Welcome, folks, to another session of the Imagineer Tech Showcase sponsored by the Heart Rhythm Society. My name is Roy John. I'm an electrophysiologist at the North Shore University Hospital in New York. And as a member of the Heart Rhythm Society Corporate Relationship and Program Development Committee, it's my pleasure to introduce yet another entrepreneurial company who is going to be showcasing one of their softwares today. Today we have Dr. Chad Burnham, who is the Medical Director of Cardiac Electrophysiology at the Community Health Network, who is going to be presenting for LifeOmic. And he's going to be showing us some software that deals with or facilitates same-day discharges after device implants. Chad? Well, thank you for the opportunity to present today. My name is Chad Burnham, and I am the Medical Director of Cardiac Electrophysiology at Community Health Network in Indianapolis. Along with me today from LifeOmic are Baiju Parikh, Vice President of Strategic Partnerships, and Justin Helmick, Chief Marketing Officer. As we all know, healthcare systems payers and clinicians need better ways to manage and leverage patient data, and in particular, medical device data. So this presentation today will highlight the Pod 1, or post-operative day one, same-day discharge use case scenario for implantable devices being used at Community Health Network in Indianapolis. This use case has a positive financial impact for a community of around $1 million per year at a use volume of 700 devices per year. So we do around 1,000 devices per year, and our estimation is that we can send around 70% of those patients home on the same day. The Pod 1 offering uses a variety of data elements to enable the care team to discharge a surgical implant patient the same day while allowing patient recovery in their own home. The technology is delivered through LifeOmic's Precision Health Cloud, or PHC. The web-based PHC dashboard is used by the care team for virtual rounding, allowing for sign-off of the Pod 1 check, and sending of the signed-off encounter via a fire connection into Epic. As well, a quick video visit can be performed if needed at that time. So features of Pod 1 include an integration with the device home monitoring servers with display of sensing, impedance capture, and overall system integrity. The PDF interrogation file can also be displayed by selecting a link. Review of wound selfie and creation of a longitudinal wound library for healing and infection surveillance. Patient-reported outcome data delivered through a patient-facing mobile application including survey results of patient comfort and discomfort, antibiotic compliance, results for ease of use of establishment of their home monitor, results for mobile patient engagement inquiries, and for us we have initiated surveys for appreciation of community as a digital health provider. Medication data is also imported from the electronic health records such as antibiotics and pain medications. And then a chest x-ray is imported into the dashboard as well for review by the care team. Patient use of Pod 1 is facilitated through the LifeXtend mobile application that's already available in the App Store and on Google Play with over 300,000 downloads. This app incorporates tracking of mindfulness, sleep activity, nutrition, and intermittent fasting as a baseline wellness offer. Wearable data is also incorporated from commercially available products such as the Fit Index Scale, Oura Ring, Fitbit, Garmin, Apple Health Kit, and ketone analyzers. Once invited to join the Community Digital Health Clinic, patients will see the Community Health Network designated tile on their app. Upon opening the provider tile, patients are given the tasks related to their post-operative needs such as acquisition of their wound selfie and completion of clinical surveys and educational courses. This is one example of the lifology educational courses assigned to the patient. It's our remote monitoring course. The lifology courses pair scientists, researchers, and clinicians with artists and storytellers to provide high-impact content that everyone can understand and share. Also one of our courses that is named Adele is a shared decision-making course for AICDs. These courses can be assigned throughout the patient's medical device journey, particularly for education and shared decision-making preoperatively and, of course, post-operatively for wound healing, limited arm movement restriction instructions, as well as in the weeks after for coming into their wound check and changing of device parameters. This is an example of a customized survey that a patient would complete in order for the clinician to get a check-in on pain, wound healing, hospital and clinic satisfaction, and care plan adherence. The surveys only take a couple of minutes to create in the office, and then they are published and can be sent out to the patients. So again, any particular physician or practice can customize their surveys and send them out to their patients. An ability to engage with a clinician resides in the app or via desktop using the Secure SkillSpring video calling capabilities. And this particular feature has been of great value to me over the last few weeks as I've scheduled not only my same-day discharges and wound checks, but fortunately I've been able to maintain full clinics in this current environment, and the patients have been super appreciative of that. And finally, in the web-based PHC portal, the clinician can perform virtual rounds, filtered cohort and population analyses, and can assign the surveys and educational contents to their patients. In the next developmental cycle, we'll be able to assign device model notifications to the patient, as well as provide upstream demand notification to the device manufacturer. So in conclusion, POD1 provides immediate value by streamlining same-day discharge into a single clinical viewership platform. In addition, it rests upon PHC and the Precision Health