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Walgreens Launches Digital Platform Utilizing Gamification to Boost Medication Adherence

August 18, 2016
by Heather Landi
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Walgreens has partnered with Norwalk, Conn.-based HealthPrize Technologies to offer a digital patient engagement and medication adherence platform for patients filling certain brand-name prescriptions on the Walgreens website.

The platform, HealthPrize Action Engine, uses gamification, concepts from behavioral economics and incentives redeemable at Walgreens to motivate patients to be engaged in their health care and remain adherent to their medications.

“Gamification” is the use of game mechanics and game design techniques in non-game contexts.

The Action Engine platform offers condition-related quizzes and surveys, daily health tips, leaderboards and competitions, daily medication prompts via email or SMS, monthly refill reminders and medication adherence scorecards to help patients engage with and learn more about their conditions.

The Walgreens program powered by HealthPrize will finish development later this month and will be presented to pharmaceutical sponsors as a way to support patient adherence for prescribed medications, according to a HealthPrize press release. It is planned to be offered to patients filling certain brand-name prescriptions for chronic conditions such as diabetes on Walgreens.com.

The concept of the gamification of healthcare has been gaining ground. According to an issue brief published by New York City-based The Commonwealth Fund, fewer than half of the more than 1,000 healthcare related-apps reviewed by researchers appeared to be useful for their potential for patient engagement while also offering high quality and safety. Researchers from the Commonwealth Fund recommended that the most engaged patients may benefit from peer support delivered through social media or ongoing motivation challenges delivered through gamification, such as using elements of game design, like competition or point scoring, to make activity more fun.

“We are continuing to innovate in digital health, enhancing our services and solutions to extend the basic care our pharmacists provide for our patients,” Greg Orr, Walgreens Boots Alliance senior director of digital health, said in a statement. “This platform gives us another opportunity to help improve patient adherence and outcomes, furthering our commitment to being a patient champion and partner of choice.”

The HIPAA-compliant program will also allow participating patients to track any of their other medications filled at Walgreens. It is planned to be ready for implementation with partners in the third quarter of 2016 for diabetes, with additional conditions such as GI, high cholesterol, depression, asthma and COPD, expected in market by the end of the year, according to the press release.

Medication nonadherence is a significant challenge for both the healthcare system and patients.  It is estimated to be the cause of $290 billion of otherwise avoidable cost to the U.S. healthcare system each year, including poor health outcomes.

“We are pleased to be able to offer the HealthPrize platform to select Walgreens patients through this collaboration,” Tom Kottler, HealthPrize CEO and co-founder, said in a statement. “This will also give healthcare brands an omni-channel approach to educating and motivating patients to take their medications and achieve improved health outcomes.”

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AMIA, AHIMA Call for HIPAA Modernization to Support Patient Access

December 7, 2018
by Heather Landi, Associate Editor
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Modernization of the 22-year-old Health Insurance Portability and Accountability Act (HIPAA) would improve patients’ access to their health information and protect their health data in a burgeoning app ecosystem, according to two leading health IT industry groups.

During a briefing on Capitol Hill Wednesday, leaders with the American Medical Informatics Association (AMIA) and the American Health Information Management Association (AHIMA), health informatics and health information management experts discussing how federal policies are impacting patients’ ability to access and leverage their health data.

While other industries have advanced forward with digital technology and have improved individual’s access to information, and the ability to integrate and use information, such as booking travel and finding information about prices and products, healthcare has lagged. Healthcare has not been able to create a comparable patient-centric system, AMIA and AHIMA leaders attested.

“Congress has long prioritized patients’ right to access their data as a key lever to improve care, enable research, and empower patients to live healthy lifestyles,” AMIA president and CEO Douglas B. Fridsma, M.D., Ph.D., said in a statement. “But enacting these policies into regulations and translating these regulations to practice has proven more difficult than Congress imagined.”

