Coalition of support building in favor of the RUSH Act

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Every single day, thousands of elderly nursing home patients are subjected to disorienting and costly transfers to the Emergency Department for health challenges that could potentially be treated in place, if the resources were in place to do so.

Nearly one out of every five ambulance transfers to the ED come from nursing homes. These are often chronically ill, medically complex patients with acute medical needs. The chaos of the ambulance trip causes additional mental and physical distress. They arrive at the hospital alone and are forced to bear the burden of interacting with a new set of “clinical strangers” who are unfamiliar with their symptoms. They’re often put in beds in the hallway and left alone. Frail, vulnerable, elderly patients are simply ignored.

It doesn’t happen because clinicians don’t care or anyone wants these patients to be suffering the loneliness and isolation of the hallway ED, it happens because we have a system that’s broken. One area where politicians can and should be able to find common ground is value-based care arrangements, which have proven to be better for patient care and less costly for the healthcare system. 

Healthcare Outlook: How the Industry Will Trend and Transform in 2019

This past year was a transformative one for healthcare. From big tech’s entrance into the field to the rise of virtual care to Congress warming to reimbursing innovative care delivery models, the healthcare industry has started to see some significant shifts in the space. The importance placed on value-based care has also been a major driver for industry change for patients, providers and payers. The opportunity to improve patient outcomes while decreasing cost will drive the industry forward and help reshape legacy practices.

In a speech at an Alliance for Connected Care telehealth policy forum in November, CMS (the Centers for Medicare & Medicaid Services) Administrator Seema Verma spoke about how “relentless innovation is a crucial driver in creating value across all industries.” With that sentiment in mind, here are five trends that will impact the health tech landscape in 2019:

The Cost of Quality Care Through Telemedicine

As value-based care takes center stage, how medical professionals can incorporate technology to better serve underserved communities

Providing comfort to those in extremis is among the most important things medical professionals can do in the field. Being with people at the moment of their greatest vulnerability and providing companionship, connection and support can be just as important as providing breathing treatments, fluids or antibiotics. This is especially true for patients in nursing homes, one of most vulnerable populations in the nation, but how can we make this type of care a priority to this demographic?

In 2015, I cofounded Call9 after living in a nursing home for three months. I was 34 years old and wanted to understand this patient population and their experience so I could better serve them. Before then, I had been an Emergency Physician at Beth Israel Deaconess in Boston and time and again had cared for patients making seemingly avoidable visits to the Emergency Department (ED). If the facilities had the time, tools and technology to treat them in place, it would make for a more comfortable experience for the patient and would be more cost effective to the payer. There were three key takeaways from my experience.

Executive Decisions: In-house emergency med tech keeps the doctor away

A telephone call out of the blue has helped 202-bed Central Island Healthcare slash its rehospitalization rate, capture about $150,000 in bonus government payments and earn a No. 1 rating among the nation’s 15,000 certified skilled nursing facilities. The secret ingredient for this metro New York provider? Embedded paramedics who connect with off-site, contracted physicians via telemedicine. McKnight’s Editor James M. Berklan spoke with CIH Executive Michael Ostreicher about the startling results.

Podcast: Why Tim Peck Built Call9 A Platform That Reinvents The 911 System

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Today marks one of the most exciting milestones in the history of 20 Minute Fitness. We’re bringing you the very first episode of ‘Why I Built This’, a mini series introducing innovations that are revolutionizing the health & fitness industry and of course the master minds behind them.

On our first episode we had the pleasure to sit down with Tim Peck, who left his Chief Resident position at Harvard Medical School and moved to Silicon Valley to build Call9, a platform that can reinvent the 911 system. Although most people thought he “lost his sanity” at that time, Tim has proved all of them wrong. Call9 has already delivered life-changing care to over 3,500 patients and this is just the beginning.

Call9 Helps SNF Partner Achieve Maximum Bonus for Value-Based Purchasing Program

Central Island Healthcare Joins Elite Class of SNFs to Receive CMS Reimbursement

BROOKLYN, NY (November 29, 2018) – Call9, a telehealth pioneer for the nursing home industry, responded today to new data released by the Centers for Medicare & Medicaid Services (CMS) that provides facility-specific performance information for the fiscal year 2019 Skilled Nursing Facility Value-Based Purchasing Program.

