Emerging Technologies: The Geneva Healthcare Suite

In this interview we speak with Dr. Gilanthony Ungab, Chief Medical Officer of Geneva Healthcare, Inc.,  about their innovative technology platform for managing data from cardiac devices.

Tell us about Geneva Healthcare Suite and its capabilities for implantable cardiac device data management. 

The Geneva Healthcare Suite is a software-as-a-service (SaaS) solution that is designed to make cardiac device data that comes from point-of-care interrogations and remote monitoring transmissions usable and accessible for all healthcare providers. Typically, data from implanted devices is presented in proprietary formats with disparate reports from each device manufacturer. The Geneva Healthcare Suite can ingest data from point-of-care interrogations undertaken from the multiple clinical locations where these devices are commonly encountered. The platform also receives a passive flow of data from each of the major cardiac device manufacturer’s remote monitoring sites, thus obviating the need for clinical support staff to navigate through multiple portals and providing one central device information management system for the provider. Geneva presents all device data in a uniform, standardized, intuitive dashboard so that device status can be ascertained immediately without waiting for a device manufacturer sales representative, improving the speed and the quality of care for cardiac patients. In addition, Geneva has created a seamless electronic documentation workflow module to allow a physician to review, interpret, and electronically sign the interrogation report and integrate with the provider’s EMR. Geneva archives both the discrete data and the PDF reports for each interrogation, and a cardiac device patient’s information can be viewed longitudinally.

How was this innovative technology platform developed? 

Geneva Healthcare was founded by Gilanthony Ungab, MD and Manish Wadhwa, MD, FHRS, two practicing cardiac electrophysiologists, and Kai Worrell, CEO of Worrell Industries, an industrial design firm based in Minneapolis. The founders focused on both the quality of care “pain points” when a cardiac device patient presented to an acute care setting and the information management challenges of centralizing, reviewing, and archiving device data across different manufacturers. They set out to design and develop a SaaS solution to help improve the efficiencies in these clinical settings for cardiac device patients and provide a usable interface to manage cardiac device data across all manufacturers. 

How does the Geneva Suite change clinical practice and workflow? 

There are multiple levels of how the Geneva Suite changes practice and workflow primarily into two functional areas — immediate presentation of point-of-care device data in an intuitive dashboard to improve clinical decision making, and an electronic workflow module to allow a physician to review, interpret, sign, and archive the information. In point-of-care settings such the ER, OR, MRI or Radiation Suite, Geneva allows data to be accessed via simple device interrogation using the current programmers and then uploaded to our servers for processing. This data, now held in an electronic format instead of on paper, can be accessed anywhere via the Internet by the most appropriate healthcare practitioner, including an EP and the EP staff. By presenting the data in the Geneva Dashboard, utilizing a red, yellow, green format to indicate values within or outside of the normal range, the complex device data is simplified and allows the end user to better understand the patient’s clinical state. In a clinic setting, where there is already resident staff knowledge to read manufacturer device reports, the Geneva Suite provides a seamless electronic documentation workflow platform for both point-of-care interrogation data and remote monitoring transmissions. Remote monitoring data from all the device manufacturers are transmitted to the Geneva repository, providing the provider one central information management system to access and review data. The passive flow of remote monitoring data has a marked effect upon workflow versus requiring an active monitoring mechanism for all the major remote monitoring sites, particularly since managing this data continuously has become a challenge for most clinics. As an interrogation is a billable procedure, it warrants a report and storage of the raw data identified during the transaction. The Geneva Suite creates an electronic documentation workflow that marries an e-report of the interrogation and the full PDF printout from the interrogation, with related diagnosis and CPT codes. These interrogations are then archived for access in the future, if needed, and the reports can be sent to the institution’s EMR from the Geneva EMR.

How have patient wait times been affected using the Geneva Suite? 

Data was published in an abstract at the Society of Academic Emergency Medicine conference demonstrating a 92-minute reduction in wait time for cardiac device patients presenting to the ER at UCSD Medical Center.¹ 

How does cost figure in? 

Geneva provides its SaaS solution as a monthly service. The return on investment is multifold. Since time is money, increasing the efficiency of healthcare delivery affects the bottom line. Not only does the Geneva Suite reduce the time to make the data more accessible and usable in acute care settings, but the Geneva Suite creates efficiency by streamlining the management of all remote monitoring data from the different device companies. Additionally, enabling better care to patients also enhances the value proposition of the Geneva offering. The solution provides for identification of not only issues directly attributable to device function, such as lead and battery measures, but also provides access to usable data on the patient’s well-being, such as data from health failure sensors and arrhythmia data. This arrhythmia data not only includes ventricular arrhythmia data, but data on the occurrence of atrial fibrillation, which is of paramount importance relative to the need for anticoagulation or medication adjustment or consideration for ablation.

In what other ways can the Geneva Suite help integrate mobile health data? 

The need to make data both accessible and usable does not end with implantable cardiac devices. Geneva has been designed to digest information from disparate data sources and to allow for the interaction and presentation in a common portal. We have designed pilots for several partners utilizing our dashboard with non-cardiac data while maintaining consistency across portals. This serves not only providers, but also patients, as doing so maintains consistency through the healthcare experience.

What are some of the institutions the Geneva Suite is being used or tested at? 

Because Geneva is headquartered in the San Diego area, the company’s initial focus was to onboard key regional provider systems including Sharp Healthcare (system-wide), UC San Diego Medical Center, Paradise Valley Hospital (part of Prime Healthcare Services), and start a pilot at Scripps Mercy Hospital (part of Scripps Health). Geneva has also initiated a pilot at the University of Nebraska Medical Center’s Heart Clinic.

Is Geneva Suite currently part of a clinical trial? 

We have 2 future studies looking at device-detected atrial fibrillation, sponsored by Pfizer, Bristol-Myers Squibb, and Biosense Webster. 

Is there anything else you’d like to add?

Over the last 4 years, the company has made strong progress in clinical settings in the Southern California region. What started as an acute setting, point-of-care solution to standardize proprietary device data feeds into a common dashboard for improved quality of care has grown into an enterprise cardiac device management solution for hospitals and clinics. Geneva is unique because it is offered as a software-as-a-service that allows all key stakeholders to access critical information, anytime and anywhere. Founded by practicing EPs, we have a unique perspective in medicine, having lived in the complex world of implanted devices and propriety data for all our careers. While we are just currently seeing the tip of the data iceberg in device data management, we are excited to provide the market a solution that can adapt as healthcare continues to evolve. 

Disclosure: Outside the submitted work, Dr. Ungab has a patent pending for a Medical Device Information Portal.

Reference

1. S274 2014 SAEM abstracts  662 Does Emergency Department Interrogation Reduce ED Time for Patients with Pacemakers or ICDs?- James P. Killeen, Edward M. Castillo, Jesse J. Brennan, Gary M. Vilke, and Theodore C. Chan University of California, San Diego, San Diego, CA.