Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.
In today’s COVID-19 update, a discussion with NODE.Health about using its digital health expertise to support innovation during the pandemic. Also a look at NODE.Health's upcoming events, including a digital medicine conference and a certificate course*.
*Course worth 12 AMA PRA Category 1 credit(s)™. Use AMA promo code AMA30 for 30% discount on events.
Learn more at the AMA COVID-19 resource center.
- Brian Van Winkle, executive director, NODE.Health
- Sameer Badlani, MD, executive board member, NODE.Health
- Ben Rosner, MD, director, Research, NODE.Health
Unger: Hello, this is the American Medical Association's COVID-19 Update. Today we're talking about how one organization NODE.Health is using its expertise in digital health to support innovation during the pandemic. I'm joined today by Brian Van Winkle, executive director of NODE.Health in Bozeman, Montana. Dr. Sameer Badlani, chief information officer at M health Fairview, executive board member of NODE.Health, and also the NODE.Health planning committee chairman in Minneapolis, and Dr. Ben Rosner, a researcher at the Center for Clinical Informatics and Improvement Research in the Division of Hospital Medicine for UCSF and director of research at NODE.Health in San Francisco. I'm Todd Unger AMA's chief experience officer in Chicago. Mr. Van Winkle, can you begin by telling us a little bit about NODE.Health and what it aims to accomplish?
Van Winkle: Absolutely Todd and thanks for having us on. We're super excited to be able to talk about an organization we're passionate about. I am the executive director for NODE.Health. NODE.Health stands for the Network of Digital Evidence in Health. We're a non-profit focused on research and education, and we really came about under this recognition that everybody's working on the same problems. And if we could really bring the ecosystem together to understand what's working, what's not, we might be able to help accelerate the rate of change.
Our mission is to create, gather and share evidence and best practices and digital health. In terms of creating, we actually do research. So, we're one-part CRO where technologies will come to us and say, "Can you help us validate the solution?" And we also gather and share the best practices and the things that are working in the industry with our leadership, or I should say our membership. And we do that through our working sessions, we do that through our scholar team, we do that through the conferences. Really again, in the hopes that we can share what's working and what's not with the industry. And I hope to talk a little more about the conference that we have coming up in December later on, but thanks for having us.
Unger: You bet. Dr. Badlani, obviously the pandemic's kind of changed the game for everyone. How is NODE.Health supporting physicians during COVID-19?
Dr. Badlani: Thank you for that question. And I echo Brian's comment and appreciating the opportunity to speak with the AMA and you guys personally. For us NODE.Health exemplifies being able to show the evidence behind a lot of these interventions. If you go pre-COVID, we had so much money being put into digital health. It was hard to sift through the signal from the noise. In the crisis that we are in currently and will be for the foreseeable future, unfortunately, it's really important that physicians and provider organizations like mine, peer organizations and other organizations, understand what works, how much investigation to do before you start implementing something. NODE.Health fills that gap. What we want to be sure is that people have an understanding of, if I do this intervention, these are the likely outcomes and this is the evidence behind it. In some cases, you require a very high level of evidence like digital therapeutics. In some cases, you are willing to go in with an outcome at a peer organization. So, NODE.Health helps clinicians and executives in health care and outside life sciences as well, make those important decisions.
Unger: Dr. Rosner, any other comments on how you're supporting physicians during COVID-19?
Dr. Rosner: Yes. As Dr. Badlani mentioned, many health systems are trying to figure out how to provide digital therapeutics or digital evidence to their patients and actually arm their providers with kind of best in class digital interventions. One of the challenges, Todd, as you may remember in 2016, when James Madara was the CEO of AMA, was speaking to the AMA annual conference, was the term he used "digital snake oil". And the reason he brought that term up is because in the U.S. we don't have yet kind of a solid regulatory framework for showing evidence of efficacy and safety for digital therapeutics. And so, what organizations like NODE.Health do is that they help arm patients and providers and payers with evidence around digital therapeutics, so that we know that what we're serving up to patients and providers is both safe and efficacious.
Unger: Dr. Rosner, how has the pandemic affected innovation and the way that you think about evidence as part of the process?
Dr. Rosner: Yeah, that's really interesting. I mean, the pandemic certainly shifted a lot of people's focus to innovation around COVID, but it also brought about certain changes that we don't typically see, except for when there's a public health emergency. So as you know, there have been over 30 federal regulatory changes that actually rapidly enabled the deployment of telehealth so that patients and providers can interact in a way kind of like we're doing right now in a live way, but also the FDA sort of changed the goalposts a little bit by granting emergency use authorization to a variety of digital therapeutics. Most notably in mental health saying that right now we're going to waive a lot of the other requirements that we might've otherwise had in place under discretionary review in order to try to get therapeutics out that we think are probably going to be pretty safe so that people can benefit from them under this public health emergency.
Unger: Mr. Van Winkle, how's COVID-19 changed NODE.Health's approach to supporting the evidence process?
Van Winkle: Yeah. Like everything in this world it's changed everything. In terms of our support, the very basics of course, we went virtual with our avenues of sharing best practices and evidence, of course. The second is we created a resource stash if you will, which is a library on our site where you can go and read about the references of the best practices specific to COVID adoption or things that are working across the membership. A lot of our validation services are now focused on technologies related to COVID. So, we had one technology come to us and said, "We want to improve the avenues with which patients and consumers get education about COVID." And so, we convened a virtual panel of experts, epidemiologists, researchers, clinicians and provided some feedback on this technology solution so that they could more effectively develop an educational platform focused on COVID patients.
