Winners of Pilot Health Day 2014 and NYC Institutions Partner to Pilot Health Tech in the Big Apple

June marked Pilot Health Day 2014 -a program that provides $1M in funding to projects that pilot innovative health technologies in NYC, sponsored by Health 2.0 (http://www.health2con.com/), an organization that showcases and catalyzes health technology, and the NYC Economic Development Corp.

Held at the Alexandria Center for Life Sciences, over 200+ leaders in digital health, healthcare and venture convened to see live demos of this year’s winners. Eric Gertler, Executive VP of the NYCEDC and Managing Director for the Center for Economic Transformation opened the event. The goals of the PILOT Health program were to increase healthcare quality, fill the need of startups to meet with potential partners and to increase the number of jobs in the space. Indeed, Josh Stein, a winner of Pilot Health Day 2013, and CEO of medical adherence startup Adheretech, spoke of the need for emerging digital health companies to meet with hospitals and payors to present their technologies and garner data that investors and future clients would be interested in. Potential partners benefit by being able to adopt and validate technologies in a 4-9 month pilot study.

The process of Pilot Health and its culmination in demo day 2014 began months ahead. Interested parties attended information sessions as a first step. Then, potential host institutions and startups filled out applications indicating interest. A matchmaking session was held between startups and institution hosts. Last, a joint proposal between matched pairs was presented before 18 distinguished judges who represent all sub-sectors of healthcare and digital health. Health 2.0 CEO Indu Subaiya, explained that the proposals put forth had to address pressing healthcare needs and represent Health 2.0, which means (1) health tech that is adaptive and can integrate well (2) tech that has a strong user experience and (3) uses data to drive intelligent decision-making.

Benjamin Branham, Chief Strategy Officer at the NYCEDC spoke about NYC’s role as a major digital health and life science hub. NYC is second only to Boston in NIH funding and there are major initiatives under way to further strengthen the city’s position as a leader in science, healthcare and technology.

The 11 Winners of Pilot Health Day 2014:

1. Canopy Apps (http://www.canopyapps.com/)/ Visiting Nurse Services of New York (http://www.vnsny.org/) VNS will use the Canopy medical translator app to improve communication with non-English speaking patients during home nursing and physical therapy visits. Other goals include improved patient-provider satisfaction with communication and improved workflow efficiency.

2. Hindsait (http://www.hindsait.com/)/New York Blood Center (http://nybloodcenter.org/) The New York Blood center will used Hindsait’s artificial intelligence, natural language processing, machine learning and predictive analytics software to score blood donor’s probability of donating blood. A communications platform will use tailored messaging to reach potential donors. Goal is to increase the number of African American donors, who are at higher risk for sickle cell disease.

3. Urgent Software, LLC (#urgentsoftware)/Mount Sinai Health System (http://www.mountsinai.org/) Mount Sinai’s Cardiovascular Institute (CVI) will use Urgent Software to link local primary care physicians and their patients to cardiac specialists from CVI for referrals and follow-up care. Goal is to use the platform for better care coordination.

4. Nonnatech (http://nonnatech.com/)/Elderserve (http://elderservehealth.org/) Elderserve will use Nonnatech’s smart sensor technologies, which include monitoring medication adherence, toileting, fluid intake, sleep, and activities of daily living to prevent hospitalization. Goal is for early physiological detection and intervention to prevent hospitalization, increase staff resource allocation and efficiency and create cost savings.

5. Smart Vision Labs (http://smartvisionlabs.com/) /SUNY College of Optometry (http://www.sunyopt.edu/) SUNY College of Optometry will use Smart Vision Labs’ smartphone attachment to test patients’ vision by measuring refraction and generate a prescription for eyeglasses. Goal is to test Smart Vision Labs’ technology versus that of standard machinery. Smart Vision Labs was also a winner of a $1M Verizon Powerful Answers award for healthcare in 2014.

6. QoL Devices-Alv.io (http://alv.io/)/Children’s Hospital at Montefiore Medical Center (http://www.cham.org/) Children’s Hospital at Montefiore will use Alv.io’s mobile and gamified respiratory training technology to engage, monitor, and conduct performance analysis in the management of children suffering from asthma. Goal is to improve asthma care and reduce costs. Alv.io, nominated by NYC hardware accelerator R/GA, also won both Gold and Bronze awards at the Cannes Lions International Festival of Creativity 2014 (an honor shared only by 2 other companies from the U.S., Google and Nike).

7. Fit4D(http://fit4d.com/)/ HealthFirst (http://www.healthfirstny.org/) Healthfirst will use Fit4D’s certified diabetes educators and algorithmic technology to help Spanish-speaking populations manage their diabetes. Goal is to reduce healthcare costs via education, monitoring and prevention of diabetes-related complications.

8. Tactonic Technologies (http://tactonic.com/)/ Rusk Rehab Center at NYU Langone (http://rusk.med.nyu.edu/) Rusk Rehab Center will use Tactonic’s sensor technology to objectively measure mobility and gait in elderly patients prior to discharge. Goal is to provide an objective measure of patient readiness for safe discharge in comparison to the current standard of subjective measures and prevent re-hospitalization.

9. AllazoHealth (http://allazohealth.com/)/Accountable Care Coalition of Greater New York (http://www.accgreaterny.com/Default.aspx) Accountable Care Coalition of Greater New York will use Allazo’s predictive analytics technology to improve medical adherence in developmentally disabled populations by effectively anticipating the need for intervention and identifying the most cost-effective method. Goal is cost savings and evaluating impact of predictions and interventions.

10. Healthify (https://www.healthify.us/en)/VillageCare (http://www.vcny.org/) VillageCare’s case managers will use Healthify’s platform to connect patients with services that address social determinants of health inclusive of housing issues, food insecurity, etc and engage them with text messages. They will also be able to use the platform to review and rate community resources. Goal is address the social determinants of health via improved care coordination.

