On Episode 1 of Season 4 of the Healthcare Reimagined podcast, I spoke with Manav Sevak. Manav is the founder and CEO of Memora Health, which helps healthcare organizations digitize and automate care journeys, and make complex care delivery simple for patients and clinicians to navigate. Manav's journey to building Memora health began with a personal story - a close friend with a chronic diagnosis, who despite being young and tech savvy, found it difficult to navigate his care.

There are three major challenges that Memora addresses: Digitizing clinical workflows, saving providers time by utilizing automation, and allowing patients to use text messaging to get the information they need about their condition.

By looking at the things that happen for every patient, every time, in the course of a particular care episode, Memora has been able to use technology to automate and even standardize certain follow-up procedures. That has cut down on inbox messages and phone calls, and even eliminated them all together. Research out of Dartmouth suggests that people forget up to 80% of what they’ve heard from their healthcare professional. As a result, getting critical information to patients in a digestible format is crucial, and text messaging has proven itself to be a very reliable format for Memora.

The best course of care will vary based on a given patient’s condition and their response to treatment. However, according to Manav, the way patients get reminded to manage their medications, come to appointments, and the way that symptom management are done, should look very similar across clinical areas. What Memora is aiming to build is a best in class process for conveying information to patients and receiving that information back from them.

Memora is also able to leverage its digital approach to ensure adherence to ever-changing guidelines. When the protocols for screening patients for mental health conditions during the prenatal period changed, Memora was immediately able to update their postpartum care program across different care sites to reflect best practices.

Manav and I went on to discuss the challenges of EHR integration for digital health startups, and the challenge of building technology before Memora had access to data from pilot customers. We closed by exploring what percentage of the back and forth between care teams and patients it might be possible to automate in the future, and the tradeoff for early stage founders between staying at a high level and diving into the weeds.

You can learn more about Memora Health on their website.

On Episode 10 of Season 3 , I spoke with my grandmother, Sydell Aaron. Ultimately, we all become consumers of Healthcare, like it or not. On Healthcare Reimagined, I typically showcase healthcare innovation - the truth is that innovations are only interesting in so far as they are making life  better for patients. Last week I spoke with my grandmother about her experience as a consumer of U.S. healthcare over the past 9 decades. 

Sydell, or Meema as I call her, was born in 1932. In 1929, 3 years before she was born, the first polio patient was saved.  In the 1940’s when Meema was a teenager, scientists succeeded in isolating penicillin and antibiotics became widely available for the first time. Before that, you could die from a simple infection. The first kidney transplant was done in 1952, when Meema was 20.  In 1964, for the first time human blood was successfully stored. Meema was 32 years old, with 3 children.

Meema has already lived 50% longer than the average life expectancy for a woman the year she was born (it was 62 back then). We spoke about her family doctor making house calls, the awe and wonder of medicine before technology that made medical information available to all, and about the trade off between safety and independence as one gets older.

We discussed a few quotes from Atul Gawande's book Being Mortal, and the loss of independence as one ages.  One of the quotes from Gawande's book really captured the essence of the challenge Meema faces in her interactions with her adult children. They want the best for her, as she knows, but at times, they infringe upon her freedom in an effort to protect her: "We want autonomy for ourselves and safety for those we love.”

We went on to discuss the framework in which death is addressed in U.S. Healthcare, and a system that selects for those who can and want to fix things (Doctors), when sometimes the best option is not to fix but to provide comfort in one's final days.

We closed with a discussion about Meema's own hopes, desires, and observations after over 9 decades on this pale blue dot we all call home.

Please make sure to check out the Society for HealthCare Innovation's (SHCI) website for more content.

On Episode 9 , I spoke with Shiv Rao. Dr. Rao is the founder and CEO of Abridge, which uses ambient AI to summarize conversations into clinical documentation. He is also a practicing cardiologist, and previously led the provider-facing investment portfolio for UPMC.

“What did the doctor say?" is inevitably the first question we ask a loved one who has just been to see a clinician. But how often do we get a clear answer ? How many of our loved ones are actually knowledgeable enough to grasp the details of their condition/diagnosis/care plan? Research out of Dartmouth suggests that people forget up to 80% of what they’ve heard from their healthcare professional.

That's what makes Abridge so important, and is likely the reason that over 300,000 people are using the free version of the Abridge app (which you can download here on the app store) to help make sense of medical conversations and share information from clinical consultations with loved ones.

As Dr. Rao pointed out in our conversation, there is a public health emergency occurring in the United States - we do not have the supply of clinicians necessary to meet the demands for care delivery. Compounding a lack of clinicians is an uptick in burnout. The AMA currently estimates that physician burnout is at 63%, and an article in the Journal of Internal Medicine that said clinicians would need 27 hours per day to do all the work that’s required of them. Shiv started Abridge to reduce the documentation burden on physicians, and to provide patients with a digestible, “translated” version of their clinical encounter that they can share with family members.  

The benefits are also significant for clinicians. Over 80% of the clerical work that used to be involved in documenting is now getting automated by Abridge - this solution is currently saving clinicians on the platform an average of 2 hours a day! 

Ultimately, as we discussed, a clinical note has three stakeholders:

1. Other clinicians on the care team - they need to understand Dr. Rao’s medical differential, and how he was thinking about the diagnosis/care plan.
2. Health plans - Dr. Rao needs to build his note in such a way that the diagnosis and follow-up recommendations can be properly coded and billed.
3. Patients and their family members, who may need to take action based on Dr. Rao’s findings, which they thus need to understand.

A single note cannot be all of those things at once. Abridge solves this problem by summarizing and structuring the information to create different artifacts for all three sets of customers.

Abridge has raised $27 million to date from investors like Union Square Ventures, Bessemer Venture Partners, and Wittington Ventures. For more information,  you can check out their website: https://www.abridge.com

Please make sure to check out the Society for HealthCare Innovation's (SHCI) website for more content.