August 14, 2024 • 23 mins
Jason talks with Joe Ebberwein. Joe is the Co-founder and Chief Financial Officer of Corstrata, a technology-enabled care management solution focused on improving outcomes for wound and ostomy patients. We gain data-oriented insight into this often-neglected area of care and how Corstrata is working on solving this care gap; then, they discuss how virtual care and telehealth are viable solutions for any provider to utilize.
Joe & Corstrata can be found at:
Corstrata.com, Twitter, Facebook, LinkedIn
Transcript of the interview
Credits
Production Assistance & Editing: Nyla Wiebe
Scripting by: Aaron C Higgins
Show Notes & Transcription: Aaron C Higgins
Social Media Management: Jeremy Miller
News Co-Hosts: Aaron C Higgins & Jason Crosby
Interview hosts: Jason Crosby
Executive Producers: Mike Scribner & John Crew
Visit our website
Like us on Facebook
Tweet @ us on Twitter
Follow on Linkedin
Send an email contact@shpllc.com
Production © Strategic Healthcare Partners, LLC.
All rights reserved.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Aaron Higgins (00:00):
Welcome to Beyond the Stethoscope Vital
Conversations with SHP.
As we take our summer break toprepare for the exciting Season
5, we're revisiting some of ourmost impactful episodes to keep
the conversation going.
In this episode from Season 1,jason Crosby sat down with Joe
Everwine, the co-founder and CFOof Corstrada, a
technology-enabled caremanagement solution focused on
(00:23):
improving outcomes for wound andostomy patients.
Joe provided data-orientedinsights into this
often-neglected area of care anddiscussed how Corstrada is
addressing these care gaps.
They also explored how virtualcare and telehealth are becoming
viable solutions for providersto enhance patient care.
So don't miss this opportunityto revisit a thought-provoking
episode filled with valuableinformation and practical
(00:46):
solutions.
And, as always, if you enjoyedthis episode, please be sure to
rate and share our podcast inyour favorite podcast app.
It really helps the show.
Thanks for joining us and let'sdive back into our vital
conversation with Joe Eberwein.
Jason Crosby (01:11):
Hey everyone.
Hey everyone, I'm Jason Crosby,with Strategic Healthcare
Partners and your host forBeyond the Stethoscope Vital
Conversations with SHP.
Today, we are joined by JoeEberwein, who is co-founder and
CFO for Crestrata, atech-enabled solution provider
for the wound and ostomy caremarkets.
Joe, thanks for joining ustoday and welcome to the podcast
.
Joe Ebberwein (01:27):
Yeah, great to be with you today.
Jason Crosby (01:29):
Look forward to it .
Well, we've got some questionslined up for you, but first
let's start with just somebackground information on
yourself and kind of yourjourney in the healthcare
industry.
Joe Ebberwein (01:39):
Absolutely yeah.
So my background is actuallyaccounting and finance, got an
undergraduate in accounting andthen did the CPA route and
worked for both and this willage me, but both Arthur Anderson
and Price Waterhouse andstarted working in healthcare
(02:01):
early in that career doing cbawork auditing.
Was in atlanta for a littlewhile and then moved back to
savannah and actually began workwith memorial medical center,
now part of hca, but workedprimarily on the post-acute side
and the for-profit entitieswhich back then were the air
(02:22):
ambulance and MedStar, theground ambulance and then all of
the other ancillary in-homeservices such as home health,
dme etc.
So I've really spent most of mycareer in that space, just
about anything that could bedone in the home, from nursing,
traditional home health, hospice, private duty care and then, as
(02:47):
the years went on, back in theearly 2000s, the agency that I
was involved with, we got intotelehealth in a big way and the
use of vital signs monitoring inthe home.
So we were one of the earlyadopters really nationally and
kind of became known as nationalthought leaders around
(03:07):
implementing that use oftechnology in the home health
space and we saw some prettyamazing results.
We saw improvement in clinicaloutcomes and improvement in
financial outcomes.
So we were much more equippedto manage patients with chronic
conditions like CHF, copd etc inthe home using this equipment
(03:31):
Again back in the early 2000sclunky, expensive equipment, but
fast forward.
That was really kind of theinitial groundwork for what my
business partner, kathy Pate,and I ended up doing at
Corstrada about seven years ago.
And really what we did is wetook that concept of how can you
(03:52):
apply technology to ahealthcare problem and we had
experienced a big problem inmanaging chronic wounds for
patients that were in homehealth.
So similar to the teleradiologymodel, we thought kind of came
(04:12):
up with a thesis that we couldmove images similar to
radiographic images to adistributed workforce and that
workforce happened to be boardcertified wound and ostomy
nurses.
