NEJM Catalyst

In the December issue: leadership for artificial intelligence, cybersecurity, pediatric firearms injuries, behavioral health treatment, public health and care delivery collaboration, diabetes care, and improving care after gynecologic oncology surgery. ?? View the issue: https://nej.md/4fSCcsb ?? Read/listen to the editor letter, How Collaboration Leads to Health Care Transformation: https://nej.md/3ACpFKJ ?? Insights Report: The Rising Risks of Cybersecurity Breaches: https://nej.md/4exclF3 with expert advisor Jigar Kadakia ? In Depth: A Hybrid Care Model to Manage Diabetes Mellitus in the United Arab Emirates: https://nej.md/3UX1hKs ???? Case Study: Together Care: Transforming Perioperative Care for Patients Undergoing Benign and Oncologic Gynecologic Surgery: https://nej.md/4fxVLGm ?? Article: Advancing the Quintuple Aim Through Public Health and Health Care Collaboration: Perspectives from Washington State: https://nej.md/48Tj2Ah ?? Article: Improving Treatment and Lowering Costs for Behavioral Health Patients Through a Value-Based Care Program: https://nej.md/3Z8x0ed ???? Commentary: Health Care Leadership in the AI Era: A Seventh Test for the Decade Ahead: https://nej.md/4fNkSW9 with our Editor-in-Chief Thomas Lee, MD ?? Commentary: Moving Beyond Thoughts and Prayers: Creating a Firearm-Related Injury Task Force: https://nej.md/3YLfPhB

Automated texting platforms offer the promise of interacting with patients in real time and reducing the burden on clinical teams to triage concerns. The population of patients with gynecologic cancer is characterized by high symptom burden and consequent high utilization of the ED while navigating treatment, especially in the perioperative setting. Similarly, high ED utilization has been noted among benign gynecologic patients undergoing surgery. A text-based program that triages patient concerns and promptly engages clinical teams for acute concerns could have particularly high utility in these patient populations, but as of 2021 had not been validated. In 2021, Penn Medicine, University of Pennsylvania Health System began developing a novel text-based remote monitoring program called Together Care within the Division of Gynecologic Oncology with the aim of reducing unplanned patient encounters, including patient contacts, ED visits, and readmissions. This program initially used a fake backend texting platform that was iterated across multiple mini-pilots and transitioned to a fully automated texting algorithm that was scaled to other divisions within the Department of Obstetrics and Gynecology. The authors share both their utilization of innovation methodology and their key takeaways from developing this automated platform: https://nej.md/4fxVLGm Leslie Andriani, Ashna Aggarwal, Nick Bailey, BSN, RN, Emily Seltzer, Sirithepphavanh Oliver, Lisa Mills, Mary DeAgostino-Kelly, Ashley Haggerty, Nawar Latif

The GluCare.Health hybrid care model represents a potentially groundbreaking approach to diabetes management that integrates on-site and remote components. With the global burden of diabetes projected to affect 783 million people by 2045, this model addresses the shortcomings of both traditional care and virtual care as stand-alone modalities, emphasizing patient engagement. Hybrid care combines the strengths of both in-person visits and digital health technologies to provide a continuous-engagement care model. Under the GluCare.Health hybrid model, the physical clinic, aligned with American Diabetes Association standards, offers personalized consultations and an intuitive layout. The virtual component employs remote continuous data monitoring and utilizes wearables such as the Oura ring for real-time tracking and mobile apps for remote monitoring and engagement, primarily around habits and behaviors across specific parameters that affect metabolic health. Implementation was effective in December 2022 when the model went live. Within just 3 months, significant improvements in certain health parameters were observed, and data at 12 months show similar results. Challenges for this model include scalability, talent recruitment, the physician adoption of continuous care models, reimbursement issues, resistance from older patients, and ethical considerations. The model’s success hinges on proactive policy advocacy, community engagement, and iterative refinement to navigate evolving health care landscapes. In essence, GluCare.Health’s hybrid model has the potential to become a transformative, patient-centric solution to the escalating global diabetes burden, driving innovation in chronic disease management: https://nej.md/3UX1hKs Ihsan Almarzooqi, Hala Zakaria, Ali Hashemi, GluCare.Health Integrated Diabetes Center

Cybersecurity emerged more tangibly as a concrete threat to health care organizations in 2024. First came the widespread Change Healthcare security breach in early spring that affected business processes and provision of care. Then, in the midsummer, the outage of CrowdStrike/Microsoft Windows brought care delivery organizations to a near standstill as they reverted to paper notes. In the aftermath of these events, members of the NEJM Catalyst Insights Council were surveyed about current and future threats of cybersecurity events, their organizations’ formal cybersecurity training, their knowledge of how to report suspected of cyberattacks or other suspicious activities, and the data safeguards and cybersecurity leadership at their organizations. Survey results show awareness of the risks and potential impact of cybersecurity and data breaches, as well as surprising gaps in some capabilities to recover from attacks. Read the report, with expert analysis from Jigar Kadakia, MBA, Vice President and Chief Information and Security Officer at Emory Healthcare, and an experienced hospital cybersecurity leader: https://nej.md/4exclF3

"Health Care Workforce Innovation: Solutions to the Staffing Crisis" - free web event December 11, 12-2pm ET, with live Q&A. Experts will discuss how health care organizations can approach workforce challenges through leadership and organizational culture changes, technology innovations that can reduce clinician workloads, and new models of care to address burnout. Register: https://nej.md/3YQeLJp #NEJMCatLive

