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PITTSBURGH, Sept. 22, 2016 – As a geriatrician who has cared for patients in nursing homes across western Pennsylvania, Steven Handler, M.D., Ph.D., has seen first-hand how some are transferred unnecessarily in the middle of the night to hospital emergency rooms. That’s because nursing staff couldn’t get the right medical advice at the right time. “Transfers to the emergency room, which frequently result in admission to the hospital, are highly disruptive to older adults and sometimes harmful to their health,” said Dr. Handler. “What’s more, these avoidable hospitalizations are costing Medicare, private insurers and taxpayers billions of dollars every year.”
Dr. Handler’s experience prompted the creation of Curavi Health, a new UPMC Enterprises-backed company that is bringing its comprehensive telemedicine solution and physician care to the nursing home bedside, where patients and staff need it most. “We’ve spent three years developing and refining the equipment, software, training and support to help nursing homes significantly reduce potentially avoidable hospitalizations. That means better care and higher satisfaction for patients and staff,” said Dr. Handler, now Curavi’s chief medical and innovation officer and associate professor of geriatric medicine and director for geriatric telemedicine programs at the University of Pittsburgh.
Curavi, a Pittsburgh-based company, offers its customers CuraviCart telemedicine equipment, specifically designed for the workflow in the challenging, nursing-home environment, and CuraviCare software that allows staff to easily request a telemedicine consult. Curavi has also developed a formal relationship with University of Pittsburgh Physicians, part of UPMC, to provide after-hours consults from fellowship-trained geriatricians. UPMC ranks No. 12 for geriatric medicine nationally in the latest quality scoring by U.S. News & World Report. Consults from additional UPMC subspecialty services, such as cardiology, dermatology and geriatric psychiatry, are planned for the coming months, expanding needed clinical services and reducing the burden of travel for nursing home patients.
“The average nursing home will pay for this service with the reduction of just one potentially avoidable hospitalization a month,” said Nicholas J. Kuhn, president of Curavi Health and a veteran of other health care-related startups. “For many nursing home staff, patients and families, the peace of mind that comes with the instant availability of this expertise is priceless.”
Although Curavi Health is new to the market, its deep expertise with nursing homes and telemedicine stems from work done by Dr. Handler and his team over the last several years, starting with 17 non-UPMC nursing homes under a Centers for Medicare and Medicaid Services (CMS) Innovation Grant. Those efforts to reduce potentially avoidable hospitalizations for conditions like urinary tract infections and pneumonia were then expanded to include UPMC’s owned skilled nursing facilities. That combined experience resulted in training more than 1,000 nurses and health care professionals in telemedicine, 212 real-time video consults and avoidance of 108 unnecessary transfers of patients to hospitals over the last two years.
“The quality and cost-effectiveness of post-acute care—including skilled nursing homes and home health—are under increasing scrutiny as our health care system moves from volume to value,” said Deborah Brodine, president of UPMC Community Provider Services, which includes UPMC’s post-acute care continuum. “Given the national focus on measuring performance, improving patient outcomes and enhancing care coordination, it is imperative that nursing homes take advantage of tools and technologies like Curavi’s to better care for patients and to position themselves as capable and responsible members of integrated care-delivery teams.”
According to recent data released by CMS, of the $14.3 billion spent by Medicare in 2011 on inpatient admissions from nursing homes, an estimated $8 billion was spent unnecessarily. In Pennsylvania alone, those potentially avoidable hospitalizations total 27,000 annually from about 700 nursing homes, at a cost of $220 million.
Curavi’s telemedicine solution aims to change that by allowing nursing home staff to access UPMC geriatricians at night and on weekends so that they can identify acute changes in a patient’s condition and intervene in a timely way. The CuraviCart equipment allows physicians to remotely interact with patients and nursing home staff through a pan/tilt/zoom camera, Bluetooth stethoscope, digital otoscope, document scanner and 12-lead EKG system. The proprietary CuraviCare software, which facilitates interaction between the remote physician and the patient, is designed for simple operation by nursing home staff and tailored to their workflow.
“Curavi Health is a great example of our focus at UPMC Enterprises: identifying and nurturing the innovative technologies and companies that will solve some of the toughest problems in health care,” said Tal Heppenstall, president of UPMC Enterprises, the commercialization and innovation arm of UPMC. “Entrepreneurs and innovators both inside and outside of UPMC turn to us not only for capital but for access to the clinical, technological and business expertise that lies at the heart of one of the nation’s leading integrated health systems.”
Curavi expects to soon offer a “bring your own provider” solution that will allow nursing homes to use their own attending physicians and nurse practitioners for on-demand telemedicine consults. That means Curavi can expand quickly across the country without the need to license physicians across state lines. “As we’ve seen first-hand, this is a solution that can save frail patients and families from so much distress and potential harm,” said Dr. Handler. “With the support of UPMC Enterprises, we can help to dramatically improve care at nursing homes nationwide.”