SBR Health at Brigham & Women’s Hospital

 

As virtual doctor visits take off, debate over who should pay heats up

Melissa Bailey, writing in the new Pulse of Longwood column for the Boston Globe’s Stat News leads the piece with a description of how the SBR Health virtual visit platform is being used in endocrinology at Boston’s Brigham and Women’s Hospital. Not only does the patient love it, but the doctor says it’s improved patient attendance.

VillageCare

We would like to welcome VillageCare Wellness Innovations to our family of customers. VillageCare recently received a Health Care Innovation Award from The Center for Medicare and Medicaid Services Innovation Center (CMMI) to pilot “Treatment Adherence through the Advanced Use of Technology” (TAAUT). This program aims to increase patient activation and treatment adherence for people living with HIV and AIDS by providing a multi-faceted intervention involving a social platform for behavior change, virtual visits, text reminders and peer support.

From the VillageCare site:

VillageCare Wellness Innovations expects to improve adherence in the most cost-effective manner by delivering education and support through technology. Participants will be able to access a customized private social network, virtual video support groups, treatment adherence professionals for questions, and text messaging for medication and appointment reminders. In addition, peer mentors will provide one-on-one encouragement and mentoring for behavior change.

“VillageCare has long been a leader in care for people living with HIVAIDS in the New York City area,” says Emma DeVito, President and Chief Executive Officer for VillageCare. VillageCare developed the first comprehensive AIDS Day Treatment program in New York and since then, has continued to create effective and innovative care models. “We are excited for the opportunity granted to us to develop a new and innovative way to encourage adherence and wellness for those living with HIVAIDS.”

The overall goal of the program is to improve viral loads and CD-4 counts, thereby simultaneously improving health and reducing overall health spending for the population. VillageCare was awarded just over $8.7 million to create and operate this program for three years. CMS will be conducting evaluations during and upon completion of the pilot program. More information may be found by visiting www.villagecare.org.

The project described is supported by Grant No. 1C1CMS331353-01-01 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.

What’s wrong with telemedicine?

While studies have shown that successful use of videoconferencing and real-time communications can profoundly benefit patients and doctors alike, how do we define success?

Telemedicine has been in use now since the 80’s but due to complexity, specialized equipment, expensive network infrastructure and poor Medicare/Medicaid reimbursement policies, it remained limited to a small number of users. These challenges made it impractical to use televideo technologies for care delivery on a larger scale.

Today, low cost and ubiquitous technologies do exist that can facilitate a world in which videoconferencing has a place on the desk of every doctor, nurse and clinician. However, what is needed at the clinician level are applications designed specifically for the health care industry with televideo as a method of communications.

What does this mean?

As studies have shown that health care outcomes improve when truly collaborative communication takes place among patients, doctors and specialists, televideo is becoming more mainstream. But for televideo to be both successful and effective, televideo technologies must be user friendly, highly secure, low cost and fully customizable.

Is that all?

Fixing televideo goes beyond cost and complexity. While there are a number of innovative televideo technologies, there is still the problem of integrating televideo seamlessly into clinical workflow. The success of any technology depends only 10 percent on the technology and 90 percent on how the technology is integrated with existing workflows.

To deliver care successfully and effectively across the healthcare continuum, televideo must be mapped to existing workflows to improve patient and clinician use experiences and to minimize change management issues.

Change is good but it’s not always great.

To make televideo great, let’s start with improving the usability.

 

 

SBR Health Q&A: The mobile shift in healthcare

Everything is moving to mobile these days, and healthcare is no exception. Christopher Herot, co-founder and CEO of SBR Health, is a recognized business and technology leader who has spent years developing and evaluating video, mobile and real-time video communications solutions. In this one-on-one interview, Chris shares his thoughts and predictions for how mobile technology will transform the healthcare space and beyond. From how we buy care to keeping in touch with family, mobile’s intersection and influence on our daily lives is significant.

How have you seen this shift?

There was a time when every young ambitious professional had a day planner. The iPad is now the equivalent. It’s your phone, calendar, email, entertainment, and computer – your method of communication for everything. This has really transformed a number of industries. Retailing is now different. People can do comparison-shopping using their phone. It’s even changed travel to some degree. You can get your boarding pass on your phone and check into places on Foursquare. For the longest time, it looked like healthcare was not a tech-savvy field but this is quickly changing.

What role does mobile play in the healthcare space?

iPads are taking the medical world by storm. They’re just the right form factor for healthcare. Apple reimagined what you can do with a tablet and has provided for an entirely new experience. Doctors don’t want other tablets. They want the iPad.

Some thought early tablets failed in terms of usability based on size but Apple demonstrated it wasn’t just about size but more about the user experience. There’s something truly unique about being able to type medical information while looking at your patient. This increases physician-patient engagement.

What’s the benefit?

