A New Healthcare Delivery Model With AI & RPM

The COVID-19 pandemic has exposed significant weaknesses in our healthcare system today. Increased patient volumes stressing staffing capacity, increased caregiver exposure, and dwindling supplies of PPE continue to strain our hospital and senior care systems. The people that this affected the most are the patients and frontline healthcare workers who are working with antiquated resources and without adequate support to deal with these challenges. These problems are not new, but the pandemic has highlighted how ill-equipped our existing system is to deal with them. We have seen that a new delivery model is necessary in order to move forward, which is why many healthcare providers are considering AI and RPM platforms. 

COVID-19 Changed Everything

Dr. Tom Hale, Chief Medical Officer at VirtuSense Technologies says, “We’ve been aware of the possibility of a pandemic, but since the last true global pandemic was over 100 years ago—the Spanish Flu in 1918— healthcare delivery has not changed significantly in preparation of pandemic extremes. COVID-19 has unmasked the inadequacies in our healthcare delivery model. Healthcare will be forever changed and it is evident that to not change the model is a recipe for disaster.” 

For decades healthcare has operated based on a reactive model of care delivery, with patients acting as the sentinel alerting event. You feel sick, you call a doctor, they give you medicine or send you to a specialist, you get better. Rinse and repeat. “Most care models in the healthcare industry have spent billions on infrastructure to support this model. By definition this causes providers to enter the disease cycle in the middle to the end—never the beginning,” Hale explains.

Research by the American Journal of Medicine suggests early interventions are the key to better outcomes, COVID-19 being no exception.

“Many patients who arrive at the hospital by emergency medical services with COVID-19 do not initially require forms of advanced medical care. Once hospitalized, approximately 25% require mechanical ventilation, advanced circulatory support, or renal replacement therapy. Hence, it is conceivable that some, if not a majority, of hospitalizations could be avoided with a treat-at-home first approach with appropriate telemedicine monitoring and access to oxygen and therapeutics.”

Predictive Analysis

VirtuSense Technologies’ mission is to change this delivery model. Through years of work around AI and sensor technology the team at VirtuSense developed VSTOne. This breakthrough technology has enabled a proactive model for care delivery. VSTOne is a continuous remote monitoring and telehealth device using artificial intelligence (AI) and machine learning (ML) to aid providers in acute and post-acute settings to more effectively care for chronically ill and COVID-19 patients. The platform uses an array of machine vision and IoT sensors to monitor patient vitals (movement, heart rate, respiratory rate, blood pressure, O2, etc.); artificial intelligence to recognize anomalies; and mobile applications to alert healthcare workers before a patient’s condition declines. 

VSTOne receives a constant stream of health data from chronically and critically ill patients and leverages AI to interpret it, resulting in actionable alerts and decision support. Instead of waiting for a patient to report their symptoms, VSTOne recognizes early warning signs before the symptoms themselves manifest. Early warning enables early intervention, which means that patients will be able to avoid many serious health issues all together.

Telehealth is the Way Forward

Because of VSTOne’s telehealth capabilities and vital sign data acquisition, caregivers can manage more patients with fewer resources and lower exposure to infectious agents such as COVID-19. Traditionally, a nurse or tech will check patient vitals every few hours to monitor their condition. During the pandemic, every visit means new PPE. Remote monitoring reduces the need for them to enter the patient’s room. With VSTOne, a patient’s vitals are continuously monitored and are available as data points in time or as trends to the nurse’s phone as well as to a central monitoring station. Rather than 3-4 snapshots of the patient’s condition, VSTOne creates a movie of real time trending information. When relevant changes occur alerts are sent immediately so that interventions can begin as quickly as possible. Because of the use of the AI and ML the specificity is remarkable with little to no false alerts.

During pandemic surges, this is crucial for maintaining open rooms and resources for critically ill patients. “VSTOne gathers patient information in the hospital room in real-time. It has telemedicine capabilities with a camera and microphone, so when a nurse receives an alert she can see the patient and communicate with them from her smartphone,” Hale explains.

“There’s nothing more inefficient than going back and forth to patient rooms, taking vitals, etc. This technology will streamline workflows and potentially allow nurses to care for 30–40% more patients with greater accuracy and less work.”

