Like many who venture into healthcare to seek solutions to one or more of its many ailments, Anne Weiler's rallying cry came from a firsthand experience of how the system failed a loved one.
"When my mom contracted a rare autoimmune disease, she spent six months in a rehabilitation hospital and was discharged with no instructions, only a date for a follow-up visit," says Ms. Weiler, CEO and cofounder of Wellpepper. "I was really frustrated and confused by this lack of continuity of care. She'd had excellent care when she was in the hospital and it went from that to, 'You're on your own.'"
Ms. Weiler, who has spent her career developing tools for collaboration and communication at companies like Microsoft, among others, called a former colleague and began brainstorming ways to solve the continuity of care problem she and her mother experienced.
"We wanted to figure out how we use digital technology to deliver treatment plans so when people are discharged from a hospital, they really feel they know what they need to do and can get remote support from their healthcare team," Ms. Weiler says.
Wellpepper, the platform they would develop, is now used by health systems like EvergreenHealth in Kirkland, Wash., and Sentara Healthcare in Norfolk, Va., to increase patient engagement and improve care continuity. Ms. Weiler spoke to Becker's Hospital Review about using psychology to engage patient populations, leading a healthcare startup after working in the technology sector and why there is skepticism around digital engagement.
Question: What did you find when you began looking into solving the continuity of care problem?
Anne Weiler: What we found at the time was a lot of emphasis on consumer health and not enough emphasis on the continuity of care, connecting patients with their care teams and providing them with instructions after they leave the hospital. When we started Wellpepper, we interviewed a lot of patients, who told us when they received their instructions, and when they were in the hospital or at a clinic and working with their healthcare team, they really felt confident and understood their care plans. But when they got home, they were afraid and they really didn't know what they were supposed to do. Oftentimes that led to them not following their treatment plans.
Then we talked to the health systems, and one of the things we found was that the way they were delivering these care instructions could be improved. The problem was not so much in patients on their own or providers on their own, but it was connecting the two. Frequently, care instructions are confusing, providers may need to give patients instructions for a month's worth of treatment or activities between visits, and the patients get overwhelmed by that.
We thought if we could break that down into actionable, task-based care plans where we make sure the patient knew when it was time to do something — and made it very clear what they needed to do — that we could drive over 70 percent engagement in care plans, which is what we see from our platform.
Q: Did research about patient psychology play a role in developing platform functionality?
AW: Definitely. We have a published patent for an adaptive notification system that changes based on patient behavior, so if you're adherent to your care plan you receive different messages than if you're not adherent. From that, we can learn what is working and what's not working. The other piece is including intrinsic rewards, things like being able to see your goal and know what you're working toward, being able to track your own progress and being able to communicate with your care team. Some of the best consumer applications have this reward component, not in the sense of something like a badge, but just receiving a message that makes the user want to log in and see what's going on. We're continuing to look at what those drivers are.
Interestingly, our population of patients over the age of 50 are more adherent to their care plans than the overall population of patients. So we're continually learning and making sure the application can adjust to users. Another key factor is making sure people feel ownership of their care plans. We do that by designing the plan to be made up of building blocks based on a health system's practices and protocols, but then personalize them for each patient. So we do things like enable the healthcare professionals to capture video of the patient so when the patient reviews the care plan, they're actually seeing themselves. That helps them feel ownership, they feel confident and they know this plan was specifically built for them.
Q: What has the feedback been from providers and patients?
AW: I'd say we're still in the early adoption phase, but the awareness is growing. Within the last few months alone, we've started to see a shift in healthcare organizations looking specifically for patient engagement solutions. A year ago we weren't seeing that. I think awareness is driven by some of the initiatives that CMS is putting forward, like the Comprehensive Care for Total Joint Replacement Model, which requires organizations to track patient-reported outcomes. They need to be doing that when the patient is not right in front of them, and many organizations don't have ways to do it.
Sometimes we field skepticism that the challenge is with older people because they can't use technology, but that's a myth. I think we're doing a disservice to seniors if we assume they can't use iPads or mobile devices, because they are the fastest growing group in mobile adoption. We've partnered with researchers from BostonUniversity and HarvardUniversity [in Cambridge, Mass.] to focus on making our software highly usable for older populations. I think that skepticism is lessening as adoption increases.
Q: What was it like to found a healthcare startup coming from the previous positions you've held?
AW: When I was at Microsoft, my experience spanned consumer to enterprise — I spent a lot of the time working with large enterprises and industries around implementing communications and collaboration tools, and I've found healthcare isn't that different. Providers are looking for return on investment, they're looking to solve crucial problems and improve care and engage their patients outside of hospitals.
In the past year, the shift to value based payments has really driven the adoption because reimbursement is increasingly dependent on whether they track and improve outcomes when the patient goes home. I think there are probably more similarities than differences to other industries, and I'm really optimistic about what I think will be a rapid adoption of both cloud technologies and tools expanding beyond the health system into the patient home.
Q: What will 2016 look like for Wellpepper?
AW: We're just going to keep expanding our platform. Wellpepper is made up of task-based building blocks that you put together to create a care plan, and as we begin working with more health systems, we keep adding new task types so we can support more types of care plans. We'll certainly be looking at growing our customer base as well doing more research. In September 2015, we announced a collaboration with Harvard University and Brandeis University's School of Public Health [in Waltham, Mass.]. That study will last a year, but we will continually be publishing information from those research partnerships.