Dx Developers Hedge on SARS-Cov-2 Rapid Antigen Tests, Citing Conflicting FDA Messages
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Lawmakers seek long-term limit on governors' emergency power
      NIH aims to address COVID testing disparities in underserved communities
      Diabetes patients at high risk from COVID-19 are managing conditions more effectively
      Some GOP-led states target abortions done through medication
    • Lawmakers seek long-term limit on governors' emergency power
      NIH aims to address COVID testing disparities in underserved communities
      Diabetes patients at high risk from COVID-19 are managing conditions more effectively
      More Black Americans open to vaccines after outreach efforts
    • Calls mount for Biden to track U.S. healthcare worker deaths from COVID
      Front-line workers want more assistance after a year of COVID-19
      Healthcare providers enter Philadelphia's legal fight to enact gun laws
      Taking population health expertise to the market
    • Cigna and Oscar expand their small business partnership
      5 things to know about Agilon Health's proposed IPO
      More than a half million Americans gain coverage under Biden
      Insurance auto-retention policies could halve number of people kicked off coverage
    • Lawmakers seek long-term limit on governors' emergency power
      Reforms follow deadly year in New York nursing homes
      MACPAC approves recommendations on specialty drugs, behavioral health
      No region in the world spared as virus cases, deaths surge
    • Outgoing UHS chief made almost 50% less in 2020 than 2019
      A hundred dollar bill cut into strips with a colorful background.
      Population health still at odds with fee-for-service
      Private equity could increase long-term Medicare spending, MedPAC says
      Jeb Bush, Marilyn Tavenner getting in on healthcare SPAC frenzy
    • Healthcare data breaches
      By the Numbers: National health information service providers
      Health systems are navigating the digital divide and vaccine access
      woman doctor shaking hands with nurse and smiling
      Sponsored Content Provided By Philips
      A stronger healthcare system requires bold new ways of working together
    • More Black Americans open to vaccines after outreach efforts
      Fight against STDs lost amid coronavirus testing blitz
      Beyond the Byline: Kids' unchecked mental health needs pose long-term consequences
      Hospitals vary widely in reducing C-section rates, but some progress in other maternal health metrics
    • Novant Health adds chief payor performance officer
      Kaiser Permanente names Comer chief IT officer
      Mass General Hospital's Slavin to retire as CEO
      UnitedHealthcare names Thompson as new CEO
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • A close-up of a woman receiving a COVID-19 vaccine.
      Providers in underserved communities work toward equitable vaccine distribution
      Josh Bradshaw
      How one rural Illinois county vaccinated 84% of its senior citizens by early March
      Dr. John Fischer
      Patient-reported outcomes tool for hernia surgery helps physicians improve care
      New care model helps primary-care practices treat obesity
    • Jennifer Pannone and her daughter Victoria.
      Mental health access for children needs attention
      A family photo of the the Hangens.
      Stressing the already burdened pediatric behavioral health system
      What's next for on-demand telehealth companies?
      A map of the U.S. with images of the coronavirus.
      The digital divide becomes a new social determinant of health
    • Ryan McGinnis
      Finding efficiencies in the OR using tech
      Dr. Daniel Hall
      UPMC pilots machine learning, telehealth to inform patient transfers
      A woman being recorded using her inhaler on a smartphone.
      Digital check-ins, connected inhalers help control asthma
      A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Diabetes patients at high risk from COVID-19 are managing conditions more effectively
      Nearly 1 in 5 Americans skipped care due to cost last year
      COVID-19 long-haulers need holistic treatment, providers say
      Amazon expanding employee clinics into two more states
    • Malpractice premiums peak in 2020, AMA survey shows
      A rendering of a cancer research institute at the University of Southern California that will include 5G.
      Healthcare providers determine how to best use ultrafast 5G
      Two-thirds of largest hospitals aren't complying with price transparency rule
      'Silver lining': Hospitals keep practices born in COVID rush
    • Addressing long-standing barriers needed for mental and physical health integration
      A close-up of a woman receiving a COVID-19 vaccine.
