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 Welcome to this week in Health IT News, where we take a look at the news which will impact health it. This is another field report where we talk with leaders from health systems and organizations on the front lines. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set up podcasts, videos, and collaboration events dedicated to developing the next generation of health leaders.

Are you ready for this? We're going to do something a little different for our Tuesday Newsday show. Next week we're gonna go live at noon Eastern 9:00 AM Pacific. We will be live on our YouTube channel with myself, Drexel Ford Sus Shade. And David Munch with Starbridge Advisors to discuss the new normal for health.

It, uh, with you supplying the questions with live chat. Also, you can send in your questions ahead of time at hello at this week in health it.com. Uh, I'm so excited to do this and I hope you'll join us. Mark your calendar. Noon Eastern 9:00 AM Pacific on April 28th. If you want to, uh, send the questions, feel free to do that.

Um, and uh, you can get to the show by going to this week, health.com/live. This episode and every episode since we started the Covid 19 series has been sponsored by Sirius Healthcare. Uh, they reached out to me to see how we might partner during this time, and that is how we've been able to support producing daily shows.

Special thanks to Sirius for supporting the show's efforts during the crisis now onto today's show. Today's conversation is with Tiago Fernie, the, uh, tele telemedicine medical manager for America's Medical Service and Varun Anand Healthcare entrepreneur and Co-founder for MPR hx, MPH rx, uh, which is the, uh, company that has created this platform called Minerva.

And I'm really excited to talk to you guys about this. Uh, but before we going, good morning. Welcome.

I'm looking forward to it. So we are, we're cross continent here, so I'm looking forward to this. Um, you know, we're a big proponent of platforms on this show, so I'm really looking forward to, uh, discussing the, the use case, uh, around this and what you guys have been able to do. Uh, before we do that, uh, Tiago, uh, Varun, if you guys could introduce yourself, give a little, uh, little background for the audience, that would be great.

Okay, can, I'll start. So my name is, uh, I'm a Brazil. I'm, I'm a Brazil Brazilian doctor. Uh, I work with, uh, health IT for.

I work now for, as a telemedicine medical manager from AM Medical Services, which is part of, uh, Brazil. Uh, so it's a company that you, you might know as United Healthcare Global. And, and then I started working with. About, uh, nine years ago when I started to, to implement some decision support tools for, for the physicians embedded into the emr.

So the, the physicians was, and they, they, they wanted to, to know that the treatments and, and the diagnosis for.

And building a new platform called Minerva. Um, so at a high level, uh, you know, it's a, uh, it's an open interoperability and digital transformation platform deployed in over 20 countries, uh, serving over 300 million patient lives overall. And, um, you know, the way I kind of try to explain it is, uh, we we're kind of like a Lego box.

Of tools that can be very quickly stitched together, uh, in a vendor neutral manner to, uh, drive engaging digital transformation projects. And, uh.

Yeah, so the reason I'm looking forward to talking about this, we talk about platforms a lot and people are like, well, why do you push platforms so much? Well, it's really the speed and the agility that people can work with because the, the security's already baked in and it's, as you say, it's Lego blocks, right?

So it all just sort of pieces together. And so when, when I came across this, I thought this would be a great conversation. So America's medical services part of UHG Brazil deployed the Covid-19 triaging monitoring and Teleconsultation workflow on the Minerva platform in a vendor neutral format across multiple EHRs.

So there's a lot in that statement. So let's just start with, uh, Tiago. If you could talk a little bit about the problem you were trying to solve, uh, as you were approaching this. Um, sure. Uh, so as you can see from my background here, uh, we're shelter sheltered working from home. Uh, and then we, we have as, uh, three Brazil here.

We have more than, we have 35 hospitals and a lot of urgent clinics. As you can, you can tell is big issue in Brazil and.

Go home, uh, and does not stay into the hospital and get more infection than more, uh, other diseases. So we have both, both, uh, workflows that's implemented. So the, before the patient come to the er, we have this trial system. So the patient is not, uh, unnecessarily.

Hospital

questionnaire. Their symptoms and then tests are, uh, automatically created to, to the physicians so we can track this, uh, these patients. But my, my bigger problem is, was actually that I do not have much physicians or, um, nurses available for, for this. Uh, since they're on the, on the, the front of the battles with the, the covid-19.

