Business of Well-being

It’s Time to Get Real About Care Delivery

Employee Healthcare

Transformational technologies are briskly changing our healthcare ecosystem — altering patient-centered care delivery while advancing quality improvement with validated clinical excellence algorithms. These, in turn, create powerful, actionable insights for improving people’s lives, achieving better healthcare, and lowering costs while also fueling healthier, stronger organizations.

Necessity prompts strategic adaptation.

We always knew innovation was imperative to pave the way for disruptive improvement in the workplace, but what we did not realize was that primary care would be the harbinger of self-care accountability — creating clinician-employee partnerships to achieve sustainable health outcomes and reduced benefits spend.

“We know that patients trust their family physicians to entrust whole-person care, consequently enabling self-care accountability at the same time optimizing the sanctity of the patient-physician relationship,” said Paul Grundy, MD, MPH, FACOEM, FACPM, Chief Transformation Officer, Innovaccer, Inc., and Founding President of the Patient-Centered Primary Care Collaborative. “Everyone knows that there is no better specialty than family medicine vis-à-vis human connection paired with digital health technology for future medicine,” adds Grundy.

Digital health innovation must be examined through the lens of evidence-based improvement to yield a productive advantage using real-time data at the point of care to boost human performance.

Ineffective digital health offerings abound in the market; nonetheless, when done right, these innovations provide an inextricable link to improving employee vitality, building thriving and productive workforces while simultaneously reducing total cost of care and accelerating enterprise-wide human performance excellence.

Importantly, recent TripleTree interoperability research revealed shortcomings from vendors providing “meaningless use” digital platforms that lacked robust capabilities to empower employees with personalized care support tools. However, there’s a better way forward.

The TripleTree report, The Rising Stakes of Interoperability in Healthcare, revealed strategies to overcome the challenges and implications of many existing “meaningless use” digital health platforms that appear not to meet the immediate needs of countless patients. Notably, many digital health platforms purport to provide financial benefits to healthcare providers intending to use appropriate EHR technologies in meaningful ways — but many still may not.

“Interoperability and seamless data exchange among patients, payers, and providers continue to be a major focus for all healthcare constituents seeking to provide the highest quality and most affordable patient care,” states Joe Andriacchi, Investment Banking Associate, TripleTree.

“Without access to a comprehensive view of patients and their medical records, providers are left partially blind to the status of the patients’ health. This can potentially lead to lower-quality care, higher costs, and worse medical outcomes,” further states Mr. Joe Andriacchi.

From non-integrated technologies to virtually ubiquitous models of virtual care delivery, the current situation is obscure. What is needed is a comprehensive, agnostic digital health platform with longitudinal views of actionable point-of-care data that does not leave providers partially blind in their quest to help patients achieve sustainable health outcomes.

“There is a significant health burden and economic impact in the workplace if employers do not ‘get it right,’” stated Atish Jaiswal, MD, MBA, MA, CHCQM, Physician Advisor, Westchester Medical Center —Westchester Medical Center Health Network and Physician Quality Advisor, Bon Secours Charity Health System. “Mindful coordinated care delivery of the patient is the first concern for all doctors — collaborative interaction is key to ensuring best patient outcomes via real-time point of care communication with patients and family members,” further states Jaiswal.

The needs of the patient come first.

Quality improvement at the point of care is a definite requirement of any new technology. Transformational technologies coupled with patient-centered best practices are improving care quality and reducing costs by empowering patients and creating clinician-patient partnerships to achieve sustainable health outcomes, according to the American College of Cardiology’s (ACC) Innovation Program.

Employers are increasingly focusing on optimizing whole-person care delivery through value-based benefits plan design in tandem with primary-specialty care, trusted-clinicians while improving self-care compliance using clinical platforms that leverage patient data. These strategies, in turn, lower healthcare costs while accelerating organizational performance.

Front-line clinicians and workers understand the benefits of whole-person care delivery in action. A Medicina study, The Case for Whole-Person Integrative Care, revealed that whole-person care delivery models were designed to improve overall patient-reported outcomes, including patient satisfaction, health outcomes, healthcare costs, and provider burnout.

Functional outcomes matter. A recent American College of Occupational Medicine and Environmental Medicine study affirmed the principles of using patient-reported functional outcomes (fPROMs) in medical practice: 1) Evaluating and optimizing patient function should be a central focus of all clinical encounters and 2) To improve the quality of patients’ lives and wellbeing, there must be more focus on the use of functional outcome measurements including participation in work, home life, and society — all major elements of a patient-centered model.”

