Episode Transcript
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Speaker 1 (00:03):
Welcome to the Wellness and Healthy Lifestyle Show on your
vocm Now, here's your host, Doctor Mike Wall.
Speaker 2 (00:12):
The show.
Speaker 3 (00:12):
I'm your host, doctor Mike Wall. Today we're diving into
a story the shows how technology can transform healthcare, not
by adding more staff or more money, but by improving
the systems we already have. We all know hospital bids
are precious resources, and too often patients can remain in
the hospital not because of medical needs, but because of
delays and discharge. Now that costs our system money, it's
(00:35):
strained staff, and it keeps patients from getting home or recovery.
Is best to explore this, We're going to start off
with Andy Fisher, director of Bounce Health Innovation, who's been
helping local companies turn bold ideas into real solutions for
a healthcare system. Then we'll be joined by aon Shahead
from Discharge Hub, whose technology is already freeing up hospital
bids and giving patients a smoother path home. There's a
(00:58):
lot to cover, so let's get to it. Hey, Andy,
welcome back to the show.
Speaker 4 (01:02):
Hey, thanks, Mike's great to be here again.
Speaker 2 (01:04):
Yeah, it's fantastic.
Speaker 3 (01:05):
We've had a great season this year where we have
talked to all sorts of tech companies about the different
innovations that they've come up with, and quite often we're
hearing about it from the perspective of the owner, creator
of the company. But now we're going to learn about
something that's in the field, something that's been tested in
our healthcare system. And maybe you could give us a
bit of a background of why you wanted me to
(01:26):
talk to our guests today.
Speaker 5 (01:28):
Yeah, absolutely, so you're right.
Speaker 4 (01:30):
So Bounce Health Innovation is about accelerating the growth of
the health tech sector. So that sounds all very technical
and it's all about enterprise and business and these things,
but health is an intensely human endeavor and so really
none of the companies that we've talked about are None
of the technology that we talk about work in absence
of the human systems that are involved and the people
(01:52):
that are involved. And so I think it's time that
we explored what's that really about. And I really encourage
listeners to think about this whole story. This interview is
going to take it a little longer than our normal
little sections because there's so many elements that get involved
for having the technology enable whatever.
Speaker 5 (02:11):
The win is that we're looking for in each particular case.
Speaker 3 (02:14):
And not to give away the conversation, but the reality
is sometimes there's problems that we don't even know about
that are major, significant problems in our healthcare system that
technology can come in and really allow people to stick
to their strengths and allow our healthcare system to function
more efficiently. And I think efficiency is something that is
really valuable when it comes to how.
Speaker 5 (02:35):
Do we do more with less?
Speaker 4 (02:38):
Yeah, I mean it's there's some hard things to keep
in your head all at one time, and there's some
easy things, and I think we need to find those
easy things and latch onto them.
Speaker 5 (02:46):
Right, So what do we know for sure?
Speaker 4 (02:48):
We know for sure that in this province we spend
forty percent of everything that we spend as a province
on healthcare. We know that now that adds up to
four point five billion dollars. We know that we have
the worst health outcomes in Canada, and Canada does not
rank high on the global scale. So that's enough to know.
(03:11):
So if you just take that, one of those big
problems is not how do we spend more money, it's
how do we get more effect with the money that
we're spending currently? And so today's example is exactly that
it's within the healthcare system and the objective of the company.
If you listen to the guest today, you'll hear the
compassion for the people that are involved, and ultimately it's
(03:35):
about saving those dollars.
Speaker 3 (03:37):
And I think that's the other aspect of this is
very human, is that sometimes we have technology that comes
in it allows things to be done more efficiently and
more effectively. But this is actually helping individuals get on
with their life after they've experienced a hospital stay, which
I think is also really important. I think that there
is tremendous value, even if it's not just financial, to
(03:58):
allowing people to get on with their life after an
incident that put them in the hospital setting, which can
be really challenging for folks.
Speaker 4 (04:05):
Right, I think every listener will have either a personal
experience or somebody that they can relate to who has
had that journey right through through a hospital system and
then out of the hospital system. Our hospital system is taxed.
The individuals working there are fantastic, but they're stretched to
the limit. They're putting out the most pressing fire. And
(04:26):
the guest today is going to talk about let's focus
on some of these other things that are really slowing
down the pathway through that system, and for those individual journeys,
it makes a tremendous difference.
Speaker 3 (04:37):
So this is an example of a technology that has
gone through the system here in Newfolin of Labrador and
has gone from an idea to something that's actually working
in a healthcare system. If people have an idea that
they want to start this process on, how do they
reach out to Bounce?
Speaker 4 (04:53):
Yeah, some bounce is easy to get a hold of.
We have a website Bounce Innovation dot Ca. There's you know,
how do you a hold of us? Is on that
website and it truly is about sort of standing back
and thinking about new ways of doing healthcare. And also,
and I think our guests will talk about this at
the end, the future of healthcare is not fixing people faster,
(05:17):
it's helping people stay healthy. And so there's a tremendous
amount of thinking going into what about wellness? How do
we help people help themselves? What role can technology play?
But again, even that will be a tremendously human system
that's enabled by technologies. So yeah, no, Bounce Innovation dot
Ca and be delighted to talk with anybody who's got
(05:38):
some ideas.
Speaker 3 (05:39):
So fantastic, let's get to our conversation.
Speaker 5 (05:41):
They on fantastic.
Speaker 3 (05:48):
Hi, Yeah, welcome to the show. A wake are going
really good, really good. I'm glad we got a chance
to get together and chat today. I think both of
us live in a world where it's awful lace to
see if things go from theory into practice, and that's
what we're going to talk about today, is the sort
of shift in how new technologies can help things that
(06:08):
we currently do in our healthcare system. Maybe you could
give our listeners a little of a background on yourself.
Speaker 6 (06:14):
Yeah, absolutely, and excited to be here on your show.
Congrats on all the amazing things you've been doing recently.
So my name is ae Ansha Head. I'm with a
group called Seafair here at Own. So we're a group
of organizations. We're largely focused on healthcare and community well
being within our province and so we have a number
of organizations that focus on providing care to folks who
are vulnerable, to seniors, to folks with disabilities. But we
(06:38):
also do a little work in supply chain and in technology,
and so as we think about where healthcare is going,
we're thinking about bringing innovation across a broader spectrum.
Speaker 7 (06:47):
And particularly when we think about where care happens.
Speaker 6 (06:50):
You know, there's a lot of discussion around clinics and hospitals,
which is really really important, but the continuum of healthcare
is borrowing that right, and so we think a lot
about how do those spaces relate to and connect to
other spaces like home, and so how do we build
innovation and access across that broader continuum. So that's where
a lot of our thinking is and I've thought the
work that I'm focused on is trying to link those
(07:12):
different spaces where care can happen.
Speaker 7 (07:14):
Well, that's true.
Speaker 3 (07:14):
I mean it's not just going to a doctor or
getting a surgery, it's all the things that happen afterwards.
And I think that's one of the technologies and approaches
I really want to focus on today. Is something that
you've recently launched and you were starting to get some
data on how effective it's been, and that's called discharge Hub.
Can you give me an overall view of what it is?
Speaker 6 (07:36):
Yeah, for sure, So maybe I'll build on that idea
of the continuum. So when we thought about what problems
we wanted to dig into, you know, in that continuum,
we try to think about how do people travel through
the system, right, and so you access care at a hospital,
at a clinic, but there's points of almost like procedure
that aren't really medical in nature that are really impactful
to the experience and what happens to a patient. And
(07:57):
so that's things like intake, it's things like communication, like triage,
but it's also discharge, right. Discharges the fundamental experience that
people have, and it affects everything from the patient's well
being and how they get home, what they're prepared to do,
but also impacts efficiency at the hospital. How quickly can
you leave when you're good to go, how we easily
(08:17):
can we coordinate the care that you need on your
way home. And so we wanted to tackle this idea
of discharge to make sure that the patients had the
best experience possible and that you weren't in the hospital
any longer than you needed to be. There's this stat
or term called ALC. I'm sure you know you've heard
all about it, called alternative level of care, and this
is a wicked problem across the country. And you know,
(08:40):
this is a simplistic way to think about it, but
it's basically during the hospital when you don't need to
be so you're medically clear, you're just there and you're
waiting for something to be able to go home. So
you may be waiting to have a ramp built at
your home, you may be waiting for your folks to
be ready for you to get home, maybe waiting for
respiratory and need a fire inspection done before oxygen can
be at the home. There's a few reasons why you
(09:01):
may be at the hospital longer than you need to be,
and that's not really good for anybody. For the patient,
you're in a disease rischh environment, potentially away from work,
you're not around your social supports. For the hospital, it's
a bed someone's waiting for right So it's not good
for patient flow, it's not good for efficiency. And so
we thought if we could tackle some elements of the
discharge procedures, could we bring down AOC rates, which is
(09:23):
a challenge across the country. Could we get more out
of our hospital systems, have more people go through the
system and get you home sooner so you can get
well and be.
Speaker 7 (09:31):
Where you want to be.
Speaker 6 (09:32):
So that's what Discharge Hub is trying to tackle and
we're really proud of full we've been able to do.
So we're looking at us some specific challenges in that space.
Really around a non medical procedure, So after you've been
kind of cleared to go home, what's left to do?
And a lot of that is administrative in nature, and
so right now we're tackling kind of three main areas
(09:53):
of procedures.
Speaker 7 (09:53):
So that's around respiratory.
