With the success of the pneumonia care pathway, Flagler Hospital leaders also deployed a new sepsis pathway. The hospital has expanded its plans for using Ayasdi to develop new care pathways, from the original plan of tackling 12 conditions over three years, to now tackling one condition per month. Future plans are to tackle heart failure, total hip replacement, chronic obstructive pulmonary disease (COPD), coronary artery bypass grafting (CABG), hysterectomy and diabetes, among other conditions. Flagler Hospital expects to save at least $20 million from this program in the next three years, according to officials.
Klomp, who helped out with strategy while working in private equity at Bain Capital in Boston, quit in 2014 to join Collective Medical. And last year, Benjamin Zaniello, who was a chief medical information officer at Providence Health & Services in Washington, joined as chief medical officer. Zaniello helped implement Collective Medical at Providence. He was impressed. “They did this alone for many years,” he says. “It wasn’t just a bunch of people with a power point and a dream, or someone from Google with a personal story in healthcare who wants to fix the system.”

The state of Virginia had phenomenal leadership and vision. They didn’t just talk about interoperability that could move data from A to B. They’re goal was real coordination. It’s called the EDCC — Emergency Department Care Coordination — initiative because it starts in the emergency department, the front door of the healthcare continuum for so many vulnerable patients. Virginia is seeking to instantiate workflow broadly out into the rest of the community. Not just through interoperability, but by actually prompting coordinated sequences of engagement of various providers across specific patient archetypes to drive resolution.
A recent evaluation of Collective Medical’s impact throughout the state of Oregon, conducted by the Oregon Health Leadership Council, found a promising downward trend in ED visits by patients with history of high ED utilization during a three-year period. As a participant in this evaluation, Kaiser Permanente Northwest initially used Collective Medical’s EDIE application to identify and collaborate on care plans for a group of approximately 363 patients with complex clinical and social challenges who visited the ED more than six times in six months. Over the three years of this program Kaiser has seen a 42 percent reduction in ED visits and a 47 percent reduction in inpatient admissions for those individuals enrolled in this program.
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Collective Medical currently has relationships with each US national health plan and hundreds of hospitals and health systems, according to a statement. There are 13 states currently on Collective's network, with plans to add another 10 states scheduled for 2018. In August, the company was featured for the first time on Inc. Magazine’s Inc 5,000 list of fastest growing companies in America, with $5.8 million in 2016 revenue and 561 percent growth over the last three years.
There continues to be growing interest, and also some hype, around AI tools, but Sanders notes that AI and machine learning are simply another tool. “Historically, what we’ve done is that we had an idea of what we wanted to do, conducted a clinical trial and then proved or disproved the hypothesis, based on the data that we collected. We have a tool with AI which can basically show us relationships that we didn’t know even existed and answer questions that we didn’t know to ask. I think it’s going to open up a tremendous pathway in medicine for us to both reduce cost, improve care and really take better care of our patients,” he says, adding, “When you can say that to physicians, they are on board. They respond to the data.”
“In 2013, President Barack Obama’s attorney general advised prosecutors not to waste money targeting pot growers and sellers that were abiding by state laws but to go after flagrant violations such as trafficking across state lines or selling to minors. Under this policy, several states legalized recreational pot, growers and sellers had begun to drop their guard over fears of a federal crackdown and the business blossomed into a sophisticated, multimillion-dollar industry feeding state government programs with tax dollars.”
One of the ex-ganja peddlers from Fateh Nagar said, `the area is under complete surveillance and many have left such illegal businesses in the locality. However, few of the peddlers continue to sell ganja as they own a vehicle which helps them deliver the drug at a different and preferably safe spot in the city. ``The buyers have the contact details and everything is planned over a phone call”, he said. 

Klomp, who helped out with strategy while working in private equity at Bain Capital in Boston, quit in 2014 to join Collective Medical. And last year, Benjamin Zaniello, who was a chief medical information officer at Providence Health & Services in Washington, joined as chief medical officer. Zaniello helped implement Collective Medical at Providence. He was impressed. “They did this alone for many years,” he says. “It wasn’t just a bunch of people with a power point and a dream, or someone from Google with a personal story in healthcare who wants to fix the system.”
Since its founding eight years ago, Collective Medical (not to be confused with employee benefits company Collective Health) has produced a software platform comprised of two main products. EDIE, designed for emergency departments, connects emergency teams across multiple facilities to identify high-risk, complex needs patients and immediately access care history upon admittance. The PreManage product is intended for a wider population of patients, and is marketed to health plans and providers. It also identifies and tracks high-risk patients upon admittance and discharge from inpatient or emergency care, while allowing teams to easily communicate and coordinate throughout a patient’s care.
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Baran says that although automation of repetitive tasks is the ultimate goal, the first step in automation is delegation. “That means shifting the work from physician to staff and using technology to make that process as easy as possible. For the physicians it looks like automation because you are taking this work off their plates, and we use technology to make the process as easy as possible for the staff.”

As a young adult, I was in a very serious car accident. I broke a lot of bones — my second vertebrae, my neck, ribs, a compound fracture in my leg... It’s a miracle I’m not a quadriplegic. I was on a respirator and couldn’t breathe because there was fluid between my lung and ribcage. I couldn’t move because I had this thing holding up my head. A nurse around every few hours to help me cough so I wouldn’t get pneumonia. Eventually after getting off the respirator, one nurse came around and he mentioned cannabis. He said, “Did you know cannabis does the same type of thing to your lungs? It’s a bronchial dilator. The drug I’m pumping into your lungs is a bronchial dilator.” From that point on I realized I had a choice. I never took another pain pill. I just used cannabis for the next eleven months to recover. I always loved cannabis, but now I had an even more personal connection to the plant.


Collective seeks to close provider communication gaps that undermine patient care. It uses data feeds, risk analytics, notifications, and shared care guidelines to reduce emergency department (ED) utilization, inpatient readmissions and downstream care transitions, including to post-acute operators. After collecting data from all EDs visited by a patient, its solution packages that data into actionable insights, and delivers them to clinicians via real-time notifications. Collective is currently partnered with more than a dozen state hospital associations, and recently added the Florida Hospital Association to its network of partners.
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Cool Collective Medical Technologies (CMT), the leader in network-driven collaborative care manageme...nt, today announced that it has, through its EDIE and PreManage applications, earned Certified Status for information security by the Health Information Trust (HITRUST) Alliance. With the HITRUST CSF Certified Status, CMT meets key healthcare regulations and requirements for protecting and securing sensitive private healthcare information. See More

Our goal now is to invest in the platform and to grow networks. Building network effect-enabled platforms is capital intensive because you need to reach critical density in a given geography to create value for the constituents there. We’ve done a pretty good job of that. We’re live in 17 states, not just with one or two hospitals, but penetrated broadly to 100 percent of acute hospitals. We’ve got a bunch more in the hopper.
Unfortunately, that's not the only message this raid sent. Thanks to decades of demonization, much of it fueled by alcohol and tobacco interests, marijuana still carries a stigma. Police actions like this only reinforce that stigma. That people who get their medicine from dispensaries instead of pharmacists are druggies, and the employees of such establishments can still get their mugs displayed like drug dealers.
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