Ardha: Hospital Care Coordination Application

by Cameron Escovedo

Ardha is a hospital-based project management web application that tracks, coordinates and displays task completion by providers and allied health professionals.
Orange, CA United States Hospital Solutions HIT Informatics

All Team Company Patients Physicians Hospital Partners Mission Innovation Details Supporters Comments Updates

About our project

The problem we solve: Care coordination has been lauded by health policy experts as a method for achieving cost containment and quality improvement. Here, care coordination is defined as improving access to health care services, facilitating communication between providers, focusing on total healthcare needs and clarifying patient instructions. This requires coordination of tasks between providers and allied health professionals including case managers, social workers and discharge facilitators, who are under similar pressures that necessitate the use of project management methods in non-healthcare industries. Project management software is designed to help teams collaborate, execute in a timely manner and manage resources and cost. With regards to healthcare specifically, poor care coordination leads to negative outcomes which include, but are not limited to, delivering below-standard care, unnecessarily extending hospital stays and prescribing non-covered meds at discharge.

About our solution: Ardha is a hospital-based project management web application. Ardha tracks, coordinates and displays task completion by providers (physicians and nurses) and allied health professionals (case managers, social workers, research coordinators and discharge facilitators). It focuses on tasks not discretely described by electronic medical records including regulatory requirements, insurance coverage of outpatient meds and clinical trial participant screening. Future applications could potentially involve utilization review (e.g., to track high utilization of low value interventions like ordering CT scans for low back pain). In its pilot study, Ardha will be deployed at an UC Irvine Medical Center inpatient psychiatry unit. Further studies and deployments are planned for other specialties and units within the hospital.

Progress to date:

Ardha has progressed from brainstorming to design to app development within the previous three months. Design has been informed by focus groups and interviews with multiple stakeholders including hospital administration and staff (including physicians, nurses, case managers and social workers). Ardha is scheduled to begin a pilot study at an UC Irvine Medical Center inpatient psychiatry unit in November 2018. The study will investigate key pre- and post-deployment measures including average length of stay, percent task completion and percent clinical trial participant screening. With further funding, Ardha will continue to undergo development for deployment in additional departments.

About Our Team

Creator: Cameron Escovedo

Location: California

Education: David Geffen School of Medicine UCLA

Bio: Cameron is a General Pediatrician and Clinical Informatics Fellow at UCLA. He graduated AOA from the David Geffen School of Medicine at UCLA, and completed Pediatrics Residency including a Chief Resident year at UCLA. His interests include provider EHR experience, and has performed at-the-elbow workflow analyses for numerous providers including pediatricians, surgeons, and anesthesiologists, as well as allied health professionals including case managers and care coordinators.

Hospital Affiliation: UCLA Health System

Title: Chief Information Officer

Advanced Degree(s): MD

About Team Members

Drew Park
Chief Executive Officer, MD
Biography: Drew is currently a senior psychiatry resident at the UC Irvine Medical Center. He has experience with digital health startups, having founded and navigated Q-Cigarettes, Inc., which produced a tobacco use cessation mobile app and medical devices, to an exit in 2015. Drew has an interest in clinical informatics, digital health and clinical research, having multiple peer-reviewed articles published. Drew also graduated as a top-10 student from the University of Iowa Carver College of Medicine.
Title: Chief Executive Officer
Advanced Degree(s): MD

About Our Company

Ardha Health

Location: 101 The City Drive South
Orange, CA 92868

Founded: 2018

Website: http://www.ardhahealth.com

Product Stage: Prototype/MVP

Employees: 1-2

How We Help Patients

Patients benefit from improved care coordination by being delivered higher rates of clinical best practices and experiencing lower rates of preventable hospitalizations. In its pilot study, Ardha will focus on a number of key areas. First, Ardha is designed to decrease unnecessary hospitalization days due to administrative oversights including updating long-term care facilities and caregivers of clinical status changes previously preventing discharge. Second, it will prompt reviews of health insurance including coverage of discharge medications. Third, it will prompt potential clinical trial participant screening. And fourth, it will verify the transmission of completed discharge summaries to outpatient providers. Future directions include tracking high utilization of low-value and potentially harmful interventions, e.g., ordering CT scans for low back pain.

How We Help Physicians

Physicians benefit from improved care coordination by decreasing labor cost of and improving execution of team communication. Team communication occurs throughout the work day in rounds, interdisciplinary meetings, pages, text messages and e-mails. Ardha generates a dashboard of tasks updated in real time by ancillary staff. These include process-of-care quality measures including CMS quality measures. Furthermore, it directly involves staff not present at point-of-care, e.g., research coordinators. And finally, Ardha tracks post-discharge actions including verifying transmission of inpatient provider recommendations to outpatient providers.

