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Breaking Business As Usual

I recently attended Exponential Medicine in San Diego, a conference that attracts thought leaders and a broad cross-section of people involved in healthcare.  Daniel Kraft, the physician/inventor/founder of the original FutureMed conference, does a masterful job of attracting an elite mix of technologies, providers, and brilliant thinkers from a diverse realm of healthcare endeavor.  Daniel is brilliant, and the Exponential Medicine conference is unlike any conference I’ve ever attended.  To me, for anybody involved in trying to drive the future of healthcare, Exponential Medicine is THE PLACE.

That said, the most insightful assessment of healthcare today came from a woman who I adore – Dr. Jennifer Brokaw, daughter of the brilliant journalist, Tom Brokaw.  Jennifer started out as a physician, and has evolved into areas related to case management and helping patients navigate the impossibly difficult world of managed care.  Like so many people who I’m drawn to, Jennifer is committed to making a difference.

I shared with Jennifer our platform for patients with heart failure.   I told her that even though we have a mobile solution that can help patients avoid re-hospitalization, finding cardiologists willing to adopt/implement our solution was a missionary task.  It requires finding other forward-thinking physicians who want to look beyond the status quo.

And then Jennifer shared with me an insight that blew my mind.  She told me the following:

“The system is not designed for better patient care…it’s designed for revenue. When the ACA was passed and the incentives were supposedly re-aligned, entrepreneurs lined up to create solutions. Many have found, like you, that it is still “business as usual.”

Wow!  Business as usual.

Here are these heart failure patients who are being discharged, after being hospitalized.  And, they’re sent home where they have nothing.  Managing their chronic disease is a total crap shoot.  50% are re-hospitalized within 6 months.  We believe there’s a significant portion of those patients that can avoid being re-admitted if they’re given a simple tool to track basic functions (e.g. medication compliance; vital signs tracking; alerts to medical staff in a risk situation; etc.).  And it’s free!  Who wouldn’t want to at least pilot with MyDigitalHealth Network to determine if those patients can better manage their chronic disease at home.

And yet, the nurse practitioners and cardiologists balk at doing anything that isn’t “business as usual.”  Let’s run it through a grant program; let’s evaluate it through an IRB process; we need to assign resources to determine the impact; etc.

But here’s the thing –  1 out of 2 patients are coming back within 6 months anyway.  Why not see if you can do better.  One cardiologist told me, “if they just take their BP and heart rate; if they just get on the scale; and they take their meds the way they’re supposed to – they’re going to avoid re-admission.”

But the system is so cautious; the drive to prove lower cost/improved outcomes so pervasive; the approach so overwhelmingly risk-averse and status quo inert; that any additional step or new technology must be established as the standard of care.  In other words, “come back and see us when everybody else is doing it.”

When I started MyDigitalHealth Network a year ago, it was clear that heart disease was the #1 killer in America (700,000/year).  It was clear that Heart Failure cost $32 Billion annually and that there was an opportunity to bend the curve on readmission.  Our goal was to keep CHF patients at home and managing their chronic disease; not simply get them to Day 31 when somebody else would pay for the cost of readmission.

But it was Dr. Brokaw who enlightened me – that beyond simply building a great solution for CHF patients, we must fight the “business as usual” syndrome and enlist progressive medical professionals who are prepared to experiment and explore new ways to treat chronic disease, and break the status quo.

Filed under Company News by david@mydigitalhealthnetwork.com @ 5:55 am

The Challenges of mHealth

There is no doubt that mobile health (or mHealth) has been painfully slow to reach any meaningful adoption. In July 2014, McKinsey stated that mHealth is not a game changer.

Just yesterday, Anna McCollister-Slipp, a data analytics specialist and judge for the Qualcomm Tricorder X-Prize said unequivocally The digital health revolution has failed… so far.

I believe there are 2 fundamental reasons why mHealth has not seen widespread adoption: a) patient ignorance; and b) provider barriers.

Patient Ignorance: There are more than 100,000 healthcare apps in the App Store. Just finding one, even if the patient knew the right name, is challenging. Then they have to download it; register it; configure it; and if they need to sync with other wireless devices, they have to pair it. I must say that many of these wireless monitors are not very easy to pair.

The bottom line is it requires a lot of steps by consumers to adopt mHealth solutions. The Universal Truth in the world of consumer products is, each additional step that you make the user do, is one more step they won’t do. It has to be easy or consumers will lose interest quickly. Even if their health is involved.

