Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.


AMA Chief Experience Officer Todd Unger talks with health care experts about innovations to support physicians, practices and health systems during COVID-19.

Learn more at the AMA COVID-19 resource center.

Speakers

  • Nick Dougherty, managing director, Mass Challenge Health Tech
  • Beth Andrews, vice president, Managed Accounts, Moving Analytics 
  • Josh Reischer, MD, founder and CEO, Health Note

Transcript

Unger: Hello, this is the American Medical Association's COVID-19 update. Today we're talking about Mass Challenge Health Tech, a digital innovation hub, and how companies are innovating to support physicians, practices and health systems during COVID-19. I'm joined today by Nick Dougherty, managing director of Mass Challenge Health Tech in Salem, Massachusetts, Beth Andrews, vice president of managed accounts at Moving Analytics in Los Angeles and Dr. Josh Reischer, a physician and founder and CEO of Health Note, a startup working to reduce the physician administrative burden in San Francisco.

I'm Todd Unger, AMA's chief experience officer in Chicago. Mr. Dougherty, let's start with you. Can you tell us a little bit about Mass Challenge Health Tech, and specifically how it's supporting physicians during COVID-19?

Dougherty: Happy to Todd and thanks for inviting us here. So, Mass Challenge's mission is to solve the world's massive challenges through entrepreneurship and innovation. I run the Mass Challenge Health Tech program, and we are focused on health.

Our goal is to bring amazing entrepreneurs, to bear, to support physicians in addressing their challenges. And it's been such a pleasure to be able to team up with the American Medical Association to do just that. So these are two great entrepreneurs that are working on these challenges and excited to hear their stories today.

Unger: Ms. Andrews?

Andrews: Great. Thanks. We're excited to be here and it's just a really impactful time for virtual solutions. So, at Moving Analytics, we provide virtual home cardiac rehab. We're able to support physicians and patients and provide that care continuity to help manage the patient on their journey in managing the risk factors.

Unger: And Dr. Reischer?

Dr. Reischer: Thanks again so much for having us as well. So at Health Note, we automate, collect and organize data that patients give to their physicians. And we've seen really a huge burning need right now that anything that facilitates telemedicine is really, really impactful at this time. So it's been a very interesting time to be able to be here.

Unger: Well, Ms. Andrews, why don't you tell us a little bit more about the work that your company is doing and how you've been supporting healthcare professionals during the pandemic?

Andrews: Sure. So, Moving Analytics provides evidence based virtual home cardiac rehab. There's lots of challenges today in patients being able to access cardiac rehab. It is a Class 1A recommendation. There are many decades of published evidence, but it is challenging for patients to find a center that's nearby to go and do cardiac rehab during work, if they're back to work.

So, we deliver a virtual solution and we also have care managers that really form a relationship with the patient and support them, identifying the risk factors; coaching them and encouraging them. So with COVID-19 many centers have been closed or reopening are really constrained from capacity. So we can provide home cardiac rehab to anyone, anywhere.

Unger: Dr. Reischer... I'm sorry, go ahead.

Andrews: And I'll add that with the increased usage of telehealth and adoption with COVID-19, there has been really a surge in interest from health plans and payers to provide home cardiac rehab as a benefit.

They look at the outcomes from patients who participate and complete and graduate from cardiac rehab programs and they see those big outcome differentials. So payers and health plans are accelerating adoption and coverage of home cardiac rehab today.

Unger: And Dr. Reischer, tell us about your work and how that's been changing during the pandemic.

Dr. Reischer: So at Health Note, again, we collect, organize and document patient's information. So, essentially we ask patients all the questions a physician would normally ask during a visit, but we do it before the visit. So we send them a text message, they answer all of these questions. We enable them to prepare for their visit before it actually happens.

And functionally, what we do has not changed at all, but the medium in which physicians are seeing their patients of course has gone up and down between in-person and via telemedicine. So the ability to have all that information upfront has significantly helped.

So, when a physician is seeing patients via telemedicine beforehand, they may have had one or two other people who have gathered information from patients beforehand, written that information into the EMR, but now they're doing it all themselves.

It becomes that much more burdensome for them to ask all of these questions, document all that information. And they essentially don't have as much time with their patients. So we help in that middle process gathering all of that, doing all of the tasks that take a lot of time for them and enable them to do their job.

Unger: Do you have any sense of what portion of that EHR episode per patient you take off the plate of the physician because you've already done it?

Dr. Reischer:  We're finding actually between 30 and 60 percent. It really depends on the specialty. So for example, if we're talking about internal medicine or neurology where it's more history focused, we're taking 60+ percent. If it's more of a surgical sub-specialty, it might be a little bit less, but either way, we're finding a huge value in multiple different specialties. And we're working with folks around the country.

Unger: Well, that's amazing, to be in a world right now, especially where, for every hour of face to face contact with the patients, you've got physicians spending two hours in an EMR. So to be able to take that kind of chunk off could have a huge impact.

Dr. Reischer: That is our goal.

Unger: Amazing. Mr. Dougherty, you interact with a lot of health system partners. What are you hearing from physicians and health systems about their needs in terms of innovation right now, or any key learnings that will influence your work going forward?

Dougherty: ... to me, I think one of the biggest challenges that we're seeing right now is the uncertainty around the incentive structures. So we have just had to transition from an almost entirely in-person apparatus to a very virtually first driven apparatus. And so I think with that comes a lot of challenges.

And so when you're looking at, how am I going to invest in the future of my practice? There's a lot of questions around what that future looks like. And so I think we're hearing from a lot of our health systems that they want to see more from their government.