AI is Everywhere

AI is proving to be a valuable tool during this pandemic to detect and prevent the spread of COVID-19. For example, AI technology has been deployed in public places like Beijing’s Qinghe railway station and at hospitals like Tampa General to detect people with COVID-19 symptoms and prevent them from spreading the virus. 2

We developed VSTOne to be the first step toward a better, more connected healthcare system. Many different organizations are addressing isolated parts of the issue, but these solutions are still triggered by patients’ self reporting symptoms consistent with the traditional reactive healthcare delivery model. What VirtuSense has done with VSTOne is create a comprehensive ecosystem that addresses multiple angles of the care delivery problem with greater sensitivity and specificity. 

Technology will change how healthcare is delivered both during the pandemic and after. Continuous monitoring combined with AI gives providers the full picture of a patient’s health without burying them in data. The insights and alerts will enable healthcare providers to care for their patients irrespective of time, place and situation making high-quality care accessible to everyone. VSTOne is the first step.

This article first published here.

Healthcare Economics: Value vs. Volume

The case for value-based care (VBC) has been evident for decades, but why has it taken so long for healthcare providers to embrace it? “It’s a mindset. ‘This is what we’ve always done,’ is the excuse,” says Bill Wynn, Vice President of Strategic Partnerships, VirtuSense Technologies. “COVID-19 has been the catalyst to start shifting providers toward a mode of value-based thinking and has highlighted the need to diversify revenue streams by augmenting fee-for-service (FFS) income with VBC.” 

Various legislation and programs have been approved over the past decade, but a universal implementation of value-based healthcare still alludes most care providers. The biggest barriers for initiating VBC, according to the 2019 survey by Definitive Healthcare, are lack of resources like staff shortages and integrated health IT systems; access to healthcare data; and unpredictable revenue streams—i.e. determining the financial risk involved in population health management. 

“The way we’re delivering care is becoming financially prohibitive,” Wynn notes. “When looking at the months where the COVID-19 impact was biggest, providers that operated on the VBC model were still making money, but other providers that make most of their money from elective procedures and are FFS-based didn’t, because they didn’t have patients coming in.” 

In September 2020, CMS issued guidance to healthcare providers to accelerate the adoption of VBC. “Many states have made progress in moving toward value-based payments in healthcare, yet there are still growth opportunities for more states to improve health outcomes and efficiency across payers including Medicare, Medicaid, and private insurance, by ensuring healthcare systems are financially incentivized to deliver the best quality, best value care. Aligning value-based care programs across payers could reduce the burden on providers who participate with multiple payers and improve the healthcare experience for patients.”  

Resetting the Healthcare Trajectory 

“The reason the healthcare industry is so slow in adopting a VBC model, is because providers are trained to fix things. The mindset of VBC is to never get to a point where you have to fix anything because you’re keeping your population healthy,” explains Dr. Tom Hale, Chief Medical Officer, VirtuSense Technologies. “Our current healthcare system is not preventative or patient-centric. It’s very much reactive.”

Here’s a typical scenario Hale gives to illustrate the inefficiencies of FFS. “Howard is having mild chest pain, so he calls his doctor, but the doctor either doesn’t get back to him right away or he can’t get in, so he calls his neighbor who advises him to to go to the emergency room. Howard goes to the emergency room—mind you, the ER is disconnected from the primary care physician. The ER doctor says, ‘Since you have chest pain, I’m going to admit you.’ They run a series tests, do a CT scan of the heart, and seek the advice of several specialists. At the end of the day the doctor determines Howard has chest wall pain, and that it’s not a problem. Now there’s a $30,000 medical bill, all because Howard couldn’t get timely access to his physician.” 

Lack of access and increased variation contribute to an environment that encourages higher and unnecessary utilization. “We have created the perfect model and infrastructure to get the results that we are getting—i.e. a model of care delivery that is inaccessible to patients, inefficient for providers, and wasteful and expensive,” Hale notes. 

