Taking Healthcare by Storm: Industry Insights with Dr. Tom Ahrens

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Tom Ahrens, PhD, RN, FAAN, founder of Viven Health. 

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. 

This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-ARPA-011025-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

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Hello everyone and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, Medical Director at Quality Insights, and today I am honored to have a very special guest with us, Dr. Thomas Ahrens. Dr. Aarons is a trailblazer in the field of infection prevention and critical care. He's over 30 years of experience, and his work is focused on improving outcomes through better communication, advanced technology, and the evidence Dr.

Aarons has been a leader in based practices. From his pioneering work in sepsis management to his recent contributions to public health education. Dr Aarons has made a significant impact on both the clinical and educational sides of health care. We're going to be discussing today his latest work with Vivint Health, particularly their healthy workplace and health university programs, innovative online based infection prevention solutions.

So very important right now as we're entering the respiratory season, and these programs are designed to reduce the spread of infectious diseases like flu, colds, COVID, and we're going to dive into how these programs are changing the way organizations approach hygiene, and we're going to be talking about why behavioral change is key.

To reducing infections and the role that technology is playing in making these programs Accessible and effective. Dr. Aarons. Thank you very much for being with us today Oh, it's my pleasure. Thank you so much for inviting me to participate Great. So just going to jump right in. You've had an incredibly impactful career, especially in the areas of sepsis and infection prevention.

So both so very important. What initially drew you to focus on these critical areas in healthcare and how has your perspective evolved over the years? Yeah, it's a wonderful question. And you can call me Tom. It's okay. Perfect. And you can call me Jean. Okay, wonderful. Yeah, you know, Jean, when we were, you know, most of my career has been in critical care.

Uh, so the intensive care units and as you're well aware, the sickest people we get are those with infections. And you know, whether it's pneumonia or, um, you know, any COVID things like that. But the danger is they progress to sepsis and that's really what kills people. And so sepsis has been on my, or in my career for, you know, 30 plus years.

Um, and so the problem is, is in the intensive care units, we get people where. When they've already got the infection, when they develop sepsis, what really struck me was Most of those patients, uh, come in through the emergency room, they already have sepsis because an infection starts at home, much more than in a hospital.

Now people get sick in the hospital with infections, uh, you know, hospital acquired infection, but most of them are sick before they get to us. And so, what I needed to do in my career is, Move a little way from critical care, which is my first love. But really, how do we help the community? avoid infections and this is really what's fascinating is the ability for us to impact communities is Where our focus is now and trying not quite ICUs, but really how do we help?

An average person avoid getting sick and that's really what, where our focus is now. And I think that's where it should be. We're not in silos, you know, as COVID demonstrated, we're all affecting each other. That's exactly right. So, such important work. So you've published extensively on the role of technology and clinical practice.

How do you see technological advances like the simulation software using Vivint Health's programs playing a role in improving infection prevention at both the individual and organizational level? This is probably, Gene, the most important question, and it's really why we formed Our company, Vivint Health, the concept of, uh, technology and what it can do to improve lives is really at the core of what we're trying to do.

Um, and I'll give example of artificial intelligence. If you want to use AI to give you information, it's readily available. Um, we, I do the lectures and, uh, During the presentation, I'll, on, for example, I'll be talking on sepsis and I'll pull up chat GPT and I'll say, what is sepsis? How do you treat sepsis?

And chat GPT will do a wonderful job of telling you that. So the concept of providing content. isn't unique. We have an acceleration with artificial intelligence at giving content. So if you really just want to know an answer, um, you can just go online and get that. What makes Vivint different is the focus on behavior change.

So When in, I'll give another illustration people know they should get a vaccine, but they don't people know they should go to the dentist, but they don't. And so it's not that they don't have the content. What they don't have is the motivation to change their behavior. And that's where Vivian changes, uh, typical education.

And I see this as a precursor to all education, not just in healthcare. But what you do, what we do is we put people into scenarios. And in those scenarios, they have to make a decision as to what to do to correctly solve the problem. And so in healthcare, for example, uh, I'll use an illustration of infection prevention.

So we put a person in a situation where they're at a gas station. Are you at risk at a gas station? Well, the answer is, of course, the pump handle's probably never been cleaned. And so you could easily pick up an infection or a pathological organism from the pump handle. Um, I like to joke, uh, if you drop something on the floor, can you eat it?

And the answer is probably, uh, but you're taking a chance. And so what we do is we put people in real life scenarios where they need to identify their risk and what action to take to prevent that. So for example, in our gas station scenario, they must either use a hand sanitizer after they touch the pump handle or clean the handle with a antiseptic wipe.

