Relentless Health Value

Tom Kottler is co-founder and chief executive officer of HealthPrize Technologies, the leading cloud-based patient experience and adherence platform for life science companies. In collaboration with CEEK Enterprises, HealthPrize recently released a new report, “The Pharmaceutical Triple Aim,” showing how 21 of the world’s top pharmaceutical companies can increase revenue and boost earnings per share with improved adherence. Tom has led multiple high-growth organizations during his career, including Advanced BioHealing, which was acquired by Shire for $750 million, and MedAptus, an innovative health care IT company based in Boston. 01:10 A new study on medication nonadherence. 02:36 The pharmaceutical triple aim. 02:47 The 4 ways Pharma can make money. 03:04 The pressure on the key elements of the pharma business model. 03:45 The big revenue opportunities for Pharma and how they’re really difficult things to solve for. 05:39 “Adherent patients get better outcomes, and they cost less … all the way around.”

Caroline Znaniec, MBA, MS-HCA, is the founder and principal of Luna Healthcare Advisors LLC. Her boutique consulting group provides revenue integrity advisory services to other consultancies and large advisory firms, software companies and developers, and health system and physician providers. Caroline writes and speaks regularly on topics of revenue integrity for many nationally recognized professional associations, including the Association of Healthcare Internal Auditors (AHIA), American Health Information Management Association (AHIMA), Health Care Compliance Association (HCCA), Healthcare Financial Management Association (HFMA), and National Association of Healthcare Revenue Integrity (NAHRI). She has more than 20 years of industry experience, having worked with the nation’s top health systems and health care talent.

Don helps organizations launch new health IT products and services. He’s a product and business development consultant and accomplished health IT expert with a 20-year track record of driving value with technology. Don began his career as a custom software developer and eventually built and led a team of more than 30 engineers. Later, he was the subject matter expert, product manager, and head of sales and marketing for a digital health start-up that launched a software as a service (SaaS) platform focused on administrative simplification in health care. Today, Don is president of Glide Health IT, LLC, a consulting firm that helps forward-looking organizations align their health IT and business strategies. The firm specializes in business and product development with a focus on data aggregation, interop, analytics, and quality measurement. Don is also the host of The #HCBiz Show!, a podcast dedicated to unraveling the business of health care, as well as a partner at VBP Forward, a new conference focused on value-based payment for complex and special needs populations. 01:09 What problems the VBP Forward Conference aims to solve. 01:45 “Providers are being asked to take on risk.” 03:13 “The health systems have to engage with these existing resources.” 03:27 Bridging gaps in order to solve a common goal. 03:45 Finding the shared priority. 04:03 Value-based care conference vs a value-based payment conference. 05:44 Care = perspective; payment = retrospective. 05:58 National conference vs regional conference.

Katie D. McMillan, MPH, has dedicated her career to imagining and building technology to improve health care for patients and providers. Her experience spans multinational global health organizations, lean software start-up companies, and large academic medical centers. Katie’s latest venture is the creation of the Mobile App Gateway (MAG) at Duke University Health System. The MAG serves as the hub for digital health at Duke and provides product consulting services to clinicians and researchers, monthly events and workshops, and content exploring the many facets of the health tech industry. Roylyn Fernandez, RN, has more than 15 years of combined experience in clinical and informatics roles integrating technologies such as electronic health records (EHRs), virtual desktop infrastructure (VDIs), and mobile applications into system processes. Her passion for nursing and health care enable her to leverage her clinical, operational, and informatics knowledge to design and execute technology adoption strategies that support organizational goals related to quality, patient safety, and revenue capture initiatives. In 2016, Roylyn joined DeLappe Consulting after leading enterprise-wide technology implementation and optimization projects for Kaiser Permanente, Sutter Health, and Cottage Health Systems.

