Category: Health

2023 was a banner year for MedTech, especially in terms of technological innovations. Incidentally, it also witnessed the largest ever number of FDA approvals on novel medical devices in a single year. This list included a number of AI-enabled MedTech products, among others. 

These approvals come as a strong nod to digital care delivery that is focused on driving positive outcomes for patients. Earlier this month, a new AI tool that helps doctors spot early signs of heart failure received FDA clearance – showcasing developments solely aimed at improving quality of care have picked up pace since.

MedTech firms must continue capitalizing on this progress as personalization and digital transformation is no longer an afterthought. 

The path ahead will be defined by technology that ensures faster, more intuitive, inclusive, and secure care at affordable costs. 

Nurturing tomorrow: Redefining patient experiences

As the market evolves, MedTech firms are pressed to keep up with the changes afoot for competitive edge and business growth. The early mover advantage will be a crucial factor here as the heat intensifies. Three key areas are continuing to shape the industry: 

1. IoMT for connected care 

Delivering personalized care is the need of the hour, and MedTech leaders are turning to intelligent devices and AI-powered, cloud-first platforms to fulfill this. For instance, many providers are adopting intelligent devices equipped with smart sensors that can accurately relay patient data in real-time to an AI-enabled, cloud-first application for remote patient monitoring. 

The Internet of Medical Things (IoMT) is a transformative technology that allows healthcare providers to deliver remote care using connected medical devices and software that transmits patient results online. 

IoMT allows physicians and experts to analyze data in real-time to provide optimized patient care through informed decision-making and timely interventions. This is especially true in today’s scenario, where chronic diseases are straining already limited medical staff and resources. 

Thus, IoMT offers a potential solution by enabling effective and affordable remote patient monitoring while significantly reducing the response time in emergencies. Integrating AI further improves the process.  

However, MedTech firms must approach this issue cautiously to uphold the security, safety, and reliability of sensitive data and device compliance.

2. AI, the better care ally

AI, and more recently GenAI, presents a plethora of opportunities in medical imaging and chronic disease management. Here, data is the key. 

For instance, several medical players are integrating AI systems with medical devices such as colonoscopy equipment to scan every image taken during the procedure in milliseconds, flagging potential lesions. The AI system can sift through tremendous amounts of data to provide insight-driven care and significantly improve the chances of early detection of colorectal cancer. This is just one example of AI transforming healthcare by empowering MedTech advancements. 

Besides, AI algorithms can analyze vast amounts of patient data, including medical history, genomics, demographics, and lifestyle choices collected by MedTech devices. This helps to personalize the treatment by recommending medication, diet, and exercise regimes tailored to the patient’s unique genetic markers and lifestyle factors.

3. Digital platforms for accessible care delivery

Patient care has reached beyond the four walls of the hospital. Through continuous monitoring, virtual hospital wards and e-clinics powered by wearables, AI-powered cloud platforms, AR/VR, and connected devices are set to reduce in-patient visits. Recently, the FDA cleared a digital clinic that leverages virtual reality (VR) and augmented reality (AR) technology for at-home therapy. 

Digitally equipped platforms like this can be used by hospitals, critical care centers, and rehabilitation centers to tackle a wide range of mental, physical, and occupational health challenges, including chronic pain, anxiety, fibromyalgia, and even dementia.

Delivering future-forward care

As the MedTech industry enters the next phase of digital evolution, it’s important to diversify the perspective – and think of accelerators like GenAI, cloud, and IoMT as tools for enhancing patient care and engagement. This will also aid providers and payers, who will now benefit from intelligent workflows, connected data streams, and preventive interventions, ultimately reducing costs and administrative burdens.

This synergy between payers, providers, and MedTech firms will also have a significant impact on public health. Cloud-based technologies and IoMT devices can facilitate remote patient monitoring and telehealth consultations, expanding access to care for individuals in underserved areas or those with limited mobility. 

Moreover, AI-powered tools can determine potential health risks and enable early disease detection. This allows for preventative measures that can be rolled out before a condition progresses – leading to a healthier population overall. 

To conclude, the digital transformation of MedTech will result in improved collaboration between stakeholders, paving the way for an interoperable and patient-centric ecosystem.