Cloud, which is an award-winning HIPAA high-trust and GDPR-compliant platform, and it's incorporated into the LifeXtend app. Combined with this SkillSpring telemedicine video capability, the overall offering and infrastructure is exceptional for managing device patients. So thank you very much for this opportunity to present in the HRS 2020 Imagineer Science Sessions. It's been our pleasure, and we'll be happy to take any questions. Thank you, Chad, for that great presentation, very informative. And welcome, Beiju and Justin. I had a couple of questions. As you know, most of us have been doing these same-day discharges for the past 10, 15 years or so. And, you know, one of my first questions is, what's different? What are you guys offering over and above the usual PA or NP calling in and a telemetric evaluation of the devices and perhaps a picture of the wound? What is it that you're adding here? Yeah, it's a significant benefit for us. In our network, we're certainly a higher volume, and we work out of multiple hospitals. And so at any time, we could have, you know, devices from multiple locations. So it allows us to discharge the patient and to have any sort of information on problems very early on without having any time delays in between hospitals, keeping people, you know, in the hospital. So that's helpful for us. As well, this offering is really a beginning offering for us. So when I mentioned in the presentation that we're doing analytics and cohort analyses, we're able to monitor other information from patients as well in terms of arrhythmia and their heart failure sensors. And have been able to do a really good job with HeartLogic, in fact. And with HeartLogic, we have done financial analyses for our fee-for-service-based patients as well as our value-based contract patients. So it's really, the pod one is really an initial offering for a much larger digital health clinic value proposition. But it, in and of itself, again, for our volumes and our projected volumes, has around a $5 million value over a five-year period. So we've built the model over a five-year period. It's just, what's been interesting is that, you know, we were planning on starting this and did start it, and then the whole coronavirus pandemic happened. And now it's really become, I guess you would say, an essential offering. Yes, exactly. No, that's very true, very true. Now how do you deal with different types of EMRs? I mean, you know, I know that most of the country now deals with Epic, but I work in a system called Northwell who have refused to have Epic, and then you do with Epic, and they have a totally different EMR. So how do you interact with all these different EMRs? So the Precision Health Cloud platform from day one was built to be an open platform. So we're built on an emerging standard called FHIR, F-H-I-R, which is the next generation of interoperability between electronic medical record systems. It's something that's being pushed by the government as a requirement in the future. And what that allows us to do is have a standard data model across all different EMRs, and then we build the integrator connector into specific EMRs. So as you mentioned, Epic is definitely the highest penetration in the United States. Cerner's not too, too far behind. And then there's this whole myriad of other EMRs. So basing it on that open standard means integrating to EMRs is work, right? There's no silver bullet in that, but it facilitates that integration in a very open standards-based way. And we see as FHIR becomes more and more adopted, that that even just gets easier and easier over time. Sure. And then maybe, Baje, you can answer this. What's the point of enrollment, and where does the patient come into, and at what point do you approach the patient with this software? How does all the logistics of this work? And I'll let Chad comment as well. But we want to actually engage them pre-operation, right? So they want to download the application, be aware of what they're going to get into. And it does bring comfort to the patient, right? So it's a fantastic way to onboard them and get them prepared for device implementation. Yeah. So our goal is to have an offering that extends across the timeline of device implantation. So for example, if I see a patient in the office, we'll go ahead and get them enrolled in the application and make sure they know how to use it, make sure they can do a wound selfie, but then we provide pre-education. So we have these lifeology educational courses, and again, they're very heavy on art and on pictures. So the pictures provide a lot of explanation, and there's just minimal text involved. But that provides the patient with education and the importance of remote monitoring. As well, we can bring in shared decision-making pre-procedure. Our goal is to bring in another feature where we can actually tell them the specific manufacturer and model that they are going to get, and then pair them with the vendor's own educational content about that model. And then the remote monitoring setup ahead of the procedure. That way, after the procedure, right during the procedure, when a lot of times people are paired with the monitor, there's just so much on their mind, and the absorption is pretty low. They're just trying to get through their surgery. So all of that is set up ahead of time, and they know how to use the application. And then post-operatively, taking the wound selfie, going home, setting up the monitor is a cinch. Our monitoring compliance at Community is around 96%. It's super high. We've put a lot into that, but we put a lot into it, so we know what it takes to maintain that. Well, it sounds like you guys are at the right place at the right time, the time especially. And thank you very much for a fantastic presentation. It was very informative. And thank you again, everybody. Nice getting to know you folks. And have a good day. Thank you.

same-day discharges

device implants

software

Pod 1

recovery