ORHub is a HIPAA compliant, physician-driven digital software company focused on improving profitability and the cost effectiveness of hospitals through real-time smart data and analytics. ORHub provides a cloud-based software solution that captures information before, during, and after surgery, filling a void in the current surgical information infrastructure and providing a method to capture and measure the surgical process: evolving Big Data into Intelligent Digital Data.
In other words, ORHub’s software applications allow hospitals and medical device vendors to utilize any web-enabled device to create an anatomical graphic depiction of exactly what occurs during surgery. The application automatically translates the resulting schematic into an intelligent, electronic operative report that links every detail of surgery, including implant location, surgical techniques, product usage, and all clinical parameters to create a dynamically new source of comparative information.
As a result, this is how hospitals and surgeons can make real-time, data driven decisions to improve business profitability and the quality of patient care. We had the opportunity to interview Colt Melby, CEO of ORHub.
Alice Ferng, Medgadget: How did you get involved with the company? Who was the founder and what was the inspiration behind ORHub?
Colt Melby, Chairman & CEO of ORHub: At ORHub, we believe that we all play a vital role in lowering healthcare spend. Our founder, who is a physician himself, was inspired by technology to transform OR economics when he witnessed how burdened his care team was with manual and disparate processes after each procedure which ultimately took time away from caring for patients. He then sought to analyze and automate resource allocation for his procedures, which required numerous steps to account for data registration and information cataloguing at the point of care across the surgical continuum. At that point, he collaborated with Microsoft to develop a cloud-based solution on their HIPAA compliant Azure platform to bring state-of-the-art technology into the operating room and that is how ORHub was born. Each surgical procedure is complex with numerous individuals, departments and vendors involved and ORHub unites the relevant parties to capture data real-time, remove manual errors, remove duplication of efforts and bridge communication gaps. We then partnered with a leading orthopedic hospital to advance their surgical system into the digital era. Through our proprietary scanning technology, we have captured compliant data across 4500 surgeries to date and have proven that providers are able to generate meaningful cost savings per physician per procedure, compress the reimbursement cycle, optimize time savings and create efficiencies across care teams.
Medgadget: Tell me more about ORHub – how does it work? What does the platform look like, and how is it accessed and used? Who uses it? (e.g., Front desk, managers, surgeons, nurses, etc.).
Mr. Melby: Each hospital and team is provided a Microsoft Surface device. When a surgeon schedules a surgery, a medical device rep uses an app to select the implants required for the procedure and schedules them for delivery to the hospital sterilizing department where they are prepared for the OR. At the hospital, a number of Surface devices are charged in a specially designed station outside the OR, ready for use. In the OR, the surgical nurse opens the ORHub app on his/her computer and provides the medical representative with a PIN so the vendor can sign in and access the pre-populated data on the surgical procedure in progress. Each product, implant and surgical process is then scanned onto ORHub’s platform and that is how data is captured real-time. At the point of care, users of the platform include the nurses, physicians and medical device representatives. Post-care, users of the data analytics expand to include hospital administration and perioperatives.
Medgadget: What type of data is utilized by the platform, and what types of analyses are performed on the data. Can you share some metrics?
Mr. Melby: The data that is used by the platform include patient demographics, procedure information, materials information, revenue data and outcomes data.
ORHub was founded with value-based care in mind. We collaborated with over 40 surgeons to create a granular and discreet data set that captures what is missing in legacy software for procedures performed and materials used. We then marry real-time data to existing demographic and finance data to get a true apples-to-apples view of similar episodes of care that we can link to ICHOM designed outcomes and determine the efficacy of procedures performed, money spent and quality of patient care. An example, is that ORHub would look at rotator cuff repair as a distinct surgery and record the approach, size of the tear, single vs. double row repair, and differentiate between metal, PEEK, and bio-composite anchors and how many were used. This allows care providers to understand the impact of their choices, and make an informed decision for value.
Since we have automated the surgical process, we now have real-time data that account for all of the materials used for each procedure down to the manufacturers of each product and can benchmark which are used more or less in frequency and determine the reasons why. By all accounts, we can create real-time purchase and delivery orders, which improves inventory management, a large factor in the OR cost equation.