So we started doing a lot ofR&D into research around how
could we come up with atechnology solution to that
(04:34):
problem.
So that's really kind of howCorstrada was born seven years
ago.
But that's my background.
You know finance, accountingbut a whole lot of other hats
along the way in early stagecompanies.
Jason Crosby (04:48):
Yeah, it sounds like a natural evolution from
the early 2000s.
You know you got to seetelehealth early on and home
health and now that's kind ofall you're hearing about, right.
So kind of makes sense now thatyou mentioned with Corstrada.
So let's dive into that.
You've touched on it.
Tell us a little bit more aboutthe operations of Corstrada,
(05:08):
the problems you're trying tosolve and who you're trying to
solve them for, right.
Who's your typical client, whattype of provider setting?
Dive into that a little bit forus, Sure.
Joe Ebberwein (05:18):
Yeah, you know wounds are an interesting
problem because no one reallyowns wound outcomes.
You know you've gotcardiologists that are dealing
with cardiovascular issues orendocrinologists dealing with
kidney and diabetes function andthat kind of thing, but nobody
really owns wounds because theycross multiple comorbidities.
(05:42):
You might have wounds relatedto vascular issues, lower
extremity wounds, a hugeprevalence of diabetic foot
ulcers in the diabetespopulation.
One in four diabetics will geta diabetic foot ulcer in their
lifetime and one in four ofthose will have an amputation.
And then the five-yearmortality rates are off the
(06:06):
chart crazy for people thatrecover from an amputation.
So those are the kind of wounds.
Additionally, you have amultitude of other wounds
related to different conditions,whether it be pressure injuries
from immobility or you know.
A lot of times you hear themreferred to as bed sores and
(06:29):
unfortunately that's highlyprevalent in skilled nursing
facilities and a lot of them canbe prevented with the right
education, with the righttechniques, the right surfaces,
etc.
So it's a $96 billion problem.
15% of all Medicare patientsmembers have a wound and the
(06:53):
real problem that we're tryingto solve and chipping away at it
is that there are only 15,000board-certified wound nurses in
the country and that equates toabout one nurse for every 600
patients.
It's not sustainable.
The number of diabeticsobviously we know that that's
(07:16):
growing.
We've got about 37 milliondiabetics and another 96 million
pre-diabetics.
Million diabetics and another96 million pre-diabetics.
So it's a really, you know,it's like a freight train going
down the track and it doesn'thave a good ending.
There's a big wall at the endof it and it's all around access
(07:37):
to these specialists.
So, as I said, no one knowswounds across multiple
specialties, multiple providersettings, whether it's home
health, skilled nursingfacilities, where about
one-third of the patients have awound, ltac, rural hospitals
All of these different caresettings have patients that
(07:58):
present with wounds and yet wedon't have the expertise to
really manage them and getevidence-based care.
One out of 10 nurses that arecertified in wound and ostomy
care practice in the post-acutespace.
So and that includes homehealth, hospice, snfs, rural
(08:19):
hospitals 90% are practicing inthe hospital settings and
outpatient wound centers.
So I mean you can see there'ssuch a disparity with where the
experts are.
We're solving that problem withtechnology in a number of
different ways and I can go intothat if you want.
Jason Crosby (08:40):
Yeah, so with that , the key obviously being
technology adoption on theprovider side and some are a
little bit more accustomed tothat adoption, some aren't.
With that and with the gap inqualified nurse on the
outpatient side, as you justmentioned, are you seeing those
(09:02):
as your key barriers or whatother barriers are you seeing to
entry into those spaces?
Joe Ebberwein (09:08):
There are a number of barriers.
One of them that's reallyinteresting is some providers
don't want to take wound imagesof their patients' wounds and
you can kind of see that rightbecause of litigation
discoverable in the chart etcetera, because of litigation
(09:28):
discoverable in the chart, etc.
But what's interesting is mostof those patients say with a
pressure injury or pressureulcer, if it gets bad enough,
somebody is probablyphotographing that wound and
what we try to get across.
Our client says do you want youknow a qualified professional
taking photographs of the woundover time to show the
(09:49):
progression and have the medicalrecords support that decline or
, hopefully, improvement?
Or do you want you know thepatient's nephew to have the
photograph in a court of law?
So a lot of times we can getover that barrier pretty quickly
.
The other barrier is we'rereally a value add to our
(10:10):
customers.
So whether it's home health orhospice or skilled nursing
facilities, because we are anursing model, we're not billing
any Part B, we're not billingany commercial Medicaid, we bill
our clients and our clients geta return on investment from
having access to experts.
