Latest / StartUp Health NOW Podcast / Safer, Faster, Smarter: How Entrepreneurs Are Upgrading Hospital Tech

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Safer, Faster, Smarter: How Entrepreneurs Are Upgrading Hospital Tech · StartUp Health NOW Podcast

• 0:00
  When they don't label these things, bad things happen. For instance, there was something in the news about a, a, a patient who accidentally had a nurse start a fentanyl pump instead of a lactated Ringer's pump. Okay.
• 0:11
  He OD'd. He died. You know, relatively straightforward procedure. And so it's, it's mission critical that these things are done, and we've gotta automate it for them.
• 0:21
  [upbeat music] Welcome to Startup Health NOW, the podcast where we celebrate the entrepreneurs and innovators who are transforming health. I'm your host, Logan Plaster.
• 0:31
  So when you go to the hospital for care, you accept that the outcome isn't completely under your or your doctor's control. Even with textbook healthcare, bad things can happen.
• 0:41
  For a variety of reasons, your health can decline. Put another way, it's hard enough when good care results in a bad outcome, but what about when a preventable error occurs?
• 0:51
  It can seem incomprehensible, bewildering, this idea that mistakes can happen in the hospital that take an already tenuous situation and make it even worse. And yet, to err is human and hospitals are full of humans.
• 1:05
  Mistakes happen. Thankfully, there are brilliant people out in the world working to reduce these preventable hospital errors in creative ways, like my guest on today's show.
• 1:15
  So our first interview today is with Fox Holt, CEO of VigiLant. This startup is digitizing medication tracking by doing away with handwritten medication notes.
• 1:26
  No more scribbling instructions on the side of an IV bag, or worse, on a syringe.
• 1:32
  With VigiLant's easy-to-launch system, nurses can immediately start labeling and tracking meds in automated ways so patients get the right dose every time, and no preventable medication errors occur.
• 1:44
  Bonus, hospitals reap the benefits of all that medication data on the back end, data they were missing with handwritten labels. Let's get into the show. Here's Fox Holt from VigiLant.
• 1:57
  [upbeat music] Fox, thanks for joining me. Thank you, Logan. Great to be here. All right. Okay, let's talk about what you've built with VigiLant.
• 2:04
  I know, uh, you're helping, uh, nurses, you're helping hospitals, uh, you're decreasing burnout, you're doing a lot of great stuff, but what is the product?
• 2:14
  Well, we have a, initially a, a product safety and compliance platform where we're digitizing drug delivery. Okay. So we're automating the safety steps associated with drugs that hospital clinicians prepare and give.
• 2:29
  Now, I'm no expert in hospital medications and how they're tracked. Why was this necessary? Well, you know, the example is an ICU nurse, right?
• 2:38
  When they hang in a, an infusion, they have to create three labels for an IV tube. Currently, we have about 30% of the time they're hanging one. COVID hit, a lot of these, uh, kind of processes went out the window.
• 2:52
  Baby boomers left. You know, it's just not a process for 2023, and it takes a lot of time, and it's, it's just something that they don't get to. And when they don't label these things, bad things happen. Okay.
• 3:04
  For instance- Like what? There was something in the news about a, a, a patient who accidentally had a nurse start a fentanyl pump instead of a lactated Ringer's pump. Okay. He OD'd. He died.
• 3:16
  You know, relatively straightforward procedure. Yeah. And so it's, it's mission critical that these things are done, and we've gotta automate it for them. Yeah.
• 3:23
  This is, this is something that is tremendously easy to automate. There's no PHI data. It's low-hanging fruit from an automation perspective, and, um, it, it, it provides significant impacts.
• 3:36
  How big is the problem in terms of that risk profile? You talked about that one case, but- Yeah... how big of a problem is it nationally? It's, it's, well, it's every area of a hospital, right?
• 3:46
  So we have modules for ORs, EDs, PACUs, oncology units. In every one of these areas, there are medications that nurses or, or clinicians, doctors are having to prepare.
• 3:59
  And right now the standard of care is handwriting on syringes, or just, it's just not, it's just terrible. Like writing on the side of a syringe. Yes. And it's impossible to do.