“AHIMA’s members are most aware of patient challenges in accessing their data as they operationalize the process for access across the healthcare landscape,” AHIMA CEO Wylecia Wiggs Harris, Ph.D. said. “The language in HIPAA complicates these efforts in an electronic world.”

AMIA and AHIMA recommend that policymakers modernize HIPAA by either establishing a new term, “Health Data Set,” which includes all clinical, biomedical, and claims data maintained by a Covered Entity or Business Associate, or by revising the existing HIPAA “Designated Record Set” definition and require Certified Health IT to provide the amended DRS to patients electronically in a way that enables them to use and reuse their data.

According to AMIA and AHIMA, a new definition for “Health Data Set” would support individual HIPAA right of access and guide the future development of ONC’s Certification Program so individuals could view, download, or transmit to a third party this information electronically and access this information via application programming interface. Alternatively, a revision of the current DRS definition would provide greater clarity and predictability for providers and patients.

The groups also noted that a growing number of mHealth and health social media applications that generate, store, and use health data require attention as part of a broader conversation regarding consumer data privacy.

Congress should “extend the HIPAA individual right of access and amendment to non-HIPAA Covered Entities that manage individual health data, such as mHealth and health social media applications, the two groups said. The goal is uniformity of data access policy, regardless of covered entity, business associate, or other commercial status, the group leaders said.

Beyond HIPAA, during the briefing Wednesday, panelists discussed the success of efforts to share clinical notes with patients during visits, including the successful OpenNotes initiative, and recommended that federal officials look for ways to encourage more providers to share notes with patients through federal policies, such as Medicare and Medicaid payment programs.

“More than two decades after Congress declared access a right guaranteed by law, patients continue to face barriers,” Thomas Payne, M.D., Medical Director, IT Services, UW Medicine, said in a statement. “We need a focused look at both the technical as well as social barriers.”

What’s more, AMIA and AHIMA recommended federal regulators clarify existing regulatory guidance related to third-party legal requests, such as those by attorneys that seek information without appropriate patient-direction.

“HIM professionals continue to struggle with the existing Office for Civil Rights guidance that enables third-party attorneys to request a patient’s PHI,” Harris stated. “We recognize there are necessary circumstances in which a patient has the right and need to direct their health information to an attorney. However, AHIMA members increasingly face instances in which an attorney forwards a request for PHI on behalf of the patient but lacks the information required to validate the identity of the patient. As a result, the HIM professional is challenged as to whether to treat it as an authorization or patient access request, which has HIPAA enforcement implications

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Health Systems Work with Epic on Electronic Patient-Reported Outcomes for Oncology

November 18, 2018
by David Raths, Contributing Editor
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With eSyM app, patients will provide feedback to their cancer care team via the EHR

Six U.S. healthcare systems are sharing a $9 million grant to research introducing electronic patient-reported outcomes (ePROs) into the routine practice of oncology providers to improve symptom management and to decrease hospitalizations.

The National Cancer Institute, in association with the Beau Biden Cancer Moonshot Initiative, recently announced the funding of the collaboration, the SIMPRO (Symptom Management IMplementation of Patient Reported Outcomes in Oncology) Research Center. The SIMPRO team will work with Epic, the EHR system used by all six participating institutions, which are New Hampshire-based Dartmouth-Hitchcock, Dana-Farber/Brigham and Women’s Cancer Center in Boston, Baptist Memorial Medical Center in Memphis, Lifespan Cancer Institute in Rhode Island, West Virginia University Cancer Institute, and Maine Medical Center in Portland.

SIMPRO will develop, implement, and evaluate an ePRO reporting and management system through an app called eSyM. Patients’ smart devices will enable a secure connection to their cancer care team via the EHR, and facilitate symptom tracking following cancer surgery or chemotherapy. The study will test whether monitoring the symptoms patients experience and providing coaching on how to manage them can decrease the need for hospitalizations and emergency room visits.