So we can reduce, you know,nursing time, home health visits
(10:33):
.
We can reduce those.
We can reduce their spend onadvanced wound dressings and
also really, to be honest, helpthem with coding and
reimbursement as well, because alot of times they're
misidentifying wounds andthey're leaving dollars precious
dollars on the table from areimbursement standpoint.
Jason Crosby (10:53):
Sure, and it sounds like if 15% of the
Medicare population have woundsand there's obviously a growing
number there I would justimagine there's greater demand
for that type of service.
Where are you starting to seesome of those trends, knowing
that you've got the agingpopulation, you've got hospital
closures, not only ruralhospitals, but you've got
(11:16):
Wellstar, for goodness sake, inAtlanta, yeah, at the hospital,
large hospital in Ohio, andthat's only gonna continue,
right.
So go down that path a littlebit.
Do you envision continueddemand for such a service, or is
that just going to become abarrier for you as well?
Joe Ebberwein (11:33):
I think it's going to become quite an
opportunity for furtherpenetration in multiple markets
and I'll tell you just a coupleof examples.
We are we're working with somelarge hospital systems on the
West Coast and these are bighospital systems in urban
(11:54):
settings and because of lack ofstaffing they're closing their
ostomy clinics.
So literally we're getting thatbusiness.
Through our virtualconsultations.
We are able to do a 30-minutelive video with the patient in
their home, troubleshoot theappliance, save an ER visit and
(12:16):
assist these hospital systemsthat are desperate for staffing
of these nurses.
On Indeedcom I went on theretoday there are 4,001 open wound
nurse positions across the US.
Well, if there are only 15,000certified period, you can see
(12:37):
there's such a disparity andwith COVID kind of the great
resignation, a large number ofnurses who are considering
leaving the profession.
It's a big and growing problem.
So hospital systems, as youmentioned, rural facilities,
really just about anybody thatin the post-acute space also
(12:59):
that is dealing with the wound.
Jason Crosby (13:01):
What do you say to those?
Then there's obviously theappetite, the demand for the
service that you guys areproviding.
Many reasons, as you just laidout.
There's still slow adoption tothat.
Whether you're a skillednursing facility, rural hospital
provider, large health system,you know practice setting Across
the board, there's not aprovider that can't utilize the
service.
What do you tell those that arejust hesitant to look in that
(13:25):
direction and startinvestigating a service like
yours?
What do you say to them to getthem across the line?
Joe Ebberwein (13:31):
Great question, and I do think that COVID and
the adoption of telehealth brokedown a lot of those barriers
for us, because a lot offacilities had to move to
virtual care.
They had to put the systems inplace not only from a technology
standpoint but also all theinfrastructure, and so that has
(13:53):
actually helped us in that, intelling that story.
But, for instance, when we talkto, say, rural hospitals that
now are either not able to admita wound patient or they're
having to transport them to ahigher acuity system because of
lack of expertise, it becomesreally an amazing impetus to
(14:17):
start considering using virtualcare so the market's almost
telling them itself hey, this iswhy you need to look into it.
Jason Crosby (14:24):
They don't necessarily need the sales pitch
.
I mean, just listen to themarket and let the market tell
you you need to look into it now.
They don't necessarily need thesales pitch.
I mean, just listen to themarket and let the market tell
you you need to look into it Nowthat that makes sense.
Let's pivot somewhat into that.
To me, that virtual health,telehealth, is kind of a you
know, a disruptor that we need.
So continue looking at that andlet's let's also look into your
crystal ball right.
What are some innovations thatyou're seeing in these service
(14:47):
areas?
What are you seeing coming downthe horizon there?
Joe Ebberwein (14:50):
Yes, so interestingly we have and this
is one example but we have adiabetic foot ulcer prevention
program.
So obviously diabetic footulcers don't just occur in the
Medicare population.
These are people that areworking.
They're 40s, 50s, some evenyounger, that have severe
(15:12):
diabetes, they developneuropathy and they end up with
a diabetic foot ulcer and it'sjust an incredible kind of cycle
.
It can spiral down.
Well, we have working withcompanies that have electronic
sensors for measuringtemperature and pressure in the
insoles of shoes.
(15:33):
A lot of technology is movingtoward prevention and most
diabetic foot ulcers arepreventable if you have the
right early detection.
So that's one example.
There are sensors built intoorthotics for measuring
compliance and you know whatends up happening is that data,
(15:56):
that sensor data that tells thatsomeone's getting into trouble,
that comes to an entity likeCorstrada and then we're able to
intervene.
Entity like Corstrada, and thenwe're able to intervene.