So, uh, I was looking for a platform that could scale up the, the, the physician I have and, um, and can, could automatically triage this, this patient. So I don't.

Yeah, no, that's, that's fantastic. And we've seen the, the telehealth, um, telehealth, the triaging, the monitoring, anything where we can, uh, really reduce the number of touch points and exposure to, to potential covid-19 is in protecting the clinicians has, has been, you know, just a phenomenal solution in this, at this point.

But why, why a vendor neutral solution? Why is a vendor neutral solution, uh, important. Actually

we.

System that was provided by us. And then, and again, we are not charging the patients from that. So, uh, the patients had already gone to one of our hospitals and we're giving this, uh, platform, this access for them, uh, for free. Uh, so we can implement, uh, improve their health and that's why we look for a neutral vendor.

Fantastic. So Varun, give us some idea of what some, what are some of benefits?

The engagement. Sure, sure. So, so, you know, I mean, um, just to kind of walk you through the story, right? So as we guys started talking to Tiago and, and, and, and actually a few other customers, we started really learning about, uh, you know, what the ground realities were around covid-19, uh, specifically in Europe and what we were seeing in Brazil and the us.

Uh, and biggest.

You know, was the overall healthcare delivery capacity, right? Anyone that came in with any kind of cold, you know, found flu symptoms. Uh, you know, they thought that they had covid-19, uh, even patients that had mild symptoms at the end of the day, the, uh, the way they were taking care of was by asking them to go back home being cell isolation.

And where we were seeing, uh. Was when everyone would actually end up coming to the er, everyone would end up, um, you know, having to come to, uh, see their doctors to get diagnosed, only to be actually told to go back and, and, and, and, and be in quarantine. Um, as we noticed this, we actually realized that there were a lot of building blocks that we already had in the platform, right?

The ability to create a.

Put in their symptoms, um, you know, automatically register onto a patient app. Um, the ability to create a, a quarantine care plan, which essentially meant that, you know, Thiago and his, uh, and our customers were able to define and say, when a patient is in self quarantine every day, I wanna send them a, a check-in questionnaire, right?

Asking them if their symptoms have changed every day. I wanted to send them some educational material. So these, these capabilities were already configurable through a user interface where in fact, uh, you know, what's, what's really been interesting is, uh, you know, our customers are actually defining a lot of those workflows on our own.

Um, the Teleconsultation piece, the ability for, uh, you know, patients, um, you know, that are identified.

Put into a work list where, you know, the clinical teams could essentially start focusing on patients that at high risk or medium risk symptoms, um, set up telecon around that and keep them, uh, uh, you know, basically engaged remotely. Um, the, the overall objective here was to. Was to basically, you know, have our clinical resources focus on patients and on, uh, you know, essentially part of the public that really needed, uh, you know, um, uh, you know, to be seen in an emergency room or needed to be seen, uh, in the hospitals rather than, you know, having to monitor a much larger.

So it's, it's really a scale problem, right? That's basically what the pandemic really showed. Now, uh, give some numbers. I mean, we deployed this. So we actually set up a new platform, a new instance for UG uh, branded it, uh, actually translated it into Portuguese, which was, which was, which was quite a fun exercise.

Uh, translated it into Portuguese, uh, put it out there and, and, you know, they started using it on the fourth day. Um, in terms of, uh, you know, and, and what we also realized.

Of me making.

You had to make any of those modifications would've been a development cycle. And, and I don't think that could have been up and running in 72 hours. So that's, that's really the power of how, uh, you know, having these platforms in place, uh, can really help, you know, uh, deploy, go to market with these kinds of solutions really, really quickly.

Yeah. So I mean, so that is the benefit. It's configurable versus programmable, right? So you're, you're essentially interface.

For deployment, uh, at that, uh.

That's correct. That's correct. And, and, and, you know, I mean, if you really think about it, uh, you know, doing this in 72 hours. And the other piece also, which we're seeing is, uh, you know, as, as the virus and as the pandemic is progressing, uh, the actual needs are also changing on the ground, right? So the same triaging logic, uh, which was earlier being used by, you know, for patients, um, uh, you know, outside the hospital or.

Now the bigger concern is the health workers, right? The doctors and the nurses, they're actually contracting Covid-19 as well. So the same workflow with a little modification needs to start work working for tracking, uh, you know, health workers on the other end, right? So these, this agile approach of being able to really respond to these situations that, that, that really in handy

Tia.

