When Milwaukee-based Aurora Health Care announced plans invest $5 million in local startups over the next five years through its new InvestMKE fund, Aurora president and CEO Nick Turkal said the new fund will help the organization “deliver high-quality, cost-effective healthcare, ultimately helping people live well here at home.”
What Turkal’s comments accompanying last week’s InvestMKE announcement didn’t convey was that Aurora has in recent years been quietly investing in several healthtech startups, including some based in the Milwaukee area. The hospital and clinic network has provided more than just cash to the companies it has invested in; Aurora has also worked with them to develop, install, and test their products at sites within Aurora’s network, which it says comprises 15 hospitals and more than 150 clinics in Wisconsin and Illinois.
Aurora is also a partner of StartUp Health, a New York-based organization that helps connect its members—mostly small but growing healthcare technology companies—with larger, more established players in the industry. Unity Stoakes, co-founder and president of StartUp Health, calls Aurora “one of the most progressive health systems in the country.”
“Many hospitals are going out of business, or they’re focused on [mergers and acquisitions] and cutting costs,” Stoakes says. Through its use of, and support for, innovative technologies, Aurora is “setting themselves up to better serve their 1.2 million patients, and really lead the way,” he says.
One startup Aurora works with is Babyscripts, which develops virtual care software for pregnant women, as well as the obstetricians and other healthcare workers who care for them. The Washington, D.C.-based company’s mobile app and other digital services allow healthcare providers to assign weekly tasks, and provide educational materials and additional monitoring to their pregnant patients, says senior VP of sales Kerry Waltrip. Aurora is a Babyscripts customer, and has also invested in the startup.
An expectant mother visits the doctor an average of 14 times during a typical low-risk pregnancy, says Sarah Nicholson, VP of business development at Babyscripts. Some customers have used the company’s tools to decrease the volume of prenatal visits among women in this category, which can have a broader effect of making care more convenient and precise, she says.
For example, Nicholson says Babyscripts has worked with some of its 13 health system clients to provide pregnant patients with Internet-connected blood pressure cuffs that can be used at home. The startup’s mobile app sends them reminders to take their blood pressure throughout their pregnancy. These measurements are automatically uploaded to the Babyscripts app, and are visible to both patients and obstetrics teams at their health systems, she says.
“If anything was [beyond] clinical thresholds for healthy blood pressure, we would alert that patient’s physician as soon as possible, as it could be a detection of elevated risk,” and occasion for an in-person visit, Nicholson says.
In mid-2015, Babyscripts and Aurora began having conversations about implementing the startup’s software at one or more Aurora locations. The two sides later signed a contract, under which Babyscripts agreed to install its tools for managing low-risk pregnancies at Aurora West Allis Medical Center, Nicholson says. The project was a success, she says, and led Aurora to ask the startup if its software might be able to help improve outcomes in a different population of female patients.
“Aurora said to us, ‘Hey, we also have this clinic in Milwaukee [with] a high Medicaid population,’” Nicholson says, referring to Aurora Sinai Women’s Health Center in Milwaukee. “The pregnancies that were going through that clinic had very low compliance to care. They were coming in about three times during a pregnancy. [Aurora] wanted to figure out if there’s a way to use technology to increase the number of touch points for those patients, and get them into the clinic more frequently.” The thinking was that more contact between the two sides could lead to detecting issues earlier and ultimately, healthier births among patients in this particular population.
Nicholson says that from November 2016 to May 2017, Babyscripts and Aurora conducted a pilot program at Aurora Sinai Women’s Health Center aimed at getting a group of pregnant patients to attend more of their scheduled prenatal appointments, and supplement those visits with interactions through the startup’s app.
Babyscripts worked with physicians, nurses, social workers, and other Aurora employees to help them identify program participants who required care beyond what health systems typically provide during a low-risk pregnancy, Nicholson says. She says patients enrolled in the program came in for more than seven prenatal visits on average, and Aurora also saw a 60 percent decrease in the no-show rate for those prenatal appointments at Aurora Sinai Women’s Health Center. Between in-person visits and interactions over text message or the startup’s app, participants had an average of four touch points per week with their care teams, according to Babyscripts.
“There was definitely some improvement in the care and compliance for the women who were [in] Babyscripts’s program,” Nicholson says, adding that her company and Aurora plan to launch a second phase of the program at the same site in early 2018.
Aurora Sinai Medical Center is also where the health system began implementing technology developed by EmOpti, a startup based in the Milwaukee suburb of Brookfield, in 2015. The company’s tools are aimed at making emergency room wait times and hospital stays shorter by allowing patients to consult with physicians in a remote “command center” using hospital-provided tablet computers and other devices, says Jack Berkery, EmOpti’s VP of sales and marketing.
EmOpti’s approach is to replace the traditional arrival process in the emergency room, where patients meet with a triage nurse in or near the lobby to assess their condition, with a remote “provider-in-triage” model. Having a doctor examine patients just after they arrive could in theory save time because physicians can prescribe medications, order tests, and perform other actions most triage nurses cannot. And by stationing triage physicians offsite, they’re able to assess patients across multiple hospitals.
Berkery says since EmOpti and Aurora began working together two years ago, the health system has put in the startup’s technology at two more of its Wisconsin hospitals, in West Allis and Kenosha.
Paul Coogan, president of emergency services at Aurora, says his organization plans to expand EmOpti’s Aurora footprint by introducing its tools at two to three new hospitals per year. To date, doctors have performed about 50,000 remote consults for Aurora hospitals, he says. On average, a patient’s stay in one of the three emergency rooms is 45 minutes shorter than it was before they began using EmOpti’s technology.
The goal is to shift the provider-in-triage approach from being an experimental model at some hospitals to becoming the “standard of care” across health systems’ entire networks, Berkery says. Since 2015, Aurora has “made the EmOpti technology a part of the standard care process, which has enabled Aurora to sustain the initial improvements in key emergency room quality metrics, including decreases in door-to-provider times, decreases in the number of patients that leave the emergency room prior to being treated, and decreases in the overall time patients spend in the emergency room,” he says.
Rodgers says co-developing products and services alongside startups is where he believes Aurora can add the most value. He says the health system has had positive experiences working with “early-stage companies [that] have an idea or have started to build a prototype for a solution, and they really need feedback directly from a physician, caregiver, or even patients.”
Aurora is also working with at least one local startup that isn’t focused specifically on healthcare, Rodgers says. The health system has recently started using software developed by Milwaukee-based Ideawake, which makes tools allowing employees at medium- to large-sized organizations to suggest and receive feedback on ideas for new products and initiatives. Aurora uses Ideawake’s software to facilitate “crowdsourcing ideas from caregivers on solutions to problems and challenges,” Rodgers says.
Numerous other U.S. health systems, including Cedars-Sinai Medical Center and Johns Hopkins Hospital have in recent years introduced or expanded programming for healthtech startups. While Aurora lacks the stature of those two organizations, it has nevertheless demonstrated that it believes providing early-stage companies with capital and access to its healthcare professionals can be beneficial for all parties involved. And now, with its new $5 million InvestMKE fund, Aurora appears to be even better positioned to help move healthcare innovations forward.