Speaker 6 (09:56):
Care at home, it's home equipment, and it's also coordinating
homes support. So those are kind of three distinct barriers,
and you may be experiencing you may need one or
all three of those on your way home. But we've
been working to optimize those procedures, digitize them where we can,
and kind of move that pace along so you can
get home soon.
Speaker 3 (10:16):
Today we're talking about how technology is making its way
into our healthcare system through innovative companies like discharge Hub.
When we come back, we'll dive deeper to how these
tools are helping patients and get home sooner and making
sure our hospital systems run more efficiently.
Speaker 2 (10:30):
We'll be right back after the break. Welcome back.
Speaker 3 (10:42):
We're continuing our conversation about how new health technologies are
reshaping patient care. Today we're talking about discharge Hub and
how it's tackling the challenge of freeing up hospital bids
and helping patients transition home smoothly. Let's get back to
it now. That's excellent. I think that's the important side
of it is that we think, Okay, we've got the care.
We might have the physicians, the nurses, the healthcare staff.
(11:05):
We even have the space in some cases, but it's
not unlimited. And I think you really hit a good
point there with people. It's hard for them to get
well when they're still in the hospital and they're ready
to get home. That's the last place you really want
to be if you don't need to be. Is that
really the gap that you saw was that Number one
for the patient outcomes, there's an improvement by getting them
outen Number two, there obviously has to be a massive
(11:28):
cost with having people at a hospital setting that don't
need to be there.
Speaker 7 (11:31):
Yeah, the cost is massive.
Speaker 6 (11:33):
If you think about our hospitals and in acute bed
that's you know, it's an intensive way to get care,
and we need those beds for.
Speaker 7 (11:39):
The next person.
Speaker 6 (11:40):
Right the problems we run off their feet, there's the
next crisis to attend to, and in that busyness, it's
really hard to manage administrative tasks and to keep on
top of kind of a series of things that need
to get done because you're there as a nurse of
a social workers as a position to provide care. When
we think about these procedures and respriatuorary equipment and un reupport,
(12:03):
it's things like getting quotes from vendors.
Speaker 7 (12:05):
It's coordinating around emails.
Speaker 6 (12:07):
It's making sure the fire inspector goes on time and
the family knows what to expect and so they can
pass that inspection so that you can go home. Those
things are getting done, but the tasks are kind of
spread out amongst people, and if maybe the last thing
on your list not because it doesn't matter to you,
it's because someone's in crisis and needs your help right now.
Speaker 7 (12:25):
And so that disparate way of how tasks.
Speaker 6 (12:28):
Were getting done on these processes is where we found
this delay was happening. Right So what our solution does
is we can centralize what needs to get done and
then we can kind of expedite that through some automations,
and so all of a sudden, you're able to take
quite a bit of administrative burden off folks and then
get someone home sooner. And so what happens the outcome
(12:49):
to your point absolutely is on the patient they get
home sooner, the hospital gets to utilize their beds more.
So we get to return what we call bed days,
and so the hospital has more bed days available. The
other thing that's been fantastic is the actual return of
clinical capacity, and so we're leaving about five hours of
clinical time for the discharge that we do. So if
(13:11):
you think about a social worker or a nurse when
we do a discharge, we're for all and again kind
of manage that coordination through our solution. That's time they
don't have to worry about and they can practice at
the top of their scope, do what they trained for
and provide that value to to the next patient there
are you know, that's that's literally powder of that because
of how stressed people are in healthcare, right, I do
(13:32):
want to say on the flow side, it's pretty pretty
remarkable impact as well. So yeah, there's this there's this
term used often when when a patient is admitted to
the hospital called expected discharge date, and so we we
monitor how often can we meet or beat that date
right right, because it's after you've been taking care actery.
(13:54):
Medical needs are soort and we're actually able to beat
the d D about half the time.
Speaker 3 (14:00):
To me, that's incredible, and I think that also. I
think about like when you need an expert to do something,
you call the person that does it on a day
to day basis. Not saying that the individuals that are
in charge of this is the hospital setting, aren't capable
of doing this, but if they're trained to the medical world,
their best use of time is probably dealing with medical
issues and having somebody who understands who we talk to
(14:22):
for this vendor, for building this, forgetting this. It sounds
like that's what you're doing, is you're taking this non
expertise off of somebody's plate so they can focus on
their expertise and then you guys, in turn, are able
to be experts to get things done quicker because you're
probably used to dealing with the providers. Is that essentially
kind of what you're doing, allowing people to stick to
(14:43):
their strikes you got That's a.
Speaker 6 (14:45):
Really good way to put it, like sticking to your strains.
And that's not only great for a work experience and
for the patient, but it lets you bring a certain
level of attention to detail too, Right.
Speaker 7 (14:55):
So the way we interact with the.
Speaker 6 (14:57):
Providers in the community, the way we're able to talk
to fans and explain the situation, what the next steps are.
These are things that are I think in most of
cant as dirational because you're just so busy, right, and
so we can have a chattle to the samely, we
can tell them what to expect when they get home.
Speaker 7 (15:11):
We can do a follow.
Speaker 6 (15:11):
Up, you know, forty eight hours after they've gone home
to make sure things are okay. Those things are I
think actually quite transformative, even though they seem small.
Speaker 3 (15:21):
When it comes to just the amount of time that's
extra the bed days that you have here. Is there
any stats out there about saying how many people are
currently using bed days that don't necessarily have to be
in a medical setting.
Speaker 7 (15:36):
Yeah, it varies across.
Speaker 6 (15:37):
The country, but it is a sticky problem in Newfoundland
and we look health accord about I believe it was
twenty two percent of the beds at any given time
in our province or within this ALC status. So that
means someone is occupying that bed that doesn't need to
be in the hospital. Now, we can't tackle all of that.
So when we looked at the issue, some folks are
(15:59):
in there because on a long wait list for long term.
Speaker 7 (16:01):
Care, right, But there is a subset.
Speaker 6 (16:03):
Within that percentage that are just waiting for these kind
of coordination elements to be put in place. And so
we figured out we can tackle a portion of that
ALC issue and we can do it across the country.
When we think about what we're returning in terms of
bad days, and I mentioned we're beating that expected discharge date, often,
another way to think about that is actually we're avoiding
(16:24):
an ALC altogether. Yeah, so you're gone, right, You're gone
exactly what you need to be or before that the
expected date was.
Speaker 7 (16:31):
So that's huge.
Speaker 6 (16:33):
On the other side of managing the ALC kind of burden,
there's there's something called patient length of stay, right, and
so what's the total length of state? So when we
looked at what was the total length of state inclusive
of ALC days for patients in the system before discharge
shop and after discharch hup, we were reducing that anywhere
(16:53):
between two to three days on average. Oh well, so
that means for every patient that we we are discharging.
Through our solution, we're either avoiding the ALC or returning
two to three days back to the system. And that's
you know what percentage of that twenty two percent are
we hitting. I think it'd be still to dig into that,
but but the returns are so clear and then you know,
(17:13):
it's been really exciting to know that we can have
that impact. And it's you also think about, you know,
how how expensive healthcare has become, and you know, our infrastructure.
Lets us get the most out of our assets too, right,
there's so many benefits to making sure there's good flow.
Speaker 7 (17:30):
It's reallysis.
Speaker 3 (17:31):
I think it was a lot of time of efficiency.
So let's talk about how you rolled this out. Because
you're talking about results, which means this has been in
play for a while. Tell me about where you guys
laid it out. What what did the initial rollout look like?
And how long has it been going and where is
it operating currently?
Speaker 7 (17:49):
Yeah, so we were we were.
Speaker 6 (17:49):
Really fortunate today a new plant. We have a pretty
thriving innovation ecosystem. You know, we've got great groups like
Bounce Health and tech and now but with your new plant,
health services also an innovation team and so that's kind
of where this started. We brought this concept to them,
we wanted.
Speaker 5 (18:05):
To tackle this.
Speaker 6 (18:07):
They were able to take us on as a project
to kind of code design what this solution was going
to look like. So we worked very close to with
the innovation team and with Clinical Efficiency team, which which
was a really excellent partner for us. And there's still
the still quite strong we engage as we do this rollout.
So we initially we did a pilot just at two
sites on a couple of floors at Health Sciences in
(18:28):
Saint Clair's. That's where we started to get some really
good feedback, you know, some things we needed to improve.
We had really strong positive reviews from some user groups.
We had a lot of feedback to work on from
other user groups, so exactly what you want and want
to figure out what's working and what's not. And so
we really refined in two in our procedures and our
solution on habits was going to go the pilot. At
(18:48):
the end of it, we saw some really compelling data.
So some of that land of state data I talked
about was coming out of that pilot. So now we
wanted to see could we do this at a little
bit of a larger scale, and so we the can
Health Project, which is a kind of an innovation cad
innovation support organization in Canada. And so with that can
Health Project, we were able to add two more sites,
(19:10):
and we're all to add two sites in fundamentally different settings,
and so we added the two hospitals in Western so
Western Memorial and Sat Thomas Rodick. So they're more of
a rural setting, different mix of kind of providers in
the community, different challenges and pressure points. And so now
with these four sites, we're able to do our can
Health Project and we're will to get a lot more
(19:31):
data on the efficacy and kind of where we needed
to improve things. Up Coming out of that was also
really strong data and so from there we were now
actually building out two Category A sites across the province incrementally,
so hopefully this fall will be in a couple hospitals
in Central as well as a couple of hospitals in
(19:51):
the World Zone in Eastern and then you know, we're
looking at smaller sites, we're looking at Labrador. But you
know what, when you think about going on this, there's
some really interesting additional effects that come and and maybe
they're they're they're not as impactful when you think about
kind of velor numbers I talked about. But you know,
process unification is huge, Like if every site's doing things
(20:15):
a little bit differently, you don't get the same kind
of impact and kind of comparitors. And so we're able
to do unification of certain procedures because we're going site
to site and bring this across the province. The other
thing we can do is have repatriations can happen a
lot more smoothly. So typically right now, let's say you
were at the Saint Claire's but you lived in Clarenville.