So the idea is those simple actions. Are what lead to behavior change and we put those throughout our program. So people are dealing with real life situations. Um, in our workplace settings, you know, we'll put people in, uh, a workplace that is Pertinent to them. So we customize the program. So if you're in a nursing home, they'll see nursing home scenarios.

If you're at a Construction site, you'll see a construction sites, you know scenario And so the idea being is it let's not just tell people to wash their hands Let's let them do it in real life And it's those little things that people remember and that is what leads to behavior change Uh, so feel free to ask me if I didn't answer the question if I go, you definitely did.

I think that, that, that, uh, gas pump, uh, scenarios is so appropriate because people might not even think about it, right. It might not even come into their awareness. That's exactly right. Yeah. And so, you know, the more that they, people can see everyday scenarios. Where they're at risk, then that helps. Now, we also then, and this is the stuff that artificial intelligence doesn't do yet, um, is, say for example, a person, uh, goes home.

It can be from a hospital or a nurse home, doesn't matter. But, they've had sepsis before. And so, how do they make sure they're not getting it again? And so, in our scenarios, we actually have the user, and it can be the patient or the person who is sick, or it can be their family member. Well, they need to recognize the signs of sepsis.

are signs of an infection and when they should call their provider. And so we give scenarios where they're not at risk and where they are at risk. And these interactive scenarios are what helps people learn, well, this isn't a normal infection. So for example, if you get a cut on your finger in one of our scenarios and your finger is, looks, you have to identify is the finger abnormal?

Is it something you should contact your provider about? And so they, the user actually develops a little critical thinking skills. In terms of what they should be doing and that's really what makes the program different to this point. Yeah. And I think you that's I think it's a great resource outside of social media, you know, a lot of this.

Well, you bring up another good point is like with social media. Um, the program is designed to be fun. And it's designed to not last long. Um, you can take our scenarios that the individual scenarios only take a minute or two. Um, now when you combine them into a program, they can take, you know, 10 to 15 minutes, but they're designed to be short in fun.

And again, we try and give positive reinforcement throughout the program. Um, but you know, Jean, the other thing is, is the program's never intended to be. a standalone. It's designed to work with other efforts, uh, especially if you're looking at a program that's voluntary. So that, you know, if we have, um, a mass education program for the public, we need other groups to help, you With dissemination.

Uh, so, you know, again, our company can't do that on its own. So we look to partners like Quality Insight has been a wonderful partner. Um, and we look to continue to grow, you know, partners who can reach people and also help with behavior change. One thing we found very clearly it helps with behavior change is some type of incentive.

Um, doesn't have to be a big incentive, but just some positive, you know, reinforcement for going through the program. So it's going to take more than one, you know, program like ours to really get good behavior change. Yeah, I agree. So your work is long centered on improving communication between clinicians and families in high risk situations.

So very important. How do you think improving communication around infection prevention can affect both outcomes and overall health costs? Well, it's, it's a really good question because the, the point of our program is not to give medical advice. Our program is to help the user know enough when to contact their provider.

Um, and so the idea would be is when a user goes through our program, they also know what to tell the provider. So, for example, if we are working with. Um, say for example, staff members at a nursing home, before they contact the primary care provider or the medical director of the facility, they know what to, what information to have available.

And so we put them in scenarios where they need to identify those. And the same thing would be for a patient or their family, if they're calling their physician or primary care provider, that they know what to say. Rather than, you know, some vague term like, you know, they're not feeling well, uh, be as clear as they can.

Now, the goal would be at the overall program, is you look at infection prevention and sepsis. Um, these are things that come with enormous costs. Um, if you look at, for example, uh, just employers, they lose enormous amounts of money, not only in, uh, medical costs, but just absenteeism. So one of our goals is, if we could reduce how often a person gets sick, even by once a year, that's a benefit.

Now, sepsis is a tough nut. And when we look at hospital costs, I know you're well aware of this, is that sepsis is leading costs in hospitals. And our goal is to, if we can reduce the incidence of sepsis, then we've really done something. Uh, there's some other great organizations trying to do the same thing, like the Sepsis Alliance.

Uh, the public has to know about sepsis, And when it's present before they really can have, we can have an impact on that. So over the next couple of years, our goal is to educate the whole country on sepsis. And so they can recognize it. Um, and then get involved early. Now, unlike preventing infections.

Once sepsis starts, we can't stop it. And so all we can do is treat the symptoms. And so we don't have a cure for it yet. And that'll be the, the, I think the biggest advance of this century is if we can stop sepsis, but the idea is all we have right now. And it's a very powerful tool, but we just don't let anybody get an infection because that's always how sepsis starts, but the economic impact could be enormous if we could slow down the rate of sepsis.

