Using Telehealth AI Solutions to Improve Patient Outcomes

In 2015, a patient bled to death due to an accidental medication overdose just 8 weeks after being discharged from the hospital. That fatal incident would have been 100% preventable, if the patient had had access to a proper medication and disease management system in place. PharmD Live founder and CEO Dr. Cynthia Nwaubani created our telehealth solution to prevent similar incidents and to improve patients’ longevity and quality of life, specifically, older patients and those dealing with multiple chronic health issues along with the patient care teams who treat them. 

We know our solution is necessary and will produce the results we intend. Research shows that 75% of elderly patients take multiple medications prescribed by different doctors, leading to 50 million Adverse Drug Events yearly and 100,000 related deaths. 90% of our national healthcare cost is attributable to patients with chronic conditions, making this a large market ready to be addressed with our solution. We have multiple additional data points informing our product and sales market:

●        50 million Adverse Drug Events (ADEs) yearly, the 4th leading cause of deaths: 100,000 per year.

●        Patients on 7+ medications have an 82% risk of experiencing an ADE.

●        It costs patients and insurance companies $300 billion per year due to medication non-adherence.

●        Costs of chronic diseases are projected to exceed $4.8 trillion by 2023.

●        Costs of chronic conditions are 86% of the total healthcare expenses in the US.

●        Medicare has authorized $40B in Chronic Care Management funding to combat the problem, yet only 1.5% was used in 2021.

●        Time, training, and technology limit physician practices in providing this additional structured service.

 Our 24/7 clinical pharmacist-directed solution will prevent some of these deaths; the more health care teams we can enroll, the more Adverse Drug Events and deaths we can prevent. Time, training, and technology limit physician practices in providing this additional structured service – a gap we will fill.  

The time is right for the implementation of our solution because only a tiny fraction of the $40B in Medicare funds designated to pay for Chronic Care Medicine is being utilized, while rates of Adverse Drug Events continue to climb. With our scalable service, we can reach over 600,000 patients by our 5th year, save thousands of lives, and generate a potential $450 million in revenue.

Our solution utilizes evolving technology to create a network of highly skilled clinical pharmacists available 24/7, enabling patients to take charge of their own health. Our personalized and proactive care delivery model – unique in the telehealth industry – is designed to improve patient outcomes and drive clinical efficiency and value-based care quality. Our clinical pharmacists empower patient self-management; enhance coordinated care; and improve medication adherence through medication reconciliation and risk management, customized care planning, motivational counseling, and patient education, leading to lower healthcare costs. 

Our pharmacists reinforce the physician’s plan of care through increase of patients’ health literacy, motivational counseling, cultural and religious sensitivities, and other social determinants of health, leading to better patient outcomes and fewer adverse drug reactions and potentially providing a longer, better-quality life. This can also lead to fewer medical malpractice lawsuits, improving physicians’ financial situations and ability to treat patients. 

By using our solution, healthcare providers create multiple benefits for themselves and their patients: 

Benefits to patient care teams:

• Alleviates physician workload and burnout.
• Provides an additional revenue stream (direct and indirect).
• Access to pharmacist 24/7/365.
• Provides actionable clinical intelligence.
• Improves patient outcomes, satisfaction, and loyalty.

 Benefits to patients:

• Access to personal pharmacist 24/7/365.
• Decreased medication-related problems.
• Improved disease self-management.
• Reduced healthcare cost.
• Decreased hospitalizations, ER visits, and readmissions.
• Longer lives with better quality of life.

This 24/7 telehealth solution is powered by our HIPAA-compliant proprietary AI-Driven platform, which seamlessly integrates with most electronic health records to enable a bi-directional patient data flow in real-time. Our predictive analytics and side-effects profiling algorithms enable the identification and prevention of potential medication risks and gaps in chronic care and generate actionable business and clinical intelligence reports. Our technology allows us to partner with physicians and healthcare organizations in delivering collaborative telehealth solutions, including Advanced Chronic Care Management with medication risk management and Remote Patient Monitoring. Our long-term vision is to end Adverse Drug Events for all patients with the use of our adaptive technology and expert pharmacists. 

