Transforming episode of care delivery

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POSTED July 17, 2019

Smart Tasks: seamless, proactive patient outreach

Smart Tasks enables proactive care management at every critical point in an episode of care. Click here to read more about how our latest feature works.

At Force, we take pride in the technology we build for our clients. Our Product Team is expert at collaborative discovery of the most complicated challenges in healthcare. After all, solutions are only as great as your understanding of the challenge you’re facing.

Why Navigation

As organizations start taking on more risk as part of a shift to value-based care, we have seen several strategic themes emerge, centered around controlling cost, patient experience in the home, and outcomes. Success with these themes require justifying services and increasing efficiencies. Patients are spending more time than ever outside the well-controlled walls of the hospital, but there is not efficient infrastructure for controlling the home, where patients spend 90% of their episode of care. Maximizing the reimbursement also requires collecting and demonstrating quality patient-reported outcomes.

The most effective way to operationalize these goals is to:

  • reduce variation across the system
  • create value by strategically allocating services / resources
  • prevent leakage outside of the system

The Challenge

Understanding the importance of navigators in our evolving landscape was the first step. After years of working with some of the most distinguished medical centers, we understood that it’s crucial for providers to implement a comprehensive care continuum. However, we knew very little about the role navigators play in creating that care continuum on a day-to-day basis. So, we conducted discovery interviews and onsite shadowing, with the people who understand this problem best -- nurses and navigators -- to help us answer two questions:

  1. 1. What are indicators of true “patient navigation” (either as a dedicated navigator or shared responsibilities amongst care team members)?
  2. 2. What are the most common challenges regarding navigation?

It quickly became clear that navigation still largely relied on stacks of paper, folders, post-it notes and spreadsheets. After synthesizing our findings, we found that navigation can be defined as:

  • identifying and optimizing high-risk patients
  • conducting proactive outreach and relationship building
  • managing peri-op expectations and discharge planning

The Solution

Almost everyone we spoke with was tasked with overseeing thousands of patients, with extremely limited resources. Their challenges and frustrations became apparent, most consistently regarding the care team’s ability to: 

  • standardize touchpoints
  • set reminders to follow-up
  • plan for discharge
  • build lasting relationships with patients

Having identified these key pain points in the existing navigator experience, our next step was to brainstorm potential solutions that would comprise the bulk of the Smart Task feature. Some issues arose more often than others, helping guide our team according to the navigators’ core needs. 

For example, navigators consistently identified standardizing patient touch points as a central part of their workflow, but it was not always clear who they needed to contact, or when and how to contact them. To complicate matters even further, high-risk patients typically require additional check-ins or follow-ups that differ from the standard pathway. 

Spreadsheets, post-its, highlighters, and paper checklists aren’t the answer, which is why we set out to design a streamlined, intuitive tool to help navigators manage patients across the episode.

The Design

Our next step was to begin translating these feature proposals into digital designs that strategically balanced ease of use and visual appeal. Before launching Smart Tasks, we conducted several rounds of user testing to ensure our solution and design actually met the core needs of the end-users. 

For these tests, we recruited a handful of navigators who graciously volunteered their time to try out our prototypes. As each navigator interacted with the prototype, we took note of where the designs succeeded, where the tester struggled, and what noteworthy patterns emerged. By the end of each round of testing, we were able to identify and prioritize the design tweaks that needed to be made before putting in the hands of our users, to ensure that our final product would set navigators up for success. 

The Future

The introduction of Smart Tasks is only the beginning. As we learn from the experience with each patient and provider we serve, our team becomes increasingly aware of workflow challenges and causes of outcome variation. Although we can’t give too much away, our next series of iterations will be incorporating data from over 100,000 patients to further augment navigator tasks with predictive analytics, so you as a provider will know exactly where your efforts will yield the greatest impact on patient care.

Click here to learn more about how Smart Tasks works.


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POSTED May 7, 2019

PRESS RELEASE: University Hospitals embraces new technology to extend physical therapy reach

“This video platform and series allow our orthopedic department to extend far beyond traditional geographical borders. We are enhancing patient engagement and communication with care providers with this telehealth tool throughout the episode of care for total joint replacement.” 

-- Matthew Kraay, MD, Director, Joint Reconstruction and Arthritis Surgery, UH Cleveland Medical Center


University Hospitals announced that they are expanding Force across their 18 hospital system. This decision is the result of a successful pilot with seven surgeons and 200 patients in which 90% of the patients who were offered the platform logged in and readmissions were reduced by 28%. Read the full press release below. 

