As we observe National Suicide Prevention Week 2017, we sat down with Dr. Shareh Ghani, vice president and medical director at Magellan Healthcare who lead Magellan’s Driving Suicide to Zero Initiative.

Magellan Health Insights: Dr. Ghani, thank you for chatting with us today. Tell us about the work you did with the Driving Suicide to Zero Initiative
 Dr. Shareh Ghani: In some parts of the healthcare community, there is a view that suicide is something ‘that just happens’; that it is unavoidable and acceptable. The Driving Suicide to Zero Initiative sought to change that paradigm. Through our efforts in a public health program, we shifted the viewpoint to one that believes that suicide can be stopped and can be driven to zero.

MHI: You have lead a number of initiatives for Magellan, what was your interest in this particular program?

SG: I have been working in mental health since 1993. From 1993 to 1995, during my residency, I had a lot of experience with suicide prevention research, and again working in community psychiatry. There is a lot of good research on the how of suicide, but I want to understand the why.

MHI: You looked at a lot of data as a part of this initiative. Tell us about that.

SG: We were managing the behavioral health contract for Maricopa County between 2007 and 2012. At the time, Phoenix had the seventh highest suicide rate in the country. The suicide rate for those with mental health issues was even higher.

During that time, we reviewed every case of completed suicide to see what could have been done differently.

MHI: What was the Driving Suicide to Zero Initiative hoping to achieve?

SG: Of course, we were looking to significantly impact suicide rates in Maricopa County. But more than that, we were looking to develop a systematized, data-driven, reproducible model.

Part of that meant preparing the clinical workforce to confidently identify at-risk individuals and improve treatment access and engagement. It also meant incorporating family and community participation to better identify early warning signs, navigate the clinical system, and support members at risk.

Finally, there was the integration of a sustainable and replicable clinical and support model and program tools into an EMR [Electronic Medical Record] to ensure that healthcare providers can, from a single source, identify, manage and plan for zero suicides through the safe management of those at risk.

MHI: And what were the results of the initiative? Was it successful?

SG: The results were highly encouraging. Between 2007 and 2012, there was a 67 percent reduction of the suicide rate for the population. Furthermore, there was a 42 percent decrease in the suicide rate of people with serious mental illness.

MHI: You mentioned earlier that the suicide rate was much higher for those with serious mental illness?

SG: Yes, it is a fact that individuals suffering from severe mental illness are six to 12 times more likely to die from suicide than the general population.

MHI: If you could hope that people would take away one thing from the Driving Suicide to Zero Initiative what would it be?

SG: That employing a rigorous, data-driven, scalable and reproducible population health approach to address suicide prevention, and creating a sustainable ecology of support around the individual and the community, is possible.

The Magellan Driving Suicide to Zero Initiative successfully incorporated population surveillance, analytics, research, early detection, intervention and monitoring to shift the paradigm from crisis mitigation to early prevention of suicide.

We’ve all been impacted by the horrific flooding taking place in Texas due to Hurricane Harvey, and witnessed the many instances of heroism and community support in response to this tragedy. In addition to the widespread damage occurring, we have a number of Magellan team members and their families who live in impacted areas and who are witnessing the devastation first-hand. Unfortunately, some are without power, and others have been displaced from their homes.

Leading humanity to healthy, vibrant lives is what we do on a daily basis on behalf of our members, so it’s no surprise that so many of us want to do something to help. I’m proud of what we as a company are doing to support our Texas-based customers, members and affected communities:

• Supporting the Houston Community: The State of Texas, specifically the Houston area, will be living with catastrophic damage for some time and rebuilding from this damage for even longer. The Magellan Cares Foundation is supporting these clean-up efforts with a contribution of $25,000 to the Houston Relief Fund, which is the organization that has been established by the mayor. This contribution will help local efforts to assist those in need.
• Utilizing Our Expertise: When we looked at the forecast for Hurricane Harvey, we opened our 24-hour crisis line early Friday morning for all Texans affected by the storm, whether they are our members or not. Free, confidential counseling services and other resources, such as referrals to local non-profit organizations, shelters and additional community-based support are available to assist Texans as they work to cope with this natural disaster. This line will remain open in the coming weeks and months as the community begins to assess damages and the full impact of the storm.
• Customer/Member Impact: We continue to serve our Texas-based customers, members and others who have been impacted by the storm. Some have likely spent time in shelters, others have lost power, and still others are facing challenges of which we are probably not aware. I’ve asked all of our associates to think about their situation and consider additional ways in which we can best serve them.

