The White House has launched a program, the Community Connected Health initiative, to sketch out plans for federal policy around the use of technology in community healthcare. In mid-March, the government put out a request for information to digital health companies — and last week, around 10 digital health companies from the PandemicX Accelerator met for an initial listening session.
One of the organizations represented at the White House session was virtual care platform Carium. MM+M spoke with co-founder and executive chairman Mike Hatfield on the initiative’s path forward. This transcript has been lightly edited for length and clarity.
MM+M: How was the Community Connected Health initiative developed?
HATFIELD: There’s a group of companies put together through the MassChallenge PandemicX, an incubator and accelerator initiative, and the Community Connected Health initiative was uncovered by the group at MassChallenge. They said, “Hey, we’ve got this group of innovators who would really love to weigh in on what’s going on with digital health policy.” MassChallenge was the intermediary with HHS to connect to the White House initiative. Last week was the first listening session, where we got a chance to talk about what we’ve been doing at Carium and share what’s possible and what we see coming.
What has Carium discovered in recent years about community digital health?
We shared that we’ve seen real success when you combine technology with people who need the help and their care teams. So there’s sort of three components: There’s the person who needs the help and is looking for better health, there’s the technology that we provide and then there’s the care team that uses that tool and communication path.
What should community-based healthcare policy look like?
What we recommended is that they focus on reimbursement models that will facilitate it. Right now, the primary reimbursement model in healthcare is to pay for someone to go into the office and get care in the office. That’s the primary means for compensation. And particularly when you talk about chronic diseases that have an extended life to them, like hypertension or diabetes, they don’t lend themselves as just a periodic visit. When you look at how to compensate someone for taking care of someone who’s on that particular journey versus, “Hey come into the office,’ it’s a different model.
For many people, taking time off to go to the doctor is not easy. If you can do this community approach and have a technology basis for it, it’s much easier for them to get that care, because they can just get a quick message from someone about how they’re doing – checking in to say, “How’s it going?” Encouragement is an important piece.
As part of this effort, there’s a focus on health inequities and disparities. What can digital health companies do to address them?
It’s about ease of connection with the health system. If someone can hop on their phone and get the help they need at that moment that’s right for them, that’s very valuable.
It’s also about education. We put our work into Spanish to make it more accessible. I’ll give you an example: One of the people we’ve helped is a native Spanish speaker and she didn’t really understand what hypertension and blood pressure was, because you go into the office and the doctor is in a hurry and goes through things quickly. She hadn’t really embraced what it was really about.
She was someone who got a connected cuff and took it home, and is now taking her own blood pressure. She understands it much better, she sees her own numbers, and the education in Spanish around what blood pressure is helpful. She’s been able to drive her numbers down. She was so into it that she bought a blood pressure cuff and sent it to her sister, and said, “You need to be doing this.”
It gives people the ability to have that information in the moment. If they get a high blood pressure reading, one of the things that happens is our system will say, “Hey this is high, would you like to learn more about why blood pressure could be high?” It gives them something relevant to what they’ve actually seen for themselves in that moment, versus going into an office and just getting a pamphlet for high blood pressure. All these things that weren’t possible before are possible with digital health.
What are your ultimate hopes for this initiative?
The first is that the possibilities are well understood. If someone doesn’t think something is possible, they’re less likely to try to do something. Hopefully what they’re seeing is that change enabled by these approaches are real, that we’re getting real results from the work we’re doing with digital health. It’s not aspirational; we’ve got real evidence that makes an impact.
What you can see now is the richness of a health dataset. That’s going to be much clearer in terms of what’s happening with that patient and what the impacts of certain approaches are to either making the problem worse or better. That’s what’s encouraging me: You can get the policy right to encourage this mode. You’re just changing the nature of how you can provide care.
What are next steps for the initiative?
They’re in a fact-finding mode through this request for information and the listening sessions. The intent is that this summer, they would potentially aggregate it all into something they could issue recommendations on, based on what we learned. That’s what they’re trying to do: Collect all this information and come up with recommended actions the broader industry could implement.
It’s excellent to see this information-gathering and how thoughtful everyone is about it. At Carium, we’re biased: We think this is a really important moment in time. But to have others grab that information and try to assess it and make a decision based on it, it’s fantastic, because that’s what’s needed.
When change like this is possible, you need everybody contributing. You need the technology to be developed, you need the people to use it and you need policies that encourage it. I was excited to see how much effort was going into thinking about these things and what’s possible.