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The Global Virtual Clinical Trials Market research report studies the key opportunities in the market and the influencing factors that are valuable to the enterprise. The market analysis focuses on the various market segments that are required to witness the fastest business development within the forecasting framework. The report introduces the overall scope of the market, including future supply and demand, the latest market trends, high growth opportunities, and an in-depth analysis of the future prospects of the market. In addition, it provides comprehensive data analysis on risk factors, challenges, and possible new routes in the market.

The research provides a comprehensive knowledge platform for market participants and investors, as well as senior companies and manufacturers active in the global Virtual Clinical Trials market. The report includes market share, gross profit margin, revenue, CAGR value, volume and other key market data, which can accurately show the growth of the global Virtual Clinical Trials market. All statistical data and numerical data calculated using the most mature tools (such as SWOT analysis, BCG matrix, SCOT analysis and PESTLE analysis) are expressed in the form of graphs and charts to obtain the best user experience and clear understanding .
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Competitive landscape:
The report provides a company-level market share analysis based on the company's annual sales and departmental revenue in all target end-use industries. The market is predicted based on a constant exchange rate. The report provides detailed competition and company profiles of the major players operating in the global market.
Manufacturers covered in this report are: LEO Innovation Lab, Covance Inc., CRF Health, Oracle Corporation, Medable, Inc., Paraxel International, Clinical Ink, Inc., PRA Health Sciences, Science 37 and ICON plc
*Note: Additional companies can be included on request.

The report provides detailed information about the industrial base, productivity, advantages, manufacturers and the latest trends, which will help the company expand its business and promote financial growth. In addition, the report also shows dynamic factors, including market segments, market segments, regional markets, competition, key major players and market forecasts. In addition, the market also includes recent collaborations, mergers, acquisitions and partnerships, as well as regulatory frameworks in different regions that affect the trajectory of the entire market. The report includes the latest technological advancements and innovations affecting the global Virtual Clinical Trials market.
Market Segmentation: Polaris Market Research has segmented the Virtual Clinical Trials Market report on the basis of design, by indication, by phase, and region Virtual Clinical Trials Design Outlook (Revenue - USD Million, 2016 - 2027)

Observational Trials

Interventional Trials

Expanded Access Trials

Virtual Clinical Trials Indication Outlook (Revenue - USD Million, 2016 - 2027)

CNS

Autoimmune/Inflammation

Cardiovascular Disease

Metabolic/Endocrinology

Infectious Disease

Oncology

Genitourinary

Ophthalmology

Virtual Clinical Trials Phases Outlook (Revenue - USD Million, 2016 - 2027) An overview of the market's regional outlook:
The Virtual Clinical Trials report provides information about market regions, which are further broken down into sub-regions and countries. In addition to market share in each country and region, this chapter of this report also contains information about profit opportunities. This chapter of the report mentions the share and market growth rate of each region, country, and sub-region over the estimated time period.

North America (USA, Canada)

Europe (Germany, France, UK, Italy, Russia, Spain, Netherlands, Switzerland, Belgium)

Asia Pacific (China, Japan, Korea, India, Australia, Indonesia, Thailand, Philippines, Vietnam)

Middle East and Africa (Turkey, Saudi Arabia, UAE, South Africa, Israel, Egypt, Nigeria)

Latin America (Brazil, Mexico, Argentina, Colombia, Chile, Peru).

Cumulative impact of COVID-19:
The report provides the impact of COVID-19 on the Virtual Clinical Trials market and the impact on the entire industry and the world economy. In addition, since it mainly affects market growth and sales, it increases the changes in consumer buying behavior. The report also adds distributors and traders for marketing strategy analysis, which focuses on regional needs in the covid-19 pandemic. The last part of the COVID-19 impact chapter includes the restoration and major changes selected by the major players in the Virtual Clinical Trials market.
The main features of Virtual Clinical Trials market report:

By determining the growth, size, leading players and market segments of the global Virtual Clinical Trials market, save and reduce the time for entry-level research.

Highlight key business priorities to help the company realign its business strategy.

The key findings and recommendations highlight the vital and evolving industry trends in the global Virtual Clinical Trials market, so that participants in the entire value chain can formulate effective long-term strategies.

Develop/modify business expansion plans by using the massive growth provided to developed and emerging markets.

Carefully study global market trends and prospects, as well as the factors driving the market and the factors hindering market development.

Enhance the decision-making process by understanding strategies that support business interests in customer products, segmentation, pricing, and distribution.

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Polaris market Research is a global market research and consulting company. We provide unmatched quality of offerings to our clients present globally. The company specializes in providing exceptional market intelligence and in-depth business research services for our clientele spread across industry verticals.
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Virtual Clinical Trials Market Prediction After Covid Pandemic And Analysis Offered By Latest Study Report - The Courier

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The Global Virtual Clinical Trials Market research report studies the key opportunities in the market and the influencing factors that are valuable to the enterprise. The market analysis focuses on the various market segments that are required to witness the fastest business development within the forecasting framework.

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HCA Healthcare will be tapping Google's data science expertise to develop new analytics capabilities around patient care and administrative workflows, the major health system announced this morning.

As part of a new multiyear strategic partnership, HCA will be using Google Cloud's healthcare data products-such as the Google Cloud Healthcare API and BigQuery-to support custom-built analytics tools for use in various settings, the companies said.

By doing so, HCA hopes to deliver algorithm-based alerts to clinical staff's mobile devices when a patient's condition takes a turn for the worse. These new capabilities and other workflow tools will come to the 90,000 mobile devices HCA said that it has already deployed across its caregiver teams.

"Next-generation care demands data science-informed decision support so we can more sharply focus on safe, efficient and effective patient care," Sam Hazen, CEO of HCA, said in a statement. "We view partnerships with leading organizations, like Google Cloud, that share our passion for innovation and continual improvement as foundational to our efforts."
RELATED: Beth Israel Deaconess Medical Center joins Ascension to pilot Google's EHR search tool
The partners will also be looking to upgrade non-clinical operations that could benefit from data analytics and insights. HCA's supply chain, human resources, physical plant operations were each named by the companies as potential areas of focus for those efforts.

HCA and Google Cloud's announcement was rife with reassurances of data security and patient safety.

The tech company's named analytics products are built to comply with HIPAA regulations. Further, all access to and use of patients' data "will be addressed through the implementation of Google Cloud's infrastructure along with HCA Healthcare's layers of security controls and processes," the partners wrote.

"The cloud can be an accelerant for innovation in health, particularly in driving data interoperability, which is critical in streamlining operations and providing better quality of care to improve patient outcomes," Thomas Kurian, CEO of Google Cloud, said in a statement. "We are honored to partner with HCA Healthcare on this unique opportunity to be at the forefront of advancing care through the power of real-time data availability to support clinical and operational workflows."