Provider Barriers: Nobody on the provider side wants any other provider organization to win. If Mayo Clinic has developed a mobile app, Stanford Hospital won’t use it. Consequently, there are hundreds of apps that do essentially the same thing but are proprietary to each institution. Further, as we know, the EMR systems are not interoperable, so a patient using an app may not be able to access their own health records because their PCP and their Specialist physician are both in-network but associated with different hospitals.

And finally, often these applications are developed by a doctor or clinician that doesn’t know anything about developing consumer products. So they hire an App developer that knows nothing about healthcare. And the resulting application is neither intuitive nor easy to use.

We’ve thought a lot about these issues in creating a turnkey mobile platform for managing Heart Failure.

First off, CHF patients tend to be older, so you can’t require them to be tech savvy or perform a lot of steps. The solution has to be pre-configured.

Second, the interface has to be elegantly simple and intuitive – as readily simple as the iPad or iPhone were the first time you saw them. If the patient needs a lot of instruction on how to use the platform, they simply won’t do it.

Third, the solution needs to tie back to the clinical side. It’s not enough to register a dangerously high systolic pressure from an app. There has to be transmission of that data back to the medical staff (cardiologist or nurse practitioner) to alert them that their patient is at risk.

Fourth, the solution needs to integrate medication compliance as well as vital sign tracking and alerts. Half the battle is simply getting the patient to take the right meds at the right time. {This is something MyDigitalHealth Network does automatically without requiring any data uploads or configuration}

To further remove friction from the process, we provide both the tablet computer and the requisite wireless monitors to the patient for free. Our interest is to make managing their chronic disease so easy, all they have to do is use it.

The bottom line is that if we can’t change the outcome on readmission by giving patients something really easy to use at absolutely no cost, then mHealth will have a much longer road to adoption than I imagined. It should be interesting to see how it plays out.

#mydigitalhealth; #heartfailure; #congestiveheartfailure

Introducing MyDigitalHealth Network (MDHN)

blogpost-imgHere at MyDigitialHealth Network (MDHN), we’ve been busy with the launch of our new platform for Heart Failure (CHF) with a nationally renown cardiology team in the U.S.

It’s an exciting day for us, and we are looking forward to connecting with you.

Who We Are And What We Do

The idea for MDHN stemmed from my frustration over the persistence of heart disease as the #1 killer in America and the inability for people to manage their chronic disease.

Why should your odds of survival be tied to the care you receive in the hospital?  

Why can’t I effectively manage my disease at home and not only improve my quality of life, but avoid hospital readmissions in the process?

I began a personal odyssey for 2 years to understand the dynamics of patients, providers, and payers and the home-based solutions that are available.  While a lot of companies and hospitals are creating their own apps and mHealth products, it was clear that nobody had really cracked the code.

How were seniors with CHF supposed to locate an app that’s right for them?  There are more than 100,000 healthcare apps in the App Store.  Even if they could find an app, they would need to know how to download it; register it; configure it; pair it with wireless monitors; upload their personal health information (PHI) and somehow store & forward the data to a medical professional.

If there’s anything that I’ve learned from 30+ years studying consumer behavior, it’s that every additional requirement you make a person do, is one more thing they won’t do.

So, it seemed clear there was a need for a well-designed, simple, comprehensive solution that’s easy to use.

A Problem That Needs a Solution

The statistics on Heart Failure are overwhelming:

  • 5.1 million people in the United States have CHF1
  • Heart failure costs the nation an estimated $32 billion each year²
  • The readmission rate after discharge is alarming — 25% are readmitted within 30 days and 33% within 90 days.³

I began having conversations with cardiologists, Nurse Practitioners, CHF patients and healthcare executives to research how we could deliver an integrated solution.

Here’s what we (and our clinical partners) believe: if a CHF patient does just 3 things – track their weight, heart rate and blood pressure–while taking their medications as directed, we can bend the curve on avoidable hospital readmissions.

MyDigitalHealth Network was specifically designed to address not only these key factors, but to provide a turnkey solution to help Heart Failure patients stay at home, and avoid readmission to the hospital.

1Heart disease and stroke statistics—2013 update: a report from the American Heart Association

²Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association . Circulation. 2011

³Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia – JAMA January 23/30, 2013, Vol 309, No. 4

Filed under Company News by david@mydigitalhealthnetwork.com @ 10:50 pm