Photo: marchmeena29, Getty Images

Dhaval Shah, Executive Vice President and Market Head, MedTech, at CitiusTech, is responsible for developing the vision, capabilities and solutions for partnering with leading healthcare and life sciences organizations. He has more than two decades of experience in healthcare IT, including senior level roles in engineering, research, software development and IT architecture and management roles serving pharmaceutical companies, physician practices and health insurance companies.

The story didn’t make national news. But as a pharmacist, it spoke to me on a visceral level: Ohio’s Board of Pharmacy fined one pharmacy for $250,000 in February, citing a 2021 investigation that revealed understaffing, unsafe storage for medications, 10 cars in the drive-thru with not enough staff to service them, and the fact that the pharmacy was 30 days behind in filling prescriptions. 

Imagine not being able to fill your prescription for 30 days. What if the prescription was your mom’s? Your kid’s? What about patients with chronic conditions, or transplants, or cancer, or those who may need daily medications to live? This one fine levied at this one pharmacy is living proof that all the margins in the prescription drug industry have been so eroded that the healthcare ecosystem is running on a skeleton, with patients left holding the empty prescription bag.

Much has been made of how we’ve gotten here, with blame spread to the pharma manufacturers, the pharmacy benefit manager (PBM) middlemen, vertical integration and monopoly power of conglomerates, and more. But the question is: How do we move forward?

The answer: We must realign the financial incentives and democratize access through data sharing. Pharma needs to lead the charge, but employers and pharmacies must also be agents of change. Here’s how we can do it.

Realign financial incentives by connecting pharma and employers directly

There’s a reason the Big 3 PBMs own more than 80% of the market and are in the Fortune 25. It all comes down to the money. Pharma shells out billions in rebates, but those billions are not offsetting the cost of their products, so where does it go? Though employers do receive a portion of the rebates, PBMs and their Group Purchasing Organizations (GPOs) typically keep part of the rebates, and/or add admin and data fees to the rebates that they then pocket. It is estimated these fees can total up to about 5-11% of the WAC, or Wholesaler Acquisition Cost. These fees have nothing to do with the actual cost of the drug – and are incremental to the administrative fees that PBM’s may charge employers for managing the same benefit services.  

Additional practices of PBMs to hold on to profits are well established by now and under scrutiny from regulators. But let’s boil it way down: Pharma knows what they pay in rebates. Employers know what they spend on drugs. But these two healthcare players are disconnected from each other by the PBMs, who obscure the flow of money in their contracts. Pharma and employers have no way to reconcile their spending to know – are we getting a good deal? A competitive one? A fair one? Without the receipts, no one can tell. 

Free the data to understand the real cost of drugs and improve outcomes

Speaking of receipts: The PBMs rob us from a lot, but one of those things is knowledge. They are the masters of the data, and they obscure it in their complicated, confusing contracts. Even if an employer becomes an expert in contract language, there are so many loopholes and loose definitions that the PBMs can get around almost anything. The system is PBM-created, and they know how to game it.

Without the data – the cost information, what was paid to the pharmacy, the utilization of the drug, the success of the drug, more – we can’t really change anything about the system. But when we know better, we do better. A new prescription drug system must connect the data from the pharmacies to the claims at the prescription level, returning that data back to employers, pharma, and centers of excellence so that all players know the outcomes. Freeing the data creates an informed view for patient care, which helps impact health outcomes.

The solution: Bring the players together on a direct pharma marketplace

These issues are the side effects; the root diagnosis is a broken system. So to make change, we have to attack the core issue. Pharma should seek alternative market-access channels that allow them to control the price of their product in-market. That channel has to decouple fees from WAC and transition to transactional-based fees. 

In a new direct pharma marketplace, pharma can contract directly with employers, finally controlling their price in-market while having the data to understand the true cost of their therapies. Without the legacy PBMs in the way, think of the possibilities:

• Pharma can reestablish a direct relationship with patient-members; access real-time data on product adoption, utilization, and medication success to help develop products and services in a more informed manner; and capture higher gross-to-net profits, which allow for the R&D that will cure the next disease.
• Employers can actually know what they’re paying for prescription drugs and focus on a lowest net cost approach to pharmacy benefits. 
• Pharmacies can end the reimbursement games that PBMs play and, to bring it back to that Ohio fine, afford to staff appropriately without the financial threat of bankruptcy.

