CHF connect app for managing patients with chronic heart failure
Gangadhar Sulkunte Co-FounderCONFIDENTIAL Feb 3rd 2013
Introduction• The App - CHF Connect: Reduce readmissions of CHF patients and improve at-home care• Allscripts Integration: Out of box CHF solution for Allscripts clients• Technical Integration: No EHR modification or IT team involvement needed for successful implementation.• Pilot Program Status: In discussions with NYC hospitals for pilot programs• The application developed addresses the following category of the Allscripts challenge: Applications that improve management of high cost chronic diseases. Innovative approaches to addressing value-based care imperatives. Both
The SituationHospitalized patients with CHF are not a monolithicgroup1. They tend to be extremely illupon discharge2. Outpatient care is fragmented3. High percentage will be readmitted3
Readmission Rates are HighReadmissions rates for CHF patients are high: • 13% @ 15 days1 • 25% @ 30 days2 • 45% @ 180 days3How can we lower readmission rates?4
Readmissions can be LoweredReadmission rates are lowered by: • Post discharge care6-10 • Pre-discharge planning1,12 • Home-based follow-up13 and testing • Patient education11,14,16But, solutions lack comprehensiveness and cohesion.5
CHF Connect – The Solution MONITOR: CHF specific at-home patient monitoring MANAGE: Manage CHF patients discharged in the last 30, 60 or 90 days INTERVENE:Early warning Early Intervention Fewer Readmissions6
CHF Connect – How it WorksCHF CONNECT:• Connects your healthcare providers with patients more efficiently than any other disease management system.• Utilizes “management by exception”, clinical algorithms and guided workflow processes that standardize care.• Facilitates targeted intervention that results in reduced hospital readmissions and improved patient quality of life.• Integrated with Allscripts EHR out of the box.7
CHF Connect – How it Works 1.Patient Education 2. At-Home Pre and post Monitoring Discharge 3. Proprietary Rules Driven Algorithms Allscripts 4. Compliance EHR Integration8
CHF Connect – How it WorksCHF CONNECT:• Prioritized and categorized daily follow-up. Guides your care team through an efficient intervention process.• Rules-driven algorithms can be customized for your CHF population and configured at the individual patient level.• Efficiency and ease of use allows one heath care provider to remotely manage several hundred patients.9
Demo Video• Movie: http://youtu.be/-eBzYjBIVmg• The video describes our app and shows how a nurse can use our app and manage patients with Chronic Heart Failure.
Development Stage• Please indicate the development stage as of the Phase 1 Submission Date: Idea Prototype Code development in progress Code complete Code complete, tested and approved by Allscripts.• The prototypes for the apps in both Win8 platform and iPad are complete. They can be accessed here:• We are working on a backend which will power both the Win8 and iPad apps.• We are also working on native apps for Windows 8 and iPads.
Integration Description• Our app will use the Allscripts login API calls to authenticate the providers into the app.• The app will then query the EHR for patients who were discharged in the last 24 hours using the call GetPatientsbyICD9().• The app will then identify the relevant condition for the patient by calling GetPatientProblems().• Get patient contact details using GetPatientFull().