Yeah, I would agree. And I really think that's that's so interesting about, um, thinking about the workplace. So your programs, healthy workplace, healthy university, they emphasize handwashing, sanitizing, respiratory hygiene. So very important. So what do you believe are the most Critical elements in teaching these behaviors and and, you know, we talked about behavior change and and how does the program ensure lasting behavioral change?

There's no easy answer on that. Yeah, it needs reinforcement. Um, like if you go through our program, we will see very quick behavior change. And people are, you know, after they go through our program, they're talking about it. They're, um, you know, talking with their friends and family and colleagues about it.

So we see pretty quick behavior change, but to sustain that, um, the program needs to be repeated. Um, and that's what we do in, in our, uh, program is we alter and improve the scenario so that people would take it. More often than just once we don't know. The answer yet is how often it needs to be done. Um, and that's something we actually still need some better research on, but probably at least yearly.

And you can make a case for refreshers, um, you know, between the years. So, you know, we're still trying to figure out what's the best way to ensure the cementing of behavior change. Um, you know, one thing that really does work well, Gene, is when it's done in a group. And so the group kind of monitors each other.

So this is one of the reasons it was advantageous to work with nursing homes, because if we can get their staff to work on the program together, Um, that does reinforce some of the peer pressure to perform certain behaviors. So there's other ways that the program can be effective beyond just taking the program.

There's other factors that could be pulled into play to help. Yeah. And I was reading on the website, your website, that One of the results from the program was a 48 percent reduction in cold incidents sustained over two years, which I think anyone would welcome. Nobody, nobody enjoys getting a cold. Um, so what do you think contributed to this success?

And no, I apologize. I don't mean to interrupt. No, that's okay. The, uh, that study was one that we did, um, is kind of a pilot study a couple of years ago. And. I think the reason for success, quite honestly, was, you know, we had a, um, a control group who didn't go through our program, and then we had our intervention group, which took the program, but that one did what I alluded to, and the intervention, uh, we contacted people actually every month, and sent them either a new scenario, didn't have to go through the whole program, but just gave them an update, So only took him a couple minutes, but it kept reminding them.

I think the behavior to keep themselves safe. I was actually surprised how big the effect was. Um, and you know, we need bigger studies to really confirm those results. But the idea was by doing some very simple behaviors. Uh, which is hand washing, which is masking, um, and we didn't even emphasize vaccines, which we really do.

Now, um, we can reduce often. Somebody gets sick. Um, and actually, if all we focus on was a common cold, it would be a benefit. But obviously, the more severe, the better. You know, infections like COVID, um, pneumococcal pneumonia, um, even the flu. If we can cut down the instance of those, then we also can have a, you know, an impact and keep people safe.

But the big impact of that program really was the common cold. Yeah. I'm, I'm sure lots of people would. Appreciate not getting a cold. I know I would. If I can avoid one cold a year, you've made me happy. Yeah. So the, your, the Vivint Health programs are available across multiple platforms, mobile, tablet, desktop, which I think is fantastic.

So how does this flexibility benefit organizations in terms of adoption and engagement, especially when it comes to busy. Um, are diverse populations, right? Everyone's busy these days, especially healthcare workers. Absolutely. The, um, we built a program actually, our original program wasn't for hospitals.

It was really for employers. Um, and so. What we did is we, we knew, certainly from our experience with hospitals, that our employees have very little time, um, so the program had to be short, it had to be something they wanted to do, it had to be engaging, and so as we implemented the program, we started measuring satisfaction with the program.

And we got really super high satisfaction, like 95 percent of people who enjoy taking the program, which is really a key factor. But the other thing we do when we work with an organization is try and have this as part of their. new employee orientation. So new employees actually need to take the program.

And the best way that we recommend for an organization is to make it part of their annual competencies. You know, you look at organizations that have annual competencies and you know, you know, this gene is, uh, and if you're in a hospital type setting, you have to do certain things, um, you know, like blood borne infection risk and things that, you know, fire safety.

Well, one of the most important things that we're not requiring is infection prevention. Um, how do we keep ourselves and our, the people we serve safe? And so one push we're going to really try and work on over the next couple of years is to make employers, um, include this as part of their annual competencies.

And if we do that, then we guarantee high participation rates. and have a much more likely chance of impact in an organization. Um, so when we look at, um, when it becomes optional or voluntary, it's much more difficult to get very high participation rates. We've had some wonderful success within the quality insight organizations.

