What You Should Know: 

– GoodRx today announced it is working with Sanofi, a global leader in diabetes care, to offer a new way for people living with diabetes to access Lantus® (insulin glargine injection) 100 Units/mL in the U.S. for only $35.

– This collaboration builds on Sanofi’s recent announcement to lower the list price for Lantus and cap out-of-pocket costs at $35 for all patients with commercial insurance, which goes into effect January 1, 2024. It leverages GoodRx’s reach and scale to broaden access and affordability for people living with diabetes and means that, effective today, all Americans with a valid prescription, regardless of insurance status, can use GoodRx at over 70,000 U.S. retail pharmacies to access a 30-day supply of Lantus for only $35. 

$35 Price Coupon: How It Works

This collaboration builds on Sanofi’s recent announcement to lower the list price for Lantus and cap out-of-pocket costs at $35 for all patients with commercial insurance, which goes into effect January 1, 2024. It leverages GoodRx’s reach and scale to broaden access and affordability for people living with diabetes and means that, effective today, all Americans with a valid prescription, regardless of insurance status, can use GoodRx at over 70,000 U.S. retail pharmacies to access a 30-day supply of Lantus for only $35. 

Patients can visit GoodRx.com/lantus to access the $35 price coupon, which can be redeemed at any pharmacy that accepts GoodRx, including CVS, Walgreens, and Walmart. This complements other savings programs already offered by Sanofi, including offering Lantus for $35 per month to people without insurance. GoodRx also offers supportive resources to help consumers holistically manage their condition, including discounts on continuous glucose monitors and coupons for diabetes medications, as well as a Diabetes Hub that offers diabetes-specific articles and resources written by medical experts on GoodRx Health.

“Efforts to make insulin more accessible have been at the forefront of the news for months, and a critical piece of delivering on this promise is making it as simple as possible for patients to get the lower price right at their regular pharmacy counter. Sanofi is taking action and providing Americans who need insulin with the ability to access Lantus in an easy and affordable way, regardless of insurance status. We’re proud to collaborate with them on this initiative,” said Dorothy Gemmell, Chief Commercial Officer at GoodRx.

Though we seldom see their use in our modern world and, even then, only in fiction, there was a time when it was common for people to actually use things like crystal balls and divining rods to try to uncover unknown yet valuable information. As unbelievable as it may seem, soothsayers peered into crystal balls aiming to help seekers look into the future for guidance, while prospectors would rely earnestly on divining rods as they attempted to locate underground riches of water or oil.

While we may still entertain such images in some of the literature, TV, and movie fantasies we enjoy, in our modern professional world, we tend to entrust industry predictions to those with real, practical knowledge of the business landscape, because they trek, mine, and drill there regularly.

The world of medtech is no different, and for me and my team, connected care is the ground we travel, excavate, and explore on a daily basis. As we venture further into 2023, here’s our perspective on some of the connected care trends we expect to see on the road ahead, from digital therapeutics to remote patient monitoring and clinical trial management.

Precision engagement is an emerging development within digital therapeutics

One of the fast-growing categories within medicine today is digital therapeutics (DTx), which is the delivery of evidence-based treatment through digital solutions that help prevent, manage, or treat a disorder or disease. One recent report valued the global DTx market at $4.2 billion in 2021 and predicted it would expand at a compound annual growth rate of 26.1% between 2022 and 2030, with other estimates projecting even faster growth.

Within DTx, the emergence of precision engagement is a development that holds great promise, especially for chronic conditions where day-to-day choices and behaviors have a significant impact on health outcomes—conditions like diabetes, obesity, and hypertension.

While remote patient monitoring is clearly important for giving care teams visibility into the management of a patient’s condition in order to facilitate vital provider interventions, those living with chronic conditions requiring day-to-day management must also make dozens of additional decisions every day. But initiating provider interventions for all of these would simply not be possible nor even desirable. With diabetes, for example, these can range from food and exercise choices to the need to take medications or interact with a medical device, like a glucose monitor or an insulin pen or pump.

Enter precision engagement. Just as precision medicine can utilize a patient’s genetics or metabolic profile to uniquely fine-tune the dosing of a drug to an individual, precision engagement—with the help of AI and machine learning—can be used by digital health developers and physicians to program connected care platforms to issue electronic interventions or “nudges” that are uniquely tailored and helpful to the individual patient.

These digital nudges prompt a patient to take necessary actions throughout the day that are not only personalized to their needs but delivered in a way that is consistent with their lifestyle and preferences, leading to a better likelihood of engaging the patient and, ultimately, guiding them to better health outcomes. These digital interventions are known in behavioral medicine as just-in-time adaptive interventions or JITAI, and they are helping healthcare professionals use software to precisely engage the right patients with the right interventions at the right time.

With precision engagement, these solutions programmed into connected care platforms are able to digitally “learn” about an individual patient’s preferences from their responses to questions and from the daily decisions they make in their self-management as they engage with the platform’s corresponding app. This learning enables the software to personalize future digital nudges for the patient.

Precision engagement software might be used, then, to help identify the right moment of the day to generate a nudge, like suggesting the patient eat an apple or take a walk at a specific time of day because that’s when the individual is most receptive to such a suggestion.

Or, a digital nudge might involve time- or activity-triggered reminders, such as the need to take medication or to sync the patient’s medical device to the connected-care platform. It might even send the patient an encouraging message prompted by their reaching of a daily target, such as meeting a specific exercise goal.

Precision engagement can even tailor the type of communication used for nudges, from the use of a pop-up message or the suggestion of a video or article to the kind of voice used—maybe through empathy or even humor—to deliver the nudge. 

Precision engagement is one of the most exciting new developments within digital therapeutics, using digital health tools to deliver highly personalized, time-adaptive interventions in ways that lead to positive behavior change, extraordinary patient experiences, and improved health outcomes.

The need for greater RPM awareness is resulting in a measured pace of adoption

While necessity may have forced the issue for care teams during the pandemic regarding the adoption of telemedicine appointments, it turns out that remote patient monitoring (RPM) is still “one component of telehealth that has lagged,” according to the Medical Group Management Association (MGMA). In a Stat poll of 586 healthcare leaders taken by MGMA last year, the association found that 75% of medical practices had yet to offer RPM services.

