LeanTaas CEO: EHRs are not built to handle capacity optimization

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One of the biggest sources of patient dissatisfaction is waiting. LeanTaaS founder and CEO Mohan Giridharadas says hospitals are much better off using SaaS products embedded with sophisticated artificial intelligence to optimize their capacity rather than relying on their EHR capabilities or in-house data analysts if they want to see measurable results.

CVS Health Launches New Virtual Primary Care Platform

CVS Health Launches New Virtual Primary Care Platform

What You Should Know:

CVS Health launches of its new Virtual Primary Care solution on a single digital platform for a more coordinated and consumer-centric health care experience.

– The new offering, which is being sold to Aetna fully-insured, self-insured plan sponsors, and CVS Caremark clients now, will become effective for eligible Aetna members starting January 1, 2023, and for eligible CVS Caremark members during the second quarter of 2023. It complements Aetna’s virtual care strategy currently in market.  

CVS Health Virtual Primary Care Offering

On average, it takes 24 days to schedule an appointment with a primary care physician, and the average wait time to see a mental health provider in-person is 48 days. CVS Health Virtual Primary Care is designed to help members schedule timely virtual appointments with their Care Team.  CVS Health Virtual Primary Care will give members access to primary care, on-demand care, chronic condition management, and mental health services virtually, with the option of being seen in-person when needed at an in-network provider, including MinuteClinic. The virtual primary care provider can also help members identify appropriate in-network specialists and other in-network health service providers, if necessary.

Member-Selected Physician-Led Care Team

CVS Health Virtual Primary Care will feature a member-selected physician-led Care Team that can consist of nurse practitioners, registered nurses, and licensed vocational nurses who can easily be accessed through the platform. The Care Team will consult with a dedicated CVS pharmacist when needed, which can provide opportunities for medication management. CVS Health Virtual Primary Care will also use an interoperable electronic health record that will help members transition between virtual and in-person care, and their clinical data can also be shared with their other providers. A comprehensive view of data and care activity will allow providers to deliver personalized health alerts that help close gaps in care and maintain wellness.

Benefits for Aetna and Caremark Members

With the introduction of CVS Health Virtual Primary Care, Aetna is offering plan sponsors more benefit options to meet their member’s evolving needs. Additionally, Caremark members will now have a solution that will allow them to access more CVS Health services and capabilities. By combining health services, a coordinated Care Team and clinical data on a single digital platform, CVS Health Virtual Primary Care will help all members receive health guidance and care coordination that directs them to the lowest cost, clinically appropriate care.

Geisinger & Tempus Create AI Model to Identify Structural Heart Disease

Geisinger & Tempus Create AI Model to Identify Structural Heart Disease

What You Should Know:

– Tempus, an $8B precision medicine company, announced a collaborative study with Geisinger focusing on artificial intelligence (AI) model that can accurately identify patients at increased risk of undiagnosed structural heart disease (SHD). The study addresses a critical diagnostic gap – SHD is a progressive disease that affects the valves, walls, chambers, and muscles of the heart, and causes debilitating symptoms or death, yet many patients with the disease go undiagnosed.

– Tempus and Geisinger’s study, known as rECHOmmend, aims to aid clinicians in identifying at-risk patients faster before SHD ​​reaches a severe stage. The study was published in Circulation

ECG-Based AI Model Can Predict Undiagnosed Structural Heart Disease

Structural heart disease (SHD) is a group of conditions that adversely affect the valves, walls, chambers, or muscles of the heart. SHD is typically a progressive disease that causes a variety of debilitating symptoms or death, making it important to diagnose and treat patients early to prevent these poor outcomes. However, many patients with the disease are undiagnosed.

The team of data scientists and medical researchers used 2.2 million ECGs from more than 480,000 patients over 37 years of patient care at Geisinger to train a deep neural network—a specialized type of AI model—to predict who, among patients without a prior history of SHD, would develop clinically significant disease that could benefit from guideline-directed monitoring or treatment. Overall, the study found that the model achieved excellent performance, exceeding the performance of any previously published model predicting any single disease. The findings show that clinicians using this model could find more diseases with fewer diagnostic studies.

“Structural heart disease carries a high burden of morbidity and mortality, and this model can be both actionable and practical for identifying undiagnosed patients in clinical practice,” said Joel Dudley, Ph.D., chief scientific officer at Tempus. “Our two teams are working to find new ways of applying AI to predict heart disease before it reaches a severe stage of irreversible debilitation for patients, and the rECHOmmend study builds on that foundational work.”