“The United States spends more on healthcare than any other country, with costs approaching 18% of the gross domestic product (GDP). Prior studies estimated that approximately 30% of health care spending may be considered waste. Despite efforts to reduce over-treatment, improve care, and address overpayment, it is likely that substantial waste in US health care spending remains.”   – Waste in the US HealthCare System

 

If You Build it They Will Come 

Healthcare has built an infrastructure that creates $3 trillion in spending per year.  It is an infrastructure centered around hospitals and specialists that requires a high degree of utilization in order to financially survive. “It is what I like to call ‘Feeding the Beast’ — the healthcare beast. VBC changes the dynamic. The economic driver is based on keeping people well and out of hospitals and, by necessity, can only work if there is increased access to caregivers and providers and a decrease in the variation of care delivery and a navigated pathway for the patient’s healthcare journey,” Hale explains.

“Virtual care is the engine that will drive the success of a value-based healthcare model utilizing the technologic tools, data analytics, and AI and maintenance of the relationship between the caregivers and providers. The first two are occurring rapidly in all other industries, and the third is the ‘art of medicine’ applied through a different medium.” 

According to Hale, VBC needs to be a healthcare community endeavor. “Build the infrastructure around the doctors so they are able to do the right thing. The FFS economic model causes physicians to be bricklayers rather than being able to use their talents to be a general contractor. The physician/bricklayer, sees a patient and treats them, then moves on to the next one. The physician as a contractor, manages a population, which requires a more proactive approach to care.” 

Hale points out that VBC thrives on access, decreased variation in care (through centralization of the data) with intelligent distribution of the knowledge and support generated by that data—a 360-degree view of a patient’s health history, versus snapshots. Access is created through a multimodal approach which includes synchronous and asynchronous communication, telehealth communication tools, and a team care approach based in patient-centricity.

Bridging the Technology Gap 

“The difficulty in creating models which utilize virtual tools and data acquisition technologies is not the availability of the tools, but rather the transition in the infrastructure models. The economics have to work in the transition phase—the best of the past needs to be carried forward to the future and the pace of transformation needs to be certain that patients, providers and caregivers are not left behind,” he says. “This is evolution not revolution.” 

Remote patient monitoring (RPM) technologies and telehealth options are a big part of the solution for VBC because it decreases in-person visits and hospitalizations and keeps people healthier, especially during a pandemic. It also increases access to healthcare providers so you avoid costly scenarios like the one above with Howard. 

In the 2021 Physician Fee Schedule CMS is expanding its reimbursements for RPM and telemedicine and has commissioned a study of its telehealth flexibilities provided during the COVID-19 public health emergency. “The study will explore new opportunities for services where telehealth and virtual care supervision, and remote monitoring can be used to more efficiently bring care to patients and to enhance program integrity, whether they are being treated in the hospital or at home.”

“The inherent core to value based care is to keep people healthy. The tools, like remote patient monitoring, asynchronous communication, and Artificial Intelligence/Machine Learning create the ability to be the patient’s ‘general contractor’ as well as their personal physician and friend,” Hale explains. “Healthcare costs go down, profits go up, and patients have better outcomes from the proactive care that is created.  

“Everybody wins.”

This article originally published here.

How AI Can Augment an Already-Stressed Nursing Workforce

According to the American Nurses Association, there will be significantly more registered nursing positions available by 2022 than any other profession—more than 100,000 per year. This isn’t even factoring in the more than 500,000 RNs that are planning on retiring. The U.S. Bureau of Labor Statistics projects the need for 1.1 million new RNs in 2022 to avoid a nursing shortage. 

There are four driving factors impacting these numbers: 

1. Nurses are retiring earlier

The ANA estimates that 1 million nurses will retire between now and 2030. Not only is the profession expected to lose a large number of nurses, but when experienced nurses leave, healthcare organizations are left to mitigate the threat of lost knowledge. Nurses will leave with the critical nursing experience and knowledge they have accumulated

2. The Aging Population is increasing

The U.S. has the largest number of Americans over the age of 65.  As the population ages, the number of health conditions, chronic illnesses, and co-morbidities requiring healthcare services grow. These increasing healthcare needs require healthcare organizations to increase nursing staff to provide quality care safely.  