Despite patients’ positive perspectives of RPM, demonstrated outcomes, payor recognition of RPM’s value, and the establishment of reimbursement mechanisms, the actual pace of RPM adoption has turned out to be more deliberate than these factors had originally led many to predict. In fact, in our work, we’ve found that a large part of preparing providers to make the actual leap to RPM adoption has really been a challenge of growing awareness.

For one thing, we’ve found that in the busy world of providing clinical care, some providers simply haven’t gotten a complete understanding of what RPM reimbursement looks like. So, we continue to chip away at the task of making sure our provider partners have the latest information.

And while some may have caught wind of RPM reimbursement, we’re coming across other providers who have the misconception that only Medicare reimburses for RPM. In reality, there are dozens of private payors covering RPM, with some reimbursing at even higher levels than Medicare. 

Another misconception we encounter among some providers is the mistaken belief that, to get reimbursement for RPM, they must implement every piece of it all at once, from getting patients set up and syncing their data to analyzing the data and providing patient consults. Not only is that not true, but the idea of such a weighty burden is partly why CMS has assigned unique CPT codes for discrete RPM activities. For many providers, implementing RPM is such a significant change management challenge that it actually makes the most sense for them to start small, which they can do by getting patients set up and focusing them on simply sharing their data remotely on a monthly basis. With that, providers can begin submitting for reimbursement, then build from there.

One of the most useful steps for providers unsure of where to begin is to find a reliable partner who specializes in RPM planning and implementation. Resources like AMA’s recently published 12-step RPM Playbook can help, as it covers every stage of establishing a fully operational RPM program.

Pandemic-induced use of decentralized clinical trials provided an up-close view of their efficiencies and is leading to increased adoption

Decentralized clinical trials (DCTs) are trials in which some or all study assessments are conducted at locations other than the investigator site via either tele-visits, mobile or local healthcare providers, local labs and imaging centers, home-delivered investigational products and/or mobile technologies. During the pandemic, when thousands of non-COVID trials—some 80%—were interrupted, virtual trial companies experienced an explosion in demand.

And if market projections are any indicator, demand for DCTs will continue to increase, with an analysis issued earlier this year projecting the global DCT market will grow from $6.1 billion in 2020 to nearly $16.3 billion in 2027.

While the need for social distancing that precipitated the sharp uptick in DCT demand may have subsided from its peak during the pandemic, it’s clear that continued demand for DCTs will be driven primarily by the efficiencies of the model that researchers witnessed first-hand during the pandemic.

One of the biggest advantages of DCTs is how they boost trial enrollment, as they often allow for patients to sign up and participate from home via remote monitoring. Remote participation opens trials and the benefits they provide to those living outside urban centers, which means the trend toward DCTs is also broadening the number and diversity of eligible enrollees.

DCTs can also reduce patient dropout rates and speed up study timelines, two of biggest challenges in life sciences R&D. And they help researchers realize significant cost savings from decreases in the number of physical trial sites and reductions in research staff and travel.

Driven by this wide range of efficiencies benefiting subjects, researchers, and study sponsors, it’s expected the demand for DCTs will continue to ramp this year and in the future.

Overall, we expect 2023 to be a year where our prospecting and development efforts in the connected care landscape will continue producing exciting advancements that will enable us to better support patients living with chronic conditions as well as the physicians and teams who care for them.

About Russ Johannesson

Russ Johannesson is Chief Executive Officer at Glooko, a leading provider of connected care, patient engagement, digital therapeutics, and clinical trial optimization. Deployed in over 30 countries and 8,000 clinical locations, Glooko’s mission is to improve the lives of people with chronic conditions by connecting them with their caregivers and equipping both with digital health technology for improved outcomes.

According to Grand View Research, the global artificial intelligence (AI) in the healthcare market size was valued at USD 15.4 billion in 2022 and is expected to grow at a compound annual growth rate (CAGR) of 37.5% from 2023 to 2030, to reach an estimated USD 208.2 billion. That’s an impressive growth rate, indicating the expected value delivery to a mostly early-phase adoption of AI in the healthcare marketplace. With such aggressive predicted growth, many health industry professionals may ask themselves why they are not investigating AI yet.

AI deploys applications that mimic human-level intelligence, while machine learning (ML) is the subset of those applications that are not explicitly programmed or learned. Together, these rapidly evolving technologies are driving efficiency and productivity across a wide range of industrial manufacturing. 

For pharmaceutical and healthcare manufacturers, AI offers deep predictive and data analytics capabilities, and those implementing AI in their manufacturing processes stand to benefit from improved productivity, higher efficiency, and faster production of life-saving drugs or medical devices. The use of AI technology enables, for example, manufacturers to analyze patterns in data sets to understand the implications, benefits, and success rates of new drugs before launching them into the market. Applications such as process modeling enable manufacturers to develop new insights and deliver predictive quality values before measurement information is available, predictive maintenance to eliminate unplanned downtime, and intelligent machine monitoring to eliminate equipment-driven production deviations. Customers can run manufacturing design scenarios and extrapolate from small experimental design cases to optimally determine the next predicted step for more successful test cases. AI, when properly designed, is expected to merge human and machine intelligence to accelerate innovation.

Applications of AI Technology

Imagine equipment essential to producing an in-specification insulin pump (something a large population, and I, rely on). Such equipment is monitored during the production of each pump with classical regulatory measurements and control systems. Today, with modern intelligent AI monitoring, known deviations or anomalies can be detected for any measurements outside normal ranges. Medical device companies know that using and evaluating leading-edge technologies can identify failures earlier within a significantly less costly time frame. This change in technology can dramatically impact manufacturers and end customers.

Modeling predictive control uses mathematical models to drive performance to maximize yields, productivity, and energy efficiency in drying, fermentation, distillation, crystallization, filtration, and other processes familiar to healthcare manufacturing. One relevant focus for healthcare and validation is AI ‘explainability,’ or the ability to understand what drives action and how adaptive/ intelligent applications respond to different conditions. Inexplicable applications seem much less favored in healthcare and life science, as understanding assists AI evaluation and validation. ‘Black box’ closed solutions are less likely to meet the requirements of this set of needs. To be clear, validation is defined as assuring a specific system will consistently meet the requirements and intended use, these are significantly easier to specify and verify compliance with explainable and not black box AI.

