Orbita Demonstrates Power of Conversational Platform at the Bedside


Bill Russell / Nick White / Nathan Treloar

Nathan Treloar and Nick White Orbita This Week in Health IT

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I caught up with Orbita President and COO Nathan Treloar and Nick White the EVP of patient care solutions to discuss their new point solution which leverages a powerful platform for conversational technologies.  Have a listen and I hope you enjoy.


Bill Russell: 00:04 Welcome to This Week in Health IT events where we amplify great ideas with interviews from the floor. My name is bill Russell, recovering healthcare CIO and creator of this week in health It a set of podcasts and videos dedicated to developing the next generation of health leaders. We want to thank our founding channel sponsors who make this content possible. Health Lyrics and VMware. If you want to be a part of our mission to develop health leaders, go to the homepage this week, health.com and click on the sponsorship information. This week we’re at the health conference in Las Vegas and during the conference I received a bunch of interview requests and I decided to highlight the solutions that I’m personally excited about and I thought would benefit my clients and listeners of this show, uh, within the health it community specifically, I was looking at solutions that address clinician burnout, um, mass efficiency through automation, mental health, voice solutions among others.

Bill Russell: 00:55 Uh, one of the things I’m always advising my clients about is the need to find platforms. There’s a reason that the average healthcare system has 400 plus distinct applications. Point solutions are great for a season, but if they don’t leverage platforms, eventually you’ll be looking to replace them down the road with something that could handle more use cases. Happens all the time. A voice and chatbots are emerging. And it is one of the areas that we have seen a ton of point solutions. And I’ve been looking for a platform and I found one in Orbita. I spoke with, Kristi Ebong at the health 2.0 conference a few episodes back, uh, where she educated me on the space. And today I caught up with the president and COO, Nathan Trelour, and Nick white, the EVP of patient care solutions to discuss their new point solution, which leverages a powerful platform for conversational technologies. Have a listen and I hope you enjoy.

Bill Russell: 01:50 All right. Another interview from the, uh, health 2019 conference here in Las Vegas. Actually, we’re, we’re on the, uh, showroom floor in a booth and I’m here with one of the companies I’m really excited about on, uh, with conversational technologies. Orbita the, uh, uh, CEO or your president, president and CEO. Let me see. Oh, there you go. Nathan Trelour and Nick White. what’s your title?

Nick White: 02:17 ABP, of patient care solutions.

Bill Russell: 02:20 Phenomenal. So, and that’s what we’re going to talk about today. We’re going to talk about at recent announcement. In fact, there’s the, uh, what you’re showing off here Orbita, which I think is really exciting, but before we get there, uh, we had, we had Christie on the show a little while ago and she educated me on conversational technologies and I was one of those people that probably creates the problem in healthcare. I was a CIO and I would stare and go, okay, we’re going to do chatbots. And, Oh, okay, now we’re going to do a voice thing, then we’re going to do, and I would create that problem where you have 10 different things, but you guys have a platform because can you fill us in on sort of the Genesis for it and where it’s at?

Nathan Trelour: 02:56 Yeah, sure. Um, recently we got into this, we recognize

Nathan Trelour: 03:00 that, um, with the rise of things like Amazon Alexa and similar technologies who are entering into a third wave of digital experiences in healthcare, where if you characterize this the first wave, the web portal second wave being in health, this idea of a virtual health assistant and conversation agent that can be an alternative to traditional UIs, engaging patients, engaging clinicians in, in and around care plans. Uh, where we looked at ’em was, um, there are plenty of ways to develop point solutions that do this, but what was needed just like in those first two waves, is a platform that allows you to do this as scale and repeatability with security interoperability. So that’s how we approached the marketing. So we wanted to develop a platform that would support doing this, uh, with the operational sensibilities that large organizations require.

Bill Russell: 03:51 Yeah. So it’s interesting. So this is, um, so you actually have point solutions and you have the platform. When health systems look at you, I mean, are you selling a platform or are you selling point solutions? Because I would imagine it’s hard as a CIO, unless I see it, platforms are hard to sort of envision.

Nathan Trelour: 04:07 It is a platform. Selling is a, it’s an art form. It really is. And uh, you know, we’re fortunate that, uh, the team that we built at Orbita comes from a background enterprise platform, uh, developing sales. So it wasn’t completely strange to us, but healthcare, they want to see, they want to see the proof of the solution that that platform can enable. Whether it’s a clinical outcome improvements or a clinical efficiency, they want data and that requires an actual solution. You want to see something that targets a particular problem. Once you’ve solved that, then the opportunities can you rinse and repeat that across other conditions or other scenarios. So, um, as we went to market, we, we realized we need to be really selling that solution, which means build with taking our platform, building additional capabilities on it, either ourselves or in support of a partner or the client themselves. So often we become white labeled technology that’s inside the solution that somebody else bill. But like anything, the further away you are from that value, you know, the less that you can actually capture that and repeat it. So we’ve been very intentional, particularly in the last year of identifying the highest value solutions and moving up the stack in our technology so that we’re adding as much value towards the end solution.

