NJBIZ panel discusses what comes next
NJBIZ panel discusses what comes next
During NJBIZ’s most recent panel discussion, a consensus emerged among participants that the pandemic served as a catalyst to a wider adoption of technology across the health care landscape. And, quite frankly, they would know.
On Sept. 27, NJBIZ Editor Jeffrey Kanige led a virtual conversation with experts working in, and serving, the sector, featuring Hackensack Meridian Health Executive Vice President and Chief Digital Officer Kash Patel, Caregility Vice President of Marketing Bryan Schnepf, CentralReach Chief Product Officer Cheryl Michael, and National Association of Social Workers – New Jersey Chapter Executive Director Jennifer Thompson.
“The pandemic was really the impetus – or the catalyst – to get us moving with technology,” explained Schnepf. The technology had been there, you see, we just weren’t using it. “Getting it really adopted was a problem. We needed a crisis like the pandemic to really kick us forward, and if we don’t take advantage of the momentum that we built up right now, shame on us.”
Now that the genie is out of the bottle, though, the panelists agreed that it’s important to take into consideration how technology should be integrated with health care, where technology is best applied and what the future may hold.
Pre-COVID there were challenges to the adoption of telemedicine; but the technology was already there. The pandemic forced everyone – consumers and providers – to “lean in” to telemedicine out of the necessity to restrict person-to-person contact. “What we’re finding now, I think we’re sort of contracting – and I think that contraction is temporary,” Patel said. “[W]e were seeing all kinds of disease states, all kinds of conditions. And now we’re sort of going back to sort of figuring out what works in telemedicine.”
“We’re figuring out what models of health care are best delivered in telemedicine,” Patel added. “And I think that vertical will go deeper and will grow. … We went big and went sort of back to small and thinking about areas where it’s needed.”
A persistent issue with the adoption of telemedicine referenced by the panelists was reimbursement.
“I don’t think our business model supported it,” Patel, who joined HMH in October 2021, said. “I was in New York at the time, building the technology to do this – the mechanism for a physician to get reimbursed, or the technology to see the person where it wasn’t flawed, where you weren’t worried about bandwidth and access … The scale wasn’t there.”
In the present, Michael said there has been some progress in that regard. At CentralReach, they’ve seen a lot coming from Medicaid in terms of being able to reimburse for additional technologies. “We’re seeing a lot of times: where Medicare, Medicaid lead, commercial will follow,” she said. “So we’re definitely seeing improvements in reimbursement and funding for other devices and technology.”
Integrating technology into the care model itself, in addition to the business structure of the industry, is also something to be mindful of. Like the initial adoption of remote work, we went big with the introduction of telehealth because we had to. Just as employers are now trying to figure out how to strike the balance between in-person and out-of-office situations, Schnepf said he sometimes refers to the evolving care model in the health field as a hybrid one.
As Thompson explained, telehealth is not a “one size fits all” tool – when it comes to dealing with children or mental or behavioral health issues, in particular, it’s a harder fit – which is why it’s so important for providers to be engaged in the development of technology and best practices. “[I]t is here to stay, we are going to see expansion of this, and I think this has called us to be more forward thinking, as providers, and really sort of claim a seat at the table in developing this technology, because while it was helpful, there are also ways in which it probably evolved a little bit faster and maybe there are other considerations to be made,” she said.
Michael’s work finds her doing just that. CentralReach offers technology solutions for providers working with individuals with autism. While in-person meetings are crucial for the industry, Michael pointed to other ways that technology can help to facilitate the delivery of care. “Some of the things we’ve been talking about, with AI and being able to leverage data, [is] to make recommendations that help with the building of the solar system,” she said. “Are there opportunities to take what’s been like, [a] data collection workflow [and] turn these into more of a business workflow; actually improve, make the process faster, more intuitive for the therapists who use our application.”
Data can also be a useful tool for predictive care. Patel touched on the benefits – and the scalability – that increased health screenings could have for diagnoses. If a patient has a family history of cancer somewhere within their record, when they turn a certain age or reach another such milestone where risk is considered higher, data can be used to automatically suggest that they get screened. Thompson, too, spoke to the ways in which data can help inform care, agreeing with Patel about trusting the data that is already available.
“One of the things that’s very interesting to us is the sort of information that is available [via] social media, for example,” Thompson said. “There’s tons of predictive models out there that sort of collect all this data about the posts that people are making on social media and being able to accurately correlate that to instances of mental health, crisis and instances of violence. And if we can start to use that data to really predict what is going to happen, and also intervene in real time, I think that there is a really great space for us to be even more effective.”