Central Island Healthcare (CIH) in Plainview, NY—the first facility Call9 partnered with—was one of only 3% of SNFs to receive the maximum bonus of 1.6% for improved 30-day readmission rates back to hospitals. CMS compared a baseline period of calendar year (CY) 2015 with a performance period of CY 2017 to determine whether a facility received a bonus or penalty. Of the nearly 15,000 SNFs included in the program, only 27% received a bonus, and 73% were penalized.

Since its implementation in 2015, Call9 has worked in partnership with CIH staff to provide a superior level of care for residents who might have previously been sent to the Emergency Department with conditions that Call9’s solution treats in place. Central Island experienced a 44% reduction in hospital transfers as a result of Call9, which provides technology that connects embedded emergency-trained first responders—who work on-site in the facility 24 hours a day, 7 days a week, 365 days a year—to remote Emergency Medicine providers to deliver care at the bedside for patients experiencing an acute change of condition.

Timothy C. Peck, MD, Call9’s Cofounder and CEO, released the following statement:

The recent data released by CMS regarding the Skilled Nursing Facility Value-Based Purchasing Program identified that nearly three-quarters of skilled nursing facilities were penalized for poor 30-day readmission rates. This reflects the shift to value in Medicare reimbursement that will only be taking greater hold in the coming years. Call9 is proud to partner with Central Island Healthcare, our first SNF, with whom we were working with throughout all of 2017. That CIH is one of only 3% of SNFs to have received the maximum bonus reflects the strength of our partnership and the quality of Call9’s solution in helping facilities reduce unnecessary transfers and achieve a greater census of patients. As Medicare continues to search for decreased costs and improved care, the shift to value will only grow. The ability for nursing homes to care for patients in place, both by lowering 30-day readmits and providing less discontinuity of care, becomes even more important. Call9 is excited to continue working with CIH and other like-minded SNF partners to deliver value to patients and to the healthcare system.

Michael Ostreicher, Executive Director of Central Island Healthcare, contributed this statement:

Call9’s impact on our patient care has been dramatic. In conjunction with our team of dedicated staff, Call9's technology and services solution allows for vastly improved coverage for our residents, which results in better outcomes for them, less stress for their families and more resident days for CIH, all at a lower cost to the healthcare system. We are thrilled to be identified as one of the best SNFs in the country in terms of the value we’ve delivered to the system and to our residents, and we are grateful for the Call9 team for the many ways they drive value to our facility on a daily basis.

About Call9

Call9 provides Emergency Medicine without brick and mortar limitations. Call9 humanizes telemedicine by connecting on-site, emergency-trained first responders to remote physicians, delivering care to patients at their bedside in nursing homes and rehabs. The company’s embedded care model approach is a replacement of 911 and subsequent hospitalizations and readmissions, lowering healthcare costs while improving care outcomes. Learn more at call9.com.

Call9 Partners with Lyft to Provide Transportation for Family Members of Nursing Home Patients

Integrated Application Will Enable Call9 Partners to Provide Reliable On-Demand Rides and Improve Overall Patient Experience

BROOKLYN, NY (November 13, 2018) – Call9, a telehealth pioneer for the nursing home industry, and Lyft, whose mission is to improve people's lives with the world's best transportation, today announced a partnership that will provide an enhanced transportation experience for family members visiting patients living in the skilled nursing facilities where Call9 operates.

As a result of the partnership, Call9 physicians and on-site emergency-trained first responders will be able to schedule on-demand Lyft rides for family members—even those without the Lyft application—directly through its Concierge platform integrated into Call9’s proprietary dashboard. The program will strengthen communication with family members when patients are experiencing an acute change in condition and offer reliable access to patients in an emergency situation - providing families with peace of mind that they will be there when their loved one is in need.

“Call9 can bring our emergency medical providers to the patient’s bedside within minutes, and now Lyft will help us ensure that their family members arrive in a reliable, efficient and comfortable manner,” said Timothy C. Peck, MD, Call9’s Cofounder and CEO. “We founded Call9 to be with patients at the moment of their emergency. Being able to offer them and their families one less thing to worry about so they can focus on important healthcare decisions is something we’re really proud of. Our partnership with Lyft is a unique opportunity to integrate our resources to provide a new, concierge service that transports family members to where they’re needed the most.”