Implementation Considerations

Before applications scale to hundreds of use cases in each facility, industrial customers will want to understand the cloud strategy and start to adopt a cloud management infrastructure. While local access has excellent benefits, having shared-cloud management and application control access from the cloud can be essential to provide quick and specialized data science oversite or support whenever needed. A single cloud infrastructure that can monitor and oversee hundreds or thousands of applications simplifies tracking what is working, and what is being used, and identifying any applications that are turned off, failed, or need attention. The cloud can mean a local private cloud or a secure public cloud. Still, the fundamental value proposition is a browser, distributed access to information, and connection of the stakeholder to data to support decision-making. Cloud-based strategies create efficient and distributed environments that can push technology or security updates automatically to many systems. In the IT to OT world that is developing IT system management practices, this will be desired before too long.

This use case inherently takes data, learns to develop a digital twin of the system of interest, and leverages an adaptive digital twin running in parallel to manufacturing to evaluate and support intelligent decision-making. 

So, what are some of the use cases that this can lead to in the future? 

Many come to mind. Users will be more connected to product maintenance and design teams. The connected world means users who are better informed about their product experiences and motivated to get something more valuable and straightforward in the future, will want to provide medical device manufacturers with feedback on product issues. A direct connection and cloud data store of standard input from many customers can drive early and/or ongoing device updates. This means improved device ownership and more compliant usage, alongside updates that improve user alerts and experiences. This will become important in the early days of, for example, closed-loop blood sugar to insulin pump control, but I do not anticipate that decreasing in the later stages of adoption. Imagine a future where continuous blood glucose monitoring is becoming more and more integrated with insulin pump control.  Users currently familiar with adapting their own dosage to carbohydrate intake and activity levels will have “hands-free” adjustments but also discover their own expectations of necessary information levels to be comfortable and be able to accept these new automatic adjustments.  As more devices become more connected to the manufacturer, this can promote extended utilization and more active device checkups/check-ins, if needed, from device alerts.

Predictive Maintenance

In both manufacturing and medical facilities, the investment required in equipment is significant. The cost of a high-end MRI machine, for example, can be north of $3M, no small change. On a larger scale, the time and capital investment required to build a pharma manufacturing facility is considerable. Construction can take between 5 and 10 years and cost up to $2B. 

The common theme here is that to recoup investment as quickly as possible, optimizing equipment use is key to operational efficiency. More patients can be treated. More devices or therapeutics are produced. That said, equipment failure is a fact of life. Disruptions cost money. Patients must rebook appointments. Manufacturing is delayed. 

Remote maintenance has been the accepted model of support for almost three decades. Performance parameters are set and monitored, and deviations are flagged so that technicians can assess necessary maintenance, order replacement parts and so forth. This all takes time, and it’s reactive. As the saying goes, “prevention is better than cure,” and it’s here that AI and Machine Learning (ML) are starting to play an increasingly important role as equipment connectivity to direct monitoring networks moves into the mainstream. 

Capital equipment manufacturers are now able to partner with customers, to minimize potential downtime through predictive maintenance. ML learns from past system data and experiences to identify normal and deviated operational patterns which support intelligent predictions with minimal need for human intervention. By collecting enough deep device data AI algorithms can define and model failure modes and predict when a potential failure event becomes more likely. A lot of the investments are being made in collecting data from equipment out in the field and being able to draw insights from that, whether in terms of predictive maintenance, better performance, and efficiencies. The data can be so detailed that equipment manufacturers know where and what components are prone to failure, depending on the usage pattern, and the frequency of use, so they can proactively schedule service calls or advise customers of potential issues, based on that data collection, to ensure action is taken to maximize uptime.  

Future Opportunities

Given customer approval, treatment success metrics can be aligned with broader populations, and dosing can be improved via connection to health devices that are becoming more sophisticated. This data can be monitored with duplicate anomaly detection and alert mechanisms used in IT systems to provide early hack detection. In the case of medical impacts, it is personally critical and valuable, however, in the manufacturing plant, sets of AI applications will integrate to provide both local and holistic oversight. The health of the line or plant can be monitored to provide information on decisions such as sanitation or contamination risks, or safety issues when things like systemic anomalies are detected. In addition, production planning and scheduling switchovers can be coordinated and optimized to efficiently manage the site or line activity, maximizing production runs with quality.

It’s still being determined whether these opportunities will happen sooner or later. However, the value achieved and expected from digitizing operations with learning engines and human staff augmentation is exciting. Decision support from helpful, intelligent agents will maximize the value of feedstock, equipment, people, and products.

About Michael Tay

 Michael Tay is the Platform Lead at Rockwell Automation, a global leader in digital transformation and industrial automation. Michael’s been working in the area of modeling and AI for more than thirty years with seven patents in the areas of Model Predictive Control and Real-Time Optimization across a variety of industries. His current focus is on democratizing and simplifying successful ML in helping to drive manufacturing performance.

What You Should Know:

• Glytec, the only provider of cloud-based insulin management software across the continuum of care, today announced the next evolution of GlucoMetricsⓇ to provide new analytics, dashboards and data visualizations that give hospitals and health systems new insight into glycemic outcomes. The enhanced visibility this provides is essential as hospitals prepare for new measures from the Centers for Medicare and Medicaid Services (CMS) on severe hypoglycemia and hyperglycemia that encourage facilities to report metrics starting in early 2024.
• GlucoMetrics is powered by data from Glytec’s eGlycemic Management System® (eGMS). Centered on Glucommander,Ⓡ eGMS is an EHR-integrated, HITRUST certified, cloud-based software solution that supports personalized insulin dosing decision support at the point of care. Providers and nurses who use Glucommander help their patients get into target range faster, stay within tighter parameters and experience fewer insulin-related adverse drug events than patients treated with other protocols.
• With significant enhancements to GlucoMetrics, glycemic management committees and hospital leaders now have self-serve access to key performance indicators, trends, and benchmarks related to glycemia treatment across their entire health system. GlucoMetrics is pre-configured with six interactive dashboards to help surface insights at both a macro and micro level. 
• These dashboards include powerful filters to segment data by time frame, facility, unit, treatment type (IV or subcutaneous) and more, to provide granular details across an entire healthcare system or down to an individual hospital unit level. Users can also customize their experience with saved views and personalized email subscriptions. In addition, they can easily export charts, tables, graphs, and data to Microsoft Excel or PowerPoint for even more sophisticated analysis, further annotations, or distribution.

