn back the clock,” he said.

Not on his watch anyway.

Photo: MANDEL NGAN, AFP/Getty Images

Digital health companies merge to launch patient engagement business serving Medicaid patients

Voxiva and Sense Health have merged to form Wellpass, a patient engagement business designed to help providers and payers send timely messages and alerts to their patient population, according to a news release. The digital health startup is led by Voxiva Cofounder Paul Meyer. The new business is the latest in a series of mergers and acquisitions that reflect the steady drumbeat of consolidation in digital health.

Wellpass includes mobile health and wellness programs Voxiva developed with a patient engagement platform developed by Sense Health. Some of those include Voxiva’s best-known programs Text4Baby for infant care and Text2Quit for smoking cessation.Those programs have resonated with the Medicaid patient population that provider and payer customers serve, with a 44 percent increase in dental visits and 40 percent boost in appointment attendance.

The company’s combined resources give it a client base of more than 30 healthcare providers, more than 70 state Medicaid health plans, and 10 state government agencies, the release said. Although Voxivia has been around since 2001, Sense Health launched in 2012 and took part in the New York Digital Health Accelerator’s 2014 cohort.

Text messaging is viewed as a more effective way to reach Medicaid patients because research indicates they are more likely to have access to email through a mobile phone rather than a computer.

Meyer said in the release that Wellpass is intended to surmount the challenges of deploying fragmented engagement and population health solutions by enlisting Sense Health’s platform for Voxiva’s messaging programs.

Several digital health groups have harnessed text messaging to boost patient engagement, such as HealthCrowd and Babyscripts, a company that seeks to prevent pregnancy complications. Digital health initiative coactionHealth, created by Centerstone Research Institute (CRI), Ginger.io and Verizon, seeks to improve patient quality of life and hospital utilization through a combination of case management, wellness coaching and smartphones.

The Wellpass deal underscores the consolidation trend in digital health, which saw a flurry of deals last month. This year Castlight Health acquired Jiff Health — a deal that closed today. By Rock Health’s reckoning, there were at least 112 digital health acquisitions in 2016, a figure that could well be outstripped in 2017.

Photo: Getty Images

The rise of oncology nurse navigators in the shift to value-based cancer care

A cancer diagnosis can be frightening and confusing for a patient. There’s where the nurse navigator comes in.

Navigators are often oncology nurses who offer individualized assistance to patients, their families, and their caregivers to overcome barriers in the healthcare system through the duration of the patient’s treatment. That might mean providing educational materials to a patient or working with a patient’s oncologists to help gain access to clinical trials. Sometimes a navigator’s tasks have nothing to do with a patient’s cancer diagnosis — like finding a babysitter. Helping patients manage their cancer care and plan for the future is quickly becoming as important as administering chemotherapy treatment for the roughly 1.68 million Americans diagnosed with cancer last year.

As of last summer, the job of a navigator became even more crucial, as Tricia Strusowski, a registered nurse and consultant with Georgia-based Oncology Solutions, explained during a talk at the Association of Community Cancer Center’s 43rd annual meeting in Washington, D.C., last week.

Advertisement

Many of the current cancer patients in the U.S. are 65 years or older and paying for treatment using Medicare benefits. In search of a new way to provide better quality and more coordinated oncology care, the Centers for Medicare and Medicaid Services (CMS) rolled out a new model for delivering care to cancer patients over the summer last year. The Oncology Care Model (OCM) is a five-year model being tested through June 2021 with nearly 200 physician groups and 17 payers. The goal: Better care, smarter spending, and, ultimately, healthier patients.

One of OCM’s hallmarks is that all the participating practices, as well as the CMS, have committed to providing enhanced services, like navigation, to cancer patients on Medicare. Already some early results from several participating practices are showing the difference. At one oncology practice in Pennsylvania, enhanced services including navigation have resulted in a 51 percent drop in emergency room visits among cancer patients.

But as the role of the navigator becomes more important, so too does the means by which navigators can measure job performance. As of this year, a new set of 35 navigation metrics is available to oncology practices participating in the OCM. The metrics are a baseline, which can be used by any medical institution, and were developed in part by Strusowski, — she was one of the team leaders of the Standardized Metrics Task Force of the Academy of Oncology Nurse and Patient Navigators.