(20:38):
Right when you're being discharged, you typically be sent to
the Claricicle hospitalogy be crossed, and then discharge planning will
start when you get there. Right with discharge job, we
just start discharge planning while you're at Saint Clair's and
we just send you on and so the repatriation getting
back home, that whole process can be so much smoother
for the for the patient and you can not had
(21:00):
to use up another bed at another site on your way.
So as we go provincial, there's additional wings that we're
kind of really excited to deliver.
Speaker 2 (21:08):
Today.
Speaker 3 (21:09):
We're talking about how technology is making its way into
our healthcare system through innovative companies like discharge Hub. When
we come back, we'll dive deeper into how these tools
are helping patients and get home sooner and making sure
our hospital systems run more efficiently.
Speaker 2 (21:22):
We'll be right back after the break. Welcome back.
Speaker 3 (21:35):
We're continuing our conversation about how new health technologies are
reshaping patient care. Today we're talking about discharge Hub and
how it's tackling the challenge of freeing up hospital bids
and helping patients transition home smoothly.
Speaker 2 (21:49):
Let's get back to it.
Speaker 3 (21:51):
Well, I think about a few things with this, and
number one, the first thing that comes to mind obviously
is resources. Not only are professional resources, but also financial resources.
Speaker 7 (21:59):
It sounds as.
Speaker 3 (21:59):
Though a product like this you can determine a return
on investment. Number one, if you can save time, then
you can show how much cost savings, which then allows
it to be transparent on how they're saving money. But secondly,
there's also got to be an economy of scale here
that if people were going off on a one off
nature trying to find resources for somebody to go home,
(22:20):
as opposed to one organization having relationships with these providers
that sell the equipment that people are going to need.
Does that also offer a level of consistency and maybe
even value financially for the healthcare system?
Speaker 7 (22:35):
I believe.
Speaker 3 (22:35):
So.
Speaker 6 (22:36):
I think it's consistency. There's a kind of fairness of application.
You know, there's a lot of policies that we have
to follow and to compliant with, and we're able to
make sure those are maintained and kind of good adherence
to those policies and how different vendors are utilized. And
so I think it brings a lot of accountability to
you know, whether it's measuring that expected discharge day or
(22:56):
making sure we're compliant with policies for different vendors. We
can we kind of everything's you know, because with technology too,
everything's log nottted it so we can make sure that
everything is transparent and clear. So I think there is
some additional value there with scale and that consistency and
having that centralized approach to this church.
Speaker 5 (23:13):
Hup.
Speaker 3 (23:14):
Yeah, Now I think that's an interesting innovation that way.
I mean, I guess it comes down to the human
side of things too, right. You talk numbers all day long,
but it comes down to the people that you're making
a difference with. Have you guys had any first person
accounts of how this was helpful to them in the
real world.
Speaker 6 (23:32):
Yeah, I mean we've obviously we did it with some
really interesting surveys with the with the pilots and the
can Health and we hear all the time from patients too,
So you know, I'll share a couple of things.
Speaker 7 (23:43):
One would be.
Speaker 6 (23:44):
Particularly from some social workers. We've heard how what dramatic
impact has had on some of their workslops allowing them
to focus on doing social work for more people and
really being there for their patient rather than trying to
get through all these kind of procedures around getting someone
the support at home. They can really do the assessments,
(24:05):
make sure that you know they're doing that well and
moving on to the next patient. And so the amount
of time we're saving for some of these user groups
is huge, and so there's you know, people are saying
what they used to take in some cases a couple
of days is being done in twenty minutes, and they
can they can now have that confidence that there's this organization,
there's a solution that's going to handle that part my
(24:27):
client are patient is taken care of and I can.
Speaker 7 (24:29):
Just focus on social work.
Speaker 6 (24:31):
That's been a really compelling piece of feedback from them.
We're hoping to get that level of rave reviews from
other groups, right from ots and pts and nurses, and
so we're continuously trying to improve. You mentioned, you know
this is about people though at the end, and so
you know we are a tech solution. Do we have
a commanded service side of this to be able to
(24:51):
make sure where you know, all of this work gets done.
But it's not all tech, right, and it's not just
because it's new for land, Like we're on the phone
a lot because you've got a healthy board, like we
still log everything in the tech you got to write
down your notes and what happened. But man, there's so
many phone calls because the family wants to know something.
You can't get a hold of the person you need
to at the two shop, or or you're trying to
(25:14):
get infrecent equipment that only this one space has, or
the Red Cross is really busy with other stuff, so
you're trying to get a hold of somebody. You know,
a lot of the fire crews are volunteers right now, obviously,
you know everyone's really busy with everything that's going on.
An incredible response with the lot of fires, but the
phone calls, there's a lot, and so we're able to
(25:34):
do those, build those trusted relationships, and kind of as
those things are settled, we can still document them in
the platform. So as much as we drive technology, as
much as we drive innovation and automation, healthcare is are
these people and you're kind of part of this is
just working through people's anxieties. And the reason we do
the patient follow up calls now, for us, it started off,
(25:57):
as you know, we're a new new organization to startup.
You want to follow up with your quote unquote customer.
That's the one way to think about it and make
sure they were happy with the experience. But they turned
into quality checks and safety checks, and so when we
do the call forty eight hours later, you know we
can figure out, Mike, are you okay with the auction stuff?
Speaker 7 (26:16):
You know how to use it?
Speaker 6 (26:17):
You know, did the worker show up that was supposed
to show up at that time? Is the equipment what
you thought it was going to be? And again, we
can't actively intervene and problem solve all those things.
Speaker 7 (26:28):
But if there's a flag.
Speaker 6 (26:29):
We can raise the flag, right, so we can raise
a flag to make sure that the training is delivered
for auction, we can raise a flag to make sure
someone does a new assessment if something wasn't done the
first time around. And the interesting thing there is we're
likely avoiding some rehospitalizations as a result because we're catching
things on that follow up call.
Speaker 5 (26:50):
Yep.
Speaker 6 (26:51):
And even when we're not, that's where we get kind
of the most kind of heartwarming conversations. That follow up
call is like soppreciated someone just checking in, like you
made it all.
Speaker 7 (27:02):
Everything's cool.
Speaker 6 (27:03):
Yeah, we have everything you need. And you know, we
apparently that's best practice for for for discharge, and I
imagine it's very hard to pull off across the country,
but it's something I think, you know, we'd really like
to to think of as as what makes us unique.
We're around ninety five to ninety six percent of patients
we discharge, we follow up with within two days.
Speaker 7 (27:24):
That's that's going home to make sure you know everything's good.
Speaker 6 (27:28):
There's anything you know that fell through the gaps, so
we need to talk about Yeah.
Speaker 3 (27:31):
Yeah, oh that's fantastic.
Speaker 7 (27:33):
I love that.
Speaker 3 (27:33):
And you know, when I look at this sort of
marriage between technology.
Speaker 7 (27:37):
It's new.
Speaker 3 (27:37):
Change is always difficult for people, right, and a hospital
system or a medical system that works.
Speaker 7 (27:42):
A certain way and that there's a new player coming in.
Speaker 3 (27:44):
Obviously, you did pilot studies and then you've been expanding
these over time as.
Speaker 7 (27:49):
You sort of worked out any bugs.
Speaker 3 (27:51):
But what were the biggest challenges with like implementing this
into an existing healthcare system that's been doing things a
certain way for quite a while.
Speaker 6 (27:59):
Yeah, I mean there's a lot of an inertia in healthcare, right,
and I think it's driven by you know, crisis just
kind of wins every day, and so there's not a
lot of time to think about how to do something differently.
And that's a nobody's fault, right that it's how do
you You got to deal with the patient in front
of you.
Speaker 7 (28:15):
You got to deal with the issue that's the right there.
There's also disparate workflows.
Speaker 6 (28:19):
You know, you have really different teams that build different
cultures over time, different procedures over time. So the challenges
we faced was how do we pull people into a
space where there's enough trust and enough time to co
design something right?
Speaker 7 (28:34):
Like we needed we needed to sit down with the
right group of people.
Speaker 6 (28:36):
So we sat down at the patient group, we sat
down with the clinical efficiency group with ots and pts
and nurses to understand that workflow.
Speaker 7 (28:44):
But just to get that time is really difficult.
Speaker 6 (28:47):
So why we're really grateful to the innovation team that
was able to help us organize that and do that
process mapping together and then figure out where it can
we make it better work?
Speaker 7 (28:57):
Could we deploy technology? Yeah, other challenges.
Speaker 6 (29:00):
You know, a pilot is inherently limited in scope, right, yes,
and so there's only so much value and so you're
you're there's this always push and pull with the user group,
like like I'd love free to use it and then
tell me how it's going, but it's also not going
to be like perfect yet and it may create some
more work for you. So early on the pilot is
you need a lot of people to like buy in
(29:21):
and believe that in this future Evice is going to
be great, but right now it may I feel awesome.
And so that was hard, but I think every pilot
you know has that challenge, and so we spend a
lot of time just being honest but also building trust.
