Jefferson Health taps Teladoc for telehealth needs

Purchase, New York-based Teladoc is making moves in the telehealth space.

Jefferson Health in Philadelphia recently went live on Teladoc’s telehealth platform.

What prompted Jefferson Health to handpick Teladoc as opposed to another vendor? “Many of the other vendors were not designed the way Teladoc was,” Dr. Judd Hollander, the associate dean for strategic health initiatives at Thomas Jefferson University’s Sidney Kimmel Medical College, told MedCity in a phone interview. Instead, it was designed with health systems in mind, he pointed out. “The advantage is they have a platform that does what we need to do,” Hollander said.

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Dr. Alan Roga, president of Teladoc’s provider market, echoed that sentiment. “We understand the unique needs of hospitals and health systems and have developed a purpose-built telehealth solution specifically for them,” he said in a statement.

The Teladoc system is now part of Jefferson Health’s existing telehealth program, JeffConnect. But the new go-live doesn’t mean JeffConnect has disintegrated.

“JeffConnect still exists. It’s the brand of our program,” Hollander said. “We’ve changed nothing about JeffConnect. We’ve added the Teladoc platform, which is branded as JeffConnect, to that.”

JeffConnect, which includes inpatient care, outpatient care and transitions in care, enables patients to connect with physicians via phone, computer or tablet. Using JeffConnect, patients can see a physician in a variety of different ways. They can connect with their physicians 24/7 through on-demand visits. Patients can also schedule video visits or use the remote second opinion option to get additional thoughts on their care.

Whereas other hospitals and health systems outsource some of their telehealth visits to other providers, Jefferson Health does not. That’s what sets JeffConnect apart — patients always see a Jefferson Health physician, Hollander said. “That’s really unique about JeffConnect,” he said. “We believe our patients want to know that when you call Jefferson, you get Jefferson. We’re able to do that on this platform.”

And JeffConnect’s services aren’t limited to a certain physician specialty. “If you have an appointment, you can have it with every type of specialty at Jefferson,” Hollander said.

Though the price of a JeffConnect visit varies depending on one’s insurer, an on-demand visit currently costs $49.

Working with Teladoc and improving its JeffConnect platform aren’t the only things Jefferson Health is doing in the telehealth field. For one, it’s developing the National Academic Center for Telehealth, a hub focused on the intersection of technology and healthcare. Jefferson Health is also training medical students and residents in telehealth.

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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.

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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.

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Which health tech startups made the cut in Dreamit Health’s latest cohort?

Cybersecurity for medical devices, remote monitoring for earlier detection of diabetic foot ulcers and improving patient transportation to reduce missed medical appointments are some of the priorities for Dreamit Health’s latest cohort.

There are also a couple of changes to the program this time around, Seth Berk, Dreamit Chief Marketing Officer and Partner, said in an email. The management teams for the eight participating companies will spend more time in Philadelphia — about half of the 14-week program. Also, Dreamit will open up its entrepreneur seminars to the entire Philadelphia startup community. Among the topics these presentations cover are honing elevator pitches, customer feedback, and finding and working with investors.

The accelerator, with local partners that include University of Pennsylvania Health System and Independence Blue Cross, includes eight companies this year. Here’s a summary of them based on an announcement obtained from Dreamit.

Biorealize, whose founders Orkan Telhan and Karen Hogan teach at University of Pennsylvania, produces low-cost tools for designing and growing organisms for biotech applications. Its flagship product makes the process of designing, testing and monetizing biology at the bench and field more accessible.

Bluedrop Medical is developing a smart, home-based remote monitoring system capable of the early detection and prevention of diabetic foot ulcers. Advanced algorithms monitor daily foot scans to detect diabetic foot ulcers before they develop, providing actionable alerts to both patient and provider.

Citus Health has a suite of workflow automation and remote patient support software solutions that makes home healthcare less cumbersome and stressful for patients, while enabling providers to more cost-effectively deliver superior patient support and better patient outcomes.

Cylera is a cybersecurity company that helps healthcare organizations and their patients by guarding against cyber-based threats to medical devices, such as data breaches, and ransomware.

Group K Diagnostics is a rapid, paper-based diagnostic system, providing multiple results from one patient sample within 30 minutes or less at the point of care. The modular system, which claims to be low cost, can currently combine up to three different tests and can be read via a smartphone app, desktop app, or comparison paper guide, allowing the test to be conducted in any setting.

Kaizen Health developed a platform to connect health systems and transportation fleets to make patient transportation more efficient.

Marmo Health has a patient support service delivered through ultra-personalized peer groups in a mobile phone messaging app with coach-led education programs and natural language processing.