HCA sees 32 million annual patient encounters among the nearly 200 hospitals and roughly 2,000 ambulatory care sites it operates across 20 states and the U.K. The for-profit system recently enjoyed a stronger-than-expected first quarter in which it generated $13.9 billion in revenues and $1.4 billion in profit.
RELATED: Google Cloud teams up with Deloitte, KPMG to launch healthcare interoperability program for providers and payers
HCA characterized the new partnership as its latest push toward data-driven care, highlighting papers its researchers have published in peer-reviewed journals that describe similar algorithm-based clinical decision support tools.

The system also collaborated with Google Cloud last year on the COVID-19 National Response Portal, an open data platform intended to help hospitals and others understand how the novel virus was impacting hospitals.

The new data analytics partnership is the latest such deal between Google Cloud and a large provider. The tech company has been supporting Mayo Clinic's digital innovation efforts since 2019 and just six months ago positioned itself as the lynchpin of Highmark Health's new "Living Health" delivery model.

However, Google has also racked up a few privacy-related demerits in its race against Microsoft and Amazon Web Services to become the go-to cloud and analytics partner of the healthcare industry.
RELATED: Microsoft updates Cloud for Healthcare with new virtual care, patient monitoring features
Last year lawmakers pressed Google and Ascension on a controversial data deal announced in 2019, in which the health system shared personally identifiable information on millions of patients without first notifying those patients or their doctors. Ascension announced that it was continuing to move forward with that partnership a few months ago.

Another deal between Google and the University of Chicago Medical Center also drew data privacy critiques and a lawsuit-which was tossed out by a federal judge last September in a win for the tech giant.

In response to today's announcement, Arielle Trzcinski, a principal analyst at Forrester who focuses on digital business in healthcare, reiterated the need for deidentification and other privacy measures with these types of analytics partnerships. She also stressed that any large-scale use of health data should, first and foremost, aim to benefit the patients who are contributing their sensitive information.

"Healthcare organizations and big tech need to be mindful of data governance in these initiatives," she told Fierce Healthcare in a statement. "Do not collect data for the sake of collecting data-it must have a purpose; it must deliver value to the stakeholders benefiting from the output of the algorithm."

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Google Cloud to beef up HCA Healthcare's clinical, operational data analytics in new multiyear partnership

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HCA Healthcare will be tapping Google's data science expertise to develop new analytics capabilities around patient care and administrative workflows, the major health system announced this morning. As part of a new multiyear strategic partnership, HCA will be using Google Cloud's healthcare data products-such as the Google Cloud Healthcare API and BigQuery-to support custom-built analytics tools for use in various settings, the companies said.

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A few years ago, attending a tech conference that catered to an industry-friendly audience, I listened as a venture capitalist praised the upcoming possibilities for growth in the U.S. health care market. This V.C., who invested mostly in bioscience companies, was exultant at the possibility that personalized genetic mapping and other innovations would allow people to spend even money on health care, purchasing everything from customized nutritional supplements to advanced targeted cancer treatments. The result would be great profits for people like him and the companies in which he invested, as health care would become as personalized and consumer-driven as shopping for clothes online.

Consumer choice and bespoke vitamin packets with your name printed on them are not solutions to much of anything in American health care; fancy artificial intelligence diagnostic tools and online pharmacies have not solved the essential problem of provisioning and accessing care. Yet Silicon Valley acts as if it is an innovation or two away from solving the problem-made glaring and overwhelming during the Covid-19 pandemic-of furnishing something like universal health care.

Whether it believes its own rhetoric-or just smells another profit opportunity-the tech industry shows little sign of slowing its march into the world of commercialized medicine. Following years of rumor and hype about its health care intentions, it was reported this week that Amazon may soon launch brick-and-mortar pharmacies. Amazon also has a forthcoming public health care offering known as Amazon Care, in which it will offer telemedicine and in-person care. That program has already been available to Amazon employees for about 18 months.

Amazon isn't alone. Microsoft has a data initiative with Providence St. Joseph Health, which operates dozens of hospitals in the United States. In 2019, Google signed a deal with the Mayo Clinic to manage and parse health records for "insights," explaining that cloud computing and data analytics would provide better performance. Google also reached an agreement this week with HCA Healthcare, a large hospital chain, to mine patient records to develop algorithms that might improve care. Like many Google initiatives, it's essentially a data grab. "Data are spun off of every patient in real time," HCA's chief medical officer told The Wall Street Journal. "Part of what we're building is a central nervous system to help interpret the various signals." This "nervous system" may help hospitals better handle digital medical records or diagnostic data, but it will also serve to implant Google, or companies like it, at the digital heart of operations for medical facilities all over the country.

And i n the case of Amazon, this isn't its first effort to "disrupt" health care. Earlier this year, a health care consortium known as Haven, which was funded by Amazon, Berkshire Hathaway, and JP Morgan, folded after accomplishing nothing in three years. At the time, a spokesperson told CNBC that Haven produced useful insights that would yield advantages for its partners' individual initiatives: "The Haven team made good progress exploring a wide range of health care solutions, as well as piloting new ways to make primary care easier to access, insurance benefits simpler to understand and easier to use, and prescription drugs more affordable."

This bloodless technocratic language should sound familiar: It's the same attitude exhibited by the V.C. at that tech conference a few years back, and it is totally removed from people's fundamental material needs. There's talk of ease of access and furnishing better care but little discussion of what really matters: universal care that's free at point of service. Nor do Silicon Valley's would-be health care entrepreneurs evince much concern for concepts like health care justice, reproductive rights, or repairing systemic inequities. New algorithms may hold out promise for processing masses of medical images , but even these supposed breakthroughs come with deficiencies, often owing to biased training data. One study New England Journal of Medicine that algorithms used in a variety of medical contexts can reinforce racial biases, compromising care. In this arena, "disrupting" health care doesn't mean repairing a broken system; it means leveraging that system's vulnerabilities to innovate new delivery systems and new forms of profit.

That V.C.'s dream of Americans spending more of their income on health care may have been ghastly in its insensitivity to people's real concerns, but it remains a sad market reality. U.S. health care spending grows consistently, reaching per person in 2019. Insurance premiums-and insurance company profits-have far faster than workers' wages. One study that Americans now spend double on health care what they did in the mid-1980s. Tales of Americans refusing health care for fear of bills-passing on an ambulance ride or delaying treatment for an acute condition-are legion. Medical bills remain one of the leading contributors of consumer bankruptcy -a novelty for large swathes of the world where no one must pay for medical care, much less risk bankruptcy.

The solution, as it's long been, is clear: a universal health care system that provides free care. The principle is as simple as the fire department or the local library-shared services that everyone pays into and are free when they need them-but it's one that would likely be lost on most politicians today. (If public libraries were proposed now for the first time, how many Democrats would join Republicans in voting against them?)