Taking advantage of available data and fostering operating efficiencies are important, generally, but they’re even more important amid a national shortage of health care workers. Aside from working better, technology in health care can help with working smarter. For instance, creating expanded options for filling open positions.
Michael said that ability to “shorten the process” by leveraging data, described above, can really help with staffing shortages because it frees up time to focus on providing care. Schnepf highlighted virtual nursing as an emergent tool that is also helping with shortages. The technology allows nurses to be involved with patient care without being physically “there,” or even here, in New Jersey. “[T]here’s a shortage of nurses and we’re at a crisis point right now within our industry and there’s not enough nurses to go around,” Schnepf said. “So by using technology … allows for nurses to really care for more patients.” Patel said Hackensack Meridian Health uses virtual nursing, along with other initiatives – like virtual training modules – to create “flexible” nursing teams.
In addition to added convenience from telemedicine and facilitating workflows with new efficiencies, the health care tech of the future – even the near future – can also bring new skills.
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According to Thompson, within the mental health space there are lots of cool developments in and around using technology. For instance, she explained that her organization launched an office in the Metaverse, where people can seek care, but where NASW – NJ can also help to train other social workers on ways to use the tech. There are lots of therapeutic ways to utilize advancements, she said, “but there are also a lot of ethical concerns that we need to sort of parse through.”
Patel said there are already a lot of algorithms around dermatology; he described a potential scenario where technology can be used during a virtual appointment to interpret the composition of a growth to determine whether or not it is potentially cancerous. HMH is also working with a robotics company to help train future “surgeons.” The idea uses an AI model, he said, so that the program learns the best movements to make to lead to the quickest healing times and the least complications.
Michael touched on using AI to leverage and understand data in her field, to create predictive models and be able to figure out quality outcomes. “I think we’re collecting, and our providers are collecting, a tremendous amount of data and we’re starting to look at that data and say, ‘How can it help us?’” she said. “This space, autism, is a little bit behind other spaces in health care, but there’s starting to be a push with payers to sort of say, if we want to do some bundles or value-based models, we need to know better. What are some of the quality measures? What moves the needle on outcomes? … We’re starting to see that we’re in this space and that opportunity to use data.”
Just two years after the pandemic pushed us into the thick of the world of health care tech, we’re still at the forefront of what’s to come. But, after years of resistance, and amid those staffing shortages, the tide really looks like it’s changing. “I go back to shortages in the certified clinicians and the therapists that are delivering care,” Michael said. “There’s also an openness now to being able to take recommendations. … [A]bout the learning plan or plan for that particular individual. And there’s definitely more openness to actually looking at those.”
Patel also called attention to that shift. “I think we’re seeing a more openness to sort of seeing this outside information in the clinical settings.” Part of that he attributes to a generational shift. “I think we are also now beginning to educate the clinicians to trust those models,” he said. “And I’m beginning to see a shift in in in the clinic and saying, ‘Yeah, I want to now learn what that model said, with the algorithm, the mathematical formula said.”
Physical technology is also making its way into the clinical setting, but as Schnepf pointed out making sure those advances work for providers or patients, and not the other way around, is the goal. “The onus is on us to make the technology as intuitive as possible,” he said. “Our goal is really for technology to blend into the background and not be something that becomes a burden, and for people to be able to utilize it properly.”
Some of that tech involves physical endpoints being installed in care settings that could offer translation services, for instance, or help with inter-hospital communications — think about loved ones that were unable to visit with COVID patients during the worst of the pandemic or how a lack of PPE restricted access for care providers and how important FaceTime became.
In what sounds like a fully futuristic approach, Schnepf brought up the idea of “ambient intelligence.”
“We’ll see what’s going on inside the patient room, for example, making sure that no harm is being brought to the patient, make sure the patient themselves is not harming themselves, or doing something dangerous like getting out of bed undetected” he said. And in addition to seeing – and not just looking – the cameras are also listening, using natural language processing to be able to order procedures just through the telehealth device, Schnepf explained. That sort of functionality also harkens back to improving operational efficiencies: natural language processing can make documenting examinations more efficient by removing the reliance on inputting the information manually with a keyboard.
“I think that we’re really just at the … proverbial tip of the iceberg, if you will, with what technology can really bring toward health care in the future,” Schnepf said.
Even though the industry is taking a narrower view to figure out how to best utilize technology in health care, both fields are ripe for thinking big. But without access – it’s important to bear in mind as we continue to move forward – big ideas are just that.
“I think that we also have to go back to sort of like the accessibility of it,” Thompson said. “We know that while lots of communities now have access to telehealth, we’re still not where we want to be. There’s still lots of challenges with that. And so, as the technology continues to develop … how much more progress do we need to make so that those tools are accessible to all communities?”