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Virtual SmartCare: How AI Can Assist With Staff Shortages And Improve Patient Care

April 24, 2024

In this episode, we sit down with Dr. Dean Rottinghaus, serving as the Chief Clinical Officer for QurHealth and Infinity Care Partners. These affiliated companies are pioneering the use of voice-enabled AI and virtual care management across both inpatient and outpatient healthcare settings.

Dean‘s three decades of experience in healthcare, coupled with his determination to confront prevailing industry challenges such as staffing gaps and elevated readmission rates, underpin these transformative efforts. Tune in for an enlightening discussion with Dean, offering valuable insights into these innovative approaches shaping the future of healthcare.

Guest: Dean Rottinghaus, DC - Chief Medical Officer, Jenkins County Medical Center-Diabetes Management Clinic

Dr.  Dean Rottinghaus has over 30+ years working in the healthcare industry.  Twenty-one of those years were devoted to his chiropractic practice and the other 9+ years included work in the lab space, hospital IT space and with multiple EMR systems.

As a chiropractor, Dr. Rottinghaus owned and operated a large multi-disciplinary clinic that included pain management, acupuncture, massage therapy and chiropractic care in the greater Cincinnati area.  In addition to his clinic, he served as a team physician for several local high schools and two universities, as well as, a staff physician at multiple hospitals.

During his career in the medical field, Dr. Rottinghaus identified a need for improved documentation in the chiropractic, orthopedic and physical medicine outpatient setting.  As a result, he designed, developed, and brought to market the first web-based EMR for small practice physicians. Dean led that separate company in an executive position for nearly 15 years.

While treating patients throughout the years, Dr. Rottinghaus has developed a passion for people with chronic conditions who are seeking direction and answers. As a staff physician at multiple hospitals Dr. Rottinghaus provided medical care to many patients with diabetes, hypertension, and other metabolic disorders. He has long seen a need in this area of patient treatment and management as these patients are many times forgotten or just “pushed through the system.”

Dr. Rottinghaus has a deep desire to help these patients dealing with chronic conditions, especially those in small hospital settings and those in underserved areas in our country. Moving the diabetes management concept forward into these areas, will allow these patients the help that they desperately need to improve their quality of life. It is for this reason that Dr. Rottinghaus, along with Lenny Schonfeld and Matthew Pinyerd, brought the Diabetes Management Clinic to Jenkins County Medical Center.

Transcript

Aaron C. Higgins: 

Hello and welcome to Beyond the Stethoscope Vital Conversations with SHP. On today’s episode we sit down with Dean Rottinghaus. If you recall, he visited with us a few seasons ago and we had a great conversation. Now we’re catching up. We talked to him about how AI is changing the healthcare landscape and what emerging technologies are doing to improve healthcare. Are you ready for this vital conversation? Let’s get started vital conversation.

Jason Crosby: 

Let’s get started. Hey everyone, this is Jason Crosby of Strategic Healthcare Partners and your host for today’s episode, alongside my co-host, aaron Higgins, and today we are joined by Dean Rottinghaus, chief Clinical Officer for CureHealth and Infinity Care Partners. Dean, thanks for joining us today and welcome to the podcast.

Dean Rottinghaus: 

Thanks for having me, Jason and Aaron.

Jason Crosby: 

Dean’s a repeat. If you listened before previous seasons we had Dean on before, so we’re glad to have him back as a repeat customer. I guess that’s a good thing. Give us some background on Cure Health and Infinity Care Partners and how they came about.

Dean Rottinghaus: 

Sure Again. Thanks for having me guys. Cure Health let me start with Cure Health. So Cure Health is a voice-enabled AI technology company and I was introduced to them a little over a year ago and got to know the owner and the founder, ravi Kunduru, really well. Everyone here who is listening to this podcast will know who Ravi Kunduru’s original company is, but have probably never heard of him. The original company is called Ventec and it is the largest data aggregator for CMS quality measures worldwide. He has had that contract for about 14 years and the sole contract for CMS. So anybody who submits any hospital system, healthcare system, dialysis center, who submits quality measures will have gone through Ventec. That is who Ventec is and who Ravi is.