And so for us it was you know, the innovation
team made a big difference in terms of getting those
groups together. And I think we knew we needed to
(29:42):
be transparent and build trust with folks because we were
not their priority, like the patient and next crisis. That's
what's important, and so making sure we you know, roll
that into our plans was really important.
Speaker 3 (29:54):
Today we're talking about how technology is making its way
into our healthcare system through innovative.
Speaker 2 (29:59):
Companies like charge Hub.
Speaker 3 (30:01):
When we come back, we'll dive deeper into how these
tools are helping patients and get home sooner and making
sure our hospital systems run more efficiently.
Speaker 2 (30:08):
We'll be right back after the break.
Speaker 1 (30:13):
You're listening to what we broadcast of The Wellness and
Healthy Lifestyle Show with Doctor Mike Wall. Listen live Thursday
nights at seven pm and Sunday's at four pm.
Speaker 2 (30:26):
Welcome back.
Speaker 3 (30:26):
We're continuing our conversation about how new health technologies are
reshaping patient care. Today we're talking about discharge Hub and
how it's tackling the challenge of freeing up hospital bids
and helping patients transition home smoothly.
Speaker 2 (30:40):
Let's get back to it.
Speaker 3 (30:42):
Yeah, I think it's you know, it's an interesting evolution
it's obviously something that's a big challenge for us. If
you say twenty percent of the beds that in province
are being used and don't necessarily have to be people
would rather be at home, and then they're grateful when
they get the support to get home. These all sound
like good solutions, and I wonder, you know, getting philosophical
here on a different level when it comes to technology.
The technology is evolving at such a rapid rate. We're
(31:05):
seeing it all the time. I'm seeing it on the
side when I'm educating the next generation of physicians. But
how do you see technology being used to solve other
systemic challenges within our healthcare system?
Speaker 6 (31:19):
Yeah, I mean technology is moving a mile a minute
these days, especially with with AI and all the kind
of innovations we're seeing, and there's a.
Speaker 7 (31:27):
Lot of promise a lot of risk in that space too.
I think there's some.
Speaker 6 (31:33):
Obvious ones that kind of our extensions of what we've
been doing at discharge job that we're seeing a lot
of streamlining and automating documentation. We think about how much
time a physician or a nurse, you know, doctor's offices
spending on documentation, and there's a lot of ways to
automate that by leveraging technology. So I think we'll see
(31:54):
a continual push how technology can drive efficiency and administrative work.
So I think that's just that's an obvious one, right,
and that's going to kind of keep going so you
have more folks can practice at the top of their
scope more often.
Speaker 7 (32:08):
That's a natural win.
Speaker 6 (32:10):
I think some of the more interesting things that only
coming is also how do we do patient communication and
access to healthcare? Right now, access is person to person.
In some instances, we're able to do virtual care, but
that's still early in Canada especially, So I think the
ways we access care will change. Is it through calls
(32:31):
and in video channels? Is it through text messaging? Where
are our physicians and providers?
Speaker 7 (32:37):
Is another thing?
Speaker 3 (32:38):
Right?
Speaker 7 (32:38):
And so I think about safety efficacy.
Speaker 6 (32:42):
You know, there's a lot of concerns where we think
about clinical decision support with AI and diagnostics support with AI.
I believe, you know, in a relatively short over might
be the safety argument will flip.
Speaker 7 (32:56):
I think right now it'll it.
Speaker 6 (32:59):
Feels like introducing those tools introduces some safety risks, and
I think in a few years, not using those tools
will be the safety risk. Yeah, And I think that's
going to be an interesting shift where we'll always need
the physician or the nurse or the practitioner at the
center or what tools do they have access to, and
those tools will be these kind of you know, digital
(33:20):
assistants or digital decision support systems. And if we think
about it a little bit differently, what gets exciting for
me is particularly in places like Newfland where it's hard
to attract every kind of specialist or hard to have
those specialists. Can we think about specialists through those systems?
You can we have AI specialists that support a group
(33:43):
of GPS. Well, I think what you said, you know,
with certain generations.
Speaker 3 (33:46):
Every generation is different, right, Some generations prefer to be
online and not interact, and other generations want to interact.
And I think that having that face to face and
that personal connection might be a risk of too much
tech without the personal side, given that healthcare is so
personal in nature, you know, that would be an intending consequence.
(34:08):
I think that I could think of Can you think
of any other consequences that could happen as we implement
new technologies into the system.
Speaker 7 (34:17):
I'll answer that.
Speaker 6 (34:18):
I want to say one other thing on the adoption
side and transition side. I think we also can't underestimate
how quickly people do take up things that work well.
Like texting is a really interesting example. Texting is dominating
in terms of how people prefer to communicate, and that's
across associate now a spectrum that's across the age spectrum, right,
(34:40):
And so when something works really well and it's easy,
even if it's new, I think adoption can happen quite quickly.
Speaker 7 (34:47):
We just can't assume that it will.
Speaker 6 (34:49):
But I think we can plan for it if we
transition things well and then the system is designed well, you.
Speaker 7 (34:54):
Know where things could go wrong.
Speaker 6 (34:55):
I mean, I think there's a lot of know when
we think about AI and scribing automating, we need to
make sure we build in the.
Speaker 7 (35:06):
Checks and balances.
Speaker 6 (35:08):
So where is there a verification, where's their oversight, where's
the person interfacing with the system to make sure things
are still following the right rule set or we're not
kind of introducing different biases. I think those are really
important kind of criteria burdens that are on the not
just on the tech providers, but on the medical and
(35:31):
kind of administrative users of the tech. And so I
think what one risk that I see is who is
using all these solutions that are being delivered, right? Are
they medical office administrators and nurses and social workers? And
do they have the technical literacy to understand when a
tool is failing them, when a tool is wrong? And
(35:51):
I think that's really that's really tricky, right, because that's
not what they're trained. And so how do you start
to see through and how do you start to know
when something is is doesn't sound right? And for us,
you know, when we think about technology in our own
organizations or even in discharge hub, you need a certain
level of knowledge and intimacy of your work to be
(36:12):
able to catch those things. Because if you come in
day one into a fully automated environment, you don't necessarily know.
Speaker 7 (36:19):
What you're looking for for things to go wrong.
Speaker 6 (36:22):
And so I think it comes down to the training
and exposure to really understand the breath of use cases
that could happen, and so when tech is introduced, you
can kind of see through it when it's wrong.
Speaker 7 (36:32):
Well.
Speaker 3 (36:32):
Also a benefit of being developed here at home for us,
for a very specific medical system is that maybe the
ability to speak up or the incentive to give feedback
is greater because they realize this is being made right
here as opposed to some prepackaged product comes off the
shelf designed somewhere else. So I think, yeah, that's also
I mean the fact that we have such a thriving
(36:53):
healthcare or health tech sector. I think that's going to
be a really important You know, you've mentioned a bunch
of stuff today, you know, as we start to get
wind up here, but you've mentioned the need for interaction
with patients, even in rural settings, that being a challenge,
but a consistency being important. You talk about optimizing people,
letting them stick to their strengths. You've mentioned several different things.
(37:17):
Where do you see the biggest opportunities as we look
at the big picture for New Flint and Labrador going forward.
Speaker 6 (37:25):
You know, I think for certainly for New Flint Labrador,
but I think large and an opportunity that I think
we've continuously struggled to meet anywhere in the country is prevention.
Prevention is so powerful and it's so hard to invest in.
You know, you can measure disease reduction when you do
(37:49):
a new drug intervention. You can measure and change in
well being after a surgery, But if none of the
bad things happened. You prevented all of it. It's really
hard sometimes to think about how do we justify how
do we prioritize prevention? But but I think culturally we're
starting this fear shift. So investments in you know, health, education,
(38:14):
in good food and exercise, stress management, sleep, counseling, housing,
you know, these are huge dividends that will come back
in health. I think that's the opportunity. And innovation in
that space I think is as yet to come, and
we're seeing it a lot from I think, you know,
like high tech, private organizations. But I there's a way
(38:36):
to think about innovation, like how does that happen at school?
You know, how does that happen at the cafeteria?
Speaker 3 (38:43):
You speak in my language? It does really ring true
to me that you think that prevention is key, so
I think it is as well. I guess I really
appreciate you coming here today. It's something that I've learned
more about as we've prepared for this interview. But realizing
that there's a challenge as large as we have with space,
but then also that their solutions being put in place
that we're showing effective results for I think that's a
(39:06):
huge kudos to you guys and all your efforts, but
also really great representation of how our health tech sector
is trying to solve problems with modern solutions.
Speaker 7 (39:14):
Now, thanks so much for joining me today. Is a
really great conversation. This was fantastic. Thanks so much, Mike.
Speaker 2 (39:20):
Well, that's our show this week.
Speaker 3 (39:21):
A big thank you to Andy Fisher and Bounce Health
Innovation for the leadership in building our.
Speaker 7 (39:25):
Health tech sector here at home.
Speaker 3 (39:26):
And aon Shaheed and his team at Discharge Hobe for
sharing how their solution is improving patient care and freeing
up valuable hospital bits. Now, if you're listening today and
you have a health tech idea of your own, you
can reach out to Bounce Health Innovation through their website
Bounce Innovation dot Ca. They're always looking to support new
ideas that can strengthen our healthcare system. Well, that's our
(39:48):
show this week. I'm your host, doctor Mike Wall. We'll
see you back here next week for another episode of
the Wellness and Healthy Lifestyle Show on the Staying Ry
Podcast Network and your vocm
Welcome to the Wellness and Healthy Lifestyle Show on your
vocm Now, here's your host, Doctor Mike Wall.
