Gregg Masters 00:08
Welcome to this special edition of PopHealth Week recorded live in the HealthcareNOW Radio studio at HIMSS 2021, in Las Vegas. PopHealth Week is brought to you by Health Innovation Media. Health Innovation Media brings your brand narrative alive via original or value-added digitally curated content for omnichannel distribution and engagement. Connect with us at www.popupstudio.productions. Welcome, everyone I’m Gregg Masters, Managing Director of Health Innovation Media and the producer co-host of PopHealth Week. Joining me in HealthcareNOW Radio studio is my partner, colleague, and lead co-host Fred Goldstein, President of Accountable Health LLC. So Fred, with that introduction over to you, who do we have on deck for today’s HIMSS 2021 Special Edition.
Fred Goldstein 00:58
Thanks so much, Gregg. Our guest today is George Valentine, the executive director of Cox Communications. George, welcome to PopHealth Week.
George Valentine 01:05
Fred, it’s a pleasure to be here and to be with you here at HIMSS 2021, right?
Fred Goldstein 01:10
Well, thanks so much, really, for joining us. And let’s get into a little bit why don’t you provide our audience with a sense of your background? And a little bit about the company Cox Communication?
George Valentine 01:17
Oh, fantastic. Well, I come from a startup background, I was involved in founding and starting two technology startups. And then I joined Cox Communications innovations group. And so a lot of you may know, Cox Communications, we are the largest private telecom in the United States. And we are part of the broader $21 billion Cox enterprise organization.
Fred Goldstein 01:42
And so you’ve now obviously have this technology company that does all kinds of things with communications, what is it specifically you’re talking about here at HIMSS that you’ve done in the healthcare space?
George Valentine 01:51
And today, we were excited to talk about Cox Communications, vision in connected health. And so in 2015, Cox acquired a company called Trapollo, which is one of the nation’s leading virtual care in RPM, remote patient monitoring companies. And what’s great about that acquisition is it gave us an entree into the home. So when you think about virtual care today, going to the home, we have that end of the health care node covered very well the care continuum. On the other side, the hospital side, today we’re excited to announce our new product, Cox Prosight. This is an ROT platform, an IoT platform that enables hospitals to track and monitor equipment, people, and conditions inside the hospital.
Fred Goldstein 02:44
So when you think about that, you’ve got a hospital out there, obviously, with all this equipment, a lot of employees etc. You’re talking about the possibility to real-time monitor where this stuff and individuals and people are?
George Valentine 02:55
Yeah, that’s exactly right. So if we just take those three things, so we have equipment, conditions, and people so equipment, think about dopplers, think about IV pumps, think about SEDs, all this Mobile Equipment. A decade and a half ago, there were about eight to nine pieces of connected equipment per bed. Today, we’re at 11, 12, and 13 pieces of connected devices per bed. And so how do we monitor those? How do we pull that data out? What do we do with that data? These are the kinds of things we like to do on the environmental side temperature. Think about vaccinations in vaccines, think about conditioned environments, like the operating room to think about food storage, a lot of that stuff needs to be monitored and reported against and so we can automate all that process. Then lastly, think about people, staff, and patients the ability to track them, either to help them in staff to rest kind of environment or from a patient tracking perspective.
Fred Goldstein 03:58
So I’m thinking back to the days when I was a hospital executive. And I would assume that most of this was done on paper and sort of in somebody’s head, is that what you’re solving for?
George Valentine 04:07
Yeah, exactly right way, especially when you think about environmental monitoring duties, that’s the easy one to think about if you go around, you see the clipboard with the paper on it with the initials MK at 513. At two o’clock, 56 degrees, we can completely automate that process. So when JAHCO or M and V or anyone comes into the facility, you can automatically produce the reports that are needed for that compliance effort.
Fred Goldstein 04:36
And in terms of finding equipment, etc. I mean, hospitals, obviously under incredible stress to become more efficient to create value, reduce costs, I would assume this is an efficiency play as well.
