Collective Medical improves outcomes and lowers costs on an impressive scale. In a Brookings Institution review of Medicaid patients who visited emergency rooms in Washington State, Collective Medical’s network and EDIE application—allowing actionable, real-time coordination across organizations—was one of the core strategies for lowering the number of ED visits by patients with patterns of high ED utilization. By partnering with Collective Medical to focus on these patients, Washington State reported $34 million in savings in emergency costs and a decline of 9.9 percent in emergency department visits in its first year of use in 2013.
CEO Jonathan Baran identifies two forces that have jump-started the company. Number one is that all sorts of routine tasks are piling up on physicians and staff, leading to high levels of burnout and negative consequences. “Health systems have really seen this problem and understand there has to be a better way to do this,” he says. Number two is a change in approach by the EHR vendors themselves. “When we started, it was a foreign concept to have an app store for the EHRs. None of them had one yet. But now we have seen widespread adoption of this model across all the major EHRs,” he says. “They now think about themselves as platforms and open marketplaces where people like us can build technology on top of APIs that allow us to integrate our technology into the workflow. That is a big piece. Without those two major forces—market awareness and enabling innovation by building on top of EHRs—this wouldn't be possible.”

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En ce qui concerne le domaine de la médecine, les salariés des cabinets médicaux et des médecins libéraux (assistants médicaux ou secrétaires par exemple) sont concernés par la convention collective du personnel des cabinets médicaux. En revanche, les cabinets inter-entreprises de médecine du travail sont soumis à la convention collective du personnel des services interentreprises de médecine du travail.
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The AI application uncovered relationships and patterns that physicians either would not have identified or would have taken much longer to identify, Sanders says. For instance, the analysis revealed that for patients with pneumonia and COPD, beginning nebulizer treatments early in their hospital stays improved outcomes tremendously, hospital leaders report.
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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.”
The state evaluated a number of different paths and vendors and ultimately partnered with us. In five months, we connected 100 percent of the state’s acute care hospitals. We brought on all of the managed Medicaid organizations. In the next wave, we’re onboarding skilled nursing facilities and non-Medicare and other ACOs. We’re beginning to bring on ambulatory providers as well.
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.

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“When we had conversations with physicians about the data, some would say, ‘My patient is sicker than yours,’ or ‘I have a different patient population.’ However, we can drill down to the physician’s patients and show the physician where things are. It’s not based on an ivory tower analysis, it’s based on our own data. And, yes, our patients, and our community, are unique—a little older than most, and we have a lot of Europeans here visiting. We have some challenges, but this tool is taking our data and showing us what we need to pursue. That’s pretty powerful.”
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“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.”

Le domaine vétérinaire possède deux conventions collectives différentes, suivant le statut de l’entreprise. Les vétérinaires praticiens salariés, qu’ils exercent à domicile ou dans des associations, sont concernés par la convention collective nationale des vétérinaires praticiens salariés. Alors que le personnel des cabinets et cliniques vétérinaires est soumis à la convention collective nationale des cabinets et cliniques vétérinaires.
After being fed data of past pneumonia treatments, the software automatically created cohorts of patients who had similar outcomes accompanied by the treatments they received at particular times and in what sequence. The program also calculated the direct variable costs, average lengths of stay, readmission and mortality rates for each of those cohorts, along with the statistical significance of its conclusions. Each group had different comorbidities, such as diabetes, COPD and heart failure, which was factored into the application's calculations. At the push of a button, the application created a care path based on the treatment given to the patients in each cohort.
“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.
The company has an intriguing startup story. Fifteen years ago, one of the founders’ mother, Patti Green, was an emergency department social worker in Boise, Idaho, and suspected that some patients were opioid seekers. She set up a rudimentary collaborative care plan for providers to use to identify and help these patients. “It is easy for us now to talk about the opioid epidemic. Nobody was really talking about it 15 years ago, but she was seeing it on the ground,” says Chris Klomp, Collective’s CEO, “and she did something about it.”
En ce qui concerne le secteur dentaire, les dentistes qui emploient du personnel, doivent appliquer la convention collective des cabinets dentaires, qu’ils exercent seul ou à plusieurs sous forme de cabinet dentaire. En revanche, cette convention n’est pas applicable aux prothésistes dentaires, ni au personnel des laboratoires de prothèses dentaires, qui sont concernés par la convention collective nationale des prothésistes dentaires et des personnels des laboratoires de prothèse dentaire.
Collective Medical Technologies (http://www.collectivemedical.com) empowers care teams to improve patient outcomes by closing the communication gaps that undermine patient care through seamless collaboration. With a nationwide network engaged with every national health plan in the country, hundreds of hospitals and health systems and tens of thousands of providers—including hospitals, emergency departments, skilled nursing facilities, primary care providers, mental and behavioral health clinics, and others—Collective Medical’s system-agnostic platform is trusted by healthcare organizations and payers to identify at-risk and complex patients and facilitate actionable collaboration to make better care decisions and improve outcomes. Based in Salt Lake City, Collective Medical is proven to streamline transitions of care, improve coordination across diverse care teams, and reduce unnecessary hospital admissions.
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Besides EDIE, Collective now has other software it licenses to payers and accountable care organizations, but it does not charge post-acute operators, ambulatory providers and others who don't have risk. “Our model is that we license our software to those who could see economic benefit through improving coordination of their members, which makes sense,” he says. “Others may not benefit economically, so we don’t charge them.”
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