• 4:08
  That's not- Have you ever tried to, like- Oh, it's impossible... it's impossible. So they don't do it. Okay. Okay, okay. And if they do, I'm sure that comes with its own host of sort of human error potential. Exactly.
• 4:19
  Uh, how'd you get into this? Oof. Well, I started my career in the printing industry, but you know, in the last couple years of my grandmother's life, she had a bad medication event, right?
• 4:30
  So a nurse accidentally gave her wrong medication, and it was, it was amazingly frustrating. It was complicated, and, you know, the anger that goes with that. Mm. And I really wanted to do something to help it.
• 4:44
  And I had a colleague from my old Lexmark days, printing industry, who, who helped found this company. And I saw it, and I saw how easy it was to implement, and I wanted to be a part of it. Yeah.
• 4:57
  We've talked about how reducing errors, uh, in these med- in medication tracking could save lives, you make a mistake with a medication.
• 5:04
  What are some of the other downstream benefits of digitizing the whole process and delivering that data to the hospital? Great question. So anytime you automate a process, you digitize it, you have a lot of data, right?
• 5:15
  So we can now create compliance reports. And so a CNO can say, "Okay, the travel nurses from this group are not doing the procedures." Yeah.
• 5:23
  "And so let's, let's focus on these guys, or let's, let's make sure that they're doing the right thing quick, or we gotta work with a different agency." Yeah. Or, um, you know, we can add it to predictive analytics data.
• 5:36
  You know, the more data you're able to put these algorithms, the better it is. Yeah. And so it's a whole new data set, uh, for instance, CLABSI, uh, hospital-acquired conditions. Yeah.
• 5:46
  You know, being able to understand what is going on and making sure that, you know, we- we're able to predict what's gonna happen. Where are you at in the product rollout?
• 5:55
  So we have, you know, this, we have a VigiLant Verify platform, which is the automation tools. We have products-Actually sold to eighteen of the top forty health systems, and then more.
• 6:07
  Um, and our next step is really to use those evangelist customers to spread throughout the rest of the system. Okay. So they become your evangelists.
• 6:15
  So I was gonna ask, what kind of responses are you getting from nurses on the front lines?
• 6:20
  So Northwestern just did a-- published a poster, did a study where they saw a seventy-five percent increase in nurse satisfaction around delivering drugs. Seventy-five percent increase in nurse satisfaction.
• 6:31
  Because of Vigilant or because of this concept g-general- Because of Vigilant's product. Really? Uh, additionally, we're seeing four thousand hours of nurse time saved in a unit per year.
• 6:42
  Break down why a nurse's life would be better under this paradigm, uh, versus it being sort of another thing they have to go do, print out a ticket. You know, w-why is it really improving life?
• 6:54
  Well, because when a nurse comes onto a new shift, and she's got a patient with twelve lines going through- Mm... she spends time line tracing, figure out where it's going in where.
• 7:05
  And because if, if a patient starts crashing out and needs some Levaquin, they, you know, it takes a lot of time to find the carrier fluid.
• 7:12
  I mean, you've, you've gotta pick the right line in order to inject that drug, and, and it takes time. And so there's a lot of time, um, spent trying to understand what's going on.
• 7:21
  And when a patient is going from one unit to the next, like, uh, let's say they're going from the IC back to the OR, well, the OR team has gotta figure out what's going on, and they go back to the PACU, and it, it, you know, it just hits that unit every time it comes through.
• 7:36
  Um- What have the conversations been like with hospital systems? Do you feel like they understand the short-term and downstream benefits of this kind of tracking? I think, uh, initially they see the, the initial impacts.
• 7:50
  Um, you know, the data perspective, they, they don't get as, you know, right away. But, you know, they have such problems with the burnout. The shortage is huge.
• 7:59
  So anything they can do to make their nurses happier, uh, more efficient, um, while increasing patient safety, I mean, it's the trifecta. And, uh, it's so easy to implement, right?
• 8:10
  Because our s-initial solution doesn't need IT to work with. That's where a lot of the delays occur. Additionally, we price the product below capital budget, so we don't have to wait a full year. Oh, smart.
