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Monday, October 15, 2018

How Claris Reflex is Changing The Orthopedic Rehab Game

Claris Reflex is a patient-worn sensor and care management system that helps orthopedic practices manage knee replacement patients covered by the new bundled payments for total joint replacement programs (BPCI, CJR and private insurers).

 

Claris Reflex motivates patients to better comply with their prescribed pre-and-post surgical rehabilitation program by providing real time feedback on their recovery in their own homes. For clinics, better patient compliance saves time and money by reducing the likelihood of hospital readmissions, the number of days patients spend in hospital and skilled nursing facilities (SNF), as well as reducing the number of physical therapy, home care and emergency room visits.

 

Medical Device News Magazine recently had the opportunity to interview Mr. Geof Auchinleck, CEO of Claris Healthcare.

MDNM: Up until now, how have orthopedic surgeons monitored their TKR patients?
Mr. Auchinleck: Typically, surgeons will assess the patient immediately after surgery, then again during scheduled office visits at 3 months, 6 months and 1 year.

During the critical first 90 days though, the progress of patients is typically assessed weekly by Physical Therapists during their 1 hour therapy visit.

But up until now, there hasn’t been any way to quantitatively monitor what patients are actually doing the remaining 99% of the time.

MDNM: Why is that not working?
Mr. Auchinleck: The accuracy of self-reported compliance of patients with their recovery regimen varies widely. Even if they do remember what they were doing a week ago, there is a tendency to ‘improve’ their answers a bit. Worse yet, patients who are really struggling to manage their own recovery may be reluctant to admit it and end up falling further behind, ultimately requiring significant, yet preventable, intervention.

In the worst case, the first time a caregiver finds out that a patient is in trouble is when they arrive in the emergency room.

MDNM: As this is designed for the older patient, what are some of the advantages a patient has using the Claris Reflex coaching system?
Mr. Auchinleck: A patient is given the Claris Reflex care management system by their caregiver two weeks before their total knee replacement operation – this includes both the wearable sensor and tablet. Claris Reflex is unique in that it stays with the patient from their preoperative period right through to post-surgery recovery, which is usually 8 weeks. All the way through, it reminds the patient exactly what they need to do and gives them the confidence to know that they are on track.

Claris Reflex allows care providers to develop the most appropriate rehabilitation plan for each patient, or select from a preconfigured list of care templates. For patients, this means that each day they are instructed on what to do by the Claris Reflex tablet, such as, exercises, range of motion tests, icing, pain scale surveys, and various health checks. These daily activities, as well as their recovery goals, change over time to keep patients motivated and on track.

Claris Reflex also has personalized coaching that can be delivered via the tablet in the form of video calls with their PT, messaging with photo sharing, and custom videos.

Claris Reflex gives patients the confidence to manage their recovery from home.

MDNM: Considering that seniors may not be technologically savvy, can patients put the wearable device on with ease?
Mr. Auchinleck: We’ve designed Claris Reflex to be as intuitive and simple to use as possible. It is a dedicated device that doesn’t require any setup or technical knowledge to use. Knee replacement surgery can be a source of anxiety and fear for a lot of patients, especially older patients. We do as much as possible to remove this fear by providing them with the knowledge and tools to confidently and independently manage their pre-and-post-surgical recovery in their own home. We certainly don’t add stress with complicated technology.

The patients who have used Claris Reflex have told us they feel empowered, engaged and accountable in their recovery. We’ve also seen improved surgery preparation and quicker recovery time.

MDNM: Who provides the training?
Mr. Auchinleck: Claris Healthcare provides staff of orthopedic practices and hospitals with onsite and online training. Patients receive 20 minutes of instruction on using the Claris Reflex system during the usual patient education session about 2 weeks prior to surgery.

We’ve worked very hard to make the system as easy to use by patients and care staff as possible, effectively reducing the amount of training required to a minimum.

MDNM: Can you share some of the technological features of the Claris
Reflex?
Mr. Auchinleck: Some features of the Claris Reflex include:

An activity and temperature sensor: accurately monitors a patient’s range-of-motion flexion, extension, body position (walking, standing, lying and sitting), temperature and compliance

Wireless patient connectivity: patients can wear the Claris Reflex sensor anywhere: they are not restricted by a tethered system and the data uploads automatically when it is in range of the tablet.

A simple patient dashboard: providers can quickly see how patients are progressing with their therapy and be alerted to any potential issues with the patient’s recovery.

Objective data capture: enables providers to proactively manage care costs and monitor post-acute outcomes.