Another favorable outcome as a result of our data analytics is the ability to recognize the disparity between the inputs of CPT and DRG codes per procedure which has enabled administration to compress reimbursement cycles and enhance cash collection cycles.
Medgadget: How are the platform cases decided and how are outcome measures analyzed for significance and efficacy?
Mr. Melby: ORHub is an ICHOM TechHub partner and we utilize internationally recognized outcomes measurements that consider Pain, Disability, Quality of life, Work Status, and Analgesic use to measure the impact that surgery has had on a patient. Measurement is done by the Surgeons’ clinical office, and they look at a baseline before surgery, 3 months, 6 months, 1 year and 5 years post operation to see how much the operation affected the patient’s life.
We started with spine cases as it is one of the most complicated procedures with one of the highest revenue points for hospitals but also carries with it the highest expenses. With this detailed outcome information, we can look at patients with similar conditions undergoing surgical care, and group them by improvement to their quality of life and then see if there are any correlations with procedure, materials, length of stay, medications, anesthesia, etc. Over time, we can begin to assign value scores to time and materials spent treating patients. This would be the cost of materials, OR Time, recovery time, and any other drugs, materials, tests or procedures performed on a patient administered with the intent to treat the underlying condition. By comparing outcomes to dollars, we can determine the value of different treatment options and massively reduce unnecessary tests, procedures, and overly expensive materials that do not affect quality of care. We have since expanded from spine into hips and knees, cardiovascular and neurological surgical procedures.
Medgadget: Can you provide examples of the “real-time data driven decisions to improve business profitability and the quality of patient care” in more specifics? What are these data, which decisions are being made, and how does that improve business or patient care?
Mr. Melby: To our knowledge, the way we capture the data has never been done before in order to obtain the highest level of granularity that is validated by the care team including the surgeon, immediately after the case, not hours or even days later. Our platform provides full transparency across a united platform that link each steward of medicine in the care delivery chain that help to ensure that patients are not given unnecessary materials or levels of care.
Based on our data, we have seen physicians make meaningful changes not only to the products they use, but even the fundamental approach they use when treating specific patients due to data that shows them alternative care paths with either lower cost, superior outcomes, or possibly both.
For example, a group of orthopedic surgeons had never discussed their various approaches to treating a condition together. In looking at a specific operation, there was a massive range of cost on anchors. (Anchors are used to attach soft tissue to bone). This was due to both the number of anchors used, and the material type. On the bottom end, anchors made of metal can cost under $100, while bio-composite anchors that dissolve over time can cost more than $500. Additionally, some surgeons like using as few as two anchors, and some as many as six.
The cost differential between someone using two metal anchors and someone using six bio-composite anchors was nearly twenty-times in material cost alone, not to mention the extra operation time, anesthesia, and other costs linked to recovery. After comparing notes on outcomes, it was clear to this small group that there was no discernable benefit to the patient for twenty times the cost, and over time they began to gravitate towards a practice that was just as effective, but substantially lower in cost. Now our platform can effect behavioral change.
Medgadget: What is lacking in current surgical practice that makes this platform viable? What type of data do you have showing that adoption of this platform is likely in surgical management? Can you provide any data or charts for our readers?
Mr. Melby: While many hospitals are doing heroic things with their legacy systems, they are all aware that the level of information provided by the underlying systems that power their decision-making can be improved upon to achieve greater efficiencies. Surgeons and administration constantly have trouble seeing eye-to-eye on the data they are using to drive optimal care. Physicians see ORHUB as the answer to this issue, and for an audience frequently pushing back on their administration, this is the first-time surgeons as front-line decision makers are actively lobbying their facilities to adopt a value platform. In 2018 alone, we have seen an 87.65% adoption of all surgical cases conducted by our hospitals.
Medgadget: Thank you for your time. Is there anything else you want to share with our readership?
Mr. Melby: For all of us who work in healthcare, it is ingrained in our DNA to solve complex issues including healthcare spend which places a tremendous burden on patients, physicians, care teams, providers and policy makers. Through the use of real-time data and data analytics that push the boundaries of technology today, we can empower providers to make economic decisions without compromising quality of care or clinical outcomes. We are committed to advancing technology to drive optimal performance so that we can better serve our communities.
Link: ORHub homepage…