11. Gerijoy (http://www.gerijoy.com/)/ Pace University (http://www.pace.edu/lienhard/university-health-care) Pace University and Mount Sinai will evaluate the GeriJoy Companion, a virtual pet avatar that engages elderly patients while reporting data to remote caregivers, in pursuit of a reduction of hospital utilization for the Affordable Care Act’s top 3 preventable readmission risks: congestive heart failure, pneumonia and MI (heart attack). Goal is to reduce hospital resource utilization and re-admission. Gerijoy has been recognized by AARP, TEDMED, and the American Society of Aging as an innovative leader in senior care. Gerijoy is also a winner of a Verizon Foundation grant. Pace and Gerijoy were originally introduced at Pilot Health 2013 matchmaking day.

Pilot Health Day 2014 showcased innovative digital health companies working in partnership with NYC institutions to improve the quality and experience of healthcare. Trends amongst the pilot projects reflect aspects influenced by Affordable Care Act, but above all reflect areas of need within the healthcare ecosystem inclusive of better care coordination, cost control, improved efficiency, reductions in hospital (re-)admissions, improved medication adherence, addressing the social determinants of health and the needs of underserved populations, and the incorporation of sensor technology. They also are examples of technical solutions for large, real life, market -responsive problems and a collaboration between clinical innovators and technologists with applications to real world situations. Pilot Health, along with other sister initiatives from cross-industry innovators in the ecosystem, are proof positive that NYC is in the mix when it comes to creating and pioneering Health 2.0 and beyond.

New York Blood Center launches $50M Venture Fund and Translation Center

June 2014- At the latest Riverside Chat Speaker series held by NYC Tech Connect (a private-public partnership to foster entrepreneurship in the sciences), the New York Blood Center announced the launch of a $50 million venture fund and translation center.
     The event began with an introduction by Maria Gotsch, President and CEO of the Partnership Fund for NYC, an organization that invests in both for-profit and non-profit ventures in NYC, with a priority goal of enhancing the local economy and job creation. Greg Bonfiglio, Managing Partner of Proteus Regenerative Medicine gave an overview of the fund and its goals -the first of its kind in NYC.
     The venture fund will operate under the New York Blood Center, the largest nonprofit blood and blood product collection and distribution center in the U.S. and a major brain trust and research center, as well as the home of the National Cord Blood Program at the Howard P. Milstein Cord Blood Center.
     The fund will focus on second generation blood products, cord blood, blood disorders, and new blood-related technology and therapeutics.

How A Small Digital Health Startup Won a Statewide Contract (and the T-shirt Story ;) #NewYork #tech

I’ve written about design in medicine before (http://charlenengamwajasat.wordpress.com/2013/06/08/design-in-medicine-steam-power/) and my thoughts on the patient portal right before we handed in the rfp (http://charlenengamwajasat.wordpress.com/2013/06/05/my-thoughts-on-the-upcoming-nys-patient-portal/), so I thought it would be great to write about the process of its development -especially the funny T-shirt story. Entrepreneurship is hard, but when you are working towards something that really matters to you, and that can impact those around you -even those not yet born, it can be an incredible journey that is beyond worth it.
 
How a small digital health startup won a statewide contract… 

The Patient Portal for New Yorkers will be launching soon and I am proud, as a native New Yorker, woman in digital health, and a NYS-trained and licensed physician, to have been a part of it -especially the design process. Just a little less than a year ago, we were all nervously awaiting the results of the rfp process and here we are, excitedly awaiting the patient portal’s prime time debut.

