Category: Health

The hospital landscape remains a competitive one, with health systems constantly experimenting with new technology to help them achieve commercial success. Many of the digital tools that hospitals are adopting focus on streamlining workflows for their employees or enhancing the patient experience.

During a recent virtual panel held by Reuters Events, three health system executives shared some of the most important lessons they’ve learned from the digital initiatives they’ve worked on in the past couple years. Below are three key lessons the panelists discussed.

Start with a problem, not a solution.

Jared Antczak, chief digital officer at Sanford Health, said that his health system always tries to begin its digital initiatives by defining a problem that needs to be fixed.

“Too often, organizations start with the solution. They get dazzled with all of the bells and whistles of a demo or a conversation with a vendor, and then they try to work backwards to figure out a problem that it can solve. That backwards process often leads to failure, negative returns on investment or just a poor experience overall,” he explained.

For example, when Sanford launched its digital registration tool, it was doing so to address a pain point it knew patients found frustrating and employees found difficult to manage, Antczak explained.

He noted that nobody enjoys arriving early to an appointment so they can be handed a clipboard and asked to fill in pages of the same information they gave the last time they came in. Additionally, providers are undergoing workforce pressures and don’t always have enough staff to sit at front desks and check people in.

“Once we identified that problem, we were able to design and deploy the right solution. We launched a new digital registration tool just this last year that has been incredibly successful — really simple and intuitive for our patients, really frictionless. And it’s resulted in major time savings for our workforce,” Antczak declared.

Financial ROI is important, but it’s not everything.

Healthcare providers shouldn’t use financial ROI as their only motivator when pursuing digital initiatives, argued Brian Hoberman, CIO and national technology leader at the Permanente Federation.

“The financial return, obviously, is something you think about, but the motivator isn’t, ‘Hey, let’s go find something that’s going to have the biggest financial return.’ The motivator is much more oriented towards what the impact is going to be on the patient and the workforce,” he remarked.

Hoberman highlighted his organization’s recent deployment of ambient listening technology as a successful project. He thinks the initiative is a hit because it not only alleviates burnout among its workforce, but also increases patient satisfaction.

By using technology that automatically drafts clinical notes, doctors can spend less time on documentation and more time interacting with their patients face-to-face, he explained. And when doctors don’t have their head buried in the EHR, patients feel like they’re being heard.

Invest in your digital doors.

Hospital leaders must not underestimate the power of digital marketing, said Shweta Ponnappa, chief digital experience officer at Providence.

“Two key initiatives that have driven sustainable growth for us are machine learning-based digital marketing and our investments in our digital doors. I don’t call them digital front doors because patients don’t always use the front door. They might use a side door, garage door, back door or window to come in if that’s what’s closest to them. And we’re okay with that,” she declared.

Patients may become aware of Providence’s providers through an array of channels, such as the health system’s website, their health plan, MyChart or Zocdoc, Ponnappa explained.

“It’s really up to the patient. Our job is to make sure that we’re showing up in a meaningful way with all the information they need to make their decision,” she stated. “We’ve got to make it easy for the patient.”

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For U.S. consumers, the pharmacy can sometimes be a bit of a scary place. Many Americans have been hit with a ghastly sticker shock at the pharmacy — learning the exorbitant cost of their medication only after they had reached the counter. The lack of transparency in drug pricing exacerbates this issue, leaving patients unaware of cheaper alternatives or potential discounts. As a result, families all over the country face difficult choices between affording essential medications or other necessities.

A recent partnership between EHR vendor Elation Health and health information network Surescripts seeks to tackle this issue. The collaboration aims to bring prescription price transparency to the point of care for primary care clinicians so they can discuss their patients’ likely financial responsibility during visits.

Elation sells its EHR and other technology solutions specifically to primary care providers. Physicians in this specialty want to provide greater access to prescription drug pricing information and support their patients at the point of care, given that cost remains one of the most significant barriers keeping patients from adhering to medications, pointed out Elation CEO Kyna Fong.

To help primary care physicians have more meaningful conversations with their patients about medication affordability, Elation integrated Surescripts’ real-time prescription benefit tool into its EHR. The tool gives clinicians immediate access to patient-specific medication coverage and cost data.

“Surescripts’ real-time prescription benefit data automatically displays based on information entered in the form, and providers can use that to quickly switch coverages or medications to find the best option for the patient. This includes on-demand formulary data, providing in-workflow access to patient-specific medication coverage benefits as well as cost data for all prescribing providers using Elation’s EHR,” Fong explained.

