Necessity is the Mother of Invention
99% of innovation comes from solving a problem. REUNIONCare is the direct result of my father’s medical journey more than a decade ago. After retirement as he and my mother settled into what was supposed to be the golden years. He began suffering what appeared to be unrelated aches and pains. They changed their diet. He would visit his local doctor who would treat him one symptom at a time. You know his story; it happens every day to millions of people. Then the one practitioner who then starts to look deeper, finds the underlying disease, cancer.
2008 Great Recession
Unrelated but simultaneous to his journey, I embarked on a career upgrade. I entered the Workforce Retraining Program that follow the 2008 Great Recession to become a Health Information Technology specialist. I loved it! Once graduated, I was ‘guaranteed’ a position in the lucrative electronic medical record industry. Despite my academic performance and credentials (HIT and CPHIMS), the industry continued to see me as a twentieth century dinosaur not ready for this fast-paced high-tech world.
Enterprise Electronic Health Record
My parent’s journey collided with mine when Dad was receiving cancer care at my alma mater, the University of Pittsburgh. You see, back then, they had already invested well over a billion dollars on a state-of-the-art EPIC enterprise EHR. Wow, wow, wow. It was fantastic. My father moved between hospitals and departments in the system without a piece of paper or redundant intake. In fact, his name and vitals were listed on his patient whiteboard before we could get from one inpatient room to another. Outstanding.
Transitions of Care Failure
Then he would be discharged from the hospital. The entryways on large urban hospitals are like metro transportation stations. They are load and chaotic. My mother would retrieve her car from the large parking garage and wind her way around to the hospital entrance where my father would be waiting in a wheelchair. He was loaded into the car along with his belongings and new bag of drugs. Slam goes the door. Now it is my mother’s job to make him whole again.
Remember that well-oiled EPIC EHR? That ended when the car door slammed shut. My mother was now the doctor, nurse, and aide for his recovery. Dad had a bag full of cancer drugs each with their own unique regime, some with food and others without. No education on what side effects he could experience related to which drug. Then the task of ‘selecting’ a home health company to visit him and monitor his progress. My mother was lost, overwhelmed, and exhausted. There is no real preparation for caring for your dominant spouse and dealing with your own emotional issues on little sleep or training.
Product Market Fit
Turns out that the fast-paced high-tech world would have to wait. My training could help to solve this problem, “how can we extend the amazing information sharing that happens inside a very expensive and powerful EPIC EHR for people, not institutions.” REUNIONCare began as a wireframe and specifications document that unites my knowledge in public health, social work, and my new skills in health information technology.
Social Determinants of Health
It has taken over a decade since the Office of National Coordination began to get progress. Today we are experiencing an honest effort to tear down the information siloes to feed into community-based care. The community care hubs, Medicare Advantage, and the ACO REACH models are showing real promise in building collaborations in whole person care. Most importantly, our nation cannot afford to continue to finance healthcare with an open checkbook. Social determinants of health play the leading role in determining what treatments succeed and those that fail so focus on the root causes with social and behavioral health interventions. Addressing health inequities and the related social determinants of health to curb medical cost and improve the nation’s quality of life should not have been this long and hard. REUNIONCare was built for this moment years ago. I am pleased we are now finding product market fit.
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