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Turning ideas for apps into real-world solutions

By Dianne Daniel

You may think you’ve invented the next great, transformative healthcare app. And maybe you have. But when it comes time to move your idea beyond your test group so the entire hospital, community, province or country can benefit, what then? Do you have the foundation and resources to navigate your way through the complexities of security, privacy and interoperability that follow?

As easy as it is to build mobile health products and services, scaling them is an entirely different story says Raymond Shih, co-founder and president of Toronto-based QoC Health.

“Every week you see or hear about a pilot app being tested at a hospital and there’s always the promise that if it’s validated, and people use it across the healthcare system, it’s going to save money,” says Shih. “But very rarely do you see that article a year later that says everybody’s using it.”

One of the first healthcare-related companies to join the growing global community of Certified B Corporations, sustainable companies in business for the greater social good, QoC Health is on a mission to change that scenario. Founded in 2010, the fast-growing company is bridging the gap between innovation and scalable products for a diverse group of healthcare clients.

Leveraging a highly skilled in-house team of healthcare experts, IT professionals and entrepreneurs, QoC Health has developed a cloud-based platform it says provides all of the functionality required to rapidly prototype mobile healthcare solutions. It also provides the underlying infrastructure to scale those solutions across multiple stakeholder groups and jurisdictions, all for the purpose of supporting others.

As Shih explains, the company isn’t in the business of coming up with game-changing ideas. Rather, its job is to ensure those ideas don’t end up on a shelf, collecting dust.

“We don’t want to be a healthcare company that’s just making money,” he says. “We really want to be a company that tries to improve the overall quality of care in the system.”

Obtaining B Corp certification is one way to demonstrate that commitment. B Corp companies are routinely evaluated on many levels to ensure they meet rigorous standards of social and environmental performance, accountability and transparency. One of the core principles is that a B Corp is “purpose-driven and creates benefit for all stakeholders, not just shareholders.”

Collectively, B Corporations are leading a growing global movement of “people using business as a force for good.” Individually, each one aspires to use its business power to solve social and environmental problems.

QoC Health’s self-declared B Corp mission is to re-imagine the patient care experience by shifting care to the community, reducing healthcare costs and improving access to care. Its cloud-based platform-as-a-service and infrastructure-as-a-service offerings do that by helping to create and grow electronic circles of care, applying the company’s technology to securely connect patients, providers and other community support services in a way that fosters stronger collaboration and ultimately improves patient outcomes.

Healthcare apps spring to life in a variety of places. It might be a researcher in a lab, a physician in a clinical setting or a service provider in the community who comes up with the notion; no matter where the idea originates, the creators eventually reach a point where their idea is proven in a small test group or pilot project and it’s time to roll out to a wider population.

That’s when the complexities of privacy management, interfacing to legacy systems, seamlessly integrating with an electronic medical record (EMR) or adhering to strict regulations can prove challenging.

“There’s a temptation to go it alone and that typically doesn’t end well,” says Shih, noting that each jurisdiction has its own set of requirements.

That’s where QoC Health steps in, partnering with innovators to expand their ideas by adding the foundational layer beneath. “We provide all of the components out of the box so that healthcare providers are spending their time, effort and resources on improving their tool, doing rapid iterations and testing rather than spending a year building something that’s already been built,” he explains.

Some of the core components provided by QoC Health’s Cloud Connected Platform include profile management, multi-directional collaboration, HIPAA/PHIPA compliance, analytics and business intelligence, and turnkey EMR integration.

Each building block is white labelled, meaning how a customer applies the technology will be unique to their solution. The underlying infrastructure required to scale, supported by secure data centres in Canada, the U.S. and U.K., is already in place and managed by QoC Health.

By leveraging that foundation, customers are free to focus on what their app might look like and who it might connect, says QoC Health co-founder Sarah Sharpe, who is responsible for Healthcare Analytics and Quality Improvement and works hands-on with clients to evolve their ideas. “What we try to do in any discovery process is to imagine the ideal scenario because it actually may be possible,” says Sharpe.

For most clients, the starting point involves conceptualizing a circle of care: Who needs to be connected to who and what do they need to do? From there, QoC Health helps to establish a framework for moving forward, including objectives, timeline and cost. Several development methodologies are used, from experience-based co-design to research-based design.

“We can look at any scenario and say, ‘Here’s where you need help. Here are the points where you’re strong. Here’s where we can step in and actually help you through the journey of actually developing an app, making sure it’s evaluated and sustainable,’” explains Sharpe.

Sometimes the electronic circle of care is already well established and the mobile app is proven. All that’s required from QoC Health is the expertise to grow.

