The Silicon Review's 30 Best Leaders to Watch in 2019

cliexa’s Founder and CEO, Mehmet Kazgan, is rated as one of the “30 Best Leaders to Watch in 2019” Mehmet was featured in an article highlighting his success as an entrepreneur, and business owner. Mehmet founded cliexa in late 2015 and has been working diligently to grow the company. Mehmet sat down with the Silicon Review team to discuss his experience as a leader in business, and healthcare technology.

Here is a snippet from the article:

“What is your greatest fear, and how do you manage fear?”

“My greatest fear is to over-promise and under-deliver, in any form, within a business or non-business related context. I manage fear by acknowledging it and facing it when the time comes.”

“What were the biggest initial hurdles to building your business and how did you overcome them?”

“Convincing others about my entrepreneurial approach and vision was one of the biggest hurdles. Validating the concept and demonstrating the outcomes was one of the ways I worked to overcome them.”

To read the full article, click HERE.

“cliexa’s vision is to be the state-of-the-art patient-reported outcomes and remote patient monitoring platform for comorbidities and real-time data provider for future medicine by increasing patient-provider engagement and compliance,” said Mehmet Kazgan, Founder & CEO of cliexa.

On March 5, 2019, the Agency for Healthcare Research and Quality (AHRQ) announced three winners from Phase 2 of the AHRQ Step Up App Challenge, a competition that was designed to address the need for patient-reported outcomes (PRO) data into clinical care. Out of 10 semifinalists, and over 50+ applicants, cliexa® was selected as the 3rd place winner, and will receive $25,000 in prize money.

cliexa is a HIPAA-compliant cross-communication platform that improves the quality of care, clinical workflow, income generation, and time spent with patients. Patients will play a more significant role in their care with cliexa and will be able to make valuable correlations to causative factors for pain flare-ups through remotely reported outcomes. The discrete clinical data and patient-reported outcomes enable providers to improve clinical decision making while reducing liability and billing concerns with payors. These algorithms help providers respond more efficiently to new data so their patients will have fewer complications or side effects. Payors will be provided with longitudinal data to understand the necessary treatment decisions and patient status better. This will lead to improved communication and greater efficiency in the billing process while expanding the understanding of clinical methods that support patient well-being for future coverage improvements.

cliexa-EASE is a native application developed for Phase II of the AHRQ Step Up App Challenge, designed to track physical function, pain interference and depression using PROMIS measures. The application also has a patient reporting function where the patient can see the recorded scores over time and email this to other care team members, as well as a medication and complication tracking functionality. The application was tested for functionality on 6 patients at an integrated pain center, New Health Services, in Denver, Colorado. The application helps clinics fully leveraging PRO data to integrate validated clinical assessments to patient intake and remote-monitoring processes while collecting clinical metrics and compliance data for quality reporting. The discrete clinical data and PRO data enable providers to improve clinical decision making while reducing liability and billing concerns.

cliexa-EASE White Paper (FB)

We want to thank the Agency for Healthcare Research and Quality for rewarding us this opportunity. It has been a pleasure working with the folks who have dedicated their time and resources to ensure a smooth operation. Congratulations to all other companies who participated in the Step Up App Challenge. We believe programs of this nature foster an environment for technological innovation and provide a great path for advancing the healthcare industry.

cliexa is a semifinalist in the AHRQ's Step-Up Challenge

cliexa is a semifinalist in the AHRQ's Step-Up Challenge

cliexa is one of 10 companies out of 50+ advancing to Phase 2 of the Agency for Healthcare Research and Quality (AHRQ)‘s Step-Up App Challenge with the “goal of developing an app that integrates standardized patient-reported outcomes (PRO) data into clinical care and research.”

For Phase 2 of the Step Up App Challenge, cliexa will design, develop, and demo our application using the FHIR technical specifications and PROMIS® resources for patient-reported outcomes with the hope to be selected as one of the three winners, who will get the opportunity to test their product in nine practice settings affiliated with MedStar Health in Washington, DC.

Read the blog announcing the 10 semifinalists from Director of the AHRQ, Gopal Khanna, M.B.A: https://www.ahrq.gov/news/blog/ahrqviews/stepup-challenge-finalists.html

Check out our portfolio of patient-reported outcomes applications: cliexa Mobile

Who Would Have Thought - Digital Health Podcast

cliexa’s CEO & Founder, Mehmet Kazgan, is featured in the Who Would Have Thought – Digital Health Innovation Podcast! The Who Would Have Thought – Digital Health Innovation Podcast host, Robert Niichel, CEO and Founder of SmartTab, was joined by Chief Marketing Officer, Sacha Heppell.

