May19

Wearable Wonder: Will They Improve Patients’ Quality of Life?

LeanneLakeBlogImageSizedClearly wearables are “all the buzz” in our industry. Soon our Fitbits, watches and the like will become an essential part of connected healthcare, monitoring our bodies and feeding important data about our health to the cloud to be analyzed by our healthcare professionals. More data in, better outcomes come out—it’s fantastic news. But what if these devices can go the next step and actually respond to the data they are monitoring? Can you envision a future where a wearable device can improve our body’s function and a person’s quality of life in real-time? I recently learned about one that just might.

It’s called the WAK, short for the Wearable Artificial Kidney. This wearable innovation has the potential to be truly life-changing for the more than 400K patients with end stage renal disease who are currently undergoing hemodialysis every day in our country.

For the majority of these patients, treatment is their lifeline, but it can also take over their life. Hemodialysis patients receiving treatment in centers spend on average 4 hours a day, 3 days a week completely immobile—tethered to a chair, tied to a machine. Much like chemotherapy, the treatment that is saving them often makes them sick for hours afterward. In the absence of a successful transplant, they will undergo dialysis until the end of their life.

The WAK is designed to help patients get out of the chair and back into life. It is a miniature battery-powered dialysis device that is worn like a tool belt. It is connected to the patient by a catheter, weighs approximately 10 pounds and offers dialysis 24/7. Some experts believe that in a perfect world, more frequent dialysis would yield better control, however this comes with a tremendous burden to the healthcare system. If proven successful, the WAK could improve outcomes and deliver new hope for patients, reducing their time in the chair and giving them the mobility to go about activities of daily life—a more “normal” existence. The FDA fast-tracked the WAK, and it is currently undergoing its first human trial in the United States. Human clinical trials conducted in Italy and London already concluded successfully.

For me, following the progress of this wearable technology is personal. I lost my dad to end stage renal disease and its complications three years ago this June. During the five years he “survived” on dialysis, I watched his body and spirit wear thin. Early on, the dialysis center gave him the personal connection he needed to share with patients having a similar experience, but soon after getting into the three-day-a-week routine, he and my mom longed to get back the flexibility that every retired person deserves. The ability to hit the driving range with his buddies on a Tuesday, attend his grandson’s football game on a Thursday, or even make the trek to NJ to visit me and my family on a Saturday afternoon.

Looking back, I wonder how the WAK would have changed my dad’s dialysis experience and the burden it placed on both him and my mom.

What’s your wearable wonder?

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Also posted in adherence, Apps, behavior change, Culture, Data, Design, Digital, Health & Wellness, Healthcare Communications, Self-monitoring, Technology, Wearable Health Technology | Tagged | Leave a comment
May12

Product Launch Made to Work

Product Launch Blog ImageIntroducing a new product into the highly diluted pharmaceutical market is no easy feat. Our industry spares no time for coming up short of flawless, where the barriers to entry are a proverbial North Korea for the inexperienced and unprepared. The road to success is windy and narrow, but once achieved, the view is unmatched.

In today’s marketplace, suppliers are red-flagged for doing things the way they have in the past, and the competitive edge gained is in the ability to differentiate completely in some cases, and only partially in others.

How can we differentiate ourselves?

For a baseline, any transaction within the pharmaceutical space is a complex sale. The traditional model of selling a product, handling the logistics, and looking forward to a reorder does not cut it. As suppliers, we must adapt to the notion that we are no longer offering or launching a product, but rather have entered the era of solution-based selling. We must come to terms with the reality that being “geared” toward a client or industry is no longer acceptable, and complete customization comes at little or no extra revenue.

Make no mistake: selling a product is still physical, but an in-depth understanding of the customers’ base is now essential to the sale of a creation. The utilization of that understanding is to align our goals to match the customers’ needs. The result of a properly executed alignment is the transformation of the supplier into the partner. By outgrowing the paradigm of being the wholesaler, and embracing a newfound cooperative mantra, trust becomes the foundation of our rapport.