      Providers in underserved communities work toward equitable vaccine distribution
      The waiting room of a Kaiser Permanente clinic at a Target location.
      Health systems revamp their approach to retail clinics
      Josh Bradshaw
      How one rural Illinois county vaccinated 84% of its senior citizens by early March
    • CMS wants to bump pay for hospices, SNFs next year
      CMMI pauses new Direct Contracting model applications
      CMS wants to boost payments over 2% for inpatient rehab, psych facilities
      40 Oregon providers, insurers sign value-based care pact
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Dr. Alan Kaplan
      The risks, rewards of taking organizations 'where they haven’t gone before'
      Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
    • Drs. Hal Paz and Joshua J. Joseph
      Mobilized to fight the COVID crisis: a blueprint for community and academic partnerships
      Dr. Stephen Markovich
      Making sure we're aligned along the path to achieving inclusion
      Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
    • We're losing engaged providers, and healthcare will pay the price
      Dr. Chris DeRienzo
      How COVID-19 broke health systems and made them stronger
      Bonnie Castillo and John Welton
      Dueling opinions: The role of mandated nurse staffing ratios
      Still crossing the quality chasm: a look at the IOM's seminal report 20 years later
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Voting Open - 50 Most Influential Clinical Executives
      Nominations Open - Top 25 Innovators
      Nominations Open May 24 - Top 25 Emerging Leaders
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Minorities in Healthcare
      • - Luminaries
      • - Top 25 Minority Leaders
      • - Minorities to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • emburse certify modern healthcare custom media webinar logo lockup
      Sponsored Content Provided By Emburse
      Webinar: Making it easy to manage costs
      virtualmed staff modern healthcare custom media logo lockup
      Sponsored Content Provided By VirtualMed Staff
      Webinar: Best practices for creating a successful telepsychiatry program
      telehealth visit man touching neck while speaking to doctor on computer
      Sponsored Content Provided By Accumen
      Webinar: How telehealth has evolved into a standard of care
      modern healthcare custom media and trimedx custom webinar logo lockup
      Sponsored Content Provided By TRIMEDX
      Webinar: Bridging the gap between clinicians and administration to improve capital equipment planning
    • Women Leaders in Healthcare Conference
    • Social Determinants of Health Symposium
    • Healthcare Transformation Summit
    • Leadership Symposium
    • Virtual Briefings
      • - Hospital of the Future
      • - Mental Health
      • - Patient Safety & Quality
      • - Strategic Marketing
      • - Virtual Health
      • - Workplace of the Future
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Dr. Chris DeRienzo
      Next Up Podcast: Building team spirit in the wake of COVID-19
      Mikelle Moore
      Next Up Podcast: Mikelle Moore on recognizing all hospital workers during the pandemic
      Empty boardroom
      Next Up Podcast: What's going to happen tomorrow? Succession planning during emergencies
      Next Up Podcast: Educating patients on the COVID-19 vaccine with Tanya Andreadis
    • Beyond the Byline: Kids' unchecked mental health needs pose long-term consequences
      Beyond the Byline: How COVID-19 has impacted hospital finances
      An older man sitting on a hospital bed with his back toward the camera.
      Beyond the Byline: Upcoding could explain why hospitals are increasingly billing for the most complex treatment
      Beyond the Byline: Insurers are betting on virtual-first plans as COVID-19 shifts care pathways
    • James garvert neustar healthcare insider podcast image
      Building on basics
      Healthcare Insider Podcast Episode Art - Premier
      Why Roger Weems and other consultants are leaving the big firms to join Premier
      James garvert neustar healthcare insider podcast image
      Outreach during COVID-19
      ann barnes healthcare insider podcast image
      Leading with intention to promote diversity and inclusion
    • The Check Up: Matt Eyles
      The Check Up: Matt Eyles of AHIP
      The Check Up: Dr. Tom Shanley
      The Check Up: Dr. Tom Shanley of Lurie Children’s Hospital of Chicago
      The Check Up: Dr. Harold Paz
      The Check Up: Dr. Harold Paz of Wexner Medical Center at Ohio State University
      The Check Up: Pat Schou
      The Check Up: Pat Schou of the Illinois Critical Access Hospital Network
    • ivana naeymi-rad one on one intelligent medical objects
      Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Safety & Quality
March 05, 2021 11:01 AM