We had a really interesting thisis just an anecdotal story, but
we had an interesting encounterwith a gentleman who was using
one of these monitoring systemsand every weekend he would alert
(16:19):
, and so we knew something wasgoing on on the weekend where he
was getting elevatedtemperatures, which is a
precursor to ulceration.
And so one of our nurses saidokay, let's dig into this, let's
do a video call.
I want you to show me everyshoe you have.
I want you to tell me whatyou're doing on the weekend.
Well, turns out he had apart-time job at a funeral home
(16:42):
and he had to wear a certainkind of black shoe and it was
not the proper shoe to relievethat pressure.
So we got him in the right shoe.
The alert stopped coming in,but that's the.
That's the illustration of.
You got all this great sensordata, but what do you do with it
?
And then that humanintervention, that biofeedback
(17:05):
and coming up with a plan to toreally prevent that ulceration
Wow that's a great, applicablestory that anybody listening can
certainly resonate with right.
Jason Crosby (17:17):
I mean that's great Appreciate you saying that
.
What's now the strategicroadmap for Castrata?
What are you guys working ontoday and over these next couple
of years?
Joe Ebberwein (17:26):
Yeah.
So it's been interesting overthis last year where we had
predominantly really beenworking mostly in the post-acute
space like home health, hospice, skill nursing facilities.
What we're starting to see aresome of the emerging models for
really acute care services inthe home hospital at home, if
(17:48):
you will and we're working witha number of those organizations
that really help facilitate ahospital building a hospital at
home program.
Where that becomes reallyinteresting is and this was
really accentuated during thepandemic you've got these acute
patients who really, when thereweren't enough beds in the
(18:12):
hospital, could be managed inthe home with the right
equipment.
And when I say hospital at homeI'm talking there is
hospital-grade equipment,hospital bed, vital signs,
monitoring, all going back tokind of a Star Trek central
station, constantly monitored,you know, daily nursing visits,
(18:33):
nurse practitioner visits, etcetera.
So you know, imagine thatthey're really setting up a
command center in the home thatis, you know, transmitting data.
So hospital at home is anemerging market and a lot of
those patients have wounds andostomies and so they're engaging
with us to do virtual consultsfor the people, that maybebased
(18:57):
care bundles.
We are in discussions with somepayers that also have mobile
(19:21):
clinical teams.
So, yeah, it's really kind ofbeen an interesting year and
it's a shift in who'sapproaching us for those kinds
of consults.
Ostomies is a big deal as well.
Kind of consults.
Ostomies is a big deal as well.
Even though it's not a bignumber like the wound population
, it's a really high 30-dayreadmission rate into the
hospital and so ostomies kind ofgo hand in hand with wounds
(19:46):
because of the certification oftheir nurses.
Jason Crosby (19:49):
Interesting that you know here you just talked
about what 20 years ago thefocus was all on the skilled
nursing facility.
If that and now you can spanacross any provider setting,
acos, practice setting, itdoesn't matter Come a long ways,
and it's just the last 20 years.
So another exciting few yearsahead, I'm sure.
Joe Ebberwein (20:08):
We're seeing such incredible stories, both with
individuals living with ostomiesthat literally were driving to
an ostomy clinic four hours awaythat can now do this in the
privacy of their home to peoplewith long-term chronic wounds
that just never had the rightevidence-based treatment plan
(20:28):
and we're getting those woundsclosed, obviously saving a lot
of money for the providers, butthe human impact is amazing as
well.
Jason Crosby (20:40):
Finally, Joe, if our audience wants to learn more
, how do they go about doing so?
Joe Ebberwein (20:45):
Sure, so lots of ways to contact us.
Obviously, our website coursestratacom.
We're on LinkedIn and Twitterand Facebook and just about any
social media, so very easy toget us.
Jason Crosby (20:59):
Well, some great information and an even better
conversation, Joe.
Lots of lots of data to support.
You know what you guys aredoing is a great thing.
It's a service that's neededout there in the marketplace.
So really appreciate that, andI'm sure the listeners will find
it just as useful as I did.
You definitely opened my eyesto a lot of things there.
I appreciate that, and I'm surethe listeners will find it just
as useful as I did.
You definitely opened my eyesto a lot of things there.
I appreciate that, and wereally appreciate your time and
(21:20):
joining us today.
I want to thank our listeners,too, for your time.
We look forward to our nextpodcast and until then,
everybody, have a great rest ofyour day.
Joe Ebberwein (21:28):
Thanks for having me.
Aaron Higgins (21:31):
You've been listening to Beyond the
Stethoscope Vital Conversationswith SHB.
