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The Morning Click

Delivering post-discharge recovery instruction, care coordination and osteoporosis education in a simple digital app

Photo of Susannah Bailin
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What challenges or opportunities are you trying to address within the problem? (200 characters or less)

90% of recovery & prevention occurs when the patient is alone at home, unconnected to the care team. AC addresses this problem with a simple daily click into our app to access a Care Hub.

The Problem:

The Solution:


SEE OUR PROTOTYPES LIVE 

Download the AdviceCoach app on your phone. (Both Apple and Android)

After 1) entering your name, email address and creating a password, 2)agreeing to the privacy policy and terms of service and 3) allowing notifications, you will come to our main screen. 

Please click Find Your Provider and in the box type 583. A demo Library-Only Playbook called My Recovery will appear, click Start and you will see the experience of a user with our demo content. Click on an instruction and see how the video pops up.   You will be able to track usage, send push notifications to every user in one click or to each individual user. Your users can set reminders to play your videos on a schedule.


To see a Standard Playbook where the patient has personalized content on a private Care Plan screen, return to the home page (click the house icon bottom left) and click the + icon on the top left of screen. In the box type 584. The Bayside Health Discharge demo Playbook will appear. Click Start and the Add from Library to see bios of the patient's care team and personalized instructions. From the private Care Plan screen, video content can be added using the phone/tablet's camera so that exercises, discharge instructions and conversations can be recorded live.

An example Workflow:

Scenario 1:

In the post-acute care facility after two weeks of rehab after her hip fracture, Diana completes the discharge procedure, including entering her information in the AC Health tablet.

On her own mobile device or the one she receives from AdviceCoach, Diana downloads the AdviceCoach app (or opens the one one pre-installed) and her caregiver's playbook appears:


She clicks on "Start" and from now on, whenever she clicks on the AdviceCoach app, it automatically opens into her personal plan screen. To create the habit of her morning click, she never knows what awaits -- will there be a selfie video from her niece sending her love? or a reminder about a home visit she might have forgotten? Now she never has to worry about remembering her daily plan or her medication dosage for the day -- what she needs is on the screen with her own providers talking to her.


The feedback button is easy to see at the bottom of each instruction so that the patient can click "Did It" or "Don't understand" and the message is relayed to the appropriate provider who can asynchronously respond.


Communication between the patient, family, and clinician is open and without gaps; the patient and caregivers understand the care plan; the patient has regular contact with the care team; and patients are more confident in their own self-care abilities.


The provider/caregiver/family members -- Hamsi, Andre, Maria, Samantha and daughter Olivia --  can easily monitor Diana's activity from the dashboard.

Every click is recorded and can be accessed with a report. 


Prevention of subsequent fractures/Diagnosis of Osteoporosis The Playbook can be populated with any content -- including a step-by-step video of how to get a DEXA scan and, if diagnosed with Osteoporosis, what medications and lifestyle behavioral changes are recommended.

AdviceCoach's Morning Click is a one-stop shop for multiple morbidities (not just osteoporosis) that integrates information across diseases, so the patient has one place to go for all of their care needs.


The most important aspect of any patient app is ease of use -- especially in the demographic over 50. Our app has already been used by 1100+ patients who took an NPS survey. A score of 50 is good, 75 is great, and AdviceCoach received a 91! Many of the patients on the app are in their 70s, currently in physical therapy. They come into the clinic asking the PT to record additional exercises because the paper diagrams are so hard to follow.

Who is your target end user and why will they be interested? (650 characters or less)

Our typical user is a patient at home recovering from a hospital stay due to a first fracture. They benefit from having all of their medical instructions, appointment reminders and communications from their Care Team in one place. That single hub alleviates their fears about doing something wrong because they can watch their own carer in videos. It is also a connection with their family for support and love when they are home alone. This is what we were told by patients who looked at our prototype. Our paying client is the skilled nursing facility/hospital that discharged that patient. They benefit from having an alternative to the paper discharge materials that are lost or go unread. They are able to shorten their discharge process by choosing content previously populated in the app's library. Their willingness to pay is driven by significantly reduced readmission costs and an increase in their reimbursement bonus, as patient satisfaction boosts their HCHAPS rating.

