The power of remote patient monitoring

There is limited data comparing remote post-discharge patient treatment to that of standard in-person care, but a new clinical trial has done exactly that.

This multicenter randomized control trial measured safety events, medication adjustment and left ventricular reverse remodeling outcomes.  The subjects were low-risk patients with acute myocardial infarction treated for 6 months after discharge by a centralized nurse practitioner–led telehealth program compared with standard in-person care by a cardiologist. There were no differences in achieved medication doses or indices of left ventricular remodeling.

This clinical trial set out to answer an important question for healthcare in a COVID and post-COVID landscape:

“Is remote post-discharge treatment of low-risk patients with acute myocardial infarction by a centralized nurse clinician team under physician supervision feasible and safe?”

The answer is: Absolutely. In fact, it’s both safe and effective.

What’s next?

Researchers now want to conduct a similar clinical trial with higher-risk patients, in an effort to further test the capabilities of remote intensive patient management and care. Read this impactful new study here:

Remote Postdischarge Treatment of Patients With Acute Myocardial Infarction via JAMA Cardiology

The future is here:

cliexa-PULSE Home Health Monitoring Platform co-developed by cliexa and American College of Cardiology

“Imagine the ability to effectively capture RPM in the cardiology’s major disease states – HTN, CHF, CAD, and AFib in an easy-to-use-tool without all the data overload: Enter cliexa!” Dr. Andrew M. Freeman, MD – Director of Clinical Cardiology and Operations Director Cardiovascular Prevention & Wellness at National Jewish Health

Through the ACC Innovation Program with our partners at the American College of Cardiology (ACC), we have developed one of our latest modules, cliexa-PULSE to digitally transform and ultimately optimize cardiovascular care and outcomes. cliexa-PULSE is a mobile application designed for patients to track their symptoms, medications, episodes, complications and daily activity to manage Atrial Fibrillation providing real-time data to their clinicians. The expansion of cliexa-PULSE in 2021 will provide treatment tracking tools for patients with Hypertension, Congestive Heart Failure and Coronary Artery Disease, as well as launching a population health module. cliexa-PULSE is the ideal mobile app for clinicians to fully leverage patient-reported data, improving treatment decision-making and the overall patient experience. Learn more about cliexa-PULSE HERE

 

the role of digital health in quality reporting

The Importance of Quality Reporting

With constant access to the internet, consumers can shop around for the best product and services for almost every scenario. This even includes their healthcare. Patients no longer continue going to the same hospital because they were born there, their family does, or it is closest. Patients can pick and choose their doctor or hospital based on their quality reporting scores, patient outcomes, and cost. Various websites provide this service, as well as Centers for Medicare & Medicaid Services (CMS) or Merit-based Incentive Payment System (MIPS) public data.

Whether it is weak quality reports, lackluster patient outcomes, or high costs, patients will seek out other physicians to ultimately find the best care (See Your MIPS Score Stays with You). With the increase in healthcare locations across the country, some patients now have the option to choose their provider and institution at which to receive care. The rise of mobile technology is lending to patients receiving their care at home, saving time and effort on their end while improving the overall patient experience for the healthcare system. This newfound choice creates a greater emphasis on physicians and hospitals to pay attention to their quality reporting and patient outcomes.

The numbers of patients with multiple comorbidities are higher than ever before. These comorbidities and chronic conditions are extremely impactful to the care a physician gives to their patient. In addition, chronic conditions and comorbidities are impactful in understanding the way a patient responds to treatment and recovers from surgeries and other interventions. It is essential that physicians are collecting data, not only thorough past medical history for their patients, but also medications, and family health history.

The Role of Digital Health in Quality Reporting

For a practice to effectively collect this much data for each patient, it is incredibly time-consuming. A significant amount of time is required to not only have the patient read and sign consent forms, but also to complete intake forms for necessary information, and input all of this into the electronic medical record for the physician to read. Time and resources are precious in clinical and hospital settings, which is why it is so important to implement technology that aids clinical and hospital staff in completing this.

cliexa not only digitizes all consent forms and intake questions but discretely integrates each aspect of the clinical forms into the electronic medical record (EMR). Medical data now appears instantly in the EMR, just like a staff member or a medical assistant would have typed it. Medical staff and physicians can then review the information that is already in the EMR and proceed to treat the patient from a well-rounded point of view. cliexa allows the patient to complete their consent and intake forms while away from the clinic. Patients download the cliexa application and complete their paperwork, taking the time constraints away from the clinic or hospital, and allowing the patient to be more thorough in their information.