But trust isn’t just a way in, and a share of the market isn’t the only measure of our success. We have to continually push the limits of our capabilities to stimulate fresh ideas, and remain at the forefront of innovation to our clients. The growth driven from market advancement is what will allow us to maintain our business and simultaneously cultivate new opportunities. With trust, our new partners will expect us to act on our promises and will be more critical of our deliverables. We are no longer reacting to a signed Statement of Work (SOW) or Request for Proposal (RFP), we are building a proactive and cooperative plan of action. Suppliers cannot simply provide a product; they must also act as consultants.

The stigma of “Big Pharma” having deep pockets and quick trigger fingers is far from the truth. Pricing is critical and partners will expect us to eat a slice of the risk pie when entering into an agreement (you are a partner now, why wouldn’t you?).

We optimize the product for the consumer experience through the ability to launch a solution directed toward a specific client and their void. This style is undoubtedly the wave of the future, and the relationships formed via this approach will be more personal, more customized, and ultimately, more lucrative.

Differentiation begins with common interest, and results in great success.

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Oct17

At Face Value

At Face Value ImageThe recent 60 Minutes episode on the “eye popping” cost of cancer drugs painted pharmaceutical manufacturers and community oncologists as greedy scoundrels only interested in making huge profits at the expense of desperate cancer patients.

Reporter Lesley Stahl keyed in on a common target in the debate over rising healthcare costs—drug price, and a new term being used by oncologists: “financial toxicity.”  The program singled out ziv-aflibercept (Sanofi-Aventis) as a high-priced agent for metastatic colorectal cancer that cut its price in half only after three doctors at Memorial Sloan Kettering wrote a negative op-ed article in the New York Times suggesting that manufacturers determine drug prices similar to how one shops in a Turkish bizarre.

To emphasize the industry’s greed, the producers highlighted imatinib (Novartis), and although they acknowledged it was indeed a true advance in the treatment of chronic myeloid leukemia when it was approved, they chose to focus only on how the price has more than tripled over the past decade despite the availability of several newer, more effective treatment options.

Media coverage like this, along with ongoing policy discussions, continue to focus on whether the cost of new cancer therapies is putting urgently needed, life-saving therapy out of the reach of patients.

The Personal Side

Ogilvy CommonHealth Worldwide supports a number of organizations, including a number focused on cancer and oncology patients. One such nonprofit is the Cancer Research Institute (CRI), an organization founded in 1953 and dedicated to harnessing the power of the body’s own immune system to conquer cancer. Through their efforts, and the efforts of other institutions like them, a promising new class of therapy called immune-oncology (IO) has emerged.

Think about that—over six decades of research, funding, clinical trials, and education has led to some of today’s most promising IO agents. I imagine there are a lot of lost bets along the way; despite the millions of dollars that go into the research and development of new cancer treatments, only 13% of all compounds in development are ever approved for use in patients.1

But through the perseverance, commitment and investment of many, including the pharmaceutical manufacturers, what today is a reality would not have been possible.

I had the opportunity to attend CRI’s annual event and had the pleasure of meeting many post doc fellows and researchers, and I can assure you the value they saw in their work was not the profit their research would have for their companies, but the life-saving impact it would have for patients urgently awaiting new treatments.

One such person I met at the CRI event was “Sue,” a young woman recently married and living with a rare form of cancer (angiosarcoma) diagnosed in less than 300 people per year. She told me about how appreciative she was of the funding from CRI, manufacturers, and industry to the work she was doing and the hope that she’ll one day play a role in helping cure people like herself living with a deadly form of cancer.

Which made me think… If manufacturers and nonprofit organizations like CRI did not sustain the commitment and investment (in the billions) in search of new therapies, including areas of rare disease, what would become of patients like Sue, without the combined efforts and commitment of these institutions?

The Flip Side

So today, patients are being asked to absorb a larger portion of their prescription costs as a result of more aggressive payer cost management and growing pressure on healthcare budgets overall.

However, it’s important to recognize the overall savings to the system cannot be recognized in terms of savings for a patient individually. And the true value of cancer medicines goes well beyond the cost of a particular drug.

R&D of novel treatments has the potential to not only help patients today, but also provide longer-term value by investing in therapies for tomorrow. By limiting our view to a short-term cost savings approach, the potential to develop new, innovative treatment approaches, like IO, may never occur.