Um, but you know, it's just going to vary dependent on the local leadership to. Um, push your program to be used if it's going to be voluntary. So it becomes much more dependent on the leadership. So we try and get away from that by making the program, um, part of their annual competencies. That is a, just a great idea.

I mean, we, we talk about important things that the annual competencies like, you know, workplace harassment and all those, you know, important things. So, um, Keeping everyone healthy should be part of that, you know, and it should be in the thing that about infection prevention, why we focused on that is it impacts every person where if you look at something we should be doing, like, um, you know, an organization's, you know, Try and help their employees to stay healthy and they'll include things like a gym membership and which is awesome You know, I applaud that but It's not everybody's going to want to go to the gym or do that.

So they need to have some other types of Activities infection prevention is necessary for everybody every day It's necessary for their families. And so what we encourage is That the program is used not just for, uh, the employee, but also for their families. And it was funny, we were just reviewing one of our, uh, programs yesterday that's aimed at, uh, kids.

And young kids, like nursing, or people in, uh, nurseries. Um, you know, there's, there's a lot that we could do to help those, those families. Places stay healthy. And so we have a program that's really designed for people under second grade, uh, and it's all visual. So one of the things that the program, uh, has as a feature is we do focus on no words in the program and just all visual cues.

And so, like, instead of having a scenario with the instruction on what to do next, there'll be arrows, or there'll be something that'll be directing the user. And we found that works at any age. We've had 4 year olds go through the program, um, that is visual only because they can follow those prompts. And so, the idea being is that, um, we really think the program can be used to, um, For anyone, any employer, you know, our goal obviously is lofty.

We would like to reach every person in the U S um, but we'll start a little lower and we'll work toward that. I feel like you should reach everyone in the U S you know, you, you brought up like a gym membership. You know, the insurance, you know, offers a discount, right? If you get a gym membership and go to the gym, I mean, this would having employees participate in this program, the div and health program to reduce infections would pay out.

I think more I'll say I'm a, I'm a, I have a gym in my home, but I think that this would pay out more in dividends. You would save a lot more. Um, time, you know, preventing infection and junior. You're right on target. Um, we, we think that's going to be the case over time as we get other partners to join us.

Um, the program is very inexpensive and that's done for a reason. It's so that we get a good cost benefit and the idea is that if we can reach large numbers of people, then obviously our costs are drop as well. So, you know, I think that it's going to be an example of over the next couple of years that we will start to see partners who can reach many more people, you know, we would like to engage CMS in helping distribute this, you know, through Medicare and Medicaid, you know, we would like to see third party pairs like the insurers.

Join and pushing this forward. Um, but another thing and you might be getting to this in a minute. Um, going a little different tangent is one area that we focused on that we, or we wanted to focus on and we put that on the back burner for now, but it's pretty close to being ready is to improve healthy behaviors in a way that's not just like infection prevention, it'd be like a drug.

adherence, you know, medication adherence. So we have programs that are designed for really more in the pharmaceutical line. If you look at, just use an example, I forget what the most recent pneumococcal vaccine rates are, um, but we can improve on those. And if we do that, then we not only help protect people and keep them safe.

You know, um, pharmaceutical companies would benefit and that's one of their goals and it's not just related to things like vaccines. So this could be applied for any medication, you know, when, and you probably are familiar with this as well as people who are listening. If you get a medication and they give you the required handout, you know, the really tiny font, uh, you know, handouts that most people don't read, it'd be much better to go through our program and be able to show, you know, why you would, what behavior is necessary to take this medicine, you know, what are the barriers that you're encountering, uh, for medication compliance.

Uh, those are things that we think we can have an impact on as well. So it's going to be fun to see how our program morphs, because right now we're still in the pretty early phases of, you know, launching, like I've said, quality insight has been a wonderful partner this past year, and, you know, we look forward to continuing relations with, you know, with quality insights, um, but we're going to want to do more this week.

I think you should. Um, so what are the common barriers to implementing infection prevention programs? Um, you know, in organizations and how do Vivint Health tools address these challenges to make it easier for organizations to integrate the program? You know, again, your question is very perceptive because, um, we, as we are first building a program, you know, we've been in business for over a decade.

Um, and we've learned a lot as we've, we've grown. Um, one of the barriers that we found was making the program voluntary versus. Required, um, because we just don't get the same level of participation, even with our incentives. Um, so we really want to make this just part of the routine, um, annual competencies.

But the other thing we did is, and I'll give an example. We're talking with a very large, um, Restaurant chain, and I won't give their name, but the, uh, they were very interested in what we were doing. And we thought that they were going to implement, and this would have been a major benefits because this is a large company that sees a lot of people.

