MedStar Health Spin-Out Auxira Health Offers Cardiology Practice Extension
Last week I wrote about Chicago-based Abundant Venture Partners’ announcement of a partnership with 17 health systems to build sustainable startup companies that benefit healthcare providers. One of those health systems is Maryland-based MedStar Health, and this week it rolled out the first startup developed through the collaboration, Auxira Health, which is focused on supporting cardiology practices.
Auxira pairs clinical support teams with cardiologists to increase care access for patients, improve clinician well-being and ensure financial sustainability. The company matches cardiology practices with dedicated clinical “pods”composed of advanced practice providers (APPs), medical assistants (MAs) and registered nurses (RNs) who work remotely as an extension of the cardiology team.
Auxira’s model was initially developed and deployed by MedStar Health as part of its Connected Cardiology program, which generated improvements in care team capacity, physician satisfaction and patient access. Excited by early positive outcomes, MedStar worked with Abundant Venture Partners to refine the model and bring it to market, with MedStar Health becoming an Auxira co-developer, anchor customer and strategic investor.
In an interview with Healthcare Innovation, Inna Plumb, co-founder and CEO of Auxira Health, explained the company’s raison d’être: “Fundamentally, there's a meaningful shortage of cardiologists and an increasing demand for their services. There are 10,000 Americans aging into Medicare daily. Most of them have multiple chronic conditions, and a significant portion of those conditions tend to be in the cardiology space,” she said, explaining that on the supply side, many cardiologists are retiring, so there's a real mismatch, and it's only going to be exacerbated over the coming years. And although the advent of the EHR has created an enormous amount of access for patients to be able to reach out directly to their providers it's also created a significant burden for the physicians in terms of portal messaging, reviewing results and other administrative tasks.
“That workload has only increased over the past 5 to 10 years,” Plumb added. So you've got cardiologists who are working in the EHR hours after the day ends, as well as an increasing demand and limited supply. “What we do is provide a very seamless extension of practices. I think this is the right way to do telemedicine,” she added. “It’s a really elegant way to incorporate telemedicine into in-person practices, because it's very hard to do telemedicine well in a way that provides continuity of care.”
Auxira does not bring its own tech platform to the equation. Its practice extension team works in whatever EHR the practice already uses.
“That’s one of the key advantages, because we can really integrate very, very quickly and seamlessly with the practice,” Plumb said. “There’s no integration burden. I've done the whole API integration with EHRs; it’s hard on everyone. It doesn't always work well, and it really slows things down. We kicked off with MedStar at the end of December, and were seeing patients by April. That's how quickly we were able to get up and running.”
Bill Sheahan, senior vice president and chief innovation officer at MedStar Health and executive director of the MedStar Institute for Innovation, spoke about how the concept developed and why they thought it might work as a business model to expand. “We have a large number of cardiologists in our system, but there's always more need for access than there is capacity in our practices,” he said. “And there aren't a lot of cardiologists to hire. We had a focus on the well-being of our providers and trying to get them to practice at the top of their experience versus handling some of the administrative tasks. We deconstructed the model, looked really hard at the work that was being done in our practices, and realized what Inna described — that there was a real opportunity to bifurcate some of the work and create a remote team that supports certain functions within the practice.”
Sheahan added that a patient who has a cardiology procedure or has a major cardiac event regularly follows up with their provider for years. They don't often have new problems; they're just checking in. “So we tried to move that work onto that remote team to support those cardiologists and the patients who had those needs, and relieve some of those administrative tasks and functions in a way that created capacity without having to build new practice locations and find cardiologists that don't exist, and try to expand the network in a more traditional way.”
MedStar Health teams tracked metrics across many areas, and they were surprised by how this intervention helped with almost every measure they were interested in, Sheahan said. On cardiologist well-being, they saw a 35% reduction in after-hours EHR time. They also had a 37% improvement in access for those patients waiting for appointments, as well as a 14% improvement in Press Ganey scores for the practices that were in this model. “If you put those together, along with a model of economics that can support this kind of service delivery for patients in terms of the billing, supporting the services, that's a wonderful win for the CFO, the president of our medical group, and the cardiologists themselves,” he added.
Sheahan also spoke about the value to MedStar Health of being in the Abundant Alliance. “We are proud partners of Abundant and they really helped us bring this vision to life. Their platform was created to allow this large group of health systems to collaborate. We all have very similar problems, and this is a great example of a problem that really resonated. Part of the value that Abundant brings to this is that the idea was validated among that group of health systems and brought forward. This is our first realization of a company creation off the back of that process, in partnership with Abundant.”
In a statement, Harry Kirschner, CEO of the Abundant Alliance, said, “Auxira represents the kind of healthcare infrastructure we believe needs to exist—high-impact, scalable, and built around the way clinicians actually work. It’s a strong example of how thoughtful venture building can accelerate practical solutions for care delivery at a time when specialty medicine needs new models to meet demand.”
One of the beauties of the model, Sheahan said, is that it has allowed MedStar Health to actually move faster to get this to full scale across its enterprise. “Being a big integrated delivery network, we tend to move slowly in growing things like this, but a company like Auxira can move faster in support of us, particularly with that model where they're billing under our service, so that top-line revenue is coming in, and we're contracting with them to help us deliver this. But I think it's a really exciting way to go faster to full scale. We have a very large cardiology network, and we anticipate being at full scale with this model toward the end of this calendar year.”
Plumb said the cardiology community is fairly tight-knit and that she expects the company’s reputation will help it grow. “The most important thing for this business is going to be doing a really, really great job of gaining the trust of the providers, and then they are going to be our biggest advocates,” she said. “I think they are our strongest channel because at the end of the day anybody we pitch to, they're going to pick up the phone and call the providers on Bill's team and any other clients we have. And I think that word of mouth is really going to help drive growth for us.”
