Located at the New Jersey Institute of Technology (NJIT) Enterprise Development Center (EDC) in Newark, Navio Health is a digital healthcare startup. The company says it is easing communication between healthcare providers and others with its secure Health Insurance Portability and Accountability Act (HIPAA)-compliant messaging app, Practice Unite.
Cofounders Adam Turinas (AT), president, and Stuart Hochron (SH), chief medical officer, had known each other for many years, and they started Navio Health after attending an American Hospital Association conference in Washington, D.C. A big issue that arose repeatedly at that conference was the lack of communication among physicians, an obstacle to implementing changes mandated by the Affordable Care Act (ACA).
“By the time we got back to New Jersey, we had worked out on the back of the sheet of paper what an app to help doctors communicate with each other might look like,” Turinas said.
Turinas and Hochron had been providing consulting services to Jersey City Medical Center and suggested the application to their client, who was “very supportive,” said Turinas. So they developed the app, which they piloted last year. The duo formally launched Practice Unite on Feb.15, 2013 with the medical center and rolled it out to their fifth customer as of this writing. In New Jersey, CentraState (Freehold) is one of the hospitals using it.
Although Navio Health is well funded, Turinas told NJTechWeekly.com, “We are looking at potentially doing a round this year. We may be evaluating strategic investments which will provide capital, potentially fill in gaps and help us get to the next level.”
What problems does Practice Unite solve?
AT: The biggest issue is communication between practitioners. Here is an example: a nurse is at the bedside of a cardiac patient. The nurse needs to get in touch with the patient’s cardiologist to get some advice and ask the cardiologist to come in to look at the patient. In most places, the nurse has a couple of options. He or she can call using a cellphone but probably doesn’t have that doctor’s number. He or she can find the number of the office and leave a message with the answering service, as has been done for years. This is an established means of communication but extremely inefficient. It can take hours to get an answer. The nurse might resort to unsecured ordinary texting, which could result in a $50,000 [HIPAA] violation.
This is a big problem. More than 90 percent of doctors have smartphones, and many of them say that texting, sending pictures of wounds [and] sending photos of medical charts are things they want to do. This is where we come in. We provide a very simple, approved platform to send secure messages and secure photos so they can do this in an encrypted way that will be HIPAA-compliant for all the people … involved in the delivery of care. It does a lot more, but this is the initial problem we solve.
Will doctors, nurses and other healthcare providers use it?
SH: We have very high adoption rates because it is very doctor-friendly. After they download it, the app has a 93 percent to 97 percent open rate among doctors and nurses who are using it. Our goal is to have 90 percent of all doctors who are actually working in a hospital on the system within 15 months of hospital adoption. We have a lot of experience in rolling this out. Doctors we talk to say that the app looks and feels like it has been designed particularly for them. It gives them a lot of personal value.
What sets your app apart?
AT: One of the features … is that we let hospitals customize their information. For example, the app can allow healthcare professionals to know which doctors are on call at the time they want to reach them. The app lets the practitioner click on the On Call button and reach the pulmonologist on call via phone or get hold of them via secure text.
When a physician refers a physician to another physician, it’s called a consult. This is done in many ways, but increasingly it is being done via the electronic health record system at the hospital. The doctors have to log in to the system to find out that they are needed to consult. What we are able to do is deliver the consult request directly to the physician, … shortening the time from when a consultation is ordered to when a physician is notified.
SH: Finding a consulting physician in these … burgeoning hospital systems is not easy without an app like this.
AT: We have a feature that allows abnormal results from the hundreds of lab tests ordered every day to be pushed directly to a doctor’s smartphone.
Also, our app can reduce preventable readmissions. The ACA penalizes hospitals who have preventable readmissions within 30 days. If we can get the app into the hands of the nurses at the nursing facility where the patients go after they are discharged or into the hands of visiting nurses who go to homes, we can catch relapses or … symptoms before the patient is readmitted.
We are customizing the app so that nurses and others can make notes in a patient notebook, which is like a patient Wiki that lets them give more detail about a specific issue. There is a lot of research that shows that when communication is improved between everyone involved in patient care, it lowers likely preventable readmissions.
How do you roll out the app?
SH: We are very hands-on. We go to meetings — quarterly staff meetings, department meetings. We are personally present or have our account reps available in the hosptials for several months after the app is first rolled out. We also provide 24/7 support through our website. We are very CIO-friendly. The hospital CIOs like how we can facilitate what they need and how easy it is for us to support them.
Your company is located at the NJIT EDC. Have you found the incubator to be helpful?
AT: Yes, in many different ways. First of all, it’s a very cost-effective solution for startups. They provide many support services, like advice on funding and how to put together a pitch deck. We love having students work for us. They have some strong technology students. It’s also great from the networking standpoint. Our chief technology officer is joining us from a company in the incubator, as he was looking for his next early-stage opportunity.
What is your business model?
AT: We have an SaaS [software as a service] cloud model and generate income via ongoing enterprise SaaS licensing. We also charge a fee to customize the app for hospitals. The hospital doesn’t have to train the IT team to support the app. We provide all the support. It’s a model that hospitals are familiar with.
We set ourselves a goal last year — to get to a point where we had a number of referenceable customers — and we have achieved that goal. We also believe in the whole lean startup mentality, and we run a really tight ship.
Will it be difficult for your small startup to maintain and scale this customizable app?
SH: Since we operate from the cloud, it is very easy to make upgrades and add new features to the app. Changes don’t happen every day. We sit down and work with the hospitals on a program and then we roll it out slowly. It takes anywhere from a month to three months to introduce a new function, but we are able to do it while others aren’t.
What is the business case for your customers?
AT: One of the main selling points is that this app prevents the risk of HIPAA breaches, but honestly, this the price of admission. The real benefit is in the impact of improved communication. We are seeing some early ROI numbers that are blowing us away. One of our customers calculated that they saved $720,000 in their observation unit alone. They are also attributing shorter lengths of stay and reduced patient referral leakage to the use of Practice Unite.
SH: Customers are seeing 20 percent lower wait times in the emergency room, as they can clear patients faster. And, of course, we are aiding quality of care because people involved in care can find each other and communicate quickly.
What about competition?
SH: While there are thousands of digital health apps out there, most are oriented toward self-help for the patient and very few are focused on communication. Some of the very large healthcare systems out there, like the Mayo Clinic, have these kinds of apps. Frankly, the secure texting part of this is becoming a commodity. However, our new patient-facing component, the simplicity of the app and doctor acceptance of it will set us apart.
What’s next for Practice Unite?
AT: We are starting to pilot the patient version of the application, which will allow patients to communicate easily with their caregivers. Both the patient and provider apps will run off the same platform. This will allow healthcare systems to create tightly coordinated networks of care around a patient in need. The goal is to get attention to the patients in need efficiently and easily. It’s a huge opportunity to hit the triple aim of ACA: lowering costs, improving quality of care and increasing patient satisfaction.