The point-of-care integration also gives clinicians ready access to information regarding prior authorization requirements, lower-cost alternative medication options and out-of-pocket cost estimates for patients, she added.

Primary care doctors haven’t always talked openly with their patients about costs, but Fong thinks this is beginning to change.

“Until recently, primary care physicians didn’t have access to this type of information. When providers have tools that help them identify affordable medications, they are taking a further step to ensure patients can effectively manage their health conditions — ultimately promoting overall well-being and reducing healthcare disparities,” she remarked.

When providers have visibility into lower-cost medication alternatives, they can steer patients toward prescriptions they are more likely to fill. Cost-related medication nonadherence is a prevalent problem in the U.S., Fong noted.

She pointed out that close to 20% of U.S. adults have reported not filling a prescription medication due to its price in the past year. 

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Following the Covid-19 pandemic, there has been a boom in the digital health space. But health executives aren’t seeing the financial benefits just yet, according to a recent survey from EY, a consulting firm. The online survey received responses from 101 healthcare executives in the U.S.

It found that while 86% of health executives say that digital health solutions have the potential to reduce costs, 70% said they haven’t seen a return on investment so far. In addition, 50% of healthcare organizations say that “siloed tracking metrics” make it hard to follow tech’s initial cost value.

“I think we’re still in the early innings of this digital transformation. The Covid episode introduced to the world of U.S. healthcare that, yes, I can interact with my physician remotely and so forth. … We got this first initial wave of incredible excitement and value, but there’s so much work to be done still,” said Dr. Kaushik Bhaumik, EY U.S. health technology leader, in an interview.

That’s not to say a return on investment won’t happen someday from using tech. But other benefits will become evident before financial benefits, according to Mallory Caldwell, EY Americas health leader.

“I think we’re going to go through a period of seeing relief and unburdening and more time for the things that we really need to be doing before we get to a point where it’s robust enough and effective enough and interconnected enough to really then monetize,” Caldwell said in an interview.

Additional findings from the survey include:

• AI is taking a larger role in healthcare, with 60% of respondents saying they are investing in AI-based applications. About 96% of respondents said they’ve seen a reduction in wasted time from AI and 90% said they can better prioritize healthcare providers’ time.
• About 94% of health executives said that newer technologies improve providers’ credibility. Another 90% said they are investing in staffing their digital health tech teams.

Based on these findings, the healthcare industry needs to “lean in” to these technological advancements, Caldwell said.

“There are so many things driving us, begging us to change the way we work: increasing costs, the workforce shortage that is here today and is projected to grow. … Every other industry has had periods of industrial revolution, technological revolution. Health hasn’t had our tech revolution,” he said. “We haven’t had our industrial revolution.”

Bhaumik echoed Caldwell’s comments, stating that the “system is incredibly stressed” and the healthcare industry needs to “fundamentally look at how we deliver care and the role technology can play.”

Photo: metamorworks, Getty Images

When it comes to collecting and analyzing data, many biopharma companies are still in the digital dark ages. They process data using tools such as Microsoft Excel, which has a lot of capabilities but isn’t tailored to biopharma. Those that do undergo a digital transformation often install fragmented software tools that generate data in silos, requiring a lot of manpower to consolidate, format and chart the data. This is a laborious process that involves manually collating and assimilating data from disparate systems.

As the volume of data generated by the biopharma industry explodes, this fragmented approach simply won’t cut it. Imagine a room full of bioreactors generating process-monitoring data every minute, with cell culture sampling performed a number of times a day and wanting to compare these bioreactors for performance and efficiency. That alone would generate hundreds of thousands of data points. Today, an increasing number of biopharma companies are looking to adopt sophisticated digital technologies that would accelerate their digitalization endeavors by continuously and automatically pulling in data from the vast network of machines they use in their laboratories, which allows them to innovate with available and reliable data sooner. One such application that’s of growing interest is the “digital twin,” which pulls in data from multiple sensors and systems to model a process in silico, analyze it and provide feedback that scientists can use to optimize the process in situ.

It’s easy to see how biopharma companies could benefit from establishing a “digital data backbone.” A digital data backbone is designed to enable an organization to collect, structure and organize all data from all operational activities, and facilitate timely and intelligent analysis within a single platform. A fully optimized digital backbone can automatically take data from a diverse set of instruments and contextualize them with experimental and scientific metadata for analysis – all without the need for human intervention. It can be implemented across all stages of drug development, facilitating smooth handoffs of process and product data. For example, the otherwise laborious task of creating a cell-line history report across teams, systems, scientists, experiments, etc., could now be streamlined by the availability, accessibility and context of all related data from within the same platform.