Our front-end and back-end technology includes: 

• Interoperability to share EHR data with physicians, hospitals, health systems, and accountable care organizations.
• API Integrations with First Databank, Concord Fax, and Zoom.
• Cloud Based Software as a Service leveraging Microsoft Azure.
• Business Intelligence and Reporting via Microsoft PowerBI.
• RPM devices with 4G Cellular built in.  These cellular enabled devices provide an easier implementation for our patients versus the traditional Bluetooth. App patients receive cellular-enabled devices that work out-of-the-box, no app, pairing, WiFi or training required.  Senior-friendly, pre-configured RPM devices such as glucometer, scale, and scale are sent directly to the patient’s home, where data begins transmitting upon the first reading.

Our initial market is 8,000 clients to test our platform and make adjustments before moving to scale. Our total addressable market is 600,000 patients with multiple chronic health conditions taking multiple medications by 2025. Our innovative telehealth solution can be provided direct to the customer or other healthcare providers. Our solution serves both patients and their healthcare teams.  Many older patients have difficulty understanding how to take their medications and how they might interact with each other; our clinical pharmacists address these issues in real-time.  Many healthcare teams do not have the resources (human or financial) to provide the kind of in-depth monitoring and care that patients with multiple conditions need to stay safe and healthy. PharmD Live fills that gap and helps alleviate care team stress and burnout. 

We have additional service lines, such as transition care management, diabetes management, and pharmacogenomics. Our patent-pending custom software can effectively collect data and provide advanced predictive analytics to perform side-effects profiling, a service few medical providers can afford. The AI and machine learning identify high-risk patients, enable risk stratification, and recommend targeted interventions to deliver truly customized care, something no other product currently offers.  This increases our ability to keep patients safe and healthy.

We are building a team of disruptive thinkers comprised of pharmacists, innovators, scholars, and information experts driven by a shared commitment to compassionate care who are designing and implementing our solution. Our expertise and shared passion have allowed us to create a nimble, responsive product with the potential to save thousands of lives each year and generally improve the quality and length of life for all patients. Our pharmacists are uniquely qualified as medication experts, connecting patients and providers with actionable recommendations to improve patient health and reduce unnecessary hospitalizations. 

Our founder and CEO has seen firsthand how a lack of innovative healthcare such as PharmD Live has affected patients, leading to serious illness and even death.  She understands the challenges faced by patients with multiple chronic conditions in a way that few others do.  In merging personalized healthcare and her proprietary technology, her vision of eliminating preventable adverse drug events is tangible and already in progress as we test and start roll-out of our service. 

Our clinical pharmacists work directly with patients, gathering information on their individual needs and building out care plans that speak specifically to that patient.  As we gather patient and client feedback, we introduce iterative changes to the AI interface, constantly working to improve the product so that it best serves the needs of patients and healthcare professionals. PharmD Live is about those we serve, so we actively and constantly involve them in product development.

PharmD Live is poised to make rapid progress in the Chronic Care Management market.  We are looking for additional financial support and warm introductions to potential investors and clients.

Our top three priorities are: 

1. Access to MCIL resources; Warm introductions to capital and financial services.

2. Warm introductions to expand Sales Pipeline.

3. Mentorship opportunities to review our company’s current operations, content, and processes.

Our biggest obstacle to growth has been a sales pipeline with a heavy focus on a long sales cycle as we focused on hospitals, accountable care organizations, health systems, and payers. We now have a 1099 approach to our sales team that is based on shorter sales cycles focused on physicians and physician group practices. However, we would still appreciate insight on how we might be able to build out a more robust sales pipeline.