• 8:23
  So we have like a forty-five-day sales cycle to hospitals, right? Now, that's unheard of. Okay. Um, a- You're dir- you're selling directly into a department then? Exactly. Okay. A-a-at an easy price point.
• 8:34
  Easy price point. It makes significant impact. Uh, but then we've got a, you know, we have a different model for systems. Of course, we have to be very flexible.
• 8:44
  Um, and, and we can finance things to pay, you know, do it on a rent monthly basis, whatever it is. Very flexible. You know, you, you mentioned burnout and just making the life of a nurse better.
• 8:56
  But then I think about there's a flip side where, uh, you're, you're, you're, you're saving them from a really scary potential never event.
• 9:04
  You're, you know, the idea that a nurse could make this kind of mistake and lose their livelihood potentially- That's right... um, that's, that's a lot bigger than making my shift a little more efficient. You know? Yeah.
• 9:17
  There's this bigger upside. It's really i-intense. Yeah, that's a great point.
• 9:22
  I mean, we, we do a lot of focus on the nurse benefits and the, and the time saved because, uh, it, you know, those never events don't happen during trials, and we need to get the ROI and sell it. However,
• 9:36
  you're absolutely right. I mean, it's the never events. It's, you know, having really informative labels. Like, for instance, on our, on all our labels, we put a little tips, tricks, what to avoid. Okay.
• 9:46
  Like, this increases blood pressure, or a patient must be ventilated. Hmm. So there's an education piece- Oh, yeah... baked in. And right at the point of care, right when you need it. Interesting.
• 9:55
  And so it helps them save from a lot of errors. How do you keep all of that up to date? Well, you know, these are, you know, infusions, uh, and, and, and anesthesia drugs.
• 10:06
  A lot of these drugs, you know, it doesn't change too much. Yeah. Right? But, but when we do strive to put the printers on the network after they're in so that we can manage them and be able to change them easily. Okay.
• 10:17
  So you're, you're making waves. You've got traction. You're working with how many hospitals? Uh, we're now in forty healthcare institutions. Fantastic.
• 10:24
  Okay, so what does, uh, the rest of twenty twenty-three look like then? Uh, just driving. Sales? Product awareness, product awareness, product awareness, things like this to help, you know, the industry know.
• 10:35
  I want every single CNO to know about this because they have teams, cross-functional teams working right now, what can they do about the burnout? I want Vigilant to be one of those tactics.
• 10:46
  I want them o-on the board of something they can do quickly, easily in order to start making impact. Fantastic. Fox, I appreciate you sharing with me.
• 10:55
  It's so exciting to see how something, uh, seemingly simple, labeling your drugs correctly- Yeah...
• 11:03
  automating, digitizing medications can have instant positive impacts for a nurse on the floor and yet have these downstream, uh, positive, um, impacts for the hospital and for the entire workforce.
• 11:16
  So excited to see what you do next. Thank you, sir. All right. Thanks, Fox.
• 11:20
  [upbeat music] Our next guest is also streamlining operations in the hospital but with more of a mind towards provider satisfaction versus direct patient safety, although it's easy to see where the two intersect downstream.
• 11:35
  Sanji Silva is chief product officer at Mockingbird, a startup upgrading and streamlining the provider credentialing process.
• 11:43
  If Mockingbird has their way, gone will be the days lost to credentialing paperwork and hospitals having to scramble to find qualified workers as these standards shift from state to state.
• 11:54
  It'll all be one unified system that keeps providers up to date with continuing education and keeps hospitals fully staffed. It's not just about paperwork either.
• 12:04
  Onerous credentialing processes lead to burnout, which push providers out of the profession entirely.But I'll let Sanji break it down. Here's the interview. [upbeat music] Sanji, thanks for joining me.
• 12:17
  Thank you, Logan, for having me. So you are innovating in physician credentialing and so I want you to just give me the pitch. What is Mockingbird? Yeah.
• 12:27
  So Mockingbird was, uh, co-founded by two seasoned clinicians trying to take the chaos and the administrative burden out of credential management because every state, every board certification has continuing education, and they're all different, different timelines.
• 12:43
  So what we did is we automated the end-to-end process when it comes to continuing education itself.
