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Practice Transformation

“Every crisis brings opportunity,” says Asaf Bitton, MD, MPH, a practicing physician and executive director of Ariadne Labs. “I hope that this time around, we can move beyond our usual collective amnesia about the risks that pandemics pose and will continue to pose.” COVID-19 isn’t even the worst-case scenario, he says, citing measles and virulent forms of influenza. This pandemic “is the clarion call to preparedness and action—not just this year or even next year, but two or three years from now, when it will no longer be in the headlines.” (Harvard Public Health)

Evidence & Innovation

Broad-panel genomic sequencing may lower the total cost of care for cancer patients, according to research from CVS Health. The study identified 45 lung cancer patients who underwent broad-panel sequencing and 399 who underwent narrow-panel sequencing. Broad-panel sequencing costs more upfront, but total cost of care was lower because of more targeted interventions. On average, the six-month per-member, per-month costs for those who underwent broad-panel sequencing was $11,535 vs. $20,039 for the narrow-panel screening–statistically significant savings. (Fierce HealthcareCVS analysis)
EHRs are overdue for an overhaul, writes John Glaser, former CIO of Partners Healthcare and former CEO of Siemens Health Services. “We must reimagine the EHR not as a document but as a system that supports the generation and tracking of multiple documents, events and processes. It must surround each transaction and clinical process with intelligence to ensure clinical appropriateness and sound execution.” Among his recommendations: a data-driven master plan that would combine appropriate algorithms for treating a patient with multiple conditions—for example, asthma, arthritis, and depression—automatically resolving conflicts and redundancies. (Harvard Business Review)

Policy Solutions

Health and Human Services can compel hospitals to reveal the prices they negotiate with insurers. A federal judge has dismissed a challenge by hospital groups to a federal rule requiring them to disclose prices they quietly negotiate with insurers. “The agency fulfilled its duty to examine the evidence before it and connect it to the final rule,” U.S. District Judge Carl Nichols wrote in his opinion. “That the agency’s proposed solutions may not have been to plaintiff’s satisfaction does not render the rule arbitrary and capricious.” The American Hospital Association says it will appeal. (Reuters)
COVID-19 will “forever upend health care,” and STAT surveyed several health policy experts to learn how. Among the nine predictions: Nonphysicians (e.g., nurse practitioners and physician assistants) will play a more prominent role. We may see an end to employer-based insurance. COVID-19 could be an “inflection point” for racial health disparities. “My feeling is: For Pete’s sake, can’t this country finally get serious about closing racial and socioeconomic gaps in access to health care and health status and being able to lead a good life?” said former CMS Administrator Don Berwick. (STAT News)

In Case You Missed It!

GTMRx workgroup update: Precision Medicine Enablement via Advanced Diagnostics
David Gregornik, BA, BS, Pharm.D., director of the Pharmacogenomics Program and director of the PGY-2 Clinical Pharmacogenomics Residency at Children’s Minnesota, spoke to the Pharmacogenomics Payment and Policy Taskforce on Tuesday, June 23. Gregornik discussed the following topics: Children’s Minnesota PGx service deployments, reimbursement of PGx testing and services challenges, factors critical to the success of PGx services, key stakeholders for program buy-in and key outcomes that create a compelling story for PGx.
Booming telehealth use is transforming health care delivery, including CMM, but what happens post-pandemic? New issue brief available.
We’ve watched telehealth gain ground over the last few years, but none of that compares to the spike in the last few months. Driven by the necessity of social distancing—and a loosening of regulations—telehealth is becoming the default method of contact for non-urgent encounters. And it’s proving to be a viable approach for comprehensive medication management (CMM). But will it last?
Featuring the voices of
  • Melissa Badowski, Pharm.D., MPH, FCCP, BCIDP, BCPS, AAHIVP, Clinical Associate Professor, Section of Infectious Diseases Pharmacotherapy, Department of Pharmacy Practice, University of Illinois at Chicago, College of Pharmacy
  • Jared Augenstein, MA, MPH, Director, Manatt, Phelps & Phillips, LLP

Read here.

Close to 800 people registered for our recent webinars. Did you miss them?
It makes sense that evaluation of a patient’s genotype can support the clinical decision-making process, improving patient outcomes. So, why are advances made at the bench not reaching the bedside? What are the barriers we need to overcome? Further, how do we incorporate PGx into team-based care, and how can PGx aid in treatment decisions for COVID-19 patients? This webinar will explore PGx with overviews from two recently published articles.
Featuring the voices of:
    • Colleen Keenan, consultant, The Advisory Board’s Clinical Innovators Council
    • Emily J. Cicali, Pharm.D., BCPS, clinical associate professor, University of Florida, College of Pharmacy
The COVID-19 global health care crisis has created a real opportunity to expand access to care through telehealth. How do we optimize patient outcomes and ensure appropriate use of medications virtually? Hear from a clinical pharmacist and a policy analyst as they discuss barriers to implementation and opportunities that the coronavirus pandemic offers to expand telehealth services. They will consider in what way these changes may impact care delivery.
Featuring the voices of:
  • Melissa Badowski, Pharm.D., MPH, FCCP, BCIDP, BCPS, AAHIVP, Clinical Associate Professor, Section of Infectious Diseases Pharmacotherapy, Department of Pharmacy Practice, University of Illinois at Chicago, College of Pharmacy
  • Jared Augenstein, MA, MPH, Director, Manatt, Phelps & Phillips, LLP
Remarks from the GTMRx / Bipartisan Policy Center Feb 6 keynote address by Gregory Downing, D.O.,(page 10-13) “Get the Medications Right: Innovations in Team-Based Care,” in the latest edition of the Personalized Medicine Coalition’s Personalized Medicine in BriefRead it here.
Hosted by the GTMRx Institute’s executive director and co-founder, Katherine H. Capps, Voices of Change features leaders who have knowledge, experience and ideas to solve this urgent need to get the medications right. The most recent episode features Orsula V. Knowlton, PharmD, MBA, president and chief marketing & new business development officer of Tabula Rasa HealthCare, Inc. Past guests include Anand Parekh, MD, chief medical advisor, Bipartisan Policy Center and GTMRx President Paul Grundy, MD, chief transformation officer, Innovaccer. Listen here.

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