Bill Russell: 05:23 So with, with Kristi on the show, we talked a lot about the platform and how, you know, it’s essentially, you know, you create the workflows, create the, the interactions and that’s how a platform works. But today we’re gonna talk, uh, so we’re going to talk about Orbita assist, which is a point solution that sits on top of the platform. So it gives you an idea of what this solution is about.

Nick White: 05:44 Sure. Uh, we’d be building it for about the last two years. Uh, a couple of, an event happened a couple of years ago with a colleague of mine. His father unfortunately passed away in hospital, um, after pressing the cobalt bell button and nobody was able to get to him at that point in time. He tried to get himself to the bathroom, uh, didn’t want to have an embarrassing accident and slipped and fell on the way and unfortunately never left the hospital, uh, passed away in hospital. From that, we started looking at what are some of the lightened failures that exist in traditional core bell technology and, and, and the things that can go wrong. And when we started looking at issues such as alarm fatigue, that’s really affecting the care teams, uh, the issues around patients not knowing whether anybody’s heard them and whether anybody’s coming and how long it will take.

Nick White: 06:30 And we started to think about, okay, what sort of technology could we introduce that would allow for, uh, nurses to get that contextual information about what a patient needs when they calling out for help? Uh, but also to give some sort of feedback that someone’s on their way and a kind of urgency that it’s being treated with a, it’s from there. We started looking at the technology platforms we could use. Uh, that’s one of the, uh, at the time we met the guys from Orbita, uh, and started thinking about how could we build this as a vertical solution, um, with an ecosystem play essentially underneath it and came up with the idea of putting a smart speaker into the patient’s room, allowing some of the speak their request. That request is then processed and passed through into a digital workflow and we’re able to put priorities on it.

Nick White: 07:14 We’re able to route it to the most appropriate individual to respond. Uh, and we’re able to do automatic escalation if somebody’s not able to respond. So it can actually step through a couple of tiers of escalation.

Bill Russell: 07:24 That’s fantastic. So two years in the making, I imagine, cause it’s maybe one of the first ones that we’ve done connections automatically will go a little,

Nick White: 07:32 well we had it, we had actually built says an MVP within three months. Um, from that point we was about refining the solution and getting it Oh yeah. Yeah. So, so getting your recognition levels up to an acceptable level to be able to put into a clinical environment was one of the key things we focused on. Um, in terms of thinking about the escalation models that works within work within a a care environment, uh, and just working with the, the care teams, the, the nurses themselves to actually understand what’s the user interface that works for them.

Nick White: 08:04 How do we build this in a way that is minimally disruptive for them in terms of the way they work? So that adoption is just really easy.

Bill Russell: 08:11 So you’re gonna have different patients, different backgrounds, different, uh, ethnicities, forced dialects and those kinds of things. Yeah. I mean, does your platform pick that up or is it the voice assistant, this smart speaker that’s like figuring that out?

Nathan Trelour: 08:25 Um, the easy answer is that there’s a very complex utterance model that we built behind the scenes. And the more mature we make that utterance model, the better. We’re able to deal with a variety of, of people who are using the solution. So one of the things that we’ve been doing as we’ve had this live now for 18 months is we’ve been looking at how can we tune the model to actually get better recognition across our broader representatives that have individuals.

Nathan Trelour: 08:48 But one of the first questions I get is when can we go multi-lingual? Um, and the most exciting thing, somebody at the moment is that we’re working on that right now. Uh, and that’s going to be an amazing capability as we bring it to market this bottle.

Bill Russell: 09:01 So it’s been live for 18 months. Yep. What kind of impact has it had?

Nick White: 09:05 It’s really interesting. The impact comes in different ways and, and for me, the easiest way to frame it is quadrupling. So thinking about what’s the patient experience impact we’re having for somebody who’s isolated in a healthcare environment after some sort of serious trauma that’s happened to them, the ability to reconnect with the world around them, to reconnect and have control over the environment that we have. And then also to, um, be able to reach out to the kids and when they need them, that that’s had an amazing effect on patient experience.

Nick White: 09:35 But also we’ve seen this times in terms of response times come down. And so the nurses up here foster when they make a request, uh, not only that we’ve had the patients expressed that they feel less guilty about asking for something small, like a blanket or a pillow because they know that the nurse can pick it up on the way through and just drop it off when they’re going to do something else. So they feel like they’re less of a burden on the care team. From the care teams point of view. The really interesting thing is they’ve reported that they know what the patient needs before they walk in the room and that’s equipping them to deliver care much better than they’ve been able to do before. And that’s been fantastic from a, uh, outcome point of view, we’re really focused on quality and safety. So hospital acquired complications such as folds or precious souls.

