UK healthcare communication startup CardMedic launches in the U.S.

The company has 800 pre-translated phrases for healthcare workers to communicate with patients

During the pandemic, Dr. Rachael Grimaldi, a practicing anesthesiologist at Great Ormond Street Hospital in London, was on maternity leave when she read an article about a patient who had been to the ICU with COVID in the UK and was terrified because he couldn't understand the healthcare staff through their PPE. 

She soon realized that the barriers to good communication in healthcare are long standing, so while PPE was this one barrier that came about as a result of the pandemic, there are other barriers that exist, including those having to do with language, as well as hearing impairment, blindness, cognitive problems, learning disabilities, stroke, dementia, and literacy issues. 

"That, together, impacts about 50% of the population. So, it's enormous and this group of patients suffer from huge health inequities, poor outcomes, they're at higher risk of getting sick or dying, they stay longer in the hospital, they have higher rates of readmission. Their outcomes are worse too, and they’re less compliant with medication, they have more mental health issues. Also, litigation is huge: 30% of litigation in the medical sector is due to poor communication in healthcare," she told me in an interview.

The scope of the problem was impetus for CardMedic, where she now serves as CEO: it's a digital health solution designed to improve communication between healthcare staff and patients through the the use of digital flashcards.

On Tuesday, the company announced that is crossing the pond and expanding into the US market, with five new partnerships.

How CardMedic works

CardMedic created what Grimaldi calls "an A to Z library" of scripts that are pre-written and pre-translated, which a healthcare can staff can choose, show to the patient on a screen, and use to guide their conversation. The company was also do this, she explained, as there's a certain standardization to clinical practice, and the way doctors talk to patients, with often repeated phrases. 

For example, an anesthesiologist or a critical care doctor and might need to explain to a patient about going on a ventilator; with CardMedica they would explain it in English, following the script on the app, using phrases such as, “you're unwell, you need some help with your breathing," or, "we're going to send you to sleep." They can then use the app to change those phrases into the language the patient speaks; if the patient can't read, the physician can have the app speak the sentence to them out loud, or if they are hearing impaired they can change it to sign language videos with subtitles underneath.

Of course, the conversation will not always follow the pre-translated script, so Cardmedic also has an built in chat tool, allowing the physician and the patient to talk or type in different languages, allowing for two-way communication.

Patients can also download the app on their device, which allows them to favorite the phrases the doctor sends to them, so they appear in their own library, allowing them to show it to their families or carers. There's also a section called patient questions, which is for the patient to choose frequently asked questions of the staff, like, "what's wrong with me?" or, "what do my test results show?"

CardMedic so far comes with 800 scripts, across a whole range of specialties, all written by healthcare and allied healthcare professionals. It can currently translate those into 20 languages, with another 10 in the pipeline.

So far, the app has been around a year, in which time it was downloaded by 20,000 patients, with 55,000 users in 120 countries. While the company is still gathering ROI on patient outcomes, and how that translates into savings for hospitals, there was one stat that Grimaldi did share with me: at the start of the pandemic, the company did a service evaluation that looked at patient confidence in understanding health care staff through PPE. CardMetric showed a 28% increase, up to 95%, in patient confidence in understanding staff.  

Expanding to the US

CardMedic has thus far integrated its technology with 13 health systems across the UK through a partnership with the National Health Service. The company also received the Points of Light Award from the UK Prime Minister, and was thanked by the Prime Minister for the company’s achievements in supporting healthcare workers and patients during the COVID-19 pandemic. 

Now that it has entered the US, however, the company expects to grow quickly, with its new market representing the lion's share of its sales over the next five years.

It help that CardMetric is entering the country with five new partnerships, including Nor-Lea Hospital District, a critical access hospital in Lovington, New Mexico, which is the first rural healthcare organization to deploy CardMedic’s solution; it is using the app across its 25-inpatient-bed hospital site. 

CardMedic is also partnering with Brigham and Women's Hospital, the second largest teaching hospital of Harvard Medical School, which is piloting the CardMedic solution to help its patients and hospital staff and the Texas Medical Center Innovation HealthTech Accelerator Program, which has named CardMedic as one of its newest startups to its accelerator program.  

Other partnerships include ScaleHealth, a health innovation ecosystem that accelerates the impact of health innovation on a global scale, and MassChallenge, an organization dedicated to supporting innovation and entrepreneurship through collaboration and development, which has invited CardMedic to its HealthTech Accelerator.

In addition to Nor-Lea Hospital District and Brigham and Women's Hospital, the company is also looking at doing a pilot with Penn State Health coming up; the hope is that, in a year's time, the company will have more licenses with hospitals in the US and start growing but, as Grimaldi put it, "in a focused way and taking learnings from working with those other areas of the market, gathering the metrics, strengthening our value proposition, and our understanding of the ROI to then spread out into the bigger, academic hospitals as well."

"We have a global solution for a global problem, but some healthcare settings do have great translation services and translator support. And there are others, for example rural hospitals or FQHCs or smaller niche specialty networks, like in pediatrics, where they get less innovation headed their way. So, for us, it's looking at where we can add the most value in the market in the US. It's all about supporting the underserved, underrepresented communities," she said.

"Working with those rural hospitals who don't always have the funding and resources to have the translators available 24/7, for example, and working with the Federally Qualified Health Centers who have had similar challenges around always having a whole spread of translators, is where we are really starting our focus on, whilst learning from the big academic hospitals as well." 

One thing that the company did not have to do was alter the service for the US market, except for minor changes in language, such as changing ECG in the UK to EKG in the US.  

"It's more that fine nuance rather than the broad overall content because it is pretty universally translatable and accepted as a solution. It’s the same in the UK and US, you have translators in person, telephone and video, that's all the same practice. You have sign language interpreters, the same speech and language therapists or pathologists, learning disability nurses, all the clinical roles or communication support roles are the same. So, it more comes down to that nuance of adjusting the content," she said.

More than financial returns

While there obviously will be a financial return with CardMedic, something the company is in process of figuring out how to quantify, ot is looking at the bigger picture in terms of its impact on healthcare and the world. 

That means ensuring that it has a positive social impact globally, Grimaldi explained.

"We want CardMedic to be able to do is to break down communication barriers, to empower those underserved populations, put them at the heart of that shared decision making with the clinicians, give them a voice, empower them, and improve the health literacy overall for these huge group of patients who struggle because of communication challenges," she said.

That means launching in developing countries, which the company will do through a foundation it is currently setting up to provide grants for female entrepreneurs and healthcare entrepreneurs in developing countries, and fund training for community health workers in refugee camps. The company has already worked with refugees in Kenya with StepUp.One and it has also had a team using the app in Ukraine during the war.

"Success is not just commercial success of achieving X turnover with X number of thousand of licenses but it's also the success of reaching vulnerable populations globally that all need access to equitable and accessible healthcare information in a way that they understand and is meaningful for them, that they can get the most out of their healthcare interactions," said Grimaldi.

(Image source: cardmedic.com)