Connect with us

Health Care

Dignity Health Integrates Asthma and COPD Data, Sees 54% Drop in ER Visits



Formed in 2019 through the alignment of Catholic Health Initiatives and Dignity Health, CommonSpirit Health is one of the largest nonprofit health systems in the U.S. It has more than 1,000 care sites serving 20 million patients in 21 states.

At CommonSpirit, the acceleration of new mediums of care delivery enables patients to live healthier via virtual asynchronous care and evidence-based, digital-enabled therapies.

CommonSpirit is developing the digital capabilities and clinical and administrative processes to provide these services, which will enable patients to have greater control over their care, empower education, increase engagement, target improved clinical outcomes and further support population health management.

“Propeller Health’s FDA-cleared platform is one of the digital therapeutics services that is offered to help our patients and their clinicians in the disease management of chronic asthma and COPD and to help improve clinical quality outcomes and reduce costs of care,” said Dr. Francisco Rhein, vice president of innovation and digital care transformation at CommonSpirit Health.

“The platform has proven to help reduce overuse of rescue inhalers and help patients achieve more days without symptoms, overall contributing to the enhancement of their quality of life,” he continued. “Using Propeller’s Bluetooth-enabled sensors with key medications, CommonSpirit clinicians have a line of sight into a patient’s rescue and controller medication use in real time.”

Sensors passively sync with a user’s smartphone and ultimately produce reports and alert notifications that allow a patient’s care team to intervene in order to reduce the likelihood of an acute event or exacerbation between outpatient visits.


“The platform helps keep patients informed and engaged in their care, leveraging machine learning algorithms to help identify symptom patterns and disease triggers, sharing personalized tips and medication reminders, and supporting ‘find my inhaler’ functionality for location of misplaced devices,” Rhein explained.

“Although Propeller Health’s solution is available for patients across CommonSpirit Health and has been used for many years by select Dignity Health Medical Foundation physicians in California, Arizona and Nevada, implementation has historically been on a practice-by-practice basis, and we recognized the opportunity to attract new patients and to provide existing patients with enhanced access and experiences to improve care outcomes and engender loyalty.”

“The provider can launch the Propeller SMART FHIR app to view their patients’ data right from within the patient’s chart, including rescue and controller medication uses, and to track trends.”

Dr. Francisco Rhein, CommonSpirit Health

Despite the benefits CommonSpirit was seeing, it noted there were barriers to adoption due to the innate disjointed workflow and administrative burdens for the care teams to offer this chronic-disease-management program to their patients when they must perform additional steps to login to the Propeller portal in order to complete a patient enrollment and view their enrolled patients’ results in real time.


First, CommonSpirit worked with its frontline healthcare workers, clinical sponsors, clinical informatics team, a business team and a population health team to better understand and proactively address some of these workflow barriers at the points of care and handoff, innovating together to create a path for a more scalable enterprise product offering that is more seamless for both care teams and patients to access.

“We proposed to improve integration into Dignity Health’s electronic health record system so that care teams can interact with the Propeller platform as a part of their native clinical workflow with the EHR,” Rhein noted.

“We identified an opportunity to enhance the experience of our patients and providers by developing and deploying a SMART FHIR application embedded directly within the patient’s electronic chart.

“This app would allow the care team to identify and directly enroll patients who could benefit from access to Propeller self-management tools, and also to remotely monitor their patients’ real-time data, alerts and messaging, making it easier for them to identify who would benefit from clinical intervention, all embedded within their EHR workflows,” he added.

The desired experience was an increased ease of use and a more seamless and appropriate workflow for providers. The expectation was that this would empower scaling the service for patients with more agility and increasing patient enrollments and beneficial outcomes.


“Partnering closely with our provider champions, national informatics team and population health team, we identified future state workflow and codeveloped a SMART FHIR API-enabled application embedded directly within Dignity Health’s Cerner EHR,” Rhein said. “This integration has enabled providers to interact with the Propeller platform as part of their native clinical workflow.

“We designed and deployed several phases to address current barriers and help make it more seamless to connect patients to the program, addressing identification, recruitment, enrollment and setup,” he added.

Patients with asthma or COPD who have had a recent respiratory-related ED visit or hospitalization, or who have poor disease control and may benefit from the program, are more likely to use Propeller when a member of their healthcare team recommends it. Staff members have enabled it so that providers or clinical staff can now place an order for remote patient monitoring directly from within the patient’s EHR.

“Clinic staff members will then receive a task on the Multi-Patient Task List (MPTL) to enroll the patient in the Propeller program,” Rhein explained. “Care team members can quickly create a patient’s account by launching the Propeller SMART FHIR app, which is able to streamline enrollment by pre-populating information from within the patient’s chart.