Louis Morrow is regional director of sales for Intelligent Retinal Imaging Systems (IRIS), the leading comprehensive solution provider of diagnostic telemedicine services committed to ending preventable blindness due to diabetic eye disease. Louis was one of the earliest builders at IRIS and has played a major role in saving the eyesight of over 55,000 patients (so far) through the partnerships built with major health systems and integrated delivery networks across the country. He’s an award-winning consultative sales team leader with more than 20 years of successful experience in the eye care space and has held senior sales leadership positions across multiple companies. Tiffany Wandy is executive director of the Clinically Integrated Network for LifeBridge Health, a regional health care organization based in northwest Baltimore and its surrounding counties. LifeBridge Health consists of Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, LifeBridge Health & Fitness, hundreds of primary care and specialty physicians throughout the region, and many affiliated health-related partners. Prior to joining LifeBridge, Tiffany was a senior data analyst and lead program consultant for the CareFirst Patient-Centered Medical (PCMH) Program, where she served as an adviser to primary care providers on best practices relating to the implementation of coordinated care delivery models. Tiffany has both payer and provider experience and leverages this knowledge to drive increased use of analytics, business development, and practice transformation for rural, suburban, and urban organizations.

Kathy Lokay is general manager, as well as chief cheerleader and idea generator, for Via Oncology. Kathy joined UPMC in 2008 to launch the Via Oncology product that UPMC CancerCenter started in 2004. Her background as a CPA combined with her 20 years of experience in oncology have been a great foundation to help her lead Via’s overall strategy and execution. She is passionate about driving the volume to value transition in oncology and has made clinical pathways her personal mission for the past 11 years. Kathy was previously senior vice president at US Oncology with responsibility for several business units. She received her Bachelor of Business Administration in accounting from the University of Texas.