In this episode, we take a deep dive into the value of patient-reported data and how cliexa leverages artificial intelligence (AI) to drive innovation in healthcare. Let’s take a look at the interview topics:

1. Improving Crohn’s Disease Outcomes

With any chronic disease, patients should be at the center of their own care. Our goal is to empower patients to guide their own care journey through real-time symptom reporting at the tip of their fingers. The cliexa-IBD platform embodies this approach by collecting information in-between visits to provide physicians a comprehensive overview of day-to-day symptoms experienced by their patients.

2. Patient-Centered Platforms vs. Tools for Physicians

Applications that benefit both the patient and physician journeys are critical to successful digital health tools. We subdivide our platform by two separate segments: Patient Profile and Diagnostic Profile. While the patient profile remains stagnant based on past medical and family history, the diagnostic profile is highly influenced by real-time symptoms experienced by the patient and has a large effect on their changing treatment plan. Check out our solutions for more information!

3. Data in Healthcare

The fourth industrial revolution is here, and data is at the forefront of innovation. For healthcare, the power of data is seen every day with each new discovery surrounding COVID-19. Digital health puts actionable data in the hands of clinical professionals and researchers to collect real data from patients and put it to use in defining their personalized treatment plans.

4. The Future of AI in Healthcare

Further building on how data will change modern healthcare, artificial intelligence accelerates the rate at which we identify trends in patient-reported data. With AI at the forefront of innovation, cliexa is proud to be implementing our proprietary model into chronic pain settings. Stay tuned for more information on our opioid risk AI model.

Thanks to Robert and Sacha for hosting cliexa on the Who Would Have Thought – Digital Health Innovation Podcast. We enjoyed the mindful discussion surrounding patient-reported outcomes and the future of AI in modern healthcare. Tune in to the podcast for more information on how cliexa is reinventing the way medical conditions are managed!

Telehealth and user experience

Bene Studio RapidConf Event Recap

cliexa was a proud exhibitor for the UX & Telehealth RapidConf as a part of their COVID-19 Crisis Workshop! Joining technology leaders from around the world, our team became a part of the conversation on the importance of UX design in telehealth.

The Role of UX in Digital Health

This year has been a game changer for digital health technologies, with telehealth and telemedicine being at the forefront of every clinical practice. With the rapid deployment of technologies, it’s critical to acknowledge how user experience (UX) plays a role in a patient’s healthcare journey. Designing a user-friendly application or web interface is critical to engaging patient’s in their treatment and is where UX plays a huge role in these novel technologies. With the shift to patient-driven healthcare, there is the need to instill new habits to make interacting with the technology a part of their routine.

Our team has emphasized the importance of UX/UI design on the patient journey over the recent months. While our platform primarily gears towards clinicians and medical staff, patients must have their own intuitive interface. Check out our virtual health solution to visualize the UX design work we have implemented as healthcare goes digital.

A huge thank you to Bene Studio for having us as an exhibitor and to all of the panelists that took part in the event!

Digital Health Tools

Digital Health at the Forefront

Over the past few days, healthcare professionals and industry leaders across the nation are suggesting that our healthcare environment is more akin to rural care than ever before. Given the state of our rural care in the United States, this proves to be challenging for healthcare systems to adopt novel technologies that curb the challenges of virtual care. With patients less likely to pursue care for major issues throughout this pandemic, digital interventions are more desirable than ever.

In a recent interview with McKinsey & Company and CVS Caremark’s president, Alan Lotvin, Mr. Lotvin highlights their shift to in-home models and nontraditional care during the COVID-19 pandemic. One of the larger topics discussed was how patients and physicians are working to understand the risk of avoidable emergency department visits, and how they can effectively use digital tools, like telehealth and telemedicine, to run parts of the clinical practice. Additionally, the avoidance of care persists as a valid concern across healthcare systems, as people with comorbidities are at higher risk for severe COVID-19 complications.

Our Response

It shouldn’t come as a surprise that telehealth and telemedicine have come into the forefront of the digital health conversation. As Mr. Lotvin discussed, “telehealth and telemedicine are huge right now… I think most doctors have found that there are effective ways to run big parts of their practice.” The importance of telehealth and other digital interventions emphasizes the need for tools like cliexa in clinical practices. cliexa’s own virtual care solutions were significantly expanded in response to the needs of client clinics within weeks of the onset of the coronavirus pandemic, which integrates seamlessly into the other product offerings.