George Valentine 04:47
Yeah, that’s a great point. So when you look at nursing this, just take nurses, we found that nurses spent about 21 minutes per shift, looking for equipment. So there’s a patient safety impact to that, but there’s also a nursing satisfaction issue when you poll them and say, Is this a problem for you? 73% of them say it’s this significant dissatisfactory to their job of not being able to find the equipment when they need it. So this ability to pull up a mobile app, or to go to the charge nurse station and look online and say, I need this piece of equipment, hit a button search and find it anywhere in the hospital, what’s the closest and then go get it. This is significant efficiency play.
Fred Goldstein 05:32
And so sort of from a technological approach, obviously, the Internet of Things and of healthy things is just exploding. How does some system like this work in a hospital, what are sort of the pieces that are put in place?
George Valentine 05:43
That’s a great point. So what you have to have is a sensing layer. And we use technology that’s based on BLE connectivity, so we can tag people, or we can tag equipment. And then those tags connect to gateways via BLE, Bluetooth Low Energy. And then the gateways Connect, have a Wi-Fi radio, which connect to the hospital’s Wi-Fi system and backhaul that data to our cloud where we have a location engine, and we have the ability to put it in our cloud solution, which then we can then present back to the clinicians via mobile or their desktop solution, whatever they prefer.
Fred Goldstein 06:19
So does this in essence, map the hospital and the floors and the different things so and then you have beacons or something that say, Here’s where that piece of device is because it’s pinging something or something.
George Valentine 06:29
That’s exactly right. So we would take the hospital blueprints, and we’d create higher fidelity maps of of that hospital, we would ingest that into our platform. And then after we determine where to put the gateways, and we generally put one per room, and then we put them in the hallway, as well as, as well as the other route, like clean supply and dirty supply and linen rooms. So we have the hospital mapped out with all the sensing technology. And then you have a complete visualization of where anything that you’re tracking. And literally, anything you can put a small tag on, or a patient or staff member can be tracked on that map, and you can see where they are in real-time.
Fred Goldstein 07:10
And I would assume there’s some sort of a dashboard or something that individuals can then use, how does that work?
George Valentine 07:15
Yes, for so for asset location, which is a very easy use case to understand is you have this map visualization and you can say what type of asset to I want to find, you can type that in, or you can select it from a dropdown. And you have a complete visualization by floor by department wherever you want to slice that data. But we want to make it as efficient as possible for you to see only the data you need. So you can quickly figure out where that equipment is, if you’re a nurse, or if you are, I will give you an example. One of our deployments, they have a clinical engineering staff of about four people, and this is for about a 500-bed hospital. And they spend a significant portion of their day trying to find the equipment to do your preventive maintenance per their contract. And by deploying this, within months, they were able to shave half of an FTE off their work staff requirements, because they knew exactly where the equipment was. And so their biggest challenge is now how can we tag more equipment because this gives us control over the process again, versus the old school of hunt and peck? Where is it looking for rooms opening up closet doors at they literally had implemented a nurse inventory system, asking nurses twice a month to write down where equipment was on a particular floor they had about 50% compliance and really upset for the clinical staff. And it was a big drag on productivity. After we implemented that that went away. And now they have instant access to real-time accurate location data at a room level.
Fred Goldstein 08:56
And I know you mentioned earlier the vaccines and things like that. And I know with some of the facilities, particularly in Florida, when you have a storm coming in, you have these refrigerators or freezers that have to be at certain temperatures, the power goes out, suddenly the temperature gauge goes off. I assume that’s what that sort of his monitoring.
George Valentine 09:13
Yeah, that’s a second set of eyes, right. So every one of those refrigeration units in your particular case have very good internal measurement capabilities and monitoring capabilities. We are second set of eyes for that. And not only can we see it, and then alarm if we detect something, we were able to automate that compliance and reporting on the back end. So it’s a two-fold benefit to doing that.
Fred Goldstein 09:37
And so they can bring in, for example, if they want to just track equipment, they can do that. If they want to track people, they can add that if they want to track temperature, they can do that. And is it really a software system that you’ve set up that can use other people’s technology in terms of tracking devices or things on it?