Uh, other systems once, once it goes through this workflow. Yes. We actually are working on, on one integration that will, uh, record this information that we, we input register into Minerva system, and it, it goes back to the, the hospital

has. Yeah, so, so Varun, I mean, that's always one of the questions. It's like, okay, vendor neutral, we're gonna pop this thing in. Um, and then people will sort of get stuck. They go, but you know, how, how, how are we gonna get this information moving around? But your platform actually, uh, is, is pretty elegant in terms of how it, how it stores and moves that data around.

So we latched onto fire. In fact, our data model is completely based on fire, which means, um, you know, as, as you know, even these workflows that we've deployed, the data that's actually been captured is being captured in an open standard. And, um, you know, as integrations basically open up with the EMRs with the different source systems.

Uh, there's not a lot of translation work or, you know, it's not in a proprietary format that, uh, plus interoperability was, was essentially, uh, you know, our, our mainstay, right? So healthcare integrations, um, you. Um, healthcare, uh, environments. Uh, we kind of realized the reality of healthcare data, which is, um, you know, I like to say this, that healthcare standards sometimes is like an oxymoron, right?

I mean, everyone ends up having their own version of it. And, um, so, so we built, uh, an ability within the platform to quickly integrate, whether it's with healthcare standards like x.

Uh.

Um, really makes a big difference on how effective, uh, you know, a, a solution or an engagement would be. Yeah. Farrun, I'm gonna come back to you because I wanna talk to, I want you to talk some of those building blocks. The, um, uh, you know, you know, chat bot, payment gateway and those kind of things. But before we get, get there, Tiago, I, I'd love to hear how the, um, how the, the, the consumers or the patients are responding to the, out, out at this point.

So, uh, we just, uh, uh, achieved the two week, uh, implementation. Yes, just yesterday. So we are getting some, uh, spontaneous feedback from the patients during the telecon, and they are phenomenal. The patients are really excited. The patients are glad.

We do not have a measured system like NPS or something that we're starting to, to send these questionnaires for the patients like today because we didn't wanna bother the patients so they can answer these N PSS on every single telecons, and we just. Uh, assume that would be better for us to, to have, uh, a whole program n pss at the end of the care plan.

So that's why I, I don't have this now, uh, but the, the patients are as spontaneously, uh, get giving this feedback for, for the doctors, uh, from the platform and care that we're providing. Yeah. No, that's great. Um, Varun give us, give us a couple of, of the building blocks and then we'll, we'll close out by, you know, talking about where this could go once this is in place.

I know it's two weeks into it, but one of the magic things of about a platform is, it, it, it's only limited by your imagination. Um, but with, with that being said, what are some of the building blocks that, that, uh.

Sure, sure. So, um, so, you know, some of the building blocks that really come in place is number one, uh, you know, the ability to really quickly deploy white labeled web and mobile, um, you know, apps for patients and clinicians, right? So what we're deploying here is not something which is MPH Rx branded. It's actually looks like an Amer.

App, they're actually, you know, we're releasing an iOS and an Android app, um, you know, to these patients

and the other, um, around.

Phone number. And, you know, that's always a complex, a complex thing to do. Like when you're, when you're going out and you're engaging with patients are not already part of your ecosystem. Um, we already had, uh, you know, a workflow engine where, uh, for a UI you could very quickly, um, set up, uh, care Pathways, uh.

Self quarantine plan. This is what needs to happen daily. I want them to record I their, so all of those things were, was a framework. Similarly, the ability to do alerts and notifications, um, which we're doing right now. So you're actually sending out alerts and notifications to patients, uh, as well as to the providers, um, saying that, okay, you know, these are four things you need to do today, or, you know, you know, uh, follow ups around that, and so on, so forth.

Um, the Teleconsultation piece is interesting. So we actually, within the platform had integrated, um, you know, a, a framework which was based on web rtc. A very interesting standard where, um, you know, you essentially don't need to install anything on web and mobile devices. And, and if you think about it from a, you know, we guys all get on conference calls and it's always, um, you know, every conference call is interesting if somebody's downloading an app or somebody's downloading a plugin, right?

Um, and the moment you start, you know. Becomes a bigger challenge. So, um, you know, we, uh, the telecon.