The rapid rise in the development of cell and gene therapies makes the digital backbone all that more valuable. Nearly 3,000 cell and gene therapies are currently in development, according to the American Society of Gene and Cell Therapy. Some of these advanced therapies – particularly those that are personalized to individual patients – can be developed and launched in about a month. This development process alone could generate millions of data-points very quickly. With an emphasis on accuracy of data transfer, high-risk material touchpoints and speed of development, cell and gene therapy makers need a platform that can centralize the data and provide a seamless, automated transfer of information – something that archaic information management and analysis systems simply cannot provide.

The rise of automation has sparked some questions about how the role of scientists will evolve. No doubt, with data more readily available, scientists will no longer be running from machine to machine to collect the data, and then figuring out how to put everything together in a spreadsheet. They’ll have all the related data at their fingertips, with faith that the datasets are in line with data integrity rules such as the ALCOA+ principles, while also having complete datasets, including failures and terminated experiments. Capturing failures along with successes provides a more complete picture of every experiment, allowing researchers to trace the sources of bad performance trends, and normalize the true success of their experimental work. Ultimately, scientists will be able to use these more accurately calibrated data models to leverage artificial intelligence tools that can help them predict trends and optimize their processes.

In short, scientists will be able to spend their time doing more cutting-edge science. The digital backbone will empower them to accomplish that goal. By having all correctly constructed and contextualized metadata, product and process data in one place, they’ll be able to gain the maximum potential of advanced analytics tools and generate more powerful insights sooner.

How can companies make the switch to the digital backbone? This is not something that IT departments can drive alone – it must be championed and led by scientists and their leaders. In isolation, IT experts may not be fully versed in the company’s therapeutic goals, making it challenging for them to envision how a digital technology could best drive the necessary scientific and business outcomes. True digital transformation initiatives need to be driven company-wide, with IT and scientists working together to drive the optimal outcomes. This cannot be taken on as a side project. It requires a coordinated, harmonized, global effort to assess the incumbent digital landscape and implement tools in a way that positions organizations at the forefront of scientific and digital advances.

This is an exciting time for patients, as genomic discoveries and advances in AI and automation converge to accelerate the discovery and development of novel therapies. Let’s embrace the digital backbone so the biopharma industry can make the most of this opportunity.

Photo: Madmaxer, Getty Images

On the business back end, integrating Generative AI tools into Configure, Price, Quote (CPQ) systems can increase operational efficiency, bolster decision-making strategies, and enhance process automation. On the front end, and despite the term “Artificial” in the name, these integrations promise a profound shift toward a more personalized care model. Together, this synthesis enables Healthcare and Life Sciences (HLS) organizations to focus on personalizing treatment plans and streamlining patient engagement throughout the continuum of care. A holistic transformation is underway, driven by the symbiosis of Generative AI tools with CPQ systems.

Generative AI can learn, adapt, and derive insights from large, complex data sets. Because of this, the traditionally conservative healthcare sector is embracing this nascent technology with earnest enthusiasm. Today’s most pragmatic HLS organizations were driven toward early adoption by the immediate and tangible results on business performance and patient outcomes. They believe the marriage of intelligent data insights with CPQ systems will fundamentally alter how they conduct business from the board room to patient care facilities.

Together, let’s discuss how Generative AI’s integration into CPQ systems is set to impact a myriad aspects of healthcare delivery. We’ll discuss its effect on seemingly disparate elements, including personalized treatment plans, streamlined supply chain management, and accelerated drug delivery, to bridge technical intricacies with the innate ethical considerations of this type of digital transformation. With the combination of Generative AI and CPQ, the future of healthcare delivery is adaptive, tailored, and beyond patient-centric.

Let’s take a more granular look at some use cases and aspirational applications.

• Use case 1: Personalized treatment plans

By analyzing and interpreting extensive datasets, Generative AI algorithms can discern complex, nuanced patterns in patient data to tailor treatment options to individual patient needs. This ability leads us away from outdated, one-size-fits-all healthcare modalities and toward a world where precision medicine is the new norm.

Integrating these insights with CPQ systems enhances the process further by optimizing the selection and pricing of these personalized treatment plans. This ensures that the continuum of care—from patient onboarding to ongoing management and follow-up—is finely tuned to each patient’s unique physiological makeup while effectively managing service delivery and cost-effectiveness.

