• Progress Via Collaboration

    By Laura Ramos Hegwer Mar 22, 2017

    Independence Blue Cross, Penn Medicine, and Dreamit Health are working together to bring innovative solutions to health care.

    During the past four years, leaders at three Philadelphia-based organizations—Independence Blue Cross, Penn Medicine, and the venture accelerator Dreamit Health—have helped launch more than 75 healthcare startups. Such collaboration is essential if health plans and providers truly want to transform health care, says Tom Olenzak, managing director of the strategic innovation portfolio and director of corporate development and innovation at Independence.

    Tom Olenzak, Independence Blue Cross“There really isn’t an Uber or a Facebook for health care,” Olenzak says. “Because the healthcare system is so complex, it doesn’t lend itself to complete outside disruption. You need collaboration.”

    Working With An Accelerator

    For the past four years, Independence and Penn Medicine, along with other organizations, have sponsored and supported Dreamit Health’s accelerator program.

    “During a typical cycle at Dreamit Health, we will have approximately 400 startups apply from three dozen countries, and only six to 12 will get in,” says Steve Barsh, the accelerator’s chief innovation officer. Leaders at Independence and Penn Medicine work with Dreamit Health to interview and select the companies during the two cycles hosted each year. “They help us pressure-test assumptions and make sure the startups have a solid go-to market strategy,” Barsh says.

    Each startup that is selected to participate completes a 14-week curriculum in which it has access to customers, coaching, legal counsel, and other resources that can help launch the business. But the startups are not the only participants learning from the process. “It’s an opportunity for us to get involved and learn from these entrepreneurs to see how they are thinking about health care,” Olenzak says. This insight gives Independence and Penn Medicine a fresh perspective on using new strategies, including emerging technology, to solve pressing problems.

    Working with Dreamit Health also has helped leaders at the health plan develop a framework for an ongoing relationship with Penn Medicine. “This has helped us think about how we work collaboratively to improve health,” Olenzak says.

    Roy Rosin, chief innovation officer at Penn Medicine, agrees. “With Dreamit, not only do we get to partner with our largest payer, Independence, but it is also a way that we can bring in people with a completely different skill set that may not be represented in a health system,” he says.

    Roy Rosin, Penn MedicineAmong such participants are entrepreneurs who may not have extensive industry knowledge but may be motivated to solve a healthcare problem because of a personal or family member’s experience. “We find most of our Dreamit companies, typically digital health and medical device companies, are started because of a personal need,” Barsh says.

    Finding Common Ground

    “Everyone is interested in high-value care—that is the intersection between payer and provider interest,” Rosin says. Health plans and providers also are aligned when it comes to engaging patients in their care. “Most determinants of health happen outside of the few hours that we spend with patients during the year,” he says. “Patient engagement for us is about understanding how we can appropriately become part of the patient’s life to get better outcomes for them.”

    One startup that exemplifies this alignment of goals is TowerView Health, which was developed by a group of Duke University students after one of the cofounders was diagnosed with leukemia during his first year of medical school. The entrepreneurs, who were part of Dreamit Health’s 2014 class, created a “connected pillbox” with prefilled trays designed to help patients manage multiple medications and to track patient adherence.

    The pillbox, which is being tested at Penn Medicine with Independence members, can alert the patient, a family member, or a member of the care team via text if a dose is missed. It also alerts the Penn Medicine research coordinator when patients have missed their medication consistently.

    “With TowerView Health, it was important to Independence that they fund the research and it was important to Penn Medicine that we craft and create the clinical access and allocate researchers to the pilot,” Rosin says.

    The TowerView Health program has achieved strong adherence in early trials, with compliance with complex medication schedules improving to more than 90 percent. “With traditionally low medication adherence driving both avoidable costs and suboptimal patient outcomes, it appears to be an example where all parties win,” Rosin says.

    Another company that has grown out of the collaboration among Penn Medicine, Independence, and Dreamit Health is Tissue Analytics. The company created a smartphone app to objectively and automatically measure chronic wounds and other skin conditions—an improvement over having wound care nurses use wooden rulers to measure lesions when visiting patients’ homes. Rosin says the software, which can be used in a variety of settings, has shown the potential to cut in half the time that many wound care patients require home care services because a more accurate wound assessment allows for more effective treatment.

    Lessons Learned

    Leaders at Dreamit Health, Penn Medicine, and Independence offer the following advice for healthcare organizations seeking to collaborate for innovation.

    Define your success criteria. All parties involved in innovation should share the same definition of success, Barsh says. Specifically, all stakeholders need to define the outcomes they hope to achieve and establish clear endpoints for trials.

    Steve Barsh, Dreamit HealthUnderstand what an accelerator can do. “Most of the providers that we work with don’t lack startups knocking on their door,” Barsh says. “If they have an innovation office, they are getting emails from startups every single day.” For this reason, many providers choose to work with a venture accelerator that can help curate the field.

    Providers and health plans also need to be clear on what they hope to gain from getting involved with an accelerator. Goals might include finding solutions that dramatically improve care delivery and outcomes for their patient population, attracting physicians to their organizations by giving them a channel for innovation, or finding partners for potential mergers and acquisitions as well as pilot programs. Barsh says the accelerator gives health plans and providers “a detailed look under the hood” at startups and can better guide potential partners in moving forward if they choose to do so.

    Select passionate leaders. “Finding projects where you have engaged senior leaders as executive sponsors is important, but so is having passionate and engaged clinical champions,” Rosin says. Executive champions might be department heads, the chief medical informatics officer, or business leaders responsible for service lines. Clinical champions should be front-line clinicians with access to the target patient population and setting and the relevant care team. “You need people to be excited about what they are doing,” Rosin says. “You want to find people for whom solving this problem is already a top priority and a personal passion.”

    Embrace payment reform. “As you innovate on new products and services, you often need to have a new way of getting paid,” Rosin says. “That is why payer-provider collaborations are so interesting. If you’re sitting on the same side of the table with aligned incentives, mutual wins become possible.”

    In a fee-for-service environment, advances that are better for patients and the community will tend to negatively impact either the health plan (if more costly) or the provider (if fewer services are used). Breakthrough innovations require a parallel effort focused on appropriate payment structures.

    “Payment changes have probably driven more productive innovation than almost anything else, but where those payment reforms have lagged behind, you need to move business model innovation forward with product innovation,” Rosin says.

    Make a long-term commitment to collaboration. “You can’t sign a partnership agreement and be done,” Olenzak says. “It is important to invest in building relationships and developing trust, because with innovation you are taking risks. Not everything is going to work, and you need to have a relationship that can sustain that. Obviously, that takes time.”

    However, the benefits of collaborating on innovation can be significant. As Olenzak says, “The potential impact is much greater when you work together than when you try to do things in your own silo in the healthcare system.”


    Laura Ramos Hegwer is a freelance writer and editor based in Lake Bluff, Ill.

    Interviewed for this article: Steve Barsh, chief innovation officer, Dreamit Health, Philadelphia; Tom Olenzak, managing director of the strategic innovation portfolio and director of corporate development and innovation, Independence Blue Cross, Philadelphia; Roy Rosin, chief innovation officer, Penn Medicine, Philadelphia.
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