Dean Rottinghaus: 

And so what happened about right during COVID? Ravi’s parents in India got COVID and so he flew over there and could not have any access as we all know, it happened quite often couldn’t have any access, couldn’t see him, and so he was thinking about this can’t be the way healthcare is. And so he literally he’s an innovator, he’s an entrepreneur. He came up with the idea of a voice enabled AI platform where he could interact with his parents and also anybody else could interact through this voice enabled platform. It’s kind of like Alexa or Siri for healthcare. It’s very specific for the patient and their condition. So in this instance, if a patient, or any instance if if a patient feels lightheaded, the patient can actually interact with the software. They can either use their it’s a it’s an app on a smartphone or it can be a device.

Dean Rottinghaus: 

If we’re inpatient which we have inpatient it’s an inpatient platform could be in the room with the patient and they can literally talk to the device and say I’m feeling lightheaded. It will go through a series of questions. It can do medication reminders, appointment reminders in an outpatient setting and things like that. So that is how Cure Health came about and I was, like I said, introduced to Cure Health and Robbie, about a year ago, became very good friends with him and learned more and more about the technology, and so he is a technology about the technology, and so he’s a technology. The company that I own and operate is Infinity Care Partners and we are the actual implementation side of it. So we actually have nurses, nurse practitioners, medical doctors who respond to the alerts that come about as a result of a patient interacting with Cure Health and the platform. Does that make sense to you guys. I hope it does.

Jason Crosby: 

Oh yeah, tremendous backgrounds, and it’s always interesting to see or to hear how such things come about right, and typically from a personal story like that as well. So, yeah, appreciate that.

Dean Rottinghaus: 

Yeah, Almost always a personal story and seeing a need and filling that void to take care of the need, so it’s been a great ride. It’s been about a year this has been. Cure Health is flourishing in India right now and he brought it to the United States about two years ago. We have hospital systems and payers. We’re doing pilot studies with payers and their high-risk patients, so that’s kind of where we are. Home health agencies. It’s a big thing with home health agencies Also, where the nurses are meeting with the patients on site and then the patients already have this in their home and can interact with the with the device and the technology so how does?

Aaron C. Higgins: 

or or maybe the question is more like what does uh ai look like in in today’s healthcare? Obviously the organization is ai forward and and we hear that buzzword a lot in fact we’ve had some episodes all about ai. You know how. How does that apply to hospitals and maybe even out to the practice level you mentioned? You’re kind of playing around a little bit in the outpatient setting. What does that look like?

Dean Rottinghaus: 

Well, ai, as you guys know chat, gpt and so on, la and AI was everywhere, everywhere, and so what that means in a healthcare setting is healthcare systems today and strategic healthcare partners in your client hospitals. I mean, they’re all facing many of the same problems, you know high readmission rates, low quality measure scores. If they’re PPS hospitals, length of stay is longer than what they wanted or what the CMS recommended, and another big one is that most healthcare systems right now are understaffed, and so another one is inefficient throughput, so moving a patient through the whole hospital. Those are some of the problems that are facing hospitals right now, and so AI is being used and, like I said out at Vibe in LA, this is just such a huge buzzword in the technology that I was able to see that healthcare systems are starting to use AI to help solve some of these problems that I just talked about.

Aaron C. Higgins: 

Follow-up question to that is okay, these are problems. We definitely have seen problems. Ai has some of its own problems too. I think we’ve all had those AI conversations with Copilot or ChatGPT or some of the others, and it starts making things up. Do we see that as a fear in healthcare? Do we see that as a fear in health care and if so, what safeguards do you see or have you seen in place to prevent hallucinations from occurring?

Dean Rottinghaus: 

Well, that’s a great question, Aaron, and that is a concern when we get into technology like this. Fda approval is a big thing. So being FDA approved where there’s been some kind of oversight, that’s a huge thing. We’re dealing with, like I mentioned, private health information of patients, so we need to make sure that whatever technology a healthcare system implements has safeguards in place for that, which CureHealth does. That was one that we had to get high trust, certified and so on. So that’s what we are, but those are some of the things that I would encourage or challenge healthcare systems to look into when they are trying to adopt any kind of AI technology for their healthcare system.