Let’s go back to the beginning. At that Ohio pharmacy, there were real patients who probably couldn’t get their prescriptions for 30 days. In a broken system, the patient pays the ultimate price.

But in a simplified, connected, sustainable, financially aligned marketplace, the patient benefits from a simplified process, greater access to prescriptions, more options to pay, and a transparent experience that empowers them to become full consumers of their healthcare. 

It will take all healthcare players to get in the boat and row in the same direction. But it’s worth it to impact even one patient’s ability to understand, fill, afford, and adhere to their prescription. Pharma can’t – and shouldn’t – do it alone. But we can do it together by operating in a new marketplace that aligns incentives and simplifies the prescription process.

We can do this. We must. Or else healthcare will become unaffordable for everyone.

Photo: cagkansayin, Getty Images

Kelcey Blair leads Prescryptive Health’s strategic and business development relationships with pharmaceutical companies, developing transformative access channels and innovative business models that disrupt the current pharmacy industry. She has more than 20 years of experience in pharmacy, working on the retail, specialty, PBM, and health services sides. During her time at Express Scripts, Kelcey led Clinical and Trend Solutions where she was responsible for initiatives to maximize patient health outcomes, utilization management programs, and Medicare Clinical Programs. Kelcey is a registered pharmacist and holds a BS in Pharmacy from St. Louis College of Pharmacy, and a Doctor of Pharmacy degree from Massachusetts College of Pharmacy and Health Sciences, Boston.

In a discussion led by Aneesh Chopra (former U.S. CTO and president of CareJourney), executives from leading health systems and health tech organizations explored the gaps between consent to share protected health information (PHI) and the complex workflows impeding interoperability, and how companies such as Docusign are addressing them. It also contrasted the ideal for these tasks with a bracing snapshot of the reality providers contend with, particularly in the areas of substance use disorders and mental health care.

Panelists on the webinar include:

• Michael ‘MJ’ Jackson, VP & Global Head of Industries, Docusign
• Angie Bass, Chief Strategy Officer, Velatura
• Natalie Spivak, Chief Information Officer, Southwest Michigan Behavioral Health
• Joseph Wager, Technology Project Manager, Mid-State Health Network

For example, Form 5515 in Michigan captures patient consent  for sharing behavioral health information between clinicians and other service providers. But as Spivak explained, care coordination is still often a challenge as her organization seeks to effectively treat a population that is disproportionately combatting multiple complex issues simultaneously, including substance use disorders, homelessness, income instability, recidivism, and more. So the current reality of obtaining and managing consent in order to implement patient-centered care in a compliant way is a time-consuming process.

Docusign and Velatura, the commercial arm of the Michigan Health Information Network (MiHIN), are addressing these data consent gaps in healthcare in a pilot program to reduce burdens in electronic consent management.

Bass noted that a repository enables the storing of eConsent with the provider, a copy that can now be sent to the patient who signed it, which is easier than the provider having to print off or electronically send a copy as an attachment. That represents automation that doesn’t exist today.

Docusign created a much more automated and scalable approach to collecting a consent form with an active care relationship that’s consumer directed. It involves transforming what can be a labor-intensive process into a seamless digital authorization model. Docusign envisions a multiphase approach to rolling out the program.

Jackson provided an overview of how Docusign’s new Intelligent Agreement Management platform streamlines the eConsent and ID verification process.

Before the digital signature is obtained, Jackson noted, the process of importing data from back-end systems can be automated, reducing the amount of manual entry required, which can often lead to errors.

“We can also insert a step that requires identity verification. If you are working with a highly sensitive workload or data sets like PHI, before the recipient is prompted to sign, we can require that individual validate his or her government ID by holding it up to their smartphone. The platform will check for embedded watermarks, the issue and expiration dates, and it will check against the database of the issuing entity to ensure that those aspects are valid. Then it will assess your picture on the government ID and compare it to your live image when you turn the camera on yourself to ensure that you and the image represented on your government-issued ID correspond individually. That all happens before the electronic signature is captured; and then A.I. can be leveraged to present insights from the repository of signed agreements afterwards.”