“Patients will receive an automated welcome email from Propeller, and then Propeller ships sensors to the patient’s address after they download the Propeller app on their smartphone or tablet and sign into their account.”

Once a patient has enrolled in the program, Propeller makes it easy for patients to adhere to a prescribed treatment plan by leveraging sensors that attach to the patient’s inhaled controlled and rescue medications, he added.

“These sensors collect and provide data back to the patient and care team, allowing them to monitor adherence to and appropriateness of treatment to ensure optimal outcomes,” Rhein said. “The provider can launch the Propeller SMART FHIR app to view their patients’ data right from within the patient’s chart, including rescue and controller medication uses, and to track trends.

“Following release of the remote monitoring MPage into production, we sought additional ways to enhance the care team workflow and implemented message-center integration to eliminate the need for emails,” he continued. “Propeller patient activity messages can be sent to the clinics message pool associated with the patients account, removing the need for staff to monitor daily emails and document receipt in Cerner.”


CommonSpirit has observed a reduction in acute care utilization as part of a year-long clinical trial of asthma patients who used Propeller’s inhaled sensors at one of CommonSpirit’s Dignity Health medical groups, showing a 54% decrease of asthma-related patient emergency room visits for patients enrolled in the program, and a 57% decrease in hospitalization resulting from asthma ER visits, after a year on the program.

“Further outcomes after one year showed patients had achieved 74% reduction in rescue medication usage, indicating they have learned how to avoid triggers, and require their rescue medication less frequently than when they began the program,” Rhein said. “In addition, patients had a 19% increase in symptom-free days.

“Patients also demonstrated 56% adherence to their controller medication,” he continued. “As a result of enrolling in the Propeller program, patients have taken their controller medication more reliably, which helps lead to reduced need for rescue medications. Adherence percentage is 2.4 times greater for patients enrolled in the program than the national average for patients with asthma and COPD.

This integration has been fully implemented in seven communities served by Dignity Health physicians and clinics in Arizona and California. With the EHR integration and ability to leverage the repeatable and standardized deployment of this SMART FHIR API, Dignity Health and Propeller could potentially scale the tool to hundreds of physicians who care for thousands of patients with an eligible diagnosis.

“Now, the Propeller solution can be ordered and managed through the EHR like any other medication or treatment,” Rhein explained. “Enrollment is streamlined for providers and staff, as they don’t have to leave their clinical workflow. It now takes two minutes to enroll a patient, which is a 75-80% reduction in time. We look forward to our learnings and proving out that this is a key model for all our current and future digital therapeutics.

“Physicians who are managing their patients with the Propeller program report added benefits of the EHR integration, including the greater ability to understand their patient requests for medication refills by connecting these requests with data from Propeller to better manage symptoms, establish severity and reduce risk of exacerbations.”


“Organizations considering how to integrate digital therapeutic platforms and solutions should consider the importance of developing a scalable model,” Rhein advised. “We have established pilot programs within our care teams, leveraging EHR integration and APIs, resulting in clinically led, digitally-enabled workflows that allow us to take advantage of the repeat and standardized deployment needed to launch for scale.

“Using this approach, we focus less on point solutions and more on solutions that can integrate into the care pathways and the workflows of our care teams.”

The partners one chooses to work with – from vendors to stakeholders – are also critical to the success or failure of digital transformation, he said.

“A good partner listens to the care teams on the frontlines and supports co-innovation on the points of handoff,” he said. “With our clinicians leading the way, we are able to reimagine how to use technology to be more successful in serving our communities. This leads to greater potential for impact across the care continuum and along the patient journey.

“Finally, to be successful, health systems must make the right thing the easy thing,” he continued. “This requires us to demonstrate an understanding of the needs and experiences of our providers and care teams and ensure digital solutions we build can address and support their workflow, reduce administrative burdens, and help them to practice at the top of their license.”

This will help ensure the organization delivers better care and outcomes for patients, and more frictionless journeys, he concluded.

Twitter: @SiwickiHealthIT
Email the writer:
Healthcare IT News is a HIMSS Media publication.


Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Health Care

Apple Sues NSO Group, Accusing It of Spying on Users in New Lawsuit



Apple announced this week that it was suing NSO Group, an Israeli surveillance technology company, in federal court for allegedly accessing users’ devices without authorization.

In addition to damages, the tech giant is seeking to block NSO Group from accessing or using any Apple products, or developing spyware that could be used on Apple products in the future.

“State-sponsored actors like the NSO Group spend millions of dollars on sophisticated surveillance technologies without effective accountability,” said Craig Federighi, Apple’s senior vice president of software engineering, in a statement. “That needs to change.”

Apple devices are “the most secure consumer hardware on the market,” he contended, but “private companies developing state-sponsored spyware have become even more dangerous.

