Five Questions and an Elevator Pitch: AssessMed

1. What is the need that your project seeks to address?

Arman: We began with a costly and burdensome issue, the growing patient census in hospitals. Hospitals have been overflowing with patients in recent years and this has impacted healthcare providers, including nursing staff, health systems, taxpayers through Medicare, and patients. There is a solution that has been empirically proven to help relieve this burden, hospital-at-home, in which patients with less severe, acute-level clinical conditions can get the equipment they need and be monitored remotely while at home. They can have check-ups done intermittently through nurses and clinicians that check in on them at a certain cadence.

Hospital-at-home is a burgeoning field that can save the health system money and provide patients with a better experience, and it’s where we think medicine is heading, especially holistic medicine. We decided to focus on this new paradigm with an emphasis on how providers decide which patients are candidates to be discharged for at-home care. We also want to track exactly how safe it is.

2. How does your solution work?

Rahul: There are two key parts to our software that we envision. The first would be a dashboard that can be used by a central case manager to get a bird's eye view of all the patients in their hospital. The software would take into consideration all the factors involved in the decision to discharge a patient to the home care environment. This includes the physician’s clinical perspective, as well as logistical considerations such as patient distance from emergent care. It would also look at components such as social determinants of health, to ensure that the home is a place where each person can heal and that they have a support network in place.

With all these moving parts, it would be difficult for any one physician to make the call for a large panel of patients. We’re designing the AssessMed dashboard to integrate all those components and evaluate them against hospital policies, to enable a case manager to safely and effectively determine what patients to discharge to at-home care.

The second aspect of the platform is an alert system to proactively notify physicians and the case manager of those patients who might be ideal candidates for hospital-at-home, so they don't slip through the cracks.

Arman: There’s an imminent need for this information because hospital-at-home is in the early stages of adoption at many facilities.

3. What motivated you to take on the project? And what activities have you undertaken?

Arman: We heard a lot of poignant vignettes about patients who had tough experiences going through long-term care. Their experiences often involve acute events that require frequent multi-day hospital admissions. Empowering patients to heal in the comfort of their own homes is important. So the general mission of hospital-at-home makes a lot of sense.

Through the Biodesign program, we've been able to talk to different stakeholders to understand the overflooding of hospital beds and the related financial issues. A lot of beds could be freed up by a program like this. This urgent unmet need is what excited us most about our software solution.

In terms of our activities to date, the biggest limiting factor hasn’t been developing the hospital management software, it has been getting into the right rooms, building the right partnerships, and planning for some preliminary pilots. We’ve been doing a lot of needs finding and refinement of the problem we’re addressing. This is something the Biodesign NEXT award affords us the ability to do, as we don't want to build something that is a burden on physicians. We get to work together with clinical teams to understand what their needs are. This creates a longer development and implementation process, but that works to our advantage because we're more confident that we’ll produce an impactful solution and business model that works for physicians and hospitals.

4. What are the most important things you learned in advancing your project?

Arman: We've heard far too many instances of patients falling through the cracks, either through an existing hospital-at-home implementation or just generally in follow-up. The continuity of care, particularly as we increase the lifespan and the health span of many patients, is incredibly important. That's been a huge learning.

On the administrative side, one thing we've learned is how to evaluate the way that that health systems look at business problems and unmet needs. Their priorities are not based solely on the bottom line. It’s essential to improve quality of care in a way that’s financially viable. The combination of these two incentives has been another great lesson for us.

Rahul: For me, this experience has shown me how valuable it is to have a multidisciplinary team. Arman and I share very similar backgrounds in that we're both in the MD program, so we bring clinical insight to the project. But we have other gaps in our knowledge that have been filled in by other members of the team. For example, Ethan comes with a strong CS [computer sciences] background and has been able to work through some of the more technical possibilities with us, and help us imagine what our solution might look like in production. Kenna has an interesting background in both the technical and ethical parts of biomedical engineering. She has been able to highlight some of the important conversations we need to have as we get ready to potentially impact different populations.

5. What advice do you have for other aspiring health technology innovators?

Arman: My advice is to be open-minded. Hospital-at-home wasn’t even something we were excited about initially. We didn't really understand what it was, but we approached it with a curiosity mindset. Through that process, we came to appreciate the importance of it. Now the project is a labor of love.

Also, keep an open mind to what your solution could be. There can be a gap between what's the coolest thing to build and what's the most important thing to build. That's critical in healthcare because the coolness factor of technology is irrelevant if it's not getting in the hands of a patient or making a patient better. So, being really honest with ourselves has been something we learned and something I highly recommend.

Rahul: This might be a bit cliche, but there's this idea within sculpture art where the final form of the art is already there and you're just chipping away at it to reveal the end result. And that's definitely what we have experienced. We had this initial idea, but as we chipped away at the problem, the end need made itself apparent to us through the conversations we were having.