As the Journal of Oncology Navigation & Survivorship noted in January, the metrics set guidelines on how navigators should communicate with patients and healthcare providers to help coordinate cancer care, “evaluate professional practice and care delivery and measure the impact of navigation.”

During her talk, Strusowski mentioned that the metrics will not only help demonstrate the value of navigation, but will also help meet the OCM program’s overall goal.

“The navigator needs to stay one step ahead of the patient,” she said. “And how can you enhance the patient experience when we don’t know what to measure on our navigation programs?”

Photo: PeopleImages.com, Getty Images

Healthcare urgently needs a Copernican Revolution

The year 1543 A.D. will forever be celebrated as a sentinel time in the annals of science.  In that year, Nicolaus Copernicus, a Polish mathematician and astronomer, published his model of the universe and theorized that it was the sun, not the earth that was at its center—a remarkable, if not heretical, revelation for the time.  To his contemporaries, this represented an unconditional inversion of common perception; but one that which offered a new and simplified framework and sparked the scientific revolution.  In our view, the health care industry is now currently embarking on a similarly a radical “Copernican Revolution.”   Fueled by advances in digital technology and associated cultural changes, we are in the midst of experiencing a paradigm shift from a predominantly provider-centered to a customer-centered model. Yet, despite the strong evidence of this shift and technology’s power to transform business models in other industries, many healthcare leaders are having difficulty coping with this change.  Some in fact are doing all they can to hold onto the past.   But little can be done, after all, to halt this on-coming tsunami.  Today’s digital platforms and networks will indisputably herald the success of this much-needed revolution.

In January 2016, Community Catalyst, a national consumer health advocacy organization, launched the Center for Consumer Engagement in Health Innovation.   At the conclusion of the program, Amy Berman, senior program officer for The John A. Hartford Foundation, summarized the Center’s policy priorities with these incisive comments:

We live in a pre-Copernican model where all of the planets float around the healthcare system; the patient is just one of them. What we need is a shift…an entirely new frame, and this will shift everything when we do it…we need the patient at the center. We need to put the sun where it belongs.

However, we have a very long road to travel before we truly achieve patient-centered healthcare, where individuals become the authorized keepers of their health using digital platforms and networks, just as customers are empowered in other industries using Uber, Airbnb, Amazon, Facebook and LinkedIn.

We only have to look inward to see that this is true.  As busy Orthopedic Surgeons specializing in Total Joint Replacement surgery, two of the authors frequently evaluate 40 – 50 patients in a day.  Here is the typical experience of these valued customers with our healthcare system today.  They phone our office and navigate our multilayered phone system for an appointment “on premise”, a physical space remote from their home. They wait weeks or even months for the visit and are obliged to take time away from their work or other important activities to be conveniently fit into our 8 a.m. – 5 p.m. schedules.  If a last minute surgical emergency or other scheduling conflict arises, it is not unusual for the long awaited appointment to be pushed out another few weeks. Once the customer arrives at the office, they wait until being called up to the window by a receptionist with the dreaded, “can I have your insurance card and can you please fill out these forms.”  The forms request pedantic information such as “what is your chief complaint” and redundant data that the office already has at hand—name, date of birth, primary care physician and so on. The patients then wait in the waiting room, wait in the examination room, wait for x-rays, and wait for the doctor, often multiple times.  If they have had previous imaging studies, but they are not available or accessible, the same studies are usually repeated.  If prior medical records are not available or accessible the patient is asked to pick them up at another physicians office and deliver them to ours.  And after all this hassle, the preponderance of these patients present with common orthopedic conditions and eventually receive routine treatment such as physical therapy and non-steroidal medications.  A much smaller number actually will require our surgical expertise.  This tells the all too common story of the “current state” of healthcare delivery.

Now we humbly ask: is this patient-centered health care?  Is it the patient or the healthcare provider that is the sun?  Is there any other service industry on the planet that would offer their customers such a dreadful experience and have any chance of survival?  If so, we can be assured that they are just as ripe for disruption as healthcare.