Aaron C. Higgins: 

Right, you don’t want to be having your doctors go and type symptoms into Gemini and hope for the best results.

Dean Rottinghaus: 

That’s exactly right. That’s exactly right.

Aaron C. Higgins: 

You kind of laid out a whole list of different problems that healthcare is experiencing. You know things like short staffing and even the poor patient outcomes and that sort of thing. How do you see AI being utilized to address some of those issues and be as specific or as broad as you would like on that one?

Dean Rottinghaus: 

Yeah, that’s another really great question. So one of the biggest problems facing healthcare in general what costs the healthcare system so much money is patients who utilize the emergency room or the ED as their primary care provider, or who have a procedure and are discharged from the hospital, and within 14 days which that window is 12 to 14 days, that’s the highest readmission window Patients go right back in because they get scared or whatever it might be, and they go right back to the emergency room. So, case in point, we’re working with one of the largest healthcare systems in the nation right now South Atlantic Division and we were tasked. A good buddy of mine is a cardiothoracic surgeon and he specifically asked me and this started around Christmas. He asked me that he’s the board chair. They have to decrease readmission rates, they have to decrease mortality, they have to increase quality measures, they have to increase patient satisfaction and these are some of the things that he was tasked with. And he asked me if we could do that. And so we are doing that. We are going to be implementing that shortly with this health care system.

Dean Rottinghaus: 

So how that works is prior to a cardiac procedure, the patient is given a device giving the Cure Health device and shown how to use it, and then, post surgery, they are post-acute, they’re taking it home and that they are able to interact with Cure Health. And it’s called Sheila. It’s not Siri or Alexa, it’s called Sheila, so it can actually be the doctor’s voice. So it could be they could, or it could be the mother’s voice or a son’s voice or whatever. We can make it voice specific to give that patient a peace of mind, so they could say the patient could say, hey, hey, dr Crosby, I’m feeling lightheaded today, and then the device will then interact with the patient.

Dean Rottinghaus: 

The biggest problem with readmissions is the patient gets scared. They don’t have anyone to talk to. Their home health nurse may be there twice a week, whatever it might be, but during that 24-7, 365 period of that initial 12 days, 14 days, they don’t have anybody to interact with. And so that’s where Cure Health and Infinity Care Partners can come in. We have the technology to interact with the patient. They have somebody there 24-7. And then we have the staff that follows up if there needs to be a follow-up with the patient.

Dean Rottinghaus: 

The understaffing is the same way the health care systems are tasked with, you know, trying to to fill roles within a hospital that they can’t find staff for, and so that’s where Cure Health, on an inpatient setting, can be in the room interacting with the patient and if there are any alerts, like that call button, it can be that call button. Like that call button can be that call button. They can, they can interact with Sheila and then anything that gets elevated can get elevated to the nurse’s station in real time. It’s, it’s, it’s all in real time.

Aaron C. Higgins: 

Wow, you know, I I had an inpatient hospital stay last year and I could have used your system. I was a readmit, I was discharged from the hospital and within about 24 hours I was readmitted and man, it would have been helpful having a tool such as this readily available. But I also think too, because I’m a nerd. Big surprise. I can’t help but think of Star Trek, emh, the emergency medical hologram. This is one step right towards that very thing. So, doctor on demand.

Dean Rottinghaus: 

It’s interesting that you say that, Aaron, when I was at Vive last week. There is a software technology utilizing AI holograms out there where they will actually have a full picture of the provider, whether it’s a doctor or the nurse on the TV screen for the patient to interact with. It’s different than what we’re doing. They use it in a much different way. There isn’t a lot of competition that I was able to see out there for Cure Health, but it was interesting. When you bring that up, I mean fiction becomes fact.

Aaron C. Higgins: 

It’s all coming around.