How We Help Hospitals

Hospitals benefit from improved care coordination primarily by tracking staff member performance and process-of-care quality measures completion. Individual staff member performance is tracked for performance reviews and remediation. Tasks are definitively assigned to staff members, e.g., case managers and social workers have overlapping duties which may be neglected without clear assignment. Real time tracking obviates the need for retrospective data gathering required for CMS and Joint Commission reporting. Furthermore, a guideline is generated for consideration of alternative placement for long-term patients. Future directions include prompting billers and coders to provide documentation feedback to providers.

How We Help Partners

Health insurers benefit from cost reductions and improved patient outcomes. They are likely to experience these benefits as a result of decreased lengths of stay (due to administrative oversight), coordination between inpatient and outpatient providers and improved patient compliance (e.g., verifying insurance coverage for post-discharge care).

Challenge Mission

Affiliation(s)

We are currently partnered with the University of California Irvine Medical center to launch a pilot study of the Ardha app in an inpatient psychiatric unit. Key pre- and post-deployment measures will be measured and analyzed including average length of stay, percent task completion and percent clinical trial screening.

Key Milestones Achieved and Planned

Ardha was conceived, and has progressed to design and development stages within the past three months. As mentioned above, focus groups and key stakeholder interviews have informed multiple iterations. The app is scheduled to begin a pilot study at an UC Irvine Medical Center inpatient psychiatry unit in November 2018. Future directions include deployment in other departments and expansion to involve coders and billers as new user types. Ardha is currently a web app, but another future direction is to convert the app to make it available on the Epic EMR app store.

Our Competitive Advantages

Ardha’s main competitors are other project management apps. They are primarily deployed in non-healthcare settings, but include large company publishers of Asana, Slack and Trello. Numerous other apps are available on the market, and even more have been developed and deployed in internally at companies across the globe. Ardha’s advantages it meets security requirements of and is specifically tailored for deployment within a hospital network. Furthermore, Ardha is customizable to the specific needs of client departments. Additional competitors include electronic medical records (EMR) publishers including Epic and Cerner. These companies have signaled in product development and in shareholders letters a desire to integrate with and host third-party apps on their respective app stores.

Barriers to Entry

Ardha’s design process discovered specific needs from multiple stakeholders at the UC Irvine Medical Center. The pilot study is customized to an academic center inpatient psychiatric unit’s needs, and is planned to discover and meet those from multiple specialties and levels of care. The pilot study is intended to capture measurable data regarding savings in lengths of stay and gains in stakeholder performance. Lastly, Ardha has been built to be hosted by hospital servers and hence meets HIPAA data security requirements. This final point is a barrier to entry by out-of-the-box, non-healthcare management software.

Funding, Partners and Alliances To Date

Ardha app development to date has been funded by bootstrapping. Following pilot study deployment, the company seeks to raise $200 K in angel investment to develop a saleable product. An ideal strategic investor profile is a healthcare-focused angel investor who can potentially make introductions to regional hospital, health insurer and physician group executives for potential additional pilots. Our first and primary partner is UC Irvine Medical Center, and we are receiving business advising from Paul Orlando, the USC Incubator director.

Innovation Details

Intellectual Property Summary

There are no plans to patent any proprietary technology at this time. Instead of an intellectual property strategy, we are relying primarily on agile development and Ardha-specific study results to differentiate from potential competitors.

Clinical Information

Care coordination is a major goal of health policy and is judged on cost savings and/or improving patient outcomes. At the UCI Medical Center, Ardha was developed in response to a number of challenges identified by providers, nurse managers, case managers and research coordinators. These challenges include but are not limited to the following clinically relevant issues: (1) modifying patient compliance, (2) coordination between inpatient and outpatient providers and (3) provider compliance with quality control measures. Additional challenges that indirectly affect patient care include (4) completion of tasks by individual team members and (5) throughput for clinical trial screening. Care coordination refers to easy access to providers by patients and good communication between providers, but also includes on focusing on patients’ total healthcare needs. Deployment will focus on documenting and improving communication and tracking task completion, without unduly increasing documentation burden. Measuring improvement by modifying each of the above factors, will be measured primarily by differences in length of stay. Improved patient outcomes, will initially be measured through proxy variables including tracking completion of patient-oriented quality control measures, completed discharge summary transmission to outpatient providers and verification of outpatient medications health insurance coverage.

Regulatory Status

There are no plans to seek FDA approval for any proprietary technology at this time. Ardha meets data security requirements for pilot deployment, working in conjunction with faculty and IT staff at UC Irvine Medical Center.

How we will use the funds raised

Seed funding will be used to continue to develop the Ardha app, to a commercially saleable item. Additional use of funds will be deployed to business operations including creating a corporation, legal fees and nominal employee salaries.

Thank You

Thank you to the staff at the UC Irvine Medical Center for collaborating and providing feedback for development to date.

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Cameron Escovedo
Chief Information Officer
David Geffen School of Medicine UCLA

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