But there’s more.  For decades, the modus operandi and predominant payment methodology in healthcare has been fee-for-service, a system in which providers receive compensation for offering services regardless of their outcomes.  So, the more you do—tests, visits, labs, scans—the more you earn, even if the additional activity adds no value.  This is widely recognized as the root cause for today’s highly fragmented, inefficient, wasteful, and siloed healthcare system and it is the patients who suffer the consequences.

Here’s just one example of how this commonly plays out for patients.  In our Joint Replacement practice, two of the authors have patients, complaining of hip pain, who arrived in our offices having already gone through a gauntlet of medical interventions.  They have had major lower spine surgical procedures to no avail, followed by a series of spinal injections without improvement, followed by an inguinal hernia repair and yet still had severe unremitting activity-related pain.  Only then was it determined that their primary condition, all along, was a severely arthritic hip and replacement was indicated.

Most of us have stories like this in our health history—where we bounced around through various unrelated practitioners and treatments, at great cost, effort, and stress—before finally determining the true cause of our ailment. In 2009 one of the authors developed severe burning pain and dysesthesias in both feet.  After seeing his primary care physician, he was referred to a neurosurgeon. Testing was performed and it was concluded that he had “stenosis or a ruptured disc”.  Surgery was performed but the pain persisted so a second spinal procedure was undertaken three weeks later, once again without improvement in the severe pain.  For the next 18 months, more testing was performed and the author received extensive physical therapy, various medications, and steroid injections.  The pain continued.  Finally, a neurologist confided that the diagnosis had been incorrect and recommended a consultation with a hematologist/oncologist.  More testing including a bone marrow biopsy was carried out and the diagnosis of a variant of multiple myeloma was made.  That too proved to be incorrect.  Further blood and immunological analysis finally concluded that the diagnosis was Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), an acquired immune-mediated inflammatory disorder of the peripheral nervous system.  Two and one half years after the onset of symptoms, weekly chemotherapy treatments with Rituxan and IVIG have produced remarkable clinical palliation and remission of the disease.

The toll on these patients?  Unnecessary pain and suffering and an incredible amount of lost time trying to navigate the system to find the right doctors, obtain and share their health information, and achieve the right diagnoses.  The toll on the system for patients such as these?  Millions of dollars of wasted resources.  But this inevitably happens when the healthcare universe is physician-centered.  Each provider is doing his or her best, but is limited by knowledge, connections, and perspective.  Collaboration between multiple systems and providers, often essential, is difficult and ineffective.

The system must change.  Achieving the goal of patient-centered healthcare requires two major shifts.  First, healthcare must re-design its core processes from provider-centric to customer-centric.  Second, and related, healthcare must utilize the myriad technologies that are available today in order to provide that patient-centered care without dramatically scaling up the resources required.

Utilizing technology for patient care doesn’t only mean providing care via teleconference, but embracing the wide variety of technologies that can improve a patient’s healthcare experience—including making appointments, tracking expenses, managing records, finding support, and receiving treatments.  Access, cost, convenience, and outcome can all be improved via technology.

The Institute of Medicine defines patient-centered care as: “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.”  Considering this definition and the current experience of most patients, it is clear we have a long way to go.

However, patient-centered care has become a broadly and over-used term at risk of becoming cliché.  We posit that when, not if, the health care industry truly shifts its mindset (and hence their actions!) to a bona fide customer-oriented approach using digital platforms, dramatic improvements in health care value will ensue—and costs will come down.  In his keynote remarks at the Center for Consumer Engagement in Health Innovation’s commencement, Dr. Donald Berwick said “we have enormous evidence, overwhelming scientific evidence, that when people can control their own care, the care gets better, and generally—by the way—the costs fall dramatically.”