Robyn Henderson, founder and CEO of The Uncomplicated Family, a progressive organization based in Alberta, approached QoC Health in the fall of 2015. Her company’s revolutionary technology called Teleroo, developed in 2011, is a collaboration tool designed to create efficiencies in the way essential services are managed and delivered to children with complex needs.

“Our goal is to un-complicate things so that people can enjoy the best quality of life,” says Henderson, who at the time, was looking for a technology partner to help scale the product.

The idea for Teleroo was born from Henderson’s desire to make a difference in the lives of families. The mobile app is permission based and designed to be used by anyone in a child’s circle of care, including parents, speech/language pathologists, occupational therapists, physical therapists, behavioural consultants, physicians or teachers. One of the most engaging features is a video library that enables users to capture and securely store behaviours or events on a mobile device as they occur in a child’s natural environment. The company has written a ground-breaking algorithm to blur everyone else out of the frame so that the videos can be shared without compromising privacy.

For example, one family used Teleroo to film a peculiarity in their child’s gait. After waiting six months to see a specialist, when the appointment finally came, the doctor was unable to assess the child due to behavioural issues. Using Teleroo, the parents shared the video that had been captured and the doctor was able to provide treatment.

“The whole point is to build local capacity,” says Henderson. “If a speech/language pathologist has an excellent idea for how to work with a particular child – or even across children – it can be shared with all practitioners, for example.”

Kids with autism make up 80 percent of Teleroo’s current user base in Alberta. The company has successfully demonstrated improved efficiencies in its local community and is now widening its reach to span across Canada and the U.S. Earlier this year, it received an education grant from the Ohio Department of Education to roll out a cloud-based version of Teleroo to benefit hundreds of thousands of school children in the Ohio area. QoC Health is playing an instrumental role in making sure the technology will scale as needed.

“We had been vetting different platforms to help us achieve that goal and they were just a beautiful fit for us,” says Henderson, noting that the two companies are well aligned. “We’re not just building cool technology. It needs to be built based on what kids and families need.”

The Uncomplicated Family is an example of how a private sector company is benefitting from QoC Health’s scalable platform and white-label approach to building mobile solutions. Innovations from the public sector also stand to benefit.

One example is the Women’s Mental Health Program at Toronto’s Women’s College Hospital, where psychiatrist Dr. Simone Vigod has launched an important decision aid for women faced with deciding whether or not to use anti-depressants during pregnancy. Roughly one in 10 pregnant women will suffer from depression. While there can be a negative impact when the illness is left untreated, since it often leads to drinking, smoking or general disregard for personal care, there are also theoretical risks to the baby when medication is prescribed.

“That really leaves women in a Catch-22 and some of our earlier work had shown that even when these women come from specialized clinical care, they still don’t know what to do about this situation,” says Dr. Vigod.

As lead for the hospital’s Reproductive Life Stages Program, Dr. Vigod decided to create a patient decision aid to assist women in making the best decision for their own set of circumstances. Prior to reaching out to QoC Health, she performed a comprehensive needs assessment to first validate that pregnant women facing the choice of whether or not to take antidepressants do indeed have very high levels of decisional conflict, and second, to better understand the barriers to making an informed decision.

Dr. Vigod could have gone the route of developing a paper-based decision aid, but in today’s connected world, an electronic solution made more sense. Once her research was complete, she partnered with QoC to start development.

She says QoC Health was able to work within the boundaries of strict International Patient Decision Aids Standards and offered impressive ideas to help grow the product. “In a lot of ways, they gave us a leg up because by the time we applied for funding, we had a prototype,” says Dr. Vigod. “We couldn’t have done it on our own. We provided the content, the patient steering committee to go over the various iterations; they were the ones who provided the frame for doing that.”

The resulting decision aid is accessible by phone, tablet or PC, and accessed via a secure login.

Users peruse information about why or why not to take antidepressants, what other treatment options are available, and an overview of the risks associated with treatment versus non-treatment. As they read each benefit or risk, they assign it a ranking. In the end, they are presented with a summary that reviews everything they read, how they valued it and what pieces they feel they’re struggling with.

“The idea is they go back to their doctor and sit, having done this, and make a more timely and effective decision,” says Dr. Vigod. “Because it’s one of those situations where as a physician, I can’t say for sure that it will be better if you take antidepressants than if you don’t.”

Dr. Vigod’s patient decision aid is currently being piloted by a group of 50 women. It has also gained the attention of the National Health Service in the U.K. and QoC Health is helping to scale a version that is applicable to women there as well.

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