www.chcs.org

Wednesday, September 10, 1:00 – 2:30 pm ET

For Audio Dial: 877-397-0300

Passcode: 550695

Digital Health and the Underserved, Part 2: Front-Line Perspectives

Made possible through support from Kaiser Permanente Community Benefit

Questions?

2

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Agenda

3

I. Welcome and Introductions

II. Digital Health Overview

III. Startup Spotlight: Healthify

IV. Startup Spotlight: Sense Health

V. Collaborating with Startups: The Delivery

System Experience

VI. Moderated Q&A

Speakers

4

Manik Bhat

CEO

Healthify

Stan Berkow

Founder and CEO

Sense Health

Rachel Davis

Senior Program Officer

Center for Health Care Strategies

Michelle Blackmore, PhD

Attending Research and Clinical Psychologist

Montefiore Medical Center

Portrait of the Underserved

5

• 5% of Medicaid beneficiaries account for 55% of the program’s total costs

• Low connectivity to primary care, frequent Emergency Departments

• High prevalence of physical health, mental health, substance use conditions

• Many are socially isolated and unstably housed

• Wary of the health care system

• High degree of care coordination needed to manage needs

1

2

3

Sources:

1. 2013 Super-Utilizer Summit: Common Themes from Innovative Complex Care Management Programs,

http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf407990

2. J. Billings and M. Raven, http://content.healthaffairs.org/content/32/12/2099.abstract

3. University of Washington, http://www.chcs.org/media/RTC_Evaluation_TECHNICAL_REPORT_FINAL_3_15_12a.pdf

Key Takeaways from Webinar Part I

Complex populations require tailored solutions

The development of tailored tools is lagging

Low-income populations are increasingly “connected” and already using technology to help manage their health

Organizations like StartUp Health and the Center for Care Innovations are supporting development of digital tools for this population

Increasing digital health opportunities for delivery systems, plans and programs serving underserved populations

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Healthify

We address the social needs of patients to reduce costs and improve case management

Healthcare market is trying to deal with this

Social and Behavioral Health Needs (Food, Childcare,

Substance Abuse services)

1/5th of Medicaid Spending

60%

60% of HealthOutcomes

$87.4B

Current Solution?

Team is understaffed (1:3500 patients) and relies on paper based workflows to manage patients

and referrals to social services

Hire Ancillary Care Team (case managers)

Result?

Insurers and providers can’t

meet new quality metrics

Only 7% of patients are screened for

needs

7% $$

High spending with low margins

Poor follow up

Demo

Medicaid Managed Care: PMPM + Monthly License fee

FutureDuals, ACOs, Retail Clinics, Data

Business Model

Benefits

• Reduce costs by ~2%

• Lower readmissions

• Collect enhanced patient data

Improve crucial quality metrics

LONG TERM

Increase case management capabilities

Identify 8x as many patients who are at risk

8x

Johns Hopkins: Case managers with Medicaid population.

VillageCare: Home Health managers. RCT trial being conducted.

Large Insurer in Florida: Community Health Workers.

HSC Healthcare: Special needs health plan.

Over 300 Staff on platform by EOY

Managing over 20k patients

Ongoing data collection

Customers

www.healthify.us

info@healthify.us

@healthifyUS

Contact Us

Montefiore & Digital Health

in the Underserved

Michelle A Blackmore, PhD

Attending Research and Clinical Psychologist

Montefiore Medical Center, Bronx, NY

Montefiore Medical Center:

Program Description

• University Behavioral Associates (UBA) – behavioral

managed care organization

• Managed Addiction Treatment Services (MATS) :

Designed to reduce exceptionally high healthcare costs

in high utilization substance abuse patients

• Health Homes & Medicaid Redesign in NYS

• Bronx Accountable Healthcare Network (BAHN)

Montefiore Medical Center:

Program Description

• Expansion of UBA’s Managed Addiction Treatment

Services (MATS) under Health Home resulted in:

• Care management for high-cost, high-needs patients w/

multiple behavioral health &/or chronic medical

conditions

• High increases in care managers’ caseloads

• Clients becoming more geographically disperse

Montefiore Program Needs

• Need for technology to help streamline & augment service

delivery

• Interested in testing efficacy of SMS platform to help care

managers deliver quality, high intensity care management

services in an efficient & cost effective manner

Project Details

• Pilot Health Tech NYC grant program

• Initiative funded by the New York City Economic

Development Corporation (NYCEDC)

• Matches early-stage health or healthcare technology

companies with key NYC healthcare service organizations

• Provides funding to test a technology prototype in a

healthcare setting

• Montefiore matched with StudyCue, LLC (Sense Health)

Funding and Cost

• Funding for Sense Health & Montefiore collaboration

from Pilot Health Tech NYC = $100k

•Sense Health pricing model based on number of providers

using system

•Plus initial $5,000 set-up fee for care manager training,

customer service, & development resources

•Set-up fee may increase if needs to be integrated w/

already existing EHR systems

Key Issues

• IRB & Compliance Reviews

•HIPAA compliance issues & resolution

• Target Population & Impact

•Enrollment criteria

•Feasibility of SMS intervention

• Staff Buy-In

•Initial training

•Modification & simplification of user interface

HIPAA Compliance

• Privacy Issues

• Text message content cannot

be encrypted

• Sending messages containing

PHI to a potentially non-

secure phone

• Risk-reducing strategies must

be implemented

HIPAA Compliance Strategies

• Opt-in: Clients must opt-in before provider can send support

messages

• Content Strategy: All content avoids mention of sensitive PHI

that might link client with specific health issue (e.g.

medication, specific disease)

• PHI Checker: Scans messages for PHI content before sending

• Conversation History: All patient info & stored text messages

are secured on Sense Health server in HIPAA compliant

manner

Target Population & Feasibility

Participants needed to:

• Be enrolled in MATS

• Own a mobile phone w/ a texting plan

• Be willing to provide informed consent

• Almost all participants had mobile phones w/

unlimited texting

• Majority of participants preferred texting w/ care

manager

Staff Buy-in

• Important for staff to recognize benefit of using new technology

• Proper training for care managers:

• 30-min overview & demonstration of

Sense Health platform during staff

meeting

• 15-20 min individual tutorials for each care manager by member of Sense Health team or trained Montefiore staff

• On-site assistance throughout project

Adjustments to Meet

Program Needs

• Organizational Access: allows supervisors to monitor

interaction b/w care managers & clients

• Client Alerts: texts & emails care managers when clients

indicate being in immediate need

• Sense Health API: allows organizations to integrate Sense

Health with existing care management & billing systems, &

medical records

• Custom Script Builder: care managers can instantly create

patient support plans, ensuring individualization of treatment

Tips for Delivery Systems

• Necessary for hosts & tech companies to be a like-

minded team

• Hosts need partners, not just products

• Understand infrastructure & how to work w/i the system

• Maintain clear communication

• Use the same language

• What are the host’s needs; what are the problems needing

solutions

• Work on-site

Tips for Delivery Systems

• Commitment to continuing adaptation and

improvement

• Technology implementation is an evolutionary process

• Monitor and assess data continuously

• Tailor technology to meet needs of the host’s target

population

Next Steps

• Large scale, phase II pilot

study by Montefiore’s

Clinical IT Research and

Development Dept

• Possible adoption of Sense

Health platform by MATS

immediately

Questions?

41

To submit a question please click the question mark

icon located in the toolbar at the top of your screen.

Your questions will be viewable only to panelists.

Answers to questions that cannot be addressed due to time constraints will be

shared after the webinar.