Now the healthcare world might argue that it is different, and somehow uniquely immune to the havoc wreaked by digital connectivity and network disruption in other industries.  We disagree.   Consider the following examples where once powerful industries believed that their legacy business models were immune from digital disruption:

  • Airbnb is among the most valuable hoteliers, but owns no hotels
  • Uber is more valuable than Ford and GM, yet has no cars
  • Facebook is the world’s largest publisher with 1.7 billion editors
  • Amazon’s market cap has grown beyond Walmart’s

The good news is that some leaders already understand what a healthcare revolution will look like.  Dr. John Noseworthy, President and CEO of the Mayo Clinic, recently said, “It took Mayo Clinic 136 years to serve 20m patients per year… We will innovate to serve 200m patients per year by 2020, without building new hospitals”.   How is this possible?  Only by accessing digital technologies—including everything from teleconferencing, virtual healthcare to machine learning—can the Mayo Clinic scale its patient care at this rate.

With the writing on the wall, it’s time for those in the health care industry to follow the Mayo Clinic’s lead and ask:  What is our digital transformation strategy?  Healthcare is the largest private-sector industry—accounting for 13% of the total United States workforce and 18% of the Gross Domestic Product, and if it doesn’t transform itself soon, Silicon Valley is waiting to enter the market and bring a new, more customer-friendly experience.

In fact, there is evidence that the transformation has already begun and that digital platforms are starting to re-engineer healthcare delivery.  New online networks, such as Patientslikeme, allow communities of patients to learn from each other about their conditions and potential treatments.  New platforms, such as MotherKnows, allow patients to better access, manage, and even share their personal health records.  New systems, such as Heal, Pager, and Talkspace, allow patients to access a network of doctors over phone and video chat for remote diagnosis and care.  New technologies, such as machine learning, are changing the way diagnoses are made—IBM’s Watson now can provide evidence-based treatment recommendations for oncologists!  Slowly, healthcare is changing—from end to end.

Consequently, It is now essential that leaders in the health care universe step forward and invert their thinking and their actions to put patients at the center.  Doing this will require investing in digital platforms rather than physical platforms in order to serve patients as the center of the system.

Those of us in the healthcare industry who want to be a part of this transformation will need to do three things:

  1. Change our thoughts:  what we currently believe about health care determines the system we create;
  2. Recruit new digitally savvy leaders and board members: an essential step in all transforming industries; and
  3. Change our actions: put customers at the center and given them the information they need;

Our future is in our hands.  We must come to grips with the notion that we in healthcare are not uniquely disruption-proof and that we must invert our traditional views of the provider-customer relationship.  Other industries that have held out hope that they were immune to innovation are now losing value at an alarming rate to Silicon Valley start-ups.   We still have time to put patients where they belong—at the center, but our time is running out.  Apple, Google and Microsoft have already entered the health care industry, collectively funneling billions of venture capital dollars into this space.  We are, therefore, proverbial sitting prey.  Nigel Fenwick, principal analyst at Forrester, has said “by 2020, businesses that learn to master digital will become the predator, while those that make minor changes or don’t do anything at all will become digital prey.” For decades, we’ve been insulated from forces that have unmistakably and formidably re-shaped other business sectors. Not this time. The power of the digital network is like a tsunami. Prevailing obstacles will be overcome by this wave of network power. It’s time to move, or be pushed aside.

Health Union moves into oncology in patient community expansion

The companies that set up and manage patient communities such as PatientsLikeMe, MyHealthTeams and HealthUnlocked bridge a gap between the perspective and voice of people who live with a condition and pharmaceutical companies developing treatments for those diseases. The biopharma industry wants the insight of patient experiences but is restricted by regulatory boundaries. Pharma and biotech companies, among others, have come to rely on the data they gain from working with these companies to inform clinical trial design as well as help them gain a better understanding of what truly improves the quality of life for these patient populations.

Philadelphia-based Health Union is one of those businesses. The first of the 12 patient communities it manages started in 2010 and focuses on migraine headaches. This year, it expects to grow to 17 and has moved into oncology for the first time with the launch of a lung cancer community in January. Health Union has plans to add seven to eight more oncology groups over the next 18 months, according to COO Lauren Lawhon. Among the groups it is planning to add this year are ParkinsonsDisease.net (April), SkinCancer.net (June), AtopicDermatitis.net (July), BladderCancer.net (October), and
ProstateCancer.net (November).

