Thousands of people travel to Boston every year to receive specialized treatment from one of the city’s world-class hospitals. After receiving treatment, however, the vast majority of those patients return home.
That means if they experience complications, they go to the nearest emergency department to be treated by doctors who aren’t as familiar with them or their condition.
Position Health is looking to solve that problem for patients with complex conditions. By alerting providers if their patient enters an emergency room or hospital, the company helps connect the people making treatment decisions with the people who hold critical knowledge of the patient’s prior care and condition.
Position Health co-founder Kyan Safavi came up with the idea in 2015 while working as a resident physician at Massachusetts General Hospital.
“We were seeing a lot of patients in the emergency department with complex, delicate plans of care in which the teams who were taking care of them in the long run were devoting a lot of resources to try to stay up-to-date and involved in their care,” Safavi says. “But, when the patient got to the emergency department, there was no reliable automated mechanism to alert the providers.”
Safavi partnered with Justin Wolfe, who also works as a software engineer at Charles River Development, to create the service. Wolfe’s first project was placing geofences around every emergency department and hospital in the country.
The solution uses the GPS in patient’s cell phones to trigger notifications via text, email or page. Because providers are notified in real time, they have the option to reach out and discuss treatment plans with care providers in the emergency department (ED).
That communication can be critical for patients with complex conditions that require personalized treatment.
“The reality is there’s quite a bit of fragmentation with patient information between health systems,” Safavi says. “Even when information is present, the way medical records systems display information makes it extremely difficult to extract the important information efficiently so that the ED provider can get a clear sense of who the patient is and their prior care.”
Physicians in EDs sometimes have to resort to additional testing to get patient information they could learn in a five minute conversation with a long term provider.
“With Position Health, EDs can provide more customized and high quality care plans,” Safavi says. “For example, the ED may learn from the primary care doctor the patient’s baseline symptoms and functionality so that they can send them home with a close follow-up with that doctor rather than admit them to the hospital.”
Beyond the alert feature, Position Health offers physicians a dashboard to analyze patient trends or get reports on things like which facilities their patients are using the most. The data can help physicians decide which facilities outside of their health system they should be developing relationships with.
The service works as a native app or an API that can integrate with other patient management systems.
Recently, the company has been receiving feedback on its native app in two pilot programs at Boston-area hospitals. Since January, Position Health has worked with cardiologists at Boston Children’s Hospital treating infants with Hypoplastic Left Heart Disease, a rare condition in which babies are born with functionally half a heart.
The disease requires two life-saving surgeries that occur months apart. Babies are typically sent home in between the surgeries for a scary and uncertain period where mortality rates can be as high as 15 percent.
If complications arise and the infants are taken to the nearest ED, the cardiologists want to be notified right away so they can participate in the treatment plan. The guidance they offer can be life-saving.
Another pilot program was launched in August to help physicians at a large medical center in Boston track adult patients with advanced heart failure.
Safavi says any patient with complex care needs could benefit from Position Health. The company is also targeting accountable care organizations, hospitals in bundled payment arrangements and primary care groups.
Position Health has used its pilots to expand the technology to detect critical moments beyond ED arrival, including whether the patient is sent home or admitted to the hospital, hospital discharge and post-acute care facility arrival or discharge. Other features are also being developed, such as alerts for when patients don’t show up to scheduled appointments.
In the future, Safavi says the data Position Health collects will be used to provide patient analysis and predict emergency department utilization. That won’t be possible until more data is collected, of course.
With more than 5,000 medical locations already in Position Health’s system, the company is in good position to scale. Position Health can simply add geofences to its service anytime a new partner wants to receive alerts from locations not already in the system, including skilled nursing facilities, long-term acute care facilities and rehabilitation centers.
Still, the founders are looking to continue gathering data and perfecting their service before pursuing aggressive growth.
“We wouldn’t want to put a service in physician’s hands that we didn’t have 100 percent confidence in,” Safavi says. “Our pilots have enabled us to refine our algorithms and drive our false positive rate down to almost zero. And we’re working hard to get it all the way to zero.”
Even in just two pilot programs, the impact Position Health is having on some of the most vulnerable patient populations makes it an easy company to root for.
“Patients are extremely excited to have the technology on their phone,” Safavi says. “We want to make sure that anytime a patient is experiencing a milestone moment in their care, the providers that know them best are able to participate.”
Images courtesy of Postion Health.