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In this episode of the ��ݮ���� Podcast, Dr. Joshua Liu, Co-founder & CEO at ��ݮ����, and marketing colleague, Alan Sardana, chat with Ms. Nicole Graham, Bundled Care Coordinator at Health Sciences North (HSN). See the full show notes below for details.

Guest(s): Nicole Graham, Bundled Care Coordinator at Health Sciences North (HSN), Dr. Joshua Liu (), Co-founder & CEO at ��ݮ����

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‍Episode 49 – Show notes:

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[0:00] Introducing Ms. Nicole Graham, Bundled Care Coordinator at Health Sciences North (HSN). Ms. Graham was previously an Advanced Practice Physiotherapist, study reviewer and guest lecturer. She also played an instrumental part in implementing ��ݮ���� for Surgical Remote Monitoring during COVID at HSN;

[1:40] How Health Sciences North is based in Sudbury but offers support and services to 570,000 patients across a 400,000 km sq radius at 25 sites across Northern Ontario; 20-30% of the patient population is francophone, 20% is elderly, and 17% of the population is indigenous, which has influenced decision-making regarding content, health access centres and patient navigators;

[3:50] How HSN implemented ��ݮ���� for COVID-19 to support patients undergoing Total Joint Replacement, Breast cancer, Liver & Pancreas surgery, and soon to roll out for Cardiac surgery, TAVI/TAVR and Electrophysiology procedures;

[4:15] Why HSN chose to implement Surgical Remote Monitoring for their Total Joint Replacement population because it is a Quality-Based Procedure (QBP) with evidence-based research supporting particular protocols that enhance patient care as well as its inclusion in bundled care in Ontario;

[5:50] How HSN leveraged the technology to include their pre-surgery education classes, pre-admission visits, and COVID-19 screening which allowed patients to receive the right information before surgery, consult with their physician and stay connected to the care team before (and after) surgery;

[6:35] Why HSN believes tools like ��ݮ���� can help reduce the surgical backlog for its ability to improve patient throughput by reducing patient Length of Stay;

[7:30] How HSN had planned to implement Surgical Remote Monitoring before COVID for its bundled care programs to improve patient access and provider insight for the 90-day post-op period;

[8:50] How Ms. Graham describes the technology for:

• For Patients: This is a tool that will give you all the information you need; you can access it anytime you want and it will guide you pre-operatively and allow you to “check-in” daily with us to keep you on-track post-operatively. If you ever worried about something post-operatively, you will be sent the right information and contact information based on your symptoms. ��ݮ���� will give you peace of mind.
  
• For Colleagues: This is a digitized care plan. All of the protocols and order sets, guidebooks, etc. that you’ve established are adapted into a digital medium that will support patients throughout their journey.
  

[10:30] How HSN had a “Bundled Care Committee” prior to COVID which led the implementation of virtual care at HSN, by taking a step back, high-level approach to adapting the current workflows for a digital delivery;

[11:00] Why HSN included patient advisors on the committee to maintain a patient-centered approach and to understand how patients would use the technology such as ��ݮ����;

[12:00] How implementing ��ݮ���� and virtual technology helped bring the healthcare providers together to standardize best practices and care;

[14:50] Why HSN patients using ��ݮ���� feel less worried and more supported throughout their surgical journey due to the daily touch points and education that is specific to them;

[16:15] How HSN has achieved over 97% patient activation by leveraging a Medical Secretary in their enrollment process who calls patients 2 weeks prior to their surgery to explain the program in detail and how it will help the patient stay on track;

[19:00] How HSN has a “monitoring team” of nurses for each service line (e.g. Breast surgery, Orthopedics, etc.) who can reach out to patients if they are flagged on the platform, and how this workflow has reduced ED visits from 6% to 0%;

[22:05] Why Ms. Graham appreciates the complexity of the Surgical Remote Monitoring algorithms which are tailored for each service line to provide the right patient with the right care at the right time, while empowering the clinical team to receive alerts & notifications if a patient is falling off-track;

[23:05] How ��ݮ���� has helped ensure patients get the right education post-discharge such as pain management and wound care which was historically a cause for unnecessary ED visits;

[26:50] How Ontario Health implemented a Provincial User Group of hospitals using ��ݮ���� which has allowed teams to standardize protocols & education, disseminate best practices and compare outcomes to continuously promote quality improvement across Ontario;

[30:35] Why Ms. Graham appreciates the ��ݮ���� team for their clinical expertise, emphasis on patient-centered care and responsiveness to feature updates and customization that are significant to patients;

[33:40] Fast Five / Lightning Round Questions

Q1: What is your favourite book or book you’ve gifted the most?

“Goodnight Moon,” by Margaret Wise Brown.‍

Q2: How has an apparent failure set you up for greater success?

“Losing at triathlon races has motivated me to do better.”

Q3: Would you rather have super strength, super speed or the ability to read people’s minds?

“Super speed!”

Q4: What is something in healthcare you believe that others might find insane?

“When I started my career – 30 years ago – the Length of Stay for a hip replacement patient was 9-11 days… while today, 50% of our patients are home same-day!”

Q5: What is 1 hobby or activity you’ve gotten into since the pandemic?

“Fat tire cycling! Bikes with bigger, fat tires which allows you to bike more easily on all terrain including snow!”

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