Health Union has partnerships with more than 20 biopharmaceutical companies, including eight big pharma businesses.

Advertisement

Olivier Chateau and Tim Armand cofounded Health Union. Chateau, the CEO, worked in pharmaceutical marketing for several years and Armand, the president, worked for a big pharma business. I visited their offices on 12th and Sansom as the company hosted a forum for the patient advocate contributors that write for its patient communities, some of whom also serve as moderators for the ongoing discussions within them.

“There’s a perception that patient communities don’t have scale. We think of this as small niche opportunity but over time we reach a large number of patients,” said Armand. “It’s on a larger scale than people’s initial impressions.”

As you might expect, trust is a critical component of these communities, which combine first-person narratives from contributors, who are paid as independent contractors, and people who have a condition in common. They provide a forum for exchanging information on coping rheumatoid arthritis or lung cancer, for example, from diagnosis, treatments and their side effects, the emotional struggle of living with the disease, to the experience of taking part in a clinical trial. Contributors share posts that can take the form of essays to poetry. These kinds of interactions can reduce the social isolation and stress of managing these conditions.

The patient community network does periodic surveys of their members to improve the quality of interactions and get feedback for ways to enhance the overall experience. Health Union generates income from pharma companies by making some of the de-identified data from these surveys available to them. Customized market research, advertising and sponsored content also bring in revenue and over the years the cofounders say they have learned how to balance the needs of advertising with the needs of their subscribers.

Initially, the company didn’t display advertising in its communities at all, which made community members suspicious of how Health Union generated revenue. That’s just one of many items the company has learned over the years. One no go area for ads are pages in which contributor entries highlight the benefits or unpleasant experience of taking various drugs or treatments for their condition. Lawhon noted that it also doesn’t permit pharma companies to contact contributors.

“We measure the success of these communities not by the number of people we drive to the website but by the number who come back — 35 percent come back,” Chateau said. “In return, we give them opportunities to interact with other patients and participate in clinical trials.” 

Tamara Haag, a contributor with rheumatoid arthritis, said she likes being in a position to make a difference for others with RA.

In addition to being a contributor, Haag also serves as a moderator for the RA community, which offers its own set of challenges in a space where no one has a monopoly on pain and suffering and raw emotions occasionally rise to the surface. Haag said her job is creating an environment where participants feel safe and she’s learned how to communicate more effectively both in the RA forum and her day job.

“Getting to have a perspective in a community where readers feel validated and supported is very fulfilling for me,” Haag said.

Photo: DrAfter123, Getty Images

5 healthcare trends impacting cancer care

Lindsay Conway, a managing director of The Advisory Board Company. Photo: Andrew Zaleski

Five big trends will shape the business of cancer care in 2017, according to Lindsay Conway, a managing director of The Advisory Board Company in Washington, D.C. As part of the company’s Research and Insights division, she conducts research for The Advisory Board Company’s Oncology Roundtable on topics such as the effects of healthcare reform on cancer patients and cancer-care providers.

At the annual meeting of the Association of Community Cancer Centers this week, Conway talked about trends impacting cancer care, some of which I’ve highlighted.

Reimbursement and reform are at a turning point.

Advertisement

The healthcare industry is “continuing to grapple with how to deal with cost,” Conway said, something that will “remain true regardless of what happens in Congress.” As healthcare repeal, reform, and replace continues to be debated by D.C.’s lawmakers, the question then becomes: What happens in the interim that will drive high-quality cancer care at a lower cost? Conway said private payers can do their own reform. She added that private payers are increasingly aggressive about pushing cancer patients to lower-priced care. Instead of paying for infusion therapy at the hospital, for instance, private insurera may suggest having it done at an outpatient facility. Still, Conway’s message was cautionary. “Private payers have been on the forefront of designing value-driven ways to pay for cancer care, but we’re not going to arrive at a satisfying payment solution any time soon.”

Enhanced care navigation will be necessary as cancer patient comorbidities increase.