What You Should Know:

– Sanofi cuts U.S. list price of Lantus®, its most-prescribed insulin, by 78% and caps out-of-pocket Lantus costs at $35 for all patients with commercial insurance. The price cut goes into effect January 1, 2024.

– The price cut milestone comes in addition to decisions taken in June 2022 to lower diabetes medicines costs: the launch of an unbranded Lantus biologic at -60% versus Lantus list price, and a cap on out-of-pocket costs on insulin to $35 for all people without insurance.

– With all those decisions, now Sanofi’s suite of savings programs ensures that no patient will pay more than $35 for a monthly supply of Lantus. Finally, Sanofi will also cut the list price of its short-acting Apidra (insulin glulisine injection) 100 Units/mL by 70%.

What You Should Know:

– Sanofi has agreed to acquire Provention Bio, Inc., a U.S.-based, publicly traded biopharmaceutical company focused on intercepting and preventing immune-mediated diseases including type 1 diabetes (T1D), for $25.00 per share in cash, representing an equity value of approximately $2.9B.

– The acquisition is a strategic fit for Sanofi at the intersection of the company’s growth in immune-mediated diseases and disease-modifying therapies in areas of high unmet need, and its expertise in diabetes.

– Sanofi will continue to utilize its capabilities in diabetes to maximize TZIELD’s potential as a transformative therapy globally and in the U.S., aiming to delay the onset of Stage 3 type 1 diabetes for some of the approximately 65,000 people diagnosed every year1. The purchase builds on an existing co-promotion agreement with Provention Bio which is already delivering TZIELD to patients in need of this immune-mediated therapy.

TZIELD: First and only treatment indicated to delay onset of Stage 3 T1D

TZIELD is a CD3-directed antibody indicated to delay the onset of Stage 3 T1D in adults and pediatric patients aged 8 years and older with Stage 2 T1D. Stage 3 T1D is associated with significant health risks, including diabetic ketoacidosis, which can be life-threatening, and patients who progress to Stage 3 T1D eventually require insulin injections for life.

TZIELD is also in late-stage clinical development for the treatment of pediatric and adolescent patients that are newly diagnosed with clinical T1D (Stage 3). A Phase 3 trial, PROTECT, is currently underway and top-line results are expected in the second half of 2023. Additional opportunities for TZIELD include re-dosing and formulations as well as new therapeutic indications.

– Eli Lilly and Company today announced price reductions of 70% for its most commonly prescribed insulins and an expansion of its Insulin Value Program that caps patient out-of-pocket costs at $35 or less per month at participating retail pharmacies. 

– The historic price cut makes it easier to access Lily insulin for Americans who may have difficulty navigating a complex healthcare system that may keep them from getting affordable insulin.

Affordable Insulin for Americans

Lilly is reducing the list price of its following insulin products:

– Cutting the list price of its non-branded insulin, Insulin Lispro Injection 100 units/mL, to $25 a vial. Effective May 1, 2023, it will be the lowest list-priced mealtime insulin available, and less than the price of a Humalog® vial in 1999.

– Cutting the list price of Humalog® (insulin lispro injection) 100 units/mL1, Lilly’s most commonly prescribed insulin, and Humulin® (insulin human) injection 100 units/mL2 by 70%, effective in Q4 2023.

– Launching RezvoglarTM (insulin glargine-aglr) injection, a basal insulin that is biosimilar to, and interchangeable with, Lantus® (insulin glargine) injection, for $92 per five pack of KwikPens®, a 78% discount to Lantus, effective April 1, 2023.

People who don’t have insurance can continue to go to InsulinAffordability.com and immediately download the Lilly Insulin Value Program savings card to receive Lilly insulins for $35 per month.

What You Should Know:

– MedCrypt, the proactive cybersecurity solution provider for medical devices and manufacturers, will announce the close of a Series B extension round led by Dexcom Ventures, bringing the company’s total to date to $36.4M. 

– With support from three major investors, Johnson & Johnson Innovations, Intuitive Ventures, and Dexcom Ventures, MedCrypt continues to lead the way in developing cybersecurity technologies and infrastructure for life-saving medical devices in all facets of healthcare, including the diabetes industry. Approximately 37.3 million Americans live with diabetes, meaning there are high numbers of insulin and glucose monitors being used.

Cybersecurity Hurdles for Connected Health Devices

The global wearable medical device market size is currently valued at $21.3 billion and is expected to grow 28% by 2030. Cybersecurity remains one of the biggest hurdles for connected devices across all areas of healthcare, including the diabetes industry. The Food and Drug Administration (FDA) tracked the potential cybersecurity risks associated with both insulin and glucose monitors, noting these devices need to be reliable and trustworthy as users are pairing them with other system components such as smartphones.

“Diabetes care management is one of the main categories of healthcare innovation that is highly dependent on connectivity; consequently, it is one of the main categories heavily scrutinized by the FDA,” said Mike Kijewski, CEO of MedCrypt. “The promise of software in a device can only be achieved when the cybersecurity posture of the device is secure and effective in the threat landscape. MedCrypt has built a cybersecurity platform for all medical devices – for things as small as pacemakers and insulin pumps or as large as surgical robots – and we are honored to be backed by Dexcom Ventures as we continue our push for better device security.”

Recent Milestones

In 2022, MedCrypt deployed partnerships with 18 new medical device manufacturers that are committed to improving cybersecurity in healthtech. These additional funds will be used to grow MedCrypt’s engineering team to support this growing demand for cybersecurity in devices – across all products – remaining aligned with requirements set by the FDA and the cybersecurity provisions in the latest Consolidated Appropriations Act, 2023. 

Jon Bloom, MD, CEO and Co-founder of Podimetrics

From a digital health perspective, 2022 was a reset year for many and a serious reality check. We went from sky high growth to the sky is falling, and in 2023 I think this market correction movement will continue forward. To me, the biggest surprise of 2022 was that despite the market tanking, digital health companies continued to truck forward with huge deals. This includes massive acquisitions like Amazon and OneMedical, as well as deals like CVS Health and Signify.

