START-UP NATION: Software developer Cara Health: Software that detects the likelihood of a patient needing readmittance to hospital by the phrases they use has healthy prospects
BREAKING INTO the American market is the dream ticket for any healthcare company and one Trinity College Campus start-up is doing just that by using artificial intelligence to transform patient assessment.
Cara Health has turned the head of pharmaceutical giant Janssen, which named it as one of three finalists in its $250,000 Connected Care Challenge. Following that coup, a Chicago-based accelerator for health start-ups Healthbox, named Cara as the only non-US company to take part in its programme to bring the best innovators into the American market. That relationship is bearing fruit with the University of Chicago Hospital installing the technology and interest developing across the US.
Founder Enda Madden, a computational linguist and Trinity graduate, said: “Having access to Healthbox was a huge boost for us. They were able to give us access to market and bring the company to the next step. These are exciting times but we have a long way to go still.”
This is Madden’s second start-up project, having enjoyed success with GroupNos, a company that uses internet and mobile technology to bring patients and doctors together.
His latest venture monitors phone calls to people who have recently been released from hospital. Combining his skills as a computational linguist and the expertise of Trinity’s Dr Carmel Martin, Madden has developed a system that monitors the phrases they use. By cross-referencing those with a phrase database used by thousands of other patients and their health outcomes, the software is able to detect the likelihood that a person needs to be readmitted to hospital.
“It goes like this,” said Enda. “We use non-clinical staff to make a phone call to patients a couple of times a week after they have been discharged. It’s just a friendly phone call and the staff member does not need to be a highly qualified medical professional as our software does all the work by monitoring in the background. As a most basic example, a key phrase that often comes up is, ‘I’m not feeling myself today’. Our software will recognise that phrase and it knows the health outcomes of thousands of other patients who have said the same thing. So that can be a strong indicator of how likely it is that this person needs to return to hospital.”
It sounds incredibly simple but peer-reviewed clinical trials in Ireland have shown that Cara’s system reduces 30-day readmissions by 51 per cent, simply by weeding out those people who don’t need to go back to hospital. So it’s a bonus for the patient who avoids unnecessary stints on a ward, and the hospital gains by reducing costly admissions.
In the US this is a multi-billion dollar industry. The latest figures from the New England Journal of Medicine show that state healthcare provider Medicare paid out $17.4 billion in one year on patients who had been readmitted to hospital within 30 days of being discharged. The Institute of Medicine has estimated that avoidable admissions cost about $48 billion in the US every year.
For Cara, the timing couldn’t be better. Under new legislation enacted by the Obama administration, hospitals that fail to reduce the number of patients readmitted within 30 days of being discharged face substantial fines.
As part of the overhaul of the expensive and failing US healthcare system, Medicare no longer pays for the full cost of 30-day readmissions, leaving hospitals with a potentially crippling bill.
The Cara system is capable of making a huge impact but Madden is looking to enhance its effectiveness. Trials are assessing variations in tone of voice, intonation and breathing patterns that will further point to whether a person is suffering a relapse and needs further hospital treatment.
Madden said: “Breathing patterns, particularly for patients with certain lung conditions, could be a valuable indicator. Our technology can pick up changes in breathing over the phone that it is not possible for a person to register. These are subtle changes from one day to the next that the system will flag.”
Madden has opened up a round of seed funding in a bid to raise $1.2 million. Janssen has already invested $50,000 (€38,000) through the Connected Care Challenge and should Cara take the top award at a ceremony today, it will invest a further $100,000. Other contributions have brought the fund to about one-third of what is needed.
For Dr Carmel Murphy, who has been instrumental in developing the software, the system has the added bonus of ensuring that patients get timely treatment when appropriate. “My passion for addressing the problem of avoidable hospitalisations came from many years of clinical practice working in urgent care where I repeatedly had to admit patients on nights and weekends whose illness could have been averted during the working week.”