How is your idea scaleable? (650 characters or less)

Our launched SaaS platform instantly publishes a provider's playbook in our app on Google and IOS mobile devices. If one million providers chose to use our technology tomorrow, they could. To create a Playbook, simply go to www.advicecoachapp.com, register and click Create a New Playbook. Answer 4 questions and publish the Playbook to IOS/Google Play instantly.

What do/will you measure to know if your solution worked? (500 characters or less)

EVIDENCE GENERATION PLAN: Every click is captured in our back-end data platform. We measure #opens/day, #videos watched, #Feedback messages, time inside the app, and #repeat clicks per patient, among others. The Impact of the AC app is measured by changes in behavior after use of each feature within the app. Our product development is guided by the most effective engagement methods. Examples: Goal #1 - To Take Medication Questions guiding product development -- Does the patient need an incentive to share that they took their medicine? What type of incentives work best? Will patient add "Did It" to an instruction video? Goal #2 - To get Diagnosed for Osteoporosis or Risk Level Questions guiding product development -- Which videos/content lead to the making of an appointment for a scan? Following patients over time will allow us to collect content engagement data and use machine learning to correlate the protocols that lead to the best outcome.

What is the current stage of development of your idea?

  • Early Adoption: We have completed a pilot and analyzed the impact of that pilot on the intended users of the idea. I have proof of user uptake (i.e. 16% to 49% of the target population or 1,000 to 50,000 users).

If you were to become a Top Idea, would you want to actively participate in piloting your idea?

  • I want my idea piloted, and I prefer to do my own piloting in collaboration with the health system and with assistance from the Challenge partner

Company / Organization Name, if applicable (140 characters or less)

AdviceCoach LLC

Website (if applicable)

www.advicecoach.com www.advicecoachapp.com

Tell us about yourself or your team (500 characters or less)

I know the devastating outcome of a missed osteoporosis diagnosis first hand: I am a post-menopausal woman with parents in their 80's who was on the Board of Tower One in New Haven CT (HUD-funded senior living facility). I am also a Harvard grad -- BA and MBA -- who founded a previous startup which had a successful exit in the career development training space. As an entrepreneur and technology investor, I was shocked that paper is still the primary tool for the distribution of information at discharge from a hospital stay. Given our proclivity to learn new things by video (YouTube), my Co-Founder and I developed our patient engagement technology to be optimized for multi-media. After iterating multiple times to deliver the most simple user interface & the most robust backend data collection to enable machine learning, we launched in 2018 in physical therapy. We are excited to take our existing platform and disrupt the highly inefficient discharge practices of the healthcare system.

Location (50 characters)

Woodbridge, CT and New York, NY

What is your legal / organizational structure?

  • We are a For-Profit Startup or Startup Social Enterprise

Innovator/Organizational Characteristics

  • Female-led organization

How did you hear about the Challenge?

  • StartUp Health

Why are you participating in this Challenge?

The Challenge is the perfect opportunity to take what we have built for rehab adherence and use it for fracture patients to discover risk of osteoporosis and navigate care. The patient's overwhelming needs and the numbers of caregivers -- care coordinator, home healthcare giver, family, medication adherence, exercises, balance practices, self-care -- makes the modularity and flexibility of our platform critical to bring coordination and simplicity to a complicated problem.

How does your idea help more people who have had a first fracture either 1) discover they have osteoporosis or 2) access/navigate care?

The AdviceCoach app is downloaded at discharge for any patient who has had a first fracture. Inside the app is a Playbook branded for their facility (skilled Nursing, Post-Acute care, hospital) with videos, audio and text about their specific Care Plan: their surgeon, care coordinator, home health caregiver, etc. + medication instruction, day-to-day instructions for recovery, etc. That Playbook also has a section called "Could you have Osteoporosis?" with a 2 minute video of a 53 yr old woman asking about osteoporosis and a 3 minute video of a woman having a DEXA scan. "Osteoporosis Diagnosis: Now What?" is another section with videos, audio and text about the steps to access and navigate care. (See Prototype 584 on the AdviceCoach app right now! Directions below.)

How is your idea new in the world or how does it build on existing interventions?

In a sea of apps, AdviceCoach is the only fully personalized patient instruction tool that can be branded by the facility with their current discharge content. Patients are guided by faces of carers whom they saw in during their care stay, increasing their trust and dependence on the app. New content is quickly pushed into their one-page Care Plan screen while redundant and other used content can be quickly deleted, leaving only what the patient needs. Family videos are added to their medical information adding a delightful surprise. Playbooks for all of their conditions (multimorbidity) are accessible in the same App, making it a unique Care Hub. Communication is designed as Feedback, not text/email/SMS, giving the Carers relief from a bombardment of places to check for messages.

Please upload your journey map. Be sure your journey map shows when your user is introduced to the idea and when/how they access it, and illustrates which moments in the Challenge Journey Map your journey map touches.

Who did you test your idea with, what did you learn, and how did you evolve your concept?

The prototypes were developed with our advisors from Open IDEO and members of our own healthcare advisory team. They were tested by a case manager and 3 patients who have recently returned home from a hospital stay. We learned that the on-boarding process works well during the discharge process and that it might be done prior to discharge so that content can be added to the patient's care plan during the stay by their PT/OT therapists. We also learned from patients that they wanted their family members to be onboarded and to download the app themselves and have access to the content so that they understood the patient's needs and schedule. Patients wanted an easy way to share their schedule with family members saving them the need to call all the time. The patients asked for their Care Team info at the top of the Care Plan screen for easy access as they were asked often who their Dr was and they sometimes forgot their contact info, so showing them the app would make that easy. We changed the content flow and put that information on top. The patients asked for an explanation of what the video would show and how long it would take to watch. We added the explanation & will add the time below in the next iteration. The Care Manager was shown that she could create her own Playbook. She loved that as she wanted to record video during visits.

(Optional) Share documentation of your solution prototyping and testing, such as photos.

We created 2 prototype Playbooks to test with a care coordinator, a discharge nurse and 3 discharged patients from the hospital now at Tower One, a senior living facility in New Haven CT. These prototypes are live. 1) Download AdviceCoach at the App Store for iPhone or Google Play for Android phone. 2) Register a new account with an email and create a password. 3) Click "Find Your Provider" and enter 583 for UCB Playbook or 584 for Discharge Playbook. You can add both.

Please upload your Business Model Canvas

Please upload your team video.

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Team (4)

Christina's profile
Christina Chang

Role added on team:

"Christina and I talked about the plan for generating evidence of impact. She suggested that we control the population of family support videos to the patient's Plan screen to track how the trigger affects behavioral change. Due to her suggestion, we have partnered with MotiSpark, -- https://www.motispark.com/ -- to produce and push the family support videos."

Kim's profile
Kim Berry

Role added on team:

"Kim was extremely helpful in the design of our presentation, pulling out key features to highlight and ensure that the user journey be presented as simply as it is experienced in the healthcare facility and at the patients' homes."

Marlena's profile
Marlena

Role added on team:

"Marlena del Hierra, https://www.linkedin.com/in/marlenadelhierro/ geriontologist at Seniorly, was pleased to see the simplicity of the user experience on the app. Her feedback led to the design of our Bayside Health System prototype."

Susannah's profile

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Photo of Susan Jackewicz
Team

Susannah Bailin Congratulations to you and your Team on being selected as a Top Idea! Supporting individuals home alone esp. in those first hours post-discharge with clear, articulate interactions will impact lives.....best of luck with your future developments! Susan

Photo of Susannah Bailin
Team

Thank your Susan! Please stay in touch at Susannah.bailin@ac-health.com

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