There’s proven clinical value. Tablets have given doctors better access to tests and other medical information. A recent study published in the Archives of Internal Medicine found that iPads help doctors be more efficient at ordering tests and procedures for their patients. My thesis is that iPads allow physicians to do more in real time and make healthcare more convenient.

The real and long-term benefit of mobile technology is in bending the cost curve in healthcare. This goes beyond getting doctors to accept lower fees and cut down on unnecessary tests. The bulk of the cost is to get Americans to stop eating so many donuts. The way you make people healthier is to make it easier and convenient for people to see their doctor. This will drastically cut healthcare costs.

Why?

The demand for mobile reflects where we’re at as a society. The doctor is not always in his office ready to take your call, and so many of us are on the go. Being able to get access to the healthcare system wherever you are – work, home, out and about – is really critical. To make that work, we have to be able to see the patient and share what we see with other people. Tablets are small enough to be portable but also have real data on the screen.

How will this be adopted?

It will happen fastest where the payment model is evolving away from the fee for service. You’re seeing this with concierge practices. Once you make it easier for patients and doctors to do a virtual visit, I expect the adoption will expand to other parts of the world. There are places like the payers and insurance companies who see this as a way to improve healthcare delivery. You’ll see this first in places that have the luxury of not having to worry about restrictions. Concierge and post-acute follow up are prime examples.

SBR Health is developing the technology that will enable videoconferencing and real-time communications to benefit patients and doctors alike. Healthcare outcomes improve when collaborative communication that’s convenient takes place among doctors, specialists and patients, and we’re working to make it as simple and secure as possible.

SBR Health 2011: What We’ve Learned

As we start a new year, I looked back on all that we learned from the hundreds of conversations we had with doctors, patients and hospital administrators to pinpoint the top lessons that really stood out from 2011.  There was a lot of frustration with the fee-for-service model and the fragmented care that it engenders, but there were a few points of concern that surprised us that I thought I would share with our readers.

When we asked patients what they wanted from their doctors, we heard they wanted someone who would really listen, take them seriously, and didn’t keep them waiting. When we talked to doctors, we learned they were frustrated by patients who didn’t show up for their appointments, follow up with their treatment plans or take their medications. While it is often said that anecdotes don’t equal data, there are corresponding statistics on the sorry level of readmissions, which can often be traced to a lack of coordination among caregivers and the need for patient engagement.

As we looked into where video communication might help, we observed that video had two very different roles to play in medicine. The obvious role, as pioneered in dermatology and neurology, was using video as a diagnostic tool, for example looking at a photograph of a patient’s skin or observing his performance in a neurological examination.  The other role, which may be equally if not more important, was more of a consultative role to establish rapport and engender trust between the parties. Doctors refer to the “doorknob syndrome,” where the patient mentions the most significant problem as he has his hand on the doorknob to leave the room. As this is something that occurs most likely in person and least likely over the phone, video is more like being there in person. Video, like an in person visit, ensures a higher level of trust between the patient and doctor.

We also heard a lot from hospital administrators about “change management.” Doctors are avid consumers of technology, from surgical robots to smart phones, but they have little patience for tools that are supposed to help and instead create more work. Electronic medical records (EMR) are a case in point. Implementation of an EMR can cost millions (or even billions in some cases) but we have yet to encounter a health care professional who hasn’t expressed frustration with one. Enterprises everywhere need to deal with the high level of expectation conditioned by consumer IT, and health care is no exception.

When it comes to video communication, the technical requirements are pretty straightforward: high quality, low bandwidth, interoperability with existing systems, and straightforward user experience. While there may not be one technology that satisfies all those requirements at once, we at SBR Health see an opportunity in crafting a solution that combines the best of the available video technologies with applications that are compatible with the day-to-day workflow of busy clinicians, improve communication among clinicians, patients and family members, and enable more efficient and compassionate delivery of health care.

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Chris Herot is the CEO and co-founder of SBR Health. Prior to launching SBR in 2010, Chris was Chief Product Officer at VSee Lab, a provider of high quality, low bandwidth and low cost videoconferencing solutions to enterprises and governments. Chris has been a successful business and technology leader in several high growth companies, and directed the advanced technology group for several years at Lotus Development (now IBM) where he was responsible for video, mobile and real-time communications solutions.

Chris received his BS and MS degrees from the Massachusetts Institute of Technology where he was on the faculty of the group that became the MIT Media Laboratory.

Blog: herot.typepad.com

 

 

SBR Health: 8th Annual American Health Care Congress Exhibition

SBR Health will be at the 8th Annual American Health Care Congress Exhibition to explore and evaluate post-reform integration strategies, innovative business and care delivery models, as well as health IT. Featuring two days of educational and networking opportunities, SBR is excited to join other innovators and health care executives to address the present and future challenges facing health care reform, and find solutions for improving the delivery of care.

