App linking doctors with chronically ill suddenly has bigger universe

By , Daily Memphian Updated: April 07, 2020 10:06 AM CT | Published: April 06, 2020 4:00 AM CT

In January, entrepreneur John Harrison started testing Gazuntite, an app to connect Medicare patients with chronic heart failure to their doctor’s office daily.

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“We are trying to get them do what the doctor wants them to do, like take their medicine every day and weigh themselves,” Harrison said. “You have to alert them, remind them and then give them the means to do it.”

Gazuntite does all that, and considerably more, including sharing medical records from specialists.

Three weeks ago, fewer than 20 patients at the Rentrop Geater clinic on South Lauderdale, where the app is being piloted, fit the profile of a moderately tech-savvy user with underlying heart conditions.

Then stay-in-place measures went into effect. Suddenly, 14,000-15,000 patients in the practice could be safer seeing their doctors through the Gazuntite app, with video capability, than being in the office.

“The app was really designed to work for congestive heart failure, when a sudden change in body weight can be an early sign they are getting worse,” said Dr. Barbara Geater, longtime partner in the South Memphis practice, which until COVID-19, was still making house calls.

“We starting thinking, could we just start enrolling every patient that needs a home visit or any of our patients who need routine diabetes follow-up or just need medication refilled,” she said.

Gazuntite uses interactive technologies, like record-sharing, voice, video and messaging, to allow patients to check in with their clinics from home. It also allows primary care doctors and specialists in different offices to share records and be paid for their work through a reimbursement function that sends coded records to Medicare.

“Corona highlights the need for remote patient management of the chronically ill more than ever,” Harrison said in a text message. “They are the most vulnerable and weakest to fight off the infection.”

People with underlying health conditions are particularly vulnerable to COVID-19.

<strong>Dr. Barbara Geater</strong>

Dr. Barbara Geater

The Centers for Disease Control looked at 7,000 cases where it had data on underlying health conditions. As March 31, 71% of those hospitalized with COVID had at least one underlying condition, which could be asthma or diabetes.

Among those who were in ICU, 78% had an underlying condition. Only 27% of people with at least one underlying condition did not require hospitalization.

Patients using Gazuntite will have their medications delivered to their homes in pre-dated sleeves, telling them what time to take the medication and to ping the app as soon as they do, to alert health workers monitoring their cases.

“Some of these patients are on 20-25 medications and used to carry them around in gallon bags,” Harrison said.

The problem is that often prescriptions don’t get renewed or refilled, he said.

“Sometimes an insurance company rejects it or if a doctor is required to do the prescriptions, sometimes it falls between the cracks,” Harrison said. “We have our pharmacist perform all the pre-authorizations. They are also synced so they refill on the exact same day each month.”

Devonda Harris has been participating in the trial for several months.

“It helps me a whole lot,” she said from her home in South Memphis. “They bring my medicine to my door once a month.”

Each package has a date. Each has three pills in it.

“I check my heart rate between 8 and 8:30 when I get up, record it and put it in the phone.”

She feels better, adding that she had been anxious because her doctor told her she may need a defibrillator.

“Now, I don’t because my heart has improved,” she said.

Harrison, a Memphian, is the former CEO of Ecutel, a Virginia tech company born of a gap he experienced working at the Pentagon during the Bosnian War.

“One of the problems we had is that every time one of our programs had to be unplugged from the ethernet, we lost connection,” he said. “We didn’t have the network bandwidth we have today.”

He helped design a mobile internet protocol that produced a seamless connection, a precursor to modern roaming capability, and later sold the company to the military.

His military intelligence experience taught him that when the needs of soldiers on the ground weren’t being passed to the command structure, “that leads to operating inefficiencies.”

“If we can have a tight interaction with the health care provider, it is a much richer environment,” he said.

Harrison is seeking seed investors for Gazuntite, which he intends to roll out by June.

Later this year, the plan is to test additional services, including mobile phlebotomists and home-delivered meals.

“We are a network that connects people. We wouldn’t make the food, but we would give the patients menus.”

Their orders will go to food companies that provide “prescription-type food,” nutritious food that acts as another layer of medicine for chronically ill people.

The food service, he says, would be contracted to companies interested in developing in the space.

“The main purpose of this (pilot) study is to learn about user obstacles,” said Dr. David Wright, who runs Premier Prevention in East Memphis, a direct-pay clinic to help people avoid heart attacks, diabetes and strokes.

He is not an investor, but is a member of Harrison’s team.

“We want to learn how easy this is for the provider to use so we can iterate and have a bigger beta test,” he said.

Under the model the group is testing, an LPN, RN or nurse practitioner “would be the go-between,” filtering through the daily data to determine who needs to be seen, Wright said.

Doctors, he said, know it’s possible to avoid most second trips to the hospital for heart failure. 

“They don’t have a tool to monitor. The remote-patient monitoring is what has been missing.”

On top of using the app to serve patients who need routine checks in their homes, Geater and her business manager are now talking about using the app for people who have difficulty getting to appointments.

“We have a high no-show rate at our clinic,” Geater said. “If we could say, ‘Get yourself here at least twice a year to get blood work done,' the rest of the year, we’ll make them virtual visits.”

Medicare, through new remote patient management initiatives, pays providers a onetime fee to connect patients to telemedicine, which means their phones and tablets.

“It will be a gradual process to onboard patients,” Geater said. “We probably have 60-80 patients scheduled to be seen on any day.”

When Geater first started working with Harrison, most of her patients didn’t have smartphones.

“Now, most do. Once you get them on the app, it’s easy for us to reach them,” she said, which solves another problem. 

“Many of our clients don’t give us a good phone number because they don’t want collection services calling them.”

Geater loves practicing in South Memphis, where the clinic has operated since 1947, and is aware of the implicit bias against her clients and the pain it causes them.

“It’s a little more challenging in South Memphis. If it works with my patients, it will work in the broader group even better.”

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John Harrison Rentrop Geater Dr. David Wright Premier Prevention Gazuntite
Jane Roberts

Jane Roberts

Longtime journalist Jane Roberts is a Minnesotan by birth and a Memphian by choice. She's lived and reported in the city more than two decades. She covers healthcare and higher education for The Daily Memphian.


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