“Event notification systems and care coordination applications have historically struggled to provide actionable information to providers at the point-of-care,” Noah Knauf, partner at Kleiner Perkins, said in a statement. “Collective Medical is the first technology we’ve seen that allows the providers and payers in a local healthcare system to efficiently collaborate, delivering significantly better outcomes through risk analytics, real-time notifications, and shared care planning tools. Supporting this team is a rare opportunity to be a part of something that is meaningfully changing the way care is delivered in this country.”
Anderson, who’s been practicing emergency medicine for 30 years, relies on Collective Medical for 40% of his patients. Recently, a 25-year-old woman showed up in the ER at Auburn Medical Center with abdominal pain. At check-in, an alert popped up next to her name. It was her fifth visit in a year. Her chart showed that she had also been to St. Francis Hospital, Highline Medical Center and Valley Medical Center—all within a 20-mile radius of Auburn. Her prescription drug history revealed that six doctors had ordered narcotics. Anderson contacted her primary care doctor, who was unaware of her ER visits, for a next day appointment, and started her on a treatment for opioid dependence.
“That was a major effort, but some of us had been data scientists before we were physicians, and so we parameterized all these calls. The first pneumonia care path was completed in about nine weeks. We’ve turned around and did a second care path, for sepsis, which is much harder, and we’ve done that in two weeks. We’ve finished sepsis and have moved on to total hip and total knee replacements. We have about 18 or 19 care paths that we’re going to be doing over the next 18 months,” he says.
They found Collective Medical Technologies, a little company from Salt Lake City, Utah, belonging to Adam Green and Wylie van den Akker, childhood friends from Boise, Idaho. Between school and daytime jobs, they had managed to sell their software to 35% of hospitals in Washington. Emergency doctors raved about it and pushed for its adoption. The governor gave the go-ahead, but all 98 hospitals in the state had to comply. To be effective, they had to share patient information. “The value of the network is in participants,” says Chris Klomp, CEO of Collective Medical, and a childhood friend of the founders.
Next, Providence drove usage across its five-state system, and Oregon adopted it. “All of a sudden, the world caught up as healthcare started paying for quality instead of just volume,” Klomp says. Growth was slow and methodical as the co-founders sought to understand clinical workflows. “We worked to get real demonstrable outcomes from a clinical and economic perspective,” he adds. “We are pretty conservative. This is a different story than raise a whole bunch of money and try to grow the business fast.”
As of January 1st, medical and recreational (adult use) marijuana became legal in the state of California. Per the Prop 64 measure, adults over the age of 21 can now consume, purchase, possess, and grow cannabis without the fear of prosecution so long as they are within the regulation of the new law… and in accordance with any other policies put in place by the city in which they reside.
Might next year prove to be different? Yes, absolutely, especially given the coming mandates coming out of the Protecting Access to Medicare Act (PAMA), which will require referring providers to consult appropriate use criteria (AUC) prior to ordering advanced diagnostic imaging services—CT, MR, nuclear medicine and PET—for Medicare patients. The federal Centers for Medicare and Medicaid Services (CMS) will progress with a phased rollout of the CDS mandate, as the American College of Radiology (ACR) explains on its website, with voluntary reporting of the use of AUC taking place until December 2019, and mandatory reporting beginning in January 2020.
“We’ve been able to do a lot of querying ourselves, and we have some sepsis predictive models that we’ve created and put into place. We do a lot of real-time monitoring for sepsis and central line-associated bloodstream infections,” he says. “Central line-associated bloodstream infections are a bane for all hospitals. In the past year and a half, since we’ve put in our predictive model, we’ve had zero bloodstream infections, and that’s just unheard of.”
“We’re putting collaboration at the heart of the solution to a fragmented healthcare system,” says Chris Klomp, CEO of Collective Medical. “Our job is to connect care teams. By arming providers and payers with real-time insights and a platform to seamlessly collaborate across organizations and care settings, we ensure patients don’t slip through the cracks.” Klomp adds that, “we are beyond excited and grateful to be joined by such an extraordinary group of investors who share our vision for further enriching and expanding our network to help care teams provide the most effective care possible.”
As a general rule, the lower the grade of the product the less pain relief you will get. Using medium grade products, it will take 5-6 months for you to see relief. The same is true for the process of rehabilitating cartilage. On the other hand, a high-quality product will usually end your pain in 10-25 days, depending on the extent of your disease. As well, the healing and rehabilitation process begins nearly immediately. When choosing among glucosamine products a pharmaceutical grade liquid formula in liquid form will bring the maximum relief and protection. In addition, a high quality liquid glucosamine formula will do wonders for those recovering from orthopedic surgery.
Cannabis reputedly helps unlock the creative parts of your brain. Put that theory to the test with a pot-friendly night of art at Puff, Pass and Paint. The $39 cost includes all art supplies and instruction. Attendees must bring their own cannabis, but smoking, edibles, and vaping are all encouraged as part of the creative process and the social experience. The Colorado-based company offers classes in six states and the District of Columbia. In Boston, they’re available one weekend per month, and the company hopes to launch a weekly schedule soon. During the two-hour class, the instructor provides an example of painting and teaches participants how to re-create the artwork. Attendees are urged to follow their THC-heightened inspiration wherever it leads, says national director Tyler Joyner.
The effort to create the first pathway began with the IT staff writing structured query language (SQL) code to extract the necessary data from the hospital’s Allscripts EHR, enterprise data warehouse, surgical, financial and corporate performance systems. This data was brought into the clinical variation management application using the FHIR (Fast Healthcare Interoperability Resources) standard.
Meanwhile, with regard to the new form of AI, and the inevitable hype cycle around emerging technologies, Dr. Chang said during his presentation that “When you’re going up the ride, you get excited. But then right at the top, before you are about to go down, you have that moment of clarity—‘What am I getting myself into?’—and that’s where we are now. We are upon that crest of magical hype and we are about to get the trench of disillusionment.” Still, he told his audience, “It is worth the rollercoaster of hype. But I’m here to tell you that it’s going to take longer than you think.”
In an article by the Madera Tribune, it stated that Madera growers will need to obtain a permit from the city which will need to be displayed in plain view at the residence where the growing will occur. Failure to do so could result in a $1,000 fine per plant or possibly, per day. Renters who would like to grow in their residence would need written permission from their landlord before applying for a permit with the city.