Collaborative Partnerships Driving Scalable Digital Health Programs in Colorado Safety Nets
Since 2014, Prime Health has been helping digital health startups pilot their innovations through the Prime Health Challenge, an annual shark tank style pitch event. To date, the Challenge has matched health-tech innovators with a variety of payers and providers throughout Colorado.
“This year, we’ve aligned our evaluation process and programming to match innovators with critical access hospitals and safety net institutions,” said Nicole McNew, Executive Director of Prime Health. “It is often the ‘soft’ skills that determine the success of an innovation project. Building trust and common understanding between entrepreneurs and community health leaders is critical to scaling innovation pilots.”
McNew was speaking at the April gathering of Prime Health’s Safety Net Advisory Board. Composed of prominent clinicians, executives, policymakers, and academics, the Safety Net Advisory Board meets once per quarter to identify opportunities for innovators to improve care in underserved communities.
During the April meeting of the Safety Net Advisory Board, representatives from five digital health startups spoke. The entrepreneurs presented their innovations, described the pilots they had completed, and detailed the challenges they had faced in working with Colorado safety net institutions.
These case studies will help guide efforts and programming leading up to the 2018 Prime Health Challenge.
Paying for Behavioral Health
“We firmly believe that individuals really need to view mental health the same as physical health,” said Matt Sopcich, president and co-founder of the behavioral health startup myStrength. “We provide resources that cover that broad spectrum.”
MyStrength is a digital and mobile platform that provides behavioral health programs, tools, and resources to people struggling with disorders like depression, anxiety, and substance abuse. The platform is currently in use at 150 organizations, including large payers like Anthem and Aetna, as well as community behavioral health providers and federally qualified health centers.
According to Sopcich, around a third of myStrength’s 150,000 users are in the safety net population. Many of the company’s clients are Medicaid-funded entities. The company recently completed a statewide, 22-month-long pilot in Missouri. The pilot showed myStrength had a net impact of $389 per person, which resulted in a significant return on investment for the state.
“The most common thing we hear is, ‘We love myStrength, we love what you’re doing, we love the impact it has,” said Sopcich. “But we don’t know how we’re going to pay for it.”
Reaching Patients By Text
The next entrepreneur to present was Kaakpema “KP” Yelpaala, CEO of access.mobile, a digital health startup with operations in East Africa and the U.S. A public health practitioner by training, Yelpaala founded his company to improve access to care for people throughout the world.
The company specializes in patient engagement solutions and has perfected the art of engaging patients via text message. According to Yelpaala, it currently has 150 healthcare facilities using its platform and has sent over 4 million healthcare-related texts to more than 2.5 million people.
“Last year, we started the process of thinking about how these innovations could support underserved markets in the US,” Yelpaala said. “When you look at socioeconomic status and multicultural populations, a lot of the issues are the same everywhere.”
The company has engaged in two pilots in the U.S. The first is a partnership with the virtual care provider CirrusMD. Taking place in Baltimore, Maryland, the pilot used access.mobile’s patient engagement platform to encourage members of the local Medicaid population to sign up for CirrusMD’s free virtual consultations. The platform led to a significant increase in registrations.
Access.mobile recently started its second pilot in Los Angeles with White Memorial Hospital. The pilot will target the low-income, Spanish-speaking Medicaid population there, informing them of the services they can receive at White Memorial. The pilot should allow access.mobile determine the best means of engaging with this population.
According to Yelpaala, the biggest hurdle his company has faced has been the difficulty of getting health systems to use text messages to communicate with patients. In light of this difficulty, access.mobile has been offering other means of reaching patients, including email.
Connecting With the Underserved
Chris Saxman, chief financial officer of the virtual care company CirrusMD, spoke next. CirrusMD specializes in virtual acute care, connecting patients with physicians when they need immediate medical attention.
The company’s chat-first platform has already been adopted by several national health plans, including Kaiser Permanente, and is increasingly being adopted by large health systems.
According to Saxman, 2.5 million people currently have access to CirrusMD.
“We design business models with our clients so for the patients the visit is free,” said Saxman. “Payment is a significant barrier to access.”
Prior to expanding nationally, CirrusMD completed a pilot with the Northwest Colorado Nursing Association. The pilot was focused on improving outreach to patients who needed intensive, ongoing care.
While CirrusMD completed the pilot successfully, it encountered challenges during its expansion into Maryland. Getting the contact information of patients there was difficult, Saxman explained. Programs focused on underserved populations often experience high turnover, complicating patient engagement efforts. Their partnership with access.mobile helped CirrusMD overcome this problem.
Fitting Into Provider Workflows
“Primary care is now dealing with such a huge cognitive load,” said Dr. Lisa Rue, co-founder of Preventative Technology Solutions. “They have to screen for all of these tough latent traits that haven’t emerged yet.”
Alongside her co-founder, Dr. Kate Lusczakoski, Dr. Rue founded Preventative Technology Solutions to help primary care providers better assess their patients. The company is currently focused on developing screening tools to assess teens for sexual risk, behavioral health risk, and substance abuse risk.
After winning the 2016 Prime Health Challenge, Preventative Technology Solutions engaged in two pilots with health systems in Colorado. According to Dr. Rue, “We ended up identifying 100% more risk with our sexual risk screening than what is typically done with just a verbal assessment.”
During the pilots, Dr. Rue learned that providers were having difficulty integrating her company’s screening tools into their workflows. To solve this problem, Preventative Technology Solutions recently partnered with cliexa. Using cliexa’s platform, Preventative Technology solutions will be able to push its structured risk reports directly into a provider’s medical record.
Adopting Innovation, Managing Change
The final presenter was Doug Kittlesen, co-founder of AI Health. The digital health company won the Safety Net Award at the 2017 Prime Health Challenge for its first product, Getting Home. The platform helps patients manage their post-acute care experience themselves.
The company used CMS data to rate post-acute care providers according to 11 diagnostic groups. Doing so enabled patients to pick the post-acute care provider that was best for them and schedule care.
According to Kittlesen, AI Health encountered problems among health system administrators who were worried the company’s services would impact their relationships with post-acute care providers. “Everything that we’re trying to do with innovation generally takes money away from someone else,” Kittlesen admitted.
Kittlesen was still considering the solution to this problem. During his presentation, he suggested that health system leaders begin preparing their staff for the changes that technology was bringing about.
“What I think healthcare industry needs is more accountability that is objective instead of subjective,” he said. “The real quality measure in the end is outcome.”