3. Shortage of nurse educators

According to AACN, U.S. nursing schools turned away more than 80,000 qualified nursing applicants in 2019 due to insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, as well as budget constraints. 

4. Nurse burnout

Nurses are overworked and mentally and physically exhausted, especially after the COVID-19 pandemic. 

Although hospital administrators are facing a huge dilemma in the coming years, there are technologies available now that can augment their current and future nursing workforce to keep patients healthy and safe. 

Artificial Intelligence Assists Nurse

VSTOne has enabled a proactive model for care delivery in the hospital. VSTOne is a continuous remote monitoring and telehealth device using artificial intelligence (AI) and machine learning (ML) to aid providers in acute settings to more effectively care for more patients with fewer resources. The platform uses an array of machine vision and IoT sensors to monitor patient vitals (movement, heart rate, respiratory rate, blood pressure, O2, etc.); artificial intelligence to recognize anomalies; and mobile applications to alert healthcare workers before a patient’s condition declines. 

VSTOne receives a constant stream of health data from chronically and critically ill patients and leverages AI to interpret it, resulting in actionable alerts and decision support. Instead of waiting for a patient to report their symptoms, VSTOne recognizes early warning signs before the symptoms themselves manifest. Early warning enables early intervention, which means that patients will be able to avoid many serious health issues all together.

Less Rounding & Fewer False Alarms

Because of VSTOne’s telehealth capabilities and vital sign data acquisition, more patients can be managed with fewer resources, thus reducing the workload for nurses. Traditionally, a nurse or tech will check patient vitals every few hours to monitor their condition. With VSTOne, a patient’s vitals are continuously monitored and are available as data points in time or as trends to the nurse’s phone as well as to a central monitoring station. Rather than 3-4 snapshots of the patient’s condition, VSTOne creates a movie of real time trending information. When relevant changes occur alerts are sent immediately so that interventions can begin as quickly as possible. Because of the use of the AI and ML, the specificity is remarkable with little to no false alerts.

Floor Management

The VSTOne Console allows you to manage your entire floor from a single screen. You can assign rooms to nurses and staff, track shifts, onboard patients, and view the status of each room in real-time. VSTOne automates routine vitals checks, non-emergency in-room visits, and gives patients the means to talk with family, specialists, or their doctor remotely.

A New Way Forward

We developed VSTOne to be the first step toward a better, more connected healthcare system. Many different organizations are addressing isolated parts of the issue, but these solutions are still triggered by patients’ self reporting symptoms consistent with the traditional reactive healthcare delivery model. What VirtuSense has done with VSTOne is create a comprehensive ecosystem that addresses multiple angles of the care delivery problem with greater sensitivity and specificity. 

For more information on VSTOne, please click here

This article originally published here.

Fall Detection is NOT Fall Prevention

Many fall “prevention” companies aren’t actually preventing falls at all, but rather notifying caregivers after a resident is already on the floor. There’s a big difference between detecting falls and preventing falls, depending on the technology you use. 

Most “solutions” in the marketplace are reactive, and thus ineffective: 

  • In-room sitters are expensive and not scalable
  • Telesitters require additional IT infrastructure while still requiring costly sitters to monitor video feeds
  • Bed and floor pads often send false alerts causing alarm fatigue. When real alerts are sent, it’s usually too late–the resident is already on the floor. 

These tactics serve as Band-Aids that cause more disruptions for residents without making a real impact on falls. 

Not All AI is the Same

Artificial Intelligence (AI) is a game changer in fall prevention in long-term care for older adults, but not all systems utilizing AI are the same. In fact, there are major discrepancies between fall reduction providers when it comes to their AI capabilities. 

Real-Time AI Detects Falls

Some products on the market use AI-enabled video surveillance that notify staff after a resident is already on the floor. These systems tout their ability to get to a resident within 10 to 20 minutes after a fall, but is that really effective, especially if the resident is injured? A fall is a fall.  

Predictive AI Prevents Falls

At VirtuSense, we believe the best approach to stopping a fall is to prevent it altogether. Using AI and a remote monitoring platform, VSTAlert can identify and alert staff of bed and chair exits 30 to 65 seconds before a resident gets up. One community saw an 82% decrease in falls after implementing VSTAlert. 

