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By Monica E. Oss

New developments over the past couple months are pushing executives in health and human services toward what I would call a digital decision crossroad. First, the health and human service financing landscape continues to change, making tech-enabled treatment more feasible. Second, there are more tech-enabled treatment options moving from the science to market. And, third and most important, there are some “leading edge” health and human service organizations launching new services (or re-engineered traditional services) that take these new digital treatment developments to scale. The last brings new competition—in consumer experience, in outcomes, and in cost—to the market.

We have covered the first development over the past few years—more value-based reimbursement (see Preparing For The Very Glacial VBR Rollout In Some Markets, Crawl, Walk, Run To VBR, and The Future Has Arrived For VBR) and better reimbursement for telehealth and other tech-enabled treatment (see VA Finalizes Telehealth Rule Allowing Health Care Professionals To Practice Across State Lines and Making Telehealth Work—Reimbursement & Great Execution Required).

The second is the fascinating march of science. There are new tech-enabled treatment platforms coming to market on a regular basis. Last month in our briefing, Add ‘Speed’ To Your Treatment Tech Planning List, we provided a breakdown of some of the recent approvals by the Food and Drug Administration’s (FDA) Breakthrough Devices Program. Since that announcement the FDA has made two more approvals—TMS for three-minute depression-treatment sessions and non-opioid peripheral nerve stimulation systems for pain management.

On August 23, 2018, the FDA approved MagVenture’s MagVita Transcranial Magnetic Stimulation System (TMS) for use in three-minute sessions to treat severe depression (see FDA Approves MagVenture’s TMS For 3-Minute Depression-Treatment Sessions). The device previously had clearance for the treatment of severe depression in 19- to 38-minute treatments using 3,000 pulses of 10 hertz (Hz) stimulation; the new 600-pulses protocol uses intermittent theta-burst stimulation (iTBS), a newer form of TMS that can be delivered in three minutes. And the FDA recently cleared SPR Therapeutics’ (SPR) SPRINT endura and extensa Peripheral Nerve Stimulation (PNS) systems for the treatment of chronic and acute pain (see FDA Clears SPR Therapeutics’ Non-Opioid Peripheral Nerve Stimulation Systems For Pain Management). This platform is the only FDA cleared percutaneous (effected through the skin) PNS System and is designed specifically for the periphery to deliver sustained, significant pain relief without drugs, implants, anesthesia, or incisions.

The bigger news is that the use of tech-enabled treatment and tech-enabled care seems to be moving from “experimental” to mainstream. Health care provider organizations and health system are adopting technologies and making them system wide. It’s taken awhile—telehealth has been around since the 1950s. But adoption has been and remains relatively slow (see Telehealth Gains Popularity, Telehealth Budgets Don’t). But that is changing. There is a growing body of data about the effectiveness of tech-enabled treatment—Google AI Predicts Hospital Inpatient Death Risks With 94% Accuracy, Use Of myStrength Digital Behavioral Health Intervention In Missouri Generated 484% Average ROI, Mobile App Beats WRAP For Engagement Of Consumers With Serious Mental Illness, and ECHO Autism Teleconsultation Program Reduced Wait Times Up To Six Months For Highest-Risk, Rural Children.

So, what does taking tech-enabled treatment to scale look like? There are a few announcements that have caught my attention as “driving” new treatment technologies to scale. For example, in July, Anthem Blue Cross and Blue Shield in Ohio (Anthem), in partnership with Propeller Health (Propeller), announced the start of a new Medicaid Advantage digital medicine program in Ohio for chronic obstructive pulmonary disease (COPD) care management (see Anthem & Propeller Health Launch Ohio Medicare Advantage Digital Medicine Program For COPD). The digital medicine program monitors pharmaceutical inhaler use by each health care consumer through Propeller’s sensors that attach to the inhaler. These sensors pair with Propeller’s mobile app. Information from the app can be used by health care clinical professionals to determine the use of prescribed inhaled medications, collaborate with consumers on their COPD care, and offer messages of support.

In August, Geisinger and Merck launched two applications, embedded in the Geisinger electronic health record (EHR), to facilitate medication management and care coordination: MedTrueT and Family Caregiver Application, respectively (see Geisinger & Merck Unveil EHR-Embedded Apps For Medication Management & Care Coordination). MedTrue combines information from several data sources to provide both consumers and health care professionals with medication adherence and reconciliation information, including medication fill data, medication verification information, and adherence rates. The Family Caregiver Application supports two-way communication between consumers and health care professionals.

Last month Otsuka America Pharmaceutical, Inc. (Otsuka) announced that it will collaborate with Magellan Health to bring the ABILIFY MYCITE® drug system to the United States (see Otsuka Collaborates With Magellan Health To Launch ABILIFY MYCITE®). The ABILIFY MYCITE® system is a drug-device combination that is approved by the FDA for the treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar I disorder, and for use as an add-on treatment for depression in adults. The system consists of the pill, a patch, an app for the consumer, and tools for health care professionals and caregivers.

Those are just a few examples of recent larger scale adoption of virtual health technologies. Just in the past few months we’ve also reported on these:

  1. Advocate Aurora Health & Foxconn Partner On Employer-Focused Health Technology
  2. Polk County Florida Launches New Telemental Health Program For Low-Income Uninsured Residents
  3. Beacon Health Options Adds MDLIVE Behavioral Health Professionals To Its Provider Network
  4. MYnd Analytics & Arcadian Telepsychiatry Services Launch School-Based Telepsychiatry Program
  5. Lyra Health Raises $45 Million, Planning To Expand Therapist Network
  6. Blue Cross Blue Shield Of Massachusetts Launches Digital Health ‘Emerging Solutions’ Platform
  7. Five California Counties Approved To Launch Virtual Therapies Under Mental Health Service Act

These developments are making tech-enabled services more than an experiment—they represent permanent changes in service delivery. They will change consumer experience, consumer outcomes, and cost—changing the “value proposition” needed to compete effectively for consumers and contracts. This will further disadvantage “traditional” services—and force executive teams to speed the integration of technology into their service delivery system.

More executive teams are coming to a strategic crossroad—not if they should adopt tech-enabled treatment. But which ones and how? We hope to help executives answer this question at our upcoming 2018 OPEN MINDS Technology & Informatics Institute. On Monday, October 22, our 2018 OPEN MINDS Consumer Engagement Technologies Summit will feature case studies by Janelle Wesloh, LADC, MBA, Vice President of Clinical Excellence, Innovation and Recovery Management, Hazelden Betty Ford Foundation; Michelle A. Blackmore, Ph.D., Project Director, Montefiore Medical Center; Roberta Montemayor, Director for Telehealth, Optum Behavioral Health; and Bruce L. Bird, Ph.D., President & Chief Executive Officer, Vinfen.

And, my colleague Joseph Naughton-Travers, Senior Associate, OPEN MINDS will be leading a seminar “How To Make The Right Tech Investments For Your Organization: An OPEN MINDS Executive Seminar To Technology Budgeting & Planning” on October 24. In addition, there are over 20 sessions on how to leverage technology for strategic advantage. We hope to see you and your team there in a couple weeks!

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