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Duo's model involves local care teams that see patients in the setting of their choosing
There are roughly 37 million US adults who are estimated to have chronic kidney disease. In both sexes combined, these diseases are the 8th largest cause of mortality, the 10th largest cause of years of life lost, and the 10th largest cause of disability-adjusted life years.
It's a big, and expensive problem, and one where change is badly needed, Nathan Goldstein, CEO and co-founder of Duo Health, a medical group designed around the needs of patients with chronic kidney disease and their physicians, told VatorNews.
"Not only are these family, friends and neighbors some of the most fragile and expensive patients in the system, but because CKD disproportionately impacts communities of color this leads to morally offensive inequities in the quality of care delivered. Let’s be clear: this isn’t about the behavior of practitioners. The system is failing our friends and neighbors and we have an obligation to re-wire it," he said.
Duo Health's solution involves local care teams who see patients in their homes or the sites of their choosing, providing an elevated patient experience supported by a technology platform that is largely invisible to the patient, and yet gives them a highly personalized experience of care. That's because, as Goldstein explained, the best way to reach someone who may be reluctant to, or even incapable of, accessing care is to reach outside health care’s typical sphere of influence to relate to patients on their own terms.
To achieve this goal, the company collaborates with local practices, which is why Duo Health, which launched earlier this year, announced a partnership with Arizon-based nephrology practice Desert Kidney Associates (DKA).
"When we met Dr. Mandeep Sahani and his colleagues at DKA, we knew we had found kindred spirits in terms of our total focus on the patient experience. So much of this goes back to earning the trust of patients and making it easier for them. We like to say that we can’t promise to fix this crazy system overnight, but we can promise that you will never feel alone in it again," Goldstein said.
Part of the company's ethos is to not replace local practices, but rather to enhance them, he explained.
"We can’t express how important this idea of 'keeping it local,' is to us. Desert Kidney Associates is a nephrology practice with deep roots in their communities. From the perspective of the patients, Duo feels like an extension of the great care they get today from DKA clinicians, but unlike a traditional practice, we are built to follow the patient through every step of her care journey."
For Duo's patients, the partnership between Duo and practices like DKA means that they can keep seeing the nephrologist they know and trust, as well as any other specialist or primary care physician, at no additional cost to them. They’re also given a dedicated Duo care team, which includes a physician, nurse practitioner, licensed social worker, care navigator and others who provide routine in-home visits, or telehealth if the patient prefers.
That time that its clinical teams can spend with their panel is the company's most important deployable resource, Goldstein said, and it allows for greater collaboration in goal setting with patients and their team of physicians, safer transitions after a hospitalization, better wrap-around support for a patients’ transplant journey.
"The basic ideal for patients is: call us first. We’ll never stand between you and the doctors you know and trust. But by starting here we can keep everything coordinated and simple," said Goldstein.
"The combination of our interdisciplinary medical group, advanced technology that unlocks new forms of patient engagement, and an operating model with an exemplary local partner like Desert Kidney and the global capitation that unlock the real opportunity to improve outcomes for this patient population."
Practices like DKA integrate with Duo via a technology platform that builds a learning system that drives continuously better outcomes, and the company's patient-directed medical home approach fields care teams wherever the patient needs us to be.
For example, seniors are the fasting growing segment of mobile game users, so the company is launching a gaming platform that integrates with its learning programs so that these patients can play their favorite games at home or in the dialysis chair. However, instead of buying coins or watching ads to play games, they are asked to respond to a quick survey on their health, or watch some customized education content that is curated by one of Duo's ML engines. That only lasts for a minute before they can get back to the game they're playing.
"It’s anything but frivolous. No one is fooled by attempts to 'gamify' crappy experiences, but can we healthify games? We need to find new ways of getting to patients to earn these moments of influence," said Goldstein.
Ultimately, the Duo's goals include creating healthier patients and communities, lowering stress for caregivers, creating higher quality of practice for its partners, greater access, slowed disease progression, higher transplant rates, more patient goals achieved, and better quality of life for patients. And it's through partnerships like the one with Desert Kidney Associates that it will be able to achieve those.
"These partnerships require a deep relationship built on trust and collaboration. We named ourselves Duo because of the sacred bond between patient and clinician. But almost immediately we also began to think of the other Duo, that between our local partners and ourselves. We consider ourselves a mission-driven organization. We have found a partner who thinks the same way," said Goldstein.
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