Oliver Kharraz, CEO & Founder, Zocdoc

Big tech will make noise, not real change, with their forays into fixing healthcare. Big tech companies have not worked to improve healthcare from the inside out. Instead, they’ve endeavored to make money via their respective core businesses: Apple aims to drive hardware adoption (Apple Watch), Google tried to tackle big data applied to clinical questions (Verily), and Amazon has worked to leverage its supply chain strengths (Pillpack). This does not solve the problem at the root of the poor American healthcare experience: a uniquely disconnected ecosystem that fails patients and providers. Changing this system involves building the connective tissue to make disparate systems work together, and that’s a long, hard, and slow road. It’s also not a road big tech companies are set up to travel. Focused on growing their market caps, they continually aim to leverage their core competencies to expand their business into new areas. The $4T healthcare industry is a prime and seemingly lucrative target for this expansion, whether their core competencies are relevant to healthcare or not.  As a result, big tech will not make traction against improving the systemic issues that plague the healthcare system in 2023.

Nate Fox, co-founder and CTO, Ribbon Health

Racial Bias in AI Algorithms: Since AI is frequently used in healthcare, it needs to be used with a code of ethics to prevent bias. Patients prefer familiarity and personalized care, and research shows this can lead them to choose a provider of the same race or ethnic background. Machine learning models can help extract provider data to give patients the full scope of available providers out there and their specialties, location, and more, but what we shouldn’t do is program an algorithm to predict or assume race. A human component is needed in these AI programs to make sure the system is not guessing a provider’s race based on their name due to inherent bias. If you want to use AI without bias, you need to have a human oversee its operations.

Omri Shor is the founder and CEO of Medisafe

Incorporating digital health early: I believe that incorporating digital health tools earlier in the prescription process and combining digital with traditional medication therapy will increase in 2023. As more digital medication management solutions gain FDA approval, there is an increased opportunity to integrate digital support as part of the medication process and reduce medication abandon rates.

Anish Sebastion, CEO and Co-founder of Babyscripts

Walmart, CVS, Optum, Amazon, and others have made headlines this year with a series of acquisitions and partnerships that promise to disrupt traditional healthcare models. These players are honing in on at-home medical services and primary care, extending their reach deeper into the care continuum and blurring the lines between who owns what part of the space.

These players have a wealth of consumer data at their disposal, and those in the retail space have existing locations in some of the most vulnerable areas of the country in terms of access to care (in 2017, 90 percent of Americans lived within 10 miles of a Walmart compared to 82 percent who lived the same distance from a hospital). Existing infrastructure also positions Big Retail to partner on social determinants of health risks, such as food insecurity, giving them an edge on traditional providers.

These new offerings threaten to siphon younger, healthier patients from health systems, putting increased pressure on hospitals to integrate at-home care models and own the digital front door. While health systems will continue to capture the majority of condition-specific and specialty care; ownership of primary care, insurance services, and ancillary care (lab/imaging/pharmacy) are at the center of a contentious battle.

Ankit Gupta, CEO/Founder of Bicycle Health

Flight for quality investors: Digital health startups banked a record-breaking $29.1B in 2021. With the market downturns we’ve seen in 2022, that trend will shift. Digital health companies that can’t demonstrate momentum in terms of growth, engagement or evidence-based clinical outcomes will struggle to find funding in 2023. Investors are going to be looking for good outcomes, good economics, and a path to profitability.

Veda co-founders, Meghan Gaffney and Dr. Bob Lindner

Blockchain will continue to be “buzzword” across the industry: Over the past few years, we’ve seen blockchain begin to touch almost every industry – healthcare’s no exception. Looking ahead, we’ll continue to see blockchain trending as it’s implemented across the healthcare ecosystem. While we’ve all likely heard of blockchain technology’s potential to transform healthcare by putting the patient at the center the experience, we should evaluate if it’s actually worth the hype and if it’s able to solve the problems its being advertised for.

Justin Norden, MD, Partner at GSR Ventures

In 2023, we will see accelerated adoption of digital heath companies who are using AI to ease provider burnout and shortages. As health systems are running tighter budgets in 2023, the startups that are demonstrating the return on investment (ROI) of automation will see systems move faster to partner.

Yossi Bahagon, Chairman of Sweetch

Innovating and Integrating Wearables: We should anticipate more inter-device integration and a greater variety of devices including continuous glucose monitors (CGM), insulin pumps, and hybrid closed loop systems being introduced to the markets. This will lead to advances in comfort, convenience, durability, and user-experience.

Robin Shah, Thyme Care CEO and Co-Founder

We anticipate a continued shift in the digital health ecosystem towards personalized, disease-specific care that prioritizes support throughout all facets of treatment. The trend is clear: chronic care patients and their families want a care team that supports them through every step of the process, including sourcing and explaining viable options, as well as a consistent care team well-versed on a patient’s given case. The digital health industry is rising to the occasion, with value-based cancer care  at the forefront, as we will see at HLTH 2022. As this trend continues, companies will face the challenge of creating comprehensive support through all facets of the patients’ journey to health and doing so in a cost-effective manner.

Greg Mayes, President and CEO at Reunion Neuroscience

2023 could bring the first regulatory approval for a medicine for mental health using a psychedelic backbone.  This is incredibly exciting and great news for the hundreds of millions of people that are negatively impacted by the ongoing mental health crisis in our society.  Moreover, the achievement of this milestone will validate the need for further investment in psychedelics in additional indications where the unmet medical need remains huge.

Maneesh Jain, CEO and co-founder of Mirvie

Desire for personalized, proactive and preventive care in pregnancy will rise: In 2023, expecting parents will demand the same personalized care that they receive in other areas of their healthcare in their pregnancy journeys. As such, pregnancy health must start transforming from one-size-fits-none to right-sized care for every mom to begin addressing untenable trends of rising blood-pressure disorders like preeclampsia and increases in preventable pregnancy-related deaths in the United States. Breakthroughs like predictive technology driven by biological insights to foresee complications further down the road in a pregnancy will continue to advance, enabling a new future of personalized and preventive pregnancy care.