“We can take care of securely routing the signed consent form to all of the designated providers. We can also ensure that, if another recipient should be added later, the process may be effortlessly modified n farther downstream as well. So we’re exponentially improving the ways that many of our existing customers will leverage Docusign.”

To listen to a recording of the webinar, fill out the form below:

HLTH has worked to cultivate a compelling series of discussions around health insurance practices, government policy and how public and private plans are using health tech to improve healthcare delivery, patient outcomes, and lower healthcare costs. The Payer Insights Programs at HLTH and ViVE reflect discussions around health equity, women’s health, artificial intelligence, collaboration and more.

A new eBook from HLTH and MedCity News is an extension of the Payer Insights program from HLTH 2023. It captures some of the ethical debates taking place in healthcare and looks ahead to how payers, providers and health tech companies are working together to address them. It also provides insights from executives in the field.

Executives from the Alliance of Community Health Plans, Guidewell, Softheon, Solera Health, Curative, Highmark, 10Pearls, Kaiser Permanente, and Health Net share their perspectives on these and related topics in this 14-page eBook.

To download a copy of the eBook, How is Health Tech Shifting the Healthcare Payer Landscape? please fill out the form below.

Photo: Dilok Klaisataporn, Getty Images

This roundup will be published monthly. It is meant to highlight some of healthcare’s recent hiring news and is not intended to be comprehensive. If you have news about an executive appointment, resignation or layoff that you would like to share for this roundup or the MedCity Moves podcast, please reach out to [email protected].

Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.

Hires

Aledade welcomed Helena Day Christianson as chief people officer. In the past, she has held executive roles at tech companies like FitBit, Square, Block and Quantum Metric.

Banner Health appointed Michael Reagin to the newly created role of chief technology officer. He has held leadership roles at a variety of health systems, including Cleveland Clinic, Providence and Sentara Healthcare.

Cayaba Care got a new CEO — Adeaze Enekwechi,  former associate director for health programs at the White House Office of Management and Budget. She currently holds several board positions at healthcare companies, including MedStar Health, Tia and the Public Health Institute.

Ervin Ukaj joined Newel Health as CEO. He most recently served as senior manager of strategy and growth at Novartis.

Chris Ricaurte joined digital health company Parsley Health as co-CEO alongside its founder Robin Berzin. He comes to Parsley from VillageMD, where he served as CFO and COO.

NRC Health appointed Jennifer Baron as its first chief experience officer. She comes to the company from UC Davis Health, where she served as chief experience officer.

VillageMD, which is owned by Walgreens, welcomed Jim Murray to the organization as president and COO. He joins the organization from Centene, where he most recently served as COO and chief transformation officer.

Exits

L.A. Care Health Plan CEO John Baackes will be retiring at the end of the year. He has been leading the company, which is the largest public health plan in the U.S., for nearly a decade.

Teladoc Health announced that its CEO, Jason Gorevic, had stepped down from his role after 15 years leading the company. The telehealth provider’s CFO, Mala Murthy, has stepped up as interim CEO.

Layoffs

98point6 eliminated an undisclosed number of positions.

Hinge Health laid off about 10% of its staff. 

Optum is shutting down its virtual care business. Employees have taken to social media to post about their layoffs and seek new jobs, but the number of affected employees is unknown.

Sanofi is cutting an undisclosed number of jobs and getting rid of several oncology research projects.

UPMC is laying off about 1,000 staff members, which is 1% of its workforce. The affected roles are nonclinical.

The MedCity Moves Podcast is back with another episode. During the April edition, Senior Reporter Katie Adams explores some of the executive appointments, promotions and exits occurring in the healthcare world over the past month, including new leaders at VillageMD, Aledade and Banner Health. She also discusses healthcare layoffs, such as the recent rounds of job cuts at Optum, UPMC and Sanofi.

For this episode’s guest interview, Adams chats with Adaeze Enekwechi, who recently became CEO of the maternal health startup Cayaba Care. To learn more about Enekwechi’s career journey and what she has planned as she takes the helm at Cayaba, click here:

Treating cancer with medicines that tightly attach to their targets via covalent bonds is not a new concept in drug discovery, but it is picking up pace. Some companies are trying to improve this approach as they employ covalency to address elusive targets. These efforts, at least the publicly known ones, are focused on small molecules. Enlaza Therapeutics is working to bring covalency to biologic therapies and it has raised $100 million for efforts that include work in one of the hottest areas of cancer drug research.