Nick White: 10:18 How can we build a, the solution, the linguistic model that we use, the way it’s all triaged to actually try and combat falls, precious sores and other types of hospital acquired complications, which obviously if we can do it leads to a more efficient system in terms of costs.

Bill Russell: 10:34 So measuring satisfaction. I’ll go to the nurse, I want to go to the patient first. So, yup. Um, how would you measure that? Is it NPS or is it,

Nick White: 10:45 you know, we, we, there’s a couple of ways to do it. We did use NPS when we did our surveys. Uh, but we also use another question, which was if you’re in a hospital, would you want this in your room next time you’re in hospital? And 100% of the patients said they would want it in their room. Next time they’re at a house, 100%. It’s pretty good.

Nick White: 10:59 100%. It was pretty good at that. in one patient, the net promoter score, just the straight net promoter score. From that survey, we’ve got a 92% score, which is also phenomenal. Yeah. So that, that, that, those numbers, most way we then talk to the nurses, as you said, go to the nurses. We asked the nurses, did they feel that it enabled them to deliver better care to their patients? And 87% of them reported that they felt it did.

Bill Russell: 11:23 because it fits into their workflow. Right. They’re not adjusting. Yeah. Yeah. So it reduces the ambient noise on the, on the unit flow because, you know, having the bell go off as much that it’s a loading people. It’s a, it’s a smartphone in your pocket that’s making a noise directly for you as the care for that patient. And so the ambient noise levels come down, you know, that when your devices alerting you, you need to respond. So it’s a one to one linkage in terms of alert to response as opposed to some of the other alerts that go off that don’t actually a conditions response to the causing some of the problems with alarm fatigue.

Nathan Trelour: 11:57 Yeah. Nick mentioned the, um, hospital acquired conditions like, um, bedsores, but also in fall reduction. I think you also mentioned some initial data coming out about reducing, uh, likelihood of falls because patient unable to report that they’re in pain and getting assistance. Um, the use of restroom, the toilet people get up and try to walk into the example he gave up the top. So, you know, for some hospitals, I know one hospital in the Boston area has told me that it’s a $17,000 per fall on having set of costs to the hospital. So any impact they get, you know, 100,000 a year. We really needing the, reducing that bottom line.

Bill Russell: 12:38 And we were looking at some really interesting, but it’s odd technologies to reduce falls, you know, like pressure sensitive beds and they’re just a whole camera’s in the room, which I just, uh, and, and as we started talking about, I’m like and, equipping the whole hospital with that kind of thing is kind of cumbersome but necessary to reduce the,

Nathan Trelour: 13:01 yeah. And this doesn’t preclude any of that. Right? It’s a, I would call it a certain supplemental. Right. In the sense that you’re empowering the patient to be more communicative. Right. Empowering the nurses to have more context in how they respond to the patient’s needs,

Nick White: 13:15 but the ability to give them a simple instruction. So if you, if somebody says, I want to, you know, tell the nurse I want to go for a walk. Just replying to them in a way that says, please wait, the nurse is on their way. Just that, that little instruction. Okay, cool. No worries. I’ll sit here on the bed and the nurse will be, it will be soon. So it gives them that level of confidence. Somebody’s coming, somebody heard what they want to do, they know what they want, that they want to get up for a walk and the nurse is on their way. So it just, it just, what we’ve seen is that enables the patients the more comfortable, I’ll just give it a couple of moments and then when the nurse is here, I’ll get up. Um, we did have a hospital report back on falls reduction.

Nick White: 13:52 We had to look at the data. Uh, the, this would hold true for every hospital system, but, uh, they’re reporting a 34% reduction in folds while we were, uh, doing their pilot. Uh, it’s a combination of the cultural change that happens, uh, with the care team as they started to look at the patient experience and, and why we were working and the ability to have a voice by system available to those patients so they can interact with. Um, we also did have situations where we had falls. We’ve had reported falls during, during the time we’d been live. A great example was a 14 second response time to a fall. Um, and uh, we actually had one on day one of going live in one of our, one of our hospitals. Uh, it was a 22nd response time on day one. Uh, so, so really just some amazing data coming out

Bill Russell: 14:40 central and it seems like a simple solution, but there’s pretty sophisticated technology in the background because all they see is the smart speaker they’re talking to. Yeah. So talk about, so platform point solutions, what can we expect to see next? Where, where will you be gone?