Dr. Adrienne Boissy Chief Medical Officer at Qualtrics and Staff Neurologist at the Cleveland Clinic

Transformative organizations will bake empathy into leadership and operations: 47% of healthcare workers plan to leave the industry within the next two years. Not to overstate the obvious, but this is a heartbreaking number we have never seen before. For years, studies have shown us exhaustion, lack of value alignment in the workplace, and rising mental health concerns are plaguing our caregivers. And, patients and families are seemingly more frustrated themselves – often directed at people doing their best. Surprisingly then, for the first time in years, we are hearing patient experience and communication training programs are defunded, experience leaders – and many others – are leaving their roles, and experience efforts are still fighting to be relevant and resourced. In the year ahead, experience programs – and empathy at scale – are alarmingly at risk as budgets shrink and many experience leaders are pushing the rock uphill with small teams, lack of current and future investment, and their tanks on empty.

If we continue to think about patient experience programs as doing what is required from a regulatory standpoint, we miss the enormous opportunity to understand how empathy and the human experience have a role in every single part of the organization. As with any transformation, it will require courage and creativity. Obvious additional spaces for experience work are in caring for our own people and connecting patient and employee experience more holistically, but also less obvious, more operational places like contact centers to drive access and growth, safety processes like RCAs, and revenue cycle to drive efficiency and dollars.

Rather than limiting patient experience efforts, now is the time for the industry to step up and fully support its people by ingraining empathy into broader healthcare operations, caregiver culture, and actual transformation. Whether digital or human, a commitment to empathy and compassion will connect the dots across an organization, by listening to pain points and joy in the moment in all channels, deeply understanding the emotions and values of patients and employees and then honoring them by acting on what we hear with processes that work, feel intuitive, and even delight. Experience leaders can’t do it alone – 2023 can and should be the year healthcare invests in empathy at scale.

Sandeep Shah, CEO and Founder of Skyscape

Healthcare services will be beholden to “consumerization,” or consumer demands for a more connected, transparent patient experience. Millennials and Gen Zers today have lived digitally-connected lives, and most consumer services have already catered to digital demands – whether that’s ordering grocery delivery, shopping online without visiting the store, or purchasing a car to be delivered. The healthcare industry is next, as providers must build relationships with their consumers.

I expect a more patient-friendly experience, incorporating trends such as online scheduling and onboarding to create more efficient in-person visits, automated post-visit follow ups, and better incorporating remote care into the experience, and even direct patient communication with providers to build trust.

Chris Bumgardner, Chief Technology Officer at 100Plus

The COVID-19 pandemic accelerated the adoption of digital health and virtual care, and now moving forward into 2023, we will continue to see consumerism in healthcare at the forefront of the health tech evolution. Patients now have more options for how and where they access care, and they will continue to seek a more personalized healthcare experience. Healthcare organizations will be pushed to leverage technology that can be incorporated into their patients’ daily lives. And as a result, there will be continued growth in the adoption of connected health technologies such as AI-virtual health assistants, remote patient monitoring and wearables that allow this type of personalization of the health experience while also delivering a more proactive approach to care management.  

Julie Stegman, Vice President, Nursing Segment of Health Learning, Research & Practice  at Wolters Kluwer

Nursing education goes to the metaverse: Over the last decade, technology has fundamentally transformed nursing education. Post-pandemic, experiential learning remains an integral part of educating new nurses, whether delivered online, in the classroom, in the simulation lab, or taking a hybrid approach.  No matter the setting, leveraging virtual simulation, and adaptive learning are critical to engage students and help them build clinical judgment and ensure they are prepared for practice. In 2023, nursing education continues to be a leader in innovation, leaping forward by embracing the metaverse and leveraging virtual reality.  Virtual reality creates new, immersive learning opportunities so students can enhance their clinical education by practicing skills, working in teams and gaining exposure to the fuller and more complex caseloads that nurses manage in real life, better preparing new nurses for the demands of real-world clinical practice even when they don’t have physical access to clinical practice settings.

Kuldeep Jiwani, SVP of Data Science at HiLabs

Going into 2023, we can expect to see AI used more frequently to discover the hidden potential of dirty data in healthcare. Health plans will deprioritize manual data entry and switch to ML-based techniques, which are cost effective, faster to implement and easier to manage. Where the algorithm learns context from the data itself, one just needs to feed it with large historical data to auto-discover the context. Specifically, AI will be used to solve for use cases like detecting:

– Data quality issues in clinical data: This can help in maintaining better monitoring of care provided to patients

– Misattributions in value-based care programs: This can ensure patients get attributed to the right providers

– Overpayments in claims processing: This can ensure both providers and payers are fairly compensated

– Inaccuracies in provider directory data: This can prevent surprise billing for patients

Vikram Savkar, Senior Vice President & General Manager, Medicine Segment of Health Learning, Research & Practice at Wolters Kluwer

Open medicine to come of age: Growing interest in open access as well as preprints in the medical arena, in part due to support from both the Centers for Disease Control and Prevention (CDC) and the White House’s Office of Science and Technology Policy (OSTP), has pushed the publishing side of the Open Medicine movement into the forefront in recent years.  But other global concerns – including reduction in global and local health disparities, the push towards personalized medicine, renewed focus on global health in the post-pandemic era, and the effort to more broadly distribute funding for medical research – will ensure that the conversation around Open Medicine will broaden in 2023 to become a more all-encompassing and compelling vision for global well-being.  The need for openness, dialogue, accelerated innovation, and global collaboration demonstrated by the pandemic will make Open Medicine a key topic in any conversation around society being better prepared for future threats.

Stacey Rivkin, Vice President, Client Solutions, H1

Healthcare influencers won’t leave the (Twitter) nest, but will spread their wings. Despite the threats that influencers (including healthcare opinion leaders) will leave the flock amid Twitter’s ongoing turmoil, the reality is that they will continue to use the platform to share and amplify their messages. Still, we’ll see practitioners spread their wings as they become more digitally savvy and comfortable creating digital content (think: dermatologists sharing stories on Instagram, or pediatricians creating YouTube shorts).

Evangelos Hytopoulos, Sr. Director of data science at iRhythm

There is no doubt that AI has become mainstream in many areas. In medicine, AI approaches are currently both developed and deployed at a rapid rate, fueled by the dearth of data that already exist from different modalities (genetic, genomic, images, EHR, etc.), as well as the continuous streams of data that are provided by wearables.