If you know me IRL, you know there’s a phrase I love to lean on?— a guiding principle I often weave into conversation: “Earn the Right to Win.” Today, we made a MASSIVE leap forward in that pursuit with our first publication in the New England Journal of Medicine Catalyst, a deep dive into our care model as a roadmap to the future of connected care in chronic disease: https://lnkd.in/dGCKMjvH For my LinkedIn friends here not steeped in academic medicine, the NEJM is to medical publications what Michelin stars are to chefs — a symbol of excellence and achievement that few ever attain. But what does "earning the right to win" mean when you're building a health-tech startup? One that's challenging traditional care models? Convincing payors to rethink not just what they pay for, but *how* they pay for care? Encouraging physicians to redefine their relationships with patients and the data that shapes those interactions? It means being open-source, open-book, and relentlessly accountable. Like Tesla sharing its patents to accelerate the development of electric cars, or Red Hat proving that open-source software could build billion-dollar industries, we believe progress only happens when you’re willing to share what you’ve learned and open your work to scrutiny. For NEJM Catalyst, it meant over a year navigating the painstaking peer-review process: iterating, engaging with stakeholders and reviewers, and standing behind the evidence. And now, to see it published — it’s proof that the path we’re forging is grounded not just in disruption, but in evidence.?Disruption isn’t about noise — it’s about rigor and results. This milestone wasn’t just a “submit-and-forget” effort. It’s the result of an entire self-funded research team at GluCare.Health we invested in building since Day 1. It's a result of a culture of curiosity, and the incredibly high standards woven into every member of GluCare’s clinical team. It’s also about embracing boldness — the same mindset that led us to build a model that fundamentally reimagines chronic care in the first place. Today, I’m enormously proud — of my team, of the work we’ve done together. Immense gratitude for the team at NEJM Group for publishing our work. And candidly, I’ll allow this to be a moment of personal pride as well. 22 years ago, I was expelled from medical school at McGill University, for the THIRD time.? (Yes, that's probably some kind of world record ??♂?) Getting back on the horse and forging a different path of impact in healthcare was an exercise of resilience, persistence, and patience. This achievement brings it all full circle, and feels like putting a Michelin-star chef’s kiss on a journey that’s been anything but linear. Here’s to the road less traveled — and the wins we earn along the way. Ihsan Almarzooqi Zeina A. Tom Hale ōURA Hala Zakaria meta[bolic] NEJM Group Thomas Lee, MD

Today, we have achieved a remarkable milestone with the publication of our hybrid care model in the NEJM Catalyst Innovations in Care Delivery. This marks one of the rare contributions from the Middle East to the NEJM Group highlighting our mission to redefine chronic disease care and establish global leadership in value-based healthcare. The article, titled “A Hybrid Care Model to Manage Diabetes Mellitus in the United Arab Emirates,” showcases our innovative approach to diabetes management. By seamlessly integrating in-person clinical care with real-time monitoring via wearables and mobile technology, we ensure continuous, patient-centered care that matches the ongoing nature of chronic diseases. Our hybrid model represents a paradigm shift: from sporadic clinic visits to continuous, collaborative care. By monitoring key health parameters like glucose, sleep, stress, and physical activity in real time, we empower our multidisciplinary care team to provide timely, personalized interventions leading to some of the best diabetes outcomes globally. ?? Read the full article: https://lnkd.in/dzv2cGB7 Ihsan Almarzooqi , Ali Hashemi , Hala Zakaria , Zeina A. , NEJM Catalyst #DiabetesCare #HybridCare #NEJM #ValueBasedHealthcare #InnovationInHealthcare

Today, a new peer-reviewed article that was published in NEJM Catalyst shows Cityblock's Advanced Behavioral Health Program led to a significant decrease in inpatient utilization and healthcare costs for Medicaid members with severe mental health conditions. Here are some key takeaways: ? Value-based contracts that integrate medical, behavioral, substance use disorder and social care driven by community health workers, can enable effective integrated services and meet public health needs, for populations on publicly funded health plans. ? Our particular community health worker-led, integrated model of care can improve access to evidence-based care for people with psychotic disorders and substance use disorders, including long-acting injectable antipsychotics, medications for opioid and alcohol use disorders, and social care navigation. ?? This examination of Cityblock’s ABH program shows a statistically significant reduction in inpatient hospitalizations and total cost of care and makes the case for further investment in public health. We’re encouraged by these results and want to extend a special thanks to lead researcher and Head of Behavioral Health at Cityblock Ruby Mehta, with support from Daniel Sellinger, Michael Tang, MD, MBA, David Dayan-Rosenman, MD, MS, and Pooja Mehta. Read more here: https://lnkd.in/geuTcjqd #ValueBasedCare #SUDs #Medicaid #publichealth #behavioralhealth #research

Thrilled to share the work of the Together Care group highlighted in the NEJM Catalyst: https://lnkd.in/eTyvchvy

I’m thrilled to share a study published today in NEJM Catalyst that focuses on how Cityblock Health's Advanced Behavioral Health (ABH) Program can help individuals with severe psychotic disorders or substance use disorders get proper access to care. For more vulnerable populations who rely on public health insurance, this research proves that our integrated care model for severe mental health illnesses can significantly improve access to evidence-based care, reduce inpatient hospitalizations, and lower overall healthcare costs. By engaging specialized community health workers who have a thorough understanding of members' lived experiences, the ABH Program at Cityblock seeks to integrate medical, behavioral, substance use disorder, and social care to reach those with these complex needs. A big thanks to my colleagues Daniel Sellinger, Michael Tang, MD, MBA and David Dayan-Rosenman, MD, MS for their support on this paper. Read more: https://lnkd.in/eBaQFE63 #CityblockHealth #ValueBasedCare #SUDs #behavioralhealth #medicaid #publichealth #NEJM