Cancer care programs need to worry about the services cancer patients are using across the healthcare system as they’re going through cancer treatment. As Conway said, roughly 22 percent of Medicaid patients are also dealing with ailments like diabetes, COPD, and heart disease. Citing an example from the University of Alabama at Birmingham (UAB) Health System, Conway said that enhanced navigation services are the answer to an increasingly comorbid population of cancer patients. Over the last decade at UAB, a new approach has taken shape, where care navigators work exclusively with high-risk patients and focus time on activities that might generate cost-savings. (Checking to make sure a patient is taking their medication, for instance.) The results Conway shared were huge. Of the patients in the UAB Health System who received navigation, there was a 58 percent decrease in hospitalizations. That equates to $4,000 in savings per patient to Medicare, or a total of $54 million in savings to Medicare across all patients over a two-year period.

The rise of telehealth in cancer care 

Virtual care, through smartphone app or over the Internet, can reduce costs and increase access. Virtual consultations, Conway said, will increase 60 percent by 2020. They’re gaining traction now for two main reasons: value-based payment, and the ability to quickly and easily do things like monitor patients at home remotely. Conway cited the University of Michigan’s Breast Cancer Ally app as one of the revolutionary models of virtual care currently in use today. Oncologists introduce the app to patients once they receive their diagnosis, and then the patient and oncologist collaborate to enter pertinent information into the app. From there, the app takes over, providing information, for example, about treatment options or instructions on recommended exercises to perform after surgery. As Conway said, the app serves the dual purposes of virtual care: improving patient education and a patient’s ability to make complex decisions about their breast cancer treatment in consultation with their oncology team.

Patients are acting more and more like consumers.

Patients have increasing expectations for service, convenience, and coordination of their care,” Conway said. Learning about providers and treatment options is getting easier thanks to the wealth of information available online. Even for patients who don’t have Internet access, a friend or family member usually steps in to direct and help out with online research. Perhaps most surprising: Online reviews cancer patients read on websites like Zocdoc and Angie’s List are more persuasive than experiences shared by friends or family members. Conway said 69 percent of cancer patients in a recent survey said they’d be inclined to switch care providers if they read a negative review online.

Navigating precision medicine

A variety of key innovations are revolutionizing how oncologists are treating cancer. How much of a dent those innovations, like hormone therapy and next-generation sequencing, are making all depends on how widespread they are. (The former is almost standard practice, whereas next-gen sequencing — capturing genomic information about a cancer — is still being perfected.) But as precision medicine becomes more prevalent, cancer care organizations will need to navigate three challenges, Conway said: how to make sense of new developments in precision medicine; how to prioritize investments in new medical equipment and facilities; and how to operationalize their approaches by making sure key care providers receive ongoing and up-to-date education. “We are all betting big on the promise of precision medicine,” she said.

Digital Pharmacist acquires rival app to accelerate pharmacy services product development

A digital health business formed from the merger of RxWiki and TeleManager Technologies in January has made its first acquisition, according to a news release. Digital Pharmacist acquired PocketRx —an app that’s designed to help community pharmacists enable their customers to better engage with pharmacists. The deal will help Digital Pharmacists speed up product development and consolidate their products and services into one app.

Alan Stickler, Digital Pharmacist Chief Technology Officer, shared some information about the deal in a phone interview.

The financial terms of the deal were not disclosed.

Stickler said the deal would support Digital Pharmacist’s efforts to provide a more personalized service to pharmacists and their own customer base. Customers use the app to track their own medications and refills. But for community pharmacists, the services are designed to give them access to resources that most pharmacists lack compared with the likes of CVS and Walgreens. Pharmacies use the app to improve their marketing reach and give them better insights on the needs of their customer base.

As part of the acquisition deal, Digital Pharmacist is acquiring the app from software developer Praeses. Robert Terrell, product manager for PocketRx, has joined Digital Pharmacist as product development director. Praeses will also give software development and support for Digital Pharmacist.

Stickler estimated that a fully consolidated app would be ready by the end of the second quarter or the beginning of the third quarter.

The acquisition of PocketRx follows a string of digital health acquisitions last week and the consolidation that has been happening across healthcare, particularly in the pharmacy sector.

Photo: Nicols Meroo, Getty Images