PRESS RELEASE: University Hospitals embraces new technology to extend physical therapy reach

Surgery patients can rehab from home with instructional videos

CLEVELAND – University Hospitals Cleveland Medical Center recently announced a new collaboration with Force Therapeutics to aid in the rehabilitation for orthopedic surgery patients. 

Though there can be challenges in managing care for patients who come from greater distances, particularly those who require post-operative physical therapy, UH is empowering patients with information and communication wherever they are. 

The New York-based company is a surgeon-prescribed video platform that guides patients throughout their rehabilitation through video, episode-based education and rehab, automated navigation, and digital communication.

As patients engage in their prescribed care plan, physicians are able to collect patient-reported outcomes and discrete data and analytics throughout the entire process. This platform not only scales navigation teams, but allows clinicians to more closely monitor patient progress throughout their recovery.

University Hospitals conducted a successful three month pilot of the program and is now expanding the use of this program across the 18 hospital system. The initial pilot program included seven surgeons with 200 patients who had an average age of 64.

Almost 90 percent of the patients who were offered the program logged in and completed the entire video set of physical therapy tutorials with positive outcome. Most importantly, a 28 percent reduction in readmission rates was experienced as a result of the virtual therapy sessions.

“This video platform and series allows our orthopedic department to extend far beyond traditional geographical borders,” said Matthew Kraay, MD, Director, Joint Reconstruction and Arthritis Surgery - UH Cleveland Medical Center. “We are enhancing patient engagement and communication with care providers with this telehealth tool throughout the episode of care for total joint replacement. 

The technological solution solves a multitude of problems for orthopedic surgery patients including reductions of complications and readmission rates, and serves as improved options and value for patients. 

The agreements UH recently formalized with Walmart and General Electric to provide their employees with orthopedic care is especially important for patients who would seek treatment with the hospital as the telehealth option would bridge distance and ease the rehabilitation process.

Force Therapeutics presently provides video rehab instruction for over 50,000 patients in 50 hospitals across the country with 155 surgeons participating in the programs.


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POSTED December 19, 2018

Integrating the clinical voice in health technology

Caroline is a member of the Force Clinical Integration Team

Healthcare is a complex service industry made up of a variety of stakeholders, each with varying goals and incentives. Service industries produce value through things that are primarily intangible such as customer service,, advice, knowledge, design, data and experiences. Clinicians play a unique role.  Ultimately clinicians are responsible for delivering care and therefore serve as intermediaries between the business and the patient experience of healthcare.

 

Given this unique position, clinicians have skills that are vital to excellent care delivery which can be challenging to quantify and automate through technology. As utilization of healthcare technology continues to grow, product development must recognize and be guided by expert, innovative clinical voices.

 Successful clinicials are skilled in both emotional intelligence and clinical reasoning. Clinical reasoning is a standardized process comprised of:

  • describing the situation
  • collecting information
  • interpreting information
  • diagnosing the problem(s)
  • establishing goal(s)
  • taking action(s)
  • evaluating outcomes
  • reflecting on learning(s)

A clinician may spend 5 minutes or 3 hours moving through the clinical reasoning cycle, however, each part of the process is essential to delivering high quality, effective healthcare. The graphic below provides a closer look at what happens in each phase of the clinical reasoning cycle.

Timeline of touch points across a traditional episode of care.

With increasing demands being placed on healthcare providers to provide more efficient and effective care, technology has emerged as an essential component in any value-based strategy. Despite its obvious benefits, technology in healthcare cannot fully replace the human side of care delivery. Accurately recognizing, understanding and managing patients’ emotions is extremely difficult to build into technology (artificial intelligence and machine learning are working on this challenge). Additionally, two phases of clinical reasoning stand out as particularly challenging to automate - 1) the interpretation phase, in which providers use their medical expertise and past patient care experience to process information and arrive at a diagnosis, and 2) the contemplation phase, in which providers reflect on outcomes and internalize new learnings. Because of the complex, human-centered nature of clinical care, it’s therefore essential that healthcare technology companies invest in and utilize clinical expertise to guide their partnerships and growth.