• 12:49
  We, we create a nice dashboard that's customized to the clinician, which tells you exactly what you need to do when, um, so that you don't, you don't have to guess anymore.
• 13:01
  You and I have talked about this before, but 'cause my f- my father's a physician and I've seen him deal with CME. Yeah.
• 13:06
  It's a world that you wouldn't really know or care about if you weren't a physician or had someone in your family. So help me put a, put a human face on this. What's the toll of an archaic credentialing system? Yeah.
• 13:19
  So the toll is, especially with telemedicine now, you know, a lot of clinicians are getting 20, 30 state licenses. Actually, we have clinicians who have 50 plus DC, so 50, 51 state licenses.
• 13:32
  They all expire at different timelines, and we have clinicians who say, "Hey, I took that course. I took the human trafficking course."
• 13:41
  But the reality is they took a human trafficking course, but it wasn't the very particular course that that state wanted the clinician to take, and who has time to keep up with all of this, right?
• 13:53
  And our, our co-founder spent an entire Memorial Day weekend, we like to talk about this. He, he knew he had to do CME, but didn't realize how much he had to do- Right... just that.
• 14:03
  So it's a, it's this last-minute scrambling- Yeah... and we want to get away from that. Yeah, and it's not just about missing out on Memorial Day weekend. We're in a workforce crisis. Yeah.
• 14:13
  So talk to me about how better credentialing feeds into, uh, fixing some of those problems. Yeah, absolutely. So with-- We all know that with the pandemic, the effectiveness of telemedicine has been proven.
• 14:27
  And, uh, even payers, we talk to payers, they say, "We want to increase capacity." How do you do that?
• 14:33
  There are-- A lot of our, um, existing clients actually are the, the ones who have embraced telemedicine, so they want the clinicians to get more and more licenses, but it's an operational-- because it's an operational problem from a scheduling perspective that they're trying to solve, but the clinicians say, "No.
• 14:50
  We-- I need infrastructure. I need help." And so that's where we come in a- and you take states out of, out of the picture, but stroke is an example.
• 15:00
  We, um, just last week I was talking to an administrator who has spent years learning this, um, this stuff, and she's like, "Yeah, it's clear as mud what counts towards stroke," um, because again, there's no standard, so to say, on-- 'cause even if you go take a course, um, it's not very clear.
• 15:20
  Does this actually count towards stroke? Will the accrediting body accept it? Now, how does your platform bleed into that area? 'Cause there's the just the dashboard of, "Here's what I did, my CME." Yes. Yeah.
• 15:31
  And then there's the accreditation piece you're talking about- Yeah... that's much more complicated. Yeah. No, that's a great question, Logan. So the early few years we spent creating what we call a rules engine.
• 15:41
  It's patent pending. Uh, we really did the work, the research to put the infrastructure in place.
• 15:48
  So now we have the rules, but additionally, we say to the clinician, "You take the course, you go to a conference, just upload the certificate for us. Upload the transcript for us."
• 15:58
  So we can extract all that data, and this is-- Uh, we have been training an AI model to not just extract the data, but learn because every certificate is also different. They don't all look the same.
• 16:11
  And then we can map those, uh, that data against the requirements. We do calculations behind the scenes through this rules engine, and we can automatically update the dashboard.
• 16:21
  Um, so the clinician does-- all they have to do is do the learning, take the course, and upload the evidence. Where are you at in the sort of evolution of the product? Yeah.
• 16:31
  So automation, automation, automation is kind of our theme this year.
• 16:35
  With, uh, with this data extraction piece, for example, that I mentioned, we've, we've had a lot of growth, uh, in terms of, uh, users, clients, and we're getting tens and thousands of files.
• 16:46
  So we, uh-- It's, it's not a fully automatable process, but we're doing what we can, and we're iterating on it.
• 16:54
  Every week, every month, we're training this, uh, model to extract data to know, oh, does it then map against these requirements? Um, so that's one, um, one kind of big focus. How has the market responded to the offer?
• 17:10
  Uh, it's been great because m- as more clinicians are getting more licenses, these administrators who are supporting them really are figuring out, "We can't do this." They're living in spreadsheets. It's not up to date.
