Kasey Claborn, Ph.D., an assistant professor in Dell Medical School’s Department of Psychiatry, is working with her team to address one of health care’s most pressing and complex issues: interprovider health information sharing. Claborn’s team is launching Project iCare, a software platform designed for improved provider care coordination for patients with HIV and/or a substance use disorder. Care coordination is especially nuanced in these situations, given privacy concerns and, especially, the chronic, multifaceted nature of both conditions.
Sharing patient data requires overcoming profound regulatory hurdles — rightfully so. In many ways, the regulations around patient data sharing are some of the best insurances we have for upholding patient privacy and autonomy. Regulation around patient data sharing is especially complex when the person has a substance use disorder: The government mandates higher standards for confidentiality and a more robust approach to data-sharing consent acquisition. Although 2017 changes to legislation theoretically increased data-sharing flexibility, technological solutions that would facilitate integrative, interprovider communication in line with the new standards are lacking, such that the expanded flexibility granted by the changes has gone unexplored by and large.
Project iCare is a digital platform designed to increase evidence-based screening; referral to and retention in treatment; and access to community resources for people with vulnerable, high-risk diagnoses across the care continuum. The platform supports clinical decision-making and interprovider communication with the ultimate goal of improving patient care.
Project iCare underwent a rigorous, multi-year design and evaluation process. Claborn and her team sought input from a wide array of care providers — including social workers, behavioral therapists, nurses and physicians — with the goal of producing an efficient, easy-to-use, collaborative platform. There were extensive negotiations between health institutions to determine mutual data-sharing agreements, and the team paid generous attention to ensuring patients’ autonomy in deciding whether to allow interprovider release of their information. The platform officially launched in five Austin clinics at the start of December.
The team participated in Texas Health Catalyst in 2018, which Claborn credited with helping her see the commercial potential of her academic research. Her research centered on technological interventions for aiding care coordination for people with substance use disorders.
“I had previously been focused on academic dissemination and publishing of my research,” Claborn said. “Participating in Texas Health Catalyst helped me to consider the scalability of my work from a commercial perspective.”
Texas Health Catalyst director Nishi Viswanathan, MBBS, MBA, was impressed by Claborn’s dedication to this cause.
“During the review process, it was clear that the solution offered much-needed care coordination in an area that requires urgent medical attention,” Viswanathan said.
However, from a commercial perspective, there were a few questions: Who would pay for the software? Were electronic health records integration necessary until the technology gained traction? What types of strategic partnerships might be feasible?
The program connected Claborn’s team with two business advisers: Robert Teague, M.D., chief medical officer of Green Room Technologies; and Zac Jiwa, co-founder and CEO of MI7. Working with the program and the advisers helped Claborn think through possible business models and transform the vision of her research into a clinical reality — one with the potential to meaningfully impact patients’ lives. Through Texas Health Catalyst’s startup formation package sponsored by Wilson Sonsini, Claborn started HealthEcho, a health technology startup. Project iCare is the first initiative the company has launched.
In November, Avani Jhaveri, iCare project coordinator, led a series of lunch and learns with providers in five Austin-area clinics. In these sessions, Jhaveri introduced providers to the platform, encouraged them to ask questions and asked them to provide additional input for inclusion in final design iterations. Feedback so far has been positive: With time, efficacy data for Project iCare will become available, and Claborn anticipates using it to inform project scaling. Her hope is to expand the project to clinics elsewhere, especially places the opioid epidemic has hit hardest, and to other clinical focal points.
Alongside her personal commitment, Claborn’s decision to launch Project iCare with a focus on people with HIV and substance use disorders was strategic: If the project sees success in the most highly regulated data-sharing environments, there will be a strong case for extrapolation to other clinical fields. Project iCare responds to an urgent need as stated by the American Psychiatric Association. It’s a technology designed to improve care coordination and, in doing so, improve care for some of the people who need it most.