If I was going to sum up the summaries, I might put it this way, liberally co-opting the words and sentiments of my articulate guests: The intent here is to help doctors care for patients, patients care for themselves, and all of us care for each other (thanks for that concise statement, Jim Barr). If we want to do this well, we want to and need to standardize the way that digital medicine suppliers express their value so that providers and other purchasers can make informed choices not derailed by who has better marketing. And health systems and other large stakeholders are starting to come around to the inevitability of digital medicine and also the need for evidence to separate the winners from the not-so-greats in a field of literally thousands of health tech options. You can learn more at nodehealth.org or by emailing info@nodehealth.org. Megan Coder, PharmD, MBA, is executive director of the Digital Therapeutics Alliance (DTA), whose mission is to broaden the understanding, adoption, and integration of clinically validated digital therapeutic solutions into mainstream health care through education, advocacy, and research. With more than a decade of experience in the health care industry, Megan’s expertise extends from strategic growth and partnership development within the digital health sector to the direct delivery of patient care.  James E. Barr, MD, is vice president of clinical intelligence at Atlantic Health System and medical director for the Optimus Healthcare Partners and Atlantic Health System Accountable Care Organizations. He is a board-certified family physician with an active clinical practice. He is an assistant clinical professor at Robert Wood Johnson Medical School and has worked with Aveta Health Solutions (North American Medical Management) as vice president of medical services.  Katie D. McMillan, MPH, has dedicated her career to imagining and building technology to improve health care for patients and providers. Her experience spans multinational global health organizations, lean software start-up companies, and large academic medical centers. Katie’s latest venture is the creation of the Mobile App Gateway (MAG) at Duke University Health System. The MAG serves as the hub for digital health at Duke and provides product consulting services to clinicians and researchers, monthly events and workshops, and content exploring the many facets of the health tech industry.  Naomi Fried, PhD, is an innovative and digital health thought leader and founder and CEO of the boutique advisory firm, Health Innovation Strategies, which focuses on innovation program design and digital health strategy. Naomi was the first vice president of innovation and external partnerships at Biogen, the first chief innovation officer at Boston Children’s Hospital, and vice president of innovation and advanced technology at Kaiser Permanente. She served on the board of directors of the American Telemedicine Association and the Governor of Massachusetts’ Innovation Council.  Louis Morrow is regional director of sales for Intelligent Retinal Imaging Systems (IRIS), the leading comprehensive solution provider of diagnostic telemedicine services committed to ending preventable blindness due to diabetic eye disease. Louis was one of the earliest builders at IRIS and has played a major role in saving the eyesight of over 55,000 patients (so far) through the partnerships built with major health systems and integrated delivery networks across the country. He’s an award-winning consultative sales team leader with more than 20 years of successful experience in the eye care space and has held senior sales leadership positions across multiple companies.  Adnan Iqbal is the cofounder and CEO of Luma Health, a digital health company solving the biggest challenge in health care: getting patients in front of the right provider and to the best health care outcome quickly. Adnan previously held leadership roles at Genentech across research and development, finance, operations, and market analysis and strategy. Prior to Genentech, Adnan cofounded a medical device start-up working to develop an inexpensive diagnostic test for tuberculosis and several other infectious diseases.  Roylyn Fernandez, RN, has more than 15 years of combined experience in clinical and informatics roles integrating technologies such as electronic health records (EHRs), virtual desktop infrastructure (VDIs), and mobile applications into system processes. Her passion for nursing and health care enable her to leverage her clinical, operational, and informatics knowledge to design and execute technology adoption strategies that support organizational goals related to quality, patient safety, and revenue capture initiatives. In 2016, Roylyn joined DeLappe Consulting after leading enterprise-wide technology implementation and optimization projects for Kaiser Permanente, Sutter Health, and Cottage Health Systems.  Jay Fischer, MBA, as an executive, management consultant, and entrepreneur, has earned a reputation for achieving business growth in challenging consumer and business markets in diverse industries. He has broad-based experience in marketing, business and channel development, sales, customer management, and operations. He has created strong brands from start-up through revitalization stages, developed and sold innovative solutions for diverse customer groups/distribution channels, and built team commitment for sustainable growth in organizations. Jay is a visionary and strategic thinker who has demonstrated a consistent record of translating plans into results in the face of difficult market, financial, and organization conditions.  Jitendra Barmecha, MD, MPH, is chief information officer and senior vice president of information technology, health care data and analytics, and clinical engineering at SBH Health System in the Bronx, NY. He serves on the health care advisory panel for Salesforce, Health Connect Partners, and the American College of Physicians (physician payment reform). He is a fellow of the American College of Physicians, senior fellow of hospital medicine, and fellow of the New York Academy of Medicine. While continuing his passion for bedside patient care as a hospitalist, he enjoys teaching clinical staff and routinely provides lectures on health care management, technology innovation, and policy.  02:50 Megan explains the Digital Therapeutics Alliance. 03:04 What actually is a digital therapeutic and how do you define it? 03:58 “The goal really is to make sure that there’s cohesion across this industry.”—Megan 04:32 “It’s okay to be targeted.”—Megan 05:42 “We need to find what doctors need and what patients need through data.”—Jim 05:54 What the conference confirmed for Jim. 06:14 Utilizing the abundance of health care data. 07:18 Helping physicians care better for their patients. 08:02 Helping patients care better for themselves. 09:40 How companies are looking to gather enough data. 12:45 The small stuff vs tackling the “medium stuff.” 13:08 “Are we making the same mistakes that the EHRs made?”—Adnan 14:10 “The concept of a PCP [primary care provider] is really dying.”—Adnan 15:47 "The script is being written as we talk."—Jay You can learn more at nodehealth.org or by emailing info@nodehealth.org.