This has been a production ofStrategic Healthcare Partners.
Your news hosts today wereJason Crosby and me, aaron
Higgins.
It is produced and edited byNyla Weave.
Our social media contentproducers are Nyla Weave and
Jeremy Miller and our executiveproducers are Mike Scribner and
(21:52):
John Kroop, and our executiveproducers are Mike Scribner and
John Kru.
For more information about SHPand the services we offer,
including the back library ofepisodes, episode transcripts,
links to resources discussed andmuch, much more, please visit
our website at shplccom.
Thanks for listening.
Welcome to Beyond the Stethoscope Vital
Conversations with SHP.
As we take our summer break toprepare for the exciting Season
5, we're revisiting some of ourmost impactful episodes to keep
the conversation going.
In this episode from Season 1,jason Crosby sat down with Joe
Everwine, the co-founder and CFOof Corstrada, a
technology-enabled caremanagement solution focused on
(00:23):
improving outcomes for wound andostomy patients.
Joe provided data-orientedinsights into this
often-neglected area of care anddiscussed how Corstrada is
addressing these care gaps.
They also explored how virtualcare and telehealth are becoming
viable solutions for providersto enhance patient care.
So don't miss this opportunityto revisit a thought-provoking
episode filled with valuableinformation and practical
(00:46):
solutions.
And, as always, if you enjoyedthis episode, please be sure to
rate and share our podcast inyour favorite podcast app.
It really helps the show.
Thanks for joining us and let'sdive back into our vital
conversation with Joe Eberwein.
Jason Crosby (01:11):
Hey everyone.
Hey everyone, I'm Jason Crosby,with Strategic Healthcare
Partners and your host forBeyond the Stethoscope Vital
Conversations with SHP.
Today, we are joined by JoeEberwein, who is co-founder and
CFO for Crestrata, atech-enabled solution provider
for the wound and ostomy caremarkets.
Joe, thanks for joining ustoday and welcome to the podcast
.
Joe Ebberwein (01:27):
Yeah, great to be with you today.
Jason Crosby (01:29):
Look forward to it .
Well, we've got some questionslined up for you, but first
let's start with just somebackground information on
yourself and kind of yourjourney in the healthcare
industry.
Joe Ebberwein (01:39):
Absolutely yeah.
So my background is actuallyaccounting and finance, got an
undergraduate in accounting andthen did the CPA route and
worked for both and this willage me, but both Arthur Anderson
and Price Waterhouse andstarted working in healthcare
(02:01):
early in that career doing cbawork auditing.
Was in atlanta for a littlewhile and then moved back to
savannah and actually began workwith memorial medical center,
now part of hca, but workedprimarily on the post-acute side
and the for-profit entitieswhich back then were the air
(02:22):
ambulance and MedStar, theground ambulance and then all of
the other ancillary in-homeservices such as home health,
dme etc.
So I've really spent most of mycareer in that space, just
about anything that could bedone in the home, from nursing,
traditional home health, hospice, private duty care and then, as
(02:47):
the years went on, back in theearly 2000s, the agency that I
was involved with, we got intotelehealth in a big way and the
use of vital signs monitoring inthe home.
So we were one of the earlyadopters really nationally and
kind of became known as nationalthought leaders around
(03:07):
implementing that use oftechnology in the home health
space and we saw some prettyamazing results.
We saw improvement in clinicaloutcomes and improvement in
financial outcomes.
So we were much more equippedto manage patients with chronic
conditions like CHF, copd etc inthe home using this equipment
(03:31):
Again back in the early 2000sclunky, expensive equipment, but
fast forward.
That was really kind of theinitial groundwork for what my
business partner, kathy Pate,and I ended up doing at
Corstrada about seven years ago.
And really what we did is wetook that concept of how can you
(03:52):
apply technology to ahealthcare problem and we had
experienced a big problem inmanaging chronic wounds for
patients that were in homehealth.
So similar to the teleradiologymodel, we thought kind of came
(04:12):
up with a thesis that we couldmove images similar to
radiographic images to adistributed workforce and that
workforce happened to be boardcertified wound and ostomy
nurses.
So we started doing a lot ofR&D into research around how
could we come up with atechnology solution to that
(04:34):
problem.
So that's really kind of howCorstrada was born seven years
ago.
But that's my background.
You know finance, accountingbut a whole lot of other hats
along the way in early stagecompanies.
Jason Crosby (04:48):
Yeah, it sounds like a natural evolution from
the early 2000s.
You know you got to seetelehealth early on and home
health and now that's kind ofall you're hearing about, right.
So kind of makes sense now thatyou mentioned with Corstrada.