We built this product for older patients and those dealing with multiple chronic health issues along with the patient care teams who treat them. Our solution utilizes evolving technology to place a network of highly skilled pharmacists at the disposal of clients, enabling them to take charge of their own health. Our competitors do not have the technological solution PharmD Live offers, nor do they draw on the knowledge of pharmacists to prevent adverse drug events. Instead, they rely on nurses or physician’s assistants who may make mistakes that lead directly to adverse drug events, potentially fatal ones.

Our more personalized and proactive care delivery model is designed to improve patient outcomes and drive clinical efficiency and value-based profitability. Our clinical pharmacists empower patient self-management, enhance coordinated care, improve medication adherence through medication reconciliation and risk management, motivational counseling, and patient education, leading to lower healthcare costs – a positive impact across the US economy.

Our pharmacists reinforce the physician’s plan of care through patients’ health literacy, motivational counseling, cultural and religious sensitivities, and other social determinants of health, leading to better patient outcomes and fewer adverse drug reactions. This can also lead to fewer medical malpractice lawsuits, improving physicians’ financial situations.

PharmD Live’s patent-pending custom software can effectively collect data and provide advanced predictive analytics to perform side-effects profiling, a service most medical providers cannot afford. The AI and machine learning identify high-risk patients, enable risk stratification, and recommend targeted interventions to deliver truly customized care, something no other product currently offers.  This use of real-time data is critical for improving patients’ care, outcomes, and longevity.

Impact goals:

2022: 8000 patients served

2023: 86,000 patients served

2024: 227,000 patients served

2025: 407,000 patients served

2026: 600,000 patients served

We will achieve our impact goals by working all angles to find and secure partnerships with healthcare providers, insurance companies, and other interested parties.  As we enroll more clients, we will be able to serve more patients, exponentially increasing our reach and ability to save patient lives and improve patient health outcomes.

Because our goal is simple, we are measuring this with numbers of patients enrolled.  We will also begin collecting and analyzing patient data to inform deeper, longer-term goals around decreased ER visits and improved patient outcomes.  We are still in process of determining what these goals should look like and how we can effectively measure them.

PharmD Live Theory of Change Model: 

The Problem in Context

Social Problem You Seek to Address: 

A lack of patient understanding about drugs and drug interaction (low health literacy combined with lack of access to a singular clinical pharmacy team).

The Context of the Problem:

• Assumptions (necessary conditions for change, or the underlying conditions or resources that need to exist for our planned change to occur):
  • Access to a clinical pharmacy team will help reduce adverse drug interactions
  • Access to technology that helps patients connect as needed to a full patient care team will help reduce adverse drug events
  • Healthcare teams and their teams will be interested in utilizing our telehealth solution.
  • Healthcare teams will be willing to pay for our telehealth solution.
• Other Players (what other players can help achieve our desired outcomes?):
• External Factors & Forces (factors that influence change along our major pathways and forces that affect whether one result can lead to the next):
  • Funding to support additional project development
  • Fruitful partnerships with NPOs providing healthcare and telehealth to our target population
  • Healthcare providers that are willing and able to pay for our services
  • Insurance companies that will reimburse healthcare providers for our services (similar to Medicare/Medicaid)
• Causality & Attribution (can change be attributed to our work alone or are outcomes the result of other attributing factors as well?):

• Clinical pharmacists
• Healthcare teams
• Insurance companies
• Federal government (HHS in particular)
• Dedicated field representatives

Change can be partly attributed to our work, but we must also rely on networks of medical professionals and other partners to ensure that our services are available and that we have the funding to continue to develop, refine, and improve our product.

Factors Known or Assumed to be Fueling or Complicating the Problem:

• Funding challenges – our founder/CEO is having trouble completing our SAM registration and won’t allow anyone to help her; this limits the funding we can apply for to those organizations with a specific interest in telehealth/medicine and using telehealth/medicine to improve health equity in this way.
• Finding experienced staff (clinical pharmacists, software developers, field representatives) who are willing to stick with us during a start-up period with very low salaries.
• Healthcare teams who are reluctant to try something so new, created by a new organization.
• Potential partners who are likewise reluctant.
• A patient clientele of older people with multiple chronic conditions and low health literacy; it can be hard for them to understand the technology we use and the medical challenges they face even with the help of a dedicated clinical pharmacist.

