By J. Duncan Moore Jr.
People with inflammatory bowel disease (Crohn’s and ulcerative colitis) spend a lot of time at the hospital and the doctor’s office. Some also make frequent trips to the emergency room. On average, treating their bowel disease costs Blue Cross & Blue Shield of Illinois $20,000 a year. If you could monitor their condition so they didn’t have to race to the ER, you could save a bundle.
That gave Dr. Lawrence Kosinski the idea for an app. Of the patients who go to the hospital with Crohn’s-related complaints, he says, less than a third had any contact with a doctor in the previous month. “Your illness deteriorates, you’re at the edge,” he says. Patients are “running silent and running deep. They only surface when they’re in trouble.” He decided it would be worth it to invest in keeping people healthy and out of the hospital—especially now that insurers reward doctors for doing so.
Kosinski, 65, a gastroenterologist with the 50-member Illinois Gastroenterology Group, spent five years developing Project Sonar, an app to track patient wellness. For the patients it has monitored, it has lowered annual disease-related hospital costs by 64 percent and lowered the overall cost of care by 25 percent, he says. “And the patients are happier.”
After a successful pilot with 50 patients, he persuaded Blue Cross to let his medical group keep tabs on 300 patients for a $70-per-patient monthly fee. The program has expanded over three years to 1,000 Blue Cross patients.
On the first day of each month, patients get a survey by text, email or phone with questions on matters including bowel movements, abdominal pain and other symptoms, general well-being, whether they’re taking drugs for diarrhea, and more.
“Here is a game-changing innovation in management of this chronic disease,” says Dr. Fred Rosenberg, a partner in the Gastroenterology Group and minor investor in the app. “To really make a difference you need strong patient engagement.”
Now Medicare may soon be able to sign up for this service. In April a special committee established by the Centers for Medicare & Medicaid Services to evaluate new reimbursement methodologies approved Project Sonar for possible rollout to Medicare patients nationwide. It was one of only two proposals that got greenlighted out of four submitted. Next it goes to Health & Human Services Secretary Tom Price. He does not have a published deadline, but the debate over the Affordable Care Act won’t affect Medicare’s decision on Project Sonar.
Kosinski owns the technology with three partners. He hasn’t had any outside investors so far. He developed the app himself and got a vendor to write the software. Kosinski invented a platform for doctors to capture charges on a Palm Pilot in the ’90s. In the early 2000s, he created an electronic medical record for the Gastroenterology Group. “I’ve always been a techie,” he says. “I was creating relationship databases back in the 1980s. I should wear a ‘geek’ button.”