Diagnostic developers hedge on coronavirus rapid antigen tests, citing conflicting FDA messages

Adam Bonislawski, 360Dx
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    Modern Healthcare Illustration / Getty Images

    With rapid antigen tests for SARS-CoV-2 slow to come to market, officials at the US Food and Drug Administration have tried to signal via a number of public comments that the agency would be flexible regarding test performance requirements and use models.

    These indications of flexibility have largely failed to speed development and commercialization of rapid antigen tests, however, as test vendors, wary of falling short of agency requirements, have instead stuck to the more stringent specifications presented in the FDA's test templates.

    Early in the COVID-19 pandemic, rapid antigen tests were identified as a potentially key technology for slowing transmission of SARS-CoV-2 with calls for these tests growing as it became evident that molecular test capacity was not able to keep up with demand and was unlikely to ever reach a level where regular testing at population scale would be possible.

    Antigen tests have also been slow to scale, at least to the capacities deemed necessary by advocates of population screening. In particular, the US has yet to see the sort of cheap, relatively low sensitivity rapid antigen tests that researchers like Harvard University epidemiologist Michael Mina have advocated for use in serial screening models where frequent, repeated testing could compensate for such tests' lower sensitivity.

    The FDA has often been cited as the key roadblock to the availability of such tests, with supporters of serial testing models claiming that the agency's stated requirements of 80 percent sensitivity and 99 percent specificity for home tests available by prescription and for 90 percent sensitivity and 99 percent specificity for over-the-counter tests have added to product development times and prevented lower performing tests from entering the market.

    To date, only 15 rapid antigen tests for COVID-19 have received Emergency Use Authorization from the FDA. In comparison the agency has authorized 219 molecular tests for the virus.

    FDA, however, has indicated flexibility on its requirements. Last year, an FDA official told 360Dx on background that these benchmarks are not hard-and-fast cutoffs that tests must hit in order to receive EUA. The official said that the agency was open to considering a variety of SARS-CoV-2 testing approaches including lower sensitivity rapid tests that could be used at home in a serial manner.

    On a September call for labs and test developers, Timothy Stenzel, director of the Office of In Vitro Diagnostics and Radiological Health at the FDA's Center for Devices and Radiological Health, entertained a serial testing scenario much like those proposed by Mina.

    "Where our recommended levels of sensitivity may not be achieved with a single test result in a home situation, maybe with the paper strip test, strategies utilizing serial testing, for less sensitive tests, could be deployed," he said, noting that in the case of a test with, for instance, 70 percent sensitivity, "perhaps with a two-pack, two test results you can achieve a greater sensitivity together."

    More recently, an FDA official, speaking to 360Dx on background, reiterated these remarks, noting that the agency has made a conscious effort to communicate its openness to different models of testing including speaking with some of its critics about this openness. The official said, however, that the agency has not received any submissions for SARS-CoV-2 rapid antigen tests that feature sensitivity below that specified in the agency's templates and are intended to be used in serial fashion to compensate for that lower sensitivity.

    One reason for that lack of submissions appears to be that while FDA has said it is open to such tests, vendors nonetheless consider submitting tests that don't meet the agency's template too risky a prospect from a regulatory perspective.

    Prashant Chouta, CEO of Cambridge, Massasachusetts-based E25Bio said that he was aware of FDA's stated flexibility around SARS-CoV-2 rapid antigen test requirements but questioned what that flexibility actually meant.