No one ever expects to be challenged with a catastrophic event, but I’ve been so proud of the way in which our team has sprung to action to help those in need in Houston.

Privacy is a funny thing, and peoples’ choices about privacy when technology is involved is often hard to explain. We don’t think twice about letting companies track what we like and don’t; what we search for and when we search; the photos we like and the ones we don’t; our shopping patterns and our wish lists; where we go and when; and now, we welcome full-time listening devices into our homes. I often wonder if these listening devices would find their way into our kitchens if they looked more like a reel-to-reel recording device versus a cute little modern orb with fancy LEDs.

Despite how comfortable we are with technology in some parts of our lives, there seems to be a line that many won’t cross. For some reason, discussing our finances while the orb is listening is okay, but using technology to help us manage our healthcare strikes some people as going too far.

This line is moving, albeit slowly.

There are real challenges in advancing technology in healthcare. But most importantly, we need to allow consumers to choose how they want to see their health information.

Texting is common in healthcare today, but it is inefficient, and often, confusing. Most healthcare-related texts contain either redacted information, such as, “You have not filled AtorXXXXXXXX prescription,” or contain links on which you have to click to take you to another message. Amazon doesn’t make a customer guess at the contents of their message or follow a clunky process to share information, so why do we do it in healthcare?

There are a number of regulations that govern Protected Health Information (PHI), and it’s critical that we take them seriously. After all, we’re talking about very sensitive and private material about diagnoses, medication, diagnostics and other information.

But, with careful planning and execution we can balance what is required of us by law while providing consumers with information that will help make their healthcare journey more efficient and tech-enabled. For example, we were able to craft, on behalf of our clients, end-user agreements that allow us to send texts that look like this:

“Your health is important to [Insert Client Name], please take your cholesterol medication as prescribed.”

The results from this texting pilot were nothing short of amazing. 26 percent of the people who received this message, none of whom were previously following their doctor’s orders, promptly filled the prescription. Interestingly, we saw similar results in every category we piloted. Why? It’s simple: nothing had to be decoded, no incremental steps needed to be taken, no password had to reset, etc. The best part of the pilot? 87 percent of the people who started, stayed in the program.

With pilots like this, we moved the line a smidge.

Texting was one of our first pilots and it was critical to challenging our thinking and finding new ways to solve old problems. The line needs to keep moving forward and we welcome the challenge.

Magellan Rx Management will soon be hosting the 14^th Annual Specialty Summit.  We had the opportunity to sit down with Phillip Vecchiolli, senior vice president and general manager of our specialty division at Magellan Rx Management to share his thoughts on this exciting event.

Magellan Health Insights: What can attendees expect at this year’s Specialty Summit?

Phillip Vecchiolli: The Magellan Rx Management Specialty Summit has become the source for staying ahead in today’s specialty drug management industry.  We host nationally recognized payers, physicians and industry insiders for a program packed with timely insights, thoughtful debate, and actionable dialogue on emerging trends in the evolving specialty market and effective solutions for managing specialty drug trend.

MHI: When and where is it going to be held this year?

PV: We are excited to be back in the heart of New York City. The event takes place on August 28-30, 2017 at the Sheraton New York Times Square Hotel.  And when attendees aren’t engaging in Summit activities, we encourage them to take in the sights, as we’ll be within walking distance of a number of famous attractions including Central Park, The Plaza Hotel, Radio City Music Hall, MOMA and more.

MHI: Why do you think this event is especially important?

PV: This is an exciting and disruptive time in specialty pharmacy. Specialty drug costs are skyrocketing and without an understanding of the unique dynamics around specialty drug management, payers run the risk of overlooking or misunderstanding this critical area of pharmacy spend.

At Magellan Rx Management, we specialize in connecting people with the tools, and information they need to make the best decisions for the populations they serve.  This event serves as a forum for nationally recognized payers, oncologists, and industry thought leaders to explore and discuss the key issues and challenges we face in an evolving specialty market.  Along with general topic presentations we also have a few interviews and panels for even more information-sharing discussions designed to provide an environment of teamwork and strategic information sharing.