Innovators from the nation’s largest employers, health plans, hospitals, health systems and physician group practices will unite in discussion of post-reform integration strategies through themed panel discussions, exhibitions and networking opportunities. Discussions will focus on innovative delivery models, such as Accountable Care Organizations, Patient Centered Medical Homes, Bundled Payment Models and Virtual Integration Strategies.

Our work to develop televideo solutions that enable major health delivery organizations to reduce readmissions and increase access are aligned with the theme of this year’s conference—to improve the delivery of care. Our mission and belief that ‘Connection is the best medicine’ is clear. We are honored to join health care thought leaders in developing and implementing solutions for change. The foundation of health care reform is change, and through improved real-time communications capabilities, we’re driving change.

To follow us on Twitter while we’re at the conference, visit our Twitter Page.

SBR Health selected to participate in BluePrint Health IT Innovation Exchange Summit

SBR Health is BluePrint Health IT Finalist

SBR Health is chosen as a BluePrint Health IT finalist.

SBR Health is proud to be one of 10 finalists chosen from more than 40 applicants for the BluePrint Health IT Innovation Exchange Summit, an event dedicated to accelerating innovation and adoption of transformative, healthcare IT solutions nationwide. The summit will bring together cutting-edge, healthcare providers with innovative, early-stage healthcare information technology companies to showcase and accelerate eHealth innovation across the nation.

Modeled after speed dating, the event introduces technology companies and leading healthcare providers in short 15-minute meetings with the goal of creating the ideal match and fostering a pilot project. Participants start the day by attending seminars on how to foster a successful relationship. Following the meetings, attendees will participate in the preliminary round of 10 introductory sessions. In the afternoon, companies will engage in two longer meetings with the intention of outlining a framework for a potential project.

The SBR Health team is looking forward to connecting with Midwestern hospitals to help them find ways to leverage the benefits of telemedicine among their patient population. Make sure to follow us on Twitter as we engage with some of healthcare’s leading innovators at the summit.

TEDMED 2011

The TEDMED conference took place last week in San Diego, but it has taken me this long to digest all of the content and follow up on all the connections I made there. The general theme of the conference can be summed up in two sentences: There are amazing advances coming in medical technology. These may or may not make it through the FDA approval process in time to save your life.

This was one of the few conferences where it made sense to go to every session. A representative sampling:
•    Eythor Bender of Ekso Bionics demonstrated an exoskeleton that allowed a paraplegic to walk.
•    Daniel Kraft showing what medicine can learn from other fields such as aviation.
•    Calvin Harley of Telome Health describing how we might halt the aging process by regrowing the DNA on the end of your chromosomes. (A Russian researcher on aging cautioned me that you might not want to rush out and start gobbling down the “nutritional supplement” quite yet  – remember Vitamin E?)
•    Architech Michael Graves now in a wheel chair, describing his frustration with poorly designed hospital rooms,
•    Lance Armstrong describing the decisions he and his doctor needed to make in treating his cancer.
•    Quyen Nguyen of UC San Diego, showing a video of a fluorescent dye that binds to tumor cells to make them more visible during surgery.
•    Diana Nyad describing her attempt to swim from Cuba to Florida and her encounters with box jellyfish.
•    Paul Stamets on medicines derived from mushrooms.
•    Gabor Forgacs of Organovo demonstrating an inkjet printer that was modified to “print” organs from a supply of cells.
•    Yoav Medan of InSightec describing one of the breakthroughs that did get FDA approval: a device that uses focused ultrasound to do surgery without making an incision in the patient.
•     Mehmood Kahn, Chief Scientific Officer of PepsiCo arguing that we needed processed foods (albeit of higher quality) if we were to feed the earth’s seven billion inhabitants. (Although e-Patient Dave tweeted that this does not explain high fructose corn syrup.)
•    Dean Kamen describing his frustration in trying to get FDA clearance for a robotic arm he developed for war veterans.
•    Nate Ball, an engineer and beatbox artist demonstrating how he makes all those sounds. On stage. By having Dr. Nguyen thread fiber optics through his nose so we could see an image of his vocal cords as he made various sounds.
•     Charles Pel of Physcient describing a new model of retractor that uses force sensors to back-off before it damages bones or tissue.

Next year, the conference moves to Washington, DC. In a move that can only be described as audacious, Jay Walker plans to double the size of the conference and take on the DC establishment. If anyone has the enthusiasm and resources to do it, it would be Jay.

Check out more photos of the event here.

Day Two: SBR Health at the WHITv7.0 Conference

Day two of the World Healthcare Innovation and Technology (WHIT) conference got off with less of a bang than Monday  – hard to match the energy Todd Park put forth yesterday.