 

At Force, we believe that evidence-based, excellent clinical care has always been and will continue to be at the heart of valuable healthcare. It’s our job (and the job of technology in healthcare as a whole) to elevate and empower clinical reasoning, decision-making, and evidence-based care delivery. Force incorporates multiple strategies to ensure that clinical expertise drives our product development and client relationships. The Clinical Integration & Research team is comprised of clinical and non-clinical members uniquely positioned to guide internal and external conversations around clinical best practice, research design and implementation, and product development for success across a variety of stakeholders. Force consistently over-invests in client relationships, particularly with clinical end-users, because we know that clinicians are the true drivers of healthcare quality and value.

 

The unique nature of the healthcare industry and the service it provides necessitates that technology recognize and elevate clinical care providers. To date, technology cannot replace the emotional intelligence, empathy, or expert reasoning capabilities of skilled clinicians. The real value of technology in healthcare is therefore found in learning from and with clinicians, and empowering them to provide more efficient and effective care. As an industry leader, Force is proud to be clinical at its core and dedicated to upholding the highest standards of care delivery in every partnership.


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POSTED October 24, 2018

A culture of constant iteration and improvement creates better care

The delivery of healthcare is ever-changing -- but this moment, defined by increased patient volumes and unmanageable cost, is demanding a particularly acute shift from providers. Influenced by many different parties, including patients and payers, providers are constantly under pressure to do more, with less, while delivering stellar outcomes.

Industry leaders are staying ahead of the curve by integrating the latest technology into their everyday workflow. The impact of these tools are crucial to success in a healthcare landscape defined by value -- they also take a range of adaptation and learning from key stakeholders. 

We at Force are excited to be a part of this shift, in which these stakeholders are rediscovering what it takes to deliver incredible care. It’s core-value at our company to be constantly learning, and each and every member of our team contributes to supporting our clients in tackling new challenges and opportunities in orthopedics. 

I’m a part of the Clinical Integration (CI) team, which is made up of clinicians and researchers who are dedicated to creating a data-driven vision and strategic implementation plan. At the moment, we are heavily prioritizing and invested in digitizing patient-reported outcomes (PROs) collection. Our goal is to find new and creative ways to make PROs collection process more engaging and efficient, not only driving higher collection rates, but also providing more accurate and actionable data.

One of our latest project is improving the personalization of online outcomes forms. We collaborated with the engineering team to apply conditions and branching (also known as skip-logic), allowing patients to see relevant sets of questions based on their previous responses. Also, we are in the process of implementing PROMIS CAT (Computer Adaptive Test) which uses item response theory to optimize and sharpen the outcome measure. These efforts help further improve data integrity while optimizing patients’ experience by reducing their reporting burden and fatigue. With this feature we’ll be support our clients in collecting more data for evidence-base improvement and research. 

This is just one of many initiatives that are currently underway to continue the growth of our platform and client care-delivery. Force’s value of “life-long” learning springs from a commitment to constant iteration, improvement, and knowledge collection. We will continue to learn and discover digital solutions that can help providers standardize evidence-based best practices.


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POSTED August 7, 2018

Buyer's Guide: How to Evaluate Episode of Care Technology

With value on the rise, healthcare is reaching a tipping point. Patients and paying stakeholders are demanding more for less, putting pressure on providers to cut costs. Outpatient procedures and shortened time in the hospital require greater control of the home. And initiatives for strategic improvement are not possible without useful cost and quality metrics.

 

Technology is the answer. Leading organizations understand the opportunity digital solutions have to offer and are acting quickly to future-proof their service lines and stay ahead of curve.

 

But with tremendous opportunity comes a scrambled vortex of products and platforms, all with seemingly the same message. Until the market thins out, and the best solutions become clear, below are evaluation tactics and questions to guide you in finding the right technology to support your organization.

 

Is it comprehensive? 

Is your organization using five different platforms or portals to solve one challenge? You’re not alone. Instead, find one that creates a complete care continuum by asking-

  • Which organizations have used the platform to augment or replace traditional post-acute rehab services?
  • Are average PROs collection rates greater than 80%? If so, does this include one-, three-, and five-year outcomes?
  • Which product features will help virtually navigate patients? Is there evidence showing positive impacts on care team efficiency?
  • Are there additional fees associated with any features or services?

The whole is greater than the sum of the parts -- by finding one solution that meets these requirements, you’ve probably found a solution better than any combination of point solutions.

 

Is it validated?

Too often, we’re drawn to the ‘latest and greatest’ technology (bells and whistles included). With patients at risk, it’s important to look past the virtual reality goggles and motion tracking hardware and simply ask-

  • Who uses this? [i.e. tell me about five of your clients]
  • Which clients have had 1000+ patients use the technology?
  • Have any clients expanded use of the technology based on results? If so, which ones, and what was the scope of expansion?
  • Do research studies exist that show efficacy of this product?