• 17:24
  The rules are changing. Uh, the timelines are changing. Just recently, we had to go change, uh, what the expiration date for New Hampshire is going to be because, you know, they decided it's, it's going to change.
• 17:35
  So that type of thing. Uh, it's been great. And the other thing I'll mention is, um, we take security very seriously.
• 17:42
  Last year, we got our SOC 2 Type 2 compliance, um, certification, so that also just unlocks, um, this, uh...
• 17:52
  The, the sales cycle is very long still, and so having that certification, m- making sure that we are secure, makes us get our solution out to the hands of clinicians that much faster.
• 18:03
  Is there a strong cybersecurity, uh, concern among hospitals when it comes to credentialing and- Absolutely. Absolutely. The reality is we don't even touch PHI. It doesn't matter.
• 18:13
  We-- It's a solution that's going into a health system, um, and, and I think that's the right thing to do in today's day and age.
• 18:19
  So just security has become that-- The SOC 2 certification has become s- table stakes, I would say. Yeah.Um, paint me a picture where you hope to be five, ten years from now.
• 18:31
  Mockingbird has scaled the way that you, you know and dream it could be.
• 18:35
  Um, how is a physician's life different, and how is, kind of the workforce challenges that a hospital is facing, how are they thinking differently about them? Yeah. I think five, ten years.
• 18:47
  Today, when I talk to a clinician, they say, "Oh, CME, CE." I bucket that into two different buckets. One, what I have to do, I must do, the requirements, the mandates. And um, I say, "Okay, what's the other bucket?"
• 19:01
  It's what I do to learn, to actually do better at my job- Right... to take better care. And so why are these two different buckets? We want that gap to be zero. There should not be a gap on that.
• 19:15
  So to us, our vision is really about ultimately we want the clinicians to be doing real time learning as they are working. CME should not be its own thing. I'm just gonna pause you.
• 19:29
  Uh, how does the platform encourage better education? Yeah. So I'm thinking about, I used to work with emergency physicians who would als- always decry having to do, like, CPR training. Yeah.
• 19:39
  It was just one of the checkboxes. Yeah. So how does the platform drive better training? Yeah, great question.
• 19:45
  So we actually, this year we're planning to, uh, launch the first version of what we are calling course recommendations.
• 19:51
  We have the data on all your licenses, so we are taking that data and saying, "Hey doctor, if you take this one course, it'll meet all these requirements," but also we're t- starting to take into account the specialty.
• 20:04
  What are they specializing in? Because something that might meet the requirement but is also relevant to their specialty will be a whole lot more impactful in terms of learning. That's just the start though.
• 20:16
  At the end, our end goal really is to be able to gather data that we have about the clinician, the clinician's preference, uh, what type of patients are they seeing, get, get that information from the EHRs, and then be able to make recommendations on what truly will be impactful.
• 20:34
  And so they don't have to take extra time just to check a box and do CME. Instead, they're learning. They're learning the relevant material and able to... That is actually having an impact on patient outcomes. I love it.
• 20:47
  I love it. Last question. What are you most excited about, about the next 12 months in terms of new partners, new cl- new pilots, clients? Yeah, absolutely. So, um, a new partner.
• 20:57
  One, one thing I'm very excited about already is, um, CertifyOS. So we have, uh, not just partnered, but we have an actual API integration now.
• 21:07
  Because at Mockingbird, we decided we're going to focus on this niche, because if we try to go across the board and solve for credentialing, initial licensure, it takes our attention away because CME is so nuanced.
• 21:21
  It requires so much work. So instead, we, uh, we're very intentional though about who we partner with.
• 21:28
  Um, CertifyOS also has a great culture, the team, um, and so we have worked together with them for, for months at this point, but we have multiple joint clients now, and we actually have data flowing between the two systems on production right now.
• 21:43
  I love it. I love it. Sanji, thanks so much for taking the time with me.
• 21:46
  I'm so excited about the work that you're doing, helping physicians, not just gain some of their life back, which is important, but also, uh, tackling some of these bigger, thorny workforce issues and education issues.
• 21:58
  So thank you, thank you so much. Thank you, Logan. All right. Take care. [upbeat music] Thanks for listening to Starter Health Now. We'll be back again with another episode next week. [upbeat music]