Speaker 2 (00:12):
The show.
Speaker 3 (00:12):
I'm your host, doctor Mike Wall. Today we're diving into
a story the shows how technology can transform healthcare, not
by adding more staff or more money, but by improving
the systems we already have. We all know hospital bids
are precious resources, and too often patients can remain in
the hospital not because of medical needs, but because of
delays and discharge. Now that costs our system money, it's
(00:35):
strained staff, and it keeps patients from getting home or recovery.
Is best to explore this, We're going to start off
with Andy Fisher, director of Bounce Health Innovation, who's been
helping local companies turn bold ideas into real solutions for
a healthcare system. Then we'll be joined by aon Shahead
from Discharge Hub, whose technology is already freeing up hospital
bids and giving patients a smoother path home. There's a
(00:58):
lot to cover, so let's get to it. Hey, Andy,
welcome back to the show.
Speaker 4 (01:02):
Hey, thanks, Mike's great to be here again.
Speaker 2 (01:04):
Yeah, it's fantastic.
Speaker 3 (01:05):
We've had a great season this year where we have
talked to all sorts of tech companies about the different
innovations that they've come up with, and quite often we're
hearing about it from the perspective of the owner, creator
of the company. But now we're going to learn about
something that's in the field, something that's been tested in
our healthcare system. And maybe you could give us a
bit of a background of why you wanted me to
(01:26):
talk to our guests today.
Speaker 5 (01:28):
Yeah, absolutely, so you're right.
Speaker 4 (01:30):
So Bounce Health Innovation is about accelerating the growth of
the health tech sector. So that sounds all very technical
and it's all about enterprise and business and these things,
but health is an intensely human endeavor and so really
none of the companies that we've talked about are None
of the technology that we talk about work in absence
of the human systems that are involved and the people
(01:52):
that are involved. And so I think it's time that
we explored what's that really about. And I really encourage
listeners to think about this whole story. This interview is
going to take it a little longer than our normal
little sections because there's so many elements that get involved
for having the technology enable whatever.
Speaker 5 (02:11):
The win is that we're looking for in each particular case.
Speaker 3 (02:14):
And not to give away the conversation, but the reality
is sometimes there's problems that we don't even know about
that are major, significant problems in our healthcare system that
technology can come in and really allow people to stick
to their strengths and allow our healthcare system to function
more efficiently. And I think efficiency is something that is
really valuable when it comes to how.
Speaker 5 (02:35):
Do we do more with less?
Speaker 4 (02:38):
Yeah, I mean it's there's some hard things to keep
in your head all at one time, and there's some
easy things, and I think we need to find those
easy things and latch onto them.
Speaker 5 (02:46):
Right, So what do we know for sure?
Speaker 4 (02:48):
We know for sure that in this province we spend
forty percent of everything that we spend as a province
on healthcare. We know that now that adds up to
four point five billion dollars. We know that we have
the worst health outcomes in Canada, and Canada does not
rank high on the global scale. So that's enough to know.
(03:11):
So if you just take that, one of those big
problems is not how do we spend more money, it's
how do we get more effect with the money that
we're spending currently? And so today's example is exactly that
it's within the healthcare system and the objective of the company.
If you listen to the guest today, you'll hear the
compassion for the people that are involved, and ultimately it's
(03:35):
about saving those dollars.
Speaker 3 (03:37):
And I think that's the other aspect of this is
very human, is that sometimes we have technology that comes
in it allows things to be done more efficiently and
more effectively. But this is actually helping individuals get on
with their life after they've experienced a hospital stay, which
I think is also really important. I think that there
is tremendous value, even if it's not just financial, to
(03:58):
allowing people to get on with their life after an
incident that put them in the hospital setting, which can
be really challenging for folks.
Speaker 4 (04:05):
Right, I think every listener will have either a personal
experience or somebody that they can relate to who has
had that journey right through through a hospital system and
then out of the hospital system. Our hospital system is taxed.
The individuals working there are fantastic, but they're stretched to
the limit. They're putting out the most pressing fire. And
(04:26):
the guest today is going to talk about let's focus
on some of these other things that are really slowing
down the pathway through that system, and for those individual journeys,
it makes a tremendous difference.
Speaker 3 (04:37):
So this is an example of a technology that has
gone through the system here in Newfolin of Labrador and
has gone from an idea to something that's actually working
in a healthcare system. If people have an idea that
they want to start this process on, how do they
reach out to Bounce?
Speaker 4 (04:53):
Yeah, some bounce is easy to get a hold of.
We have a website Bounce Innovation dot Ca. There's you know,
how do you a hold of us? Is on that
website and it truly is about sort of standing back
and thinking about new ways of doing healthcare. And also,
and I think our guests will talk about this at
the end, the future of healthcare is not fixing people faster,
(05:17):
it's helping people stay healthy. And so there's a tremendous
amount of thinking going into what about wellness? How do
we help people help themselves? What role can technology play?
But again, even that will be a tremendously human system
that's enabled by technologies. So yeah, no, Bounce Innovation dot
Ca and be delighted to talk with anybody who's got
(05:38):
some ideas.
Speaker 3 (05:39):
So fantastic, let's get to our conversation.
Speaker 5 (05:41):
They on fantastic.
Speaker 3 (05:48):
Hi, Yeah, welcome to the show. A wake are going
really good, really good. I'm glad we got a chance
to get together and chat today. I think both of
us live in a world where it's awful lace to
see if things go from theory into practice, and that's
what we're going to talk about today, is the sort
of shift in how new technologies can help things that
(06:08):
we currently do in our healthcare system. Maybe you could
give our listeners a little of a background on yourself.
Speaker 6 (06:14):
Yeah, absolutely, and excited to be here on your show.
Congrats on all the amazing things you've been doing recently.
So my name is ae Ansha Head. I'm with a
group called Seafair here at Own. So we're a group
of organizations. We're largely focused on healthcare and community well
being within our province and so we have a number
of organizations that focus on providing care to folks who
are vulnerable, to seniors, to folks with disabilities. But we
(06:38):
also do a little work in supply chain and in technology,
and so as we think about where healthcare is going,
we're thinking about bringing innovation across a broader spectrum.
Speaker 7 (06:47):
And particularly when we think about where care happens.
Speaker 6 (06:50):
You know, there's a lot of discussion around clinics and hospitals,
which is really really important, but the continuum of healthcare
is borrowing that right, and so we think a lot
about how do those spaces relate to and connect to
other spaces like home, and so how do we build
innovation and access across that broader continuum. So that's where
a lot of our thinking is and I've thought the
work that I'm focused on is trying to link those
(07:12):
different spaces where care can happen.
Speaker 7 (07:14):
Well, that's true.
Speaker 3 (07:14):
I mean it's not just going to a doctor or
getting a surgery, it's all the things that happen afterwards.
And I think that's one of the technologies and approaches
I really want to focus on today. Is something that
you've recently launched and you were starting to get some
data on how effective it's been, and that's called discharge Hub.
Can you give me an overall view of what it is?
Speaker 6 (07:36):
Yeah, for sure, So maybe I'll build on that idea
of the continuum. So when we thought about what problems
we wanted to dig into, you know, in that continuum,
we try to think about how do people travel through
the system, right, and so you access care at a hospital,
at a clinic, but there's points of almost like procedure
that aren't really medical in nature that are really impactful
to the experience and what happens to a patient. And
(07:57):
so that's things like intake, it's things like communication, like triage,
but it's also discharge, right. Discharges the fundamental experience that
people have, and it affects everything from the patient's well
being and how they get home, what they're prepared to do,
but also impacts efficiency at the hospital. How quickly can
you leave when you're good to go, how we easily
(08:17):
can we coordinate the care that you need on your
way home. And so we wanted to tackle this idea
of discharge to make sure that the patients had the
best experience possible and that you weren't in the hospital
any longer than you needed to be. There's this stat
or term called ALC. I'm sure you know you've heard
all about it, called alternative level of care, and this
is a wicked problem across the country. And you know,
(08:40):
this is a simplistic way to think about it, but
it's basically during the hospital when you don't need to
be so you're medically clear, you're just there and you're
waiting for something to be able to go home. So
you may be waiting to have a ramp built at
your home, you may be waiting for your folks to
be ready for you to get home, maybe waiting for
respiratory and need a fire inspection done before oxygen can
be at the home. There's a few reasons why you
(09:01):
may be at the hospital longer than you need to be,
and that's not really good for anybody. For the patient,
you're in a disease rischh environment, potentially away from work,
you're not around your social supports. For the hospital, it's
a bed someone's waiting for right So it's not good
for patient flow, it's not good for efficiency. And so
we thought if we could tackle some elements of the
discharge procedures, could we bring down AOC rates, which is
(09:23):
a challenge across the country. Could we get more out
of our hospital systems, have more people go through the
system and get you home sooner so you can get
well and be.
Speaker 7 (09:31):
Where you want to be.
Speaker 6 (09:32):
So that's what Discharge Hub is trying to tackle and
we're really proud of full we've been able to do.
So we're looking at us some specific challenges in that space.
Really around a non medical procedure, So after you've been
kind of cleared to go home, what's left to do?
And a lot of that is administrative in nature, and
so right now we're tackling kind of three main areas
(09:53):
of procedures.
Speaker 7 (09:53):
So that's around respiratory.