Receiving accurate and thorough past medical history, medications, and family history have huge effects on patients’ outcomes and quality reporting. A physician can use cliexa to identify a higher incidence of heart disease in a patient’s family and use this information to not only order tests and screen for heart disease in their patient but also discuss weight-loss strategies and lifestyle changes [1]. Our platform is designed to aid a physician in their foresight to catch an issue before it arises. This helps ensure physician’s patient outcomes and naturally improves quality reporting. Likewise, a surgeon can utilize cliexa and identify if their patient is a current smoker. They can use this information to assess the increased risk their patient has when consenting to elective surgery [2]. By including that data in their reporting, they are not only protecting themselves but can also start a conversation regarding smoking cessation with that patient.

In a time when quality reporting and patient outcomes not only influence your success as a physician but also how many patients you see and retain, it is more important than ever to partner with cliexa to help you achieve this. It is becoming more important to understand the needs and desires of patients to ensure your MIPS scores do not suffer, and virtual health is one way to address changing patient needs.  While patient experience is subject to change over time, quality reporting, patient outcomes, and physician ratings are only updated every two years. From the time you notice that your data is negative, it will take an additional two years to see if your outcomes have changed positively. Time is of the essence to enhance your data, receive more patients, and improve your quality reporting and patient outcomes.

[1] Moonesinghe, R., Yang, Q., Zhang, Z., & Khoury, M. J. (2019, July 16). Prevalence and Cardiovascular Health Impact of Family History of Premature Heart Disease in the United States: Analysis of the National Health and Nutrition Examination Survey, 2007-2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662130/

[2] Theadom, A., & Cropley, M. (2006, October). Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563647/

cliexa announces new partnership with Colorado Clinic on innovative solution for interventional, chronic pain management
cliexa announces new partnership with Colorado Clinic on innovative solution for interventional, chronic pain management

We are thrilled to announce we have teamed up with Colorado Clinic to redefine their data collection and documentation process using the cliexa platform. Colorado Clinic is a leader in combatting the opioid crisis by offering cutting-edge, non-narcotic solutions for holistic interventional pain management. The cliexa platform enables patients and physicians to track disease activity and leverage proprietary technology that makes intelligent correlations between medication dosage, frequency, and heightened or reduced symptoms. Together, we partner to offer an innovative solution for chronic pain management with the cliexa-EASE platform.

With the cliexa-EASE platform, Colorado Clinic patients will be able to digitally complete the entire intake process upon arrival to the clinic. This digitized process includes consent documentation, chief complaints, and screener questions such as the Screener and Opioid Assessment for Patients in Pain (SOAPP-14) to monitor at-risk patients. The SOAPP model is a 14-item, self-report measure designed to address the appropriateness of therapy for chronic pain patients.

Clinicians will receive a full report delivered directly into their athenahealth electronic medical record (EMR) system with auto-generated treatment recommendations determined by the Colorado Clinic staff for each individual patient. 

cliexa has also developed a proprietary risk stratification model for Colorado Clinic to determine the level of risk for patients taking opiates. Based on the calculated risk level, urine analysis frequency recommendations will be generated in the clinician report in accordance with Colorado Clinic’s clinical guidelines report.

Through cliexa’s computer adaptive testing system and individual patient matching, patients will be able to complete standardized assessments that are triggered by the chief complaints and responses in the SOAPP-14 assessment. This method allows Colorado Clinic to deliver a highly personalized patient experience. cliexa empowers providers with compliance algorithms built-in to the platform, enabling them to see billing recommendations based on the patient inputs, allowing them to gather accurate reimbursement metrics to sync with the MIPS quality report.

With this collaboration, the cliexa-EASE platform will be available soon at all 5 of Colorado Clinic’s locations including Aurora, Colorado Springs, Greeley, Loveland, and Thornton. We can not be more excited to collaborate with the team at Colorado Clinic, and we look forward to providing more content about the project in the coming months.

Is your practice using the athenahealth EMR and want to learn more about how to enable cliexa? Check out our quick, 5-step setup guide!

Researchers Receive $1 Million Grant to Study Digital Screening Intervention Tool for Adolescents and Young Adults

cliexa is excited to partner with the University of Northern Colorado (UNC) with a grant from the Department of Health and Human Services’ Office of Adolescent Health that provides nearly one million dollars over the next two years for the implementation of cliexa-OPTIONS, a digital screening intervention tool that fosters earlier identification of high-risk adolescents in a clinical setting. The funding supports independent evaluation including, cost-benefit analysis and randomized controlled trial of the cliexa-OPTIONS risk screening tool and MyPLAN mobile health follow-up. The Principal Investigator for the project at UNC is Dr. William Merchant. He is the evaluation professor in the Applied Statistics and Research Methods program in the College of Education and Behavioral Sciences. 

