Introducing MAHI Labs
At MAHI Labs our mission is to make healthcare more accessible for both patients and healthcare professionals by providing mobile health tools that assist in making patient engagement and monitoring more efficient and effective, thus ensuring providers can deliver quality care to a diverse and growing patient population.
Past research has shown a relationship between the quality of care patients receive and their health outcome based on the amount time they spend with a healthcare professional . A study conducted by the National Bureau of Economic Research focused on the effect between the hospital readmission risk and the amount of time a healthcare provider spent with patients during home health visits. These researchers found that when providers’ visits are longer than typical, the risk of readmission reduces by approximately 8 percent for every extra minute spent .
When the provider was an RN, the risk of readmission was reduced by approximately 13 percent for every extra minute. The results from this study emphasize that the time spent with the patient is the most important factor influencing the risk of hospital readmission. In addition, it also found that the extra time spent could lead to cost savings. In their examination of the cost benefits, the researchers estimated that if the RNs in the study reduced their average daily number of visits from 4.20 to 4.06, each could increase the average amount of time spent with a patient by approximately 1.40 minutes, resulting in an estimated cost savings of $7,737 to the hospital from the reduced risk of unplanned readmissions.
In a New York Times article, Dr. David Meltzer discussed his study of a group of patients who received continuity of care, meaning the same patient saw the same healthcare worker over multiple visits, serving as a representation of the amount of time a healthcare worker spends with a patient . His results found that these patients experienced 20 percent fewer hospitalizations compared to the control-group. Similar results were found in studies conducted by Permanente in which doctors were available to patients 24/7, resulting in an 80 percent decline in the number of times patients were admitted to the hospital or ED, and Vanderbilt University Hospital conducted a similar study, finding a 20 percent decrease in hospital admissions.
These studies indicate that engagement (communication) is an important factor in improving patient outcomes. At MAHI Labs our mission is rooted in the idea that continuous communication between healthcare providers and patients will result in healthier outcomes. But unfortunately for many people living in the United States, the ability to communicate with their healthcare provider in an impactful manner is a challenge due to an overtaxed healthcare system. Nurses are spending more time than ever, from 19 to 35 percent, or up to one third, of their total shift time to ensure their patient notes meet the criteria for billing and reimbursement [2, 4]. The time spent on documentation is leading to provider burnout, with many working after hours to complete notes .
Poorly designed EHRs are also a part problem leading to burnout [6,8]. Researchers found in one study that “primary care physicians spent nearly six hours out of an 11.4-hour workday on EHR tasks, including around 1.5 hours at night after the clinic was closed” . The consequence of provider burnout is that it has a compounding effect, meaning that it contributes to a shortage of healthcare workers which, in turn, leads to more overtaxed workers, thus affecting the quality of care delivered to patients .
The compounding effect of provider burnout and the shortage of healthcare workers is especially detrimental in rural and minority communities where the rate of chronic conditions among community members is higher when compared to other populations. In 2017, 22.6% of the rural population was living with two to three chronic conditions and 5.1% with four or more . In addition, people of color have a higher rate of chronic conditions than the white population. For example, the chance of being diagnosed with diabetes is 77 percent higher for African Americans and 66% higher for Hispanics than for whites .
The spread of COVID-19 has exacerbated these gaps in care, creating a negative cycle in which more people need access to healthcare, putting more stress on the healthcare workers and the resources available, leading to the failure of the healthcare system in the community and eventually the decline in health of the residents.
Given the challenges of an overtaxed healthcare system, our focus has been to develop solutions that make patient engagement more efficient and effective without adding stress to the healthcare worker and system. Specifically, we have developed the Wellness Nurse, a patient engagement platform consisting of two components: an mHealth app used by patients to assist them in managing their health and a web-based dashboard used by providers to monitor and engage their patients at the population and precision level.
The mHealth app uses Artificial Intelligence to automate both the interview process with patients regarding their health and wellness and to communicate with them about changes in their health and alert them to take certain actions without a healthcare provider being involved in the process.
We hypothesize that by using AI and automation to interview and communicate with the patients, nurses can spend the time they save on caring for patients with immediate and critical healthcare needs; they will also be able to increase the number of patients they care for without reducing the quality of the care, and finally, it will also reduce burnout, leading to a reduction in medical errors.
We believe that AI and automation will benefit patients by assisting them in actively managing their own healthcare along with giving them the sense that they are engaged with their healthcare provider, ideally resulting in an improvement in their health outcomes.
1. Andreyeva, A., David, G. & Song, H. (2018). The Effects of Home Health Visit Length on Hospital Readmission. National Bureau of Economic Research Working Papers. doi:10.3386/w24566
2. Campbell, J. & McCauley, T. (2019). Optimizing nursing documentation. Elite Healthcare. https://www.elitecme.com/resource-center/nursing/optimizing-nursing-documentation/#:~:text=19%20to%2035%20percent%20of,during%20a%2012%2Dhour%20shift
3. Health, United States (2017). Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/hus/contents2017.htm#Table_039
4. Higgins, LW, Shovel, JS, Bilderback, AI, Lorenz, HL, Martin, SC, Rogers, DJ, Minnier, TE. (2017). Hospital nurses’ work activity in a technology rich environment: A triangulated quality improvement assessment. Journal of Nursing Care Quality, 32(3), 208–217. doi:10.1097/NCQ.0000000000000237
5. Hussey, P., Wertheimer, S. & Mehrotra, A. (2013). The association between health care quality and cost. A systematic review. Annals of Internal Medicine, 158(1), 27–34. doi.org/10.7326/0003-4819-158-1-201301010-00006
6. Melnick, E. R., Dyrbye, L. N., Sinsky, C. A., Trockel, M., West, C. P., Nedelec, L., Tutty, M. A., & Shanafelt, T. (2020). The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians. Mayo Clinic proceedings, 95(3), 476–487. doi.org/10.1016/j.mayocp.2019.09.024
7. Ommaya, AK, Cipriano, PF, Hoyt, DB, Horvath, KA, Tang, P, Paz, HL, DeFrancesco, MS, Hingle, ST, Butler, S and Sinsky, C.A. (2018). Care-centered clinical documentation in the digital environment: Solutions to alleviate burnout, NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi:10.31478/201801c
8. Reith T. P. (2018). Burnout in United States Healthcare Professionals: A Narrative Review. Cureus, 10(12), e3681. doi.org/10.7759/cureus.3681
9. Taylor, J. (2020). Racism, Inequality, and Health Care for African Americans. The Century Foundation. https://tcf.org/content/report/racism-inequality-health-care-african-americans/?session=1&session=1&session=1
10. Tingley, K. (2018) Trying to put a value on the doctor-patient relationship. The New York Times Magazine. The Health Issue. https://www.nytimes.com/interactive/2018/05/16/magazine/health-issue-reinvention-of-primary-care-delivery.html