With industry leaders promoting the value of digital interventions, full-stack virtual health solutions continue to prove their long-term value in healthcare. Check out our latest blog as we discuss how the Access to Care in Rural Settings remains a challenge in the United States and continues to be an obstacle during the coronavirus pandemic.

Rural Patient Access Digital Health Tools

Introduction

It is well known that with COVID-19 cases on the rise in much of America, extra stress has been put on healthcare workers and departments. One specific area of great focus includes rural areas, where hospitals were financially ill-prepared for the onset of COVID-19. Rural hospitals are finding themselves in vulnerable positions as they consider how to manage both the extreme loss in revenue due to canceled elective surgeries and the costly nature of acquiring ventilators. 

Due to the precarious situation rural hospitals have encountered (only having an average of 21.3 days of cash on hand for Rural PPS Hospitals 26-50 beds), multiple rural hospitals across the US have been forced to close and many more are under threat of closure. These increasing closures in many rural areas cause residents to grapple with overall decreased access to care. With restricted access to care and hefty provider costs, healthcare workers are scrambling to find adaptive, modern solutions. 

However, access to care in rural settings has always been a critical issue in the US as there has been much need for the development of medical infrastructure providing affordable and high-quality care to 20% of the population. In fact, of the 170 rural hospitals that have closed in the US since 2005, only 11 have shut down in 2020. With this context, it is important to understand what barriers to healthcare are still present for rural patients today, as well as what potential modern solutions will help increase overall access to care in the US. 

Distance and Transportation

One of the main barriers to healthcare in rural areas is transportation. Since rural areas tend to be less densely populated, patients often travel long distances to see their medical providers. In a study by the Pew Research Center, the average urban travel time to a hospital was 10 minutes, while the average rural travel time was 17 minutes, with the top 25 percentile over 35 minutes.

Uninsured Individuals in Rural Settings

While urban residents benefit from public transportation and the relative proximity of their providers, for rural residents large travel times can be a serious problem for those who require immediate care. However, they can also act as an obstacle for more mild cases, deterring patients from reporting symptoms, completing patient onboarding, or seeking primary care. The significant increase in travel time introduces a myriad of other burdens for rural residents. When a patient travels to seek medical attention, they may suffer from lost wages, time away from home, and transportation fees. Patients should not have to weigh these costs in their consideration of receiving healthcare. 

cliexa’s solutions in Remote Patient Monitoring alleviate these difficulties in transportation by lowering the number of unnecessary hospital visits. Through a focus on patient engagement, wearables integration, and self-reported patient outcomes, providers can deliver high-quality care to patients exclusively through mobile devices. Also, patient intake and registration forms can be completed remotely, saving time for patients and clinicians. With the ability to receive care from the comfort of their home, patients no longer have to face the barrier of transportation. 

Workforce Issues

Healthcare Professional Shortage by Area United States

 Source: https://www.ruralhealthinfo.org/rural-maps 

Health Professional Shortage Areas (HPSA’s) are more abundant in rural locations. While many countries regulate the geographic distribution of healthcare providers, the US does not.Instead, physicians have complete discretion on where to work, leading to unequal health professional coverage across the country. According to the Bureau of Health Workforce, 61% of the country’s HPSA’s are located in rural areas. As a result, rural patients are less likely to have regular access to care. 

Healthcare workforce shortages present a dangerous situation to rural residents who may have difficulty finding an appropriate provider. In urban areas, there are about 84 physicians per 100,000 people; however, in rural areas this number drops to 68. cliexa alleviates stress on HPSA’s by virtually connecting patients and their providers. By eliminating travel times and automating digital intake, telehealth solutions dramatically increase efficiency, allowing health professionals to reach more patients. 

Poor Health Literacy

Health literacy is an important topic in modern day healthcare as new developments in the field, including new forms of treatment, can sometimes confuse patients or leave them feeling like they are not an important part of their own care decisions. According to the Rural Health Information Hub, poor health literacy can negatively impact “a patient’s ability to understand health information and instructions from their healthcare providers.” The bottom line is, poor health literacy can deter patients from taking a major role in their health journey and, in some cases, from even pursuing care in the first place. 

