NarrativeDx: Transparent Patient Experience in Real Time

By SUSAN LAHEY
Reporter with Silicon Hills News

If you have a bad experience at a hospital—and just having to go to the hospital is often a bad experience—you may write a letter of complaint, post something in social media or blast the hospital on your patient survey.

And there’s a good chance that if someone got around to reading it, it would be long after you were gone.

That sucks for the patient, but also for the hospital. According to a May survey by Accenture, hospitals that can provide superior patient service show up to 50 percent more in net margins than hospitals without it. Plus, if you’re a hospital with low patient satisfaction ratings, Medicare and Medicaid will reduce your reimbursements.

So there are a lot of reasons why optimizing patient experience should be of enormous importance to everyone. Recently, the two Austin founders of NarrativeDx figured out how to do it.

NarrativeDx uses natural language software to process everything from patient surveys to letters, phone call transcripts, and comments on social media. It can “read” this information and identify key issues in the hospital that can be as broad as a cleanliness problem in the hospital and as specific as the bedside manner of a particular provider. Historically, hospitals relied on patient satisfaction surveys from Press Ganey, but that took forever.

“You wait one to two months for patient experience surveys from Press Ganey,” said Geoffrey Hall, a NarrativeDx advisor who uses the service as administrator of Rusk Rehabilitation at New York University Langone Medical Center. “When I first started doing the pilot (with NarrativeDx) the information came back in 24 hours. Now it’s almost instantaneous. It can mine and capture data and map that out…now we might actually resolve the issue while the patient is there. It’s a game changer for me.”

Shawn R. Smith, VP of Patient Experience at Christiana Care Health System in Delaware said that, with the volume of feedback they collect, he said, it would be impossible for even a team of people to compile themes from the information they receive. NarrativeDx does it almost instantly and can identify problems in myriad areas.

“When looking at medications and adherence (a patient’s willingness to take meds according to instructions) to patient side effects, you can learn that a particular side effect has a lot to do with this one medication. You can go very granular. And you might never have thought that these side effects would be connected with this medication.”

Patients Tell Their Own Stories

One of the big advantages of NarrativeDx is that it lets patients tell a story about what happened. Too often in filling out patient surveys, there is no box to mark for the issue they faced. NarrativeDx co-founder Senem Guney did her master’s and doctoral work at the University of Texas studying the communicative fabric of work organizations and the issue of high-technology innovation in complex, multi-site organizations. Part of her studies included researching the importance of personal narrative in getting the message across. At hospitals, she said, the most important thing to patients is empathy, compassion. Patients consistently rank that higher even than providers’ knowledge. And that’s easier to capture in a narrative.

Co-founder and CEO Kyle Robertson said the team did a deep dive into patient experience before launching in 2014. “We did a lot of research before to find out what’s important about patient experience: What about listening, empathy, compassion, kindness? What’s important about meals? There is this huge tree of all those things that are important.” Robertson has degrees in computer engineering, economics, and math from Iowa State University and a juris doctorate from Boston College Law School. “We plug these into machine learning algorithms that actually learns new stuff. It categorizes the comments and builds off that. It takes the human bias out of it…. It basically marries the insights from qualitative date with scaleability of quantitative.”

NarrativeDx has its own “smart survey,” known as adaptive rounding, that is used when someone from the hospital makes patient rounds and asks about their experience. It can add questions based on previous responses. For example, if many patients complained about dirty showers in the rooms, it will add a query about whether patients were satisfied with the cleanliness of their showers.

Both Robertson and Guney worked for major institutions before embarking on the entrepreneurship journey. Robertson worked for National Instruments and was an IP attorney representing organizations including Cisco and Apple, before starting his first company. Guney served on the faculty of State University of New York and was a Fellow at the Center for Technology in Government, a SUNY Albany think tank.

NarrativeDx was accepted into DreamIt Health accelerator in Philadelphia in 2014. They received $50,000 as part of the incubator and have since raised $1.35 million from angels, LiveOak Venture Partners and Capital Factory. They will be working on a $3 million series A in the fall.

Since they returned from Philadelphia, they said, they noticed a big improvement in the ecosystem for medical startups. For example, Seton’s hiring of national virtual care pioneer Dr. Kristi Henderson as an advocate for medical innovation. But Austin has a long way to go to catch up with the northeast in terms of support of innovation and tech startups in the healthcare system. Part of the problem is that the sales cycle in hospitals can be “long and brutal,” Robertson said. There are so many different people who have to sign off on any innovation.

With help from people like Dr. Henderson, the Dell Medical School and proposed Innovation Zone, they said, the next generation of startups should find it a lot easier. Maybe Austin needs a NarrativeDx for entrepreneur experience….