

BoardRounds Helps Hospitals Follow Up With Patients - wyc
http://techcrunch.com/2014/07/22/boardrounds-dorm-room-fund/

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mzwartbol
"most patients don’t call, don’t get the follow-up they need, get sicker, and
return to the emergency room which strains hospital and health insurer
resources"

I suppose this is a USA only problem? In europe pts get an appointment on
discharge. Of the people who fail to show (~5-10%) get called which leads to a
fail to show of ~1%. Of this group a small percentage has relevant pathology
and these pts. are of the doctor avoidant type mostly low social-economic
class.

I would like to see some numbers to support their claims. Of course I welcome
the idea of improving healthcare information systems. They are notoriously
slow, inefficient, insecure and outdated. Only good one I've worked with is
EZIS. I don't know why change is so slow but it probably has something o do
with money and fear of change and all the problems which come with it.

I've never used an information system which made it easy to look in to stored
data and find ways to improve health practice. Analysis software for
healthcare is/would/will be a big thing I hope.

Sorry for bad english.

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ThomPete
Yes it's very much a US problem but not isolated to that. Even in the superior
one payer healthcare systems many mistakes are made because people don't
follow up & through.

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dr_
A system that facilitates follow up care for patients is a good idea. It's
clearly in the patients best interest. It's in the hospitals best interest as
well. A number of hospitals are doing this already though, using their social
workers to arrange follow up care and making sure the patients go. There are
also "bundlers" who are doing this, but I suppose they could outsource some of
their work to a company like boardrounds. Sometimes a more hands on approach
is required, especially when dealing with the elderly. It's possible, over
time, for a pure tech solution to this problem. Ideally it would be integrated
within the hospitals EMR (really tough, given the reluctance of EMR's to work
with outside solution providers, but I think that will change over time), set
up the appointment, and maybe go as far as setting up transportation as well -
like integrating with Stat ([http://signup.stat.com/](http://signup.stat.com/)
\- i have no connection with this company, just a thought). Over the next
10-20 years you will also have a relatively more mobile savvy elderly patient
population, which will help this, and other solutions, grow.

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kyro
> _Sometimes a more hands on approach is required, especially when dealing
> with the elderly._

I'd say that extends to far beyond the elderly. I did the majority of my
clinical training in hospitals all throughout Brooklyn, and poor
compliance/follow-up was evident across the board for a number of patient
populations. Persistent hounding by social workers only proved successful half
the time. There are cultural and educational factors at play, in addition to
blatant laziness, that I think if addressed would yield improvement.

Like you said, many of the patients just aren't tech savvy, but I'd say more
are just not well-informed, educated properly on the importance of continued
adherence, and actively engaged in their care. Patients are usually given a
card with appointment details scribbled on for when to next see their
cardiologist for their CHF, or whatever that is. The period between them
walking out of their cardiologist's office to their next appointment is, I
guarantee, almost never spent reflecting on their condition or actively taking
steps to mitigate the complications, save for taking pills. A patient's
conditions are only serious problems to them within the walls of their
doctor's office. Once they leave, they're forgotten, understandably, out of
fear and comfort and the chaos of life. That's why I think it's critical that
a patient receive continuous education and encouragement in the interim
between check-ups, to close the gaps and help maintain continuous patient
self-conern.

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msrpotus
Having gone to a few different doctors over the last year, follow-up care was
almost always the most frustrating part of the experience. Either they lost my
chart and paperwork, didn't follow up, didn't explain what care I needed or I
dropped the ball on it (and never heard back from them). Healthcare as a whole
could use some big changes but this seems like an easy place to start.

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i80and
My experience has only been in managing veterinary systems, but from what I've
heard and seen, the wider healthcare world _desperately_ needs more
technological infusion, especially in interacting with clients.

Glad to see stuff like this and Oscar insurance entering the space! One of
these days, I'll throw my hat into the ring and try to get vet clinics some
tech attention...

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kyro
Met Benjamin at a health event in New York, and was really impressed by him,
the team, and the service. Really smart guys tackling one of the biggest
issues in healthcare, patient compliance and follow-up. Congrats on the press
and funding!

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calebm
There is another company already doing this:
[http://myhealthdirect.com/](http://myhealthdirect.com/). (Disclosure: I did
some consulting work for them).

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chimeracoder
(BoardRounds co-founder)

Thanks for pointing these guys out! One point I should clarify: we recommend
and fulfill followup interventions. Appointment scheduling is a portion of
that, but it only scratches the surface of what our services can do.

Follow-up appointments are the "bread and butter" of follow-up care (most
patients who need any sort of follow-up will need a doctor's visit), but the
real power comes in being able to identify additional interventions
(transportation, medicine reconciliation, home care) and set them all up at
the point of discharge. This has to happen on a per-patient level, because
while it is incredibly valuable for the patients who require it, it's fairly
expensive, and it would be prohibitive to (e.g.) send a nurse to the home of
every single person who leaves the ER the next day to check up on them.

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jflowers45
I often use ZocDoc to find appoints/book them with doctors, but it would be
interesting if they integrated something like this. Possible partnership?

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chimeracoder
BoardRounds cofounder here - great idea! We do in fact integrate with various
service providers (including appointment scheduling APIs) when arranging
followup care.

We definitely want to leverage existing services as much as possible, not
reinvent the wheel. Appointment scheduling is the most common follow-up
intervention, but there are other services we recommend and can provide, and
our goal is to partner with other providers for those where possible.

