eCaring: Bending the Cost Curve with Big Data for Home-Based Patients
By Sarianne Gruber
“There are a lot of tech savvy people making apps for tech-savvy people. It’s a wonderful world that we live in with the ability to do that, but we are not going to bend the cost curve in the United States by providing an app for an otherwise healthy forty-year-old person with diabetes or for the sixty-year-old that has a heart condition who is out on the golf course. If you really are going to bend that curve, you have to address the cost of the neediest and vulnerable members of our population. There is a lot of stuff going on in healthcare that is all great if you have a smart phone and can use it, but the costliest, neediest users in the system are the underserved and low income. They don’t have Wi-Fi or broadband in the home. They are the people who benefit most from the digital tools that can be made available and can provide more intensive personal care,” conveyed Robert Herzog, CEO of eCaring.
About three years ago at a Health 2.0 NYC meetup, I saw a wireframe presentation of the eCaring’s patient monitoring system and was extremely impressed with the simplistic and intuitive approach to collecting data. His company’s digital platform has become the basis for getting good information out of the home and perhaps, more importantly, introducing good information into the home. I had the opportunity to interview Mr. Herzog and learn how the eCaring system is breaking barriers for in-home patients and their caregivers.
Robert Herzog has a deep compassion for the neediest recipients of health services, often very underserved in terms of their access to new tools and digital resources. Having received a grant in 2014 from the New York Economic Corporation, they worked together with Pace University to alleviate patient diversity issues. Systems were installed in the homes of frail independent seniors living in public housing residences within Manhattan’s Lower Eastside. Most of the recipients were native Chinese or Spanish speaking, however, language constraints were not a concern for these eCaring users. Mr. Herzog described the universality of the interface as “icons” that pictorially depict a condition or behavior whether patients are eating, how they are sleeping or whether they are taking their medications as well as the ability to monitor vital signs. “But to the extent that people like additional information, eCaring has a help text which people can use in their native languages like Chinese, Russian, French, Spanish or Thigala, making it an easy introduction to using this as possible,” added Herzog.
Just a year ago eCaring established partnerships with Samsung and Verizon since many of their low-income patients don’t have internet access in their homes. Working with Samsung has lead to the creation of customized care plans for populations and individuals. Depending on the engaged care management organization, Samsung prepares “lock down ready to go tablets” for each home and Verizon provides low-cost data plans. The ability to put a tablet with connectivity in the homes of people who otherwise do not have internet connection opens up a whole world of opportunities to patients and their providers.
eCaring creates a plan of care or service plan that the homecare worker sees in the patient’s home and the information that needs to be entered. Any piece of information, data point or observation can be connected to an alert that says “pay attention now”. It may be a vital sign that is out of range or maybe a state of confusion, slurred speech or a change in bodily functions such as constipation or a bloody stool. All these things happen to people can occur at home over a period of time. New triggers for alerts are customizable by population, condition of disease and for the individual. The data helps you track if patients are adhering to the care plan, keeping their appointments as well as sleeping, eating and drinking regularly.
All these things are crucial to understanding the patient’s condition and helps prevent them from going back into the hospital. Technically, all results across the continuum of care get entered and go through the cellular data network up into the cloud in real time. Care managers can then view all information that resides on an extensive database. “We generate between 500 and 8,000 data points per patient per month on average for the people who are using it. That’s a lot of data! So we don’t want to overwhelm people. Care managers are already overwhelmed, and again we want to be practical with what fits into their workflow,” Herzog pointed out.
What makes eCaring unique is its starting point – the homecare worker, patient and family caregiver. Having witnessed his ill, retired mother take a “downward spiral” because the patient-caregiver information was not exchangeable, Herzog took his entrepreneurial skills of 30 years coupled with a pioneer spirit for technology to find a way to close this gap. “With that approach in mind, it was designed for people like you and me, taking care of mom and dad. There weren’t tablets; there weren’t smart phones in any way so we used PCs in the home. Training homecare workers on this unique system in order to get information and worked really well,” recounted Herzog. When the Accountable Care Act came about, industry trends, regulations, and mandates focusing on Managed Care became important. Herzog saw an opportunity to take what they originally designed for individual families and use it with enterprises. Upon making the switch, they started focusing on enterprise solutions and managing care for large populations.
Today the eCaring mantra is “practicality”, which is the reason why so many agencies, healthcare workers, and unions have used the product. Designed to be a simple, intuitive and easy system to use for people who will use it the most, not just the homecare worker, but the care manager may also be receiving this information. In this way, a rapid respond from all parties enables early intervention to keep people in their homes. “And we had really good success with that. I know a lot of the people are not losing sleep at night if only I can get good health data in the home because that is the part that they don’t know it exists. It’s a great opportunity for me today to let people know that there is a new source of big healthcare data out in the world. We generate extensive information and we also filter it very finely in a very usable format for people who can make good use of it. That information has a great impact on reducing hospital use ER visits readmissions, cutting costs and generating better outcomes and greater levels of patient satisfaction,” he triumphantly shared.
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