The Series A financing announced Tuesday was led by the life sciences group of J.P. Morgan.

The binding of a drug is a chemical reaction between the drug and its target. Most drug interactions can be characterized by “on rates” when they are bound to their targets, and “off rates” when they are dissociated from them, said Sergio Duron, CEO of La Jolla, California-based Enlaza. Small molecules are cleared from the body relatively quickly, which is why these drugs must typically be taken daily. Protein drugs, such as antibodies, stay around longer, which means dosing can be less frequent. These biologic drugs also offer better targeting specificity compared to small molecules.

Enlaza named its covalent biologic platform technology “War-Lock.” This technology develops drugs that are nonreactive when they are circulating in the body. But when they find their target, this proximity activates them, leading the molecule to form a covalent bond. The War-Lock platform is based on technologies licensed from the University of California, San Francisco, and The Scripps Research Institute. Duron said the research involved using non-natural amino acids that are nonreactive until they are in forced proximity to a target. The research, published in the journal Cell in 2020, sparked the idea of applying this strategy to proteins, Duron said.

Unlike small molecules, which mostly work by blocking their targets, Enlaza’s biologic drugs carry therapeutic payloads. Enlaza’s initial focus is cancer, where its research interests include antibody drug conjugates (ADCs). These drugs consist of a toxic drug payload chemically linked to an antibody that targets the delivery of the therapy to cancer cells. However, sometimes the drug payload is released early, which leads to adverse effects elsewhere in the body. One way drug companies are trying to improve ADCs is with better linkers.

Using covalency to achieve selective and specific attachment to cancer cells could offer another way to improve ADCs. Enlaza aims to achieve high clearance of its drugs so they do not stay around and cause side effects, Duron said. But during the time an Enlaza cancer drug is in the body, it would have a long residency time on its target via the covalent bond.

“This is not just another ADC,” Duron said. “This is a different strategy to approach what is a very, very hot field right now where everyone is innovating on linker/payload strategies, and we are innovating on a different part of that molecule.”

Enlaza launched in 2022 backed by $61 million in seed financing led by Avalon Ventures. That capital was used to translate the science from an academic paper into a drug discovery engine. Duron said Enlaza has achieved preclinical proof of concept, demonstrating better safety and efficacy for its covalent biologic drugs. With the financing, the company will continue to develop its pipeline with the goal of reaching the clinic. Duron declined to offer a specific timeline, but said he expects “at least a couple of development candidates” will progress to clinical testing over the next several years.

The company isn’t disclosing its targets yet. But Duron said the War-Lock approach could be applied to other types of cancer drugs, such as radioligand therapies. As a platform technology, War-Lock also has potential applications in other therapeutic areas, such as autoimmune diseases. Now that the startup has emerged from semi-stealth mode, it is looking for potential biopharmaceutical industry partners interested in exploring applications of the technology. Duron said he’s looking to work with companies “that can enable our pipeline and be aligned with our vision of covalent protein drugs.”

Besides J.P. Morgan, other participants in Enlaza’s new financing include earlier investors Frazier Life Sciences, Avalon Ventures, Lightspeed Venture Partners, and Samsara BioCapital. New investors in the startup include Amgen Ventures, Regeneron Ventures, Bregua Corporation, Pappas Capital, and Alexandria Venture Investments.

Computer illustration by Getty Images

It started as a response to quell the unexpected overflow of hospitalizations during Mardi Gras in 1970s New Orleans but today travel nursing is a contentious topic that has turned into a Band-Aid solution for the nationwide nurse shortage. 

During the pandemic, travel nurses played a key role in filling major gaps stemming from historic levels of staffing shortages. However, the infusion of a temporary, contracted workforce employed by external staffing groups has come under scrutiny, sending shockwaves through the profession and sparking questions about pay equity. One report from the Massachusetts Health Policy Commission even suggests that employing travel nurses contributes to the high turnover rate of permanent clinical staff. The report surveyed nurses from across the state and showed that the staffing shortage is not caused by fewer people wanting to become nurses, but instead is caused by nurses leaving the field after they have already begun working, signaling that health leaders must focus on retention to secure the longevity of a thriving workforce. 