Bracketing social justice concerns for a moment, advocates and policy experts have known for years that universal, free, government-provisioned health care would save consumers and the government money. On neoliberal logic alone, it makes sense-which is why venture capitalists fear it. As a result, the tech industry, seeking its own share of the rentier's pie, would rather speak of novel public-private partnerships and unexpected insights garnered from parsing millions of private medical records. These initiatives do nothing for a diabetic patient struggling to afford insulin or a new parent drowning under five-figure medical bills. There is only one way to solve our broken health care system: make it accessible and free for everyone. By America's hypercapitalist standards, that would be an innovation beyond anything we've yet seen.

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A few years ago, attending a tech conference that catered to an industry-friendly audience, I listened as a venture capitalist praised the upcoming possibilities for growth in the U.S. health care market.

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The Department of Veterans Affairs' achieved a major milestone Saturday in its decadeslong, multibillion-dollar effort to upgrade its aging health IT systems.

Mann-Grandstaff VA Medical Center in Spokane, Washington, went live with a new Cerner EHR system this weekend, the first site as part of VA's massive medical records project.

It marks progress in the latest effort to upgrade the VA's system, a $16 billion technology project that's been plagued by delays, leadership turnover, and infrastructure problems since it kicked off in 2018.

According to Mann-Grandstaff officials, the transition to Cerner's EHR means veterans receiving care at the facility and at its outpatient clinics will use the new My VA Health online portal to schedule, review and cancel health appointments, refill their prescriptions, send secure messages to their VA providers, and manage their current health records.

The VA twice-delayed the initial roll-out of the Cerner EHR at the Spokane facility. The VA decided in mid-February to push off its go-live date for the new EHR at its first VA hospital.

The VA had planned to flip the switch on the new EHR at Mann-Grandstaff VA Medical Center in Spokane, Washington on March 28. The VA then said it was delaying those plans to commence end-user training.
RELATED: Federal watchdog says VA's March EHR go-live date was 'unrealistic'
In early April, the VA hit pause against on its $16 billion electronic health record overhaul due to the COVID-19 pandemic. The department restarted the project in August.

The pandemic delays bought VA valuable time to improve the EHR, even if the department won't launch with a full suite of capabilities all at once. It plans to deploy a second of two capability sets in Spokane next spring, Federal News Network reported, citing Laura Kroupa, chief medical officer for VA's Office of Electronic Health Record Modernization.

"We worked on interfaces. We worked on improving our training posture," Kroupa said last week during Cerner's 2020 virtual summit, Federal News Network reported.

In a statement issued Friday, House Veterans Affairs Technology Modernization Subcommittee Ranking Member Jim Banks, R-Indiana, said he was "cautiously optimistic" the go-live would be a success.

"Tomorrow's initial go-live is the beginning of a long journey, and in all likelihood, the challenges will become more numerous moving forward," Banks said. "I am committed to rigorous oversight, transparency, and accountability to the public every step of the way."

Banks added, "This effort is about much more than new software. It represents the opportunity for veterans and service members to control their own health information and health care decisions, and it offers the potential for VA and DoD not just to keep pace with the marketplace but lead innovation in the whole health care sector."
RELATED: VA launches new patient scheduling tool as part of massive Cerner EHR project
House Veterans Affairs Committee Ranking Member Phil Roe, R-Tennessee, praised the go-live at Spokane, noting that it marked "real progress" in the VA's EHR project.

"I know from personal experience that any electronic health records implementation is difficult and disruptive, even in a single medical practice, and the VA health care system stands alone in its size and complexity," he said.

Government watchdogs and Congressional leaders continue to have concerns about the project including infrastructure issues and leadership challenges.

A VA inspector general report released in April found that VA medical centers require significant upgrades to physical and information technology infrastructure in preparation for the EHR implementation.

The VA signed a $10 billion deal with Cerner in May 2018 to move from the VA's customized VistA platform to an off-the-shelf EHR to align the country's largest health system with the Department of Defense, which has already started integrating Cerner's MHS Genesis system.
RELATED: VA asking for $1.2B more to continue Cerner EHR project
For the VA, the Cerner EHR will replace the approximately 130 operational instances of VistA currently in use across the department. While the initial EHR contract signed with Cerner was for $10 billion, the VA has pushed the estimated 10-year cost for implementing the system past $16 billion.

In preparation for the go-live in Spokane, the VA in October transferred clinical and demographic data for approximately 88,000 veterans into the new EHR system, which provides doctors with a longitudinal view of patient information, VA officials said.

In August, the department launched its new patient appointment system at sites in the VA Central Ohio Healthcare System. In April, VA and the DOD unveiled a joint health information exchange to enable medical providers at both agencies to share patient data with each other and with private sector healthcare organizations.

The VA's electronic health record modernization program will continue over the next several years. The agency plans to have the software in place nationwide at all VA facilities by 2028. The VA operates 170 hospitals and also provides care at 1,074 outpatient sites.

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First VA medical center (finally) goes live on Cerner EHR as part of $16B project

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The Department of Veterans Affairs' achieved a major milestone Saturday in its decadeslong, multibillion-dollar effort to upgrade its aging health IT systems. Mann-Grandstaff VA Medical Center in Spokane, Washington went live with a new Cerner EHR system this weekend, the first site as part of VA's massive medical records project.

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Key Takeaways

It's soon going to be easier to read your doctor's notes from your last visit thanks to a measure to improve patient record transparency. Starting in April 2021, all medical practices will be required to provide patients free access to their medical records. The concept of sharing medical notes is known as OpenNotes.

Under the 21st Century Cures Act, consumers will be able to read notes that recap a visit to the doctor's office as well as look at test results electronically.

In the past, accessing your doctor's notes could require long wait times and fees. The Health Insurance Portability and Accountability Act (HIPAA) made it legal to review medical records, but it didn't guarantee electronic access.

More than 250 healthcare organizations in the U.S. (including multiple locations within a single system) are already sharing notes with patients digitally.

What Is OpenNotes?

With OpenNotes, doctors share their notes with patients through electronic health records (EHR). Practices and hospitals use various kinds of software for EHRs, such as MyChart. Once the mandated medical transparency measure goes into effect, patients will be able to log in and see their notes.

The mandate was supposed to begin on November 2, 2020, but in the midst of the COVID-19 pandemic, the deadline was extended to April 5, 2021.

Doctor's notes will include consultations, imaging and lab findings, a patient's medical history, physical exam findings, and documentation from procedures.

Cait DesRoches, executive director of OpenNotes (a group advocating patient note access), explains that patients will have two ways to get their notes. Either the organization will put the notes on the portal automatically or a patient can request that notes be added to the portal.

"The notes are full of great information for patients," DesRoches tells Verywell. Viewing the notes can help patients recall what they discussed with their doctors during a visit as well as remind them of what they're supposed to do after an appointment.

"My hope is that organizations will implement this in a really robust way," DesRoches says. "That's when the health system will get to the place where they're seeing the benefits.

What This Means For You

Downsides of Data Sharing

The ability to view documentation from medical care sounds like a great opportunity for patients, but some worry that it could create confusion. For physicians, there's also the potential for an increased workload, as they might need to respond to questions that arise when patients see-and question-what's in their notes.