It’s interesting, 90% of startups just don’t make it. So how does a small and relatively unknown startup without revenue or clients win a statewide contract over competitors with revenue, a board and clients? I think it has to do with a small group of people getting together at the right time, in the right place, and for the right reasons. It also has to do with the foresight of people who live and work in a pioneering state like New York.
I first met Christopher Bradley, the CEO of Mana Health, as a referral from a friend who had seen me at a number of technology events. Entrepreneurs, MD’s, students, MPH’s, MBA’s, PhD’s, etc., often come to me for clinical input, strategy/advice, or to learn more about the digital health landscape -especially in New York. At the time, Mana Health was set to be more of a clinical decision support (CDS) company and there was no portal or any bold-faced names. I even remember the first MVP of the CDS product, it was a tree diagram of some circles, lines and words and a bit of a built-out back end and that’s about it.
I decided to help because it’s part of the doctor in me to help people and I’ve been privy to how hard it is to run and be in a startup (Super, super tough!). I also saw the coming wave of mhealth, clinical decision support/data analytics (there’s no way one person can practice medicine AND read literally hundreds of millions of research articles a year, and sadly info in books can sometimes be 2-3 years behind) and tech’s ubiquitous integration into medicine. I had finished my Internal Medicine residency and gotten my license, and having always had an interest in technology, had been educating myself on what was happening in the field as well as its intersection with my own field. Also, over the past 10 years, I had always had ideas about how I thought technology could be integrated into the industry and in some ways improve access to information, workflow, and both patient and provider education. I also definitely had opinions in terms of what the interface and the experience of the tech could be (we spend so much time at work, so why didn’t the tech at work match the smartphone in my pocket?”). “No more spreadsheets!”, “Some consumer elements, please!” and “Mobile, mobile, mobile” were my battle cries.
We started to work on the CDS tool and then the opportunity for working on the Patient Portal For New Yorkers came up, run by the New York E-health collaborative (NYeC), which is composed of the major healthcare leaders across industries in NYS and who are doing amazing work when it comes to pioneering projects in digital health for the state. I thought this was a great pivot because it was the opportunity to build something for the people of New York that would help at both the individual and population level. Also, because it is a solution for a problem that has always been a hassle -getting your medical records from multiple providers from multiple institutions at any time (and not just M-F between the hours of 9 am to 5 pm vs on weekends or that midnight to 7 am emergency). In addition, personally for me, it was the opportunity to pay it back and pay it forward for a place that has given me an incredible education and an incredible life.
There were certain requirements that needed to be met to build out the portal but the competition to win the RFP was mostly about the design. I thought this was great, as a proponent of STE(A)M, and because design seemed to be missing from a lot of the technology used in the medical field. It was the opportunity to really make something that was nice-looking, friendly to use and that would be practical and useful for people. We had an amazing team of designers, Jin and Justin (I called them J^2 because they worked together in a way that was almost telepathic), who really made things come alive visually when it came to going from paper drawing/only-in-your-head-thus-far idea to physical product, and we had hard-working developers (one of which was Dmitriy, also a Mana Health co-founder) who really loved developing something that helped simplify aspects of a very intricate multi-player system. We also had med students who were part-time and mainly worked on the CDS, but who were super excited about the portal.
As for me, as in most startups, I wore many hats, but I’m proudest of my contributions related to overall design and design features. Many features of the design come from real life experiences, both clinical (inspired by specific patient encounters I’ve had) and non-clinical (the flip side of being a patient). Raise your hand if you can relate to any of the following: How many people are tired of endless drop down lists? How many people often forget some of the things their doctor said at the last visit? How many people have visited the emergency room or an urgent care center on a weekend or after 5 pm? How many people know all of the medications and procedures that their loved ones have had over the past 5 years? How many people speak English as a second language? How many people prefer universally understood pictures/symbols over words? How many people want to know who has access to and has been accessing their information? How many people want to make sure that their healthcare providers have the correct information about them and their loved ones?
In the entrepreneurial world, there are lots of words that overlap with medicine, such as viral, problem-solution format, and pain (which is now the fifth vital sign). It’s really important to address pain and pain points. That’s what we concentrated on. What irks people? What frustrates people and is a real inconvenience and hassle for them? It’s also really important to know who you are building for and understand and anticipate what their needs are. What was great as a New York-based team was that we were building for New Yorkers, as New Yorkers who live and work in the state, it was a product made for the people and by the people. Proudly, I was born here and every level of education and work experience for me has been in New York. I think it matters that the people who are building a utility have some connection to it. It makes it really personal and gets rid of technology being created in isolation from the people who will actually be using it -something that definitely irks me.
One of the really great things that NYeC included in the design competition was a public voting portion, besides also having both an Upstate and Downstate expert judging panel and public showing on demo day. All of the finalists uploaded videos that would show elements of what their design submissions would look like and the general public would have the opportunity to vote for their favorites. I saw demo day and online voting as great ways that non-techie and non-health people could get involved and I knew it would provide great feedback on what people liked/didn’t like/wanted. In a way, it was the democratization of design.
As a whole, I saw it not as just another demo day or competition but as the opportunity to really showcase how different our design was and how different our approach to building the portal would be. All of our hopes for it, all of our passion for what it would mean for people around us (our families, our friends, our patients), all of who we were and our experiences went into it. To me, design/technology/products, aren’t just the sum total of form and function, they also are about the feeling and environment that are created when you are using them. I often find that I like using things that I find aesthetically pleasing, have a funny wink or nod in them, are device agnostic, and that solve some sort of problem for me in a convenient, engaging, productive, and cost-effective way.
Besides clinical input and leading the overall thought framework for our approach, I was really involved in the social media aspect of the company as well. It was a way of engaging with the expert community and being able to talk to members of the general public. I tweeted not as a physician, but as “Mana” or well, a hu”Mana”, who was working to build the change that we wanted to see in healthcare and also shared some of the latest news and innovations that were happening in the exciting field of digital health. It was fun to interact with people not just in New York, but from different states and even from places like Ireland or Australia. It also was about asking people and organizations to vote not just for us, but as a whole, so that as many people as possible could take part in deciding who the winners would be.
And now the T-shirt story…
When you’re a startup, you’re often extremely resource *cough* -CASH”-*cough* poor. You know, fueled by ramen and all, so you really have to be mindful of what you can afford to spend, that is if you have any money to spend at all.
Demo day was rapidly approaching and the subject of what we’d be wearing came up. It was decided that we should get t-shirts made, and having gone to TechCrunch and a number of demo days (over 100), I really liked that idea because they are fun to look at and as a team, it’s very cohesive-looking and makes you identifiable in a crowd. Only issue was that for 6-8 people, the T-shirts would likely cost us $100-$200 which would be better spent on things we really needed -like getting to Albany to present to the judges upstate. Also, we needed shirts in different sizes.
Necessity is often the mother of invention, and sometimes limited resources ($0) can force you to become really creative. So what does a crackerjack team do but roll up their sleeves and come up with a cost-effective solution. I went to every dollar store, discount retailer, chain store to find t-shirts. Was really happy that white was one of the company colors cuz those shirts were the most wallet-friendly. I ended up buying 2 shirts at one store and buying the rest of the shirts at a store where I definitely hit the motherload. There was this one store that was liquidating white t-shirts that were all irregular with black lines through their tags and they were in this huge pile. I dug right in, picking over ones that were stained, had holes in them or were the wrong size. All in all, I was able to buy all the shirts we needed for a grand total of $12.
The shirts looked a little bit dingy and wrinkled, having been in that pile in that dusty crate and they were a little stiff, so I went to the laundromat and washed them at a cost of $2 for the wash, $1.50 for the dry and “free” detergent, bleach and fabric softener (a brand-name borrow of the good stuff from my parents). Then I took the shirts to the incubator space after asking my sister for her iron.
Kevin the med student had been in charge of getting the special t-shirt screen paper and he was able to get some for $12 from Office Depot. We printed out the company logo sans words onto the paper using the co-working printer. (The reason for this is that we didn’t have enough supplies if the words came out backwards or if something went wrong). Then, we set up a factory line where I pre-ironed the t-shirts and laid them on chairs in the space and Kevin steam-ironed the logos on and hung them to dry. And TADA! There you have it folks, t-shirts printed for an entire team for a little bit over what it would’ve cost to professionally print one team member’s shirt ($27.50 total out-of-pocket cost).
I personally think that whoever looks over the incubator’s security video probably had a chuckle that day and thanks to the innocent bystanders who didn’t bat an eyelash as we set up our little pop-up t-shirt factory.
If you want to see our t-shirts, head over to the NYeC Facebook page, entitled “NYC Patient Portal Finalists Demo Day”. Picture 7 of 19 is pictures of some of the team members on stage and picture 11/19 is me with the guys in our shirts.
Demo day…
Finally, demo day came. I styled us and we were dressed in our team t-shirts with blazers and nice slacks/skirt and shiny shoes. I also had a bright orange Mana-cure as a nod to the team colors. We wanted to look professional but approachable and even a bit playful because that is what our approach was. At its core, medicine/health is about people and I really feel that you can be both personable and professional. Laughter is often the best medicine, no?
There were about 8 demos in total and it was interesting to see the variations in terms of design and features, some of which were later integrated into what will be the final version of the portal before its official launch. I sat in the audience because I really wanted to hear what people in the audience had to say in an unfiltered way. It was really helpful.
I think that there were several things that really differentiated us from the competition:
1. Visually, we were the only ones that had t-shirts and looked like a team. We also looked much younger than our competitors which is different because there is often a level of gravitas that people associate with healthcare. (But I’ve worked in every single borough in some capacity from hospitals to community centers to health fairs and 10 years is a long time to be in any field).
2. We were a company based in New York. (Hometown pride).
3. Our tile design was different. It was meant to be so. It was meant to get away from the spreadsheet look of previous tools. It was meant work to well on mobile. It was meant to be accessible and device agnostic. It was meant to be aesthetically pleasing. It was meant to be a nod to apps on smartphones and the Windows desktop. (There are actually a lot of nods to things we already do, or are familiar with in the portal from stoplight color schemes to how info is presented). It was also designed to enhance those nuances that help providers and patients at the point of care.
4. Spanish version. Living in New York means living in an international urban metropolis where people from all over the world live, work, play and converse and it was important to incorporate that diversity (and very practical element) into the design. There are hundreds of languages spoken in New York and we chose Spanish because it is the #1 non-English language spoken in New York. Communication and understanding are at the crux of healthcare and it was really important to build in elements that facilitate that. (Personally, I love learning languages and I think people really appreciate it when you are able to speak to them in their native tongue and I think that taking Spanish in college really helped me become a more effective communicator, and thus a more effective doctor when I worked in areas where Spanish was the predominant language that people spoke).
5. Integration of the Quantified Self. Wearables are incredibly popular, but even more so, we recognized that we are entering the Information Age/Internet of Things and were aware of sensor technology and data streaming. It was about building with the future in mind.
6. Our approach was different. It was about changing the healthcare experience from what it was to what it could be. It was about trying to eliminate as much jargon as possible (sometimes if you string enough jargon together, it actually makes less sense than plain, vernacular language). It was about taking a whole-listic approach to health and to people. Often times people segment health and healthcare out as an industry but people don’t fit into boxes and we don’t live in isolation. What we eat, where we live, what our socioeconomics are, all affect our health. We also really wanted to meet people where they are, provide access, convenience and education (it’s not enough to just collect data, it’s also about sifting out what’s important for you and to you and helping you understand what you are being presented with).
I want to take a moment out and really comment on how great it was that NYeC (which BTW is a non-profit), took this crowdsourcing approach to securing winners for the rfp contract. It bypassed the traditional procurement process and really emphasized participation by the people who would be affected most by the portal. I also think it says something about them that they took a chance on a small unproven company to do something that at times seems incredibly daunting. But innovation is about doing something different, doing something that has never been done before and for a greater purpose, for an improved experience and for a greater good. On the flip side, when one wins a contract, it is about making a commitment to serve the people using your public utility -even if you are a for profit company- continually striving for innovative excellence, and not being complacent about anything.
I think that the portal is very much a first step in the continuum of digital health and is an evolving entity. Its purpose is to help people access their information without being tethered to any one service or system. However, ultimately what I hope it does is improve the quality of people’s health so that they are healthy enough to do the things that they dream about doing. It’s not just about blood pressure or heart rate, or lab values, it’s about better health outcomes so people are able to live meaningful, joyful, fulfilling lives and spend time doing the things they love with the people they love. That is what this is about, and that to me is the ultimate health outcome.