So let's dive into that.
You've touched on it.
Tell us a little bit more aboutthe operations of Corstrada,
(05:08):
the problems you're trying tosolve and who you're trying to
solve them for, right.
Who's your typical client, whattype of provider setting?
Dive into that a little bit forus, Sure.
Joe Ebberwein (05:18):
Yeah, you know wounds are an interesting
problem because no one reallyowns wound outcomes.
You know you've gotcardiologists that are dealing
with cardiovascular issues orendocrinologists dealing with
kidney and diabetes function andthat kind of thing, but nobody
really owns wounds because theycross multiple comorbidities.
(05:42):
You might have wounds relatedto vascular issues, lower
extremity wounds, a hugeprevalence of diabetic foot
ulcers in the diabetespopulation.
One in four diabetics will geta diabetic foot ulcer in their
lifetime and one in four ofthose will have an amputation.
And then the five-yearmortality rates are off the
(06:06):
chart crazy for people thatrecover from an amputation.
So those are the kind of wounds.
Additionally, you have amultitude of other wounds
related to different conditions,whether it be pressure injuries
from immobility or you know.
A lot of times you hear themreferred to as bed sores and
(06:29):
unfortunately that's highlyprevalent in skilled nursing
facilities and a lot of them canbe prevented with the right
education, with the righttechniques, the right surfaces,
etc.
So it's a $96 billion problem.
15% of all Medicare patientsmembers have a wound and the
(06:53):
real problem that we're tryingto solve and chipping away at it
is that there are only 15,000board-certified wound nurses in
the country and that equates toabout one nurse for every 600
patients.
It's not sustainable.
The number of diabeticsobviously we know that that's
(07:16):
growing.
We've got about 37 milliondiabetics and another 96 million
pre-diabetics.
Million diabetics and another96 million pre-diabetics.
So it's a really, you know,it's like a freight train going
down the track and it doesn'thave a good ending.
There's a big wall at the endof it and it's all around access
(07:37):
to these specialists.
So, as I said, no one knowswounds across multiple
specialties, multiple providersettings, whether it's home
health, skilled nursingfacilities, where about
one-third of the patients have awound, ltac, rural hospitals
All of these different caresettings have patients that
(07:58):
present with wounds and yet wedon't have the expertise to
really manage them and getevidence-based care.
One out of 10 nurses that arecertified in wound and ostomy
care practice in the post-acutespace.
So and that includes homehealth, hospice, snfs, rural
(08:19):
hospitals 90% are practicing inthe hospital settings and
outpatient wound centers.
So I mean you can see there'ssuch a disparity with where the
experts are.
We're solving that problem withtechnology in a number of
different ways and I can go intothat if you want.
Jason Crosby (08:40):
Yeah, so with that , the key obviously being
technology adoption on theprovider side and some are a
little bit more accustomed tothat adoption, some aren't.
With that and with the gap inqualified nurse on the
outpatient side, as you justmentioned, are you seeing those
(09:02):
as your key barriers or whatother barriers are you seeing to
entry into those spaces?
Joe Ebberwein (09:08):
There are a number of barriers.
One of them that's reallyinteresting is some providers
don't want to take wound imagesof their patients' wounds and
you can kind of see that rightbecause of litigation
discoverable in the chart etcetera, because of litigation
(09:28):
discoverable in the chart, etc.
But what's interesting is mostof those patients say with a
pressure injury or pressureulcer, if it gets bad enough,
somebody is probablyphotographing that wound and
what we try to get across.
Our client says do you want youknow a qualified professional
taking photographs of the woundover time to show the
(09:49):
progression and have the medicalrecords support that decline or
, hopefully, improvement?
Or do you want you know thepatient's nephew to have the
photograph in a court of law?
So a lot of times we can getover that barrier pretty quickly
.
The other barrier is we'rereally a value add to our
(10:10):
customers.
So whether it's home health orhospice or skilled nursing
facilities, because we are anursing model, we're not billing
any Part B, we're not billingany commercial Medicaid, we bill
our clients and our clients geta return on investment from
having access to experts.
So we can reduce, you know,nursing time, home health visits
(10:33):
.
We can reduce those.
We can reduce their spend onadvanced wound dressings and
also really, to be honest, helpthem with coding and
reimbursement as well, because alot of times they're
misidentifying wounds andthey're leaving dollars precious
dollars on the table from areimbursement standpoint.
Jason Crosby (10:53):
Sure, and it sounds like if 15% of the
Medicare population have woundsand there's obviously a growing
number there I would justimagine there's greater demand
for that type of service.