To say that nurses are burned out is an understatement – nursing is in crisis. A recent study found the leading reasons nurses left healthcare employment from 2018 through 2021 included emotional exhaustion, insufficient staffing, family obligations, concerns related to Covid-19, and unsafe working conditions. Looking ahead, the American Hospital Association projects that 610,388 registered nurses (RNs) plan to leave the field by 2027. Over the next three years, hospitals must think creatively and act with an intentional focus on improving core staff retention to fill these staffing gaps. The reason behind the mass nursing exodus from healthcare signals an opportunity for employers to do more to support their current staff and provide the flexibility they are looking for.

Travel nursing

If you ask a staff nurse what they think of their visiting colleague, you’ll hear the familiar sentiment that the pay discrepancy between staff is unfair. As one analysis puts it, “[the] perception of pay inequity between the two groups provokes animosity, jeopardizing morale and teamwork.” In addition, an appealing element of travel nursing is the ability to focus on patient care and avoid being involved in the administrative duties of a staff nurse. However, this very benefit for travel nurses can exacerbate permanent staff’s dissatisfaction as they feel that travelers are not invested in the unit they are working in. On the health system side, the high cost of travel nurses is straining hospitals’ already limited resources. Employing a high number of travel nurses is not a sustainable solution to the clinician staffing shortage; health systems must innovate to reduce full-time staff turnover and improve nurse satisfaction, allowing them to only deploy travel nurses where they truly do make an impact during seasonality fluctuations and other extenuating circumstances. The perks of travel nursing – higher pay, a larger focus on patient care and a lesser emphasis on administrative work, and more schedule flexibility – highlight exactly what nurses want from their careers and give health systems a road map to support their permanent staff.

Investing in permanent staff

We all want to feel like we are in the driver’s seat of our careers – and clinicians are no different. That’s why it is imperative to reimagine hospital staffing models to ensure that they center on nurse satisfaction and career longevity. One way to do this is to deploy a ‘float shift’ staffing model. Float shifts operate similarly to float pools, but instead of being confined to the float pool and stepping into the hospital every day without knowing which unit you will be placed in, float shifts give staff the ability to pick up extra shifts for a dollar incentive, while having full visibility into which unit they will be assigned to for that day. An important element of the float shift model is that these shifts complement a clinician’s full-time schedule, giving them more opportunities to make more money or a part-time gig that gives them more control over their schedules and the flexibility they desire. Shift flexibility is critical to nurse satisfaction. As we imagine a future where our health systems have happier and healthier full-time staff, let’s empower nurses to pick what works for their unique needs and limit the likelihood of their burnout and departure from the bedside – or worse, the profession.

Photo: baona, Getty Images

Becky Kahn, Chief Client Officer at Works & Trusted Health, is an experienced healthcare workforce solutions and staffing leader. She joined the company in 2019 as the Head of Client Solutions and took a brief hiatus from the company to serve as the Chief Executive Officer at Republic Health Resources, a mid-sized hospital staffing firm. She later rejoined Works & Trusted Health as the Chief Client Officer where she has been responsible for the development of the company’s account management and direct staffing efforts, significantly growing the Trusted presence across the US. Khan was a key player in launching the Works VMS platform to hospitals and health systems across the country.

Before joining Works & Trusted Health, Kahn served as the Managing Director, UK Operations, at Medacs Global Group, the largest provider of international healthcare staffing and workforce solutions in Europe. Prior to that, she spent nearly sixteen years of her career at AMN Healthcare where she held several executive leadership positions and was responsible for the oversight of AMN Healthcare’s travel nurse client sales and services and local staffing divisions, as well as the account management of AMN’s Managed Services and Workforce Solutions product offering, and technology divisions. Khan launched AMN’s Managed Services solution and grew it over her tenure to over $2 billion in spend under management. Khan is a passionate leader who is dedicated to bringing sustainable workforce solutions to healthcare.

In his State of the Union address this year, President Biden said that he directed his cabinet to review the federal classification of cannabis. This direction – following two other government recommendations — including a letter sent by 12 senators including Senate Majority Leader Chuck Summer to the Drug Enforcement Administration (DEA) in January and the U.S. Department of Health and Human Services’ recommendation to the DEA in August of last year to reschedule cannabis – could mean momentum is building for this much needed change.

