It was not clear at first to Mark Heinemeyer and the rest of the team at Wanda™ that the Remote Patient Monitoring-centered data analytics system of the same name that he and his colleagues were developing would be most effective when deployed by home health agencies. Understandably, they assumed health systems and payers were going to be their primary customer base.
During a careful, deliberate development period that included a 12-year collaboration with the Wireless Health Institute at UCLA, Heinemeyer kept a close eye on how hospitals and payers were using their system. "It was disturbing to me," admitted Heinemeyer, Wanda's Chief Collaboration Officer. "When I spoke with hospitals, health systems and payers to learn how they were using Wanda, I discovered that they would turn it on for 30 days and then turn it off."
Hospitals simply didn't get it
He realized that these hospitals were using Wanda to serve the needs of their 30-day readmission penalty, not the needs of their patients. That was when the team turned its focus to post-acute care providers.
"We created a useful program, then looked at how we could commercialize it," Heinemeyer continued. "First, I confess, we didn't have our eye on home healthcare, either medical or non-medical. We stayed focused on health systems. But now we've shifted to defining Wanda as a home-centered care solution. The folks who will benefit most are those in direct home care and that is where we focus our development now. While we still see that Wanda can be a value to health systems and payers, between the bureaucracy and the perverse incentives there, we find a purer play and value for us in home healthcare."
One of the reasons for the shift in focus is the company's realization that healthcare at home has the best chance to reduce the gross cost of healthcare. Heinemeyer cited statistics that show the United States spent 17.6 per cent of its gross domestic product on healthcare in 2010 while the United Kingdom spent 9.6 per cent. He believes Wanda can benefit from the need to move patients from high-cost to low-cost care locales.
"Surveil and tattle"
To help HHAs become more data driven, Heinemeyer says Wanda's mission is to eliminate some of the variance in subjective decision-making. "We looked at value of bio-monitoring on its own and saw studies that say it does not affect readmissions or mortality. We also learned that data analytics do not change outcomes unless the patient is engaged."
This led to the decision to combine bio-monitoring with data analytics. "But we thought even that was not enough, so we partnered with John Hopkins to develop an adherence score. Without this critical component, we would be nothing more than another "surveil and tattle" home telehealth company," he joked.
This adherence score is what seems to set Wanda apart from both telehealth systems and analytics software. It was developed with Johns Hopkins through over 200 evaluation studies. People are asked questions reminiscent of a personality assessment. E.g. "I wouldn't mind meeting a celebrity." or "I'd like to climb a mountain." In addition, by factoring in a PHQ depression score1, they can factor a patient's mood into predictive analytics."
Psych and bio together
With these scores, Johns Hopkins researchers can make such claims as, "This patient is 80 percent likely to adhere to a program." But they were not satisfied to stop there, still calling these predictions shooting in the dark, Heinemeyer told us. "Two people with same adherence score could have completely different needs."
Drilling down to deeper details, they are able to arrive at five or six bullet points to inform a nurse how to approach each patient. For example, "He has the mind of scientist; a cause and effect guy." Wanda instructs clinicians not to tell that guy to cut back on salt, drink more water, etc. He needs to understand the big picture. Teach him what sodium does in the body, how water flushes toxins, etc. Some other patient might respond well to direct instructions, "Don't confuse me. Just tell me what to do and when to do it." Clinicians are more effective, they discovered, when they know and can adapt to these personality traits.
Treating patients like adults
Not only are clinicians more effective but patients are as well. "Now that we can customize care plans using both psychology and medicine," Heinemeyer said, "wouldn't it be nice if we could give patients with chronic conditions information about themselves in a language they understand? 'Your blood sugar is trending up a little this week.' or 'Your weight is up today but has been down for the last four weeks.' If a patient is interested and finds it motivating to see improvements that arise from how they are taking care of themselves, they will be encouraged to continue to manage their health."
"We can see that home is where care is going to be delivered," he concluded. "We can be of help by bringing science and data driven solutions to home care agencies that want to distinguish themselves from others."
1 Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. www.uspreventiveservicestaskforce.org)
©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org