Secure messaging: patients and providers can send text messages, videos or photos; request a call and/or an appointment with a provider; and make video calls.

A dedicated, pre configured system: there is no need to download and install apps, set up wireless connections or configure devices – everything comes out of the box ready to use.

MDNM: Is the patient monitored 24 hours a day? For how long?
Mr. Auchinleck: Claris Reflex allows caregivers to remotely monitor, track and coach their patients from pre-surgery to postoperative recovery in real time all day, every day.

Claris Reflex is the only system to continuously monitor and coach patients, and this enables caregivers to better allocate their time and focus on those patients who are truly at risk.

MDNM: How much does Claris Reflex cost?
Mr. Auchinleck: The Claris Reflex system is a subscription service charged at a fixed cost per patient episode. Claris offers a number of different service packages – a clinic can choose to purchase their own tablets, for example.

The full-service package (including tablet, 4G data plan, sensor, pads, and shipping) is priced at $499 USD for each patient episode. Typical patient episode is about 10 weeks which covers 2 weeks prior to surgery and 8 weeks after.

Sensor only (tablet is provided by clinic or patient) and app only (coaching software only) pricing options are also available.

MDNM: How are care providers alerted if a patient is experiencing difficulties?
Mr. Auchinleck: We provide caregivers with a comprehensive online dashboard to monitor each patient which includes CareDot – a simple color coded ‘traffic light’ that gives a quick indication as to how well each patient is complying and progressing with their recovery. When a CareDot goes red, it is a prompt to caregivers to look into the patient’s activities to see if they need help.

In addition, Claris Reflex has a very flexible alerting system that allows caregivers to choose exactly when and under what conditions they will receive alerts if a patient is getting into trouble. These alerts can be received as emails, text messages, or through the Claris caregiver dashboard.

If patients struggle with their automated recovery, personalized coaching can be delivered via the Claris Reflex tablet in the form of video calls with their PT, messaging with photo sharing, and custom videos.

MDNM: How do you envisage Claris Reflex supporting the bundled payments system (BPCI, CJR and private insurers)?
Mr. Auchinleck: On average, post-acute care costs make up 43 per cent of the total cost for TKR procedures. Claris Reflex helps surgeons reduce these costs for patients covered by the new bundled payments for total joint replacement programs (BPCI, CJR and Private Insurers) by improving patient compliance and providing continuous monitoring of patients at home.

Claris Reflex helps contain the extremely variable recovery costs of high-risk patients by coaching these patients towards their ideal recovery path. It also automatically alerts caregivers to potential issues before things get so bad that the patient needs readmission.

MDNM: Regarding monitoring flexion and extension of the patient’s knee, exactly what does the medical specialist see on their end, and how do they respond to the patient?
Mr. Auchinleck: The Claris Reflex caregiver dashboard shows the latest maximum flexion and extension of the patient’s knee joint as measured by the sensor: the sensor actually records every single time the patient’s knee is bent – this detailed data is also available to the caregiver.

The flexion and extension achieved by the patient is constantly compared to the recovery goals for the patient and displayed as a CareDot – green if the patient is reaching or exceeding their goals, red if they are falling behind.

MDNM: Exactly how does this technology streamline care for those managing older patients?
Mr. Auchinleck: Claris Reflex allows clinicians to monitor their patient’s pre-and-postoperative progress and recovery remotely in real time, so they can better allocate their time and focus on those patients who are truly at risk.

The quantitative data provided by Claris Reflex’s monitoring system also supports orthopedic clinical research and allows clinicians to spot trends and characteristics in total knee replacement recovery.

MDNM: Regarding reduction of costs to the healthcare system. Please elaborate.
Mr. Auchinleck: On average, 43% of the total cost of a TKA procedure goes to post-acute care including physical therapy, home care, skilled nursing facilities (SNF), and inpatient rehab. Claris Reflex reduces joint surgery recovery costs while providing better monitoring and promoting better compliance of patients at home.

Costs are saved in three ways:

▪ Claris Reflex reduces costs and CJR and BPCI penalties through better identification of high-risk patients and early intervention – particularly where there is a risk of re-admission
▪ With an automated, sensor-driven, coaching in their own home, Claris Reflex improves patient compliance and reduces the costs of traditional rehabilitation programs.
▪ Claris Reflex supports earlier discharge of patients from hospital and SNF by monitoring them safely at home.

Editor’s Note: For more information, please visit http://clarisreflex.com/

MDNM

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