They want to see more from the health plans in terms of what that future looks like, so that when they make these investments in digital, they know it's not temporary. They know it's something that they can invest in for the long term. So we're hearing a lot from our physician groups around that.

And I think they're also saying, "Wow, we had digital as part of our three to five year strategy. Now, how do we do that?" In three to five days, three to five weeks, three to five months, it's really something that they're grappling with.

And so I think what the American Medical Association has done a really good job at, is try to get that out in front and say, "Here's how we think about telehealth. Here's how we think about remote patient monitoring. Here's how you can implement it in their practice."

So what I'd recommend for people that are listening to this, if you haven't already checked out some of the playbooks, I would take a look at that. And if you want to learn more about innovation or digital, that's something that we specialize in. And we'd love to help answer some of those questions because we know this is a really challenging time for a lot of practices.

Unger: Ms. Andrews, anything to add about innovation in terms of what you're finding people are looking for?

Andrews: They're just looking for value-based, evidence-based solutions. And technology that is really easy to use. Something that can be turned on and ramped up really quickly. So, at Moving Analytics, we've really taken that process of, which has been helpful to serve so many patients with COVID-19 right now, is we've been able to take that implementation and do that in a matter of days, not months. So it's scalable.

Unger: Dr. Reischer?

Dr. Reischer: We're really hearing constantly as folks preparing for the post-COVID world. So anything that shows a clear return on investment for them. There's been many layoffs and furloughs lately, and while things are starting to come back, the systems are really looking at, how can they lower costs in the future? And that's what we're looking to help with. How do we help enable them to do more with less?

Unger: Well, let's talk a little bit more about that and ROI specifically. Mr. Dougherty, anything to add about how your collaboration with the AMA is moving that forward?

Dougherty: Yeah. So over the last really couple of years now, we've been working with the American Medical Association, next strategy on a curriculum for entrepreneurs around how they develop their own ROI calculator.

We observed that this is one of those important and often overlooked things that entrepreneurs do. They think so much about the clinical solution. They think so much about the patient, but they forget that this lives within a world where you have to be able to afford it, or it has to be able to create that return on investment. Otherwise it's not going to be adopted.

And so we think that this is a really critical step. And so we want all of our entrepreneurs that we work with to understand the value that they can create for the practice that goes beyond impacting your day to day life, impacting the patients that you serve. And Joshua, you mentioned this, talking about what you could do to show the practice that investing in digital is not just easing your life. It's also saving you money or giving you opportunities for additional revenue and like what Moving Analytics is doing for a few health systems.

So I think it's a really important thing to think about if you're a digital health entrepreneur and it's also an important thing to think about as a physician, but this doesn't just have to be a cost center.

Unger: Well, lastly, for the three of you, a question based on your experiences prior to, and of course during this pandemic, what do you see as the future of health care innovation at this point, Dr. Reischer, why don't you start?

Dr. Reischer: Sure. I think that everything we're doing, I think what Moving Analytics is doing, what Health Note is doing, this is the future. It was the future before COVID-19 happened. And it's extremely, extremely important now. And I think people are realizing that it's at the forefront.

I think when I talk to my other digital health company colleagues, everyone is seeing this burning need and an increase in utilization because we all knew it was necessary beforehand. But now it's really this burning need to automate, to lower costs, to figure out how do we do things more efficiently? Where we all thought before, okay, that's something that we need to do eventually, now it's, well, eventually has happened, right?

And so I'm sure you've heard it. Many people have heard it. 10 years of change has happened in three months and we're seeing that people are open to it. Everyone we talk to is really just telling us, we're preparing now, we know things are not going to be the same, we need to get ready.

Dr. Reischer: So whether this ends in six months or one year, nobody really knows, but everyone knows that they need to prepare because the change has already happened.

Unger: Ms. Andrew any predictions from you on the future of Healthcare Innovation?

Andrews: Sure. We're seeing as Nick and Josh both said, increased reimbursement, willingness to look at that and risk sharing. When you look at the area that we're in, in providing virtual cardiac rehab currently patients are participating at under 20%. Our programs are achieving over 80% participation.

And when you complete cardiac rehab, you are doubling your post event life expectancy, you are reducing your chances of a second event. And also able to increase your health factors. Health systems and health plans, insurers, they are seeing a reduction in re-admissions. So it all just makes sense. And we see that acceleration now and it's here to stay.

Unger: Mr. Dougherty, any final thoughts on the future of innovation?

Dougherty: I think the future of innovation is something that is consumer or patient-centric. So I think that this question or this thought around access, around telehealth, is about meeting people where they are.

It's about increasing that utilization from 20 percent to 80 percent. It's making people more conscious of how they improve their lives. I mean, that's why people get into medicine is to improve lives.

And so I think that what this is forcing us to do is think about how we reimagine this system. And I hope what we install is something that will be really wrapped around the patient, that defragments the current system that we have.

And so I'm excited about that future that starts with some of the incentives that Beth outlined and some of the solutions that you're seeing right here in this conversation.

Unger: Well, thank you very much, Mr. Dougherty, Ms. Andrews, and Dr. Reischer for being here today and sharing your perspectives with us. So much of our focus at the AMA is about removing the obstacles to patient care and there are a lot of them. So to hear the progress that you're making and with the AMA it's really encouraging.

That's it for today's COVID-19 update, we'll be back tomorrow with another segment. For updated resources on COVID-19 like our guide to telemedicine, go to the ama-assn.org/COVID-19. Thanks for joining us today. And please take care.

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