Today’s keynote was delivered by Peter Tippett, MD, Vice President of Connected Healthcare Solutions at Verizon who was to speak on the revolution in HIT being enabled by the marriage of the Cloud and mobility. Although very interesting, his keynote ended up pretty much being an hour long advertisement for Verizon. Not that this was all bad, as Verizon is doing a lot of interesting work applying science to uncovering falsehoods in current security dogmas. For instance, Peter presented how Verizon is attempting to make data more secure. By studying, then releasing information on data breaches and publishing the data at www..com/databreach, the updates will appear on their blog at securityblog.verizonbusiness.com.

What I find particularly interesting is that the length of a password does not significantly reduce the chances of being compromised. However, Tippett stated that most attacks come from remote access, so just doing port scans followed by locking down open ports would reduce data breaches by 70%!

I also found his discussion of the Verizon LTE was enlightening. Evidently Verizon uses a lower frequency than other carriers so their 4G service works better at penetrating buildings such as hospitals as these lower frequencies get around walls better.

In a panel session on mHealth, Joe Kvedar, MD, Founder and Director of the Center for Connected Health, spoke of his center has found that  patients are starting to do a better job at more effectively taking care of their health. This is being enabled by connected consumer devices like the new iPod Nano that can track your daily steps. He also stated that this is a timely convergence with the change in the way healthcare is being paid for, where healthcare providers need to become better at managing their populations health so these tools could not be coming at a more plotting time.

I found the rest of the day pretty mediocre with the exception of a presentation by Cynthia Galbincea, Executive Director of Marketing Communications at the Cleveland Clinic. Galbincea spoke on their mobile strategies, stating they are seeing a lot of demand from consumers for wellness and information applications, and have been very active in developing and deploying these types of applications, especially in support of their branding strategies. From their doctors, their organization is seeing the largest uses of their iPads for sharing information with their patients, assisting with diagnosis, as well as tracking patient’s progress on them. Cleveland Clinic’s mHealth strategist, Tony Crimaldi stated they are focusing exclusively on iOS development, and with that, mainly applications for iPad devices as these are the preferred device with their clinicians.

That’s it from the final day of WHITv7. Overall, a pretty impressive line up of thought leaders and innovators and I’m looking forward to more high quality innovation events such as this one from the World Congress.

This Week: SBR Health at the WHITv7.0 Conference

I’m onsite in Vienna, VA for two days attending the World Healthcare Innovation and Technology (WHIT) conference and thought I would share some highlights of the first day with our readers.

Todd Park, Chief Technology Officer, U.S. Department of Health and Services, kicked off the event, giving a fantastic, animated and passionate keynote on a confluence of market and health policy forces that have created an extraordinary environment for health innovation. I especially like his insightful remarks on how information liberation – new initiatives allowing patients to download and transfer their own data – is creating especially significant opportunities for entrepreneurs.

Vivian Funkhouser, principle of Health IT at Motorola, spoke about issues around managing the exploding number of devices to use in acute care settings. Her talk focused on the need to create scalable wireless infrastructures and multiple use devices.

Expanding on this topic, Brian Wells, an Associate Chief Information Officer for the University of Pennsylvania Health System talked about mobile device adoption within the health system and what they are doing to support the iPad is the device of choice. He asserted their users are overwhelmingly wanting iOS enabled applications – in fact, not one person has come to him to ask why applications were not being supported on Android or RIM devices. Brian also found that support issues for the iPad applications they have deployed are extremely low – iPad users generated .05 calls per user over 6 months. However, getting wider adoption of the devices is not without it’s challenges – one of the biggest issues he is facing is that their system just spent millions of dollars to put PCs in patient rooms for the physicians to use. So, it is still an uphill fit to convince leadership to purchase and deploy more mobile devices like the iPad. If he had it his way, Brian stated he would replace all the COWS (computers on wheels) with iPads!

In the afternoon, Will Yu, Special Assistant of Innovations and Research Office of the National Coordinator (ONC) spoke on how now is the best time to innovate in healthcare, as the market and incentives are aligned. He elaborated on how his office is attempting to create the ecosystem for their programs to be coordinated with healthcare innovator’s efforts, outlining their innovation framework which is based on communication, collaboration and support.

Closing the day with a well presented keynote, Paul Grundy, MD, the Global Director of Healthcare Transformation, IBM, spoke on new delivery models to drive down costs and improve care, focusing primarily on giving a very compelling argument for the Primary Care Medical Home model. He had perhaps one of the best and shortest definitions for a PCMH I have heard to date:

“A relationship based team with a project manager.”

One of the more poignant remarks he made to show how bad our current state of medical care coordination was that his cat is in a care registry so that no vaccinations missed, but his wife has to remember to get her own mammograms scheduled.

I’d be interested to hear your feedback on that last remark in the comments section.

That’s it for today – please check back tomorrow when I’ll report on some of the highlights for day two. –Peter Eggleston, Chief Marketing Officer SBR Health Inc.