It’s 98% accurate which means fewer false alarms and fewer falls so your staff can care for those who need it most when they need it. 

Detecting falls after the fact, doesn’t inspire confidence. Predicting and preventing falls offers the best protection for residents and peace of mind for their families. 

This article originally published here.

AI Can Lessen the Burden for LTC Admins & Nurses

McKnight’s recently released its 2021 Mood of the Market survey results, which polled 627 long-term care administrators and nurse managers on the state of their profession. Not surprisingly, the survey results were pretty dismal compared to the same responses in 2020.  

When asked, “Has the pandemic made you more likely to leave the profession?” 29.4% said “yes, definitely,” compared to 17% in 2020, while the diehards who responded, “No way,” dropped nine points from 33% to 24%.  

Pandemic Burnout

Given the extreme circumstances they’ve been under the past 20 months with no clear light out of the tunnel now that the Delta variant has reared its ugly head, administrators and DONs are exhausted. Many are working extended hours and picking up floor shifts, because they’re understaffed.  

Staffing shortages are the biggest challenge in healthcare and even more so in long-term care, but there are ways to remedy this. AI technologies can assist your staff and help them care for more residents with fewer resources and better outcomes, especially for residents who are considered a high fall risk.  

AI to the Rescue

High-risk residents usually require extra staff, which isn’t feasible in current times. VSTAlert uses AI technology to monitor residents in real time and notify staff 30-65 seconds before they get up. Alerts are immediately sent to staff so they can get to them before they are out of bed. VSTAlert is 98% effective and it only sends. 5 false alarms per day, so staff aren’t wasting their time running room-to-room.  

The one bright spot in the McKnight’s survey is that 98% of respondents find their work meaningful, which isn’t something that can be said if you work as a fry cook at a fast food restaurant. Investing in an AI-enabled technology like VSTAlert, empowers your staff to focus on the meaningful work—i.e. resident care—and not the busy work created by false alarms and the lengthy documentation required after a fall.

This article originally published here.

Multiple Medications Can Increase Fall Risk for Older Adults

Most adults 65 and older take at least one prescription drug, as well as over-the-counter medications. It’s no surprise, given that 85% of older adults have chronic conditions. 

According to a recent study by PDS, an estimated 94 percent of older adults received a prescription for a drug in 2017 that increased their risk of falling, a startling increase from 57 percent in 1999. The study also found that the rate of death caused by falls in older adults more than doubled during the same time period.

In fact, between 1999 and 2017, more than 7.8 billion fall-risk-increasing drug orders were filled by older adults in the United States, the majority for antihypertensives, which treat high blood pressure. The use of antidepressants also rose sharply, from 12 million prescriptions in 1999 to more than 52 million in 2017, according to the study.

Medication Side Effects

Experts acknowledge that while these medications are necessary, they can be problematic because the side effects are often drowsiness and dizziness, which contributes to falls. The Washington Post reports, “Some drugs also can impair cognition and judgment, affect mood, and produce lightheadedness, loss of balance, blurry vision, slower reaction time, and wooziness. To try to address this, the CDC has launched a campaign to improve collaboration between health providers and pharmacists to assess patients’ medications and screen them for their risk of falls.”

Every year, millions of Americans 65 and older — 1 out of 4 — suffer falls, which are the leading cause of fatal and nonfatal injuries in this age group, according to the CDC. Even a nonfatal fall can be serious, especially if it results in a fracture or head injury. Three million older Americans are treated in emergency rooms annually after falling, and 800,000 are hospitalized.

Fall-Risk Assessments

Experts aren’t advising that doctors stop prescribing or recommending drugs to older patients, but they are suggesting that patients be more vigilant in questioning the side effects and making sure their doctors know all the drugs they are currently taking. Having regular fall risk assessments are also recommended. 

VSTBalance uses artificial intelligence and machine vision to identify mobility deficits in older adults and compare against normative data to determine their risk of falling. The system automatically generates reports after each assessment, helping therapists and physicians create more effective care plans and route patients to personalized home exercises, wellness, and/or therapy. These assessments may also quantify if their medications are impacting their mobility. 

This article originally published here.