Essentially, you do not want to be the lone runner ahead of the pack. Be risk-averse by letting your peers do the talking. You get what you pay for, so be wary of free trials or strategic partnerships.

 

Will this technology fit the specific needs of my organization?

Don’t spend tons of time and money changing your existing infrastructure to fit your purchase. Your organization is unique, which your bolt-on solutions should reflect. Adding or subtracting responsibility or workflow disrupts what you’ve already worked hard to build. Optimize and streamline what you have by asking-

  • How are Care Team workflows and pathways configured, and what is the post-go-live support model?
  • How is patient onboarding and ongoing support handled?
  • Will I be forced to integrate it with my EMR? Do I have the option to integrate?
  • Are reports catered for my use cases (registries, business analytics, etc.)?
  • What is required on my end from a technical standpoint?

 

Evidence-based change is only possible when you’ve reached a certain level of efficiency. Without customizable tech and ongoing customer support, it’s nearly impossible to move past the inevitable growing pains.

 

Is it substantive?
“Digital health” is a buzzword, and until we’re comfortable enough asking the hard questions, it will remain so. At the end of the day, your purchasing decisions reflect your business, so be curious to no end, and passionate about what matters most to your organization. Check every box, then check them again. The clinical and financial outcomes are worth the investment.


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POSTED August 2, 2018

Webinar: Future-Proofing Orthopedic Service Line Through Virtual Care

Watch this 15 minute webinar, with Force Therapeutics' Head of Bundled Payment Strategy, Bill Porter to hear about:

  • The strategic focuses of leading orthopedic centers
  • How leaders are future proofing their service lines in response
  • What it takes to build a care continuum outside the hospital

About the Speaker: 

Bill Porter is a member of the founding team at Force Therapeutics. As Head of Bundled Payment Strategy, he has helped some of the largest hospitals in the country adapt to healthcare's changing business models and save millions of dollars on care delivery.

Bill began his career in the financial sector at Capital IQ, a market intelligence company. When he transitioned to healthcare as a strategic sales leader at ZocDoc, he brought his interest in data-based strategy with him. Here at Force, Bill's passion for smart, effective solutions is a key driver in our mission to provide orthopedic patients with better care for less.


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POSTED July 31, 2018

Interview with an Intern: Max


Max Rothman is a rising senior at Cornell University, majoring in biology. He spent his summer interning at Force, working on research with the Clinical Integration team, and captaining our volleyball team. 

Why did you choose this internship at Force? 

Research has been a passion of mine since high school because I have always enjoyed asking questions and problem-solving. The opportunity to conduct research at a health-tech startup was very intriguing to me because it bridges my love for research and entrepreneurship. During my interview process, I also really liked my interviewers and the company values, which were akin to my values - grit, collaboration, and lifelong learning, just to name a few. I envisioned myself developing at Force professionally and personally and forming lasting bonds with my co-workers. Force has exceeded all of these expectations! 

What do you do in your role? 

My day-to-day responsibilities are always changing depending on the needs of the team, but most of my work is focused on assisting with data analysis for research studies validating the Force platform, improving company forms/materials, and pursuing my own research questions/topics. For instance, "do patients who login and watch a certain number of videos have better outcomes?" 

Some days, I might sit in on user interviews and a sales pitch, while other days I might be attending a conference or film shoot. It ultimately depends on the day but I have never not had interesting projects or things to do at Force. 

What does your team do at Force? 

My team (Clinical Integration and Research team) works with medical professionals to help them get accustomed to the Force platform, creates digital content for users and assists with research submissions. Furthermore, my team works cross-functionally on bigger company initiatives. Two examples of cross-functional initiatives that I have helped with are redesigning the Force website (I made suggestions that were implemented into the newest edition of the site) and optimizing the pre-op experience on Force for patients (I ran statistical tests to determine the correlation between different predictor and outcome variables). 

How does that play into Force’s larger mission? 

Force’s mission is to improve care by reducing costs, reducing readmissions and optimizing care. Medical professionals need the Clinical Integration team to help them standardize, and transition to, evidence-based care. Without the team’s constant provision of platform support, content and data, users would neither recover as quickly nor enjoy the platform as much as they do.  

What role do you think research and digital technology will play in the future?

