Inspired by shared medical appointments and Blue Zones, areas in the world where people live measurably longer lives, fourth-year medical student Sohan Japa, MBA, and Stanford alumna Bansi Shah are striving to bring back a community approach to treating chronic disease and enable better care that is efficient and evidence-based.
Japa and Shah partnered with Stanford physician Bryant Lin, MD, earlier this year on a small study to test the effectiveness of using a private social network for diabetic patients and their care teams. Based on this pilot they developed HealthCrew, a secure online platform to help clinicians more effectively manage patient populations. In the following Q&A, Japa discusses the results from the pilot, the technology behind the platform and the next phase of the study.
What about the group health visit setting did you find particularly inspiring?
The way patients leaned on each other for support and guidance was very powerful. A doctor or nurse may remind you over and over about your diet, but when it comes from a peer, it is just much more convincing and impactful. And, every group had an unofficial leader who would do an amazing job in inspiring the group and mentoring others who may not be as empowered about the condition.
What did the preliminary results of the pilot show?
In this initial pilot, we were curious how patients would respond and whether they would see the value in it. And the overwhelming response was yes. Patient engagement and satisfaction rates were higher than we expected. We are doing a second pilot to test the results with a larger group and also start tracking the software's impact on actual health outcomes. The participants in the initial pilot also gave us great feedback on how to make the platform even better.
Can you briefly explain how the platform works?
The platform is designed to deliver tailored education, which is something doctors don't have time to provide in a typical 15-minute visit.
There are three key components to our platform. The first is a medical intake tool, which is able to assess a patient's health literacy and social/emotional capacity. The second component is a content engine that takes the results of the medical intake to tailor education and materials. For example, a patient who scored low on our empowerment scale will get materials to help raise their confidence and skill set to tackle their condition. The last component of our platform is a peer-to-peer mentoring tool, which allows patients to confer securely with similar patients both online and offline.
The Affordable Care Act, in addition to healthcare reform at the state level, has put new attention on patient outcomes. Increasingly hospitals and clinics are on the hook for the health outcomes of their patients. So a platform like this is timely. Because it helps patients in between those semi annual visits they have with their doctors.
What are the advantages of the HealthCrew platform over existing online patient communities?
Today patients use anonymous patient online forums to get some of their education, but these sites can often feel like the Wild West. Our patients have voiced the need for more trustworthy sources of information. In addition, we see a greater need for local patient communities that revolve around the physician or clinic. The importance of social ties and community when it comes to healthcare has been known for many years, but the role of the physician or clinic as a part of the community has unfortunately subsided. Changing your diet, staying positive about your illness, or managing your medication can be really hard to do alone. Such communities help patients truly change their behaviors and live healthier lives. HealthCrew is aiming to help clinics and physician teams be a greater presence in the lives and communities of their patients.
What privacy and regulatory hurdles did you have to overcome in developing HealthCrew?
The platform is akin to a gated community so only patients that have been invited by their physician or clinic can join the community. Ultimately, patients decide how much to share about themselves on our secure site. And, in the event there is PHI (protected health information), the site has been designed to be HIPAA-secure.
What will the next phase of the study involve?
In the second phase of the study at Stanford, we're looking to expand the number of patients and will also be looking at key quality metrics such as HgA1c. In addition, we'll be tracking the healthcare resource utilization of our group against a control group. Our hypothesis is that the platform improves patient outcomes while reducing the number of common questions fielded by the physician team.