Harvard hospital Brigham is using Medumo to text patients about poop

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• Large hospitals are starting to embrace technology in their
  operations. 
• Adam Landman, CIO of Brigham Health, which is affiliated with
  Harvard, spoke about the health system’s work with early-stage
  startups. 
• One of the most successful projects they’ve had is
  a texting-based colonoscopy prep guide
  developed by early-stage company Medumo.

Preparing for a colonoscopy isn’t pleasant.

In a colonoscopy, a doctor uses a scope to take a look at the
inside of the colon, often to check for growths that could
indicate cancer. So that the doctor can get a good look, you have
to start eating a low fiber diet several days before the
procedure, and then transition to a clear liquid diet the day
before and take lots of laxatives —a regimen known as bowel prep.

Sometimes, though, patients don’t follow the instructions, and
the doctor can’t get a good look, leading to wasted time and
money. Or they don’t show up to their appointments at all.

The Harvard-affiliated hospitals called Brigham Health and
Massachusetts General Hospital have been experimenting with a
startup that says it can help solve both problems. And the

initial results exceeded expectations.  

“Both saw decreases in no show
rates of over 30%. That’s a very significant ROI right then and
there,” said Adam Landman, the chief information officer of
Brigham Health.

The startup is called Medumo,
and the experiment is part of a
strategic collaboration between PULSE@MassChallenge and
the Brigham
Innovation Hub, which the health system started in 2013 with
the mission of testing new ideas in clinical settings. Brigham
Health has tested out some early stage pilots and studies to see
what parts of new technology does and doesn’t work.

The innovation hub also serves as a connection point between
clinicians, researchers, entrepreneurs, and venture
capitalists. 

“What we’re trying to do is
create a learning environment. We want to work with startups that
have great ideas and great people. Because we don’t have all the
answers either,” Landman said at the Financial Times Digital
Health Summit in New York.

From doing this, Landman said
they hope to find 5 or 6 different programs that can be
implemented. Moving forward, different elements from the
different programs may be patched together into one seamless
experience for the patient.

“I think right now we’re in the
fertile field of innovation where lots of solutions are popping
up, and pretty soon, I think we’re going to see some
consolidations, particularly focusing on the patient experience
side, where we’re seeing incredible solutions coming up,” Landman
said. 

Here’s how the Medumo system
works. It sends appointment reminders to patients as text
messages, and gives them information on the bowel prep regimen.
That can be pretty detailed. It tells them what their stools
should look like, color and consistency-wise, and provides daily
reminders and a list of tasks.

It also provides patients with a
phone number they can call to reach the endoscopy clinic for help
if their stools don’t look like what the texts say they should
look like after trying a few things suggested by the
program.

On the morning of the procedure,
the app sends directions from the patient’s front door to the
exact endoscopy clinic inside the hospital. After the procedure,
the app sends a patients a survey about their experience. When
the results are available, the app can tell patients how to view
it in the patient portal, or send a sign-up link.

The program has made a big
difference for colonoscopy patients, according to the health
system. The proportion of patients whose insides weren’t prepared
for the procedure dropped from
11.5% to 3.8%, while the number who didn’t show up for their
appointments fell to about 4% from 6%.

“We have some very encouraging
results and we’ve started to spread to other procedural areas and
other use cases,” said Landman.

By keeping the form
of delivery to something as simple as texting, Landman said
they’ve been able to observe good results and high
engagement.

“Over time, as our population ages, I think this will be second
nature to many. And I think there’s services and opportunities to
think about, as digital becomes more important, such as how do
you support that in the home,” said Landman.

A possible solution, he mentions, is to have a ‘Genius Bar‘ at the
hospital, like the one created by the Ochsner Clinic in Louisiana
to help patients and families troubleshoot technology
problems. 

One of the challenges for health
systems is choosing between competing priorities, said
Landman. That includes making a decision between building a
billion-dollar patient tower with inpatient rooms, or investing
money in digital technologies, telehealth and virtual
health.

And that’s the crux of some of the key discussions coming up in
the health system, according to Landman.

“It’s a very difficult decision, but I think we are going to be
disrupted by Amazon and Apple and many of the companies here in
this room if we don’t change,” he said.