The Top 5 Things That Are Missing from the Digital Health Ecosystem

1. A practical digital health fellowship for providers and post-graduates
 Over the past 3 years, I have had coffee with MD’s, MBA’s, MPH’s, Phd’s etc and the one thing that has come up over and over again is that there isn’t a lot of formal opportunities out there. There is no official Clinical Informatics Fellowship across the board until 2018 (4 years away) although there are the 10 x 10′s and the grandfather clause but that and the fellowships that are available (of which there are very few) require deep CS knowledge. That doesn’t leave room for people with advanced degrees who don’t meet that requirement. There are fellowship opportunities that exist for undergrads and those in graduate school but not for post-grads. What I would like to see is a practical digital health fellowship that enables post-residency and post-grads to use their skills and their knowledge and apply them to healthcare (something like an advanced Code for America or Health for America). The current alternatives that exist are to work at a startup, found a startup, go into consulting or to go back to school and obtain more technical skills. This is fine if you can do it, but it doesn’t make sense for a lot of people who already carry the weight of six-figure student debt (and do not wish to incur more) and who have families at home. It also doesn’t make a lot of sense to turn away people from the field who are passionate about it, especially when all of the foundational work is happening in the here and now and we need the best people we can get to solve real and often daunting problems.
2. True interoperability 
 I believe in the power of open source and open data. I believe that people have a right to know who has access to their data, who is using their data, and for what purpose. Information is kept in silos and “walled gardens” and “walled kingdoms” because there is no financial incentive to give up the information, however, in every way there is a huge human incentive to do so. I personally would give up my information if I knew that it would be used responsibly and for a good cause, like research or public health initiatives.
3. More women in leadership positions 
This is true across all STEM fields as well as in business and government. It’s been interesting for me to float in this space, coming from programs that were led by women and where there was more of a 50-50 split amongst co-workers. I never even thought about gender but now I think about it a lot. I think it’s important to have more women in leadership positions because leadership determines what the agenda will be, what will be funded, what the future will look like. I often think it’s strange that in a space where women tend to be the primary decision-makers in a household that that is not reflected in leadership. Yes, I am aware that less numbers in the pipeline means less numbers in the output but I have met extraordinary women, both established and up and comers in this space, and I would love to see them represented in the C-suite. Thus far, I’m glad to see both men and women step up in support of this.
4. A more robust representation of people involved in healthcare 
A lot of times in going to conferences I see that a lot of focus is placed on providers. While I am one, and proud of that, I think it’s important to see healthcare as an ecosystem where there are many people who make valuable contributions and are integral parts to making things work. I think about allied health, integrative and alternative medicine practitioners, case workers, social workers, nutritionists etc and above all patients. It seems like sometimes talk is centered around people rather than to them and I think its important to be inclusive. We have a lot to learn from each other and because in practice, health is more like a team sport, rather than individual marathon.
5. A Hippocratic Oath for the Digital Age 
I think about the idea of healthcare as a business vs. healthcare as a right a lot. Even though spending has ballooned out of control and the amount of money is equal to the GDP of some countries, there actually is a limit to resources/capital. How do we proceed in a responsible way? How do we do right by the people who count on us, patients and employees? I am a believer in conscious capitalism, that we do our best to work towards win-win situations rather than extract every last drop from another human being in pursuit of profit as an end rather than a means. In medicine, every medical student, resident, fellow, physician, takes the Hippocratic Oath. I would love to see one for the business of healthcare and in the digital age. It is possible to do well by doing good and to do good by doing well. We just have to make it the standard rather than the exception.