    "Obviously, any application will be considered," he said. "It's not the consideration that matters, it is the approval that matters. There's a big difference between, yes, I will consider, and yes, I will approve."

    E25Bio has submitted for EUA a rapid antigen test to be available by prescription and is in the process of supplementing that submission with a submission for over-the-counter use. Chouta said that the test meets the performance requirements for home testing set out in the FDA template. He also said that E25Bio would probably have been able to bring a home test to market sooner if it had aimed at less stringent performance requirements.

    "Obviously, to get to a higher level [of performance] it takes time, it takes validation, it takes research," he said. "If you are asking, would you have had a product out there if the sensitivity [requirement] was lower, probably, yes."

    But, he said, "we would not waste our time with a submission that does not meet the minimum requirements that the FDA mentioned in its template."

    Stephen Tang, president and CEO of OraSure Technologies – which plans to submit a rapid antigen test for EUA for professional use and prescription-use, self-test indications by the end of March with a submission for an over-the-counter at-home self-test to follow – similarly said that the company considered the FDA template the authoritative statement on its test performance requirements, regardless of any other comments coming from the agency. 

    "We have had a long relationship working with FDA," he said. "We take them at face value. The templates are the templates. And that is what we are targeting and abiding by. That is the way we are playing the submission that we are about to make."

    Australian diagnostics firm Ellume, the first company to receive EUA for an over-the-counter at-home SARS-CoV-2 rapid antigen test, similarly worked to maximize its test's performance, as opposed to adopting a serial testing approach like those advocated by Mina and others.

    "We certainly took to trying to make the most accurate test we possibly could," said Sean Parsons, Ellume's founder and CEO.

    In a study of the test in 198 subjects ranging from 2 years to 82 years of age, it correctly identified 96 percent of positive samples and 100 percent of negative samples in symptomatic individuals and 91 percent of positive samples and 96 percent of negative samples in people without symptoms, placing it above the FDA's template requirements for sensitivity but below the stated requirements for specificity in the asymptomatic population.

    While Ellume's success getting an OTC home test through FDA shows that vendors can meet FDA's stated performance requirements, advocates of the serial model argue that the requirements have not only slowed the progress of such tests to market but also that home tests, like Ellume's, that do make it through the EUA process, are too expensive and/or not available in the quantities needed for frequent population scale testing.

    Many say that for these tests to have use for mass testing purposes, they need to be in the $10 to $15 range per test. Abbott's BinaxNow COVID-19 Ag Card test, by comparison, which received FDA EUA in December, costs about $25. The firm said it anticipates delivering about 30 million of the tests in Q1 2021, ramping up to 90 million in Q2.

    Parsons said Ellume's test will start in the $30 range and that the company expects to bring that down into at least the $20 range as it scales production. It has thus far produced on the order of hundreds of thousands of tests for the US market and aims to produce tens of millions of tests for the US market this year.

    Orasure's Tang said the company had not determined pricing for its planned OTC home test. The company's OTC home HIV test sells for around $40 to $50, but he noted that buyer behavior for this test is different than he would anticipate for an at-home SARS-CoV-2 test.

    E25Bio's Chouta said that company hoped to offer its test for under $10, though he added that whether it could bring the price down to this level would depend on the scale it produced and sold at.

    The experience of Pasadena, California-based Innova Medical Group suggests that test vendors were perhaps prudent in not taking FDA's offers of flexibility at face value. The company has produced the kind of cheap (around $5), scalable, but lower performing SARS-CoV-2 rapid antigen tests for which proponents of serial testing have advocated but have not yet been able to get them through FDA.

    Daniel Elliott, president and CEO of Innova, said that FDA turned down the company's first two EUA submissions for OTC at-home use of the test. He said it is now preparing an EUA submission for point-of-care use and will then add on submissions for prescription home use and OTC home use.

    Elliot said that he believed Innova had run up against the fact that a serial testing model didn't fit well within FDA's traditional approach to evaluating tests in which it is mainly concerned about the performance of a test when used in a single individual at a single time point.