I think research and digital technology is the future. Healthcare is a rapidly growing field that is in need of new technologies to sustain the growing population. Research is also crucial because disseminating clinical findings drives innovation and validates the inventions of the future. Force is constantly pushing the envelope to find new ways to improve care outcomes and help more people. 



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POSTED July 24, 2018

Accountability in Delivering Great Patient Outcomes

Accountability across the healthcare ecosystem is imperative to its inhabitants. As a member of the Client Success team at Force, I am accountable for ensuring a positive and productive Force experience for our clients. Our team has processes in place to listen to and understand our customers' workflows and needs - and then to be responsive, resourceful, and accountable in finding strategic [people/software/system] solutions to their challenges. The follow-through is foundational and necessary for our role. Force is a strong and effective product -- as well as a knowledgeable and proven service.

Being able to prove ourselves and our efficacy is core to Force’s mission. Every team member is accountable to our stakeholders -Patients, Providers, and Executives. We all play a key and measurable role in our mission to provide an evidence-based platform and implementation plan that will enable healthcare systems to deliver quality care to their patients while reducing costs and inefficiencies.

Force collects a massive amount of data, which we funnel into features for our clients, such as Patient Progress, Surgeons Stats, Executive Dash & Reporting, Force Research, & Hospital Scorecards. This helps our clients be accountable to their patients. We also use this data to measure patient connectivity internally. This holds us accountable to our clients and to partnership goals.

Data on the quality and cost of health care services is becoming more transparent across the landscape. New medicare payment models increasingly hold providers accountable for patient care, using hospital experience surveys (HCAHPS) as metrics for reimbursement. This, along with the increasing role that patients play as a consumer of healthcare, make the ability to create and collect stellar outcomes critical, while making providers more accountable to their patients than ever before.

The  “Wear the Cost” initiative in Maryland is an example we love. Through this program, the Maryland Health Care Commission is providing their cost and quality information publicly so that patients and providers are aware of how cost and quality differ among hospitals. As they state on their site: “With this information, everyone in Maryland can join a statewide conversation to better understand the differences in cost and quality that exist, work together to find solutions to reduce those differences, and help patients make the best choices for their care”  

Knowledge is power. I love being part of a team that can empower its clients and itself through evidence -- holding us all more accountable to delivering great patient outcomes.  


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POSTED June 26, 2018

Employers Partnering with Orthopedic Leaders for Bundled Payment Success

Join us for a 20-minute webinar on solutions for future-proofing orthopedic service line. Learn more here. 

Increasing healthcare costs pose major challenges for employers seeking to create and sustain a healthy and productive workforce. In 2014, Walmart was forced to terminate healthcare coverage for up to 30,000 part-time workers due to $500 MM spent that year on health insurance.

Facing the pressure to cut healthcare costs, progressive employers are strategically aligning with highly selective Centers of Excellence, who are establishing hospitals with highly efficient service lines to act as a destination for specialized care attracting patients and employers. Walmart recently announcing their latest bundled payment partnership with New England Baptist Hospital further demonstrates the identification of financial incentives translated through these models.

Maximizing financial opportunities to coincide with improving health outcomes for employees are driving the rapid expansion to adopt employer-provider relationships including GE, Walmart, Jet Blue, and Lowe’s. With value-based care at the center of focus, proactively pursuing an alignment with Centers of Excellence are proving to be a priority for successful growth.

Employers aren’t the only ones proactively pursuing partnerships. Recognizing the opportunity to attract larger volumes of patients, providers are deliberately establishing themselves as Centers of Excellence by implementing new methods of care delivery that demonstrate better quality outcomes and reduce variation.

Failing to meet certain benchmarks in the bundled payment model is a financial risk for providers, which increases the stakes in improving outcomes while and reducing healthcare cost. In response, providers are concentrating on high-cost areas and incorporating new online technologies that further develop their communication and patient engagement beyond the hospital.

As a solution to trim healthcare costs, providers are implementing digital solutions to reduce usage of post-acute home health and therapy services. Digitally extending the communication and control outside the hospital allows providers to deliver high-quality care to higher volumes of patients.

Several studies with leading Centers of Excellence now show that providers who deliver remote rehab through digital platforms can successfully manage patients and improve outcomes. As employers pursue leading providers for potential partnerships, providers must find ways to demonstrate their ability to deliver value. Establishing a Center of Excellence to employers requires innovative solutions and adoption of technologies such as episode-of-care platforms for bundled-payment success.

 












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