Team Dan Reich, Founder • Co-Founder of Spinback (acq. by Buddy Media, acq. by Salesforce, NASDAQ: CRM) • Top 100 of “coolest people in New York tech” – Business Insider 12’ • B.S. Electrical Engineering with Honors – University of Wisconsin, Madison Gangadhar Sulkunte, Co-Founder • Founder of Lifely, an innovative and fun Diabetes tracking app • Winner of mHealth challenge in Mobile Monday Athens • Runner up at Health 2.0 Berlin Code-a-thon • Member and Contributor to Society for Participatory Medicine Marc Straus, MD, FACP, Chief Medical Director • Co-Founder of mdINR (acquired by Lincare, NASDAQ:LNCR) • Founder/CEO of MDxMedcare, managed 300+ doctors in NY • President of Oxford Medical Group • Chair, Oncology and Professor of Medicine at NY Med College
Team James Gary, Advisor • Co-Founder of mdINR (acquired by Lincare, NASDAQ:LNCR) • COO/President of Virtual Incentives Ari Straus, Board Member • Co-Founder of mdINR (acquired by Lincare, NASDAQ:LNCR) • President & Partner, Monticello Motor Club
Appendix - References1 Keenan 10 Gonseth J, Guallar-Castillon P, Banegas JR, Rodriguez-Artalejo F. The effectiveness PS, Normand SL, Lin Z, Drye EE, Bhat KR, Ross JS, Schuur JD, Stauffer BD, Bernheim SM, Epstein AJ, Wang Y, Herrin J, Chen J, Federer JJ, Mattera JA, of disease management programmes in reducing hospital re-admission in older Wang Y, Krumholz HM. An administrative claims measure suitable for profiling patients with heart failure: a systematic review and meta-analysis of published reports. hospital performance on the basis of 30-day all-cause readmission rates among Eur Heart J. 2004;25:1570 –1595. patients with heart failure. Circ: CardiovascQual Outcomes. 2008;1:29 –37.9. 11 Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM. A2 Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the multidisciplinary intervention to prevent the readmission of elderly patients with Medicare fee-for-service program. N Engl J Med. 2009; 360:1418 –1428. congestive heart failure. N Engl J Med. 1995;333:1190–1195.3 Krumholz 12 Schneider JK, Hornberger S, Booker J, Davis A, Kralicek R. A medication discharge HM, Parent EM, Tu N, Vaccarino V, Wang Y, Radford MJ, Hennen J. Readmission after hospitalization for congestive heart failure among Medicare planning program: measuring the effect on readmissions. Clin Nurs Res. 1993;2:41– beneficiaries. Arch Intern Med. 1997;157:99 –104. 53.3 Krumholz 13Stewart S, Pearson S, Horowitz JD. Effects of a home-based intervention among HM, Parent EM, Tu N, Vaccarino V, Wang Y, Radford MJ, Hennen J. Readmission after hospitalization for congestive heart failure among Medicare patients with congestive heart failure discharged from acute hospital care. Arch Intern beneficiaries. Arch Intern Med. 1997;157:99 –104. Med. 1998;158:1067–1072.4 Ashton 14 Koelling TM, Johnson ML, Cody RJ, Aaronson KD. Discharge education improves CM, DelJunco DJ, Souchek J, Wray NP, Mansyur CL. The association between the quality of inpatient care and early readmission: a meta-analysis of the clinical outcomes in patients with chronic heart failure. Circulation. 2005;111:179–185. evidence. Med Care. 1997;35:1044 –1059. 15 Krumholz HM, Amatruda J, Smith GL, Mattera JA, Roumanis SA, Radford MJ, Crombie5 Gwadry-Sridhar FH, Flintoft V, Lee DS, Lee H, Guyatt GH. A systematic review and P, Vaccarino V. Randomized trial of an education and support intervention to prevent meta-analysis of studies comparing readmission rates and mortality rates in readmission of patients with heart failure. J Am Coll Cardiol. 2002;39:83– 89. patients with heart failure. Arch Intern Med. 2004;164:2315–2320.6 Lappe JM, Muhlestein JB, Lappe DL, Badger RS, Bair TL, Brockman R, French TK, Hofmann LC, Horne BD, Kralick-Goldberg S, Nicponski N, Orton JA, Pearson RR, Renlund DG, Rimmasch H, Roberts C, Anderson JL. Improvements in 1-year cardiovascular clinical outcomes associated with a hospital-based discharge medication program. Ann Intern Med. 2004;141:446–453.7 Phillips CO, Wright SM, Kern DE, Singa RM, Shepperd S, Rubin HR. Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. J Am Med Assoc.2004;291:1358 – 1367.8 Jovicic A, Holroyd-Leduc JM, Straus SE. Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials. BMC CardiovascDisord. 2006;6:43.9 McAlister FA, Lawson FM, Teo KK, Armstrong PW. A systematic review of randomized trials of disease management programs in heart failure. Am J Med. 2001;110:378 –384. 15