Factors Known or Assumed to be Levers for Change or Impact:

Our transformative healthcare solution – IF it is gotten into patients’ hands!

STAGE 2: Solutions & Outcomes

Proposed Strategy to Achieve Progress Against This Challenge:

We have begun implementing 1099 payments for our clinical pharmacists and field representatives, which allows us to offer a larger wage at an earlier date.  This also encourages these staff to stick with us as we grow.

We are actively pursuing partnerships with rural healthcare clinics that will enable us to apply for more types of funding.  We are also actively pursuing partnerships with universities that have medical programs. We have solid data that our solution does have the desired impact on this problem from our pilot launch; we’re now working to build out the staffing and funding that will enable broader reach.

Envisioned Results Stemming from the Successful Implementation of the Program or Intervention:

• Patients experience fewer adverse drug interactions and also understand their medications and conditions better.
• Patients are more confident speaking with their healthcare teams.
• Patients are more compliant in taking their medications.
• Healthcare teams experience less burnout.
• Healthcare teams encounter fewer medical malpractice claims. 

Long-Term:

• Patients live longer, healthier lives.
• Patients have lower healthcare costs.
• Healthcare teams stay intact or there is less staff turnover.
• National healthcare costs drop.
• National insurance costs drop. 

Size and Characteristics of the Population or Community Envisioned to Benefit from This Program/Intervention:

600,000 patients with multiple chronic illnesses enrolled by the end of our 5-year ramp-up period. Innumerable beyond that time as our footprint grows.

PharmD Live’s 24/7 telehealth solutions are powered by our HIPAA-compliant proprietary AI-Driven platform, which seamlessly integrates with most Electronic Health Records to enable a bi-directional patient data flow in real-time. Our predictive analytics and side-effects profiling algorithms enable the identification and prevention of potential medication risks and gaps in chronic care and generate actionable business and clinical intelligence reports. Our technology allows us to partner with physicians and healthcare organizations in delivering collaborative telehealth solutions, including Advanced Chronic Care Management (CCM) with medication risk management and Remote Patient Monitoring (RPM). Our long-term vision is to end all Adverse Drug Events for all patients with the use of our adaptive technology and expert pharmacists.

Our leadership team includes people of color, women, and members of the LGBTQ community.  With our leadership’s lived experiences informing hiring decisions, we have built and continue to build a team with a focus on DEI.  We periodically have the staff respond to surveys about what we should be doing and prioritizing and then act on those suggestions, creating an inclusive culture where all team members know they are valued and supported. 

We have a Glassdoor Rating Goal of 3.5; our current Rating over the last six months has been 4.2.  In addition, we have an Employee Tenure Goal of more than 1 year; over the last six months, our employee tenure is averaging 1.5 years, which is good in a start-up environment.

Our business model is a B2B. We target physician practices, hospitals, Accountable Care Organizations, and the Payers. Our customers might switch from their current solution of do-it-yourself, or they might have not been able to successfully implement chronic care management on their own due to limited resources, a lack of preparation to transition from fee for service to value based care, or lack of awareness of the availability for reimbursement for the program. PharmD Live solves all these issues, making us an easy choice as a partner. 

We utilize traditional in-person selling with a growing team of experienced Sales Directors. We also have a marketing team to provide the following:

•      Digital Marketing: Programmatic Advertising/SEO/SEM, Social Media & Email

•      Communications: Public Relations & Thought Leadership, Speaking Engagements & Educational Events, Webinars

We are using a combination of all funding streams.  Our team includes an experienced Director of Grants, who works to find sources of grant funding that for-profits are eligible to apply for along with finding appropriate accelerators and applying to those.  Our leadership and sales teams work to find both capital investors and clients for our product.

We have completed our Seed Round of $1M in investment funding and have signed 4 contracts to date, with others in progress.  We will be launching our next round of investment funding early this summer.