apx labs hospital.jpg
Photo: APX Labs

Sicker patients, higher expenses and fewer outpatient visits: Hospitals are still dealing with many problems caused by the pandemic, not to mention caring for people sick with COVID-19. These challenges are on top of ongoing efforts to meet the triple aim of healthcare: Improve patient care, make people healthier and reduce costs.

Two tech companies think a marketplace approach could help hit all of those goals. CareRev is taking on the staffing challenge, while Particle Health wants to connect all the separate data sources across all healthcare systems.

Here’s a look at how these companies are building these systems and helping everyone working in and dealing with the healthcare industry.

Helping nurses find the work they want

The CareRev marketplace creates an alternative to the traveling nurse system that has been used extensively during the pandemic. Hospitals are offering signing bonuses ranging from $10,000 up to $40,000 to attract enough nurses to keep facilities running. This approach fills a shift in the short-term but can create a longer term problem with staff members who don’t make as much money.

Before joining CareRev, Craig Aherns helped hospitals manage financial turnarounds, which often involved laying off staff only to hire them back a few months later when demand for care went up. He served as CareRev’s senior vice president of growth and strategy for just over two years until February. People were frustrated and angry before COVID-19, according to Aherns, and the pandemic highlighted the weaknesses in this approach to managing a healthcare workforce.

“Using a contingent workforce in healthcare is expensive and not sustainable and causes friction with your full time workforce,” he said.

CareRev built a staffing service designed for nurses who want to work part-time on a semi-regular basis.

“We are offering people a way they want to work,” he said. “Also, we’re saving one hospital $30 million this year by eliminating the travel contracts.”

CareRev partners with hospitals to fill open shifts and to manage the onboarding process. Once CareRev confirms the credentials of a new user, he or she can see the available shifts and sign up to work one via the company’s app. CareRev also pays the nurses also when a shift is complete.

He also sees advantages for nurses who don’t want to work full-time and aren’t looking for health insurance from a full-time gig.

“This flexible mechanism is activating a latent supply who want to work three or four times a month but don’t want to travel because it’s exhausting and they feel icky about it because they were on the other side of that,” he said.

SEE: Kaspersky: Many wearables and healthcare devices are open to attack due to vulnerable data transfer protocol

The CareRev platform also targets young professionals who need to pay off debt from getting a degree as well as more experienced nurses who don’t want to work full time but aren’t ready to retire.

He sees this marketplace model as particularly helpful for certified nursing assistants who keep the RNs from burning out but earn fast food wages.

“There’s also an education ladder built into our app, so a CNA can work a second job in a hospital and gain experience,” he said. “We also can help with transportation logistics to get people to their shift if they need a ride.”

CareRev hires RNs, CNAs, medical assistants, radiology and surgical techs in Arizona, California, Florida, Illinois, Missouri, Oklahoma, Oregon, Texas, Washington and Wisconsin.

Powering the next phase of healthcare’s evolution

After being able to see a doctor or nurse from the comfort of home during the worst months of the pandemic, many people want that option to be permanent. Healthcare providers will have to adapt to that expectation in addition to the demands of its workforce. This could include a new option that provides more personalized attention than a telemedicine visit without the need to go to a doctor’s office. Aherns sees the need for this on-demand and in-person style of healthcare and predicts that there will soon be the option to have a nurse or other healthcare provider come to the home to provide care beyond the home health services that are common today for older adults.

This at-home, on-demand care will cover every type of population, Ahern predicts from high-risk patients who need specialized care to primary care visits.

“The marketplace model is what makes that go, and payers will start to go directly to the marketplace,” he said. “This is probably two to three years out.”

Making the exchange of health data easier

Labor is not the only marketplace powered by technology and designed to make life easier for doctors, patients and nurses. Particle Health is interested in healthcare marketplaces that deal in data, not labor. Dan Horbatt, CTO and co-founder at Particle Health, said his own chronic medical condition introduced him to the challenge of healthcare data interoperability.

“I couldn’t collect my medical records because I was ill,” he said.

His journey to collect his own information revealed just how many data silos exist in a healthcare system that is not built for trading information or ease of access for patients.

Particle Health uses a federated network and grants certificates to allow users to participate on it. The network currently includes 20,000 endpoints which covers regional health information networks and healthcare providers. The platform is SOC 2 certified, HIPAA compliant and OAuth 2.0 compliant.

Horbatt describes Particle’s platform as the pipes between all the data lakes scattered throughout the healthcare system. The idea is to make it easier for healthcare providers of all types to find and share patient data and for patients to manage the information.

SEE: Chicago hospital uses Amazon’s HealthLake to tear down data silos and build a coherent patient history

Healthcare providers and insurance companies can use the Particle Health platform to manage and view data. A user can query the data based on demographic information as well as map the data to the Fast Healthcare Interoperability Resources standard.

Horbatt said that Particle Health wants to provide a platform for healthcare providers and others to build on, as opposed to specializing in a certain way to present the data or track trends.

“From my experience with years of dealing with big data, the situations where you have the best results is when you have human intuition paired with systems that can help process lots of data,” he said.

Horbatt said the platform makes patient discovery and record access easier, while also improving the overall clinical document architecture.

“We can take in very old school XML-based formats of data transfer and convert it to the latest industry standard: graph-based, JSON and restful,” he said. “This makes the data much easier to work with because users can slice and dice with the data and only pull the information they want.”

Users can write narrow queries such as pulling data on Medicare patients only and medications prescribed during a specific period of time. Horbatt said Particle and its partners could use this capability in the future to automate patient workflows or suggest an intervention for a specific condition. Customers can use the platform to pull patient data as well as make data available to the larger network.

Horbatt said the platform is helpful for telemedicine providers who can use it to import patient data.

“Data transfer has become a big thing and now they don’t need to spend the first 15 minutes doing patient history, which is beneficial to outcomes,” he said.

Making patient data easier to access also means that it’s easier to identify problems with prescriptions.

“Sometimes patients have been prescribed the same med by two providers and are taking a double dose,” he said.

Improving data access for patients

Horbatt said the company supports the larger health data ecosystem by helping partners understand the FHIR standard and creating a working group to share more data including medical images, genomics, and even notification services.

He described a standing query that a doctor could use to collect all the data on a particular patient and to send an alert if the person is admitted to the hospital.

“There’s going to be a lot of opportunities for applications to provide that ongoing care outside of being treated by a provider, especially for chronic conditions

This future functionality also could allow a person to provide and revoke access to medical records and ask for correction.

“As far as we’ve come with technology it’s mind boggling that our health is still in our hands,” he said. “We want to expand to patient requests for access so patients can exercise all their rights under HIPAA.”

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