UC San Diego Health launched a pilot program using OpenNotes for primary care patients in 2018. Marlene Millen, MD, a professor and doctor in the UC San Diego Health , told MedicalXpress that she did not see an increase in inquiries from patients when their notes were available.﻿﻿

What To Know About Doctors' Notes

There are some cases when a doctor does not have to share medical notes with patients. These scenarios are different state by state, as privacy laws vary.

Doctors can withhold medical records if they think releasing the information will lead to physical harm, such as in the case of partner violence or child abuse.

Providers also do not have to share information regarding certain diagnoses that are considered protected, and psychotherapy documentation is not shared. However, other mental health services outside of talk therapy -such as talking to your primary care doctor about depression-are included in the notes.

Depending on the state you live in, DesRoches explains that parents can also view notes of their teen's doctor visits. Parents might not have access when teens turn a certain age, based on the state. However, the rules don't supersede state laws on privacy for adolescents.

Evaluating OpenNotes

OpenNotes.org reports that reading doctors' notes benefit patients in many ways and may lead to better health outcomes. According to OpenNotes, patients who are able to review their doctors' notes:

Are more prepared for visits with their providers

Can recall their care plans and adhere to treatment, including medication regimens

Feel more in control of their care

Have better relationships with their physicians

Have a better understanding of their health and medical conditions

Take better care of themselves

Several studies have assessed OpenNotes. A study published in the journal BMJ Open in September 2020 found that medical transparency is a right that is viewed favorably among people in different countries including Canada, Australia, Japan, Chile, Sweden, and the U.S.﻿﻿

Another study published in the Journal of General Internal Medicine in July 2020 found that patients typically understand their doctor's notes and that the information in their record is accurate.﻿﻿ However, there were several notable disparities, and participants in the study had suggestions for improving the quality of access.

According to a report in NEJM Catalyst, the ability to exchange information-including requesting information from patients before a visit-has been instrumental during the COVID-19 pandemic.﻿﻿ In addition to sharing notes with patients after a visit, doctors were able to send a pre-visit questionnaire to patients that enabled them to gather more detail before the visit.

"We suspect, for example, that patients and care partners may recall even less of telemedicine encounters than they do after face-to-face office visits," the authors noted. "As a result, they may turn more often to reading their OpenNotes online."

The researchers concluded that once there are patient- and clinician-friendly mechanisms in place for record-sharing, "inviting patients to contribute directly to their records will both support patient engagement and help clinician workflow."

Advantages and Disadvantages

Wayne Brackin, CEO of Kidz Medical Services, tells Verywell that it is "fair and reasonable" to expect patients would have access to doctors' notes. However, Brackin is concerned that doctors could "moderate their description in a manner that might affect care," if they know that the patient or family will have access to records.

Wayne Brackin

"This could be particularly sensitive with behavioral health issues," Brackin says, adding that a medical interpreter of sorts could help avoid misunderstandings during the initial record review. The language, abbreviations, and terminology in physician notes can be difficult for trained medical colleagues to interpret, let alone patients.

"To have a layperson, with a more limited vocabulary, or who has English as a second language, read the notes in isolation could lead to misunderstandings," Brackin says.

Suzanne Leveille, RN, PhD, a professor of nursing at the University of Massachusetts and a member of the OpenNotes.org team tells Verywell that patients are generally enthusiastic about having online access to their office visit notes, but many providers initially expressed concerns that giving patients access to their notes could cause more worry than benefits.

"Our large surveys across health systems have not shown this to be the case. Very few patients report they became worried or confused from reading their notes," says Leveille, who also authored one of the OpenNotes' studies. "Overwhelmingly, patients report they benefit from note reading, for example, that it's important for taking care of their health, feeling in control of their care, and remembering their plan of care."

While concerns about misunderstandings are not unwarranted, most patients report they are able to understand their notes, and that they have benefitted from viewing them. In cases where patients have been able to spot-and correct-mistakes, they feel not just more empowered, but safer.

"Open notes can improve patient safety," Leveille says. "About 20% of patients pick up errors in the notes and some report the errors to their providers."

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Patient Access To Medical Records Is Set To Become Mandatory

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It's soon going to be easier to read your doctor's notes from your last visit thanks to a measure to improve patient record transparency. Starting in April 2021, all medical practices will be required to provide patients free access to their medical records. The concept of sharing medical notes is known as OpenNotes.

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MS patients most likely to engage with self-reported tracker if referred by a doctor

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A study published in JMIR found that patients with multiple sclerosis were able to capture real-world, self-reported data via an app.

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Q: Can you share what you've seen in the healthcare industry? What possibly works best in closing these healthcare experience gaps? Lastly, what do you feel are the best practices in creating a better patient-engagement strategy?
A: We've seen a lot to be quite frank. We have a lot of healthcare clients and we have a solution that's very secure around the data. If you want to know all that's knowable about someone's health, you need all the data on their health. If you want to know all that's knowable on a consumer, you need all the data on the consumer. So from that standpoint, I've seen companies that do a really good job of knowing all this.

We have clients that start with nothing - no database and no way to engage if they did. I also see customers who've gone down the journey. They've been on it for 2, 3, 4 years, always thinking about the customer-centric approach and everything they built. In that scenario, what I can tell you is there's a lot of hope because right now, we have a customer. That is what I say of generation two: they've married the payer with the provider. So now, all of the ways that you pay for the care that needs to be there, is in it together with where you're going to get the care. So essentially, that relationship is incentivized to take care of the patient's health. That's what value based care is. I'm not going to pay you fee for service for $1, I'm going to pay you for improving the patient's health.

So, providers are using the business model taking down the silos and having the same goals around changing the experience for the patient. I'll tell you why. What happens is, let's say the ACA market or individualized plan is for people who are either not working, have a small business, or they are low income, and they need to be able to get assistance to purchase insurance. Well, they also typically are the most unhealthy because they've never had insurance. They couldn't afford to go see the doctor, so instead of going into a bad healthcare experience, they're being sent to the brand new way that new doctors that are only focused on their health. Their first experience right out of the gate with healthcare is positive.

Now, here's the other thing. Some of these people speak English, some speak Spanish, right? So there's doctors who speak English, and they speak Spanish. Some people who speak Spanish prefer to be spoken to in Spanish in one way with certain groups, and they prefer to speak English with other groups. How do you know that? Well, we know that because we have consumer data, they tell us, they interact with us different ways. So this new healthcare company that I'm talking about, they send out language and videos and anything that the patient's language and the way the patient wants to see it. So that's how it starts. And now all of a sudden, you build trust with the patient, you build trust with the consumer. What happens when you build trust with someone, they give you more information, more data about them, right. And so now it's a full circle, all works together, everyone's working together. So that's what I'm seeing work in, in the industry.

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The Best Practices in Creating a Patient-Centric Health System According to Chris Evanguelidi of Redpoint Global

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Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Chris Evanguelidi, head of healthcare at Redpoint Global, about the best practices for closing the healthcare experience gap and devising an effective patient engagement strategy through a more patient-centric health system.

