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1.) Support the ingenuity of your workforce

“Leaders must encourage innovative and creative solutions to solve big and small challenges,” says Jaewon Ryu, M.D., J.D., president and CEO of the Geisinger Health System in Danville, Pennsylvania. “For us, that has included creatively redeploying staff to areas of more pressing need, 3D printing of supplies with local community partners, rethinking how we use our space, refurbishing out-of-service ventilators and so much more. These solutions have come from all across our system, from people in a variety of roles and responsibilities.”

Richard S. Isaacs, M.D., FACS, a Permanente Medical groups executive, says carpenters who were used to making furniture for hospitals and medical offices started making face shields instead. “In the first two weeks, our carpenters delivered nearly 12,000 face shields that went into immediate use for our frontline clinicians.”

2.) Stay ahead of the curve can help flatten it

Geisinger serves 45 counties in northeastern and western Pennsylvania. “We are learning from our areas with higher or earlier COVID-19 prevalence to make sure we’re prepared for what may come,” says Ryu. “Better yet, we’re working to flatten the curve in our regions that haven’t been as heavily impacted yet.”

3.) Stand by — and behind — your team

“During these unprecedented times, we are intensely focused on fostering compassion for our caregivers and team members, who are the heroes of our health system and the communities we serve,” says Carrie Owen Plietz, FACHE, executive vice president and chief operating officer of the hospital division at WellStar Health in the greater Atlanta narea. .

“Remember that standing behind your team members on the front lines of patient care is imperative,” Owen Plietz says. “It’s our responsibility to go above and beyond to support, encourage and protect them.”

4.) Make mental health services available and confidential

“It’s critical that messages be communicated from the top down to help everyone work as a great team and support each other,” says Samantha Meltzer-Brody, M.D., M.P.H., chair of the department of psychiatry at the University of North Carolina School of Medicine in Chapel Hill. She helps lead the 

, which has had added resources because of the COVID-19 outbreak. 

The well-being program is available to everyone from physicians to nurses to the staff providing dietary services, Meltzer-Brody says. “We want everyone to access these mental health services without charge, confidentially, then be directed to different or additional levels of service tailored to the individual,” she notes. “That could be support groups, the employee assistance program or more formal psychotherapy if needed.”

“As we work through and respond, draw on the expertise of those who have gone before us in this pandemic, both internationally and nationally, so we can be even better prepared,” Owen Plietz says. “We also regularly connect with our system leaders and industry peers, both locally and nationally, to share challenges and best practices.”

“Each of our 11 hospitals and other facilities has been preparing to support an expected influx of patients by monitoring and actively managing our staffing levels, capacity and supply chain to make sure we have adequate, continued access to the personnel needed to care for patients, as well as beds, materials and equipment,” Owen Plietz says. “In addition, we have an established, regular cadence of drills and simulations for different intake scenarios.”

Yes, leaders can lose people if they overcommunicate; even dedicated team members will tune out after a while. But holding back during a crisis can lead to rumors and worry. “Be visible, overcommunicate and be transparent with your people,” advises Isaacs. .

Owen Plietz says communication via different, accessible platforms can be a two-way street of listening and sharing updates. The exchange “equips team members to be more engaged and invested, which strengthens us all,” she notes.

“Understand there are good and bad decisions you can make, and good luck and bad luck are associated with each outcome of a decision,” says Steve Messinger, president of ECG Management Consultants in Arlington, Virginia, and co-chair of healthcare at the Committee for Economic Development of The Conference Board, a business group that advocates for national priorities. “Ask yourself, ‘Am I making a fundamentally sound decision, and is this a good framework?’”

Messinger has seen staffers use the best information they could to make a call and then be crushed by bad luck when they didn’t get the anticipated outcomes. “People really need to focus on the way they make decisions and on their style,” he says. “Bring people along, and help them understand the leadership role they’re taking. Be obvious, be consistent and be present.”

“Most healthcare organizations we’ve worked with are excellent during times of crisis, like a weather event or heavy-hitting flu season,” says Messinger. “They mobilize and understand logistics. This pandemic is really testing the fortitude of provider organizations due to its long-term duration.”

Messinger adds that leaders need to make sure their staffs are well supplied, a not-so-simple task during this outbreak, and address morale issues. His advice is to be kind and to listen — and to remind people of how important they are.

Stephanie Stephens is a journalist and radio and television producer and host in Orange County, California.