Work is a social determinant of health. “Savvy employers like Federal Occupation Health, Chevron and Prudential, to mention a few, are rapidly expanding employee health benefits offerings with primary care functionality,” states Fikry Isaac, MD, MPH, FACOEM, CEO, WellWorld Consulting and Advisory Board Member, Enterprise Health, Eden Health, and former Chief Medical Officer of Johnson & Johnson Health & Wellness Solutions. “Forward-thinking employers focusing on workforce human performance, employee experience, and productivity are drifting away from legacy IT software applications. Integrating occupational health and safety IT interfaces with primary and specialty care provide employees with real-time, point-of-care clinical guidance when they need it — keeping them safe and helping their company thrive and lead with a handprint,” further states Isaac.

At the center of patient care is the promise to “first, do no harm.” This is exemplified by the American College of Physicians, which advocates its High-Value Care, whole-person approach to enable a unified, higher quality service to deliver the best health care possible.

“The promise of trusted care in the workplace vis-à-vis employee health and safety, mental fitness, return to work and reintegration, entails delivering care protection that injured workers trust and depend on from “best places to work’ employers,” states Russell D. Robbins, MD, MBA, Chief Medical Information Officer PurpleLab, and former Medical Director and AVP Clinical Informatics, Blue Health Intelligence. “It is all about major leaps in ways to bring high-value care for future medicine, deriving tenfold improvement in medical management performance,” further states Robbins.

Sustainable “value” incentives amongst medical practices are propelling high-performance healthcare practices and providers. Meaningful organizational change requires single-specialty or multi-specialty groups, employed physician groups, direct primary care clinics, workers’ comp, injured worker clinics, and employer onsite, near-site, or mobile health clinics to move up healthy business performance and predictable revenue streams over time with caring, advanced practice providers and trusted-clinicians.

The sustainability imperative

Embracing a patient-first imperative necessitates a systematic approach that enables physicians to aggregate, analyze, and leverage patient-reported outcomes. This imperative entails an end-to-end clinical platform with personalized-care protocols and patient-empowered self-care tools that leverage actionable clinical insights, unleashing the full power of patient-centered data.

Importantly, the sustainability imperative entails a strong strategic fit with future medicine providers, advancing the imperative to sustain population health promotion, taking a hard look at:

  1. Clinically actionable care guidelines
  2. Artificial intelligence and machine learning methods
  3. Patient safety and social determinants of health
  4. Clinical patient treatment adherence and compliance
  5. Risk stratification tracking multi-comorbidity data
  6. Closure of care caps and planned care coordination
  7. Meaningful, productive interactions and preemptive interventions
  8. Personal care transitions and sustained engagement

 Bottom line. Patients must be met where they are on their healthcare journey.

 “A 2020 survey found that 85% of behavioral health and intellectual and developmental disability provider organizations are planning to, or have already, broadened their practices to include primary care services,” said Monica E. Oss, CEO, OPEN MINDS. “This year, we are seeing that more and more attention is being focused on expanding integrated care to encompass the “whole person” approach,” further states Ms. Oss.

Facing up to quality improvement for future team-based medicine reality is not extra or a nice-to-have, it’s a must-have.

Virtual care is top of mind for employers.

As employers start to bring people back into the office, and COVID-19 continues to mutate, it is critical to understand that the ongoing physical and mental ramifications of the pandemic may linger. The discussion about virtual care’s mainstream escalation is, therefore, timely.

Achieving value in the future of medicine is mission-critical, strengthening health systems to sustain health outcomes and fueling healthier, stronger organizations. A recent survey by Business Group on Health cited virtual care as an elemental healthcare strategy ingredient and plan design imperative for employers.

“The conversation we are hearing from our members is that virtual care really is here to stay,” said Brenna Shebel, Vice President, Business Group on Health. “We have been hearing that virtual care is not just a standalone thing on the side but is becoming integrated into the care experience. We expect this number to remain steady or even increase in coming years,” stated Shebel.

Digital health technologies build upon the trusted doctor-patient relationship. They’re designed to steer employees to high-value, personalized care support and evidence-based improvement programs. This produces better experiences for patients and clinicians alike, generating positive results on a macro level. They include improved population health, reduced health care costs, and empowered workforces that thrive.