The majority of models today are based on supervised learning, where labels are combined with measurements to teach an algorithm to predict unseen data. However, it takes a lot of effort to create a labeled data set and as a result, usually only a subset of the data can be labeled – thus limiting the learning capacity of the current models.

In upcoming years, we can expect to see AI approaches that are based on the use of self-supervised and generative AI algorithms in order to facilitate the incorporation of a larger volume of data in model training.

Supervised learning is capable of learning important features of the underlying measurements that are a richer representation of the data. The advantage of generative algorithms is the creation of synthetic data – labels coming from a different signal domain and the important features are learned from the domain of interest. In both cases, proper validation will be required to prove the validity of the algorithms and the lack of any bias in its predictions.

Mifan Careem, Vice President – Solutions Architecture and Head of Healthcare Practice at WSO2

Fostering Healthcare Innovation in Wearable Devices: From fitness bands to smart watches, consumers are increasingly turning to wearable devices to track key health measures. At the same time, employers and health insurance organizations see these devices as one way to improve health among staff and members and reduce program costs. This presents a tremendous opportunity for innovation in the healthcare industry, but too often the scope of information is limited by the inability to share data with them. This is because the healthcare data is locked up in a variety of healthcare systems using different formats and standards. In 2023, we need to see the industry move toward using APIs, ideally in the Fast Healthcare Interoperability (FHIR) format, as an intermediate layer for exchanging electronic health records. In this way, data can be readily and securely provided to stakeholders, such as third-party organizations, internal or external developers, and other apps or systems, in order to deliver new, meaningful, and more personalized digital healthcare apps to consumers with wearable devices.

Dr. Roger Seheult, MD, Medical Advisor to On/Go

I predict that bringing rapid patient care directly to people at their homes – what some are calling “direct-to-patient healthcare” – will see increased adoption in 2023 as the health industry prioritizes new, affordable, easily accessible solutions. In the olden days, before hospitals and doctors’ offices were commonplace, most people were treated by doctors who made house calls. Everything old is new again, and 21st-century house calls across the entire treatment journey from diagnostics to telemedicine to treatment will become more commonplace.

What You Should Know:

– Prescryptive Health, a healthcare technology company on a mission to rewrite the script for the U.S. pharmaceutical market partners with Eli Lilly and Company on a new and first-to-market subscription model to help lower costs for people who pay for their Lilly insulin through their employer-sponsored benefits.

– Through a flat, per-member, per-month subscription fee, employers can offer insulin to their employees with predictable, affordable, and transparent costs. This unique value-based program is designed to create price stability related to insulin utilization, with Lilly refunding a portion of the subscription fee if an employer’s total medical spend increases over time for their employees who live with diabetes.

– This new program can help address controversial rebates in the pharmacy benefit manager (PBM) pricing model and will be available through Prescryptive free of any margin or price mark-up, further reducing the cost to employers, health plans, and ultimately healthcare consumers. Additionally, the program offers opportunities for employers to supply insulin at lower costs, or at no cost, to their employees. Added benefits for employers participating in the program include the Prescryptive mobile experience that supports patient engagement and adherence for diabetes care.

What You Should Know:

– PatientsLikeMe (PLM), the trusted community health network that empowers patients to take charge of their health, announced its partnership with LetsGetChecked, a global healthcare solutions company.

– The partnership will provide PLM’s 1 million members with access to enhanced patient support capabilities for testing. PLM’s expansive patient community can now utilize LetsGetChecked’s suite of offerings directly through the PLM platform and receive a discount on screening tests for being a PLM member.

What You Should Know:

– The FDA has cleared Dexcom G7 continuous glucose monitoring (CGM) system in the U.S. for people with all types of diabetes ages two years and older, giving more people than ever access to a powerfully simple diabetes management solution.

– Cleared as an integrated continuous glucose monitoring (iCGM) system, Dexcom G7 will be part of the most connected CGM ecosystem in the world, with real-time connectivity that can drive integrated insulin delivery systems, connect with wearables like the Apple Watch and integrate with popular digital health apps.

– With an overall MARD of 8.2%, Dexcom G7 builds on the trusted performance of Dexcom CGM, which is clinically proven to lower A1C, reduce hyper- and hypoglycemia and increase time in range.

As an endocrinologist with 19 years of experience in treating patients with diabetes, one of the most important lessons I’ve learned is that communication is key.

Patients with diabetes live with the heavy burden of making choices and taking action every single day to manage their blood glucose levels. Thankfully, advancements in technology have come incredibly far, giving way to tools like continuous glucose monitors (CGM), automated insulin delivery systems and more. But for Spanish-speaking populations, there is often one more barrier to overcome in getting the care they need: finding physicians, resources, and technology in their native language. How can we expect better outcomes for these patients if the tools and methods for treatment weren’t designed with them in mind? 

The Burden of Navigating Diabetes for Spanish Speakers 

Diabetes disproportionately impacts Latinos more than non-Latino white Americans. According to the American Diabetes Association, in 2022, it is estimated that 11.8% of the Latino American population has been diagnosed with diabetes, compared to 7.4% of non-Latino white Americans.

Social determinants of health including socioeconomic status, social support networks and access to quality health care play a huge factor in this disparity. Spanish speakers with diabetes face many challenges, from navigating the complex American healthcare system in a language that can be foreign to them to finding healthcare providers that can offer culturally competent care. Additionally, the cultural diaspora of the Latino-American community is not a one size fits all approach, which can make it even more challenging for healthcare providers to provide personalized treatment that connects with these patients. 

Ongoing health inequity also continues to prevent Latino people from receiving and accessing adequate diabetes care. The CDC reports on the importance of communication in this equation—stressing that if you can’t communicate fully with your doctors or they don’t understand your values and preferences, you’re less likely to follow treatment instructions and make lifestyle changes.

Not receiving proper care or treatment can result in severe diabetes complications including eye damage, loss of limbs and heart and kidney disease. Latino people have higher rates of diabetes complications, making it even more critical to provide diabetes education in their preferred language so that they can get their diabetes under control before it causes irreversible damage. 

How I Navigate Diabetes Care with a Spanish-Speaking Population

As a native Spanish speaker based in Texas who has been working with this population group throughout my career, I am overly familiar with these patients and their needs. Communication, in their native language, between a clinician and their patients is essential in the management of chronic diseases such as diabetes. It has been my experience that Spanish speakers underuse diabetes technology. Therefore, exploring barriers to adherence, health literacy, perception of the use of technology and family support as part of the clinic visit are of the most importance.