Articles

The COVID-19 outbreak has tried the souls of people the world over, both personally and professionally, and healthcare executives are no exception. Despite seeing their plans and schedules torn up, executives can meet and master the unrelenting demands of leadership when a typical workday is anything but. Consider these tips from your industry peers to not just survive but also thrive — and to inspire your employees to do the same.  

9 Ways to Show Strong Leadership During the COVID-19 Outbreak

With 2020 just around the corner, and value-based care steadily encroaching upon fee for service, the omnipresence of digital health technology can't be ignored as the industry remains laser focused on enhancing healthcare delivery even as it reduces costs. Health technology's increasingly wide adoption brings with it vast opportunities for providers looking to harness it and for patients who find themselves no longer observing as much as participating in their own care as partners.

The broad umbrella of health technology covers categories including mobile health, robotics, wearables, remote monitoring, 3D printing, electronic health records, big data, virtual and augmented reality, telemedicine, the Internet of Things, and artificial intelligence (AI).

 proclaimed, evolution and developments in digital health technology really can help pave the way to achieving the Quadruple Aim-usually defined as enhancing the patient experience, improving health outcomes, lowering the cost of care, and improving the work life of care providers. Sounds like a win-win all around.

 spoke to three health technology leaders about what they're doing and why they do it in their respective industry categories and gleaned their advice on how to profitably embrace this disruptor now and during the next evolving decade.

Telemedicine: Answer this technology's call

"We do what we do because every life matters," says Joel Barthelemy, CEO of GlobalMed, a telemedicine company in Scottsdale, Arizona. He says the company powers the world’s largest, most advanced virtual health programs by designing and manufacturing integrated software and hardware telemedicine solutions that support a patient at any point in the continuum of care, and at any place, because that's what the marketplace demands.

To hear him describe it, telemedicine has come a long way from humble beginnings in the late '60s. Now, telemedicine's goal is to make primary care available right when patients need it.

A Brave New World of Health Technology and Digital Therapeutics

"The population isn't going to wait long when we can do so much with technology," he says, forecasting that even better evidence will be attained more quickly without attachment to wires.

By nature, telemedicine has to be everywhere. "That means in Haiti, on Air Force One, at the bottom of the Grand Canyon, at overseas military bases, at Johns Hopkins Medicine, or at [Veterans Affairs] locations everywhere," he says. To that end, the company has developed a simple dashboard that integrates and aggregates relevant information-and not just from vitals machines. It includes cameras, and not just video conferencing, as well as precision general instruments that capture images from a patient exam.

With more than 15 million virtual visits, and more than $100 million invested in research and development (R&D), GlobalMed's goal is virtual care "touch points" across the continuum for patients from early-stage symptoms to end-of-life hospice care. "It's the only platform capable of consolidating disparate systems with the integration of hospitals, homes, and clinical locations," he says.

Healthcare is moving away from solely symptoms-based diagnoses, to those with rich data behind them and augmented intelligence, says Barthelemy. Smart health technology executives should always be looking to invest in areas such as AI, as well as dental telemedicine, service lines, and vital signs systems that don't need connectivity, and in technology opportunities in pain management and opioid and substance abuse solutions. GlobalMed, based in Scottsdale, Arizona, most recently acquired TreatMD and ORCAS.

Technology is here to stay, so welcome it with open arms and be flexible, Barthelemy suggests. "This healthcare system will collapse due to high costs if we keep doing things the same way expecting different outcomes," he says.

The Internet of Things (IoT): Something big is happening here

The IoT is considered a system of interrelated computing devices. The advantages of hospitals and health systems using that kind of connectivity technology for better outcomes are huge, but security still has to be intact, says CEO and co-founder Jonathan Langer of Medigate, a medical device security firm, with locations in Tel Aviv, Israel, New York and San Diego, considered an IoT trailblazer, with main bases in Tel Aviv and New York.

"Executives know that part of 'taking care' of patients means ensuring there's no risk posed to them anywhere, and that poses a great challenge," he says. It also means protecting every clinical network from cyberattacks.

, as of July 2019, more than 25 million patient records were breached, most due to third-party vendors and phishing attacks against well-known companies such as Quest Diagnostics and American Medical Collection Agency.

Managing medical devices demands the highest levels of complexity while being connected to networks, along with more sophisticated equipment, more specialized maintenance, more challenging vulnerability tracking and remediation, and heightened compliance and safety requirements, he says.