Employers that leverage the best digital health offerings are adopting a proven center-of-excellence strategy that includes high-value, advanced practice primary care providers. An example is Everside Health, one of the nation’s largest direct primary care providers, whose more than 340 clinics in 33 states are conveniently located at or near worksites of employers, unions, and other clients.

Its technology-driven platform aligns incentives to benefit the employee, physician, and benefits provider while reducing the total cost of care. Employees and their dependents receive frictionless access to low- or no-cost in-person, virtual care, in conjunction with occupational medicine services, as well as clinical self-care guidance, reducing the need for costly ER use.

Distinctly noteworthy is that the company’s clinical outcomes exceed Healthcare Effectiveness Data and Information Set (HEDIS) measures for commercial PPO benchmarks created and recently reported by the National Committee for Quality Assurance. Employer clients typically reduce overall healthcare costs by 20%.

American Ingenuity at Work in Colorado

Imagine a state-of-the-art patient-reported outcome and remote monitoring platform for comorbidities and real-time provider data. The result, actionable patient-provider engagement and compliance insights ingrained into an EMR agnostic interface by utilizing point-of-care tools that a clinician can utilize immediately with the patient, designed to vitally impact an individual’s health outcomes and whole-person wellbeing.

Considerable ingenuity must be employed in engineering meaningful use interoperability and seamless data exchange through key performance indicators to assess and validate the efficacy of a particular intervention as compared to standard care in improving treatment outcomes.

“Identifying ‘high-value’ practices in primary care clearly leads to powerful clinician-patient partnerships and optimal patient-centered care via passive monitoring of patients, and real-time transitions to care across all levels of care, providing sustainable workforce work-life health achievement outcomes,” further states Grundy.

Transformational technologies for future medicine are booming, and forward-thinking healthcare medical practices and providers are working with agile and adaptable innovators who have ambitious plans to take patient care to the next level. Clinicians are keen on using smart user-friendly platforms as it allows them to adopt proven innovations that were previously unavailable.

Notably, in Denver, Cliexa is the brainchild of its founder, Mehmet Kazgan MSc, MBA. An engineer and data geek, his role as a VP at Aetna opened his eyes to a missing link in care delivery data capture. So, he set out to design a solution. A nexus shift of attitude—entwined root-cause analysis synergy by fusing data, tech, and clinical experts adopting a one-of-a-kind solution for future medicine — a platform that unlocks powerful data insights for clinicians and their patients to boost better healthcare delivery.

The bar for high-value care delivery with patients keeps rising. A recent paper, Adaptive Leadership Framework for Chronic Illness, proposed an adaptive leadership approach to providing care for chronic illness and framing the research agenda for transforming care. “It’s imperative we adopt progressive, adaptive health care delivery models that enable clinician-patient partnerships to support patients in making personal care transitions that result in qualitatively better health outcomes,” states Marcus Thygeson, MD, MPH, Chief Health Officer, Bind Benefits. “We also need technologies that simplify patient interactions with the healthcare system. Patients have no desire to re-enter previously reported data or click through multiple apps or links to get the information they want,” further states Thygeson.

Care Delivery Transformation through Novel Partnership Alliances

Primary care delivery serves as the cornerstone for building an empowered workforce; ensuring positive health outcomes to achieve sustainable healthcare delivery and curtail benefits spend.

Cliexa continues to aggregate data to shape and mold the digital health space, advancing clinician-patient partnerships and collaborations with preeminent organizations. Cliexa appears to be the first longitudinal access data enabler service provider necessitating digital front door experience protocols designed to meet patients where they are on their patient journey. Its remote patient monitoring (RPM) capability enables real-time, passive patient monitoring and real-time transitions to care across levels of care. The results create stronger clinician-patient partnerships for sustainable health outcomes.

Partnership alliances are unlocking the power of patient-reported outcome measures. Cliexa’s distinctive partnership with the American College of Cardiology’s Innovation Program and its TeleHealth Workbook are providing meaningful insights to advanced practice providers. Ami Bhatt, MD, Director of TeleCardiology, Massachusetts General Hospital and Associate Professor of Medicine, Harvard Medical School, and 2022 President-elect, Greater Boston Board of Directors, American Heart Association, believes state-of-the-art personalized care can be delivered to individuals in the community, empowering patients and creating stronger clinician-patient partnerships for sustainable health outcomes.

