The Optimal Hospital Part I
As I explored New Orleans for the first time, a sense of authenticity struck me. Everything about the city whether cuisine, paintings, shops, music jams or second line parades seemed to come from the heart. Everyone is in the moment and wants to share it. When I thought my trip couldn’t get any better, I stumbled upon the digital health innovation nirvana implemented by Ochsner Health System all around the city.
During a long jolly and warm night roaming around Frenchmen street, I met Henry Gould, a software engineer with innovation Ochsner (iO), an innovation lab and accelerator created by Ochsner Health System. We stood in a jazz club’s balcony and as the band played an acoustic cover of the classic WhenThe SaintsGo Marching In, Henry explained how their team has complete autonomy over a cardiology unit, and are given the budget to experiment freely with mobile health technologies. Coming from San Francisco, and having interviewed many of the incredible companies on both coasts, I was skeptical but very intrigued.
I set up an interview with Jonathan Wilt, Assistant Vice President & Chief Technology Officer of iO, and six weeks later I flew back to New Orleans. I was also just in time to see Stevie Wonder and Buddy Guy live at Jazz Fest!
Ochsner Medical Center in Louisiana is a non-profit, 609-bed general medical and surgical teaching facility. The innovation office where Henry, Jonathan and the rest of the team works is setup very similarly to a Silicon Valley start-up. Pin boards, agile post-it notes, multiple giant screens with colorful lines of code, no walls or cubicles– everyone in the room is facing the rest of the team and lots of dialogue going back and forth amidst an exciting work atmosphere.
The team is 18 people strong, with a mix of software engineers and pharmacists. They are fully endorsed and led by Dr. Richard Milani whose vision is to completely reimagine the way Ochsner’s patients receive treatment. The team has many exciting initiatives, but this piece is about how they are redesigning the process of what it means to be a cardiac patient at Ochsner.
The reimagined process goes as follows:
- The Patient is Admitted to the Optimal Hospital Cardiology Unit
The hospital is a hectic and draining place which we all dread, and the iO is making both subtle and overt tweaks in their wing to change that. First off, the patients receive wireless monitors for continuous monitoring of heart rate from their rooms. There are no wires or probes, and that also means that the nurses do not have to walk in on the patient to measure vital data. The data measured is synced to Epic, the electronic medical record, and shows up in the nurse’s office.
The team is also optimizing the patient’s sleep. Instead of having a nurse draw lab results at 4 am in the morning, the nurse spares the patient any sleep interruptions and draws them at 6 am instead. They also have switched the typical bright white glaring lights to softer red lights for night time.
A sound sensor in the hallway collects information about how much noise the patient is exposed to and if there is a certain pattern which they can modify to make for a more convenient and relaxing patient experience.
Henry showing me the Optimal Hospital Cardiology Unit with wireless sensors, mobile monitoring and hallway sound analysis
- On discharge, the patient visits the O Bar
Being a digital medicine nerd, this is my favorite part. The team has set up an Apple Store-esque O Bar which holds all the biosensors, fitness trackers and vital data monitors I can think of. Patients are greeted by a health tech expert, which helps them choose the right device, sets it up for them and trains them on how to use it. This prepares the patient for Ochsner’s home-based follow up.
The O Bar in Action: https://youtu.be/D4Bw3r5Vk5o
- Home-based follow up rather than inefficient appointments.
Most patients with heart problems are provided with a wireless scale to measure their weight on a daily basis from home, and it is directly uploaded into Epic. In addition, the team of pharmacist clinicians (hired by the iO team) follows up every 2-3 weeks to make sure they are on track with medications. This way the contact points with the patients are far more than what normally happens with 3-6 month appointment intervals. When the time comes for appointments, patients are sent a text message reminder.
Learning about Ochsner’s implementation of these programs gave me hope. What is being talked about in Health 2.0 conferences can be implemented in meaningful ways that make both patients and clinicians have a healthier, efficient and more convenient experience of healthcare. In the same vein of everything that is unique about New Orleans, the iO team definitely approaches digital medicine in a very authentic way worth studying.
Although a rainstorm hit Louisiana the next day and rained over my Stevie Wonder and Buddy Guy plans, I was far from disappointed because what I had learned from Jonathan and Henry had already made the trip worth it. To learn more about the business model and details of their innovation strategy, check out Part II of this piece with my full interview with Jonathan Wilt.