Covering the bases, says Langer, means "looking for deviations in patterns from a simple network-level message like, 'Hey, computer, I'm on the network,' to patients' health data needing to get from company A to company B." 

So executives must consider the wide array of devices inside and outside of the hospital: radiation machines, blue code meters, patient monitors, security cameras, and infusion pumps.

"It's not just one central computer," says Langer. "A cyberattacker can not only steal medical records but also place ransomware and find a really good network route to do more damage."

In spite of inherent risks, he's a big proponent of data networking overall. "If we're to harness the true power of data analysis, we can provide better care, better doctors' decisions, and faster diagnoses, and make it all more affordable. Using telemedicine for home health-especially in rural areas-is also very promising."

To effectively and safely use all the options technology presents also means cybersecurity is definitely here to stay.

Just like its name implies, AI can facilitate behaviors associated with human intelligence. As president of Acorn AI by Medidata (a Dassault SystÃ¨mes company) and the executive vice president of AI and digital solutions for Medidata, which helps life science companies and academic researchers accelerate value, minimize risk, and optimize outcomes, Sastry Chilukuri leads the charge to analyze clinical trial data in real time and deliver actionable insights to life science clients conducting trials-and there are plenty of those.

It's a father–son kind of organizational structure, since Medidata has provided data management and technology platform capabilities to R&D organizations in the pharmaceutical industry for 20 years.

"We have access to more than 18,000 clinical trials involving 5.2 million patients," says Chilukuri. "As we start to use this data, we can build AI solutions on top of it that can make data 'liquid' across the entire lifecycle and answer the most important questions." That's definitely a plus.

He believes four major categories can fundamentally change the trajectory of a company entering 2020, and executives might want to keep these top of mind:

What drugs do you want to double down on and move into clinical trials, considering costs and time? Pick wisely.

Once you decide to move and run clinical trials on particular drugs, how do you do that faster and cheaper?

In a world with so much data available, how do you demonstrate the value of a product to regulators, insurance companies, and patients?

In this era of personalized medicine, how do you help deliver the right treatment to the right patient at the right time?

To fill those needs in a "value-conscious world," Acorn AI, like others in the AI space, has scientists, physicians, technologists, and ex-regulatory officials constantly honing a suite of products.

Chilukuri envisions health technology offering up much earlier disease detection with targeted AI algorithms powering diagnoses, along with smartly tailored treatments for precision medicine, and filling the need for the right body of evidence to drive reimbursement for value.  

At the rate technology is advancing, innovation will continue to be the name of the game, and this is clearly no time to get left behind.

Stephanie Stephens, MA, is a journalist, producer, and host in Orange County, California.

Digital health technology enhances the patient experience, improves health outcomes, lowers the cost of care, and improves the work life of care providers.

Health Technology Disruption: Why It’s Here to Stay

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Although estimates of the cost of medication nonadherence differ, everyone agrees it's too high. A 2014 study in 

 cited a number between $100 and $300 billion, while a late 2018 analysis in the 

Here are six things healthcare executives should know about improving medication adherence.

 (APhA) Foundation is ‘Align the Incentives. Improve the Outcomes. Control the Costs,’” says Benjamin M. Bluml, RPh, and the Foundation’s senior vice president of research and innovation.

“If we properly invest in and align the incentives for patients, providers, and payers, we consistently observe significant improvements in care delivery, quality of care, and reductions in the total cost for care over time,” he says.

“This means collaborating in a team-based care effort-that includes a pharmacist-to change and improve the way care is delivered,” says Bluml. “After all, the primary treatment modality for chronic disease is medication, so if we don’t get medication right and help people understand its value we're never going to ‘get there.’” 

The Foundation has realized excellent success with patient-centered, team-based care initiatives to improve adherence, Bluml says, specifically citing cardiovascular disease, depression and diabetes. For example, patients made 30-minute appointments with pharmacists on a quarterly basis to review finger-stick blood glucose readings and discuss cholesterol, diet, and exercise goals.

“This gives patients a focus for their role, then an incentive to follow up with their provider,” he says. “Here’s an idea for payers: Tell patients if they keep regularly-scheduled visits with their pharmacist for diabetes-related care they'll get a free BG monitor and test strips to stay on track, and you can even take care of the copayment. You’ll spend your per-member dollars differently, but save $1,000-plus per person per year when they're not in the ER or hospital as much, eliminating huge costs. The member becomes a more engaged, informed decision maker.”

