Market Research & Positioning

[weeewake]

• Today's situation
• [Common Errors]
• Economic and Human Cost
• Our Solution
• Other Alternatives
• Why partner with us?
• [Costs]
• Who are some of the leading researchers in this field?
• How much will this cost vs. your current system?
• Why this approach might not work

[weeewake]

Current Alternatives

• Pager System
• Text Messaging
• Care Coordination

Reading List

• [ ] Gartner's Magic quadrant

Partners

• [ ] [TrueVault, a HIPAA Compliant Database as a Service]

Integrated Care Coordination

• [ ] Seratis
• [ ] Care Thread
• [ ] Voalte - Reimagining Healthcare Communication
• [ ] Vocera - Mission Critical Communication
• [ ] Perfect Serve - Single, unified communications platform that connects clinicians in any care setting
• [ ] Amcom - HIPAA compliant Texting, OnCall Scheduling, Nurse Call Systems Integration
• [ ] Medical Heartbeat

Adjacent Markets - Productivity

• [ ] Slack

[weeewake]

• About us
  • 20+ years of combined experience at MSFT, GOOG, LNKD
  • Experience in large scale systems, enterprise and consumer
• What's in it for you?
  • Developing a custom solution would cost you upwards of $1M
  • If we decide to work together, we'll develop an integrate solution for no charge
  • We'll offer it to you for free for up to a year
• Suggested next steps
  • Shadow your current workflow
  • Run in parallel with existing systems to minimize disruption
  • Solve a targeted use case
  • Evaluate every 6 weeks

[weeewake]

h1. Pricing

• [ ] How much do hospitals spend on current solutions?
  • USA Mobility
  • Spectra Link
  • Phone systems
• [ ] How much do competitors charge?
  • Tiger Text
• [ ] What would be the cost structure for a solution package

[weeewake]

What is the situation today?

To Do

• [ ] Shadow sessions
• [ ] 20-30 real world paging scenarios (including conversation if any)

Market

• Nursing is the nation’s largest healthcare profession - 3.1 million registered nurses (RNs)
• More than four times as many registered nurses as physicians in the United States.

Nature of Teams

• Teams dynamically form and disestablish around a given patient.
• On average, a patient is seen by 5-10 different providers during their hospital stay.
• Each of these providers are caring for 10-20 patients at the same time.
• All of them come on and off shifts regularly and at different times. There exists a knowledge gap of whom else is looking after their patient.
• On average, a clinician knows only 30% of a patient’s care team.

Today's technology

• More than 90% of real-time communication in hospitals still occurs via pagers
• Interruptions lead to reduction in working memory, which increase the risk of medical errors.
• Hence, psychologists and communication experts believe asynchronous forms of communication in the hospital should be encouraged unless relaying highly urgent or complex information.
• Since the pager provides little to no context on whether the incoming communication is urgent or complex, it becomes synchronous.
• ~ 81% of North American physicians use a smartphone

Economic and Human Cost

• Studies show pagers cause discharge time to be elongated by 100%.
• More than a hundred thousand people die in the USA due to medical errors. Poor communication leads to 50% of them

Example Stories

References Why can’t teamwork in healthcare work? Doctors and nurses are working with the wrong technology

Five key steps to transform healthcare through improved communication and collaboration

[weeewake]

Error Rates

• [ ] Distribution of errors by type, time of day, impact ($, time, outcome) and frequency of occurrence

[weeewake]

Notes:

• Diversity of devices has advantages; in fact, redundancy is critical. If a paging system goes down, having a backup contact method and the ability to automatically alert staff on their secondary device (e.g., a smartphone or cell phone) is critical for patient safety and continuous workflow.

A Call to Action: Overcoming Communication Challenges in Hospitals

See Highlights in PDF

How does our solution differentiate itself?

• Design Principles of the 'Ideal communication tool'
  • Only essential communication should interrupts clinicians
  • Allows clinicians to indicate their location (isolation room, in the operating room) and availability (available, performing a procedure, in critical family meeting).
  • Allows the large volume of patient information to be conveyed and shared at the appropriate time to the right person.
  • Allows clinicians to choose when and what types of information they wish to receive
• Many Competitors are looking to replace Pagers with Text Messaging
• Task Management Tool focused on Error Reduction and Cost Savings
• Unify text, voice, images into one task focused experience. Auto record and replay conversations
• Contextual - Consider where the user is, what she is doing, how important the issue is

References: Improving Hospital Care and Collaborative Communications for the 21st Century: Key Recommendations for General Internal Medicine

Why this approach might not work

Looks like a MUST read

It's not about pager replacement: An in-depth look at the inter-professional nature of communication in healthcare

RESULTS:

• Interruptions increased 233%, from 3 pages received per resident per day pre-implementation to 10 messages received per resident per day post-implementation.
• Key themes relating to unintended consequences that emerged from the interviews included increase in interruptions, accountability, and tactics to improve personal productivity.

CONCLUSIONS:

• Meaningful improvements in clinical communication can occur but require more than just replacing pagers.
• Introducing HIT without addressing the sociotechnical aspects of HIT that underlie clinical communication can lead to unintended consequences. Journal of Hospital Medicine 2013.

[weeewake]

Who are some of the leading researchers in this field?

Researchers to contact:

• [ ] Ritu Agarwal

[weeewake]

What are the economic and human costs?

Economic Costs

• U.S. hospitals waste over $12B/yr as a result of inefficient communication

  • 6B in extended hospital stay

  • 5B in wasted nurse time

  • 1B in waste physician time

  • represents on average 2% of a 3.6% operating margin
• A 500-bed hospital can expect to lose over $4 million annually
• "It is amazingly complicated and very difficult to ensure that you reach the right person at the right time" - CIO, Hospital G
• Nurses spend 3 hours per shift tracking down other people. 5-6 calls to locate the right physician

Human Costs

• Poor communication accounts for ~65% of sentinel events (unexpected occurrence resulting in death or serious injury)

References: Quantifying the economic impact of communication inefficiencies in U.S. hospitals.* (July 2010)