Brian Van Winkle, MBA, focuses on transforming health care by accelerating the adoption of digital technologies throughout the ecosystem. He is the executive director for NODE.Health, a nonprofit with a mission to combine the rigor of evidence-based medicine with emerging health care technologies to help create evidence-based digital medicine. Brian also runs an innovation center for Johns Hopkins focused on connecting physicians with promising technologies and solutions to solve real problems. Brian has spent 10 years in health care consulting with expertise in strategy design, process improvement implementation, and complex transformation at some of the biggest health care systems in the world. Jay Erickson is a founding partner and Health and Wellness lead at Modus, a digital product studio, and serves on the executive board of NODE.Health. As a cancer survivor and lifelong technologist, he works at the intersection of patient advocacy and digital health, using human-centered design methods to improve experiences and outcomes. Shahid N. Shah is an internationally recognized and influential health care IT thought leader who is known as “The Healthcare IT Guy” across the internet. He is a technology strategy consultant to many federal agencies and winner of Federal Computer Week’s coveted “Fed 100” award given to IT experts that have made a big impact in the government. Shahid has architected and built multiple clinical solutions over his almost 24-year career. He helped design and deploy the American Red Cross’s electronic health record solution across thousands of sites; he’s built several Web-based electronic medical records now in use by hundreds of physicians; he’s designed large groupware and collaboration sites in use by thousands; and, as an ex-CTO for a billion-dollar division of Cardinal Health, he helped design advanced clinical interfaces for medical devices and hospitals. Shahid also serves as a senior technology strategy adviser, helping small businesses commercialize their health care applications.

Today, I talk to Jonathan Singer, host of The Social Work Podcast as well as associate professor at Loyola University Chicago School of Social Work. I asked Jonathan to come on the podcast today because I’ve had this growing sense of disconnect between all the talk about social determinants of health, all the talk about how clinical care has a relatively small impact on patient outcomes compared to environmental factors, how the most important number in health care is someone’s zip code. All this talk swirling around, and rarely do social workers come up in the conversation—at least at the level that you’d think they would, given the number of years of education they have in addressing the environmental factors in question. You can learn more at socialworkpodcast.com. Jonathan B. Singer, PhD, LCSW, is associate professor of social work at Loyola University Chicago, secretary of the American Association of Suicidology, and an award-winning author and podcaster. His research on youth suicide and cyberbullying has been featured on NPR and Fox, and in Time magazine and The Guardian. He is the founder and host of the award-winning Social Work Podcast, with over 5 million episode downloads and 30,000 followers on social media. He lives in Evanston, Illinois, with his wife and 3 children and can be found on Twitter as @socworkpodcast and Facebook at facebook.com/swpodcast.

Jed Constantz, DBA As a Healthcare Finance and Delivery Strategic Consultant, Dr. Constantz ensures existing and prospective clients receive maximum value from current and future strategies and initiatives. In previous roles, Jed advised employers on measures to develop regional and community-based physician accountability and commitment through means of enhanced benefits and reduced costs; with the significant benefit of creating sustained loyalty between providers, patients and payers. He has successfully offered strategies that built on four pillars: actionable data, physician alignment, high-risk member targeting and network re-engineering. Having begun his career on the payor’s side of healthcare (Blue Cross/Blue Shield of Central New York), Dr. Constantz has served in several positions for hospitals, home health agencies, physician organizations and physician/hospital organizations. Over his 30 plus years in healthcare, Jed has developed tools and resources for primary care providers and employers seeking to reduce costs, drive greater efficiency and quality outcomes and thereby create a “featured-and-favored” network in their regions and community. This process includes a deep focus on the selection of the right community of primary care physicians and specialists, a thorough audit of existing patient and population data, commitment to accountable care standards and improved compensation for the physician. The end-objective is a better healthcare delivery model with an alignment of “enlightened self-interests” and a balance between rewards and value for the employer, employee and provider. For the employer, the financial benefits are immediate with on-going healthcare savings, a healthy workforce, and improved physician relationships. The provider can see greater patient volumes, improved care standards and compensation tied to performance. The employee will feel an improvement in care and attention, benefit with reduced out-of-pocket expenses and sense a higher level of satisfaction. You can learn more by visiting Jed on his LinkedIn page.