“The opportunity to partner directly with Epic and their resources, to build these tools into our electronic health record, means in the short-term the research is more likely to bear fruit “and in the long-term that successful strategies can be disseminated around the country.” said Dartmouth-Hitchcock Chief Health Information Officer Peter Solberg, M.D., in a prepared statement,

After development and pilot testing, eSyM will be fully integrated into the EHR at each participating center, allowing for direct communication and real-time updates for clinicians who will have access to a dashboard of patients’ symptoms to prioritize outreach efforts and coaching.

The SIMPRO investigators will conduct a randomized trial to evaluate implementation of eSyM from a patient, clinician and health system perspective. Across all study phases, the implementation, adoption, acceptance, and adaptation of the ePRO system will be critically evaluated to promote better delivery of cancer care.

 

 

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UnitedHealthcare to Award Members with Apple Watches for Meeting Daily Walking Goals

November 16, 2018
by Rajiv Leventhal, Managing Editor
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UnitedHealthcare Motion, an employer-sponsored wellness program, is telling its participants they can get a free Apple Watch if they meet the insurer’s daily walking goals over a six-month period.

Participants can start receiving and using the Apple Watch (initially paying only tax and shipping) and then apply program earnings toward the purchase price of the device. Participants may be able to own, with a zero balance, an Apple Watch after approximately six months of meeting daily walking goals, the insurer announced this week. If members already own an Apple Watch, they can use the one they have.

UnitedHealthcare Motion, since 2015, has been providing eligible plan participants access to wearables that may help them earn over $1,000 per year by meeting certain daily walking goals. Since the program’s inception, participants have collectively walked more than 235 billion steps and earned nearly $38 million in rewards, according to officials.

Program participants can now use the Apple Watch to see how they are tracking against the program’s three daily goals—frequency, intensity, and tenacity—helping integrate physical activity and engagement with their health plan.

Indeed, UnitedHealthcare Motion is available to employers with self-funded and fully insured health plans across the country. The program may enable employees to earn up to $4 per day in financial incentives based on achieving FIT goals:

  • Frequency: complete 500 steps within seven minutes six times per day, at least an hour apart;
  • Intensity: complete 3,000 steps within 30 minutes; and
  • Tenacity: complete 10,000 total steps each day.

“This program is part of UnitedHealthcare’s broader effort to provide people with wearables, digital resources and financial incentives that help them take charge of their health, better manage chronic conditions and make care more affordable,” officials noted.

Indeed, these efforts build on UnitedHealthcare’s existing consumer offerings, powered by Rally, which have enabled people to earn more than $1 billion in health-related financial incentives since 2016, the insurer stated.

Among all eligible UnitedHealthcare Motion participants, more than 45 percent participated in the program—compared to some other employer-sponsored disease-management programs that report 5 percent engagement rates.

Among people who registered their device, 59 percent stayed active for at least six months, a rate higher than gym memberships (29 percent). Current program participants walk an average of nearly 12,000 steps, or more than twice the approximately 5,200 steps logged by the average American adult, officials said.

The program has been particularly appealing to eligible participants with chronic conditions. People with such a diagnosis are 20 percent more likely to participate, and people who have diabetes are 40 percent more likely to participate than those who do not, according to the insurer.

As CNBC’s Christina Farr speculated in a story that broke the day before the UnitedHealthcare announcement, “The integration with UnitedHealthcare, which is the largest U.S. healthcare company, could mean a boost in sales of the Apple Watch as more people are able to buy it at an affordable price.”

It was reported last year that another major health insurer, Aetna, which already offers the Apple Watch to its employees as part of a wellness program, has also been in talks with Apple about pushing the wearable device to the health insurer’s members, according to a report in CNBC.

About a month ago, UnitedHealth Group’s CEO said on an earnings call that the insurer would be unveiling a “fully integrated and fully portable individual health record” by the end of next year, with the Rally digital platform serving as the base for development. 

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