Download Dr. Ashok Subramanian has created a way for patients to

Delaware Cancer Consortium
Quality Cancer Care Committee
APPROVED – Minutes
January 20, 2015
Delaware Technical Community College, Terry Campus - Dover, DE
10:00 AM – 11:30 AM
Attendees
Members
Did Not Attend
Attended
Attended
Did Not
Attended
Attend
Attended
Attended
Did Not Attend
Attended
Did Not Attend
Did Not Attend
(was
at ED&P)
Attended
Did Not Attend
Attended
Attended
Christopher Frantz, MD, A.I. DuPont Hospital for Children
Nicholas Petrelli, MD, Helen F. Graham Cancer Center
Kathleen Burt, Nanticoke Hospital
James Monihan, MD, Allied Diagnostic Pathology Consultants, PA
Edward Sobel, DO , Quality Insights of Delaware
Sean Hebbel, The Wellness Community – Delaware
Michelle Sobczyk, Leukemia/Lymphoma Society
Anna Maloney, Delaware 2-1-1
Judith Ramirez, Beebe Hospital - Tunnell Cancer Center
Donna Stinson, Bayhealth Medical Center
Janet Teixeira, Cancer Care Connection
Laura Simonelli, Helen F. Graham Cancer Center
Allison Gil, American Cancer Society
Cathy Scott-Holloway, Delaware Breast Cancer Coalition
Staff & Committee Liaisons
Attended
Katie Hughes, Division of Public Health – Comprehensive Cancer Control Program
Ciera Lints, Division of Public Health - Comprehensive Cancer Control Program
Attended
Staff
I. Call to Order: Review/Approve Minutes
Dr. Christopher Frantz was unable to attend the meeting so in his absence Dr. Nicholas Petrelli convened the Delaware
Cancer Consortium Quality Cancer Care Committee at 10:00 A.M. The committee reviewed and approved the minutes
from the November 17, 2014 meeting with no changes.
Dr. Petrelli announced he will have Dr. Scott Siegel present his perspective on Transition of Care at the March
committee meeting.
Dr. Petrelli reminded the committee of the Delaware Cancer Consortium Retreat on April 14 th and mentioned the topics
of discussion will be Transition of Care following a Lung Screening Update in the afternoon.
II. Animedix Inc. Presentation by Dr. Ashok Subramanian
Dr. Petrelli introduced Dr. Ashok Subramanian, President of Animedix Inc who gave the committee a presentation on
how his software works.
Dr. Subramanian stated that Animedix Inc. has been working on a model for about 15 years that leverages the
communication abilities of technology. Animedix Inc. has been able to translate complicated information whether it is
scientific, clinical or regulatory issues to the people who need to know. Communications are core for collaboration for any
type of success especially success with clinical outcomes and improved compliance. Dr. Subramanian said in the past 2
or 3 years Animedix Inc. has been working on a Coordinated Care/Transitional Care model that leverages technologies
they have developed with ideas they have seen working in the marketplace and they feel they have a novel approach to
issues that everyone is having in healthcare and they feel they can help with their software.
Dr. Subramanian provided background information on what drove him to develop Animedix Inc. Dr. Subramanian said he
has a background as an Emergency Room physician which he still practices today. Following his residency, Dr.
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Subramanian did a fellowship in molecular medicine. He was very interested in basic science, and at the time 20 years
ago molecular medicine was integrating with digital medicine and computers and the output and the amount of data that
came through was immense and he had to decide if he was going to have a career focusing on 1 molecule and 1
disease or sit back and watch the amazing things that were happening in science and technology. Dr. Subramanian
decided to be a spectator because he felt he had the ability to appreciate what was going on at a technical level and be
able to communicate that to the people that were engaged in the clinical level and more importantly be able to
communicate that information to those engaged with diseases and illnesses, or patients. While in fellowship, Dr.
Subramanian said he developed an interest for animation, and felt animation was a way to communicate complex
information to people. Dr. Subramanian stated that animations are worth millions of words that you can get across major
ideas to someone very quickly. He also added that if you pair animation with contextual information you can efficiently
communicate your ideas to physicians, scientists, patients or family members.
Dr. Subramanian said patient education is a big component of Animedix Inc.’s work. The company has created
animations for cancer, cardiovascular disease, and trainings for physicians to learn novel medicines. He reported that
Animedix, Inc. has also done animation education for pharmaceutical companies as they developed new drugs, and
trained investigators. Dr. Subramanian said that they use a platform called Lattice that allows them to take the content
they or others have created and simulate it into contextually relevant presentations that can then be delivered to precise
audiences securely which allows the presentations to be tracked to see if they are using the information, how much they
are using it, and also there is a survey engine that allows feedback from the recipient which can determine how well the
information was understood based on how the survey is answered.
As a clinician, Dr. Subramanian said he is aware of many communication issues that clinicians deal with on a daily basis.