Example: By analyzing the genetic data, lifestyle choices, and health history of a patient with a complex condition like Type 2 diabetes, Generative AI could help identify the most effective treatment regimen. For instance, it might recommend a specific combination of medication, dietary adjustments, and exercise tailored to the patient’s unique genetic markers and lifestyle factors.

CPQ systems then customize and price this personalized treatment plan. They consider the patient’s insurance coverage and eligibility for subsidies or discount programs, ensuring the proposed regimen aligns with both medical needs and financial constraints. This seamless integration optimizes treatment effectiveness while managing costs, making precision healthcare accessible to a broader patient base.

Impact: This approach streamlines patient care, sharply reduces the guesswork in treatment selection, and enhances resource allocation, improving outcomes and cost-efficiency.

• Use case 2: Streamlined supply chain management

Efficient supply chain management is crucial for maintaining high standards of healthcare delivery. Integrating Generative AI into CPQ systems introduces predictive analytics to this vital area. By accurately forecasting demand, optimizing stock levels, and predicting supply chain disruptions, Generative AI enables a more robust and responsive supply chain infrastructure. These capabilities are especially vital during health emergencies, where swift adaptation to changing needs can be a matter of life and death.

Example: An AI-enhanced CPQ system can detect early signals of an influenza outbreak through health data trends. In turn, pharmaceutical organizations could proactively increase the stock levels of flu vaccines and essential antiviral medications in affected regions. By optimizing inventory allocation based on predictive analytics, the system ensures that providers are well-equipped to handle the surge in patient demand.

Impact: This approach achieves substantial cost efficiencies and more efficient resource allocation, enhancing the ability to meet healthcare demands promptly. It marks a pivotal advancement in healthcare logistics and elevates the quality of patient care.

• Use case 3: Accelerated drug discovery

Generative AI algorithms can delve into vast datasets, encompassing molecular structures, biological interactions, and clinical trial outcomes, to pinpoint promising drug candidates swiftly. This novel methodology may significantly accelerate the research and development phase of drug development, paving the way for exciting therapeutic breakthroughs.

Incorporating these AI-driven insights, CPQ systems could play a pivotal role by streamlining the processes for bringing these new drugs to market. By doing so, CPQ systems enhance operational efficiency and contribute to strategic decision-making, enabling pharmaceutical and biotechnology companies to dynamically adjust their product offerings in response to emerging research findings and market demands.

Example: Generative AI and Machine Learning—together atop a multiomics platform—could help identify a new biomarker that could potentially target early-stage cancer cells. Following this discovery, CPQ systems quickly assess the market, configure the pricing strategy, and prepare accurate quotes for the production and distribution of this groundbreaking treatment. This seamless integration ensures that from the moment a new drug or testing modality candidate is identified, every step toward its commercial availability is optimized for speed, cost, and efficiency.

Impact: This synergetic integration transcends traditional drug discovery and market launch timelines, ushering in an era where new treatments reach patients faster and more cost-efficiently than ever before. It enables the pharmaceutical and biotechnology industries to adapt to discoveries and patient needs swiftly. It holds the potential to change how innovative therapies are developed and delivered to the global market.

• Use case 4: Fraud detection in healthcare claims

Generative AI is revolutionizing fraud detection in healthcare claims management by harnessing advanced techniques such as anomaly detection, behavioral analysis, and predictive modeling. This technology scrutinizes claims in real time, integrating and analyzing data from a multitude of sources to identify inconsistencies and potential fraud with increased precision.

CPQ systems then leverage Generative AI’s analytical power to further refine the claims management process, ensuring accurate quote generation and pricing adjustments based on risk profiles detected by AI. This enhances the integrity and efficiency of healthcare claims processing and ensures that billing and insurance claim procedures are optimized for fairness and accuracy. Together, they safeguard HLS organizations against financial losses and foster generalized trust in healthcare systems.

Example: Consider a scenario where Generative AI monitors the claims submission patterns across a network of healthcare providers (HCPs). It flags an unusual series of claims from a clinic exhibiting signs of overbilling for routine procedures. Upon further investigation facilitated by the CPQ system, discrepancies are confirmed, leading to corrective actions before substantial losses occur.

Impact: This integration significantly diminishes fraudulent claims by employing a proactive approach to detect and address fraud, leading to notable financial savings and reinforcing system-wide trust.