Where are you starting to seesome of those trends, knowing
that you've got the agingpopulation, you've got hospital
closures, not only ruralhospitals, but you've got
(11:16):
Wellstar, for goodness sake, inAtlanta, yeah, at the hospital,
large hospital in Ohio, andthat's only gonna continue,
right.
So go down that path a littlebit.
Do you envision continueddemand for such a service, or is
that just going to become abarrier for you as well?
Joe Ebberwein (11:33):
I think it's going to become quite an
opportunity for furtherpenetration in multiple markets
and I'll tell you just a coupleof examples.
We are we're working with somelarge hospital systems on the
West Coast and these are bighospital systems in urban
(11:54):
settings and because of lack ofstaffing they're closing their
ostomy clinics.
So literally we're getting thatbusiness.
Through our virtualconsultations.
We are able to do a 30-minutelive video with the patient in
their home, troubleshoot theappliance, save an ER visit and
(12:16):
assist these hospital systemsthat are desperate for staffing
of these nurses.
On Indeedcom I went on theretoday there are 4,001 open wound
nurse positions across the US.
Well, if there are only 15,000certified period, you can see
(12:37):
there's such a disparity andwith COVID kind of the great
resignation, a large number ofnurses who are considering
leaving the profession.
It's a big and growing problem.
So hospital systems, as youmentioned, rural facilities,
really just about anybody thatin the post-acute space also
(12:59):
that is dealing with the wound.
Jason Crosby (13:01):
What do you say to those?
Then there's obviously theappetite, the demand for the
service that you guys areproviding.
Many reasons, as you just laidout.
There's still slow adoption tothat.
Whether you're a skillednursing facility, rural hospital
provider, large health system,you know practice setting Across
the board, there's not aprovider that can't utilize the
service.
What do you tell those that arejust hesitant to look in that
(13:25):
direction and startinvestigating a service like
yours?
What do you say to them to getthem across the line?
Joe Ebberwein (13:31):
Great question, and I do think that COVID and
the adoption of telehealth brokedown a lot of those barriers
for us, because a lot offacilities had to move to
virtual care.
They had to put the systems inplace not only from a technology
standpoint but also all theinfrastructure, and so that has
(13:53):
actually helped us in that, intelling that story.
But, for instance, when we talkto, say, rural hospitals that
now are either not able to admita wound patient or they're
having to transport them to ahigher acuity system because of
lack of expertise, it becomesreally an amazing impetus to
(14:17):
start considering using virtualcare so the market's almost
telling them itself hey, this iswhy you need to look into it.
Jason Crosby (14:24):
They don't necessarily need the sales pitch
.
I mean, just listen to themarket and let the market tell
you you need to look into it now.
They don't necessarily need thesales pitch.
I mean, just listen to themarket and let the market tell
you you need to look into it Nowthat that makes sense.
Let's pivot somewhat into that.
To me, that virtual health,telehealth, is kind of a you
know, a disruptor that we need.
So continue looking at that andlet's let's also look into your
crystal ball right.
What are some innovations thatyou're seeing in these service
(14:47):
areas?
What are you seeing coming downthe horizon there?
Joe Ebberwein (14:50):
Yes, so interestingly we have and this
is one example but we have adiabetic foot ulcer prevention
program.
So obviously diabetic footulcers don't just occur in the
Medicare population.
These are people that areworking.
They're 40s, 50s, some evenyounger, that have severe
(15:12):
diabetes, they developneuropathy and they end up with
a diabetic foot ulcer and it'sjust an incredible kind of cycle
.
It can spiral down.
Well, we have working withcompanies that have electronic
sensors for measuringtemperature and pressure in the
insoles of shoes.
(15:33):
A lot of technology is movingtoward prevention and most
diabetic foot ulcers arepreventable if you have the
right early detection.
So that's one example.
There are sensors built intoorthotics for measuring
compliance and you know whatends up happening is that data,
(15:56):
that sensor data that tells thatsomeone's getting into trouble,
that comes to an entity likeCorstrada and then we're able to
intervene.
Entity like Corstrada, and thenwe're able to intervene.
We had a really interesting thisis just an anecdotal story, but
we had an interesting encounterwith a gentleman who was using
one of these monitoring systemsand every weekend he would alert
(16:19):
, and so we knew something wasgoing on on the weekend where he
was getting elevatedtemperatures, which is a
precursor to ulceration.
And so one of our nurses saidokay, let's dig into this, let's
do a video call.
I want you to show me everyshoe you have.
I want you to tell me whatyou're doing on the weekend.
Well, turns out he had apart-time job at a funeral home
(16:42):
and he had to wear a certainkind of black shoe and it was
not the proper shoe to relievethat pressure.