3D Heights -One-Stop Shopping for 3D-Printing Services in NYC

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3D Heights Founder Jerry Castanos and  IT Intern Jheimi Pichardo
Mcor Iris Full Color 3D-Printer 
 
3D Heights is a full-service 3D-scanning and printing store located in Upper Manhattan founded by military vet and Washington Heights native, Jerry Castanos. Launched 5 months ago, it has attracted entrepreneurs, hobbyists, inventors, and curious residents from all over the city, as well as students from nearby elementary schools, middle schools, high schools and universities (City College, Yeshiva, and Columbia) looking to learn more about 3D-printing and print models and proto-types. 
 
3D Heights offers services from concept to creation. Customers can come in, look at and try out a number of 3D-printers that are available for purchase, inclusive of models by Afinia, Cube X, and even 2 NYC-based companies, Solidoodle and Makerbot. Customers can also come in with a concept and take it from idea to CAD design to 3D-printing a physical product using 3D Heights’ design and print services. 3D Heights also offers a free one hour class called “Application of 3D-printing”, as well as paid classes related to 3D design, 3D printing, and even 3D investing. In addition, there are professional and student membership plans that allow individuals and businesses to take advantage of the 3D-printing makerspace, its network, and get discounts on classes and printer use. 
 
3D Heights’ founder, Mr. Castanos is a serial entrepreneur who developed a passion for 3D-printing (3DP) during his time in the Army working in logistics and defense contracting. He wanted to come home to Washington Heights and share his passion for 3DP with the community he grew up in. In addition to holding classes for adults, Mr. Castanos is deeply involved with STEM education and has gifted printers to nearby schools and even offers classes for kids. During my visit, he was hosting a middle school robotics club. Indeed, a rush of energetic kids and smiling moms came into the store towards the end of my interview with Mr. Castanos! 
 
3D Heights has been quite popular with families. People have printed out customized gifts and ornaments at a starting price of $25, depending on size, design, and materials used. In particular, bobbleheads have been very popular, one family even came in and 3D-printed a bobblehead of each member of the family. Entrepreneurs have also taken to 3DP at 3D Heights because of the ability to print a proto-type, test, and put a physical product into the hands of potential investors. Doctors and educators have also embraced 3DP, as it allows them to print models that help explain structures and concepts to their respective audiences. 
 
3D Heights is an example of a small business in NYC that represents the trend of new-shoring (in contrast to off-shoring), where products are manufactured locally. It also represents small business as a vehicle to provide education, opportunity, and a gathering place for people in the local community. 
 
To learn more about 3D Heights, you can visit the store or check out the 3D Heights site:
 
3D Heights
@3Dheights 
4084 Broadway, New York, NY 10032 (btwn W 172st and W 173st)

Ideas For Re-building Southern Brooklyn After Sandy

Anyone who knows me knows that I’m a proud native New Yorker. I love love love NY. In fact, when traveling abroad, when people ask me who I am, I don’t even say I’m a doctor. I proudly say that I’m a New Yorker.

I grew up in Southern Brooklyn and I love it there. I used to walk down Oriental Boulevard in Manhattan Beach and look at all the beautiful houses on my walk over to the beach. I’ve always loved how the streets were in alphabetical order. I used to visit the the fisherman’s boats out on Sheepshead Bay in the summer and head over to Roll n Roaster for their famous roast beef sandwiches, iced tea and lemonade. I used to go to Brighton Beach and to this day, still travel out 3 hours to get a taste of Little Odessa -stuffing my face with Russian, Ughuyr, Turkish food. I love walking the boardwalk as ocean breezes carry the heat of summer away on my walks to Coney Island, and have gone there for the Nathan’s hot dog eating contest, the Mermaid Parade, Brooklyn concerts (i.e. John Legend) and the Aquarium. I also have taken the train out to Bay Ridge for pizza and delicious Italian pastries and driven over to the Rockaways -that one strip of road that makes you feel like you are in a movie, with water on either side is just gorgeous. I’ve also been to Staten Island, riding the ferry over and even did my OB/GYN and part of my Internal Medicine rotation at Staten Island University Hospital, riding the bus over the Verrazzano Bridge at 5 am with hardworking people starting their jobs or coming home from overnight ones. I love the nostalgia, I love the food (I don’t care what people say, we have the best pizza), I love the people and the sense of community, I love the idyllic life affirming simplicity of being in Southern Brooklyn.

