BoardRounds Helps Hospitals Follow Up With Patients | Hacker News Reader

BoardRounds Helps Hospitals Follow Up With Patients

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51 pointswyc13 comments

"most patients don’t call, don’t get the follow-up they need, get sicker, and return to the emergency room which strains hospital and health insurer resources"

I suppose this is a USA only problem? In europe pts get an appointment on discharge. Of the people who fail to show (~5-10%) get called which leads to a fail to show of ~1%. Of this group a small percentage has relevant pathology and these pts. are of the doctor avoidant type mostly low social-economic class.

I would like to see some numbers to support their claims. Of course I welcome the idea of improving healthcare information systems. They are notoriously slow, inefficient, insecure and outdated. Only good one I've worked with is EZIS. I don't know why change is so slow but it probably has something o do with money and fear of change and all the problems which come with it.

I've never used an information system which made it easy to look in to stored data and find ways to improve health practice. Analysis software for healthcare is/would/will be a big thing I hope.

Sorry for bad english.

Yes it's very much a US problem but not isolated to that. Even in the superior one payer healthcare systems many mistakes are made because people don't follow up & through.

A system that facilitates follow up care for patients is a good idea. It's clearly in the patients best interest. It's in the hospitals best interest as well. A number of hospitals are doing this already though, using their social workers to arrange follow up care and making sure the patients go. There are also "bundlers" who are doing this, but I suppose they could outsource some of their work to a company like boardrounds. Sometimes a more hands on approach is required, especially when dealing with the elderly. It's possible, over time, for a pure tech solution to this problem. Ideally it would be integrated within the hospitals EMR (really tough, given the reluctance of EMR's to work with outside solution providers, but I think that will change over time), set up the appointment, and maybe go as far as setting up transportation as well - like integrating with Stat (http://signup.stat.com/ - i have no connection with this company, just a thought). Over the next 10-20 years you will also have a relatively more mobile savvy elderly patient population, which will help this, and other solutions, grow.

> Sometimes a more hands on approach is required, especially when dealing with the elderly.

I'd say that extends to far beyond the elderly. I did the majority of my clinical training in hospitals all throughout Brooklyn, and poor compliance/follow-up was evident across the board for a number of patient populations. Persistent hounding by social workers only proved successful half the time. There are cultural and educational factors at play, in addition to blatant laziness, that I think if addressed would yield improvement.

Like you said, many of the patients just aren't tech savvy, but I'd say more are just not well-informed, educated properly on the importance of continued adherence, and actively engaged in their care. Patients are usually given a card with appointment details scribbled on for when to next see their cardiologist for their CHF, or whatever that is. The period between them walking out of their cardiologist's office to their next appointment is, I guarantee, almost never spent reflecting on their condition or actively taking steps to mitigate the complications, save for taking pills. A patient's conditions are only serious problems to them within the walls of their doctor's office. Once they leave, they're forgotten, understandably, out of fear and comfort and the chaos of life. That's why I think it's critical that a patient receive continuous education and encouragement in the interim between check-ups, to close the gaps and help maintain continuous patient self-conern.

Its in fact a much larger issue than one might think at first and I think Athena Health is trying to do some of that.

For instance I had an early stage melanoma removed and because of various circumstances I had to deal with 5 different doctors and hospitals.

The US is system simply isn't made for this and so I spent a lot of time just understanding what I should follow up on who had what, how to get slides from A - B and so on.

If I ever want to solve something in healthcare this is the issue I wanna solve the most.

* Ideally it would be integrated within the hospitals EMR (really tough, given the reluctance of EMR's to work with outside solution providers.."*

Hospitals and clinics know that they need to open up and share data, but they're frozen in place by outdated technology and a (mostly valid) fear of accidentally violating HIPAA.

Having gone to a few different doctors over the last year, follow-up care was almost always the most frustrating part of the experience. Either they lost my chart and paperwork, didn't follow up, didn't explain what care I needed or I dropped the ball on it (and never heard back from them). Healthcare as a whole could use some big changes but this seems like an easy place to start.

My experience has only been in managing veterinary systems, but from what I've heard and seen, the wider healthcare world desperately needs more technological infusion, especially in interacting with clients.

Glad to see stuff like this and Oscar insurance entering the space! One of these days, I'll throw my hat into the ring and try to get vet clinics some tech attention...

Met Benjamin at a health event in New York, and was really impressed by him, the team, and the service. Really smart guys tackling one of the biggest issues in healthcare, patient compliance and follow-up. Congrats on the press and funding!

There is another company already doing this: http://myhealthdirect.com/. (Disclosure: I did some consulting work for them).

(BoardRounds co-founder)

Thanks for pointing these guys out! One point I should clarify: we recommend and fulfill followup interventions. Appointment scheduling is a portion of that, but it only scratches the surface of what our services can do.

Follow-up appointments are the "bread and butter" of follow-up care (most patients who need any sort of follow-up will need a doctor's visit), but the real power comes in being able to identify additional interventions (transportation, medicine reconciliation, home care) and set them all up at the point of discharge. This has to happen on a per-patient level, because while it is incredibly valuable for the patients who require it, it's fairly expensive, and it would be prohibitive to (e.g.) send a nurse to the home of every single person who leaves the ER the next day to check up on them.

I often use ZocDoc to find appoints/book them with doctors, but it would be interesting if they integrated something like this. Possible partnership?

BoardRounds cofounder here - great idea! We do in fact integrate with various service providers (including appointment scheduling APIs) when arranging followup care.

We definitely want to leverage existing services as much as possible, not reinvent the wheel. Appointment scheduling is the most common follow-up intervention, but there are other services we recommend and can provide, and our goal is to partner with other providers for those where possible.

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