Currently, Call9 covers more than 3,700 beds in New York state. Since 2015, Call9 recorded nearly 100,000 first responder visits and over 21,000 telemedicine visits, reducing unnecessary Emergency Department visits, hospitalizations and subsequent readmissions in nearly 80% of patient encounters.

“At Lyft, we're focused on improving people's lives with the world's best transportation,” said Gyre Renwick, Vice President of Lyft Business. “Together with Call9, we're making it easier for physicians to schedule rides for patients’ families through Lyft Concierge, helping to deliver better care to elderly patients by easing the burden on their loved ones.”

About Call9

Call9 provides Emergency Medicine without brick and mortar limitations. Call9 humanizes telemedicine by connecting on-site, emergency-trained first responders to remote physicians, delivering care to patients at their bedside in nursing homes and rehabs. The company’s embedded care model approach is a replacement of 911 and subsequent hospitalizations and readmissions, lowering healthcare costs while improving care outcomes. Learn more at call9.com.

About Lyft

Lyft was founded in June 2012 by Logan Green and John Zimmer to improve people’s lives with the world’s best transportation. Lyft is the fastest growing rideshare company in the U.S. and is available to 95 percent of the U.S. population and Toronto, Canada. Lyft is preferred by drivers and passengers for its safe and friendly experience, and its commitment to effecting positive change for the future of our cities.

About Lyft Business

Lyft Business offers travel, commute, event, and courtesy ride solutions that provide customers with the tools they need to reduce cost, save time, and streamline their transportation programs. We partner with thousands of organizations to create unique solutions to move their people, from employees and customers to patients and students. To learn more about Lyft Business, visit lyft.com/business.

Why this startup co-founder lived in a nursing home for 3 months

Though he's a doctor, Timothy Peck didn't know anything about nursing homes. So he decided to live in one and learn more as he started Call9, his company that uses technology to bring care to the bedside of nursing home patients.

Call9 is a startup based in New York City. Its co-founder and CEO, Timothy Peck, is an emergency physician by training. While serving as chief resident in the emergency department at Beth Israel Deaconess, he noticed he and his colleagues weren’t able to deliver the best possible care to older patients.

In a phone interview, Peck cited a statistic: 19 percent of ambulances that come to the emergency department originate from nursing homes and rehab centers. After these elderly patients arrive at the hospital, they often become delirious from the change in location and begin to feel sick. They then have to wait while physicians order tests to figure out what’s wrong.

Overall, these avoidable ED trips are harmful to patients and costly to the healthcare system.

Peck wanted to do something about it, but there was one major problem: He didn’t know anything about nursing homes. As a medical student, resident and doctor, Peck had “never once set foot in a nursing home,” he said.

Photo: jacoblund, Getty Images

Photo: jacoblund, Getty Images

Thus, he endeavored to change that. Peck lived at a nursing home on Long Island for three months. During his time at Central Island Healthcare, he slept on a cot in a conference room and experienced the various elements of the facility, from seeing how the food was made to meeting with the CFO.

While there, Peck also set up an experiment to see what the nursing home was like in the middle of the night. He set an alarm for 1 a.m. one night, 2 a.m. the next night and so on. Each time he got up and walked around, but never once did he see a physician.

“You assume as a consumer … that there are physicians there, but there aren’t,” he said. That was the biggest lesson he learned from the experience.

“It changed the trajectory of my life,” Peck added. “You can’t really go back after seeing the problem firsthand.”

The knowledge gained from his time in the nursing home assisted him as he continued to build Call9.

Here’s how the startup’s approach works: It places a first responder in nursing homes 24/7. They attend to the patient whenever there’s a change in his or her condition. The first responder can then use Call9’s technology to bring a remote doctor into the loop. The doctor can see, diagnose and treat patients, thus avoiding unnecessary ED trips.

Peck said about 20 percent of the patients Call9 treats end up going to the ED, but the other 80 percent are able to stay in their own beds in the nursing home.

The company participates in value-based arrangements with payers. It also contracts with nursing homes. “They pay us a platform fee for the utilization of some of our consulting services that are not covered by the payers themselves,” Peck said.