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Game-changing tool adds to tele-health technology at Henry Ford

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In Kas Kasravi's role as a patient adviser at Henry Ford Health Systems, he was excited to test the Tyto Care telemedicine tool. The West Bloomfield professor and inventor, who has a technology background, was curious. He set up a visit with his primary care doctor who fortunately also used the tool.

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Thirty-five percent of adults in the United States who were surveyed said they would consider leaving their primary care physician for qualified physicians providing on-demand telehealth services.

This percentage was even higher - 50% - among Generation Z and millennials, according to the data. Older adults also expressed interest in telehealth services, with 48% of respondents aged 65 years and older reporting that they will likely continue to use telehealth after the COVID-19 pandemic.

The data are from a series of surveys conducted by The Harris Poll from March 15, 2020, to March 15, 2021. Each survey was administered to a nationally representative sample of about 2,000 U.S. adults.

The results further showed that Hispanic respondents (52%) were most likely to consider using on-demand telehealth as a replacement for their PCP, followed by Black respondents (43%), Asian respondents (40%) and white respondents (32%).

About half of all the respondents said that telehealth appointments are useful for inquiring about medical questions (53%), reviewing test results (48%) and refilling prescriptions (46%). However, only 34% said they use telehealth when they are ill, and just 15% use it when their child is ill.

Most respondents (76%) reported that they would miss in-person visits if their PCP switched to mostly telehealth, and 42% said they prefer a hybrid model - "a mix of both telehealth and in-person" visits, according to the survey.

The role of telehealth in primary care

G. Caleb Alexander, MD, a practicing internist and professor in the department of epidemiology at the Bloomberg School of Public Health, and colleagues reported that in 2019, less than 2% of primary care visits in the U.S. were conducted through telehealth.

Now it accounts for a much larger proportion of visits, with one-fifth of primary care clinicians using phone or video for at least half of their patient encounters during the pandemic, according to a survey conducted by the Primary Care Collaborative and Larry A. Green Center. Among more than 750 primary care clinicians in the U.S. and Guam who responded to the survey, 45% said they are encouraged to use telehealth because patients "really like it," and 67% are encouraged to use it to meet patients' needs. Still, 46% of clinicians said they are concerned about misdiagnoses because of the lack of in-person care, and at least one-fifth of patients lack access due to limited computer literacy (57%) and broadband (35%).

Before the pandemic, Yalda Jabbarpour, MD, a family physician in Washington, D.C., and medical director of the Robert Graham Center for Policy Studies, and colleagues estimated that 69% of primary care office visits required an in-person encounter. The researchers used data from the 2016 National Ambulatory Medical Survey to assess the proportion of primary care visits that were amenable to telehealth.

"Most in-person need is driven by wellness visits, though treatment of certain acute and chronic conditions also requires in-person visits," Jabbarpour and colleagues wrote in the Journal of the American Board of Family Medicine.

The researchers noted that about 90% of immunizations and annual wellness visits occurred in primary care offices, as well as one-quarter of pelvic exams and one-third of Pap tests. Patients with chronic conditions, including hypertension, coronary artery disease and diabetes, "were less likely to have visits amenable to telehealth modalities," the researchers wrote. Some potential reasons for in-person visits include foot exams among patients with diabetes, as well as neurological and retinal exams, according to the researchers.

"Although telehealth is appropriate for certain visits and likely will be integrated into practice post-COVID-19, it cannot replace traditional care for all primary care-sensitive issues," Jabbarpour and colleagues wrote.

Benefits and limitations

Rita K. Kuwahara, MD, MIH, an internal medicine resident physician caring for patients at a federally qualified health center and a member of the Healio Primary Care Peer Perspective Board, recently conducted a small quality improvement project to evaluate the opportunities and limitations of telehealth. She found that there were "certain conditions that lend themselves to telehealth, others where an office encounter would be preferable, and others where hybrid options would be ideal."

Kuwahara said that interim telehealth check-in visits to adjust medications in between scheduled in-person visits may work well for a subset of patients with diabetes or hypertension who have resources to regularly monitor their glucose and BP at home.

"For patients who do not have a glucometer or a BP cuff at home, it becomes much more challenging, even for brief follow-up phone or video telehealth appointments to determine if a patient's medications require further adjustment following an in-person PCP visit," she said.

Kuwahara also warned that telehealth is not ideal for evaluating certain symptoms such as chest pain, shortness of breath, loss of consciousness, ear pain, sore throat and musculoskeletal pain, and "phone-only visits make it practically impossible to evaluate symptoms such as rashes."

"Those sorts of conditions are much more conducive to face-to-face encounters, where you can better evaluate a patient by performing a physical exam and have the option to check blood pressure, conduct an in-office EKG or provide a point-of-care service or testing, such as checking HbA1c or urinalysis, in order to better manage the patient during the office visit," she said.

Telehealth may also pose a challenge to providing high-value care, as physicians may be more likely to order extra tests or overprescribe medications such as antibiotics because they were unable to conduct a physical exam or did not have access to point-of-care testing, Kuwahara said.

"For patients who choose telehealth visits over in-person office visits, we must develop robust systems to support hybrid models of care to ensure that patients with telehealth appointments still get necessary in-person follow-up services such as lab testing and immunizations following their virtual visit," she said.

For example, Kuwahara stressed that patients "must be given clear instructions and reminders regarding where to have their ordered testing, imaging, and/or vaccines performed, and clinics must partner with pharmacies and testing sites to ensure that services such as vaccinations, labs and imaging ordered by the physician but performed at off-site locations have automated processes to communicate vaccine administration records and/or test results back to the patient's clinic."

While telehealth visits may eliminate transportation barriers for some patients, Kuwahara said that many patients lack access to high-speed broadband internet services. She also noted that many of her patients do not have smartphones or cell phone plans that include adequate monthly data or talk time allowances, "making it much more difficult for these individuals to engage in telehealth care."

"For these patients, video visits often fail due to an unstable internet connection or patients' lack of access to electronic devices with a camera, and these visits must be switched to phone-only audio visits due to technical issues," she said. "In addition, for patients whose primary language is not English, video visits often fail because patients cannot hear the phone interpreter who is connected to a video call, and these visits must be switched to three-way, phone-only visits to ensure that the patient, provider and interpreter can all hear and understand one another to prevent medical errors from occurring. Further, patients with hearing impairment often struggle with telehealth appointments, making virtual visits much more challenging for them."

Regarding the benefits of telehealth, Kuwahara noted that in addition to eliminating transportation barriers for some patients, video visits give physicians the opportunity to develop "a more comprehensive understanding of the patient by essentially allowing physicians to perform virtual home visits, enabling them to better understand the social factors contributing to patients' health outcomes." Physicians can better understand medication routines, obtain a more accurate medication reconciliation and provide nutrition counseling that is specific to the food in patients' homes, "if patients are able to show their physicians which medications and doses they currently have at home, how they organize their medicines or pillboxes and what foods they have recently been eating at home," Kuwahara said. The presence of housing or food instability can also become apparent during these visits, allowing "physicians to better support their patients by linking them with social workers to address patients' social determinants of health," she added.