So when considering the price of drugs, remember this reflects the cost and risk of medicine development, the complexity inherent in treating cancer, as well as value to the patient, the healthcare system, and to society. So don’t take price at face value!

The Rest of the Story

So while the producers of 60 Minutes focused solely on the “devastating” side effect of cancer (the bill), a far worse side effect would be if manufacturers chose to cut the amount (billions) they now invest at risk to commercialize new therapies. This would be especially detrimental in rare disease areas like angiosarcoma, where the investment will outweigh the profit—and ultimately the patient would have the most to lose.

Through an environment and policy framework incentivizing and rewarding research, a healthy competitive environment will pave the way for new advances so desperately needed, and everyone benefits.

One thing is for certain, the path forward should focus on continued (albeit targeted) investments, improving access to these important oncolytic advances, development of biosimilars, and for crying out loud, doing a better job communicating the value proposition (aka, demonstrate product value) of emerging therapies to providers, payers AND patients.

Reference: 1. DiMasi A, Reichert JM, Feldman L, Malins A. Clinical approval success rates for investigational cancer drugs. Clin Pharmacol Ther. 2013;9(13):329-335.

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Sep15

Responsive Web Design in Pharma

CREATIVE MOBILE BLOG PHOTO2Data is showing that we are using smartphones more and more for everyday items—searches, purchasing consumer products, travel, weather, and World Cup updates, just to name a few.

We also see smartphone users searching on prescription drugs. Healthcare professionals (HCPs) are using mobile more in their practices, yet the branded drug websites are not optimized for viewing on their phones. We see this as a missed opportunity to provide the information need to the device being used.

 

In the pharma space, we are seeing an uptick with websites moving to a responsive design methodology with consumers—but not with HCPs. We need to understand how HCPs are using their device in the office. By thinking mobile first, we can better serve their needs. Focusing on the user experience with information architecture and content strategy, we can provide the right information to the user, spanning across multiple devices.

 

This would be extremely helpful for our HCPs. If I need to look up a dosing chart for a specific drug while in the exam room, I should be able to use my mobile device to view and interact with the chart. Later, when moving to the desktop, I should have the same content and experience.


RWDP

The chart to the left is a good example to see how content can be organized from the desktop to smartphone. Take note of the design grid and how it responds to device screen sizes.

 

A good example in the pharma space is Forum Pharmaceuticals (forumpharma.com). Simple, easy to navigate, and the experience stays with you through the multiple devices. This makes for a happier end user.

 

 

 

 

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Aug27

Isn’t Patient Centricity What Pharma Has Been Doing for Years?

TinaWoodsGraphic2Patient centricity is the new buzzword. Most of our pharma clients have patients at the heart of their corporate vision and mission, and say that the patient voice drives everything that they do. But what does it really mean to be truly patient centric?

At the recent EyeforPharma Patient Summit in London, there was a lot of talk on organising companies around patients rather than brands. And this is not surprising given that a true understanding of patients’ day-to-day needs and how they behave in the real world, as opposed to trial conditions, is critical to developing successful new products over the long term.

As digital channels, including mobile and social media, continue to democratise communication networks, pharma cannot afford to pay lip service to the increasingly powerful patient voice. They need to get used to the idea of patient opinion leaders shaping the future via patient-driven networks. For example, developing patient champions who will talk about their illness will be essential in establishing disease awareness.

The notion of supported self-management and how pharma should/could be involved is a hot topic. It is important to develop integrated, personalised patient support programmes to facilitate quality interaction between patients and stakeholders (including caregivers and family members) along the patient journey. The goal should be to provide innovative solutions around patient needs and wants—to deliver an improved patient experience, addressing patients’ individual beliefs, behaviours and goals as they are on their personal and emotional journey.

Meaningful patient insight is at the heart of any patient-centric strategy. Understanding the lived patient experience, “walking in the patients’ shoes,” is the key to deriving these insights. Anything else is just observation. Unless they have been patients themselves, even healthcare professionals are merely observers and cannot truly understand the lived patient experience.

True patient centricity is in the process of being defined, not by pharma, nor by healthcare professionals, but by the patients themselves. Is it any wonder that people are saying that “true patient engagement is the blockbuster drug of the century”?

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Aug21

Adherence Is a Dirty Word

Adherence Picture BlogInstant gratification is not fast enough.