Speaker 6 (09:56):
Care at home, it's home equipment, and it's also coordinating
homes support. So those are kind of three distinct barriers,
and you may be experiencing you may need one or
all three of those on your way home. But we've
been working to optimize those procedures, digitize them where we can,
and kind of move that pace along so you can
get home soon.
Speaker 3 (10:16):
Today we're talking about how technology is making its way
into our healthcare system through innovative companies like discharge Hub.
When we come back, we'll dive deeper to how these
tools are helping patients and get home sooner and making
sure our hospital systems run more efficiently.
Speaker 2 (10:30):
We'll be right back after the break. Welcome back.
Speaker 3 (10:42):
We're continuing our conversation about how new health technologies are
reshaping patient care. Today we're talking about discharge Hub and
how it's tackling the challenge of freeing up hospital bids
and helping patients transition home smoothly. Let's get back to
it now. That's excellent. I think that's the important side
of it is that we think, Okay, we've got the care.
We might have the physicians, the nurses, the healthcare staff.
(11:05):
We even have the space in some cases, but it's
not unlimited. And I think you really hit a good
point there with people. It's hard for them to get
well when they're still in the hospital and they're ready
to get home. That's the last place you really want
to be if you don't need to be. Is that
really the gap that you saw was that Number one
for the patient outcomes, there's an improvement by getting them
outen Number two, there obviously has to be a massive
(11:28):
cost with having people at a hospital setting that don't
need to be there.
Speaker 7 (11:31):
Yeah, the cost is massive.
Speaker 6 (11:33):
If you think about our hospitals and in acute bed
that's you know, it's an intensive way to get care,
and we need those beds for.
Speaker 7 (11:39):
The next person.
Speaker 6 (11:40):
Right the problems we run off their feet, there's the
next crisis to attend to, and in that busyness, it's
really hard to manage administrative tasks and to keep on
top of kind of a series of things that need
to get done because you're there as a nurse of
a social workers as a position to provide care. When
we think about these procedures and respriatuorary equipment and un reupport,
(12:03):
it's things like getting quotes from vendors.
Speaker 7 (12:05):
It's coordinating around emails.
Speaker 6 (12:07):
It's making sure the fire inspector goes on time and
the family knows what to expect and so they can
pass that inspection so that you can go home. Those
things are getting done, but the tasks are kind of
spread out amongst people, and if maybe the last thing
on your list not because it doesn't matter to you,
it's because someone's in crisis and needs your help right now.
Speaker 7 (12:25):
And so that disparate way of how tasks.
Speaker 6 (12:28):
Were getting done on these processes is where we found
this delay was happening. Right So what our solution does
is we can centralize what needs to get done and
then we can kind of expedite that through some automations,
and so all of a sudden, you're able to take
quite a bit of administrative burden off folks and then
get someone home sooner. And so what happens the outcome
(12:49):
to your point absolutely is on the patient they get
home sooner, the hospital gets to utilize their beds more.
So we get to return what we call bed days,
and so the hospital has more bed days available. The
other thing that's been fantastic is the actual return of
clinical capacity, and so we're leaving about five hours of
clinical time for the discharge that we do. So if
(13:11):
you think about a social worker or a nurse when
we do a discharge, we're for all and again kind
of manage that coordination through our solution. That's time they
don't have to worry about and they can practice at
the top of their scope, do what they trained for
and provide that value to to the next patient there
are you know, that's that's literally powder of that because
of how stressed people are in healthcare, right, I do
(13:32):
want to say on the flow side, it's pretty pretty
remarkable impact as well. So yeah, there's this there's this
term used often when when a patient is admitted to
the hospital called expected discharge date, and so we we
monitor how often can we meet or beat that date
right right, because it's after you've been taking care actery.
(13:54):
Medical needs are soort and we're actually able to beat
the d D about half the time.
Speaker 3 (14:00):
To me, that's incredible, and I think that also. I
think about like when you need an expert to do something,
you call the person that does it on a day
to day basis. Not saying that the individuals that are
in charge of this is the hospital setting, aren't capable
of doing this, but if they're trained to the medical world,
their best use of time is probably dealing with medical
issues and having somebody who understands who we talk to
(14:22):
for this vendor, for building this, forgetting this. It sounds
like that's what you're doing, is you're taking this non
expertise off of somebody's plate so they can focus on
their expertise and then you guys, in turn, are able
to be experts to get things done quicker because you're
probably used to dealing with the providers. Is that essentially
kind of what you're doing, allowing people to stick to
(14:43):
their strikes you got That's a.
Speaker 6 (14:45):
Really good way to put it, like sticking to your strains.
And that's not only great for a work experience and
for the patient, but it lets you bring a certain
level of attention to detail too, Right.
Speaker 7 (14:55):
So the way we interact with the.
Speaker 6 (14:57):
Providers in the community, the way we're able to talk
to fans and explain the situation, what the next steps are.
These are things that are I think in most of
cant as dirational because you're just so busy, right, and
so we can have a chattle to the samely, we
can tell them what to expect when they get home.
Speaker 7 (15:11):
We can do a follow.
Speaker 6 (15:11):
Up, you know, forty eight hours after they've gone home
to make sure things are okay. Those things are I
think actually quite transformative, even though they seem small.
Speaker 3 (15:21):
When it comes to just the amount of time that's
extra the bed days that you have here. Is there
any stats out there about saying how many people are
currently using bed days that don't necessarily have to be
in a medical setting.
Speaker 7 (15:36):
Yeah, it varies across.
Speaker 6 (15:37):
The country, but it is a sticky problem in Newfoundland
and we look health accord about I believe it was
twenty two percent of the beds at any given time
in our province or within this ALC status. So that
means someone is occupying that bed that doesn't need to
be in the hospital. Now, we can't tackle all of that.
So when we looked at the issue, some folks are
(15:59):
in there because on a long wait list for long term.
Speaker 7 (16:01):
Care, right, But there is a subset.
Speaker 6 (16:03):
Within that percentage that are just waiting for these kind
of coordination elements to be put in place. And so
we figured out we can tackle a portion of that
ALC issue and we can do it across the country.
When we think about what we're returning in terms of
bad days, and I mentioned we're beating that expected discharge date, often,
another way to think about that is actually we're avoiding
(16:24):
an ALC altogether. Yeah, so you're gone, right, You're gone
exactly what you need to be or before that the
expected date was.
Speaker 7 (16:31):
So that's huge.
Speaker 6 (16:33):
On the other side of managing the ALC kind of burden,
there's there's something called patient length of stay, right, and
so what's the total length of state? So when we
looked at what was the total length of state inclusive
of ALC days for patients in the system before discharge
shop and after discharch hup, we were reducing that anywhere
(16:53):
between two to three days on average. Oh well, so
that means for every patient that we we are discharging.
Through our solution, we're either avoiding the ALC or returning
two to three days back to the system. And that's
you know what percentage of that twenty two percent are
we hitting. I think it'd be still to dig into that,
but but the returns are so clear and then you know,
(17:13):
it's been really exciting to know that we can have
that impact. And it's you also think about, you know,
how how expensive healthcare has become, and you know, our infrastructure.
Lets us get the most out of our assets too, right,
there's so many benefits to making sure there's good flow.
Speaker 7 (17:30):
It's reallysis.
Speaker 3 (17:31):
I think it was a lot of time of efficiency.
So let's talk about how you rolled this out. Because
you're talking about results, which means this has been in
play for a while. Tell me about where you guys
laid it out. What what did the initial rollout look like?
And how long has it been going and where is
it operating currently?
Speaker 7 (17:49):
Yeah, so we were we were.
Speaker 6 (17:49):
Really fortunate today a new plant. We have a pretty
thriving innovation ecosystem. You know, we've got great groups like
Bounce Health and tech and now but with your new plant,
health services also an innovation team and so that's kind
of where this started. We brought this concept to them,
we wanted.
Speaker 5 (18:05):
To tackle this.
Speaker 6 (18:07):
They were able to take us on as a project
to kind of code design what this solution was going
to look like. So we worked very close to with
the innovation team and with Clinical Efficiency team, which which
was a really excellent partner for us. And there's still
the still quite strong we engage as we do this rollout.
So we initially we did a pilot just at two
sites on a couple of floors at Health Sciences in
(18:28):
Saint Clair's. That's where we started to get some really
good feedback, you know, some things we needed to improve.
We had really strong positive reviews from some user groups.
We had a lot of feedback to work on from
other user groups, so exactly what you want and want
to figure out what's working and what's not. And so
we really refined in two in our procedures and our
solution on habits was going to go the pilot. At
(18:48):
the end of it, we saw some really compelling data.
So some of that land of state data I talked
about was coming out of that pilot. So now we
wanted to see could we do this at a little
bit of a larger scale, and so we the can
Health Project, which is a kind of an innovation cad
innovation support organization in Canada. And so with that can
Health Project, we were able to add two more sites,
(19:10):
and we're all to add two sites in fundamentally different settings,
and so we added the two hospitals in Western so
Western Memorial and Sat Thomas Rodick. So they're more of
a rural setting, different mix of kind of providers in
the community, different challenges and pressure points. And so now
with these four sites, we're able to do our can
Health Project and we're will to get a lot more
(19:31):
data on the efficacy and kind of where we needed
to improve things. Up Coming out of that was also
really strong data and so from there we were now
actually building out two Category A sites across the province incrementally,
so hopefully this fall will be in a couple hospitals
in Central as well as a couple of hospitals in
(19:51):
the World Zone in Eastern and then you know, we're
looking at smaller sites, we're looking at Labrador. But you
know what, when you think about going on this, there's
some really interesting additional effects that come and and maybe
they're they're they're not as impactful when you think about
kind of velor numbers I talked about. But you know,
process unification is huge, Like if every site's doing things
(20:15):
a little bit differently, you don't get the same kind
of impact and kind of comparitors. And so we're able
to do unification of certain procedures because we're going site
to site and bring this across the province. The other
thing we can do is have repatriations can happen a
lot more smoothly. So typically right now, let's say you
were at the Saint Claire's but you lived in Clarenville.