Ethical considerations

While the potential of Generative AI in CPQ for healthcare is vast, ethical considerations are paramount. Transparency in algorithmic decision-making, safeguarding patient privacy, and addressing biases are critical. Striking the right balance between harnessing the power of data-driven insights and ethical practice ensures that the integration of AI aligns with responsible innovation principles.

Conclusion: Toward a healthier tomorrow

As we’ve explored the transformative potential of integrating Generative AI with CPQ systems for healthcare, it’s essential to acknowledge some examples’ exploratory and aspirational nature. These scenarios are intended to illustrate capabilities while serving as beacons for what we can aspire to achieve.

This aspirational perspective is crucial as we discuss innovations ranging from personalized treatment plans to streamlined supply chain management—from accelerated drug discovery to advanced fraud detection. HLS leaders must embody a collective aspiration toward a healthcare system that is more responsive, personalized, and efficient, underpinned by the ethical application of cutting-edge technology.

In embracing this intersection, we are not merely adopting new technologies; we are reimagining the future of healthcare. The use cases outlined offer a glimpse into a future where the full potential of Generative AI and CPQ integration has been realized—a future where healthcare is not only about reacting to illnesses but predicting and preventing them.

As we progress, the focus remains on transforming these aspirations into tangible outcomes. As more and more organizations integrate Generative AI with CPQ systems, they declare their belief that we can aspire to incredible advancements in human health and well-being through digital transformation.

Explore possibilities. Enhance operational excellence.

Prioritize efficiency. Prioritize the patient.

Let’s build toward a healthier tomorrow.

Photo: alphaspirit, Getty Images

Cell therapy’s next breakthrough could be the engineering of these cells inside the patient. Two deals more than four years apart put Astellas Pharma in position to ramp up its work developing these in vivo treatments.

Under the more recent agreement announced late Thursday, Astellas is collaborating with Kelonia Therapeutics, a startup that has developed technology for precisely delivering genetic cargo to target cells in the body in order to make those cells into in vivo CAR T-therapies. Kelonia calls its technology in vivo gene placement system, or iGPS.

The genetic payload delivered to a cell gets it to express a receptor that goes after a target on cancer cells. This chimeric antigen receptor is the “CAR” in CAR T-therapy. Under the collaboration, Kelonia’s technology will be combined with the capabilities of Xyphos Biosciences, a cell therapy developer Astellas acquired in late 2019. Xyphos’s convertibleCAR technology modifies NKG2D, a receptor on certain immune cells that facilitates immune surveillance. The modification enables the targeting of tumor cells. Xyphos says its technology enables it to create cell therapies that can be engineered and re-engineered in vivo to target more than one tumor antigen, improving the ability of the modified immune cell to pursue and destroy tumors.

Terms of the Kelonia agreement call for the companies to work together to develop up to two in vivo CAR T-therapy programs. The targets of those programs were not disclosed. Xyphos will be responsible for the programs’ development as well as their commercialization if they receive regulatory approval.

Kelonia will receive $40 million up front for the first program and an additional $35 million if Xyphos exercises its option for the second program. Milestone payments could bring Kelonia nearly $800 million total. Kelonia will also receive research funding for the R&D work it does as part of the collaboration. If therapies stemming from this alliance reach the market, Kelonia is also eligible for royalties from sales.

Astellas is not the only biopharma company pursuing in vivo cell therapies. In 2021, Sanofi acquired Tidal Therapeutics, a preclinical startup with technology that uses messenger RNA to engineer immune cells inside the patient. Capstan Therapeutics, a University of Pennsylvania spinout that emerged in 2022, is also developing in vivo cell therapies. Capstan uses mRNA packaged inside a lipid nanoparticle to reprogram a patient’s immune cells.

Kelonia, an MIT spinout, broke stealth in 2022 with a $50 million Series A financing. After the financing announcement, Kelonia founder and now CEO Kevin Friedman told MedCity News that one of the startup’s goals is to make cell therapy more affordable and more accessible to patients. The engineering of a patient’s cells in vivo avoids the complexity and expense that makes current CAR T-therapy accessible only at major medical centers. Kelonia’s technology offers the potential to provide treatment at community hospitals, “making the incredible clinical benefit democratized to the patient no matter where they are,” he explained.

Last year, Kelonia presented research from mice and monkey studies demonstrating in vivo delivery of CAR molecules to T cells that led to durable tumor clearance. These results were achieved without the typical toxicities associated with cell therapy and without the need for the chemotherapy preconditioning regimen that is one of the steps required of currently available CAR T-therapies. Kelonia said at the time that it is working to advance its lead internal program to the clinic as a treatment for multiple myeloma.