That’s the short answer to what derails (or drives) patient engagement. It’s simple really—you’re asking someone to change their routine, visit the doctor, spend their money, change their lifestyle—for something that doesn’t necessarily have a recognizable payoff tomorrow.

We design programs, apps, and all kinds of resources to “encourage adherence,” but they may only add to this burden. So what, exactly, is that burden?

Try it yourself.

That’s what patient educator and advocate Catherine Price (@catherine_price) has folks do. Dubbed the Tic Tac Challenge, participants use Tic Tacs as placebo pills, to see what it REALLY takes to remember to take your meds.

I organized a small Ogilvy Payer “Adherence Challenge” among my Payer, Creative and Shared Service colleagues, with the help of our fabulous summer interns. In the true spirit of a new prescription, each person got a script (with varying dosing regimens) which was filled at the “intern pharmacy.” Some scripts even had a prior authorization (PA) hurdle, which required a trip to our Director of Operations to answer SOX questions, to mimic the health plan benefits investigations and appeals process.

So how did we do?

Well. I didn’t even fill my script. The PA hurdle I landed with proved too great a barrier in my schedule.

Others’ success ranged from “almost compliant except for one travel day” to sporadic compliance, and some reported back compliance—but only on workdays when it fit into a routine. Variations on time of day, taking with food, or polypharmacy had a noticeable impact on the adherence burden. While some had routines or other reminders to help them along, no one was 100% compliant. With so much going on in our lives, it’s no wonder it’s easy to forget.

 

What’s the answer?

Well, there is no single solution. Merely knowing that “you have to” is not enough. There needs to be a reason you WANT to take a pill every day. Health needs to be integrated into life, not an add-on to it. HCPs need to speak the language of their patients— à la shared decision-making—to truly engage patients toward the benefit that adherence gives them in their life. Technology, while helpful, cannot solve everything for the unmotivated patient (hit that snooze button again!). Far-off benefits are strongly outweighed by what the patient needs/wants/feels right now.

For us, this is just something to keep in mind as we design apps, resources and CRM programs. Simple, integrated, and aligned with the patient’s goals is the mantra I will be marching forward with. A patient cannot just be adherent (a supporter or follower). Instead, a patient must be an enthusiast—active in his or her health interests.

 

These insights came from my attendance at the Patient Adherence & Access Summit this past June. If you would like the full write-up from the summit, just shoot me an email and I’ll happily send it over!

claire.pisano@ogilvy.com

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Jul16

“It’s not a tumor!” Cyberchondria and the Diagnoses That Spawn From It

2287994It’s 7 am; I’ve just awoken. My eyes are adjusting and I’m sprawled in my bed. My mind is not coordinated enough to move my body. Man, I am exhausted, I think. How is it only Thursday? My head kinda hurts. Good God I have to pee. I could probably snooze for like fifteen more minutes, if I shower quickly. Seriously, my head hurts. Right in my left temple. I must have slept wrong. I don’t remember hitting my head or anything. I sit up abruptly. Oh Lord now I’m dizzy. I’m dizzy and I have a sharp pain in my temple. Holy crap what if it’s a tumor, or an aneurism. When I did those brain cancer interviews last year they all said they woke up with headaches. This is that exact same situation. Where’s my iPhone? How do you spell meningioma, two “n”s? No, one “n.” Thanks Google. Okay WebMD…signs and symptoms…yup, here it is. Headache: check. Dizziness: check. Weakness in arms and legs: now that you mention it, I can barely hold this phone it feels so heavy. Blurred vision: that one’s probably next. Yup. It’s definitely a meningioma. I should call my dad. Just tell him I love him.

But just as Arnold said, it’s not a tumor. And while that example might be a tad exaggerated, I’ve certainly had this type of half-awake, neurotic, cyberchondria once or twice in my life. Though the above situation was more likely caused by one too many glasses of wine and a refusal to admit to a hangover.