What is particularly noteworthy is Cliexa's KPIs clinical outcomes-validation by American College of Cardiology at New Health Pain Clinic:

● 10% decrease in visit cancellations;

● 10-minute time saving per visit per provider;

●     15% increase in revenues; and

●     97% accuracy in predicting opiate risk at integrated care management powered by AI.

Moreover, Cliexa’s primary care providers and multi-specialty group practices typically realize a value on investment of 3:1 ROI.

Social connection is a critical determinant of health and THE key factor in whole-person, wellbeing — and the ability to thrive in the workplace — empowering healthy flourishing communities. A recent Social Determinants of Health — an Employer Priority consumer-patient vital conditions study by Health Enhancement Research Organization (HERO) validated the ‘interconnectedness’ of behavioral and cognitive conditions and physical health. “Many community stakeholders (employers, primary care medical practices, trusted-clinicians, accountable care organizations, health plans, units of government) are finally concluding that ‘whole-person approaches to care are not only a better consumer experience and lead to better consumer outcomes, but they also decrease costs as well,” further states Ms. Oss.

Minding the bottom line

Minding the gap for business performance requires integrative thinking, not to mention intense focus on charting the medical performance management metrics that really matter, which is a mission-critical imperative to maintain growth and profitability goals.

AI is transforming the way adaptive data enablers achieve profitably. Putting AI and patient-reported data at the center of their capabilities, data enablers systematically envision how they design, synthesize, and share value — and are achieving imposing growth as a result.

The point is that physicians are in the best position to improve the quality of health care through evidence-based standards of care delivery and evidence-based improvement to boost total worker health, vitality, productivity, and employability — and it all starts in the doctors’ office.

The volume of data generated within the healthcare ecosystem is overwhelming, with transformational technologies experts estimating that the data doubles every 73 days. “Cliexa’s platform design is a game-changer in motion. This platform provides a unified clinician-patient-payer, data-driven approach with an inclusive cloud-based EMR agnostic interface designed to support whole-person care as well as provider merit-based incentive payments (MBIP) schemes,” said Dan Cave, principal, Mountains Call Consulting, LLC, co-founder, and co-chair, Centene Center for Health Transformation.

“The ability, with its AI, to leverage risk stratification tools that interface longitudinally and seamlessly with patient-remote monitoring interfaces plugging in preemptive interventions — including mental health and wellbeing best practices along with advanced care facilitation patient engagement protocols — appears to place Cliexa in a position where its platform well could be the “next normal” stirring digital transformation of care delivery” stated Dan Cave.

Enabling, Nurturing, and Empowering Patients

The future of medicine brings high-quality, patient-centered care that improves the health and mental wellbeing of patients served by community providers.

The genie is out of the bottle. There is no health without mental health. The mind-body connection mindset is thriving. In integrative medicine, the whole-person approach is enabling, nurturing, and empowering the clinician-patient therapeutic alliance to sustain positive health outcomes for future medicine and fuel healthier, stronger organizations.

So, let’s do better. Health is a personal and national resource. It is what empowers people to engage with life. Without mind-body-health-wellbeing, people cannot share in loving, enduring relationships with family and friends, contribute to their communities, or fully participate in work. When people can optimize emotion, engagement, relationships, meaning, and accomplishment, they flourish.

“It appears the holy grail of future medicine is what Cliexa’s platform, and more importantly, its expansive interoperability, could enable – namely, the ability to align clinical providers, care and case managers, across disease or disease risk-factor states, and the array of virtual care applications within the provider community to provide the prerequisite infrastructure for truly whole-person health,” further stated Dan Cave.

George Westerman, a research scientist and senior lecturer at MIT, nailed it in suggesting that “when digital transformation is done right, it’s like a caterpillar turning into a butterfly, but when done wrong, all you have is a really fast caterpillar.” 

About the Authors

Les C. Meyer, MBA, is a healthcare strategist, serial entrepreneur, and global executive leader with experience in understanding the forces driving mindful innovation, seizing the upside of disruption, and leveraging the strategic value of enterprise-wide organization health resilience.

Russell D. Robbins, MD, MBA is the Chief Medical Information Officer (CMIO) at PurpleLab. He has spent the majority of his professional career working with healthcare data, creating episodes of care groupers, and health and benefits consulting. Through this work, he has gained insights into healthcare costs, disparities in care delivery and created many models to improve employee wellness and productivity.

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