“Payers already know they're paying for medications and that there will continue to be more highly specialized therapies,” says Deborah Hauser, RPh, MHA, and network director of pharmacy for 

She seconds strategic use of medication management therapy programs that incorporate pharmacist “touch points” with patients during the course of therapy and result in engagement.

Survey: Effective Medication Adherence Tools

"This is not about just filling a prescription and walking away,” Hauser says. “If a patient doesn’t take their medication, a pharmacist can also assess whether there's a lack of motivation, a socioeconomic reason, intolerable side effects, or the inability to follow proper instructions.”

When they wonder out loud if their medication is “doing anything,” the pharmacist can explain the medication is not for symptomatic control, but to treat underlying disease, she says. “Especially with costly therapies, when a health plan has standards that apply to their use, there must be accountability. Is the medication being used as intended?”

At Einstein's specialty pharmacy, pharmacists call members to ask, “How many have you taken?” or “Do you have any left over?” and then re-educate and reinforce how important the medication is to overall health status.

“There are a lot of stakeholders here, so who's going to do the work?” says Hauser. “A pharmacist is the best stakeholder to assess and engage the patient about the importance of medication adherence.”

3. Realize one-size-fits-all isn’t long term

At the clinical services and analytics company 

, Kerri Petrin, MPH, and vice president of client services, knows that effecting behavior change in members remains a major challenge.

“We’re first approached by clients because they notice that a static approach to adherence outreach has resulted in flattening population-level adherence rates,” says Petrin. “We see a tremendous value materialize when we’re able to help our clients adopt an evidence-driven, member-centric approach that identifies the best method and time to engage a member-based upon their predicted risk of nonadherence, past receptivity to interventions, and the most effective time to intervene.”

When plans use these concepts to drive intervention strategy, Petrin says, two critical markers of a successful adherence program emerge. “There are steadily improving adherence rates while remaining within the health plan’s target intervention budget. The result is that plans are better able to plan for future member needs and can effectively quantify what it takes to achieve their adherence goals each year.”

Many health plans have been using phone calls, mailings, and emails to encourage patient adherence. “Now they're looking for innovative ways to meet patients when they want and where they want, and that's where smartphones come in,” says Kyle Amelung, PharmD, director of clinical solutions for 

Since nearly 80% of adults in the United States own one and check them nearly 80 times a day-and they’re different ages, have different demographics and incomes, and live in both rural and urban areas, Amelung says. He cites apps as a way to “affect and send a message in real time, receive data back and act on it right away.”

It is, in a word, “convenient.” Conditions really can be managed with digital connectivity and yield improved outcomes for patients and lower costs for health plans.

“A smartphone is not the overall solution but it can certainly be the means to a solution,” he says. “You must have uptake and believability from patients, providers, and payers. And you must remember that none of this will move the dial unless you tie in a human element. Our job is to create that therapeutic formulary for smart devices.”

Don't forget the member probably sees their pharmacist probably once a month, while seeing the physician one to two times a year, says Amelung.

However, when reaching out to a member about medical adherence, remember their health is a personal and intimate topic, says Lindsay Conway, managing director at the 

. “Maybe they don’t feel well and don't want to confide in someone with whom they don’t have an existing relationship. You must earn the right to have what may be an intimate conversation and to earn their trust.”

Top 3 roadblocks to medication adherence and how to avoid them

Having a professional sit down for face-to-face time with a patient costs money, Amelung says.

“We see those kinds of programs most often with the sickest and most complex patients who stand to benefit most from medication. It can be difficult to determine what makes a financially sustainable model,” he says.

Whatever the model, the professional doing interface needs skills and training, says Conway. Most important and most challenging is “coordination, coordination, and coordination.”

“When it’s missing, patients sometimes have to jump over hurdles with automated systems or phone messages,” she says. “We’re seeing more hospitals, health systems and physician groups operate their own pharmacies to solve coordination challenges and offer better care and continuity,” she says.

“If you’re a provider managing a complex population, some patients may be getting medication management from their health plans, others from pharma companies, and each program is a little different,” Conway adds. “So, it’s a challenge to keep track of which patients are getting support; what kind of support; and when you need to step in and provide support.”

Experts agree that with coordination, innovation, support, and education, medication adherence goals can benefit both payer and provider.

is a journalist, producer, and host in Orange County, California.

Key ways healthcare executives can improve therapy compliance.

Stephanie Stephens

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