Building a Health System With a Connected Patient

Healthcare is slowly but increasingly moving to more digital solutions, and the COVID-19 pandemic has helped to drive that even more the last 20 months. However, the sudden increase in the use of digital health solutions has also highlighted challenges that weren’t as obvious when it was used in a limited form previously.

A panel during the Galien Week of Innovation included the 2021 nominees for best medical technology and a discussion on achieving a health system with a connected patient.

The panelists were:

• Renee Ryan, CEO of Cala Health, which has a product called Cala Trio that is a non-invasive targeted therapy that reduces hand tremors for adults living with essential tremor. The device is worn on the wrist and calibrated to treat a patient’s unique tremor.
• Eric Mayes, PhD, CEO, Endomagnetics Ltd, which produces Magtrace, the world’s first, non-radioactive dual tracer for lymphatic mapping in women with breast cancer. After Magtrace is injected, it migrates to the sentinel lymph node and helps surgeons find the key sentinel nodes that can be removed.
• Yuri Maricich, MD, MBA, chief medical officer and head of development, Pear Therapeutics, which produces prescription digital therapeutics. The lead products are reSET and reSET-O, which were authorized as a treatment paradigm for opioid and substance use disorder (SUD).
• Eric Chan, director of product management in digital health, Teva Pharmaceuticals, which developed the Digihaler system. The system of digital inhalers have a companion mobile app which can store and transfer data to be accessed by a healthcare professional dashboard.

Technology solutions represent an advancement, but they do rely on having infrastructure in place and reimbursement can be a challenge. Cala Health is working around both issues, explained Ryan. The technology has everything it needs to care for patients with onboard sensors allowing for the initial calibration and additional adjustment. In addition, the memory life can last for 3 months, which means it continues to dose and provide readings without connecting to the internet.

As for reimbursement, Cala is working with Medicare to achieve unique codes to seek reimbursement. “We have the opportunity to allow patients to benefit, but we also have the opportunity to seek reimbursement,” she said.

Both Maricich and Chan noted that the notion a lot of older individuals or lower-income individuals don’t have cell phones is not true. It may be that the phones are older, which requires supporting legacy devices with older operating systems, but across socioeconomic status and age, there are high rates of mobile device ownership, Maricich said. Chan added that not everyone has $1,000 iPhones, so digital solutions have to be compatible with all phones, including Android and older ones.

The software used for Pear Therapeutics’ SUD app doesn’t need to be online all the time. Pear recommends that it connects once a week, which may just be when the user is at the clinic, so they can share information for their clinician to review.

Maricich said there’s a “clear ROI to provide patients with mobile devices” when you consider the cost of supporting wireless data plans versus managing their disease. “But that’s a separate conversation.”

While Cala is seeing progress with reimbursement, in general there is a lack of parity between physical and mental health when it comes to reimbursement, Maricich explained.

Chan added that for his company’s solution, an emergency department visit — the most likely outcome of uncontrolled asthma — is far more costly than the Digihaler, so it’s a matter of “showing payers, PBMs, Medicare and Medicaid that they gain more in the solution” than the cost of it.

Mayes said that for the patients Magtrace is helping, travel is a big barrier. The solution makes a treatment available to more patients who would have normally had to travel far distances to a select few medical centers. In addition, he said the solution is saving hospitals money — approximately $4,000 per patient.

The panelists closed out the discussion with what makes them excited to work in healthcare and most of them said improving access to healthcare and outcomes. Ryan added data to the mix, because it is important for improving cost and care for everyone.

“Data is mission critical,” she said. “I don’t think we’ll have dumb devices anymore. All medical devices will be smart in the future.”