Digital therapeutics (DTx) create new healthcare delivery pathways that extend clinical interventions beyond the clinical setting, making healthcare services more accessible. Since they enable new relationships between healthcare providers (HCPs) and patients, no healthcare system can pass indifferently around the changing clinical ecosystem.
I can imagine digital therapies will be an indispensable element of every treatment process regardless of the stage of disease advancement. It will be a part of a standard protocol for chronic diseases management, says Ostrowicka.
With a team of experts from Banner Health, Ostrowicka is responsible for implementing the digital-oriented strategy, which is already at a very advanced stage. The first digital therapies were targeted at pregnant women and patients with some mental health conditions. Soon new therapeutic areas will follow: diabetes, hypertension, different forms of addiction, and others.
Digital Formulary Platform to Manage DTx and Streamline Care
Banner Health underwent a comprehensive organizational transformation to achieve the goal of Make Care Easy and Convenient for patients using digital health technologies. It’s based on four key pillars regarding the execution of their novel digital therapies strategy:
- Developing a roadmap for digital therapies implementation: choosing the health conditions and the patient population due to receive digital therapies.
- Selecting and applying a platform where digital therapies are accessible to HCPs. The objective was to standardize the process of prescribing DTx directly from the Electronic Health Record (EHR) system.
- Evaluating digital therapies to adjust them to patients’ needs.
- Conducting change management processes to reshape clinical workflows resulting from the introduction of digital therapies into the clinical pathways.
The focus areas have been defined around improving digital consumer access and digital physician experience.
We have built a dedicated team of dozens of experts working closely with clinicians and patients. The goal was to design and deploy innovative technologies to enable the provision of coordinated and smart healthcare for our patients, highlights Ostrowicka.
Smart digital health technology is capable of exchanging medical data and communicating with patients to help prevent, diagnose, and treat conditions.
To create a coherent ecosystem for prescribing digital therapies, Banner Health adopted the Xealth platform for releasing DTx and monitoring health data. It is integrated with the EHR system and enables the prescription of digital therapies in a unified way within the entire organization.
Digital Literacy is not a Barrier if it’s Part of the Plan
Digital therapies are part of Banner Health’s comprehensive Digital Health Engagement strategy. It aims to provide patients with a range of closely related electronic services that support communication with their system and medical staff.
Ostrowicka points out that the change management process starts with an extensive analysis of patient needs.
“We have to know and understand the patient populations our organization serves. This is the foundation of our patient education strategy, which also includes digital tools. Only educated patients and patients who understand the benefits of digital therapies – and know that they are available in our clinics and hospitals – will be those who will use these therapies after a doctor prescribes them.”
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Banner Health expects a rapid increase in the use of digital therapies among all medical specialties. Over time, patients get used to new forms of prevention and treatment. This will create a closed loop – the more patients use DTx, the more data will become available. As a result, it will contribute to the holistic patient health view allowing for even better and more personalized responses to patients’ health needs.
We believe that by maximizing the use of data collected in digital therapy processes, Banner Health will be able to provide truly personalized and coordinated health care services for our patients, says Ostrowicka.
Transformation Speeds Up, Financial Barriers Vanish
Regarding reimbursement dilemmas, Remote Therapeutic Monitoring (RTM) and Remote Patient Monitoring (RPM) health services are increasingly the focus of the Center for Medicare & Medicaid Services (CMS).
Over the last years, the CMS has published several new Current Procedural Terminology (CPT) billing codes. For instance, the CMS released the 2022 Physician Fee Schedule on RTM, with five new RTM codes introduced on January 1, 2022.
Along with the initiative taken by the CMS, private payers are also willing to settle services based on digital therapies. However, this is just the beginning of adopting digital therapies in payment models and reimbursement procedures.
However, the range of remote services that can be reimbursed is not yet broad enough. On the other hand, due to Ostrowicka, HCPs are not very well prepared for billing procedures for RTM and RPM services.
In response, Banner Health has started developing a systematic approach to standardize the processes of billing digital therapies. This can also open new opportunities for exercising and supporting value-based contracts with Banner Health’s payers.
“We already see a positive impact both on health outcomes and clinical workflow efficiency,” says Ostrowicka – highlighting that Banner Health strives to influence the shape of federal and state regulations and policies to facilitate the use of innovative technologies in healthcare.
Pioneers will Redefine Healthcare Delivery. Others will Have to Follow
When asked about the motivation to lead the change in healthcare, Ostrowicka answers without hesitation: “Patients need access to tools that will support them in achieving their health goals – every day and outside the walls of clinics and hospitals. In the case of chronic diseases, it’s a lifelong task.”
Of equal importance is the prospective view. Healthcare systems worldwide are experiencing medical staff shortages and growing costs in healthcare. In addition, the COVID-19 pandemic introduced new problems.
I do not see any other option than the intensification of the use of digital health in order to meet the growing health needs of patients. And digital therapies have here an important role to play, adds Ostrowicka.
The transformation is long underway. Many organizations and health systems want to lead in embracing digital therapies and create a new way of delivering healthcare to their patients. They are not only mission-driven leaders and visionaries but also hard-headed realists. Clinical workflows will have to be augmented with advanced digital therapies.
“Whoever is ready to start the amazing adventure with digital therapies today will be ready to deliver incredibly powerful digital health tools for their own population of patients. Banner Health wants to be at the front of this peloton of transformation. When other providers and health systems follow, legislators and payers will have to support this movement,” concludes Ostrowicka.
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About the author
Artur Olesch is a Berlin-based freelance journalist and correspondent for digital health-related topics.