And so those are just a few of the things that we've changed. And then of course, for the educational material and the conference coming up in December, that will have undertones and major themes related to COVID. Why evidence matters, where evidence matters, when evidence doesn't matter. All in the context of a pandemic that changes the nature of the conversation a little bit, meaning that the balance between safety and speed never before is more important than today. And NODE.Health has really been focused on bringing that conversation to the forefront.
Dr. Rosner: And Brian, we should also mention, NODE.Health has a team of writers and researchers who kind of dig through the literature and also industry to surface best technologies or best practices. And during the pandemic, this group of researchers and writers has published a series of blogs on NODE.Health's website on different topics related to the pandemic. So, one week was a topic on contact tracing. Another week was a topic on evidence in the emergency room for managing pandemic related issues. And so, people can go to NODE.Health's website and read the blog on each of those topics, that surface kind of best evidence pertaining to the pandemic.
Van Winkle: Yeah. And I'm glad you mentioned that, Ben. One of the things we're proud of at NODE.Health Todd, and Sameer knows this as well, is how much we focused on practical, pragmatic information that matters to clinicians, information that matters to the frontline nurses. So sure, we have inspirational topics that every innovation organization has, but implicit or explicit in everything we do, we really want to bring practical, real time information to our members or anybody really that's part of NODE.Health as we are a part of the larger ecosystem.
Unger: Mr. Van Winkle, let’s talk a little bit about your work with the AMA. You've been working closely with us. Can you tell us more about the partnership and why it's so important?
Van Winkle: Yeah, for sure, Todd. We're excited about the work that we're doing with AMA. It started maybe a year or two ago where we just started getting more and more together to work on developing resources related to best practices, for example, around telehealth adoption. How do we make sure we roll that out and integrate some of these technologies into clinical workflow that has really emerged into more and more opportunities for two places? One is to have AMA leadership or AMA members be a part of our faculty or a part of our conferences in terms of speaking or sharing what they're learning in their practice. But even more importantly, a part of the research that we do.
So, AMA has hundreds of thousands of experts when it comes to clinical practice. At the same time, we have technology companies coming to us and saying, "We need access to these clinicians." So, NODE.Health really serves as the convener between technology needing the input and clinician having that expertise. And so, we're working on more and more formal avenues to provide research opportunities to AMA members, as well as decreasing the barriers to getting some of that clinical expertise like Sameer and Ben. But I can't have a hundred Sameers and I can't have a hundred Bens, but through AMA partnership that really does expand the pool of researchers that we can bring to the market.
Unger: Dr. Badlani, based on your experience during the pandemic, where do you see health care innovation and the role of evidence moving forward?
Dr. Badlani: That's a great question, Todd. In my mind, and I've expressed this at other forums and I'll take the opportunity to say this again. Innovation without transformation is a very expensive scientific hobby. What NODE.Health strives for and what COVID has mandated to us is that any innovation we invest time in, we have to do the last mile effort in seeing whether it transforms our business or not, transforms the experience that our consumers face every day. So, making sure that the outcomes are available at scale is something that NODE.Health helps the mission with.
The second thing I will add to this somewhat unrelated, but very important and we are very passionate about it. And I'm really proud to say that NODE.Health as the organization I'm representing in this conversation and M Health Fairview is the organization that I work for, we are embracing the challenge of dealing with another pandemic and that's the pandemic of racism and inequity in health care. So, what you will see in the DMC 2020 is not just a focus on finding the evidence, when is it appropriate and when is it adequate the validation at way to doing interventions. You will also see conversations around equity and access to health care and how we are hoping digital medicine becomes a way to tackle racism and not just a way to perpetuate the inequities in outcomes and access to health care that have existed for so long across the globe. It's not just a U.S. problem.
Unger: Mr. Van Winkle, if a physician wants to get involved with your efforts, what should they do?
Van Winkle: Yeah, first of all, we'd be honored to have AMA be more involved with our efforts. We certainly could use the help. First and foremost, it's being an active member of our community and you can get involved by coming to our conference, speaking at our conference. If you want to reach out to me at [email protected], to let me know your interests, please do so. The conference is December 7th through 11th. We would be honored to have AMA. We've created a discount code, AMA30, that gives everybody at AMA 30% off of every NODE.Health activity. And that's really the conference that Sameer alluded to. And I mentioned in my opener, which is a five-day event, that includes 30 plus interactive sessions, all around digital medicine, evidence transformation. We have some of the world's premier speakers talking across those five days. Ben himself is leading a highly interactive workshop on designing clinical studies. Sameer is in the agenda as much as we could put him in the agenda. And so, we really do welcome everybody to be involved.
That conference also has workshops that you can sign up for where we're working on a particular problem that is of interest to the stakeholders. So that's one area, Todd. The second area is the conference kicks off on December 6th with a Sunday digital medicine foundation certificate course. This is formal education around digital medicine and evidence and transformation across eight classes. It's going to be from 10:30 to 6:30 Eastern time, divided into classes like telemedicine and care in the home, wearables, connected devices, artificial intelligence. There's going to be a panel which AMA is featured led by the founder of NODE.Health, Ashish Atreja, just talking about clinical applications for digital medicine. Beyond that, becoming a member again, reach out to me, go onto our site nodehealth.org. If you want to register for the conference, you can go through there as well, nodehealth.org/conference. We'd love to have you.
Unger: That's excellent. Again, that's nodehealth.org to find out more about the conference and how you can get involved with NODE.Health's initiatives. I want to thank Dr. Badlani, Dr. Rosner and Mr. Van Winkle being here today and sharing their perspectives with us. That's it for today's COVID-19 Update. For resources on COVID-19 visit ama-assn.org/covid-19. Thanks for joining us, please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.