George Valentine 09:54
Yeah, that’s exactly right. So once you set up the sensing infrastructure, and that is the gateway per patient room and then all the other critical rooms in the hallway, and you tag whatever you want. Once that infrastructure is set up, if you have an IoT approach to this, you can literally add modules as desired, you might want to start with asset tracking, you might want to layer on staff to rest on top of that. The other this infrastructure would also support Wayfinding capabilities. So if you have an aggressive digital front door strategy on how we create a digital version of our hospital for our patients, and you want to enable patients to be able to walk into a facility with their mobile phones, whatever it may be, and then use automated geofinding, tagging, to be able to figure out where to go, where’s discharge? Where is my loved one? Where is the restaurant inside the facility? You can do that through a Wayfinding capability.
Fred Goldstein 10:51
And you’ve mentioned that, is that your app that they use?
George Valentine 10:54
That is correct. We have our suite of applications that have these modules that are able to plug in again using the same infrastructure?
Fred Goldstein 11:03
And how about the connectivity of your software platform, say to an EMR or some of the obvious vendors that produce these electronic health records, etc? Is it capable of connecting there
George Valentine 11:13
it is, we want to have APIs to all the standard, large EMRs. And what’s interesting, when we talk to CIOs, we hear two schools of thought, one school of thought is we actually like your analytics your rules engine, your learning capability. And we want to plug in some older legacy systems into that and use your capability for the RTLs side, or we hear some of the more advanced health systems that have invested heavily in analytics and have their own Big Data lakes. And they want to export and have a lot of that data field feed real-time into their own systems, which then go to the EMR or their own data lake where they do their own analytics.
Fred Goldstein 11:53
And that’s an interesting point you just brought up in terms of alerts. And I’m thinking of a temperature alerts. But can you set up say to alert because something is being moved?
George Valentine 12:01
Absolutely.
Fred Goldstein 12:01
You know, that we’re thinking it’s in that room, but somebody’s suddenly moving it?
George Valentine 12:05
Yeah, absolutely. So if that is an important, depending on the piece of medical equipment, you can absolutely set by equipment class, different levels of alert. And we found that that was important to clinicians because they already suffer from alarm fatigue inside of the hospital walls. And so they don’t want more alerts. So it has to be customizable to what is really germane to their specific roles, or what is critical to the operations of the unit.
Fred Goldstein 12:34
And one of the things that are going obviously, with COVID is, you know, people get very sick, and suddenly you’re moving them to a different floor, you’ve set up a new unit for them, etc. Does that sort of track what they’re connected to etc, being used as they move?
George Valentine 12:47
Yeah, the clinic can follow them. Patient tracking is another module of ours, we haven’t deployed that module yet. But that is another functionality you can use inside of an RTLS system, the ability to put a band on a patient itself and follow them through the workflow of the hospital.
Fred Goldstein 13:04
But if they were moved to another unit, and they had some piece of equipment that would be tracking, suddenly, you know, that piece of equipment is in this room in another building.
George Valentine 13:11
That’s exactly right. And that’s why something like EMR integration is so important, right? The ability to tag that patient to that piece of equipment for some limited amount of time is why you would need that EMR integration,
Fred Goldstein 13:22
right. And as these individuals are, as they move around to understand also, you’re working on something around handwashing, is that correct?
George Valentine 13:30
Yeah, hand hygiene. So this is a classic use case for our type of technology. So hospital-acquired infections, as we all know, are a big deal inside of the hospital walls. And, and, and cleaning and literally just hand hygiene as you walk into a room is one of the simplest ways to prevent that. And what we don’t know is how many clinicians, nurses doctors, when they go into a room, how many times do they actually use the hand hygiene solutions. And so coupling that with the sensor that can then identify the staff member with the plunger, depress, or the activation of the dispensing system is a very easy value proposition for our type of technology, which creates huge benefits through a health system.
