By MATTHEW HOLT
In some interesting news this week, Inland Empire Health plan (IEHP), a major Medicaid health insurer in southern California with about 1.2 million members, and its contractor Preveon Health announced that they were “extending a pilot” with Surveyor Health, for their MedRiskMaps product.
This is interesting for a bunch of reasons. First it’s a good example of how technology is now being applied to help with the almost absurd complexity of modern medicine–complexity that technology has both added to and may yet cure. Secondly, Surveyor Health has been building its technology for several years and (FD) I’ve been advising them off and on since 2009 and know the principals well. Thirdly, and this is mostly for grins, it represents some of the absurd language used to describe our crazy health care system.
What does the tech do? Surveyor Health’s technology is very complex optimization technology that examines the incredible number of symptoms and interactions undergone by patients taking multiple medications. As you know most chronically ill patients are on upwards of half a dozen medications and some are on many more. The more medications, the more the potential for serious and sometimes fatal drug-drug interactions, side effects and more. You only have to think of the litany of celebrity drug deaths (Michael Jackson, Prince, Anna Nicole Smith, Health Ledger, Tom Petty, to name a few) to understand the seriousness of the issue. Erick von Schweber, a real theoretical physicist and CEO of Surveyor Health tells me that when you get above 11 drugs the calculations involved are more complex than what Google has to do to index the web. (And yes, he now is allowing me to call it AI!)
The MedRiskMaps are used by pharmacists to examine what drugs patients are on, and work with their physicians to change the regimen to moderate risk, reduce side effects and improve outcomes. Since IEHP has been using them, their clinical pharmacists have been able to cut their medication review times in half—a screaming big deal when there’s a massive shortage of pharmacists who earn six figures plus.
Patients have seen reductions in their medication risks as well as in their pill burden, with most having two medications removed from their daily regimen and their medication costs reduced by 18%
The clinical pharmacist is an essential member of the team. But in another display of the complexity of health care delivery, IEHP actually outsources their pharmacy service to Preveon, a specialty pharmacy care management company. In turn Preveon’s pharmacists are making recommendation to doctors who are contracted to IEHP. These relationships will grow more complex as analytic cloud-based technologies like Surveyor Health’s are going to become an integral part of care management and the clinical experience—as health care tech begins to flip the stack. (Look here for an explanation of what I mean)
Finally, and I told you I was getting to absurd nomenclature, this is being described as a “pilot extension” but as IEHP’s board meeting is public, a little sleuthing reveals that it’s a $ 700K+ contract which is indeed some “pilot”. (My other business Catalyst @ Health 2.0 runs pilots for a living and they usually get funded at $ 15-50K!). I assume lawyers are involved.
What’s next for this type of technology? Obviously there need to be more experience with patients in the real world and more clinical studies showing that this works, but as the complexity and individuality of care guidelines increases, this level of care management using technologies like MedRiskMaps will likely become the standard. It’s highly likely that this type of technology is going to be more or standard for patients using drugs in the future. After all while spending better part of a million dollars on an analytics tool for a million lives may sound a lot, saving a decent percentage on drug costs not to mention avoiding the human misery and death from accidents and errors due to polypharmacy, looks like a pretty good deal.
Matthew Holt is the publisher of THCB and President of SMACK.health