This study expands the AI-based cardiology research the Tempus and Geisinger teams have pursued in recent years, starting with a Nature Medicine paper that demonstrated that AI can predict mortality directly from ECG data even in the large subset of ECGs interpreted by physicians as normal. In 2021, a jointly created AI model that can predict risk of new atrial fibrillation (AF) and AF-related stroke was published in Circulation and was later granted Breakthrough Device Designation by the U.S. Food & Drug Administration. 

CMS expands Medicaid postpartum coverage into four new states

The Centers for Medicare and Medicaid Services has approved California, Florida, Kentucky and Oregon to expand Medicaid and Children’s Health Insurance Program coverage to up to one year postpartum – bringing the total number of states expanding postpartum Medicaid coverage to 11.

CMS estimates this would affect a total of about 126,000 families annually across the four states.

Civil rights groups help put privacy legislation within reach

By Cameron F. Kerry

Even before the death of George Floyd added urgency to issues of racial equity, it has been clear that federal privacy legislation cannot and should not pass without a provision bringing to bear civil rights laws on how personal information is used. This is why a May 25th, 2022 letter from major civil rights organizations, joined by a broad coalition of civil rights, consumer, and privacy organizations totaling 57 signers, is a big deal. It signals that federal privacy legislation “during this session” of Congress is priority for civil rights organizations, and, with support from a spectrum of advocacy organizations, it frames elements that are included in existing bills and can garner bipartisan support.

I have written previously that, based on Brookings convenings of various cross-sections of stakeholders and numerous conversations with individual ones, it was clear privately that a broad swathe of stakeholders both understood the bargains needed to pass privacy legislation and were ready to make them. Now, the May 25th coalition letter makes this posture public on behalf of most of the organizations on the civil society side of the privacy debate.

The letter focuses on civil rights online and was spearheaded by the Leadership Conference and the Lawyers Committee, which have been the point organizations for civil rights language, but it also includes bullet points covering additional major elements of privacy legislation, several of which are addressed in proposals from both Democrats and Republicans. The letter effectively acknowledges as much, stating: “[t]here are many avenues to enacting comprehensive data protections.”

Broadly, the civil rights coalition is calling on Congress to enact privacy legislation “[p]rohibit[ing] [the use of] personal data to discriminate on the basis of protected characteristics.” This simple framing resembles not only an abbreviated version of the civil right provision in a 2019 bill from Senate Commerce, Science & Transportation Committee chair Maria Cantwell (D-WA) but also language in a draft bill from Republican staff of the House Energy & Commerce Committee in November of 2021. The latter was surprisingly well-received among civil rights groups, and since then had provided a basis for bipartisan discussion. If Republicans and civil rights groups can converge on this issue, that is a huge step toward privacy legislation.

The list also includes “[p]reserv[ing] state civil rights laws and other types of state laws that are important for the protection of consumers and marginalized communities.” This implies federal preemption of other state legislation — a notable step away from what has been the position of numerous organizations involved, and of bills like the 2019 Cantwell legislation that federal law should allow states laws that go further in protecting privacy. The coalition letter opens the door for preemption of inconsistent state laws with certain carve-outs, along the lines of the approach recommended in the June 2020 Brookings report on bridging the gaps in the federal privacy debate.

Another substantive issue in the coalition’s letter is a right to bring private lawsuits. That is a sticking point for some in industry but, at a Senate hearing in September of 2021, both industry witnesses and Republican senators opened the door to a private right of action “with guardrails.” The May 25th coalition letter is not specific about the scope of a private right of action, but there are reports of progress toward bipartisan agreement on some form of private action.

Now, it’s up to Congress. Can legislators show the same kind of pragmatism as these advocacy groups?

At this point, several bills from both sides of the aisle propose better, stronger privacy protections than proposed legislation of the past — including the 2012 Obama Consumer Privacy Bill of Rights that I helped frame. And all signs, from whatever signals emitted from what has been a tight-lipped negotiation among committee leaders in both houses, indicate that negotiators have bipartisan agreement on most of the points covered in the coalition letter. The reported sticking points are on other issues that have been peripheral to the privacy debate.

Congress has never been this close to a comprehensive privacy bill capable of passage, but the call to action from civil rights nudges it even closer. It would be a shame to miss this opportunity to put in place long overdue protections of individual privacy, including protection against discrimination in the use of personal information. Another one may not come for a long time.