So we got him in the right shoe.
The alert stopped coming in,but that's the.
That's the illustration of.
You got all this great sensordata, but what do you do with it
?
And then that humanintervention, that biofeedback
(17:05):
and coming up with a plan to toreally prevent that ulceration
Wow that's a great, applicablestory that anybody listening can
certainly resonate with right.
Jason Crosby (17:17):
I mean that's great Appreciate you saying that
.
What's now the strategicroadmap for Castrata?
What are you guys working ontoday and over these next couple
of years?
Joe Ebberwein (17:26):
Yeah.
So it's been interesting overthis last year where we had
predominantly really beenworking mostly in the post-acute
space like home health, hospice, skill nursing facilities.
What we're starting to see aresome of the emerging models for
really acute care services inthe home hospital at home, if
(17:48):
you will and we're working witha number of those organizations
that really help facilitate ahospital building a hospital at
home program.
Where that becomes reallyinteresting is and this was
really accentuated during thepandemic you've got these acute
patients who really, when thereweren't enough beds in the
(18:12):
hospital, could be managed inthe home with the right
equipment.
And when I say hospital at homeI'm talking there is
hospital-grade equipment,hospital bed, vital signs,
monitoring, all going back tokind of a Star Trek central
station, constantly monitored,you know, daily nursing visits,
(18:33):
nurse practitioner visits, etcetera.
So you know, imagine thatthey're really setting up a
command center in the home thatis, you know, transmitting data.
So hospital at home is anemerging market and a lot of
those patients have wounds andostomies and so they're engaging
with us to do virtual consultsfor the people, that maybebased
(18:57):
care bundles.
We are in discussions with somepayers that also have mobile
(19:21):
clinical teams.
So, yeah, it's really kind ofbeen an interesting year and
it's a shift in who'sapproaching us for those kinds
of consults.
Ostomies is a big deal as well.
Kind of consults.
Ostomies is a big deal as well.
Even though it's not a bignumber like the wound population
, it's a really high 30-dayreadmission rate into the
hospital and so ostomies kind ofgo hand in hand with wounds
(19:46):
because of the certification oftheir nurses.
Jason Crosby (19:49):
Interesting that you know here you just talked
about what 20 years ago thefocus was all on the skilled
nursing facility.
If that and now you can spanacross any provider setting,
acos, practice setting, itdoesn't matter Come a long ways,
and it's just the last 20 years.
So another exciting few yearsahead, I'm sure.
Joe Ebberwein (20:08):
We're seeing such incredible stories, both with
individuals living with ostomiesthat literally were driving to
an ostomy clinic four hours awaythat can now do this in the
privacy of their home to peoplewith long-term chronic wounds
that just never had the rightevidence-based treatment plan
(20:28):
and we're getting those woundsclosed, obviously saving a lot
of money for the providers, butthe human impact is amazing as
well.
Jason Crosby (20:40):
Finally, Joe, if our audience wants to learn more
, how do they go about doing so?
Joe Ebberwein (20:45):
Sure, so lots of ways to contact us.
Obviously, our website coursestratacom.
We're on LinkedIn and Twitterand Facebook and just about any
social media, so very easy toget us.
Jason Crosby (20:59):
Well, some great information and an even better
conversation, Joe.
Lots of lots of data to support.
You know what you guys aredoing is a great thing.
It's a service that's neededout there in the marketplace.
So really appreciate that, andI'm sure the listeners will find
it just as useful as I did.
You definitely opened my eyesto a lot of things there.
I appreciate that, and I'm surethe listeners will find it just
as useful as I did.
You definitely opened my eyesto a lot of things there.
I appreciate that, and wereally appreciate your time and
(21:20):
joining us today.
I want to thank our listeners,too, for your time.
We look forward to our nextpodcast and until then,
everybody, have a great rest ofyour day.
Joe Ebberwein (21:28):
Thanks for having me.
Aaron Higgins (21:31):
You've been listening to Beyond the
Stethoscope Vital Conversationswith SHB.
This has been a production ofStrategic Healthcare Partners.
Your news hosts today wereJason Crosby and me, aaron
Higgins.
It is produced and edited byNyla Weave.
Our social media contentproducers are Nyla Weave and
Jeremy Miller and our executiveproducers are Mike Scribner and
(21:52):
John Kroop, and our executiveproducers are Mike Scribner and
John Kru.
For more information about SHPand the services we offer,
including the back library ofepisodes, episode transcripts,
links to resources discussed andmuch, much more, please visit
our website at shplccom.
Thanks for listening.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.