This is a real problem especially in some rural areas where there may not be an interpreter on the staff to help non-native English speakers understand health information and services related to their care. Even aside from that case, according to the US Department of Education, only “12 percent of adults had proficient health literacy,” and “adults living below the poverty level had lower average health literacy than adults living above the poverty threshold.”Furthermore, this plays a significant role in rural areas given that The United States Department of Agriculture reports that “the large majority (301 or 85.3 percent) of the persistent-poverty counties are nonmetro… ”

However, cliexa helps patients be engaged and educated in regards to their care. All of our services have at least some features built into them to support patient education so they can be proficient in the subspecialty of care that is most relevant to them. From the Office of Disease Prevention and Health promotion, studies have shown that “adequate health literacy may increase a person’s capacity to take responsibility for their health and their family’s health,”further promoting their access to care 

Another way that cliexa supports improving health literacy is through our telehealth services. Telehealth is the “delivery and facilitation of health care services through the use of remote mobile technologies.” We know that our telehealth services help patients be more connected and active in their care. With remote access to care, rural residents can utilize our telehealth services to improve their poor health literacy and find easier solutions to their barriers to care.

Health Insurance Coverage

Health insurance coverage plays a crucial role in determining access to healthcare. Rural areas tend to have consistently less coverage than metropolitan areas. According to a U.S. Census report, 9.1% of rural populations live without any health insurance compared to 8.4% of urban populations. Additionally, an article from ACA Implementation reveals that premiums are higher in rural areas and “on average, $39 more per month (10% higher) than those in urban areas”.

Distance to Nearest Provider Rural Settings

A higher percentage of uninsured individuals can lead to significant gaps in healthcare in rural areas. A report from the Office of the Assistant Secretary for Planning and Evaluation found that more than 25% of uninsured individuals withheld from receiving healthcare due to costs. This issue has become even more prevalent in the last few months as 5.4 million Americans have become uninsured due to Covid-related job losses.

cliexa combats sparse health insurance coverage in rural areas with innovations in telehealth. Telehealth allows patients to receive health care at lower costs than in-person visits. Virtual visits also provide a safer alternative to access care under the current conditions of COVID-19 in America, potentially saving thousands of dollars for vulnerable, uninsured individuals.

Social Stigma and Privacy Issues

A common trend across rural areas is the lack of anonymity associated with living there. This plays an important role in healthcare as some rural residents may avoid seeking necessary care as a result of social embarrassment or privacy concerns. The main avenues of care that this directly impacts includes substance abuse, mental health, sexual health, and chronic illness. 

In fact, a report from the US National Library of Medicine National Institutes of Health reports that although HIV cases in rural areas have been on the rise since before 2005, “HIV-related stigma can significantly impact care utilization and health outcomes including quality of life and medication adherence and people living in rural regions often experience high levels of HIV-related stigma.” Not only is HIV-related stigma a prevalent factor in rural social settings, mental health is not regarded as much in rural areas as in urban areas. The CDC reports that “children in rural areas with mental, behavioral, and developmental disorders face more community and family challenges than children in urban areas with the same disorders.”

Although “rural adults have higher rates of alcohol abuse, tobacco use, and methamphetamine use, [and] prescription drug abuse and heroin use has grown in towns of every size… rural areas often lack options for specialty substance abuse treatment programs… which may discourage treatment utilization among vulnerable, underserved populations.” Learn more about how cliexa is taking part in Combating the Opioid Crisis with Pain Management Technology

cliexa’s platform is perfectly geared towards helping rural residents receive care without social stigma or fear of privacy issues. Our Remote Patient Monitoring Platform lets patients report their symptoms and update their care providers securely and privately. Furthermore, our forms and assessments, such as the Fagerström Test for Nicotine Dependence (NIDE), offered on our Behavioral Health Platform, help providers have easy, reliable access to information about multiple patients coming from a wide range of areas. Finally, our Adolescent Resiliency Platform is perfectly geared towards users at risk for a number of personal health issues including sexual health, depression, and anxiety. Overall, it is clear that cliexa’s options will greatly help improve access to care for rural residents, by providing ways to circumnavigate social stigma and privacy concerns.  

Conclusion

Rural health is in a critical state in the modern day healthcare world due to rural hospitals being financially at risk, rural residents at risk for a variety of serious conditions (including substance abuse outcomes and chronic illnesses), as well as physical and organizational barriers that limit patients’ access to care. As Georgetown University’s Health Policy Institute cleanly states, “the rural population is consistently less well-off than the urban population with respect to health.”

cliexa, however, is a virtual health platform that is set on improving access to care for rural residents via remote patient onboarding, remote patient monitoring, telehealth, secure and private form access, and patient education models. One of our fundamental goals is improving outcomes, a goal which is greatly limited due to access to care being restricted for a variety of reasons in the rural world. We are confident that our host of solutions are perfectly suited to resolving these issues and improving outcomes in one of the most critical areas of the modern healthcare world. 