Nevertheless, the concept of self-diagnosis is an ever-growing phenomenon in this digital age. According to a survey conducted by The Pew Research Center, over 35% of Americans in 2012 had gone online to diagnose themselves, and more than a third never confirmed that diagnosis with a doctor. What’s worse: some 30% of self-diagnosed women have admitted to purchasing and consuming medication for their supposed illness, without a consultation. That’s the part that shocks me. Sure, I might convince myself I have a pet-dander allergy, but that does not mean I trust my diagnostic abilities enough to assault my leg up with an EpiPen.

But it does happen. And those working in the healthcare industry appear to be the worst culprits—after all, we live and breathe this stuff; it shouldn’t be hard to tell if we have chronic migraines, or insomnia, or endocarditis, right? Our increased level of knowledge mixed with a splash of arrogance is just enough to convince us that there is little a PCP’s gonna tell us that we don’t already know.

And while the hyperbolic, often terminal, self-diagnoses are more my style, physicians say they are more concerned with the prevalence of under-diagnosis among systematic Googlers—as we all know, convincing oneself that a rash is just a rash, or numbness is just an innocent side effect can have irreparable effects.

Now, I’m a huge proponent of self-education and using today’s technology to our advantage—in fact, I think it sparks productive dialogue when information is brought into the doctor’s office—but as cliché as it sounds, I cannot emphasize enough the need for a professional diagnostic assessment. Trust me; the $15 copay is worth it.

Think of it this way: your doctor is your agency of record, but for some reason, you’ve decided to do your own brand website, aka diagnosis. We all know from AOR experience that your doctor is going to take one look at that diagnosis and say, “Damn, this is a mess; I wish they’d just paid me to do it.”

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Jun18

The Movement Toward “Pill Plus”

extramileHistorically, the relationship between manufacturers and payers has been transactional in nature. Payers needed to work with many manufacturers to meet financial objectives. With markets like hypertension and cholesterol at their prime and filled with branded agents, contracts benefiting both parties were the No. 1 priority. The majority of the discussions were branded, and there was a lack of trust and transparency between parties.

That was the old world, however—and this is the new world.

In today’s healthcare market, manufacturers and payers are dependent upon each other to meet their business goals. More focus has been placed on “above brand” or “pill plus” initiatives, over and above rebates for contracted products, resulting in a more collaborative environment among stakeholders. Contracts and transactions are no longer the only indicator of a positive relationship.

This shift was due in part to market trends that have required pharmaceutical manufacturers to step up their game. They needed to move beyond a transactional relationship in order to continue to provide value and differentiate themselves and their portfolios from the competition. Because there is such a huge generic market satisfying the needs of many patients with chronic illnesses, payers are relying less on their manufacturer partners to satisfy their formularies. Such market trends include:

  • Genericization of pharmaceutical marketplace
  • New branded agents with marginal improvement over existing therapies
  • Introduction of expensive orphan and specialty products
  • Access to payers and providers being minimized as stakeholders consolidate

This new environmental dynamic presents a great opportunity for our clients to take it up a notch…and where there is opportunity for our clients, there is opportunity for us. It is becoming increasingly important for us to approach tactical planning in a different way. So…what should our clients be doing to reserve a seat at the “pill plus” table?

  • Improve quality of care—focus on patient engagement, care coordination, quality measures, and optimizing the patient experience
  • Provide real world outcomes that demonstrate the value of therapies
  • Focus on developing deeper, more meaningful relationships with payer customers by providing added value through above-brand programs

So, you see, pharma must raise the bar—they must adapt to sustain value over time…because “if you’re not at the table, you’re on the plate.”

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Also posted in Brand Awareness, Customer Relationship Marketing, Healthcare Communications, Learning, Personal Reflections, Pharmaceutical | Tagged , , , , , | 2 Responses
Feb28

How Can Self-monitoring Best Support Behaviour Change?

3907691Some of today’s biggest public health challenges, such as obesity and  heart disease, can be linked to personal lifestyle decisions. Governments have tried tackling these issues with smoking bans and taxes on high-fat foods, with moderate success. However, personal health behaviour change is needed to make a significant, lasting impact. Can self-monitoring of health information be the answer?

Studies in diabetes, hypertension, medication compliance and weight loss have shown that patients who successfully self-monitor their activities and set personal goals enjoy improved health outcomes and better adherence to treatment 1-6. We now have an abundance of apps and wearable technology at our fingertips to comprehensively track numerous aspects of our lifestyle, analyse results and observe improvements over time. These self-monitoring tools can then be easily integrated into social health networks so that we can share experiences, track our progress against that of our peers, and give and receive advice on how to succeed.