“While these cybersecurity threats only impact a very small number of our customers, we take any attack on our users very seriously, and we’re constantly working to strengthen the security and privacy protections in iOS to keep all our users safe,” Federighi added.

NSO Group offered a statement to Healthcare IT News in response to requests for comment.

“Thousands of lives were saved around the world thanks to NSO Group’s technologies used by its customers,” said NSO Group representatives. “Pedophiles and terrorists can freely operate in technological safe-havens, and we provide governments the lawful tools to fight it. NSO Group will continue to advocate for the truth.”


NSO Group says its surveillance technology is used by government intelligence and law enforcement agencies to track criminals.

But as Apple outlines in its complaint, the company’s spyware has reportedly been used against journalists, human rights activists, dissidents, public officials and others.

This month, the U.S. Department of Commerce included the NSO Group in its Entity List for “engaging in activities that are contrary to the national security or foreign policy interests of the United States.” Specifically, the agency said that NSO Group had enabled foreign governments, via its spyware, to “maliciously target” individuals such as embassy workers and academics and to “conduct transnational repression.”

In its complaint, Apple zeroed in on “FORCEDENTRY,” an exploit for a vulnerability used to break into a victim’s device and install NSO Group’s Pegasus spyware product.

The company accused attackers of creating Apple IDs to send malicious data to a victim’s device, which then allowed NSO Group or its clients to surreptitiously deliver Pegasus.

“On information and belief, Defendants provide consulting and expert services to their clients, assist them with their deployment and use of Pegasus, and participate in their attacks on Apple devices, servers and users,” according to the complaint. Although Apple has not observed any evidence of successful remote attacks against devices running iOS 15 or later, it said that each attack carries substantial costs for the company, including the necessity to redirect resources.

“In the meantime, on information and belief, Defendants continue with their pernicious efforts to target and harm Apple and its customers by infecting, exploiting, and misusing Apple devices and software,” said the complaint.

The company also announced that it would be contributing any damages from the lawsuit, plus an extra $10 million, to organizations pursuing cybersurveillance research and advocacy.

“At Apple, we are always working to defend our users against even the most complex cyberattacks,” said Ivan Krstic, head of Apple Security Engineering and Architecture, in a statement.

“The steps we’re taking today will send a clear message: In a free society, it is unacceptable to weaponize powerful state-sponsored spyware against those who seek to make the world a better place.”


Nation-states have increasingly relied on sophisticated software to carry out governmental objectives.

As Errol Weiss, H-ISAC chief security officer, pointed out in an interview with Healthcare IT News earlier this month, cyber-offensive capabilities have now become the norm, not the exception.

“A few years ago, you could count maybe a few dozen countries that had a decent, offensive cyber capability. And now it’s probably the opposite,” he said. The U.S. government has raised the alarm about these developments, most recently regarding an Iran-sponsored hacker group targeting healthcare.


“Our threat intelligence and engineering teams work around the clock to analyze new threats, rapidly patch vulnerabilities, and develop industry-leading new protections in our software and silicon,” said Apple’s Krstic in a statement.

“Apple runs one of the most sophisticated security engineering operations in the world, and we will continue to work tirelessly to protect our users from abusive state-sponsored actors like NSO Group,” he said.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.


Continue Reading

Health Care

French Researchers Reveal Chatbot Skills to Override Vaccine Hesitancy



A team of French cognitive scientists has addressed the urgent issue of vaccine hesitancy within many EU countries and proposes a new approach. With a study published in October this year, the researchers successfully demonstrated that the reluctance to be vaccinated could be decreased by deploying chatbot technology.


The chatbot study involved researchers from the Centre National de la Recherche Scientifique (CNRS), the French National Institute of Health and Medical Research INSERM and ENS-PSL.

The study, published in the Journal of Experimental Psychology: Applied, found that interaction with a chatbot developed by CNRS, ENS-PSL and INSERM was able to reduce vaccination refusal by 20 per cent within a test group of 338 participants.

In the control group, which received only brief information about the COVID-19 vaccination, there were no comparable results in terms of general views and willingness to vaccinate.


Although nearly three-quarters of all adult Europeans are now fully vaccinated against COVID-19, there remain huge disparities in vaccination rates across countries.

According to the vaccine tracker of the European Centre for Disease Prevention and Control (ECDC) as of 25 November 2021, individual EU countries such as Portugal (81.5 per cent), Ireland (76.2 per cent) and Denmark (76 per cent) have already made great progress in immunising their populations with a full COVID-19 vaccination, while the vaccination rate of other countries such as Germany, France or Austria continues to stagnate at below 70 per cent.

In other parts of Europe, especially in the south-west, the vaccination rates are significantly lower than 50 per cent. In Slovakia (45.7 per cent), Romania (37.3 per cent) and Bulgaria (24.7 per cent), very few people have received the double COVID-19 vaccine dose.