"I think finding a balance between the benefits and limitations of telehealth care is what is most important," she said. "Once we know what that balance is, having the flexibility to provide the best care to patients and be able to practice in a hybrid environment will be vital, and ensuring that there are policies to support all those initiatives will be critical."

Continuation of telehealth support

From Kuwahara's perspective, now that physicians and patients have had more experience with telehealth, it is here to stay in some capacity; however, one constraining factor is whether policies will allow telehealth reimbursement to continue beyond the public health emergency.

"There needs to be action from Congress, but HHS also has power to determine which telehealth provisions are allowed once the current public health emergency ends," she said. "There are some pieces of legislation that have been introduced to address issues of ongoing telehealth support, both during the public health emergency and also afterwards. There is a lot of interest in allowing telehealth to continue, but whether or not this will be something that is here to stay and to what extent will be based on what is allowed in terms of policies that are implemented."

In December 2020, CMS announced that 60 of the 144 telehealth services that were newly offered during the COVID-19 pandemic will become permanent, including services for group psychotherapy, cognitive assessment and care planning, psychological and neuropsychological testing, and domiciliary, rest home or custodial care services for established patients. In addition, CMS finalized a list of services that will be included under Category 3, which consists of services added during the pandemic that will remain covered until December 21, or until the end of the calendar year when the COVID-19 public health emergency is declared over. These telehealth services include home visits for established patients, certain ED visits, nursing facilities discharge day management, critical care services, inpatient neonatal and pediatric critical care, and physical and occupational therapy services.

CMS also finalized the decision that direct supervision in telehealth visits can be provided with interactive audio and video technology through the end of the year that the pandemic ends or December. The public health emergency was previously set to expire on April 21, but HHS Secretary Xavier Becerra extended it for at least another 90 days through July 21, according to the Primary Care Collaborative. CMS told Healio Primary Care that there have been no changes in its telehealth policies since the December 2020 announcement.

Kuwahara said that legislation has been introduced in the House and Senate to support the continuation of telehealth services. One provision that is critical to include from a health equity and patient safety standpoint is ensuring that permanent policies are in place beyond the current public health emergency to allow reimbursement for audio-only phone visits that do not require a video component, according to Kuwahara. During the current public health emergency, she said that "allowance and reimbursement for audio-only telehealth visits has been vital to providing necessary care to patients with limited access to broadband internet services and for patients whose primary language is not English, where it is necessary to engage phone interpreters in a three-way call during the encounter."

"It's really important to advocate for our patients when it comes to providing telehealth services in ways that allow equitable access to care," she said. "It is important for physicians and other providers to speak to their members of Congress and with the leadership at HHS to describe the current issues that their patients face, as well as advocate for the importance of providing ongoing coverage of allowances such as audio-only telehealth services for patients beyond the public health emergency. Maintaining a hybrid model of audio, video and in-person office visits would likely be the most beneficial route so that we can best tailor care to our patients' needs to reduce existing inequities and improve our patients' health outcomes."

References:
Alexander GC, et al. JAMA Netw Open. 2020;doi:10.1001/jamanetworkopen.2020.21476.
CMS. Final policy, payment, and quality provisions changes to the Medicare physician fee schedule for calendar year 2021. https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-1. Accessed April 2, 2021.
Jabbarpour Y, et al. J Am Board Fam Med. 2021;doi:10.3122/jabfm.2021.S1.200247.
Primary Care Collaborative. Primary care & COVID-19: Round 27 survey. Available at: https://www.pcpcc.org/2021/03/22/primary-care-covid-19-round-27-survey. Accessed May 10, 2021.

Primary Care Collaborative. Public health emergency extended. Available at: https://www.pcpcc.org/2021/04/29/public-health-emergency-extended. Accessed May 10, 2021.

The Harris Poll. The great awakening. Available at: https://theharrispoll.com/wp-content/uploads/2021/03/Harris-Poll-COVID-1-year-FINAL-3.pdf. Accessed May 10, 2021.

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How will PCPs use telehealth after the COVID-19 pandemic?

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Thirty-five percent of adults in the United States who were surveyed said they would consider leaving their primary care physician for qualified physicians providing on-demand telehealth services. This percentage was even higher - 50% - among Generation Z and millennials, according to the data.

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The answer largely depends on whether Medicare and private health insurers will adequately cover virtual doctor visits once coronavirus outbreaks subside.

While David Collins of Houston appreciates the ease of telemedicine, he sometimes prefers an in-person doctor's visit. "If you break your arm, an e-visit isn't going to help you at all," he said. Credit... Callaghan O'Hare for The New York Times

Telemedicine is having its moment. Over the last few months, millions of people have relied on video or telephone calls to talk to their doctors. But as the pandemic moves across the United States, and eventually recedes in some places, how long will the moment last?

While patients used virtual visits to avoid overcrowded and potentially infectious doctor's offices or emergency rooms, many are returning to face-to-face appointments in cities where the threat has subsided.

And insurance payments for telehealth services, especially at full cost, may only be temporary.

Medicare's coverage of a broad range of services is slated to end when the coronavirus no longer poses a public health emergency. Private insurers, which followed the federal government's lead, could revert to paying doctors for virtual visits at a fraction of the cost for traditional visits, if anything at all.

Some of the nation's biggest insurers, like UnitedHealthcare and Anthem, say they haven't decided beyond September or October on whether to extend the policies they adopted that allowed for coverage in lieu of doctors' visits during the coronavirus crisis.

"The concern everyone in the industry has is that reimbursement is in jeopardy," said Dr. Mia Levy, the director of the cancer center at Rush University Medical Center in Chicago, which treated patients virtually during the height of the pandemic. "Because of telehealth, we were able to stay actively engaged with our patients," she said.

While there is broad bipartisan support for telehealth coverage, Congress would have to pass specific legislation to make some of Medicare's changes permanent.

"Reversing course would be a mistake," said Seema Verma, the administrator for the federal program, which reimbursed doctors the same for virtual visits, including those over the telephone, as for in-person ones and relaxed rules about who can use telemedicine.

About nine million people under traditional Medicare used telemedicine services during the early months of the crisis. Early data does not show wide variations in use by race or ethnicity.

"It was really a no-brainer for us," Ms. Verma said.

And spending on telemedicine services during the first peak of the coronavirus pandemic in the United States underscores the demand. In addition to federal spending through Medicare, nearly $4 billion was billed nationally for telehealth visits during March and April, compared to less than $60 million for the same two months of 2019, according to FAIR Health, a nonprofit group that analyzes private health insurance claims.

But to convince insurers they should continue paying for virtual care, doctors must demonstrate they can move beyond treating simple respiratory infections to caring for patients with chronic conditions like depression or diabetes. "From the perspective of managing the cost and quality, there's a lot we don't know about telemedicine," said Dr. Rahul Rajkumar, the chief medical officer at Blue Cross Blue Shield of North Carolina.