Last week, I attended a Town Hall Sandy Oversight meeting held by NYC Comptroller Scott Stringer, Councilman Chaim Deutsch, Councilman Mark Treygar, Councilman Alan Maisel and other senior NYC government officials held at Coney Island Hospital, a place I know very well, having grown up in the 11235 zip code and having done a medical rotation at the hospital, as well as having written a community health assessment on the area in college.

I attended the meeting because my family was directly affected when Super Storm Sandy hit 18 months ago. I helped evacuate my family from the area and I was there to see the destruction when we came back: a five foot water mark, mere remnants of our life in that house, mold, and the stench of mud, dirt, and human waste greeted me. But we were lucky because at least the four walls that make up our residence still stood. For others, it was as if a nuclear bomb, a water wall, had leveled their homes and to a certain extent their lives.

We were hit hard by Sandy. It was way worse than Irene, which only came up to about a foot high. My parents have lived with my sister and I since the day the storm hit because of the damage caused by the storm and the after effects.The house is currently inhabitable due to mold and a roof that is pretty much shot and we have been robbed twice. The first time was a minor break-in. The second time, the house was trashed and ransacked -they even took rice cookers, pots, pans, and all of the presents/tchotchkes people have given my mom (and what she has cherished for the past 30 years), carrying it away in our pillowcases to boot, to add insult to injury.

Like many people affected by the storm, we signed up for the Build it Back program and I knew that many people had signed up for it and that people were literally left homeless. I thought that things were taking so long because we were likely third tier just based on how the program was structured and so we were patiently waiting our turn (because there was a stipulation prior to the current changes that you needed to wait for your assessment before starting work on the re-build). I was really shocked to read in the paper that 18 months later, despite the millions of dollars of funding, very little aid has reached people affected by the storm. I was even more shocked to have learned that 18 months later, only 4 of the 6400 people in Coney Island who applied for aid have received it.

Going to the Coney Island meeting was an eye-opening experience for me. I was able to hear first-hand accounts of people’s experiences after the storm and the fact that the meeting even came to be and that there was a strong willingness to listen on the part of our civic leaders has made me hopeful. Government works when it takes the time to listen to the people it represents and acts to fulfill its promise to serve and protect the people.

Comptroller Stringer opened the meeting by talking about what has happened (or what has not happened since the storm). Other city officials also spoke. I thought it was great though, that 90% of the meeting was community leaders and individuals affected by the storm giving their testimony. About 300+ people were in attendance.

Many of the stories were heartbreaking. One woman who spoke was a retired police officer who runs a youth group. She took in and housed 50 teens because her nonprofit has received very little aid. A woman with Stage 4 lung cancer and a partially resected lung took the floor, her breathing labored by her condition, and gave testimony about her ordeal navigating the aid process. Another woman stood up and talked about how she had to dig into her most of her life savings and her 401K to re-build her home and was now being told she might have to tear it down because the foundation wasn’t high enough for flood protection. (She doesn’t have the funds to do that.) Another woman stood up and she too has Stage 4 cancer, with mets to her spine (which are incredibly painful) and she is sleeping on a friend’s couch because she is unable to return to her home. The lead representative from the Sea Gate community stood up and spoke about the need for a rebuild and repair of the Coney Island sewer system -every time it rains, the community is flooded with raw sewage. A representative of various mom and pop stores in Brighton Beach stood up and spoke up about how many businesses hadn’t received aid because they had been turned down for small business loans because for some reason they didn’t qualify. Another man spoke about how applying for a small business loan invalidated his eligibility for other assistance. A woman stood up and talked about how some people in charge of aid refused to go to her basement because there was raw sewage in it, even though it is something she has to deal with on a daily basis. One after another, more and more people stood up to speak about their struggles and grievances. In speaking to the civic leaders, they said, “We need you to be our superheroes”. To which, the Comptroller replied, “Anyone who gives us their information…if you don’t get a call back tomorrow, someone in the Comptroller’s Office is getting fired”.

Ideas For the Re-build:

So much time has past and so much money has been spent. It’s time for action and accountability. It’s time to do what needs to be done. It’s time to re-build the places we call home.

1. De-centralize the distribution process for funding (top-down ->to grassroots/hyperlocal)

I think that taking a grassroots->up approach to funding will be very helpful moving forward. A lot of local non-profits in the affected areas really stepped up during the storm and its aftermath and even became mini case and disaster management agencies. Many houses of worship also stepped up. They know the areas they serve very well and many nonprofits already run on really tight budgets -making dollars out of pennies, so there is a natural tendency and skill towards a lean model and streamlined process. I think that allocating aid through and to community organizations and boards will help get aid to those who need it most. It also will hopefully cut down on the number of layers that people will have to interact with in order to get things done, in addition to being able to handle the nuances and special circumstances surrounding specific cases. Think mini-Navy Seal teams.

I also think that giving local Build it Back centers more authority when it comes to making decisions will be helpful especially when they are made in the context of participatory budgeting and in conjunction with the community and its members.

2. Cut waste wherever possible and allocate the savings to areas that need it.

One of the things that was pointed out during the meeting was the amount of booklets and papers used. I think that’s a fair point. Perhaps it would be better if we had people opt-in for an all digital version of what they need and how they get their information. This would save paper and $$$. For those folks who prefer paper, they would just state their preference and get paper versions.

A second point that was made at the meeting was the use of “overpriced consultants”. I think that having community experts with special skills weigh in might be the way to go. I also see universities potentially lending their expertise. What if someone’s project on say, storm prevention design was put into a real world, real time practical application? I’ve also heard of a program in Chicago where corporations have lent out their consultants to the government/city at no charge to help tackle city issues.

3. Crowdsource ideas from the community and share.

Empower people to step up and be heard. Have a platform that allows them the opportunity to do that. People who live and work in a community are invested in it. They know what’s going on and they know what the issues are. They know which traffic lights are broken and which streets have the most potholes. They also have ideas as to what they want their neighborhood to be. Why not crowdsource ideas and ask people what the issues are, what needs to be done, and how they would solve a problem? I really liked the Talking Transitions event http://talkingtransitionnyc.com/ Perhaps we could do something similar but maybe at a more local level.