Photo: Kiyoshi Ota/Bloomberg, via Getty Images

Healthcare insiders and industry observers have become preoccupied over the past year with bedside applications for artificial intelligence and other advanced technologies. And rightly so. They’re revolutionizing not only patient care, but also elevating operational efficiencies that will reduce costs and improve clinical outcomes.

In witnessing these breathtaking developments, it’s easy to overlook key trends involving humans and not machines. One of them involves mounting interest in fertility treatments at a time when the definition of family has undergone massive change, though it also is being powered by advances in medical science.

Contemporary households reflect the evolving tapestry of society, embracing the diversity of same-sex partnerships, single parenthood, and professional women choosing to embark on parenthood later in life through various paths, such as fertility treatments, adoption or surrogacy. While still very common, the conventional notion of a uniform nuclear family, characterized by a smiling heterosexual couple with 2 children, a dog and a white picket fence, has gracefully yielded to a more inclusive and varied understanding of family structures.

A universal desire

The desire to have children and journey to parenthood is a deeply personal and sometimes complex expedition that transcends all backgrounds. Parents and families now come in all shapes and sizes, irrespective of whether someone is partnered up, single, straight, gay, lesbian, transgender, nonbinary, or otherwise. As a result, more medical practitioners are lining up to handle the growing demand for safe and affordable fertility care for all.

These changes are also evident across the American workplace where crying babies, barking dogs and a harried work-life balance that were once on full display during video conference calls are hot topics of post-pandemic water-cooler discussions. Co-workers finally had a chance to learn more about one another in isolation and stay connected through the rise of remote work arrangements, and there’s no looking back.

Employers have followed suit, albeit out of necessity. With the U.S. labor market more competitive than any time in recent memory, organizations are looking for creative approaches to building a high-performance workforce. That includes the healthcare field, which is in dire need of preventing burn out of valuable frontline employees and improving morale.

Recognizing workforce diversity

One winning formula for burnishing talent management has been incorporating affordable family-forming programs into employee benefit packages. Rather than serving as a checkbox approach by management to please a certain segment of the workforce, it serves as a commitment to fostering a workplace where virtually anyone can embark on the transformative journey of building a family.

The expanded definition of family also aligns seamlessly with the growing emphasis on diversity, equity and inclusion (DEI) programs, shining a spotlight on health equity issues in the process. A compelling argument can be made for building a diverse workplace, which a growing body of research suggests is good for business.

Understanding that family-forming benefits extend beyond fertility treatments and encompasses the diverse phases of life that individuals experience is crucial. Menopause, a natural transition that many women undergo, is another critical aspect of reproductive health that requires attention and support. By recognizing the importance of menopause benefits alongside fertility treatments, employers can truly embrace a holistic approach to family-forming benefit programs. Just as with fertility care, providing resources, education and support for women navigating menopause can contribute to a more inclusive and caring workplace. A comprehensive family-forming strategy acknowledges that employees’ needs evolve over time, ensuring that organizations remain supportive at every stage of their journey, from parenthood to menopause and beyond.

Today, there are many options for building LGBTQ+ families, including assisted reproductive technology (ART). In addition to ART, they include home testing; genetic screening; pre-pregnancy counseling; donor sperm, eggs and embryos; in vitro fertilization (IVF); egg freezing; surrogacy and adoption. With so many safe fertility treatments available now, the dream of parenthood is achievable for everyone.

Easing financial pressures

The trick, however, is making them accessible and affordable to the public at large. Financial pressures are a major impediment to the dream of parenthood for too many working Americans. Along a rocky landscape where roughly one in six people face fertility challenges, it is critical to ensure that the road to reproductive healthcare is a smooth one. Rising out-of-pocket expenses for health insurance has restricted the size of the typical nuclear family for lower-paid and middle-class employees. Many families that live paycheck to paycheck or lack emergency savings are saddled with high deductibles, copays and coinsurance that have made fertility treatments unattainable.

The situation is worse for households that face other health challenges. Consider, for instance, that few U.S. states mandate coverage for fertility preservation in the event of medical procedures that could undermine a woman’s ability to have biological children. Moreover, many of these mandates exempt public insurers – leaving those who are least able to afford the $20,000-plus price tag for fertility preservation to pay out of pocket. $20,000 to $65,000 for IVF, and the cost becomes even more inaccessible.