The cost-benefit analysis assesses cost savings between the cliexa-OPTIONS risk screening against current paper pencil and verbal screenings. Also, the cliexa-OPTIONS risk screening identifies 30- 50% more risk in adolescent populations fostering early identification of adolescents at highest risk for acquiring an STI or experiencing an unplanned pregnancy. Improving quality in clinical workflows for adolescent and young adult populations is timely, given that sexually transmitted infections for young people ages 15 -24 are at epidemic proportions.

Saving time and keeping providers satisfied with new technology in clinical workflows is no simple task. The cost-benefit analysis will also assess the benefits of early identification of adolescents at highest risk for adverse reproductive health outcomes, substance use, mental health, and wellness.

Read the full article at: //www.unco.edu/news/newsroom/releases/million-dollar-grant-digital-screening-intervention-tool.aspx

Mobile Health Applications - Value Based Care

In today’s healthcare system, there is a focus on creating a value-based care system to foster a standard of effectiveness, and efficiency when it comes to patient health outcomes, and reduced costs. Through this model, healthcare providers are incentivized to deliver high quality care and this value is derived from measuring health outcomes over time. There is significant pressure that many providers face to be able to quantify their patient’s health outcomes in order to show they are in fact delivering “value-based care.” A value-based model creates a need for a fruitful cross-communication system that extends to patients, providers, payers, and all involved in the healthcare system in order to quantify and qualify health measures.

In a effort to utilize patient-reported health status to improve care, cliexa is collaborating with the American College of Cardiology to develop technical modules targeting cardiology-specific diseases using remote patient monitoring. The first module, cliexa-PULSE, has been developed is for Atrial Fibrillation and includes patient-reported symptom tracking, medication reconciliation functions, connections to wearable data and claims data connection. This information will fulfill reporting needs for patients through visual tracking graphics in the application and to physicians in a summarized, customized manner. Moving forward we are looking to commercialize this product through the ACC’s 2,500 members and beyond.

Improved communication and reduced costs can be achieved by improving patient engagement, streamlining clinical workflow, and implementing a customizable technology that will automate clinical processes, analyze and simplify patient data, which can lead to improved care and health outcomes. By the incorporation of patients’ health status and value via patient-reported outcomes (PROs), providers can monitor the quality of health care delivery.

PROs can be used as absolute terms, or as a change from a previous result as well as a measurement in clinical trials. Physicians can better determine baseline status, clinical trial endpoints, monitor therapy effectiveness, assess change in stats and prognosis predictor, while the patient experiences positive impacts on daily activities, emotional wellbeing, psychological health, and social function. In addition, PROs can aid clinics to improve patient outcomes, quality of life and satisfaction by using the PROs to better inform their care. PROs prioritize the important details in a clinical encounter and aid a better understanding of the motivation behind patient behavioral change. With this information, the clinic can analyze the evidence, design clinical trials and change their practice and policy. In addition, PROs can aid clinics to improve patient outcomes, quality of life and satisfaction by using the data to better inform their care. PROs prioritize the important details in a clinical encounter and aid a better understanding of the motivation behind patient behavioral change. With this information, the clinic can analyze the evidence, design clinical trials and change their practice and policy.

Patient-centered data collection outside of a traditional clinical is the next frontier of modern healthcare. By digitizing and automating PROs, both patients and physicians benefit financially and through effective time management. PROs tackle the challenge of long surveys, care integration, multimorbid patients, and improving the relationship between patient and provider. Clinicians need instruments (surveys) to capture patient-reported measures of symptom status, functional status and health-related quality of life. PROs help quantify the disease from patients’ perspectives, makes disease- specific measures more sensitive and relevant, help meet all the requirements of performance measures and can improve the process of delivering clinical care while bringing the patients’ voices into care. Physicians have found that PROs, in the right setting with the right workflow, are a helpful mechanism for shared decision making and help tackle the treatment goals of patient survival, free of hospitalization, and increased quality of life.

Read more from ACC: //www.acc.org/latest-in-cardiology/articles/2019/04/14/12/42/innovation-at-acc-collaboration-using-patient-reported-health-status-to-improve-care