BlueCross BlueShield of Tennessee says it is the first major insurer to make coverage of telehealth services permanent, but it has not yet determined how much it will eventually pay for the care. A few insurers, including Cigna and the Blue Cross plan in North Carolina, said they will continue to cover telehealth services at pandemic levels through the end of the year.

"We need to give providers time to get more comfortable," said Dr. Scott Josephs, the chief medical officer for Cigna. To make remote medicine successful and worthwhile, doctors and medical groups need to invest in technology and train staff. "If they don't have the time, they won't make the investments," he said.

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Dr. Meeta Shah taking telemedicine calls at Rush University Medical Center in Chicago in March. Credit... Danielle Scruggs for The New York Times

The biggest hurdle to widespread adoption by both the government and insurers is the potential cost.

Lawmakers are reluctant to pass any bill that would significantly add to Medicare's budget, with the government already spending a total of some $750 billion a year.

And private insurers see telemedicine as a way to save them money, said Sabrina Corlette, a research professor at Georgetown University, who helped author a recent report on how the companies responded to the pandemic. "Unless they are required to by the states or federal government, a lot of carriers will try to reimburse less for telehealth than an in-person visit," she said.

For those at risk, telemedicine is particularly valuable. When a fever sent Susan Varak, 45, who has breast cancer, to the emergency room during the height of Chicago's outbreak in April, she felt as if she were "walking into this war zone," she said, because she was so terrified of catching the virus.

She appreciates she still can see her oncologist remotely. "I don't think it's absolutely necessary to be face-to-face every couple of weeks," she said.

Other patients like the convenience. David Collins, 67, didn't have a choice when he had a 20-minute video visit in March to rule out a diagnosis of coronavirus. Like many practices during the pandemic, the Kelsey-Seybold Clinic, a large physician group in Houston, was not allowing most patients to come in.

"I loved it because it saved me a lot of time." he said, adding "I'd much rather do that than drive across town and look for parking."

But, a few months later, he didn't hesitate to go to the clinic for his checkup. "There's a little more hands-on required," he explained, like getting a physical exam and having his blood pressure taken. Not everything can be done virtually, he said. "If you break your arm, an e-visit isn't going to help you at all," he said.

After seeing about 90 percent of its patients virtually, Kelsey-Seybold has "almost flip-flopped back," said Dr. Donnie Aga, an internist who oversees telehealth for the group. Most patients seem to prefer an in-person appointment. "You could really see that people missed coming in," he said.

With coronavirus cases now at epidemic levels in Texas, the clinic wants to shift to dividing visits to half virtual, half in person. "You've got to have a balance, for sure," Dr. Aga said.

But how doctors and insurers can do that is still unknown.

"We need to see where the equilibrium ends up," said Dr. Andrea Gelzer, the corporate chief medical officer for AmeriHealth Caritas, a Medicaid managed care company. "If the total number of visits far exceeds pre-Covid, I don't think that's sustainable," she said. Additional visits that do not improve patients' health will only result in higher costs.

Dr. Donnie Aga oversees telehealth at Kelsey-Seybold in Houston, which has seen telemedicine rise and fall in waves since the pandemic began. "You've got to have a balance, for sure," he said. Credit... Callaghan O'Hare for The New York Times

Doctors have to be more discriminating about which patients to see remotely, said Rita Numerof, a health care consultant.

Telemedicine "was a solution to an immediate problem," she said, and doctors did not have clear criteria about who should be seen, under what circumstances and for which conditions.

Many in Congress are already convinced that Medicare should continue the current coverage. "The Covid-19 pandemic has been a trial by fire, but the experience to date has made clear that the health care system is ready for broader access to telehealth on a permanent basis," said Sen. Ron Wyden of Oregon, a Democrat who introduced legislation earlier this month.

On Thursday, Sen. Lamar Alexander of Tennessee, a Republican and chair of the Senate health committee, introduced the Telehealth Modernization Act, which would also make some changes permanent. The experience of the previous four months "will likely mean that hundreds of millions of physician-patient visits will be remote or online that were in-person before," he said.

Since May, nearly 20 telemedicine bills have been brought to the House floor and about the same number in the Senate, said Miranda Franco, a senior policy adviser for the law firm Holland & Knight. She thinks legislation will be passed by the end of the year.

While some lawmakers favor permanently expanding Medicare payment for a broad range of telemedicine services, others are concerned about the technology's cost and potential for fraud. "Now you're talking about reimbursing services we haven't reimbursed before," Ms. Franco said.

Some patients say telemedicine is not a substitute for in-person care. Jorge Cueto, who is in his mid-20s, said a virtual visit is often an additional step before going to the doctor's office for, say, a sore throat.

"It's another fee, it's another gating mechanism," he said.

His parents, who are not fluent in English, prefer going to the doctor's office because they find it easier to communicate in person, he said, and they have difficulty setting up video calls. "I don't think they would be willing opt for telehealth if they weren't required to do it," Mr. Cueto said.

Others may not have access to a computer or smartphone to connect for video visits, and insurers are particularly wary of doctors charging for phone calls to follow up on lab results or tell someone to come to the office.

Even patients who have cellphones may not be able to afford a lengthy consultation, Dr. Levy said. She and her colleagues discovered some people stopped answering their phones at the end of the month because they had run out of minutes. "That was very eye-opening to us," she said.

Some proponents argue the goal of telemedicine should not be to lower health care costs over all. One of its main benefits is improving patients' access to care, said Dr. Ateev Mehrotra, a professor of health care policy at Harvard Medical School, adding that it would be foolish to expect savings if more people also get treatment. "Those don't reconcile," he said.

Insurers should evaluate whether telemedicine is more effective for treating conditions like depression than it is for, say, cancer. They could then make those distinctions in reimbursing for virtual visits, he said, just as they do for different prescription drugs.

"There should be no single telemedicine policy," Dr. Mehrotra said.

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The answer largely depends on whether Medicare and private health insurers will adequately cover virtual doctor visits once coronavirus outbreaks subside. Telemedicine is having its moment. Over the last few months, millions of people have relied on video or telephone calls to talk to their doctors.

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Sports leagues, large employers and colleges are turning to devices that could usher in more invasive forms of surveillance.

Oakland University in Rochester, Mich., plans to introduce a wearable sensor that will continuously track students' skin temperatures and other vital signs. Credit... Emily Rose Bennett for The New York Times

In Rochester, Mich., Oakland University is preparing to hand out wearable devices to students that log skin temperature once a minute - or more than 1,400 times per day - in the hopes of pinpointing early signs of the coronavirus.

In Plano, Texas, employees at the headquarters of Rent-A-Center recently started wearing proximity detectors that log their close contacts with one another and can be used to alert them to possible virus exposure.

