- Large hospitals are starting to embrace technology in their operations.
- Adam Landman, CIO of Brigham Health, which is affiliated with Harvard, spoke about the health system’s work with early-stage startups.
- One of the most successful projects they have had is a texting-based colonoscopy prep guide developed by early-stage company Medumo.
Preparing for a colonoscopy isn’t pleasant.
In a colonoscopy, a doctor uses a scope to take a look at the inside of the colon, often to check for growths that could indicate cancer. So that the doctor can get a good look, you have to start eating a low fibre diet several days before the procedure, and then transition to a clear liquid diet the day before and take lots of laxatives -a regimen known as bowel prep.
Sometimes, though, patients don’t follow the instructions, and the doctor can’t get a good look, leading to wasted time and money. Or they don’t show up to their appointments at all.
The Harvard-affiliated hospitals called Brigham Health and Massachusetts General Hospital have been experimenting with a startup that says it can help solve both problems. And the initial results exceeded expectations.
“Both saw decreases in no show rates of over 30%. That’s a very significant ROI right then and there,” said Adam Landman, the chief information officer of Brigham Health. The startup is calledMedumo, and the experiment is part of a strategic collaboration between [email protected] and the Brigham Innovation Hub, which the health system started in 2013 with the mission of testing new ideas in clinical settings. Brigham Health has tested out some early stage pilots and studies to see what parts of new technology does and doesn’t work. The innovation hub also serves as a connection point between clinicians, researchers, entrepreneurs, and venture capitalists.
“What we’re trying to do is create a learning environment. We want to work with startups that have great ideas and great people. Because we don’t have all the answers either,” Landman said at the Financial Times Digital Health Summit in New York.
From doing this, Landman said they hope to find 5 or 6 different programs that can be implemented. Moving forward, different elements from the different programs may be patched together into one seamless experience for the patient.
“I think right now we’re in the fertile field of innovation where lots of solutions are popping up, and pretty soon, I think we’re going to see some consolidations, particularly focusing on the patient experience side, where we’re seeing incredible solutions coming up,” Landman said.
Success in poop texts
Here’s how the Medumo system works. It sends appointment reminders to patients as text messages, and gives them information on the bowel prep regimen. That can be pretty detailed. It tells them what their stools should look like, colour and consistency-wise, and provides daily reminders and a list of tasks.
It also provides patients with a phone number they can call to reach the endoscopy clinic for help if their stools don’t look like what the texts say they should look like after trying a few things suggested by the program.
On the morning of the procedure, the app sends directions from the patient’s front door to the exact endoscopy clinic inside the hospital. After the procedure, the app sends a patients a survey about their experience. When the results are available, the app can tell patients how to view it in the patient portal, or send a sign-up link.
The program has made a big difference for colonoscopy patients, according to the health system. The proportion of patients whose insides weren’t prepared for the procedure dropped from 11.5% to 3.8%, while the number who didn’t show up for their appointments fell to about 4% from 6%.
“We have some very encouraging results and we’ve started to spread to other procedural areas and other use cases,” said Landman. By keeping the form of delivery to something as simple as texting, Landman said they have been able to observe good results and high engagement. “Over time, as our population ages, I think this will be second nature to many. And I think there’s services and opportunities to think about, as digital becomes more important, such as how do you support that in the home,” said Landman. A possible solution, he mentions, is to have a ‘Genius Bar‘ at the hospital, like the one created by the Ochsner Clinic in Louisiana to help patients and families troubleshoot technology problems.
One of the challenges for health systems is choosing between competing priorities, said Landman. That includes making a decision between building a billion-dollar patient tower with inpatient rooms, or investing money in digital technologies, telehealth and virtual health. And that’s the crux of some of the key discussions coming up in the health system, according to Landman. “It’s a very difficult decision, but I think we are going to be disrupted by Amazon and Apple and many of the companies here in this room if we don’t change,” he said.
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