Tine Health‘s mobile platform augments medical devices with Just-In-Time training and compliance tracking for front-line healthcare providers. Pilot studies have demonstrated over 50% reduction in error rates, generating additional revenue for hospitals.

Photo: plustwentyseven, Getty Images

Report: Information management in EHRs tops patient safety concerns (Updated)

This post has been updated with comments from William Marella, ECRI Institute executive director of Patient Safety Organization Operations and Analytics and Lorraine Possanza, ECRI Institute program director, Partnership for Health IT Patient Safety.

The steep learning curve the healthcare industry faces in adopting new technology combined with the wide adoption and implementation of electronic health records have made EHR issues a regular feature on ECRI Institute’s annual top 10 list for patient safety concerns. The list highlights healthcare technologies associated with the most adverse events or, more frequently, near misses jeopardizing patient safety and what can be done about them.

This year, information management in EHRs made it to the number one spot on the top 10 list, according to an ECRI news release. The development suggests there’s an urgent need for better training on these EHR systems or at least make it easier for the correct information to be entered and viewed.

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Information management in EHRs is a pretty broad category, but ECRI Institute’s William Marella said it’s at the heart of many of the adverse events the institute has seen. Marella, the executive director of Patient Safety Organization Operations and Analytics, said in an emailed response to questions.

“When clinicians don’t have access to complete information, or when the information isn’t timely, or it’s inaccurate, it can have real consequences on the quality of care a patient receives. For example, we’ve seen cases where allergies are listed in the header of the EHR, but the space only accommodates one or two allergies, while others are visible in a pop-up window only if the user hovers over that space. We’ve seen cases where drugs are listed in a drop-down pick list, and the names are truncated so the user doesn’t know if they’re ordering a standard formulation or an extended release version.”

Marella offered another example from the report — a drug overdose.

“The patient’s current weight wasn’t available to the pharmacist because the interface from the EHR to the pharmacy system was pulling from a field that wasn’t updated. It could also be because the info was not updated or was not visible.”

The report recommends having members of health IT management and health IT workers play a bigger role in patient safety, quality, and risk management programs. Other strategies include encouraging staff who use the EMR system to report concerns.

Lorraine Possanza, an ECRI Institute senior patient safety, risk, and quality analyst and health IT patient safety liaison, noted in the report that it’s not enough for hospital staff to know how to use the EHR system. They need to know what it is capable of.

Do users know which information is available to them? Do they know which information transfers to other systems? Do they rely on information in the record? Do users know what to expect—for example, do they know whether the most recent lab result appears at the top or bottom of the list?

Marella noted that better system testing of hospitals’ EHR systems could avoid many of the adverse events he cited in the report but this but unfortunately this often isn’t treated as a priority due to resource constraints.

The goal of EHRs — to make it easier to share patient records and identify patient’s needs — is also what has the potential to create pitfalls when the wrong patient information is entered. Health information needs to be clear, accurate, up to date, readily available, and easily accessible, the report said.

Clinical decision support is supposed to guide care teams to make better choices for the patient’s benefit, but if a system produces too many alerts, or don’t produce that insight when it is needed, that can undermine the effectiveness pof these products.

The report recommended that a multidisciplinary team of healthcare professionals oversee CDS to ensure that users have the training they need and that the system is tested properly.

Also, since each healthcare facility is different, these multidisciplinary teams should also address basic questions such as when CDS alerts are triggered, the patients this should be used for and other critical factors controlling the use of this tool.

Another issue that should be considered: Should the CDS alert be structured so that providers need to do something before they can proceed?

Asked in an email to share her thoughts on what hospitals should look out for regarding EMR implementation, Possanza cautioned institutions not to use EMR and EHR interchangeably.

“The EMR is the limited record that was typically limited to one practice setting, and the EHR is the record that becomes available in multiple settings—the hospital, the ambulatory setting, the long-term setting, for health information exchanges and for patient portals. Best practices include understanding and using your system to its capacity, using the tools that are available to you.”

Other concerns outlined in ECRI’s list include:

  • Unrecognized patient deterioration;
  • Test result reporting and follow-up;
  • Antimicrobial stewardship;
  • Patient identification;
  • Opioid administration and monitoring in acute care;
  • Behavioral health issues in nonbehavioral health settings;
  • Management of new oral anticoagulants;
  • Inadequate organization systems or processes to improve safety and quality.

Although these reports are aimed at hospitals, I hope healthcare startups are paying attention, because this list of pain points in healthcare settings and what needs to be done to improve them is exactly the kind of insight they should be applying to their businesses.

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