MHI: Who typically attends the specialty summit?

PV: The Specialty Summit is designed especially for health plans, employer groups, states, third-party administrators, oncologists, practice managers, brokers, consultants and pharmaceutical manufacturers.

MHI: What are you most excited about this year?

PV: This year’s program is packed with timely insights from thought leaders across the specialty landscape and is designed to shine a light on the emerging trends and effective solutions in this evolving specialty market.

From its beginnings 14 years ago, this conference has exploded in terms of attendance and the caliber of our programming. This year, we’re expecting over 600 attendees, with numerous opportunities to network and meet with our peers, as well as compelling programming and dialogue around the most pressing topics in our industry. I’m particularly looking forward to the presentations and discussions about the oncology landscape, the Affordable Care Act, biosimilars, and medical pharmacy.  Our keynote Dr. Matt Iseman is going to be pretty spectacular too!

MHI: Any closing words?

PV: We are thrilled to again be hosting the 14^th Annual Specialty Summit.  At Magellan Rx, we are proud to be pioneers in specialty pharmacy management. By leveraging our industry-leading expertise and value-driven solutions, we help our clients solve their specialty pharmacy challenges. Our passion is to help people live more vibrant lives and to motivate them to take better control of their health.

Learn more about the Specialty Summit

A study by a team of Magellan researchers, demonstrating the pervasiveness of opioid addiction, was presented at the American Psychiatric Association (APA) Annual Meeting, and was also the subject of an article by Clinical Psychiatry News.

The study, an analysis of medical and pharmacy data from 2009—2012 for 2.5 million people aged 20-64 who were part of a commercial health plan, showed that 48 percent of patients who had stopped using opioids for at least six months went on to use them again.

Dr. Shareh Ghani, vice president medical director at Magellan Healthcare, and lead author of the study spoke of the importance of fully understanding the scope of the addiction crisis: “Having worked in commercial and Medicaid markets, I have reviewed numerous cases of accidental overdose and suicides related to pain prescriptions. The opioid crisis in this country demands that we understand the issue and identify predictors of risk.”

Study co-author Gowri Shetty, vice president of analytics, underscored the importance of the work: “This study helped us understand the clinical characteristics associated with long-term and persistent opioid use and provided a better understanding of how to tailor interventions targeting those at increased risk of inappropriate opioid use.”

The opioid crisis remains a key area of research and development across Magellan Health. You can read the article by clicking here to visit the Clinical Psychiatry News website.

Over the past decade, technology has become enmeshed in our lives. From the ubiquitous smartphones we all carry, to connected houses, cars, cameras and more — it seems like just about every object we come into contact with is gaining new capabilities from being connected to the cloud. At Magellan Health, we feel strongly that an individual’s health should benefit from these technological advancements, too.

We are excited to announce that Magellan is expanding its existing collaboration with Click Therapeutics to create Food and Drug Administration (FDA) cleared therapeutic apps.

Digital health apps are an area that Magellan continues to lead in research and development. Magellan’s Director of Innovation, Brian Keenaghan, recently shared his experience building apps to promote healthy vibrant lives.

 FDA Clearance for Digital Therapeutics

Click will leverage Magellan’s portfolio of software programs, associated intellectual property, and data to create mobile apps for people challenged by conditions such as insomnia, substance abuse, depression and anxiety, and apply for FDA clearance for such apps on the basis of valid scientific evidence supporting the safety and effectiveness of the software. This augments Magellan’s work to provide broad-based, digital and data-driven programs for primary care and specialty care providers.

Magellan Health and Click Therapeutics: Rethinking Healthcare

Last year, Magellan launched a tobacco cessation program with Click Therapeutics leveraging Magellan’s clinical coaching and pharmacy benefit management (PBM) capabilities with Click’s technology and machine learning platform, including the mobile application, CLICKOTINE®, to create an all-in-one solution.

Magellan’s CCBT modules have undergone numerous clinical trials in which they have matched, and in some instances exceeded, those reached by conventionally delivered cognitive behavioral therapy. In addition, Cobalt has received the highest rating from the Substance Abuse and Mental Health Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP).

You can learn more about Magellan’s Cobalt CCBT capabilities here.

