Founder of Call9 springing back with Curve Health for nursing home telemedicine

Tim Peck MD, founder of Call9, which provided in-facility emergency care staff with telehealth capability for nursing homes, announced a new venture also targeted to nursing home/skilled nursing home (SNF) and rehabilitative health. Curve Health will provide telemedicine and health information exchange technology to SNFs and physician groups. Physicians calling on SNF patients will be able to access patient information before a telemedicine visit. According to Dr. Peck, Curve Health’s telehealth and HIE software are built on that of Call9’s. POLITICO Morning e-Health.

Call9 closed operations last July after four years and $34 million in investment. It achieved some success in New York state, covering 3,700 beds and a total of 11,000 patients treated. While they experienced measurable success–in a 200-bed SNF, they achieved a 50 percent reduction in ER admissions and a savings of $8M per year–made inroads with major payers like Anthem and Healthfirst plus expanded into community telemedicine, it ran into a funding wall all too common with this sector. While the book of business was decent and they had gone through two well-funded rounds, Call9 could not move easily into a Series C. Value-based care is a great buzzword and beloved by CMS, but it is a long payout curve, too long for many investors. More discussion on this is in our article 26 June 2019

It is a shame as New York has been the epicenter of COVID-19 nursing home fatalities, due to a foolish (and this Editor is understating) state mandate of returning recovering patients right back to their nursing homes, which could not provide the level of care or isolate them. These patients often worsened, but also infected other patients and staff. Perhaps this could have been mitigated by Call9 or similar–but likely not.

Sadly, there’s a spotlight on nursing homes, rehabs, and LTC because of this pandemic. We look forward to more news from Dr. Peck and Curve Health in this specialized and underserved area of telehealth.

Robots, robots, everywhere…even when they’re NHS 111 online algorithms

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]The NHS continues to grope its way towards technology adoption, gets slammed–but is it justified? The Daily Telegraph (paywalled–see The Sun) revealed a draft December NHS report that recommended that the NHS 111 urgent non-emergency care line’s “enquiries will be handled by robots within two years.” Moreover, “The evaluation by NHS England says smartphones could become “the primary method of accessing health services,” with almost 16 million inquiries dealt with by algorithms, rather than over the telephone, by 2020.” (That is one-third of demand, with one-quarter by 2019.)

Let’s unpack these reported statements.

  • An algorithm is not a ‘robot’. This is a robot.[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”100″ /]
  • What is so surprising about using algorithmically based questions for quick screening? Zipnosis in the US has been using this method for years as a pre-screener in major health systems. They call it an ‘online adaptive interview’ guiding the patient through branching logic of relevant questions; a provider can review the provided clinical note and make a diagnosis and treatment recommendation in 2 minutes. It also captures significant data before moving to an in-person or telemedicine visit if needed. Babylon Health uses a similar methodology in its chatbot-AI assisted service [TTA 26 Apr 17].
  • Smartphones as a primary means of accessing health services? How is this surprising when the Office of National Statistics says that 73 percent of adults use the internet from their mobiles? 51 percent go online for health information.
  • Based on the above, 66 percent would still be using telephonic 111 services.

It seems like when the NHS tries to move forward technologically, it’s criticized heavily, which is hardly an incentive. Over New Year’s, NHS 111 had a 20 percent unanswered call rate on its busiest day when the flu epidemic raged (Sun). Would an online 111 be more effective? Based on the four-location six-month test, for those under 35, absolutely. Yes, older people are far less likely to use it, as undoubtedly (but unreported) the disabled, sight-impaired, the internet-less, and those who don’t communicate in English well–but the NHS estimates that the majority of 111 users would still use the phone. This also assumes that the online site doesn’t crash with demand, and that the algorithms are constructed well.

Not that the present service has been long-term satisfactory. David Doherty at mHealth Insight/3G Doctor takes a 4G scalpel to its performance and offers up some alternatives, starting with scrapping 111.

Hospital Directions

London, 27-28 November 2013, ExCeL London Convention Centre

The second annual Hospital Directions conference focuses on Secondary Care and care integration, including the crisis of emergency care with winter looming, the benefits of telehealth in secondary care and comparatives from the US, notably the Kaiser Permanente model. There are seven speaker streams, seminars, workshops and hands-on skill sessions and an exhibition. Presented by CloserStill. Please see attached and their website for more information and registration.