And in Knoxville, students on the University of Tennessee football team tuck proximity trackers under their shoulder pads during games - allowing the team's medical director to trace which players may have spent more than 15 minutes near a teammate or an opposing player.

The powerful new surveillance systems, wearable devices that continuously monitor users, are the latest high-tech gadgets to emerge in the battle to hinder the coronavirus. Some sports leagues, factories and nursing homes have already deployed them. Resorts are rushing to adopt them. A few schools are preparing to try them. And the conference industry is eyeing them as a potential tool to help reopen convention centers.

"Everyone is in the early stages of this," said Laura Becker, a research manager focusing on employee experience at the International Data Corporation, a market research firm. "If it works, the market could be huge because everyone wants to get back to some sense of normalcy."

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The BioButton uses algorithms to try to detect early signs of Covid-19. Credit... BioIntelliSense, Inc.

Companies and industry analysts say the wearable trackers fill an important gap in pandemic safety. Many employers and colleges have adopted virus screening tools like symptom-checking apps and temperature-scanning cameras. But they are not designed to catch the estimated 40 percent of people with Covid-19 infections who may never develop symptoms like fevers.

Some offices have also adopted smartphone virus-tracing apps that detect users' proximity. But the new wearable trackers serve a different audience: workplaces like factories where workers cannot bring their phones, or sports teams whose athletes spend time close together.

This spring, when coronavirus infections began to spike, many professional football and basketball teams in the United States were already using sports performance monitoring technology from Kinexon, a company in Munich whose wearable sensors track data like an athlete's speed and distance. The company quickly adapted its devices for the pandemic, introducing SafeZone, a system that logs close contacts between players or coaches and emits a warning light if they get within six feet. The National Football League began requiring players, coaches and staff to wear the trackers in September.

Don Shumpert, a coach for the Arizona Cardinals, wearing a Kinexon proximity detection device before a game. Credit... Brandon Wade/Associated Press

The data has helped trace the contacts of about 140 N.F.L. players and personnel who have tested positive since September, including an outbreak among the Tennessee Titans, said Dr. Thom Mayer, the medical director of the N.F.L. Players Association. The system is particularly helpful in ruling out people who spent less than 15 minutes near infected colleagues, he added.

College football teams in the Southeastern Conference also use Kinexon trackers. Dr. Chris Klenck, the head team physician at the University of Tennessee, said the proximity data helped teams understand when the athletes spent more than 15 minutes close together. They discovered it was rarely on the field during games, but often on the sideline.

"We're able to tabulate that data, and from that information we can help identify people who are close contacts to someone who's positive," Dr. Klenck said.

Civil rights and privacy experts warn that the spread of such wearable continuous-monitoring devices could lead to new forms of surveillance that outlast the pandemic - ushering into the real world the same kind of extensive tracking that companies like Facebook and Google have instituted online. They also caution that some wearable sensors could enable employers, colleges or law enforcement agencies to reconstruct people's locations or social networks, chilling their ability to meet and speak freely. And they say these data-mining risks could disproportionately affect certain workers or students, like undocumented immigrants or political activists.

"It's chilling that these invasive and unproven devices could become a condition for keeping our jobs, attending school or taking part in public life," said Albert Fox Cahn, executive director of the Surveillance Technology Oversight Project, a nonprofit in Manhattan. "Even worse, there's nothing to stop police or ICE from requiring schools and employers to hand over this data."

Executives at Kinexon and other companies that market the wearable trackers said in recent interviews that they had thought deeply about the novel data-mining risks and had taken steps to mitigate them.

Devices from Microshare, a workplace analytics company that makes proximity detection sensors, use Bluetooth technology to detect and log people wearing the trackers who come into close contact with one another for more than 10 or 15 minutes. But the system does not continuously monitor users' locations, said Ron Rock, the chief executive of Microshare. And it uses ID codes, not employees' real names, to log close contacts.

Mr. Rock added that the system was designed for human resources managers or security officials at client companies to use to identify and alert employees who spent time near an infected person, not to map workers' social connections.

GlaxoSmithKline, the pharmaceutical giant, recently began working with Microshare to develop a virus-tracing system for its sites that make over-the-counter drugs. Budaja Lim, head of digital supply chain technology for Asia Pacific at the company's consumer health care division, said he wanted to ensure maximum privacy for workers who would wear the proximity detection sensors.

As a result, he said, the system silos the data it collects. It logs close contacts between workers using ID numbers, he said. And it separately records the ID numbers of workers who spent time in certain locations - like a packaging station in a warehouse - enabling the company to hyper-clean specific areas where an infected person may have spent time.

GlaxoSmithKline recently tested the system at a site in Malaysia and is rolling it out to other consumer health plants in Africa, Asia and Europe. The tracking data has also allowed the company to see where workers seem to be spending an unusual amount of time close together, like a security desk, and modify procedures to improve social distancing, Mr. Lim said.

"It was really designed to be a reactive type of solution" to trace workers with possible virus exposure, he said. "But it has actually become a really powerful tool to proactively manage and protect our employee safety."

Tyler Dixon, an Oakland University senior, started a petition objecting to a requirement that dorm residents and athletes at the school wear the BioButton. Credit... Emily Rose Bennett for The New York Times

Oakland University, a public research university near Detroit, is at the forefront of schools and companies preparing to making the leap to the BioButton, a novel coin-size sensor attached to the skin 24/7 that uses algorithms to try to detect possible signs of Covid-19.

Whether such continuous surveillance of students, a young and largely healthy population, is beneficial is not yet known. Researchers are only in the early phases of studying whether wearable technology could help flag signs of the disease.

David A. Stone, vice president for research at Oakland University, said school officials had carefully vetted the BioButton and concluded it was a low-risk device that, added to measures like social distancing and mask wearing, might help hinder the spread of the virus. The technology will alert campus health services to students with possible virus symptoms, he said, but the school will not receive specific data like their temperature readings.

"In an ideal world, we would love to be able to wait until this is an F.D.A.-approved diagnostic," Dr. Stone said. But, he added, "nothing about this pandemic has been in an ideal world."

Dr. James Mault, chief executive of BioIntelliSense, the start-up behind the BioButton, said students with privacy concerns could ask to have their personal details stripped from the company's records. He added that BioIntelliSense was preparing to conduct a large-scale study examining its system's effectiveness for Covid-19.

Oakland had initially planned to require athletes and dorm residents to wear the BioButton. But the university reversed course this summer after nearly 2,500 students and staff members signed a petition objecting to the policy. The tracker will now be optional for students.

"A lot of colleges are doing masks and social distancing," said Tyler Dixon, a senior at the school who started the petition, "but this seemed like one step too far."

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The Hot New Covid Tech Is Wearable and Constantly Tracks You

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Sports leagues, large employers and colleges are turning to devices that could usher in more invasive forms of surveillance. In Rochester, Mich., Oakland University is preparing to hand out wearable devices to students that log skin temperature once a minute - or more than 1,400 times per day - in the hopes of pinpointing early signs of the coronavirus.