Momentum gives me hope that we are a step closer to reclassifying cannabis from a Schedule I substance, reserved for the most dangerous controlled drugs including heroin and LSD, to a Schedule III substance, drugs with a moderate to low potential for physical and psychological dependence, such as ketamine, testosterone, and Tylenol with codeine. 

Rescheduling cannabis would mean significant changes for healthcare on several fronts: 

• Most importantly, it would open the floodgates for clinical research to show scientific evidence of the medical benefits of cannabis.  
• By reducing its stigma and the risk of arrest, reclassifying cannabis would knock down one of the biggest obstacles that prevent patients and their caregivers from openly engaging in conversations with clinicians in mainstream medicine about their use.
• And it could reduce barriers to access for patients suffering from cancer pain and treatment-related symptoms, chronic pain, and other serious conditions. 

Despite growing acceptance and legalization in 40 states, there still exists a significant level of negative perception and misinformation about cannabis as a medical therapy because it’s still classified as a Schedule I drug. 

As a director of supportive oncology services, I see firsthand how the confusion and mistrust around medical cannabis plays out for my cancer patients and their families. Prior to establishing a need blind, interprofessional cannabis clinic, most patients would use cannabis without medical guidance or feeling safe discussing this interest with providers. We have seen over 1,000 patients with cancer and those in survivorship between the ages of 18-95 who expressed interest in using cannabis to reduce their symptom burden. The ask is universal: help me understand what cannabis can help me with, what it can’t and what I can safely use. 

Medical cannabis is not always accessible for many of my patients because there are myriad hurdles to access, from digital literacy issues to financial toxicity of cancer treatment. As a Schedule I substance, cannabis is not covered by health insurance; it’s an out-of-pocket expense that cannot be purchased with a credit card. As a result, some of my patients buy street marijuana, which is not only illegal but leaves me in the dark about what they’ve purchased, how they use it, and how it could affect their health.

My patients are just a microcosm of the problem. Currently 40-50 percent of cancer patients in the U.S. use cannabis to manage cancer symptoms, and many say it’s confusing and expensive, and there is no medical oversight. Many of these patients are alone, with inadequate information, when they are at their most vulnerable.

The American Society of Clinical Oncology’s Journal of Clinical Oncology, just published guidelines recently for clinicians, adults with cancer, caregivers, researchers, and oncology institutions on the medical use of cannabis and cannabinoids, including synthetic cannabinoids and herbal cannabis derivatives; single, purified cannabinoids; combinations of cannabis ingredients; and full-spectrum cannabis. They highlight the critical need for more cannabis and/or cannabinoid research.

Cannabis as part of cancer care has been a topic of great interest for years. In fact, in 2019, The Journal of Palliative Medicine, published a research study called “Relationship of Cannabis Use to Patient-Reported Symptoms in Cancer Patients Seeking Supportive/Palliative Care.” The study concluded that patients seeking specialized symptom management are self-treating with cannabis, despite the lack of high-quality evidence for its use in palliative care. Unsanctioned use is likely to increase in cancer patients. Accurate information is urgently needed to help manage patient expectations for its use and increase understanding of risks and benefits.

Once cannabis is reclassified, the uncertainty and lack of clarity will change. Clinical research will help us understand the benefits and risks associated with cannabis use. The well done, rigorous, scientific evidence of the medical benefit of cannabis will be the primary catalyst for change in the medical community’s attitudes and practices around cannabis care. In addition, here are two initiatives we can take to ensure more effective cannabis use by our patients – starting right now: 

• Meet the need for more education and training to increase clinicians’ comfort in discussions with their patients about the use of cannabis for medical purposes. While medical use of cannabis is on the rise across the United States, medical education and clinician comfort discussing cannabis use for medical purposes have not kept pace. For instance, according to a study I co-authored, of the 344 clinicians in the state of Pennsylvania we surveyed, only 51% of clinicians reported completing any formal training on medical cannabis. Compared with non-certifying clinicians (pharmacists, nurse practitioners, and physician assistants), physicians were significantly more comfortable with patient use of medical cannabis, saw fewer risks, more benefits, and felt better prepared to discuss its use with vulnerable populations. All clinicians noted significant limitations to their understanding of how medical cannabis can affect patients, and many indicated a desire for more research and training to fill in gaps in their knowledge. 
• Open lines of communications between clinicians and patients about their use of cannabis along with other drugs. It is important to assess the use of medical cannabis along with other medications when assessing for polypharmacy, i.e., the use of five or more medications. However, while more patients are using cannabis, little is known about how often they use it with other medications. This needs to change. It is best to continually check in with patients to reassess their use of medical cannabis products, given the high rate of variability of what products people are using in different time periods. 