And we believe we could have helped prevent infections, both in the employees and in their customers. But the decision rested in the HR department. And the HR department said, well, I've got too many things on my plate now. And I, we don't have time. And so the time issue was the main reason they didn't implement.

Of course, then COVID hit and that was another reason, but the, uh, What we did is we made the program so easy to implement, um, we can train the, um, staff member who's in charge of implementing it in three to five minutes. Wow. Employees can access the program simply by scanning a QR code. And then what we do is we provide, you know, we have our own internal LMS.

Our learning management system, although we can integrate with, you know, another one if that's what the employer wants, but we provide reports on who's taken the program, how far they went in the program. Did they get through the program? And so we can start to look at that. Um, the one thing that a little bit unrelated to the question is, you know, if an organization really wants to measure impact, we can help them do that.

You know, my background is as a research scientist. Um, and one of the things that we like to do is measure results. The problem is a lot of the things are very multifactorial. So, for example, infection prevention. Um, if we want to reduce the flu or the cold or COVID. We have to include the home. So an employee who's taking the program might do very well at work, but when they go home, what do they encounter?

Um, I was just in a meeting yesterday with our human subjects committee and our chair was sick, but he was sick because Over Thanksgiving, he had all his grandkids over and, you know, people are listening to that a little once, either their kids or their grandchildren certainly know that the kids are at risk.

So one thing that, you know, we need to do is make sure if an employer has taken our program, Make this available to the family. And at that point we would give their family a different program, you know, one of the same for a family member or for kids. And that's the way we would try and overcome that.

Yeah. You can't wear a mask when you're playing with your grandkids. But you bring up a wonderful point. The, uh, what you can do, and I do this You can't have a, uh, air purifier in your house. Oh, yeah. You can do some very basic things. Uh, you know, the more air movement in, you know, as I talk in this, it really is not for someone your expertise.

It's really for a general population who doesn't know some of this, you know, but the more you can filter the air, the, you know, even if it's in, you know, spring or fall, have your windows open, have a fan on, you know, those things make a difference. Okay. make hand sanitizers and antiseptic wipes available.

We implemented a program in, um, one company and, you know, I went to check on them personally cause they were local. And, um, right after they went through our program, they bought a whole bunch of hand sanitizers and antiseptic wipes. And I said, where are they? Well, they were in a cabinet. And I said, well, they're not going to do any good in the cabinet.

You got to make them easily available. And so we found something very simple gene. It was actually pretty interesting is, and it gets back into, uh, implementation, overcoming barriers. If you just make things available, it helps with compliance, have something that is, um, you know, sanitizer within sight.

Then it makes it easy. Um, the harder you make things to reach, the more difficult it is, you know, we talk about in a lot of, um, companies have done this, uh, retail has done it pretty well is they have sanitizers. It commonly use places. Um, you know, I get an elevator, uh, things that, you know, upon entry into the store.

Uh, or the business. Those are important things to do to help with, you know, reducing infections. And so we learned a lot with COVID. Uh, we still got more to go, but some simple things like that can make a difference in compliance. Absolutely. So looking ahead, what are some key challenges or trends you see in infection prevention and how do you envision the next phase of the Vivint Health program evolving to meet those needs?

Yeah, it's a good question. I think, um, we're on a, a good path right now. Um, we've got several organizations that are working with us, some fairly large ones, um, that can help us reach. First of all, one of our main targets is nursing homes. So we want to be able to reach nursing homes, but beyond that is employers.

And so to reach that, we really need, um, more partners. And for example, third party payers insurers would be able to help us with that. Our groups like CMS, we think CMS, we can give a very good cost benefit, uh, with the Medicare and Medicaid population. So the biggest challenge I think we see right now is You know, distribution.

And so our focus in 2025 is looking to have stronger partnerships with groups who have bigger reaches than we do.

I think that's so very important, Tom. Thank you so very much for being with us today. If a listener or an organization out there wanted to find out more information about Vivint Health, how can they do that? Uh, they could reach out to me personally. The, uh, we can probably share my email. Okay. Although I probably would then pass it to my sales team.

But the, uh, we would be happy to answer questions or, you know, if there's anything we can do to help, um, my colleague, Natasha Dickinson, who's our, um, uh, director of clinical affairs is wonderful to work with. And Natasha would be the one probably would handle most any inquiries at this point, but we would love to hear from people.

Perfect. We will link, uh, the Vivint Health website and your email in the podcast description. Again, Dr. Tom Aarons. Tom, thank you very much for being with us today. Oh, Jean, my pleasure. Thank you for inviting me. 

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

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