Fred Goldstein 14:15
Absolutely. And if you just joined us, our guest on PopHealth Week is George Valentine, Executive Director of Cox Communications. So George, let’s get on to some of the use case. You mentioned one of the hospitals with their maintenance staff was able to reduce it sounds like in excess of 10% of an F of A expenses associated with those 4 FTEs. Are you seeing other examples now beginning to be able to measure things like that?
George Valentine 14:36
Yeah, we’re early on in measuring this. And this is a core focus of ours but we just loved that was a fresh insight, not two weeks from the field. And so as we get more and more of those, we will share and publicize those
Fred Goldstein 14:50
and where is this being deployed now?
George Valentine 14:52
Right now we we are here today at HIMSS to talk about our Lafayette are Ochsner Lafayette general health system deployment. It’s in Lafayette, Louisiana. It’s a 450-bed hospital, main Medical Center. And that just went live with asset tracking. It’s just a wonderful customer and partner of ours.
Fred Goldstein 15:11
It’s fantastic. We just had some Ochsner folks on our show a couple of months.
George Valentine 15:14
They’re great
Fred Goldstein 15:15
weeks ago, actually. Yeah, excellent. facility. Let me ask you another question. So what do you do say in the case of an Ochsner, or they have multiple facilities, clinics, hospitals? Can you put that and set that up?
George Valentine 15:27
Yeah, so that’s a great, that’s all about the data hierarchy. And so when you look at how we’ve structured the data inside of the system, you can start at a system level, drill down to a facility level, drill down to a group level growth, drill down to a unit level, drill down to a clinician, or even clinical engineering level, right? This specific department. So you have this ability to take the data and roll it up in any way you think is relevant to the internal analysis or setting up even more importantly, the automated rules and alerting, right, there’s, there’s, we can create a lot of data. But hospital systems don’t have a lot of data engineers that are sitting in the back office waiting to parse through this data to create new insights. So we have to provide that to them. And one of the best expressions of that is alerts, rules and alerts. So we take all that data, we can parse it and put it together, and then create alerts that really makes sense for the people on the floor and for the jobs they’re trying to do.
Fred Goldstein 16:28
And it’s just a thought crossed my head. Could you use this, in essence, to track you know, patients as you’re through the facility or individual through your facility besides nurses, if that was something of interest?
George Valentine 16:40
Yeah, you absolutely could, again, that that system is called patient flow. And there are bands that can be disposable bands to go on the patient. If you’ve ever been to a Disney Cruise or a Disney park, and you have those magic bands, a very similar concept, where you have the ability is they check in beyond crew include that location capability. For us, that module is under development, but it’s not commercially available. But it’s a point.
Fred Goldstein 17:05
Yeah, it just reminds me I had a physician visit recently got a survey. And the survey said, Well, how long did you sit there? And I don’t remember, well, you know, when did you get back to the room? Well, I don’t quite recall. But obviously, all of that if once you deploy that would be available. And they would have that data and be able to meet those requirements to look at whether that’s reporting out to an oversight group or something like that.
George Valentine 17:24
Well, if you think about leaving without service, or leaving without treatment, right, this is a big problem in the industry. And two to 3% of that is, which is a massive number in terms of millions of dollars per significant health system is really preventable. And a lot of it’s preventable for either better communications and ultimately better processes where people are not sitting out there. And that requires data.
Fred Goldstein 17:49
And do they? Does the system have full access to the data? Or? Or is it pretty much the dashboard? Could they then take some of that data and work it themselves? If they want to look at it in different ways?
George Valentine 18:00
They absolutely, again, we see two different types of health system maturities, we see the sophisticated health systems that say we have all the tools, all the analytics, we have all the data legs that can take that information loaded into our toolset and allow us to do what we do. And then we see some of the other health systems that don’t have that level of sophistication or and or funding. And they say we need that done for us that’s use your system or systems like that.
Fred Goldstein 18:28
And what did the deployment typical deployment look like? time putting it out things like that?
