Win Burke, president, CEO and co-founder of iGetBetter, finds it easy to talk about the successful pilots of his company’s technology at healthcare organizations around the country. But it’s much harder to discuss the reasons behind his personal desire to fix the problem of coordinating patient care. Burke’s sister died of cancer three years ago, and he says his sister knew for much of that time that she was terminal. However, he believes that she died much sooner than she should have and in much more pain, largely because her healthcare providers didn’t coordinate her care. “I wanted to make a difference. I didn’t want people to have to go through that pain unnecessarily,” he says.
Cue iGetBetter, which helps clinicians create standardized care plans for high-risk procedures and for patients transitioning from the hospital to their homes. Patients respond to questions on smart devices and provide biometric data to their physicians, all of which allows their physicians to track progress and intervene when necessary, before hospitalization is required.
MedTech Boston recently sat down with Burke to find out more about what iGetBetter is up to:
Q: What problem are you trying to solve with iGetBetter?
Payment models are changing, and providers are taking on more shared financial responsibility for population health management. But they don’t yet have the infrastructure, technology and processes to do that effectively today. Our system helps them make that transition much more rapidly.
We allow healthcare providers to create care plans for patients once they return home from the hospital. Those care plans are specific to given conditions, such as congestive heart failure, and can be customized on a per-patient basis. Patients self-report via their Apple iPad minis on questions such as how much they’re exercising or whether they’re taking their medications on a daily basis; that information is then shared with their care team, along with automatically uploaded biometric information such as their weight and blood pressure.
With access to this information, healthcare providers can monitor and intervene, if appropriate, avoiding unnecessary emergency room visits or hospital readmissions – or even unnecessary visits to the physician’s office.
Q: What’s the physician experience with the iGetBetter solution?
Let’s say you have a patient with congestive heart failure. They’re just out of the hospital and their primary care provider is now managing their care. The primary care provider logs into our system and goes to the library of care plan templates, selects the congestive heart failure template, and then decides if they want to make any changes to it. They need to set the thresholds for body weight and other things that they want alerts on. In congestive heart failure, for example, there are three things you want to monitor: a patient’s medications, their blood pressure and, most importantly, their body weight. Fluid retention is literally the killer in congestive heart failure.
Here’s how that works: The patient weighs 200 pounds when they come out of the hospital; their physician wants to know if the patient loses or gains as little 3 pounds, so they request notifications if the weight goes up to 203 or if it goes down to 197. The primary care provider assigns this customized care plan to the patient, then they explain to the patient that every day they’re going to get instructions on their mobile device about what they’re supposed to do that day. Patients will need to step on the scale or take their blood pressure, for example. Physicians then give patients the Bluetooth scale and blood pressure cuff and show them how to use them; they’ll also give the patient one of our iPad minis. The whole process takes 10 or 15 minutes at the most.
Q: What happens after the patient goes home?
On a daily basis, the primary care provider is getting data from that patient. The primary care provider can either monitor it on a daily basis or when they log in they’ll have an alert list. If a patient is out of bounds on something, then there’s an alert and the primary care provider can see what the alert is about and what they need to do.
Typically, it will be an alert that the patient’s weight is going up. The physician or a nurse can call the patient and find out that nothing has changed but their fluid retention is going up. Then they’ll tell the patient to take a diuretic and check their weight again later in the day. If the weight goes down, everything’s ok. If the weight doesn’t go down, the primary care provider needs to intervene.
Q: Tell me what you’ve learned as a result of your work with Signature Healthcare Brockton Hospital, where you had a pilot of the software.
Signature Healthcare Brockton Hospital was our first real-world deployment; our first study was with MGH Connected Health – that was a very controlled environment.
The pilot at Signature Healthcare Brockton Hospital included congestive heart failure patients who were categorized as high risk for 30-day readmissions. During the pilot period, no patients were readmitted to the hospital for congestive heart failure-related complications. In addition, there were considerable reductions in emergency department visits, inpatient stays and outpatient appointments for cardiology and internal medicine, ranging from 68% to 92%.
Based on what we’ve learned at Signature Healthcare Brockton Hospital, we’re continuing to simplify the user interface for elderly people. For example, we got feedback from one elderly patient that they couldn’t find the off button on their iPad mini; the patient was expecting the button to be round.
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