(20:38):
Right when you're being discharged, you typically be sent to
the Claricicle hospitalogy be crossed, and then discharge planning will
start when you get there. Right with discharge job, we
just start discharge planning while you're at Saint Clair's and
we just send you on and so the repatriation getting
back home, that whole process can be so much smoother
for the for the patient and you can not had
(21:00):
to use up another bed at another site on your way.
So as we go provincial, there's additional wings that we're
kind of really excited to deliver.
Speaker 2 (21:08):
Today.
Speaker 3 (21:09):
We're talking about how technology is making its way into
our healthcare system through innovative companies like discharge Hub. When
we come back, we'll dive deeper into how these tools
are helping patients and get home sooner and making sure
our hospital systems run more efficiently.
Speaker 2 (21:22):
We'll be right back after the break. Welcome back.
Speaker 3 (21:35):
We're continuing our conversation about how new health technologies are
reshaping patient care. Today we're talking about discharge Hub and
how it's tackling the challenge of freeing up hospital bids
and helping patients transition home smoothly.
Speaker 2 (21:49):
Let's get back to it.
Speaker 3 (21:51):
Well, I think about a few things with this, and
number one, the first thing that comes to mind obviously
is resources. Not only are professional resources, but also financial resources.
Speaker 7 (21:59):
It sounds as.
Speaker 3 (21:59):
Though a product like this you can determine a return
on investment. Number one, if you can save time, then
you can show how much cost savings, which then allows
it to be transparent on how they're saving money. But secondly,
there's also got to be an economy of scale here
that if people were going off on a one off
nature trying to find resources for somebody to go home,
(22:20):
as opposed to one organization having relationships with these providers
that sell the equipment that people are going to need.
Does that also offer a level of consistency and maybe
even value financially for the healthcare system?
Speaker 7 (22:35):
I believe.
Speaker 3 (22:35):
So.
Speaker 6 (22:36):
I think it's consistency. There's a kind of fairness of application.
You know, there's a lot of policies that we have
to follow and to compliant with, and we're able to
make sure those are maintained and kind of good adherence
to those policies and how different vendors are utilized. And
so I think it brings a lot of accountability to
you know, whether it's measuring that expected discharge day or
(22:56):
making sure we're compliant with policies for different vendors. We
can we kind of everything's you know, because with technology too,
everything's log nottted it so we can make sure that
everything is transparent and clear. So I think there is
some additional value there with scale and that consistency and
having that centralized approach to this church.
Speaker 5 (23:13):
Hup.
Speaker 3 (23:14):
Yeah, Now I think that's an interesting innovation that way.
I mean, I guess it comes down to the human
side of things too, right. You talk numbers all day long,
but it comes down to the people that you're making
a difference with. Have you guys had any first person
accounts of how this was helpful to them in the
real world.
Speaker 6 (23:32):
Yeah, I mean we've obviously we did it with some
really interesting surveys with the with the pilots and the
can Health and we hear all the time from patients too,
So you know, I'll share a couple of things.
Speaker 7 (23:43):
One would be.
Speaker 6 (23:44):
Particularly from some social workers. We've heard how what dramatic
impact has had on some of their workslops allowing them
to focus on doing social work for more people and
really being there for their patient rather than trying to
get through all these kind of procedures around getting someone
the support at home. They can really do the assessments,
(24:05):
make sure that you know they're doing that well and
moving on to the next patient. And so the amount
of time we're saving for some of these user groups
is huge, and so there's you know, people are saying
what they used to take in some cases a couple
of days is being done in twenty minutes, and they
can they can now have that confidence that there's this organization,
there's a solution that's going to handle that part my
(24:27):
client are patient is taken care of and I can.
Speaker 7 (24:29):
Just focus on social work.
Speaker 6 (24:31):
That's been a really compelling piece of feedback from them.
We're hoping to get that level of rave reviews from
other groups, right from ots and pts and nurses, and
so we're continuously trying to improve. You mentioned, you know
this is about people though at the end, and so
you know we are a tech solution. Do we have
a commanded service side of this to be able to
(24:51):
make sure where you know, all of this work gets done.
But it's not all tech, right, and it's not just
because it's new for land, Like we're on the phone
a lot because you've got a healthy board, like we
still log everything in the tech you got to write
down your notes and what happened. But man, there's so
many phone calls because the family wants to know something.
You can't get a hold of the person you need
to at the two shop, or or you're trying to
(25:14):
get infrecent equipment that only this one space has, or
the Red Cross is really busy with other stuff, so
you're trying to get a hold of somebody. You know,
a lot of the fire crews are volunteers right now, obviously,
you know everyone's really busy with everything that's going on.
An incredible response with the lot of fires, but the
phone calls, there's a lot, and so we're able to
(25:34):
do those, build those trusted relationships, and kind of as
those things are settled, we can still document them in
the platform. So as much as we drive technology, as
much as we drive innovation and automation, healthcare is are
these people and you're kind of part of this is
just working through people's anxieties. And the reason we do
the patient follow up calls now, for us, it started off,
(25:57):
as you know, we're a new new organization to startup.
You want to follow up with your quote unquote customer.
That's the one way to think about it and make
sure they were happy with the experience. But they turned
into quality checks and safety checks, and so when we
do the call forty eight hours later, you know we
can figure out, Mike, are you okay with the auction stuff?
Speaker 7 (26:16):
You know how to use it?
Speaker 6 (26:17):
You know, did the worker show up that was supposed
to show up at that time? Is the equipment what
you thought it was going to be? And again, we
can't actively intervene and problem solve all those things.
Speaker 7 (26:28):
But if there's a flag.
Speaker 6 (26:29):
We can raise the flag, right, so we can raise
a flag to make sure that the training is delivered
for auction, we can raise a flag to make sure
someone does a new assessment if something wasn't done the
first time around. And the interesting thing there is we're
likely avoiding some rehospitalizations as a result because we're catching
things on that follow up call.
Speaker 5 (26:50):
Yep.
Speaker 6 (26:51):
And even when we're not, that's where we get kind
of the most kind of heartwarming conversations. That follow up
call is like soppreciated someone just checking in, like you
made it all.
Speaker 7 (27:02):
Everything's cool.
Speaker 6 (27:03):
Yeah, we have everything you need. And you know, we
apparently that's best practice for for for discharge, and I
imagine it's very hard to pull off across the country,
but it's something I think, you know, we'd really like
to to think of as as what makes us unique.
We're around ninety five to ninety six percent of patients
we discharge, we follow up with within two days.
Speaker 7 (27:24):
That's that's going home to make sure you know everything's good.
Speaker 6 (27:28):
There's anything you know that fell through the gaps, so
we need to talk about Yeah.
Speaker 3 (27:31):
Yeah, oh that's fantastic.
Speaker 7 (27:33):
I love that.
Speaker 3 (27:33):
And you know, when I look at this sort of
marriage between technology.
Speaker 7 (27:37):
It's new.
Speaker 3 (27:37):
Change is always difficult for people, right, and a hospital
system or a medical system that works.
Speaker 7 (27:42):
A certain way and that there's a new player coming in.
Speaker 3 (27:44):
Obviously, you did pilot studies and then you've been expanding
these over time as.
Speaker 7 (27:49):
You sort of worked out any bugs.
Speaker 3 (27:51):
But what were the biggest challenges with like implementing this
into an existing healthcare system that's been doing things a
certain way for quite a while.
Speaker 6 (27:59):
Yeah, I mean there's a lot of an inertia in healthcare, right,
and I think it's driven by you know, crisis just
kind of wins every day, and so there's not a
lot of time to think about how to do something differently.
And that's a nobody's fault, right that it's how do
you You got to deal with the patient in front
of you.
Speaker 7 (28:15):
You got to deal with the issue that's the right there.
There's also disparate workflows.
Speaker 6 (28:19):
You know, you have really different teams that build different
cultures over time, different procedures over time. So the challenges
we faced was how do we pull people into a
space where there's enough trust and enough time to co
design something right?
Speaker 7 (28:34):
Like we needed we needed to sit down with the
right group of people.
Speaker 6 (28:36):
So we sat down at the patient group, we sat
down with the clinical efficiency group with ots and pts
and nurses to understand that workflow.
Speaker 7 (28:44):
But just to get that time is really difficult.
Speaker 6 (28:47):
So why we're really grateful to the innovation team that
was able to help us organize that and do that
process mapping together and then figure out where it can
we make it better work?
Speaker 7 (28:57):
Could we deploy technology? Yeah, other challenges.
Speaker 6 (29:00):
You know, a pilot is inherently limited in scope, right, yes,
and so there's only so much value and so you're
you're there's this always push and pull with the user group,
like like I'd love free to use it and then
tell me how it's going, but it's also not going
to be like perfect yet and it may create some
more work for you. So early on the pilot is
you need a lot of people to like buy in
(29:21):
and believe that in this future Evice is going to
be great, but right now it may I feel awesome.
And so that was hard, but I think every pilot
you know has that challenge, and so we spend a
lot of time just being honest but also building trust.