When we discuss diabetes management with our Spanish-speaking patients we need to consider how the behavior change can impact not only our patients but the family dynamics. Health and technology literacy can be intimidating, but the reality is that most of our patients with diabetes, when presented with the devices in a way that feels easy to use, can be open to the use of such technologies. Access to educational materials and technologies in their native language, in my opinion, results in increased participation in diabetes self-management. I have witnessed the positive impact in glucose control, prevention of hypoglycemia and quality of life that the access and use of diabetes technologies and medications have had in my patients with diabetes. 

Engaging our patients in their diabetes management and addressing their concerns not only about medications and devices but how the use of those medications or lifestyle modifications may impact their families is one of the things I focus on. I like to present diabetes treatments and technologies as an opportunity for the whole family to improve their overall health. Effective approaches I’ve used with this patient population to improve diabetes health outcomes include:

– Educating families and loved ones. Family is particularly important to the Latino community and ensuring that a patient’s family is on board and invested in their treatment plan helps to confirm the support network they’ll need to navigate diabetes care.

– Spending extra hands-on time to walk a patient through their diabetes treatment plan and giving them time to ask questions and speak about their concerns.

– Assisting patients in setting up their diabetes technology on their mobile devices. For example, when I work with patients to set up their Dexcom G6 CGM, I show them how to download the corresponding smartphone application, which is available in English and Spanish to ensure a seamless start. 

– Reviewing the use of technology during their follow-up visits.

– Sharing the data that I analyze during the clinic visit and evaluating areas of opportunities to improve their diabetes management.

– Referring the patients to a Certified Diabetes Educator Specialist. 

Access to CGM Technology for Spanish Speakers 

CGM technology is a powerful tool that healthcare providers like myself prescribe to patients to help them take better control of their diabetes. A CGM uses a wearable sensor and a transmitter to measure and send glucose values wirelessly to a smart device or dedicated receiver 24 hours a day. It eliminates the need for multiple daily fingersticks commonly used in blood glucose monitoring. CGM technology is widely considered the standard of care and is clinically proven to improve outcomes for people with diabetes.

There can be barriers for Latino patients when it comes to introducing CGM into their treatment plans. Oftentimes, they confuse a CGM with an insulin pump and need clarification on the role that each device plays. Once I sit down and explain to them how simple CGM is to use, they are much more open to using it. Another issue my patients encounter quite often is that treatment information and diabetes technology is largely in English, rather than their native language in which they’re the most comfortable. Receiving critical health information in a preferred language helps them to conquer their diabetes with confidence. 

Leaders in diabetes technology like Dexcom have seen how important it is for their users to receive glucose information in a language that’s native to them, leading to more features that are tailored to this population. This is a small yet crucial step toward improving health equity for Spanish speakers with diabetes. Even though there are still challenges that Latino patients with diabetes face as they navigate their health conditions, receiving their health information in Spanish—with the only translation needed being how to translate that information into actionable next steps—is a win for both patients and the healthcare providers like me. And it’s a win for the backbone of our relationship: that communication between patient and provider. 

About Dr. Rocio Harbison, MD, FACE 

Dr. Rocio Harbison is an endocrinologist with over 19 years of experience treating patients with diabetes in Houston, Texas. Dr. Harbison holds several accolades including Top Doctors by Houstonia Magazine, Texas Monthly’s 2015 Rising Star and Women of the Year in Science by Sucesos Newspaper & Solo Mujeres Magazine Houston. Dr. Harbison’s focus is on overall well-being, health and wellness with an emphasis on balanced and healthy nutrition options, exercise, and utilizing technology to improve patient’s health. Today, you can find her working at her practice, Advanced Endocrinology and Diabetes Clinic.

What You Should Know:

– Type 2 diabetes reversal leader Virta Health revealed promising one-year outcomes from its partnership with AutoZone, Inc., a retailer and distributor of automotive replacement parts and accessories in the Americas.

– Virta provides virtual, continuous health coaching, medical supervision and personalized nutrition to help patients reverse their metabolic disease, lose weight, + get off medications. At one year, AutoZoners experience long-term blood sugar control and clinically-significant weight loss while eliminating over half of diabetes medications.

AutoZone’s Health Outcomes for Employees

AutoZone currently offers Virta’s type 2 diabetes reversal, prediabetes reversal, type 2 diabetes management, and obesity and weight loss solutions to eligible AutoZoners at no-cost. Over the past twelve months, AutoZoners living with type 2 diabetes, prediabetes, and obesity have achieved transformative results with Virta, including:

– Medication Deprescription: Type 2 diabetes patients eliminated over half of diabetes medications (excluding metformin), including a 73% reduction in insulin prescribed after 12 months.

– Blood Sugar Reduction: Estimated HbA1c (a measure of average blood sugar) improved by 1% on average for diabetes patients. Every one-point decrease in HbA1c reduces the risk of long-term diabetes complications—such as eye, kidney, and nerve disease—by up to 40%.

– Clinically Significant Weight Loss: Across all groups, patients saw at least 8% weight loss on average (5% is the benchmark for FDA-approved weight-loss drugs and what is considered clinically significant). AutoZoners enrolled in Virta’s obesity program experienced 9% weight loss.

What You Should Know:

– Medtronic announced the U.S. launch of Medtronic Extended infusion set, the first and only infusion set labeled for up to 7-day wear. An infusion set is tubing that delivers insulin from an insulin pump to the body and typically requires a set change every two to three days.

– The Medtronic Extended infusion set uses advanced materials that help reduce insulin preservative loss and maintain insulin flow and stability to double the wear time of an infusion set. The innovative design of the Medtronic Extended infusion set leverages proprietary technology, including a new tubing connector that improves the physical and chemical stability of insulin, the reliability of infusion site performance, and reduces the risk of infusion set occlusion.

– The adhesive patch also has an adhesive layer that helps extend wear time and provides comfort and durability for up to 7 days. In addition to the new infusion set, the Medtronic Extended reservoir is the only infusion set reservoir tested and cleared to help keep insulin stable and safe to use for up to 7 days.