Editor’s note: This is the beginning of a multi-part series profiling the evolution and success of WiserCare, one of two winners of the inaugural HX360 Innovation Challenge competition, which recognized the best-in-class digital health companies demonstrating improved patient experience in hospital and health system settings.
On April 14th, 2015, at the HX360 Inaugural Event, WiserCare, a healthcare decision support solution, won access to $75,000 in prize money and legal services to fund new pilot programs at U.S. not-for-profit health systems using the company's products and services. Sharing the top spot was Ginger.io, the leading digital mental health program (click here to read about their journey to the HX360 Innovation Challenge). Both companies will be paired with providers to operate their pilots at healthcare systems.
WiserCare won after ascending through an original field of 83 entries.
HX360 recently caught up with David Cerino of WiserCare to learn about their evolution from brilliant idea to boosting helping patients make the best health decisions possible.
What is WiserCare?
WiserCare is an online, interactive experience that helps patients and their physicians make smarter, more confident treatment decisions in less time. Our tool ingests the latest and highest quality evidence and relevant patient clinical data, then takes the patient through a thought-provoking exercise that clarifies their goals and preferences for treatment. It analyzes this information in order to provide individualized guidance as to what treatment choices fit the patient best.
How does the information get used?
It is shared with both physician and patient in the mode of delivery and level of depth that makes the most sense for each. Doctors and patients use this information to prepare for the treatment consult, and our results show they both feel the consult is much more meaningful and their time is better spent. We also know they make higher quality decisions. We’ve achieved statistically significant improvements in decision quality with our health system partners.
How did WiserCare identify the problem of lack of partnership between patients and their health care providers?
Our co-founder, Chris Saigal, was a urology resident when he noticed how patients and their families seemed to struggle in making treatment decisions. They were overwhelmed with the number of choices and the amount of information available, and their research left them confused and stressed out, unable to decide.
Because of this, many patients didn’t assert themselves in the treatment consult, and instead would default to what the physician said was best, without expressing their own goals and preferences for treatment – which may have influenced the provider’s recommendation and their ultimate decision.
With their preferences unexpressed, they remained in perpetual doubt about the decision at hand.
So how did that inability to advocate spur this tool?
Chris felt passionately that patients needed agency in making some of the most important decisions in their lives, and that in order to have that agency, they needed:
Access to high quality, understandable and unbiased evidence on the risks, benefits and side effects associated with their options;
Assistance in clarifying and expressing their goals and preferences for treatment; and
A vehicle for expressing these preferences that their physicians would trust, and that would help them spend the time in the treatment consult more productively and meaningfully.
At the same time Chris was observing his patients’ struggle to decide, he encountered the field of decision science while in public health school. He felt sure there was a way to apply this to treatment decision-making, and devoted his academic research to the pursuit of this application.
When/how did the vision of what WiserCare could be become a concrete reality?
Chris is a principle investigator at Rand Health, and a NIH grant-funded researcher, and has since spent decades delving into medical decision making, testing different approaches to supporting patient decision making. Through this, he developed a decision analysis model that would combine evidence, patient clinical information and patient goals and preferences to help guide decisions. That model – and the approach it takes – is now patented for use in healthcare. So the research, the model and patent that resulted were critical pieces in our progression.
In addition, patients themselves had to become comfortable interacting and sharing information on line in the way WiserCare asks. That’s something that’s only occurred recently, as patients have become more comfortable using computers and the internet to help them make decisions. This occurred first in banking and other industries, and healthcare is just now catching up. That shift in people’s mindsets helped created the right environment for WiserCare to thrive.
And then?
A few years back, Chris teamed up with another entrepreneur in the technology and information services space, to seed and launch the company. Once they got the product created, up and running, they hired me to take the ball and run with it.
What’s special about WiserCare relative to its competitors?
Well, Chris felt strongly that for his approach to work, WiserCare had to solve for the challenges that other approaches in this space – a space known in healthcare as shared decision making, or SDM – have presented, as well as the challenges for the consulting physician.
Other approaches in SDM, while well-intentioned and validated, have proven expensive and time consuming to deliver at scale. So we worked hard to find a way to address the time constraints, scalability and workflow issues that mark the practice of medicine these days and prevent important transformation and from taking place.
Did those other approaches help or hurt as you went to market?
The interest in SDM has taken off in recent years, in part because of the two most important changes facing healthcare at large:
The rise in consumerism: Patients wanting to get more involved in their health and healthcare, and providers and health systems responding to that desire with more effort and resources spent on engaging these patients.
The shift from volume to value: With health systems increasingly taking on risk for population health, and payers and policy makers emphasizing value-based payment models, the industry at large is looking at new, patient-led ways to address costs. Research has shown that when patients engage in their decisions and understand the risks, benefits and side effects associated with their treatment choices, they tend to choose less intensive, less costly options that they might otherwise have chosen.
Next up: what happened after the pitch and the win.
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