Together Clinic Builds User Base With Tech Aimed to Improve Health Outcomes

by Michelle Leach, Lincoln Business Journal
Reprinted with permission from the publisher of MBJ Inc. from the April 15, 2015 issue of the Lincoln Business Journal

What started as a cardiothoracic surgeon and a cardiologist sharing the same idea — unbeknownst to each other until a chance meeting — has evolved into Together Clinic, a Lincoln-based health care startup poised to change the way providers and patients connect, and how consumers engage with clinicians from the get-go.

“At no time in the history of health care have we been able to capture patient data, utilize it in real-time and predict health care outcomes,” said Dr. Rick Thompson.

Thompson, the cardiothoracic surgeon, and Dr. Ryan Whitney, the cardiologist, founded Together Clinic in 2013.

Today it is building a user base for the mobile application.

“Rick and I complement each other well,” said Whitney, recalling that chance meeting at the airport.

They were headed in different directions in early 2013. Come to find out, as they got to talking, they were both designing the same concept — what would become Together Clinic.

“The biggest bridge we are trying to cross is: How do we provide better care for our patients? How do we improve and revolutionize that continuum of care?” Whitney said. “If you are somebody that has heart failure, your heart doesn’t pump as well as it should, this is not something you have once — it doesn’t go away. It is something you are stuck with the rest of your life.”

Whitney referenced the 25 percent chance one has of ending up in the hospital again within one year of being discharged, and how providers are now being penalized for those readmissions.

“We want to be the ‘preadmission people,’” he said.

Whitney noted they want to predict, before either the patient or the doctor even knows, what is happening health status-wise to accordingly be proactive and prevent readmissions.

When users log in, they are prompted to answer five disease-specific questions and vitals are entered. The doctor, physician assistant or nurse practitioner tracks this info.

“With the algorithm we work with, we can predict when people are getting sick and contact them ahead of time,” he said.

Whitney acknowledges there may be some overlap across disciplines with regard to aforementioned questions.

For instance, someone with heart failure might be asked to answer if, they are feeling better, much better, worse or much worse than the preceding day.

They may also be asked about breathing or swelling. From there, one can take a deeper dive into factors that can influence these symptoms, such as salt intake, exercise. One can quite visually see patients changing their answers.

For an example of technology in action, Whitney recalled a young lady with high blood pressure who

recently started using Together Clinic.

“She was feeling dizzy and her heart rate was up,” he said. “We looked at the data and ended up deciding to stop one of the medications.”

It turns the culprit med was a diuretic.

Generally, Whitney indicated Together Clinic is also bridging the gulf between the great medical care one might get in the hospital and during visits — the, say, three months between appointments whereby no contact occurs.

For instance, they can track if one was eating poorly at the family reunion and how it might affect vitals to predict issues ahead of time and deploy interventions.

After forming the company in around the third quarter of 2013, Whitney and Thompson engaged software development professionals.

“By early 2014, we were already enrolling patients into the system,” Whitney said.

Thompson said he has never had anyone say “this is a bad idea.”

“We surveyed our first 20 patients on the surgical side … and 95 percent felt better connected to the health care team, they strongly agreed with that, and they had more peace of mind,” he said. “We knew the patients would like it; we didn’t realize how much they would like it. We were surprised by how positive the response was.”

Thompson indicated patients crave being involved in health care.

“This isn’t the 1960s; patients nowadays have expectations to be more involved with care … and to be more connected to the doctor,” he said. “And in order to be really universal and be disruptive in health care, you have be simple so you appeal to all patients and you need to be free.”

Thompson acknowledged all providers are burdened with costs, and there are already many organizations developing “extremely expensive solutions.”

“Our revenue model is developing,” he said. “We believe that if we develop a strong user base, the revenue model with present itself.”

That model may be introduced in the next six months to a year and could include a health care marketplace, whereby one refills a prescription through the site, or may have access to the best deals on medical supplies.

Thompson further relayed how the app is being used on a daily basis to increase efficiency, requiring only a few minutes each day to prevent phone calls and head off issues before they become big, costly and time-consuming problems.

Also on the horizon are potential applications, due to its modular design, to expand into pediatric asthma, other corners of surgery (such as abdominal), COPD, mental illness, sleep apnea and to contain risks associated with pregnancy.

“The sky’s the limit,” Thompson said.

There are also applications for chronic care management, as how providers bill for care related to patients with chronic conditions is changing.

Other highlights mentioned by the founders include: 60 percent of its investors are health care providers; potential to bridge miles between rural patients and specialists; and its most recent grant, a $50,000 research and development award from the State of Nebraska to go alongside University of Nebraska-Lincoln’s Jeffrey S. Raikes School for Computer Science and Business to improve its predictive analytics and algorithms and help learn and adapt to data changes within the application directly.