By JULIE MINDA
Dr. Mark Kantrow, a physician at Our Lady of the Lake Regional Medical Center in Baton Rouge, La., has joined two business partners in launching a palliative care app for mobile devices to support intensive care unit patients and family members.
The app provides information to inform the difficult discussions patients or families might face regarding ICU care — decisions around such topics as do-not-resuscitate orders, life support and goals of care. The app is meant to spur broader engagement with clinicians and palliative care professionals, said Kantrow.
"With (this) support tool that engages families around sensitive subjects and encourages families to ask questions, our hope is that every family that uses this tool will receive a light palliative care touch; and those patients and families that have more complex issues will be guided to a more comprehensive palliative care interaction with the palliative care team" as well as with other clinicians, he said.
Dr. Mark Kantrow
The company that created the app, and the app itself, are called Naveon; and Kantrow is one of three principal partners.
The app went live at Our Lady of the Lake in November, and is free to users. Naveon is in the process of selling the app to other hospitals. Hospitals that buy the license to use the app would then provide it free to patients and family members.
The app contains practical information to orient people to the hospital and staff, equipment and concepts they'll encounter in the ICU. It offers resources on palliative care options. It features videos of hospital experts and local religious leaders discussing cultural and religious contexts for decision-making related to care of an ICU patient. For instance, in short videos on the app, Archbishop Gregory M. Aymond of New Orleans and Pastor Fred Luter of Franklin Avenue Baptist Church of New Orleans speak from their respective faith traditions about finding hope in the midst of suffering, how to deal with family conflict and medicine and miracles.
Kantrow, who is medical director of Our Lady of the Lake's palliative care program, developed the app with two Baton Rouge-area businessmen, Matthew Rachleff and Kevin Lyle, over the course of about three years. Rachleff and Lyle have worked in executive and governance roles for multiple companies and together founded a consulting firm called I-MPACT five years ago.
Kantrow, Rachleff and Lyle formed the private, for-profit Naveon company in 2014 to develop the app. Kantrow is chief medical officer of the company, Rachleff is chief executive and Lyle is chief financial officer.
The trio developed the majority of the content but also included some material from Our Lady of the Lake and from third parties, including CHA.
Kantrow said he saw the need for the app because not all patients and families in the ICU get palliative care information and support — although most could benefit from it. Kantrow said, "In the ICU, there is a high level of need — with lots of seriously ill people confronting difficult life choices. But, currently some people get a palliative consult, and some don't."
Currently, at Our Lady of the Lake, patients and their loved ones receive a palliative care consult only if a physician makes a referral — that referral may be prompted by a request by a patient or family member.
Typically, during a palliative care consult, one or more members of the hospital's palliative care team talk with a patient and/or family members about the details of the patient's condition, prognosis and options for symptom management and treatment. They answer questions, facilitate family discussions and provide referrals to resources such as for grief support. Kantrow said the app's content can prepare people to ask in-depth questions necessary for informed decision-making.
Nurses at Our Lady of the Lake have been letting patients and their families know about the app. If people are interested in using it, the nurse or a member of the hospital's palliative care team "invites" them, via an email, to download and access the app. The nurse or palliative care team member can provide technical help in downloading and navigating the app. More than 125 people have downloaded the app so far.
Users can invite other family members to the app and can communicate with one another and with members of the patient's care team through the app. Members of the ICU care team — including physicians, nurses and social workers — can flag certain content areas that they think would benefit the family members.
Also, people using the app can ask questions of their own care team or of members of the palliative care team. Kantrow said the care team members respond to questions face-to-face. He explained, "The goal of the (app) is to support better real-world relationships and conversations." A staff member is responsible for regularly monitoring to ensure all questions have been addressed.
In addition to Our Lady of the Lake, Kantrow and his partners have launched the app at St. Francis Medical Center in Monroe, La., which — like Our Lady of the Lake — is a member of the Franciscan Missionaries of Our Lady Health System. Kantrow and his partners are working with the Louisiana State University Health Sciences Center to survey families and care team members on their use of the app.
The Franciscan Missionaries of Our Lady congregation that sponsors the health system was the first outside investor in Naveon. Some angel investors, primarily from the Baton Rouge business, medical and investment communities, also have provided funding.
Kantrow said he hopes the app will provide an additional means for connecting patients, their loved ones and hospital staff. He said the app can lay the groundwork for better discussions between patients, family members and clinicians. "My favorite part of palliative care is the communication, and that is the foundation of the app," he said.
Copyright © 2017 by the Catholic Health Association
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