4. Set up a service core and pool resources for synergy.

In looking at the web sites for disaster recovery and following what’s been happening on Twitter, I’ve seen several small volunteer groups in Staten Island, in the Rockaways, Canarsie, etc band together and help re-build people’s homes. There are also some groups on the NYC Service Corps web site. What if we had a Habitat for Humanity-like group here in Southern Brooklyn? Or what if we asked corporations that host volunteer days to dedicate some of those corporate volunteer days to Hurricane Sandy re-build projects? What if Lowes or Home Depot, who already offer free classes on home repairs set up special classes for volunteers who help in the rebuild? What if Scripps Network (who owns DIY and HGTV etc) had a show dedicated to re-building Sandy homes?

5. Have a timeline -track progress of communities online.

I like how the city has put individual application status reports online. I also like how resource and funding applications are being put online. I would love to see community timelines, so there is a pace that is set when it comes to getting things done. What are the most urgent things we need to address?

This is about transparency and accountability. I would like to see monthly meetings, just like the town hall, that go over what progress is being made, what issues have arisen, and what still needs to be done. I think it’s important to pool resources wherever we can and also be able to talk to and share with other communities what has worked for them and what they have learned in the re-build process. For example, at the Talking Transitions event, I learned about the Red Hook Wifi Initiative and how a MeSh was put together to get people access so they could communicate during the storm. Sharing what doesn’t work also helps. Saves people time and money.

6. Look into measures that leverage existing infrastructure.

How can we maximize what we do have? We don’t necessarily have to re-build everything. Can we re-inforce existing structures? For example, the city had a campaign to “Re-invent the Payphone” and right now there are test areas where payphones will be turned into Wifi hot spots. I like libraries, community centers, schools etc as places where people can get together and make things happen.

7. Focus on the A’s -Access, Accountability, Affordable housing, Action, Audits.

It’s important that people be able to get access to help and know what is available to them. A point that was made at the meeting was to think about the people who were not in attendance. People who were afraid to speak or who had to work and couldn’t make it. People who may not speak English.

Affordable housing is a critical issue. People want to re-build and return to their homes.

Accountability is huge. The storm was bad enough, the re-build process should not be an ordeal and people should be held accountable for their actions or in-actions. At the same time, it shouldn’t be all about pointing fingers. I would like to focus on what can be done better from this point forward and what creative and cost-effective solutions we can come up with and act upon those ideas.

8. Ask for help.

We live in an amazing place, with amazingly talented people, with good ideas and big hearts. I’m a techie, and during the storm, NY tech meetup members as well as other New Yorkers really stepped up by developing ways to help people communicate, create disaster relief tools (http://nytm.org/blog/entry/12-30-2012/rallying-tech-volunteers-to-help-post-hurricane-sandy), and by physically handing out food and supplies to people who needed it.

There is CodeforAmerica and BetaNYC (http://betanyc.us), who help make city data more accessible. They help build tools for civic engagement. They have even petitioned for livestreaming of civic meetings so people can conveniently access and find out information about what is happening in the city.

There is the NYC Big Apps (http://nycbigapps.com/) which is currently running and is about ideas for NY. Would love to see some solutions targeted towards disaster relief and the rebuild.

9. Build for all New Yorkers.

We really do live in the best city in the world and it’s because of the people who live here. People bring color and life to an area. They are the core of the community and a sense of neighborhood. Southern Brooklyn is an amazing place because of the different kinds of people who live there. People speak all kinds of languages and come from all different kinds of places. I think it’s important to preserve the culture and the nostalgia. (Jane Jacobs would be proud).

10. Build with the future in mind.

The lead representative from Sea Gate spoke about the need for a codified plan & determining who and which organizations will be activated when the next storm happens (and it will). I agree, I think that being prepared is incredibly important as we move forward.

I have read all 140+ pages of the NY Rising Coney Island plan and I like that it hits all aspects, from transportation, to education initiatives. In particular I like that there were plans related to sustainability, preserving natural resources and providing education. I really like what GreenForceNY and programs like it are doing.

I would love to see something like what Take the Helm did for lower Manhattan. How do we encourage businesses to stay, come back, or build themselves in Southern Brooklyn? One of my ideas is to have a Bay Ridge, Coney Island, Staten Island, Rockaways ferry system during the summer. If you look at a map of NYC it is surrounded by water, and ferries are a lovely way to see the city. They also don’t require a huge capital investment compared to having to build out other modes of transportation.

What will the future of Southern Brooklyn look like? Will we become another tech triangle in the city? Will we be known for our solar panels or ocean powered energy sources? Will we be known for marine aquaponic farming?

I think that the possibilities of what we could be are endless, but right now it’s about addressing the issue of housing (one of the most basic needs), infrastructure, and streamlining resource allocation cost-effectively. I also would like to see this happen: town hall on issues ->action ->assessment and pivot (rinse and repeat), as opposed to meetings to set up other meetings.

As an educated, English-speaking, able bodied person, and as a citizen of the community it’s important for me to listen, to speak out (especially for people who cannot speak or are afraid to do so) and to use any skills and ideas I have to offer to help out. This is about purpose.This is about service.This is about giving people their homes back, and more importantly, this is about giving people (my people, my fellow New Yorkers) their lives and their hope (for the future) back.

Going forward we need good ideas and good people to step up and take action because honestly, it is sorely needed and long overdue. Join me, join us, in helping to re-build Southern Brooklyn back, and better than ever. I want to hear from you.

In writing this, I have followed up on the meeting, as promised, and hope our representatives step up and follow up with me. I left my email & phone # at the event and I am on Linkedin, Facebook, Twitter. Please feel free to add your ideas in the comments section below. Please RT and share.

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” -Margaret Mead

Re-designing the Patient Experience to Improve Safety and Outcomes (and Patient Room 2020)

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Patient Room 2020 at Dupont Corian Design Studio
 
Healthcare has undergone a number of changes in the last several years and will continue to undergo changes as paradigms within the industry change, and as technology becomes further integrated into its core. What will the patient experience of the future look like? What changes can we bring about to ensure that the future is the best it can possibly be?
 