It is estimated that there are more than 40,000 health and fitness apps available. But with this bewildering variety of choice, how can we know which ones will encourage lasting behaviour change?

Easy does it

The apps which make the process of data upload as effortless as possible for the end user are the ones most likely to catch on in the long-term. Devices that automatically record data and synchronise it with online analysis programmes in real time provide a seamless transition and are not hampered by general forgetfulness or lack of time.

Keep it simple

Health information needs to be engaging, and simple enough to be universally accessible. The average person is likely to find sorting the data that matters from what doesn’t time-consuming and intellectually daunting—in fact, many patients who have to actively monitor a condition like type II diabetes don’t always fully engage with self-monitoring for these very reasons.7

Be realistic

Establishing aspirational but realistic goals and providing reinforcing feedback can help bring self-monitoring systems to life and make them personally meaningful.  A recent study into self-monitoring to improve diabetes treatment found that the main concerns patients had with the system were disappointment with unmet expectations and difficulty fitting the programme into the demands of daily life. 1

Collaborate

Ideally, fitness or health tracking app developers should collaborate closely with specialist healthcare providers and device makers as well as social scientists who understand how to bring about behaviour change. Such cross-fertilisation could result in truly useful tools that track fitness alongside other health metrics, such as blood sugar levels or medication adherence.

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1.  Barlow J, et al. Self management approaches for people with chronic conditions: a review. Patient Education Counseling 2002;48:177–87.

2.  Benhamou PY. Improving diabetes management with electronic health records and patients’ health records. Diabetes Metab 2011;37(Suppl 4):S53–6.

3.  Dennis EA, et al. Weight gain prevention for college freshmen: comparing two social cognitive theory-based interventions with and without explicit self-regulation training. J Obes 2012;2012:803769.

4.  Parker R, et al. An electronic medication reminder, supported by a monitoring service, to improve medication compliance for elderly people living independently. J Telemed Telecare 2012;18:156–8.

5.  Ralston JD, et al. Patients’ experience with a diabetes support programme based on an interactive electronic medical record: qualitative study. BMJ 2004;328:1159.

6.  Wagner PJ, et al. Personal health records and hypertension control: a randomized trial. J Am Med Inform Assoc 2012;19:626–34.

7.  Choose Control Survey. Choosing to take control in type 2 diabetes. Available at: http://www.diabetes. org.uk/Documents/Reports/Choose_Control_report.pdf (Last accessed May 2013).

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Feb26

Digital Trends Impacting US Healthcare – Infographic

In the past year, digital innovations have brought about new markets and channels for digital health interactions. This infographic is a visual mapping of the technologies and innovations which are already playing a key role in shaping the future of healthcare and the experiences and journeys which surround it.

Of course the ACA is affecting healthcare coverage, but it is also affecting our healthcare experiences by placing increased importance on and driving more frequent interactions with NPs, PAs, and Pharmacists. Additionally, more priority has shifted to consumers to educate themselves and take responsibility for their own health, especially when combined with our growing culture of social media and trust networks, and recent draft guidance from the FDA. Video remains hot, but the trending has shifted to the length of videos patients are consuming, increasing its relevance to pharmaceutical marketers. Mobile and tablets continue to grow rapidly, with and quantified self driving deeper engagement though apps, not just web. Last, but certainly not least, EHR is poised to enter the next phase of meaningful use, setting the stage for a platform shake-out as certification requirements evolve to provide more and deeper data sets to systems of connected health as providers continue to on-board.

Infographic of important technologies that impact digital healthcare marketing.

Infographic of important technologies that impact digital healthcare marketing.

Technology is evolving fast, and healthcare, believe it or not, is keeping pace and even leading the charge on many fronts. Spurred on by government mandates and initiatives, innovative organizations ranging from Google and Apple to Silicon Valley startups like Practice Fusion are quickly carrying the ball forward, sometimes struggling to keep pace with consumer expectations of today’s technology. It’s these digital healthcare innovations which have set the trends affecting us today, and will carry us forward to tomorrow.

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