References

[1] UNC Rural Health Research Program; Findings Brief: Most Rural Hospitals Have Little Cash Going into COVID, May 2020. https://www.shepscenter.unc.edu/programs-projects/rural-health/projects/north-carolina-rural-health-research-and-policy-analysis-center/publications/

[2] UNC Rural Health Research Program: 170 Hospital Closures: 2005 – Present. https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/

[3]https://www.pewresearch.org/fact-tank/2018/12/12/how-far-americans-live-from-the-closest-hospital-differs-by-community-type/

[4]https://www.graham-center.org/rgc/publications-reports/publications/one-pagers/unequal-distribution-2013.html

[5]Designated Health Professional Shortage Areas Statistics, Bureau of Health Workforce Health Resources and Services Administration (HRSA) U.S. Department of Health & Human Services, June 30, 2020.

[6]https://www.graham-center.org/rgc/publications-reports/publications/one-pagers/unequal-distribution-2013.html

[7] https://nces.ed.gov/pubs2006/2006483.pdf

[8]https://www.ers.usda.gov/topics/rural-economy-population/rural-poverty-well-being/#demographics

[9]https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/health-literacy#5

[10] https://www.cliexa.com/solutions/telehealth/

[11]https://www.rwjf.org/en/library/research/2018/11/are-marketplace-premiums-higher-in-rural-than-in-urban-areas.html

[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169533/

[13] https://www.cdc.gov/ruralhealth/about.html

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995852/

[15] https://hpi.georgetown.edu/rural/

Gender Equity in Global Health

Back in January of 2020, our own Director of Product, Ashley Darnell, shared about her experience and recent manuscript publication with FHI360’s Alive and Thrive Program in Vietnam. Since then, Darnell’s time and research have obtained further publication in a second manuscript that delves deeper into the varying health policies in Southeast Asia and their subsequent effects on the region. Check out her most recent update below!

“In 2020, the impact of varying health policies when addressing a common goal is undeniable. However, in 2017 when I began working alongside the Alive & Thrive team in Vietnam, a sector focused on maternal and child health within with FHI360, an in-depth comparative policy assessment of National Nutrition Strategies across ASEAN had not been conducted. As outlined in the manuscript, “Countries in Southeast Asia have high burdens of malnutrition (Association of Southeast Asian Nations [ASEAN], European Union, UNICEF, & World Health Organization [WHO], 2016; UNICEF, 2019). For example, in the region’s 11 countries, nine have a high or very high prevalence of stunting (≥20%), nine have medium, high, or very high prevalence of wasting (≥5%), and five countries have medium, high, or very high prevalence of overweight (≥5%) among children under 5 years of age (UNICEF, 2019). The prevalence of children under 5 suffering from micronutrient deficiencies in Southeast Asia is almost 50% (ASEAN et al., 2016; UNICEF, 2019). Rates of malnutrition among school‐aged children and women are also high in this region (UNICEF, 2019). Seven of the 11 Southeast Asian countries belong to the lowest 20th percentile of height for men and women among 129 countries (N. C. D. Risk Factor Collaboration, 2016),1” presenting a valuable opportunity to review the policies in place at a national level in 9 Asian countries as they compare to regional and international recommendations.”

“At Alive & Thrive, we scrupulously analyzed the existing policies for Vietnam, Myanmar, Cambodia, Brunei, Malaysia, Laos, Timor Leste, Indonesia, and the Philippines. We assessed the context and objectives of all existing health interventions relating to maternal and child nutrition to identify how closely aligned these national efforts were. The outcome was recently published in the Journal of Maternal and Child Nutrition, titled National nutrition strategies that focus on maternal, infant, and young child nutrition in Southeast Asia do not consistently align with regional and international recommendations.”

“In this manuscript, we found that despite the continued alignment of ASEAN countries in regional efforts, the NNS did not consistently align when it came to maternal and child health interventions. We proposed that establishing a database of health intervention information on a regional and international level would not only help cross-check for effectiveness when correlating with other national statistics but also help increase alignment and overall knowledge in the application of health intervention through policy structures.

Join us in congratulating Ashley in her accomplishments in Public Health, and check out the manuscript in the citation below.

1 Nguyen, TT, Darnell, A, Weissman, A, et al. National nutrition strategies that focus on maternal, infant, and young child nutrition in Southeast Asia do not consistently align with regional and international recommendations. Matern Child Nutr. 2020;e12937. https://doi.org/10.1111/mcn.12937