And so for us it was you know, the innovation
team made a big difference in terms of getting those
groups together. And I think we knew we needed to
(29:42):
be transparent and build trust with folks because we were
not their priority, like the patient and next crisis. That's
what's important, and so making sure we you know, roll
that into our plans was really important.
Speaker 3 (29:54):
Today we're talking about how technology is making its way
into our healthcare system through innovative.
Speaker 2 (29:59):
Companies like charge Hub.
Speaker 3 (30:01):
When we come back, we'll dive deeper into how these
tools are helping patients and get home sooner and making
sure our hospital systems run more efficiently.
Speaker 2 (30:08):
We'll be right back after the break.
Speaker 1 (30:13):
You're listening to what we broadcast of The Wellness and
Healthy Lifestyle Show with Doctor Mike Wall. Listen live Thursday
nights at seven pm and Sunday's at four pm.
Speaker 2 (30:26):
Welcome back.
Speaker 3 (30:26):
We're continuing our conversation about how new health technologies are
reshaping patient care. Today we're talking about discharge Hub and
how it's tackling the challenge of freeing up hospital bids
and helping patients transition home smoothly.
Speaker 2 (30:40):
Let's get back to it.
Speaker 3 (30:42):
Yeah, I think it's you know, it's an interesting evolution
it's obviously something that's a big challenge for us. If
you say twenty percent of the beds that in province
are being used and don't necessarily have to be people
would rather be at home, and then they're grateful when
they get the support to get home. These all sound
like good solutions, and I wonder, you know, getting philosophical
here on a different level when it comes to technology.
The technology is evolving at such a rapid rate. We're
(31:05):
seeing it all the time. I'm seeing it on the
side when I'm educating the next generation of physicians. But
how do you see technology being used to solve other
systemic challenges within our healthcare system?
Speaker 6 (31:19):
Yeah, I mean technology is moving a mile a minute
these days, especially with with AI and all the kind
of innovations we're seeing, and there's a.
Speaker 7 (31:27):
Lot of promise a lot of risk in that space too.
I think there's some.
Speaker 6 (31:33):
Obvious ones that kind of our extensions of what we've
been doing at discharge job that we're seeing a lot
of streamlining and automating documentation. We think about how much
time a physician or a nurse, you know, doctor's offices
spending on documentation, and there's a lot of ways to
automate that by leveraging technology. So I think we'll see
(31:54):
a continual push how technology can drive efficiency and administrative work.
So I think that's just that's an obvious one, right,
and that's going to kind of keep going so you
have more folks can practice at the top of their
scope more often.
Speaker 7 (32:08):
That's a natural win.
Speaker 6 (32:10):
I think some of the more interesting things that only
coming is also how do we do patient communication and
access to healthcare? Right now, access is person to person.
In some instances, we're able to do virtual care, but
that's still early in Canada especially, So I think the
ways we access care will change. Is it through calls
(32:31):
and in video channels? Is it through text messaging? Where
are our physicians and providers?
Speaker 7 (32:37):
Is another thing?
Speaker 3 (32:38):
Right?
Speaker 7 (32:38):
And so I think about safety efficacy.
Speaker 6 (32:42):
You know, there's a lot of concerns where we think
about clinical decision support with AI and diagnostics support with AI.
I believe, you know, in a relatively short over might
be the safety argument will flip.
Speaker 7 (32:56):
I think right now it'll it.
Speaker 6 (32:59):
Feels like introducing those tools introduces some safety risks, and
I think in a few years, not using those tools
will be the safety risk. Yeah, And I think that's
going to be an interesting shift where we'll always need
the physician or the nurse or the practitioner at the
center or what tools do they have access to, and
those tools will be these kind of you know, digital
(33:20):
assistants or digital decision support systems. And if we think
about it a little bit differently, what gets exciting for
me is particularly in places like Newfland where it's hard
to attract every kind of specialist or hard to have
those specialists. Can we think about specialists through those systems?
You can we have AI specialists that support a group
(33:43):
of GPS. Well, I think what you said, you know,
with certain generations.
Speaker 3 (33:46):
Every generation is different, right, Some generations prefer to be
online and not interact, and other generations want to interact.
And I think that having that face to face and
that personal connection might be a risk of too much
tech without the personal side, given that healthcare is so
personal in nature, you know, that would be an intending consequence.
(34:08):
I think that I could think of Can you think
of any other consequences that could happen as we implement
new technologies into the system.
Speaker 7 (34:17):
I'll answer that.
Speaker 6 (34:18):
I want to say one other thing on the adoption
side and transition side. I think we also can't underestimate
how quickly people do take up things that work well.
Like texting is a really interesting example. Texting is dominating
in terms of how people prefer to communicate, and that's
across associate now a spectrum that's across the age spectrum, right,
(34:40):
And so when something works really well and it's easy,
even if it's new, I think adoption can happen quite quickly.
Speaker 7 (34:47):
We just can't assume that it will.
Speaker 6 (34:49):
But I think we can plan for it if we
transition things well and then the system is designed well, you.
Speaker 7 (34:54):
Know where things could go wrong.
Speaker 6 (34:55):
I mean, I think there's a lot of know when
we think about AI and scribing automating, we need to
make sure we build in the.
Speaker 7 (35:06):
Checks and balances.
Speaker 6 (35:08):
So where is there a verification, where's their oversight, where's
the person interfacing with the system to make sure things
are still following the right rule set or we're not
kind of introducing different biases. I think those are really
important kind of criteria burdens that are on the not
just on the tech providers, but on the medical and
(35:31):
kind of administrative users of the tech. And so I
think what one risk that I see is who is
using all these solutions that are being delivered, right? Are
they medical office administrators and nurses and social workers? And
do they have the technical literacy to understand when a
tool is failing them, when a tool is wrong? And
(35:51):
I think that's really that's really tricky, right, because that's
not what they're trained. And so how do you start
to see through and how do you start to know
when something is is doesn't sound right? And for us,
you know, when we think about technology in our own
organizations or even in discharge hub, you need a certain
level of knowledge and intimacy of your work to be
(36:12):
able to catch those things. Because if you come in
day one into a fully automated environment, you don't necessarily know.
Speaker 7 (36:19):
What you're looking for for things to go wrong.
Speaker 6 (36:22):
And so I think it comes down to the training
and exposure to really understand the breath of use cases
that could happen, and so when tech is introduced, you
can kind of see through it when it's wrong.
Speaker 7 (36:32):
Well.
Speaker 3 (36:32):
Also a benefit of being developed here at home for us,
for a very specific medical system is that maybe the
ability to speak up or the incentive to give feedback
is greater because they realize this is being made right
here as opposed to some prepackaged product comes off the
shelf designed somewhere else. So I think, yeah, that's also
I mean the fact that we have such a thriving
(36:53):
healthcare or health tech sector. I think that's going to
be a really important You know, you've mentioned a bunch
of stuff today, you know, as we start to get
wind up here, but you've mentioned the need for interaction
with patients, even in rural settings, that being a challenge,
but a consistency being important. You talk about optimizing people,
letting them stick to their strengths. You've mentioned several different things.
(37:17):
Where do you see the biggest opportunities as we look
at the big picture for New Flint and Labrador going forward.
Speaker 6 (37:25):
You know, I think for certainly for New Flint Labrador,
but I think large and an opportunity that I think
we've continuously struggled to meet anywhere in the country is prevention.
Prevention is so powerful and it's so hard to invest in.
You know, you can measure disease reduction when you do
(37:49):
a new drug intervention. You can measure and change in
well being after a surgery, But if none of the
bad things happened. You prevented all of it. It's really
hard sometimes to think about how do we justify how
do we prioritize prevention? But but I think culturally we're
starting this fear shift. So investments in you know, health, education,
(38:14):
in good food and exercise, stress management, sleep, counseling, housing,
you know, these are huge dividends that will come back
in health. I think that's the opportunity. And innovation in
that space I think is as yet to come, and
we're seeing it a lot from I think, you know,
like high tech, private organizations. But I there's a way
(38:36):
to think about innovation, like how does that happen at school?
You know, how does that happen at the cafeteria?
Speaker 3 (38:43):
You speak in my language? It does really ring true
to me that you think that prevention is key, so
I think it is as well. I guess I really
appreciate you coming here today. It's something that I've learned
more about as we've prepared for this interview. But realizing
that there's a challenge as large as we have with space,
but then also that their solutions being put in place
that we're showing effective results for I think that's a
(39:06):
huge kudos to you guys and all your efforts, but
also really great representation of how our health tech sector
is trying to solve problems with modern solutions.
Speaker 7 (39:14):
Now, thanks so much for joining me today. Is a
really great conversation. This was fantastic. Thanks so much, Mike.
Speaker 2 (39:20):
Well, that's our show this week.
Speaker 3 (39:21):
A big thank you to Andy Fisher and Bounce Health
Innovation for the leadership in building our.
Speaker 7 (39:25):
Health tech sector here at home.
Speaker 3 (39:26):
And aon Shaheed and his team at Discharge Hobe for
sharing how their solution is improving patient care and freeing
up valuable hospital bits. Now, if you're listening today and
you have a health tech idea of your own, you
can reach out to Bounce Health Innovation through their website
Bounce Innovation dot Ca. They're always looking to support new
ideas that can strengthen our healthcare system. Well, that's our
(39:48):
show this week. I'm your host, doctor Mike Wall. We'll
see you back here next week for another episode of
the Wellness and Healthy Lifestyle Show on the Staying Ry
Podcast Network and your vocm
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