I shared this message with all 10,000 associates at Magellan yesterday. As I said in my message, times like these require all of us not to be silent, but instead to stand tall and make it very clear that we are committed to an environment where all people can progress personally and professionally, and work in a positive, uplifting workplace. Given the current state of events in our country, and particularly the divisive events of this week, I felt it important to reaffirm the values we hold dear within Magellan.

“Leading humanity to healthy, vibrant lives” is what guides our decision making and inspires us to accomplish meaningful, positive change in the lives of those we serve. This can only be done if we respect and value each other, and every person we serve, without condition or qualification.

For the many years I have been associated with Magellan, I have been impressed by the integrity and commitment of Magellan team members to create a culture of caring. I have seen great respect for people of all races, religions, gender and sexual orientation, to name only a few of the things that make us different. There is no doubt that the diversity of our people allows us to better understand and execute our vision of making a powerful impact on the world around us.

I want to reaffirm in a direct and simple way that we will never diverge from valuing differences, and creating a culture in which we can learn from each other and grow as individuals, teams, and a company.

Times like these require all of us not to be silent, but instead to stand tall and make it very clear that we are committed to an environment where all people can progress personally and professionally, and work in a positive, uplifting workplace. Our differences are to be celebrated; they are absolutely key in helping us in “leading humanity to healthy, vibrant lives.”

Thank you for the great work you do. I am proud to be associated with you.

The past decade has seen some remarkable changes in technology, which has ushered in an era where we are always “on,” always connected and where most everything that was analog now is digital. Many of us walk around with powerful computers in our pockets –also known as smartphones–that are more powerful than the computers that help put a man on the moon only a few decades ago. Today, we can order car rides from our phones, pay for our groceries, watch movies or do just about anything from a smartphone or network-connected device from anywhere across the globe. Yet for many of us, we go through a time warp when we move from our personal lives to our work environments.

Magellan: a Digital Healthcare Company

At Magellan, we have an inspired leadership team that is building a workforce of the future. We recruit the best talent wherever we can find it across the globe and provide them with great work-life integration by providing flexible working arrangements. Over 40 percent of our workforce does not work in one of our offices, and many of our employees are mobile and on the road helping our member and providers. This kind of a workforce requires the collaboration platform of the future.

During the summer of 2016, we assembled and rolled out Magellan’s next generation collaboration platform. This platform was built with a mobile-first, cloud-first, always digital mindset designed to provide secure, seamless and context-aware experiences within the enterprise. This new platform is all about providing choices: it works across Macs and PCs, across browsers, across Apple and Android mobile devices and can work across a 4G connection and high-speed wifi alike.

The platform uses five technologies that we use in our personal lives on a daily basis:

• Workplace and Workchat for desktop and mobile devices. These are the enterprise- grade versions of Facebook and Facebook Messenger, complete with networking, group collaboration and social sharing capabilities.
• A cloud-based document and content management solution from Box.
• Enterprise-quality HD video conferencing and desktop sharing through Zoom.
• Productivity applications from Microsoft through Office 365.
• An integrated access portal tied together by a robust security and identity management solution from Okta.

Okta acts as a gateway to every other application, website or solution provided by Magellan. It simplifies password management and provides secure multi-factor authentication – in short it makes our applications accessible to everyone, anywhere, at any time over any network or device. It allows an employee to take a video call from her home office and collaborate with her colleagues in a Workplace group and continue that conversation on a mobile device as she takes the train into see a customer for an afternoon meeting – secure, seamless and context-aware collaboration.

 Technology leading culture; culture leading technology

One of the interesting developments in our culture is the use of desktop and mobile video conferencing which allows us to personalize each call, read body language and emotions and share the true benefits of face-to-face communications, instead of being on nameless, faceless, monotonous conference calls.  This is changing the cultural fabric of Magellan by making the enterprise more personal and more social.  It is challenging our management orthodoxies and help reinvent management.

With this new platform, we are building communities that span geographies, business units, departments and even companies. In the past year, we have seen over 700 groups evolve organically on this platform.  Some of these groups focus on specific projects, initiatives or events, and others focus on communities of users and social groups. We even have a community of musicians at Magellan. In short, the platform helps people stay connected in a personal way without having to be located in the same spot.

Ultimately, our technology is a means by which we can help improve the experience – and quality of care – for our customers and members. Our objective for this new platform is to make the technology invisible to the user and allow them to seamlessly play their part to help individuals live healthy, vibrant lives.