These vaccination backlogs are not only due to vaccine shortages, but in many cases a result of existing scepticism of many Europeans.

The researchers from France now hope that technology-based communication, such as chatbots, could have a positive impact on these figures in the future.


“It remains to be shown whether the effects of chatbot interaction are lasting, and whether they are the same across age groups, and among those most resistant to vaccination”, emphasised the authors of the study with predominantly young and well-educated participants.

They added: “Half of the experimental group later tried to persuade others to get vaccinated, with three-quarters of them stating they drew information provided by the chatbot to do so.”


Continue Reading

Health Care

Roundup: Medanta Adopts’s X-ray Software, India to Open a Medical Cobotics Centre, and More Briefs



Medanta taps for AI-driven chest x-ray analysis

Medanta, a multi-speciality medical group in India, has partnered with to implement the latter’s artificial intelligence software to enhance chest x-ray analysis.

The hospital group will be adopting the qXR software which automatically analyses chest x-rays and spots findings for better diagnosis and treatment. The AI tool can detect 30 abnormalities of the lungs, pleura, heart, bones and diaphragm.

“Medanta strives to deliver world-class healthcare through its high-end medical equipment and superior infrastructure. State-of-the-art technology is an essential aspect of healthcare delivery,” Dr Naresh Trehan, chairman and managing director of Medanta, was quoted as saying in a news report.

The software has also been adopted by Fujifilm Corporation for its portable X-ray FDR Xair system. Through its recent partnership with AstraZeneca Malaysia, the startup has brought its x-ray software to some primary care clinics in Malaysia to support the early detection of lung cancer there.

Medical cobotics centre to be launched in India

The I-Hub Foundation for Cobotics at the Indian Institute of Technology – Delhi (IIT Delhi) and iHub Anubhuti at the Indraprastha Institute of Information Technology – Delhi (IIITD) have signed a memorandum of understanding to set up India’s first medical cobotics centre.

The two government-backed university technology hubs have been developing advanced technologies in robotics and collaborative robots (cobotics), digital health, sensing and computing technologies for robotic-assisted surgeries, training, and medical procedures.

According to a press statement, the Medical Cobotics Centre (MCC) at IIITD will be a tech-enabled medical simulation and training facility for young resident doctors, as well as other healthcare professionals, paramedical staff, technicians, engineers, and researchers.

It will also serve as a validation centre for research outcomes in the area of healthcare cobotics and digital health. This upcoming facility will establish partnerships with companies, undertake research, and work toward the commercialisation of technologies.

MMC’s training programmes will be at multiple levels and cohort-specific, such as urology, neurology, and laparoscopy, but will be initially limited to minimally invasive surgeries. Experts from All India Institute of Medical Sciences in New Delhi and other medical colleges will be consulted for these programmes and invited as guest faculty to conduct them.

The first batch of trainees is targeted to be inducted around April-May next year. They will be initially trained with basic training simulators while advanced surgical robots will come in the next phase.

Moreover, the centre will also be a place for various technology innovation hubs under the Indian government’s National Mission on Interdisciplinary Cyber-Physical Systems to “showcase their medical-related projects and products with applications,” according to IHFC CEO Ashutosh Dutt Sharm and IHFC Project Director Subir Kumar Saha.

Philips Foundation backs cardiac rehab programme in Singapore

Philips Foundation is funding one of the centres run by social service agency Singapore Heart Foundation that provides subsidised cardiac rehabilitation services.

The year-long project of Royal Philips’ non-profit organisation aims to reduce the mortality rate of cardiac incidences and help lower a patient’s risk of hospital readmission.

Specifically, it intends to close the gap in patients’ lack of participation in rehab programmes, which is considered a huge barrier in the secondary prevention of heart diseases. It was reported that only between 6%-15% of Singaporean patients attend cardiac rehabilitation programmes.

SHF-Philips Foundation Heart Wellness Centre is one of the social services’ three centres that provide cardiac patients and at-risk individuals with access to heart health.

Philips’ support, according to SHF Heart Wellness Centres Chairman Dr Tan Yong Seng, will provide SHF with the “resources required to continue providing affordable and quality support to the patients in need, as well as give our team the capacity to focus on raising awareness on the importance of cardiac rehab[ilitation] and drive higher participation in our programmes”.

Under the partnership, 20 sites in Singapore will be equipped with the Philips HeartStart automated external defibrillators (AED) and 500 persons will be trained in giving cardiopulmonary resuscitation (CPR) and AED over a year.

“Through the heart wellness centre’s education initiatives, the AED roll-out and the CPR training, we want to equip individuals and communities with the knowledge and resources to reduce the mortality rates of cardiac incidences in Singapore,” Philips Singapore Country Manager Ivy Lai said.

Original Source:

Continue Reading