Jason Crosby: 

You know you had to bring Star Trek into this. Well done.

Aaron C. Higgins: 

What can I say other than please state the nature of your medical emergency. You know.

Dean Rottinghaus: 

I wanted to bring up one more thing. I know we’ve talked about a lot here, but one of the things that was just literally brought up to me two weeks ago. I’ve got a good friend of mine. Her name is Sarah Bateman and she started a company called Hippotrek and she’s in St Louis. I’m sure that many of your clients are utilizing Hippotrek. It’s a HIPAA compliant software system that ties in with the hospitals.

Dean Rottinghaus: 

But one of the things that she has found, especially in small hospitals and I am sure that some of these people listening will be familiar and I am sure that some of these people listening will be familiar are using baby monitors in the inpatient setting and the patient’s going to a swing bed status where the baby monitor is what the patient is interacting with, and obviously that is not HIPAA compliant. And she’s having all kinds of issues with some of her client hospitals and is now introducing Cure Health to these hospitals because we’re HIPAA compliant and the baby monitors is a cheap alternative, but it’s fraught with potential litigation and so on if a patient dies on the watch and we won’t even need to go into that. But that is something that has just come up here recently that I thought might resonate with some of the people listening.

Jason Crosby: 

Yeah, keep going down that path. In terms of the smaller, you know rural hospitals, critical access hospitals, you know your mid-size under 100 beds, et cetera. On how you mentioned, sheila, but other AI solutions smart care, et cetera can benefit that type of setting, with you setting with a little bit more granularity, if you will.

Dean Rottinghaus: 

Yeah, so the virtual smart care, which is really what what Sheila and Cure Health is, along with providing the Infinity Care Partners, which is the virtual care management on an inpatient setting, especially for these critical access hospitals and these small hospitals. I mean, funds are tight. I read about it in Becker’s nearly every day Hospitals, small hospitals in rural areas of the United States are closing because they don’t have the funds and or they’re understaffed and can’t provide adequate care and or they’re understaffed and can’t provide adequate care. And that’s where the technology on an inpatient setting, you put a device, a tablet or the TV that is already in the room in every hospital room in the United States, even in small hospitals, cure Health, sheila can be on that TV and the patient can interact through the TV with Sheila.

Dean Rottinghaus: 

Otherwise, it’s a device. A tablet can be a rugged tablet, can be in the room with the patient and interacting. I mean it can go all the way, that whole gamut. But again, what that is doing is it’s supporting the lack of potential lack of staff, with a shortage of nursing LPNs, rns, within the hospital and still providing quality care. And then the virtual care, the Infinity Care Partners we can actually support the hospitals with the virtual care, interacting with the patient, elevating it, when needed, to the nurse’s station or the medical doctor or the medical provider.

Jason Crosby: 

But you’re, you’re, you’re head on and predicting the future. Right, we’re talking AI. What does it look like here in the near future? Just AI in general, the virtual smart care, in particular for the hospitals that are listening, and how Cure Health and Infinity Care Partners is going to play a role in that impact here in the near future.

Dean Rottinghaus: 

Well, I’m glad you asked that because that’s an exciting, especially coming back from Vive, and I’m going to tell you, and I’ll actually name a few of the devices that I came across. Well, the first one. Let’s go back to that original example I talked about. With that large healthcare system with the open heart surgery and so on, we are right now working on an integration with CardioMobile. You guys have probably seen CardioMobile. It’s advertised, it’s you know. Patients can buy it over the counter. It’s a device that does a hospital grade EKG on a patient. We’re actually doing an integration with them right now for a couple of heart hospitals in Oklahoma and also this large healthcare system. So we will be completely integrated with CardioMobile where the patient post-op, post-cardiac surgery, can have the CardioMobile device right there, a six-lead CardioMobile device. They’ll put their fingers on, it sits on their knee. It will then immediately give us the Cure Health team and Infinity Care partners that reading and we can elevate it. If they’re showing AFib or whatever it may be, we can elevate that to there, and this is what we’re doing with this hospital in Jacksonville, florida. Actually, it will be elevated to the internal medicine cardiac care nurse and she will then get it to the doctor if we need to get the patient readmitted, but that’s a peace of mind thing, so that’s really where that we can decrease those readmissions.