And then more importantly, I think underneath, um, the ability to store all of this information in an open standard, making it, you know, something that can be cross leverage in the future as well. Um, also because we've been doing a lot of our projects have been patient facing, we also start looking at, you know, the overall engagement metrics, right?

Uh, which I think every time you're doing some, you kind of.

Of people that have been asked to come back to the emergency have been hospitalized. So those are the kind of metrics you really need.

Absolutely. So where, where you, I mean, and plus you have, uh, I mean, you, you guys have a ton of stuff in here. Like, uh, online payment gateway, fraud prevention, I mean, just chat bot capabilities, uh, eligibility checking. I mean, I, I was looking at the list of this stuff and I'm sitting there going, yeah, that's the building blocks, right?

I just sit back and I, I don't have to build that. I just go, yeah, I need a payment gateway. Yes, I need this. Yes, I need this. I, and that's, that's the beauty of a platform. It's, it's configurable as opposed to, uh, building it out and having been ACI who built all that stuff out, I'm, I'm glad there's now platforms that you can just configure because that's, that's, that's a work.

So do this.

Actually think I can start with that. You were implementing

need One of it's

this demand in, but.

Urgent queue line urgent here, uh, as a demand. So the patient wants see a doctor right now so they can click on the, and stay on online, on the virtual. Uh, so the, the doctor will pick this patient up and, and talk to the patient without having to, to schedule the appointment. Uh, this.

I asked to, to, to develop. Uh, but for, for, for us to have this, we, we needed to get the online payments and the eligibility to, so the, the insurance can pay us for, for this, this visits because the patient.

And then one of the things we we're trying to, to here is the, because the payers will ask us, so we're implementing the recognition the moment before tele as well. Another thing is the chat bot to, to ease the, the interactions from the, through the platform instead of the questionnaire. So it's more natural for them to answer the bot than to just answer the questionnaire.

And another thing that, uh, I, I need the Minerva platform solve.

Right now.

A group of hospitals. We have some centers, systems of excellence that are, uh, dedicated to a specialty or some cardiology cases or neurology. And we transfer patients between our hospitals. And this is one of the bigger problems I have right now because I.

The, the patient's EMR do does not, uh, is not access accessible from one hospital to the other. So we have a lot of paper being translated with the patient and a lot of time that the, the physician wastes, uh, getting the information from the other hospital. And this can be, uh, automated by, by, uh.

Uh, that's fantastic. And gentlemen, thanks for your time. Varun. How can, if people wanted more information on this, where, where could they go to get some more information? Uh, so they can, they can go to our website, nrx com and we'll actually pass you a link that you can make part of the podcast as well. So, uh, we've actually been, uh, uh, you know, talking a lot about, uh, uh, you know, this.

One, the things that I guess is, is.

Deployed and very quickly used. Uh, but once, um, you know, in the next few months,

theves um, behavior will also change, right? So capabilities we've used. Remotely can also be transferred to oncology, cardiovascular, renal diseases, and so on, so forth. So other special as well. So we've got some content on, on our website about that. And happy to share the link about it as well. MX com? Yes.

Great. I'm, I'm gonna put you on the spot one last time, which is, how, how does an entrepreneur come up with a name? I, I mean, and how did you come up with that name? Actually goes back, um.

You know, the early idea behind, um, you know, the company, you know, we were three tech guys who got into healthcare, right? And, and our, our biggest question was, why is it so difficult to get patient records from point A to point B? And, and why don't patients have access to their own records? We jumped in the industry thinking, we'll, you know, that's, that's, that's, that's a problem that that needs to be solved.

And initially we thought we'd be a patient system. Um, and we thank our stars, uh, that we didn't do that back in't down that path, the name of the personal express. Um, and, um, you know, after you have a few customers and you start basically going out. We, we, we, I think, grew attached to the name, uh, and the history behind it.

Yeah, I, I, I'm kind of making fun of you, but it, it, it's, it's a pretty easy to remember name, so and gentlemen, again, thank you for your time. I really appreciate it. Thanks, bill. Thank you. That's all for this show. Special thanks to our channel sponsors, VMware Starbridge Advisors, Galen Healthcare health lyrics, and pro talent advisors for choosing to invest in developing the next generation of health leaders.

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Uh, please chip back often as we'll be dropping many more shows, uh, until we flatten the curve across the country. Thanks for listening. That's all for now.