The NYC Health and Business Leaders (http://www.nychbl.com/), an organization that seeks to connect leaders from every aspect of the health economy together to learn, network, and foster business and innovation in NY, recently held an event at the Dupont Corian Design Studio in Chelsea, to help answer these questions. The event, called “Re-designing the Patient Experience to Improve Safety and Outcomes”, featured the following esteemed panelists:

 

  • Ilene Corina - President, PULSE of New York and nationally recognized patient safety advocate
  • Dr. Yves Duroseau- Chairman, Emergency Medicine at Lenox Hill Hospital
  • Dr. Shalom Kalnicki – Chair of the Department of Radiation Oncology at Montefiore
  • Dr. Rainu Kaushal - Chair of the Department of Healthcare Policy and Research at Weill Cornell Medical College and Physician-in-Chief of Healthcare Policy and Research at NewYork-Presbyterian/Weill Cornell Medical Center
  • Moderator: Joyce Lagnese, Esq.- Chief Legal Officer, Medical Risk Management, LLC
 
While at the space, attendees at the event were able to explore Patient Room 2020, a full-scale prototype of what a future patient hospital room could look like. Salley Whitman, Executive Director of NXTHEALTH (http://nxthealth.org/), an organization that seeks to impact healthcare via research and design, gave guided tours of the space. Highlights of the Patient Room of the Future included its sleek design, hidden storage spaces for supplies, sharps containers, and tablet technology, overhead lighting that could project clouds or rainbows (for serenity, to entertain kids), blue tooth and wifi capabilities so patients could access apps and education tools, a patient lap desk with a tablet screen embedded in it as well as side controls during meal times, and a convenient charger pad to wirelessly charge mobile phones. The bathroom was especially impressive, with features like moveable walls to make room for caretakers (or equipment like wheelchairs), hand rails and shower tools designed for stability and ease of use by caretakers and patients, a toilet with deluxe comfort features and the potential for bio-sensor technology, and a side table for personal items or use as a diaper changing station.
 
The lively panel discussion brought to light many pearls of thought when it comes to patient engagement, experience, and safety.
 
On communicating with patients:
 
The panel spoke about the importance of language, communication, and understanding. Dr. Kaushal, “We as the doctors need to try to understand the patient and and we as patients have to try to explain who we are to doctors”. Ms. Corina emphasized that it’s not about intelligence or acronyms (that both doctors and patients probably don’t know anyway), it’s not even just about health literacy, but communication and meeting people where they are. Dr. Duroseau echoed these sentiments, “The provider needs to make a connection with the patient in a language he/she can understand. It has to be language specific and age specific. Not one size fits all. You really need to understand who that patient is”. He punctuated this by telling the story of two patients, Patient A and Patient B, getting sutured in the ER. Patient A, who is told that some of the sutures may come out during the healing process (and no need to worry), will have a different experience and perception of care received than say Patient B, who isn’t given any advice or instructions.
 
Dr. Kaushal told the story of a patient who was hospitalized for newly diagnosed diabetes. Every day a nurse came in to show the patient how to inject insulin. She would draw up a syringe and inject “insulin” into an orange. The patient was discharged but came back several days later, with extremely high sugar levels. It turns out that the patient would inject insulin into an orange and then eat the orange.
 
Communication is a 2-way street. It’s about talking and listening, and more importantly it’s about understanding, regardless of literacy or education level.
 
On patient engagement:
 
For quality healthcare, the patient has to be at the center. Patients have to be integral partners. Dr. Kalnicki made the point that non-patient-centered care doesn’t exist. Patient engagment is important because a more engaged patient helps us prioritize what is important to them.
 
 
On the patient experience in NY:
 
Ms. Lagnese presented some information on healthcare in NY. When it comes to disease metrics, NY leads other states, but when it comes to patient satisfaction measures which includes communication with care providers, ability to ask questions and getting them answered, NY lags behind. NY does very well when it comes to metrics and technical aspects but there is work to be done in non-technical measures. Again, communication is key. It must also be noted that there is a direct correlation between patient satisfaction and liability.
 
 
On what healthcare can learn from other industries:
 
A lot can be learned from other industries, the hospitality industry is a great example. Dr. Kalnicki mentioned that the root of the word hospital is “shelter for the needy”. It’s about bringing back humanism to medicine and focusing on the patient experience and the healthcare experience.
 
 
On the role of technology in healthcare:
 
Technology is a tool and we’ve seen it used in the form of patient portals, social media support groups, and electronic hospital records. However, it’s not a panacea and cannot stand alone. Dr. Kalnicki said that we need “both the technical and the non-technical… alone, it’s like a great painting without a frame”.
 
Dr. Kaushal spoke about data vs. knowledge. What electronic medical records sometimes lose is clinical context, the “A” for assessment that is part of the clinical SOAP note. There is a richness in the thought process and the assessment. Access is not enough, you have to understand the value and clinical context of data.
 
Dr. Duroseau spoke about the need for leadership that understands both worlds (both tech and non-technical).
 
 
On pilot programs in place to enrich the patient experience and improve safety and outcomes:
 
The panelists spoke about different programs that are helping to improve the patient experience. One is the use of simulation labs to help teams work on decisionmaking and team processes inclusive of multi-disciplinary rounds. A second program was based on the fact that a majority of patients who are discharged from the hospital cannot identify who their primary doctor was, as they are often seen by residents, specialists, and allied health, so an online list was created, where care team members and patients could see a list with the names and photos of all caregivers. A third program was a formal caregiver support center where training was provided by volunteers who would adopt a caregiver, teach them tasks and provide resources that would be helpful post-discharge, inclusive of going over medications, cooking classes, guiding shopping lists etc.
 
It is clear that design, patient-provider input, communication skills,technology, and innovative ideas and programs will play a major role in improving the patient experience in NY. There is a lot of work to be done, but the future looks bright.