George Valentine 18:35
Yeah, it’s a few month deployment, what we need to do is we take a look at the facility blueprints. And from that we create an architecture of what this will look like where we’re going to put the gateway specifically, the tags can go anywhere, any asset, any person, but it’s the placement of the gateways. And then the tuning of that sense of capability so that we know that we have hyperactive or accurate data, right? room level data is so critical to this, these flow type of conversations. And so that process includes using the blueprints, and then doing a site survey generally for the larger facilities and walking through there and seeing where the closets are and what makes sense. Where the electrical outlets are, where do we have power for power, the gateways. And then from that, we actually install the hardware that can take a few weeks and the tuning of the system and so from, from commissioning to going live can be several months.
Fred Goldstein 19:28
makes sense. It’s a big activity, and then trying to be accurate, like you said, I can see you said the sensor up in the wrong place. And suddenly you think they’re in the hallway when it’s in the room, or stuff like that, I assume would be something you work through. So what else is Cox doing in terms of healthcare innovation?
George Valentine 19:42
So if you look at connected health, Cox has a long history of serving healthcare clients, the health systems here today, we were very happy with providing critical connectivity, networking, and increasingly cloud services. So that’s our core Cox business service. If you add on that, Trapollo, now we’ve moved into helping the system deliver better clinical care. We’re excited about that digital health move. Now with the addition of Cox Prosight, we’ve got both ends of the of the care continuum covered pretty well, how do we make the hospital operations more efficient? And then how do we enable the shift to virtual care in the home? Cox has a history of curating services, then delivering them to the home and then allowing people to transact whether it’s entertainment now increasingly, whether it’s health care, that is our focus from a connected health perspective?
Fred Goldstein 20:35
Yeah, we’re really seeing this shift to hospital at home and remote patient monitoring. We’ve talked about it for a long time, it looks like we now are beginning to see the technology that allows us to do that.
George Valentine 20:44
Yeah, we saw from telehealth the adoption rate, obviously, spike. And you know, overnight, it became completely adopted, we think RPM is almost a bungee cord attached to that it’s not an it won’t have that exact same adoption rate. We think it will lag a little bit more, but we think we’ll see that kind of adoption for RPM, because the solutions are very proven if you can monitor someone in the home, they want to be in the home, there’s no way to have a hospital-acquired infection at the home. It’s convenient, it’s lower price. And the movement that you mentioned hospital at home is increasingly scaling at some of the larger systems. And this is something our Trapollo acquisition does very well, the ability to discharge a person directly to the home and receive similar funding as if they were in the hospital is a big evolution in the delivery of digital care.
Fred Goldstein 21:37
Absolutely. And when you think about COVID, now where you begin to try to limit some access, because you don’t want people exposed to illness, or bringing it in, and you can treat them in someplace else a major push?
George Valentine 21:48
Absolutely. You know, I haven’t been until very recently to a doctor in a year and a half. I don’t know about you view. And so yeah, I’ve done everything, either haven’t done it or it’s been virtual. And I look forward to that new development in in provisioning of care.
Fred Goldstein 22:03
Absolutely. We’ve got about a minute left, what excites you the most about this space?
George Valentine 22:09
I think when you look at this space, there are really good legacy systems out there that were built on outdated technology, they work, they’re just hard to maintain and expensive. And we’re looking for every hospital in this country should have this type of solution. And we need to create an affordable implementation of that so every hospital can afford this.
Fred Goldstein 22:33
Fantastic. I really want to thank you for coming on PopHealth week this week. It’s been fantastic, have you It was a pleasure to meet you. Thank you for having me today. And back to you, Gregg.
Gregg Masters 22:43
And thank you Fred. That is the last word for today’s special edition broadcast of PopHealth Week recorded live in the healthcare now radio studio at HIMSS 2021 in Las Vegas. For more information on HealthcareNOW Radio’s lineup of live and on-demand podcasts including PopHealth we go to www.HealthcareNOWRadio.com And finally if you’re enjoying our work here at PopHealth week please subscribe to our channel on the podcast platform of your choice and do follow us on Twitter by @PopHealth Week bye now.