Building a caring culture

As employers face growing pressure to land top talent, those that embrace the ever-expanding definition of family, not to mention increasing importance of DEI and health equity, will secure a competitive leg up. Offering safe affordable family-forming programs for everyone, including vulnerable or under-served employee populations, represents an opportunity for employers to build a caring culture that also will benefit the bottom line.

HR departments play a major role in helping deliver family-forming solutions that meet the budget and lifestyle of diverse employee populations. It’s not enough, however, just to provide affordable and safe fertility treatment options. Employees who receive these benefits also need comprehensive logistical and emotional support to help their families navigate the complex journey of family-building. For example, dedicated concierge care navigators can discuss programs, financing and logistics, as well as help find a local clinic with successful outcomes.

These robust and personalized benefits aren’t only about redefining family-forming benefits. They’re about transforming lives, one family at a time, and creating more resilient and happy workforces that contribute to business success. Together, we can nurture life’s beginnings and create a future where safe fertility care is not a luxury but a fundamental right for all.

Photo from Flickr user Bradley Gordon

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Despite incredible treatment advances over the past several decades, no single phrase has more power to fundamentally transform people’s lives like “you have cancer.”

Even the most engaged patients can “tune out” after a diagnosis, retreating into a world of disbelief and the possibility of negative outcomes.  That fog often continues during treatment, as surgical interventions, chemotherapy, radiation, and immunotherapy disrupt daily lives, potentially resulting in life-altering and permanent side effects.

While patients struggle with treatment side effects, they often hesitate to call the clinic for fear of bothering their care team. From the nurse’s station, the back-and-forth communication, phone tag, and email exchange in an attempt to capture patients’ symptoms is not only frustrating and time-consuming, but it can delay intervention and leave patients sick to the point they seek care in the emergency department.

The rise of electronic patient-reported outcomes (ePRO) tools enables patients to report their symptoms from home, alleviating any concern about burdening the clinic through constant phone calls. With self-reporting, clinics can extend healing into patients’ homes by delivering disease-specific surveys that monitor symptom severity in a way that alerts medical staff to patients with new or worsening symptoms, indicative of an adverse event. In addition to empowering patients to take an active role in their care journey, active symptom monitoring can improve patient outcomes, and satisfaction, enable clinicians to pre-empt adverse events, and reduce clinician burnout.

App puts patients at the center of their treatment

Although cancer treatments have become more standardized through treatment guidelines, not every patient, their health history, their preferences, or their cancer is the same. A well-tolerated treatment for one patient can bring debilitating side effects for another. Being able to tailor treatments to patients based on their unique situation and preferences forces clinicians to deviate from guidelines and use intuition, rather than data. But when clinicians have a direct line into real-time patient symptom data, they are armed with more than a gut feeling to make personalized treatment decisions.

Continuous symptom monitoring using ePRO tools empowers patients to take charge of their symptoms while providing valuable data to clinicians to intervene when necessary. ePROs provide more than solely giving patients the ability to report their symptoms electronically from the comfort of their home – some ePROs have the ability to provide patients with personalized educational resources while they await a response from their care team. Additionally, there are ePROs that can be configured even further at the patient level, giving their care team the ability to choose which symptoms they report and how often they report them based on their treatment plan. ePROs are a key tool in the push to realize personalized medicine in oncology.

Engagement can lead to better patient outcomes

Empowering patients in their healthcare is considered a fundamental aspect of patient-centered care and has the potential to transform the healthcare experience for both the patient and their care team.

Patient engagement has been linked to better health outcomes, as they are more likely to adhere to treatment plans and medications, leading to improved disease management and prevention of complications.

Effective, shared decision-making starts with a good relationship between patients and their care team. By creating an environment where information is shared openly, patients feel supported and encouraged to express their treatment preferences.

Empowered patients are more informed about their conditions and treatment options, which enables them to make decisions that align with their values and preferences. ePRO tools can help facilitate this dialog through symptom monitoring, relevant and appropriate education, and the ability of patients to review their responses to potentially help them understand how well they tolerate or don’t tolerate certain treatments or symptom interventions.

A randomized, published study of patient-reported outcomes among cancer patients receiving chemotherapy shows that symptom monitoring:

• Improves quality of life by 88%
• Reduces ED visits by 17%
• Increases chemotherapy adherence by 30%
• Increases patient survival by 8%

Empowered patients feel supported by the knowledge that staff are monitoring their symptom reports and stand ready to intervene, if necessary, should symptoms threaten their health or could possibly result in an emergency room visit. More than 90% of patients using a cancer-specific ePRO tool express satisfaction with the app.