    "On the one side, we are advocating to do [serial testing], but on the other side, we have to fit into the very narrow cracks that FDA has defined as how you go through the approval process," he said.

    FDA did not respond to a request for comment on Innova's SARS-CoV-2 submissions.

    While modeling studies suggest that frequent and consistent testing can significantly reduce transmission of SARS-CoV-2 even when using lower performance tests, it remains something of an open question how feasible and effective such approaches are when applied in the real world.

    Liverpool, England, has been running a COVID-19 testing pilot using the Innova assay to test around 40 percent of the city's population. That followed an initial plan to test the entire population that was ultimately deemed unfeasible.

    In data published in an interim analysis, 897 individuals tested positive for COVID-19 via lateral flow while 2,902 positive individuals were identified by PCR. As of Jan. 21, 359,606 lateral flow tests had been performed on 205,836 residents (41 percent of the Liverpool population) and had identified 4,421 positive individuals.

    The Innova test demonstrated sensitivity of 40 percent, which was well below the 77 percent accuracy the test showed in validation studies collected by Public Health England and Oxford University in which trained staff performed the test. The test identified roughly two-thirds of individuals with high viral loads (as determined by a PCR cycle threshold of less than 25). Test specificity was 99.9 percent.

    While the testing program identified several thousand COVID-19 positive individuals who might otherwise have gone undetected, Alex Crozier, a researcher in the division of biosciences at University College London, said that Liverpool did little better than nearby Manchester, which did not undertake a similar testing program.

    "It seemed for a while that Liverpool might have been holding off that second wave more than comparable cities, but in the end it basically got hit as badly as everywhere else," he said. "It doesn't seem from the initial analysis that it was able to prevent the second wave or keep society more open, which I think is probably quite an important finding."

    Crozier suggested that targeted use of rapid antigen testing would probably prove more feasible and more useful than a true mass screening campaign.

    Data from a collaboration between the US National Institutes of Health and the University of Illinois could soon provide additional information on how effective serial rapid antigen testing could be at suppressing SARS-CoV-2.

    Bruce Tromberg, director of the National Institute of Biomedical Imaging and Bioengineering, said that results from the study so far indicate that "if you do these [rapid antigen tests] multiple times per week, you can actually begin to approach the sensitivity of PCR."

    The study isn't, however, currently evaluating how well rapid antigen tests with performance levels below those stated in the FDA template detect infections when used serially. Like the majority of test vendors, the NIH and Illinois researchers chose to take the agency's template as the definitive statement on acceptable test sensitivity and specificity.

    "We haven't really explored the performers that are below 80 percent, you know, say 70 percent," Tromberg said. "That's in part because the FDA has a bar. The FDA wants you to have 90 percent [sensitivity] in order to get over-the-counter approval for their test."

    He said the researchers plan to look at lower sensitivity tests in the future, but he expressed sympathy for test vendors who have decided to stick to the FDA template as opposed to pursuing a lower sensitivity, serial route.

    "Remember, this has never been done before," he said. "So, if you're a company with shareholders and you are trying to get testing into people's homes, that's exploring the great unknown."

    This story first appeared in our sister publication, Genomeweb.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    More Black Americans open to vaccines after outreach efforts
    More Black Americans open to vaccines after outreach efforts
    Fight against STDs lost amid coronavirus testing blitz
    Fight against STDs lost amid coronavirus testing blitz
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Minorities in Healthcare
          • - Luminaries
          • - Top 25 Minority Leaders
          • - Minorities to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Women Leaders in Healthcare Conference
        • Social Determinants of Health Symposium
        • Healthcare Transformation Summit
        • Leadership Symposium
        • Virtual Briefings
          • - Hospital of the Future
          • - Mental Health
          • - Patient Safety & Quality
          • - Strategic Marketing
          • - Virtual Health
          • - Workplace of the Future
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing