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Transforming Osteoporosis Care with Nurse Navigation + Health Tracking + Advanced Surgical Pathways

Goldfinch Health helps Medicare Advantage plans to enhance quality by empowering patients with osteoporosis to better navigate care.

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

Nearly all of us are under-informed consumers of surgery. Much too often, this results in unfortunate decisions leading to poor clinical outcomes. Significant financial and humanistic costs result.

Enhanced Recovery After Surgery (ERAS) pathways decrease surgical stress and improve postoperative recovery. Despite the benefits of ERAS, members and payers/employers have historically had little insight into this approach. Thousands of articles have been published over the last decade supporting the benefits of ERAS. Yet, fewer than 10% of procedures today are delivered within an ERAS pathway.


We aim to transform this high-cost, high-consequence area of healthcare.

Our solution includes 3 components:

  1. Better informed provider selection
  2. Nurse navigation throughout the entire surgical pathway, supported by our technology platform and consumer app
  3. ERAS-based care

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

Video link (not loading above) The initial target for our solution is employers and other payers. We believe the transformation necessary in surgery and recovery requires the development of understanding and demand by consumers and payers of healthcare in the United States. Only once patients and program sponsors start asking for better, 21st Century surgical care by name will the 90% of providers who haven't fully implemented ERAS pathways update their practices. While payers are our primary target today (specifically, self-insured employers), we have deep understanding of surgical pathways and the role patients play. Often, that role is one of follower. Initial consultation > lab test/xray/consultation/evaluation > surgery recommendation > referral. The status quo is patients end up with surgery scheduled before they even considered provider options and recovery.

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

Enhanced Recovery-based care has already scaled in Europe. The US, however, has lagged behind significantly. Of course, the incentives and overall system differ here. However, stars are aligning for change. Perhaps most significantly, the so-called "Quadruple Aim" continues to be a drumbeat in the US. ERAS is a rare initiative which satisfies all aspects of the Quadruple Aim.

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

1. Saved Days of recovery (vs. national average benchmarks for post-fracture surgical recovery) 2. 90% reduced opioid use post-surgery 3. Patient Satisfaction improvement post-surgery

What is the current stage of development of your idea?

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

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)

Goldfinch Health

Website (if applicable)

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

Dr. Brand Newland, PharmD, MBA, co-founder and CEO, brings a decade-plus of healthcare entrepreneurial experience to Goldfinch. John Greenwood, co-founder and COO, brings extensive experience in the operating room to the enterprise. Dr. Daniel Hoeffel, MD, is a board-certified orthopedic surgeon. He brings extensive experience in Advanced Surgical Pathways (aka, Enhanced Recovery) to the company and is a recognized leader in the medical field. Andrea Powers, RN, has over 30 years of experience in direct patient care nursing, patient engagement programs, patient shared decision making, and patient reported outcomes measures. Karen Gagnon, RN, is a Certified Case Manager with over 30 years experience in developing and implementing care management programs. Steve Flood served as a Senior Vice President of a major health care benefits consulting firm for nearly 30 years. Evan Rakowski is a seasoned entrepreneur with deep subject matter expertise in healthcare.

Location (50 characters)

Austin, Texas Iowa City, Iowa

What is your legal / organizational structure?

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

How did you hear about the Challenge?

  • StartUp Health (we are a member of the StartUp Health Academy)

Why are you participating in this Challenge?

We have a "moonshot" of reducing post-surgical opioid use by 90%. We believe we can positive impact osteoporosis care and, in fact, must do so if we hope to achieve our aspiration.

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

After the patient's first fracture, our solution engages a patient in ongoing education, encouragement, advocacy and nurse care navigation. Based on an invitation from either a primary care provider or Medicare Advantage plan post-first fracture, Goldfinch Health invites the patient to interact with our nurse care advocate via a no-cost Apple Watch. The value of this intervention: 1. Activity tracking 2. Fall tracking (and emergency SOS, when necessary) 3. Pain tracking 4. Pain medication tracking 5. Ongoing nurse interaction 6. And, in the event a future surgery becomes necessary, the ability to actively seek and receive care from a provider well-versed in Enhanced Recovery After Surgery (ERAS) care pathways designed to make recovery more patient-centric and efficient

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

To our knowledge, no solution exists today which combines: 1. Nurse care navigators 2. Digital health solutions and monitoring devices (e.g., Apple Watch) 3. Enhanced Recovery After Surgery (ERAS) care pathways The goal is to help patients avoid a second fracture but, in the event one occurs and it requires surgery, to help the patient to best navigate this care.

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?

We believe there is tremendous value in the solution we have proposed. We have yet to determined the best way to get this solution in front of patients who would benefit. Options we have considered: 1. Medicare Advantage plan sponsors purchase Goldfinch Health coverage for members and use claims data to determine when to outreach to qualifying members with an offer (MA plan pays) 2. Invitation from primary care physicians (patient pays) 3. Direct to consumer (patient pays) We believe the OpenIDEO process has served us well in crystallizing for us the solution and also helping us to clearly identify the go-to-market challenge. We welcome additional thoughts from the OpenIDEO team.

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

Please upload your Business Model Canvas


Join the conversation:

Photo of Susannah Bailin

Hi @brand, Great to talk to you yesterday. Looking forward to continuing the conversation about collaborating to improve surgical outcomes and increase HCAHPS scores for surgeons and hospital systems with a Goldfinch Health/AdviceCoach partnership.

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