Boston Children's pilots geolocation technology to help babies with weak hearts

By Jonah Comstock

Boston Children's Hospital is the latest to tackle the problem of continuity of care between a patient's doctor and any emergency room or urgent care center they might find themselves in. And they're testing the technology, from startup Position Health, in some of their smallest and most high risk patients.

"At Boston Children’s we have a population of very high risk infants with severe congenital heart disease," Dr. David Brown, who is leading the pilot on Boston Children's side, told MobiHealthNews. "We know that this group of infants between their first surgery as newborns and their second surgery at about six months of age have a fragile circulation. Historically, about 10 percent would die in that period of time between the first and second surgery. We know from experience that some of those deaths occur outside the hospital, sometimes in the home, but sometimes in emergency rooms when the physicians caring for patients have very little understanding of congenital heart disease and how it will impact their care."

With Position Health's offering, parents of these high-risk infants will download an app on their phone that will run constantly in the background. Using geolocation, the app detects when the patient enters a hospital emergency department and pings them to ask if they're there to receive care for their child. If they are, their doctor is notified automatically and can reach out to the facility to tell them anything they need to know. For instance, Brown said, these patients often have lower-than-normal blood oxygen saturation.

"Medically, they have an oxygen saturation in their blood that, to some ER doctors, would seem to be terrifyingly low and their first response might be to put the child on oxygen or try to intubate those babies, which those babies don’t tolerate well. And some of our emergency room deaths have been exactly that," Brown said. "Our goal would be to give those care teams information that would help them take care of those children."

Position Health is not the first startup to try to solve the problem of care continuity, but it is taking a different approach technologically by using geolocation.

"We settled on geolocation as a core technology because patients show up any emergency department potentially anywhere in the country," Position Health cofounder Dr. Kyan Safavi told MobiHealthNews. "It’s difficult to predict where and when they’ll show up, so we wanted a technology that works regardless of where the patient is seeking care. Geolocation allowed us to scale up immediately so currently we have over 5,000 hospitals in our day to day, so we can detect a visit at any time."

Some other companies that are pursuing the same end, like Google Ventures-backed PatientPing, rely on hospital information systems to detect when a patient is admitted. The main advantage Position Health's approach has is that its much more scalable (and in some cases more reliable) because it doesn't require the participation of other facilities.

Position Health is currently piloting the technology at Boston Children's as well as with one other large health system in the Boston area. The other pilot involves adult patients. Moving forward, Safavi says the technology can be used to detect patients entering other facilities as well such as skilled nursing facilities or urgent care centers, and future versions will also detect if a patient misses an appointment -- something that could be useful for treatment adherence.

"We’re just really proud to serve the kinds of patients that Dr. Brown cares for on a regular basis," Safavi said. "They’re extremely sick babies. We’re just really fortunate to have the opportunity to try to improve their care."