Dean Rottinghaus: 

But one of the things that I was really excited about is a company called WellBe and you guys can look it up it’s W-E-L-L-V-I-I WellBecom. I met with them out at Vive and they have a device that will be a game changer in health care. But it’s a device that literally takes nine vital signs with a blood pressure. It looks like an iPhone and the patient puts their index finger, left index finger, in the device. It takes a blood pressure reading, a pulse reading, it takes temperature. All of that all in one device instead of having all of these disparate devices. That’s a huge game changer in medicine, especially on the inpatient setting and also in the home health setting. Having these devices where they can do all of these readings all at once and have it being Bluetooth to software such as ours, where the readings automatically go in there and can get elevated with alerts if any of those nine or 10 vitals are out of what the norm should be.

Dean Rottinghaus: 

Another one is CareDaily. Caredaily is a software system that actually pulls together a bunch of other technologies that include social determinants of health being able to get rides for patients to get to appointments and other things like that where this software it can interact with the patient in the home and their devices in the home. It can have monitors in the home where, if a patient falls in the home that it immediately gets alerted to, sends an alert to a software such as Cure Health where somebody can reach out immediately. You don’t have the old PERS device where it’s around the neck and the patient falls and pushes the button. This actually has fall detection device in it, but that’s a real huge one. So just that’s where AI is going. That’s where it’s going in healthcare. Some of these things will become commonplace in the next couple of years, but I think the future is really, really exciting for AI and healthcare and both inpatient and outpatient.

Aaron C. Higgins: 

It sounds like the future is here today.

Dean Rottinghaus: 

It’s here, man. Go back to that Wellve device. It’s not cheap. I mean it’s in production. Right now they’re using it. Using it, it got FDA approval, literally on February I think six or seventh it was like two, three weeks before before the VIBE conference and it got FDA approval. So now they’re in talks with Amazon. The guy who, who, who actually designed and developed it is an MIT PhD, double PhD, and he designed and developed the entire device. I’ve met with him personally, I’ve talked to him many times and down-to-earth guy. But that’s a game changer within healthcare.

Aaron C. Higgins: 

It sure sounds like it. Well, I know we’re coming right up on time. So, Dean, thank you very much for coming on with us today. We certainly appreciate it.

Dean Rottinghaus: 

Absolutely. Thanks, guys, and I mean I look forward to this. Each time it’s just exciting, things are happening.

Aaron C. Higgins: 

This has been an episode of Beyond the Stethoscope Vital Conversations with SHP. If you enjoyed this podcast, please be sure to rate and share it with your friends. It sure helps the show.

Jason Crosby: 

Production and editing by Nala Weed. Social media by Jeremy Miller.

Aaron C. Higgins: 

And our co-hosts are me, aaron C Higgins and Jason Crosby. Our show producers are Mike Scribner and John Crew.

Jason Crosby: 

Thank you for listening, listening, and we’ll see you next time.

Aaron C. Higgins: 

Well, one more thing. So we now have a new thing that we’re doing with our guests. We’re asking one last question, one that we didn’t tell you about ahead of time. So brace yourself ready. So Dean our listeners. They want to know something very important crunchy or smooth peanut butter?

Dean Rottinghaus: 

oh, my gosh crunchy all day, all day all day. It looks like that’s favorite and well done. Yeah, I know we’re in for a reason crunchy crunchy peanut butter.

Aaron C. Higgins: 

Man, come on, it’s the pressing topic, forget ai, absolutely hey can ai truly describe the deliciousness that is crunchy? Peanut butter that’s what I want to know that’s right.

Dean Rottinghaus: 

Yeah sure, you can just ask. Just ask chat gpt, you’ll get something that’s right.

Aaron C. Higgins: 

Well, thank you, dean, once again, and, uh, we look forward to talking to you here soon thanks guys.

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