I believe that if we work together, these initiatives, along with others that have been studied, can be established as best practices that make medical cannabis safer and more effective for patients suffering from cancer symptoms, chronic pain, insomnia and anxiety. 

In a post-rescheduling world, all of us – providers, health plans, employers, regulators, financial institutions, and investors – must make it our mission to work together to begin building out a responsible, regulated and structured industry where clinically guided medical cannabis care is accessible and affordable for all. 

The Drug Enforcement Agency’s decision to reclassify cannabis to a Schedule III drug would mark a watershed moment in the cannabis market, but it does not immediately solve for our lack of data, issues with equitable access, consistent quality, and appropriate clinical and regulatory oversight. It’s the first step in a long process to establish a new normal for medical cannabis care. I’m optimistic that collectively we have the wherewithal to pull together to put medical cannabis into mainstream healthcare.

Photo: Ivan-balvan, Getty Images

A pioneering palliative care clinician and researcher, Dr. Brooke Worster is currently Director, Supportive Oncology at Jefferson Health in Philadelphia. She is a graduate of Temple University School of Medicine and completed her fellowship in palliative care and pain management at MGH Brigham and Dana Farber Cancer Center in Boston.

At the upcoming MedCity INVEST, an innovative boutique healthcare investment conference scheduled for May 21-22 at the Ritz Carlton hotel in Chicago, a snapshot of the Canadian healthcare startup landscape will be on display. Four innovative companies will present their approaches to addressing pain points in healthcare. The session is sponsored by the Consulate General of Canada.

The group of four healthcare startups spans women’s health, orthopedics, remote patient monitoring for Parkinson’s disease and AI and 3D printing. David Kereiakes, Windham Venture Partners Managing Partner, will moderate the session.

FemTherapeutics is a medical device company developing “Invisalign for Gynecology”. Leveraging artificial intelligence and 3D printing, the gynecology platform offers patient-specific intra-vaginal devices for common pelvic health conditions. The first product is a custom pessary for the management of Pelvic Organ Prolapse and Stress Urinary Incontinence, which affects 50% of women during their lifetime. FemTherapeutics is building the infrastructure to allow expansion into other pelvic health categories including menstruation and sexual wellness, labor and delivery, oncology, and more.

Reach Orthopaedics has developed a shoulder implant to treat patients suffering from massive irreparable rotator cuff tears (MIRCT). The Reach implant is designed to restore shoulder function, reduce chronic pain and protect the acromion from associated stress fractures. Currently, there is no standard of care for middle-aged persons (40-70 years) suffering from MIRCT. The durability of the Reach implant makes it ideal for use in this demographic, providing a bridge solution. 

PragmaClin Research is aiming to change the world of neurological care with a remote patient monitoring system called PRIMS. The platform uses depth cameras alongside patient-reported data to revolutionize the accuracy and efficiency of Parkinson’s disease diagnostics and monitoring. PRIMS is designed to seamlessly integrate into clinical workflows and offers neurologists and healthcare providers a comprehensive solution for evaluating motor and non-motor symptoms. Its patient-centric approach not only enhances diagnostic precision but also supports patients with valuable insights into their condition, fostering a proactive stance in disease management. By bridging the gap between traditional assessments and cutting-edge technology, PRIMS is setting a new standard in neurological care, ensuring patients receive timely, tailored, and transformative treatment strategies.

OPTT Health is a technology company that uses AI and patient narratives as its main source of analysis to generate actionable clinical insights. These insights support mental health care teams in delivering personalized, data-driven, and evidence-based care, enabling continuous monitoring and informed decision-making throughout the patient’s care journey.