With that knowledge and his background of IT, he felt there had to be an easier way to accomplish what is expected of a
clinician and fix the communication issue. Dr. Subramanian stated that he learned of a company that has begun to thrive
due to Meaningful Use Regulations and transitions to Electronic Medical Record called Scribe America. Scribe American
trains individuals to be Medical Scribes.
Medical Scribes are trained individuals who have been educated on medical terminology and coding who can take the
burden of the documentation largely away from the clinician so the clinician can focus on patient care. The use of
medical scribes also saves money as scribes are paid significantly less than a clinician. The documentation and coding
improves because that is the Scribes primary function. The Scribe is directly supervised by a physician or practitioner.
Dr. Subramanian pointed out that this allows the physician to spend more time with their patients and even increase their
patient volume. Scribes can also focus on learning various electronic medical record systems which prevents the
physician from having to devote time to learn and perfect a new system. Scribes can also assist physicians with
patients.
Dr. Subramanian stated that once trained Scribes can get patients drinks or blankets and take down any questions the
patient or family members of the patient may have for the practitioner. Scribes can assist patients with giving them more
education on what they are being seen for and ensure the patient takes their satisfaction survey which also allows for the
physician to address any issues with the patient that left them unsatisfied before they leave. Dr. Subramanian has also
developed a concept that’s called a Patient Champion which is a trained Medical Scribe whose job it is to take
responsibility under direct supervision of parallel workflows or a “checks and balances” workflow system.
Patient Champions are responsible for post discharge follow up such as contacting the patient and ensuring they carry
out what was asked on their follow up plan such as following up with their Primary Care Physician, coming back to the
Emergency Room if necessary, address side effects with the physician from medications if the patient is having them or
even assisting with scheduling an appointment for the patient. The Patient Champion completes these follow up
assessments through the parallel workflow system which is very scripted and algorithmic. The parallel workflow system
allows Patient Champions to easily take over where the other has left off during shift exchanges. Patient Champions are
also cross-trained as Scribes and are familiar with entering information into the Electronic Medical Record which gets
approved by the physician since the physician is ultimately accountable for the information entered into the system. A
Patient Champion can be considered as an extension to a Care Coordinator or Nurse Navigator without needing the
knowledge of a Care Coordinator or Nurse Navigator. Scribe America is the largest provider of Scribes in the country,
working in 43 different States in hundreds of hospitals with over 6,000 employees. Due to how much Scribe America has
emerged educational opportunities at colleges may become available in the future however at this time Scribe America
employs and trains all of their employees and contracts them out through hospitals.
Dr. Ashok Subramanian has created a way for patients to take a survey that uses animations and allows the patient to
see a picture of all of the practitioners that saw them with a description of their job title and a survey to rate the physician
and ensure their accommodations where met.
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Dr. Subramanian believes that humans need to be responsible for communication between each other, not technology.
He said you can use whatever technology you want to use but without people you just have a bunch of information in
several different places. When there is a network of people that know how to use systems and databases and are able to
pull information out of those systems then they need to communicate it. The problem is clinicians do not have enough
time to filter through DHIN or other databases. With a network of Patient Champions this information can be pulled,
centralized and communicated and Patient Champions are employed to have the time to be responsible for pulling this
together. Dr. Subramanian’s vision is to have a network of Patient Champions, or a Patient Champion team, whose
responsibility it is to pull this information and communicate it hospital to hospital provider to provider.
Dr. Nicholas Petrelli asked if Dr. Ashok Subramanian had these workflow systems in a software package. Dr.
Subramanian responded with No, it’s not in a software package but it is all web based system with people using the
technology already available and connecting it to Scribe Plus.
Ms. Janet Teixeira asked if this program would need to be funded and piloted. Dr. Ashok Subramanian answered yes; it
will be about $40,000 to pilot this program.
Dr, Sobel asked who else can see the patient information? Could he link all other providers that are caring for each
specific patient? Dr. Subramanian responded that they can link in the provider even if they do not use the software since
that specific provider will be linked as caring for the patient.
Dr. Petrelli asked to note that the pilot will be $40,000 and this may be something that is taken in front of the Advisory
Council.
Dr. Nicolas Petrelli adjourned the Quality Cancer Care meeting at 11:30 am.
.
III. Public Comment
No members of the public attended the meeting.
IV. Future Meetings 2015
The Delaware Cancer Consortium Retreat will be held at the Dover Downs Hotel and Casino on April 14, 2015.
Delaware Cancer Consortium meetings for 2015 will be held at Delaware Technical and Community College’s Terry
Campus from 10:00 a.m. - 11:30 a.m. Below is the list of meeting dates for 2015. If you have any questions or concerns
please contact Ms. Katie Hughes at [email protected] or Ms. Ciera Lints at [email protected].
Delaware Cancer Consortium Quality Cancer Care Committee 2015 Future Meetings
March 23
April 14: Delaware Cancer Consortium Retreat
May 11
July 20
September 28
November 16