Nathan Trelour: 14:58 Well, I’ll take a first cut. Um, the, uh, that, you know, we, we care a lot about the information that’s coming through these kinds of applications from the patients. So what the patient says to communicate their needs, I need to use the toilet. I need my bed adjusted, I’m in pain. That information captured in audio form is typically converted into text like Nick was described, is prioritize using AI to recognize, all right, how do we score this for the nurse to respond? There’s more information if you have the actual audio itself, right? So, um, there are techniques called vocal biomarker at those where you can analyze what’s in their voice and that technology’s advanced considerably just in the last few years. Um, it’s not intellectual property that Orbita has. But through our platform we have the ability to call out to services that can analyze vocal patterns for different types of signals. Like, is this person depressed? Is this person showing indications of a stroke or some other condition that needs, um, escalation escalated response. So the data really matters, not just terms of the upfront resp[onse, but also what can we learn from that data to be predicted and ahead of conditions that go way beyond avoiding fall risks and things like that. Yeah,

Nick White: 16:22 we already talked about multi-lingual capability. That’s obviously something that’s very topical. Um, it’s one of the most requested features that we have had. And so it’s great to see the, the technology platforms that we, that we use coming along that journey. And that’s a key part of that. Um, in terms of just thinking about the future of our hospital room and what technology is going to be in there. Um, one of the things that Orbita assist really provides is a common alarming platform for the care team. Uh, there’s a number of reports out there that talk about alarms in a clinical setting and one of them says that as much as 85 to 99% of the alarms that go off don’t actually require a clinicians response. What we’re trying to do is get a little bit of control of that and provide the care team with a predictable and a reliable means of getting an alert about something that they need to respond to. Knowing that that requires them to take an action so that we can combat that alarm fatigue issue that exists within the environment. So, so really a lot that we’ll be doing is thinking about the future technology enabled room, not just necessarily in a hospital setting but also potentially in other settings. And how do we provide an alarming platform in the loading platform for care teams that really helps them to optimize the way they deliver care.

Bill Russell: 17:36 It’s interesting there’s a balance point solutions and platforms cause there’s part of me that’s sitting back and gone, yeah I’d like to see this in sort of an any paitent place kind of scenario. But if I’m a startup I couldn’t use your platform. I mean that’s what you will white label it. And I just essentially, Hey, I’ve just created this new thing, very sophisticated technology in the background and there’s this whole, I just have to focus on this percentage of it and you’re taking care of all this other stuff. So when you become multi-lingual, you become multi-lingual.

Nathan Trelour: 18:06 That’s right. You push that concept, that capability down the platform. So as a platform provider, the one of the most effective ways to innovate is to be close to a couple of high value solutions that inform what you’re going to bring down into the platform. Multi-lingual support, local biomarker is that can be applied not just for the assistant use case, but for other use cases that either our OEM partners that are startups or very large population health companies and we have them as well. Um, wanting to take advantage that, so the, this kind of approach from you go to market point helps us innovate. It helps us focus on the highest value capabilities.

Bill Russell: 18:47 It’s exciting. Yeah. I’m looking forward to seeing what solutions, not only that you, you guys, couple of points, solutions that you bring out, but just, uh, now what health systems Might do with their stash is they sort of look at the problems and what, what the innovation community this, let’s hear my dear.

Nathan Trelour: 19:04 Yeah, we’re, we’re fortunate or, but I’d have some quite innovative partners that we’ve already been working with for quite some time. Like the Mayo clinic has been a long time partner. They’re exhibiting just around the corner and um, through that partnership we’ve, they’ve learned from us and we’ve learned from them. Uh, we want to keep those kinds of relationships strong. Continued in faith partnerships.

Bill Russell: 19:28 So sound is like a big thing to you. What’s that? Sound is a big thing to you. Yeah. I mean we were talking earlier about, you know, play the trombone Oh me oersonally Yeah. Play the play the accordion. Yup. Played all the, the big, the instruments. Banjo. I have a banjo, but I just loaned it out so I’m not gonna count that one. What other instuments do you play? You’re like a, you are a one man band. You’re like Dick van Dyke on the, you don’t want to see that. Um, I don’t have time to tell you all. That’s fantastic. Was his great, great getting to meet you. Great. Great solution. Looking forward to it. Thank you.

Bill Russell: 20:10 I hope you’ve enjoyed the conversation. If you’d like to recommend a guest or someone to be on the show, you can do that from our homepage. A recommended guesses about three quarters of the way down on the homepage. Please check that out. And don’t forget to please come back every Friday for more great interviews with influencers. And don’t forget every Tuesday we take a look at the news, which is impacting health it, the show is a production of this week in health it for more great content. You check out our website this week, health.com or the YouTube channel, which you can get to from our homepage as well. Uh, if you get a chance to take a look at our newly redesigned guest page, I think you’ll find it a fantastic, I love the way you can navigate through the content. Special. Thanks again to our sponsors, VMware and health lyrics for choosing to invest in developing the next generation of health leaders. Thanks for listening. That’s all for now.