Saving clinicians time while caring for patients

Symptoms of burnout among clinicians were already high before the pandemic hit. A survey from the American Society of Clinical Oncology (ASCO) showed that 45% of medical oncologists “had experienced classic symptoms of burnout, including emotional exhaustion and depersonalization/detachment.” Burnout doesn’t just affect oncologists, it affects every member of the care team. Another ASCO survey showed that oncologists worked an average of 57.6 hours a week while seeing a mean of 52 outpatients.

Adequately caring for patients takes more time, but the preponderance of EHRs has resulted in increased work for physicians. A study utilizing 2019 data shows that physicians spend an average of 1.84 hours daily performing documentation tasks outside of work hours.

Electronic symptom monitoring not only empowers patients, it also relieves clinicians of many charting duties that can take considerable time to complete. Instead of a nurse calling every patient who just started post-surgical treatment to check on potential side effects, self-reporting tools allow care teams to monitor symptoms remotely. Rather than individually checking in with the entire cohort, care teams can follow up with patients who report adverse reactions, which saves considerable time and eliminates much of the communication back and forth that frustrates both patients and providers.

By monitoring the patient population using ePRO tools, physicians can focus on patients who require intervention for their symptoms or may need treatment modification. Anecdotally, using ePRO tools can save physicians as many as 55 clicks within an EHR, per patient.

Improve quality of life for patients — and clinicians

A cancer diagnosis sets off a cascade of next steps, including additional tests, consults, surgery, follow-up visits, chemotherapy, and more. It’s no wonder that oncologists say that patients often have difficulty digesting their diagnosis and understanding next steps— it’s just too much information at one time.

Using electronic patient-reported outcomes tools empowers patients to take charge of their own symptom management, reassured that they aren’t alone on the journey through side effects and pain management. ePRO tools have been shown to improve not only the patient’s quality of life but also the work life balance for oncologists and their care team through speedier and more efficient processes.

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As the number of Americans with chronic conditions continues to grow, health plans are constantly trying new approaches to meet their condition management goals with fewer resources. Payers are seeking to optimize outcomes while minimizing costs by implementing innovative strategies like telemedicine, remote monitoring and personalized care plans. 

On Thursday, leaders from across the industry shared their advice on how health plans can do a better job of achieving their goals for chronic management during a virtual panel held by Bright Spots in Healthcare. Below are some of their panelists’ main nuggets of wisdom.

Use data analytics to identify high-risk individuals and provide targeted interventions.

Most insurers are aware that the U.S. has the highest rate of maternal mortality among all industrialized countries. Reetika Kumar, vice president of market clinical solutions and pharmacy services at Independence Blue Cross highlighted an initiative her company launched with the University of Pennsylvania to address this problem.

Under the program, called HeartSafe Motherhood, Independence Blue Cross used data analytics to determine which maternity patients were at high risk for developing preeclampsia. These patients were sent home with blood pressure cuffs and enrolled in a telehealth program in which they could talk to their provider via phone. Their providers would review their digital readings and intervene if they noticed spikes in blood pressure, Kumar explained.

She highlighted HeartSafe Motherhood as an example of a program that not only has potential to lower mortality and morbidity rates compared to traditional care — but also one that can be scaled up or applied to different patient populations relatively easily.

Centralized observation is a mighty tool.

Health plans should be taking advantage of the sophisticated remote patient monitoring tools that have been entering the market over the past decade, pointed out Scene Health CEO Sebastian Seiguer. 

These tools can be applied to the inpatient setting, such as by giving ICU patients wearables that quickly notify their care team when a cardiac or respiratory failure occurs. They can also be applied to patients managing their chronic conditions at home — so that providers aren’t left in the dark about a patient’s progress post-discharge — Seiguer explained.

Overall, centralized observation allows providers to react more quickly and efficiently to patient needs, which usually means improved patient outcomes as well as reduced costs, he explained. 

Use the right metrics.

When measuring progress on their chronic conditions management goals, health plans can sometimes fixate on the wrong metrics, Seiguer noted. For instance, health plans often pay close attention to refill metrics, he pointed out.

“You can spend a ton of money to get people to refill medication, but if they don’t take them or they don’t take them correctly, they’re still going to the hospital,” Seiguer declared.

Instead of dedicating heaps of money and time on pharmacy refill calls and reminders, health plans should focus more on measuring the clinical outcomes that matter to patients, such as their blood sugar and blood pressure levels, he remarked.

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