stitch.md

Turn Flowcharts into Apps

Overview• stitch.md• Problem 1: Safety• Problem 2: Quality• Problem 3: Quantity• Secret Sauce

stitch.md• We help untrained health workers

ACCURATELY IMPLEMENT practice guidelines by simplifying the navigation of complex guidelines into single Q&A screens.

Why tackle this problem?

Because it affects the safety, quality, and quantity of healthcare

People hate being sick• Health worker jobs– Assess patients– Formulate diagnoses– Create management

plans– Take Action

• Limitations– Technology– (Tele)Communication– Time– Training

Problem 1: Safety

First, do no harm

Australian

Swiss Cheese Model

Horsham

Solution 1: Clinical Pathways

“We don’t have the ability or money.”

stitch.md brings checklists and clinical pathways to mobile, affordably

Examples of stitch.md Use• Acute STEMI• Acute ischaemic stroke

• Pre-operative screening• Post-operative

management

Problem 2: Quality

(and cost-effectiveness)

Australia’s healthcare is great!

We need to make it more cost-effective.

Solution 2: Task Shifting

Nurse PractitionersCommon Illnesses Skin Conditions Vaccines

Allergies Athlete’s foot DTP (diptheria, tetanus, pertussis)

Bladder infections (females)

Cold sores Flu (seasonal)

Bronchitis Deer tick bites Hepatitis A (adult)

Ear infections Impetigo Hepatitis A (child)

Pink eye and styes Minor burns Hepatitis B (adult)

Sinus infections Minor skin infections & rashes

Hepatitis B (child)

Strep throat Minor sunburn Meningitis

Swimmer’s ear Poison ivy MMR

Flu diagnosis Ringworm Pneumonia (Oct – Dec)

Mononucleosis Wart removal Polio (IPV)

Pregnancy testing TD (tetanus, diphtheria)Conditions managed by

MinuteClinic

INTERNET

NURSE NURSE NURSE NURSE NURSE NURSE

NURSE NURSE NURSE

NURSE NURSE NURSE

DR DRWITH STITCH.MD

Examples of stitch.md Use• ED triage• Outpatient clinics• GP rooms• Nurse practitioner

clinics

• Allied health– Physiotherapy– Occupational therapy– Dietician

• Mental health services

Problem 3: Quantity

INTERNETNURSE

DR

PT

DR

PT

DR

PT

INTERNET

PT

NURSE

INTERNET

PT

NURSEDR

STITCH.MD

PT

Capturing ideas

How doctors think about problems

Enabling Technologies

Mobile Devices Sensor proliferation

Cloud Computing

QuantifiedSelf

Standardized platforms• iPhone• Android• Pebble• Google Glass• iWatch• Etc…

Plugins or standalones• HR• Pulse oximetry• BP monitoring• BSL checks• Point-of-care labs• Etc…

Solution 3: Automation• Traditional Model– Sessional assessments– Interval assessments– Limited feedback

– Patient Passivity

• Future Model– Continuous assessments– Risk based assessments– Rich analytics

– Patient Engagement

ULTIMATELY

Examples of stitch.md Use• Management of chronic

conditions– Diabetes– Hypertension– Congestive cardiac

failure

• Disease Prevention– Fitness– Diet

Secret Sauce

Disruption = Trend of convenience = elimination of limitations

• stitch.md uses technology to eliminate the– Limitation of time– Limitation of training– Limitation of (tele)communication

Medicine is about people

stitch.md EMPOWERS people

by DECOUPLING Knowledge from Practice

stitch.md

Turn Flowcharts into Apps

Questions?

info@stitch.md

References• http://www.npr.org/blogs/health/2013/09/20/224507654/how-many-die-from-

medical-mistakes-in-u-s-hospitals• http://www.abc.net.au/worldtoday/content/2013/s3778256.htm• http://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf• http://grattan.edu.au/publications/reports/post/budget-pressures-on-australian-

governments/• https://www.mja.com.au/journal/2004/181/8/using-checklists-and-reminders-

clinical-pathways-improve-hospital-inpatient-care• http://healthcare311.com/news/?p=2321• http://blog.healthecareers.com/blog/medical-careers/report-finds-hiring-nurse-

practitioners-and-physician-assistants-a-smart-decision