Exploring the Potential of Mobile Healthcare Services Delivery With Estella Health’s New COO Brenden F. Hayden Jr.

Let’s start with a little history lesson, can you kick off by telling us a bit about the origins of mobile healthcare  and how it has come to play such an important role in how care is delivered today?

So many do not know this, but mobile integrated health actually started with a project in New Mexico that was designed by the government to serve patients on an Indian Reservation that had very limited access to care due to the remoteness of their location. What that program demonstrated was that those paramedics and EMTs and other, non-physician providers were able to manage patients very safely, leveraging technology to provide access to high quality care in areas where treatment delivery was previously challenging at best.

Fast forward to where we are today, we have a modern healthcare system that has evolved a lot over the years but one that remains very challenged resource-wise when it comes to being able to appropriately and safely manage every patient that shows up. In response to this need for more help, we as an industry have started to recognize that much like years ago in New Mexico, mobile healthcare is well poised to tackle these issues safely and in an effective and efficient way. It’s truly a game changer.

How does mobile healthcare work exactly? How is it different than traditional care delivered by paramedics?

With mobile healthcare, EMS providers, paramedics, and other trained medical professionals are able to address many patients’ medical needs from within their own homes eliminating the need for medical transport, ED overcrowding, and further physician resource strain within the hospital. And unlike that initial pilot years ago it’s been well proven that the offering can be just as beneficial in an urban setting like Boston or Providence as in a remote town in New Hampshire.

For underserved populations or underserved patients, being able to receive that care in a home setting, which is a much more comfortable environment for the patients, that has the same quality standards, and the same outcomes data is really a game changer for the healthcare industry. Whether it's congestive heart failure, chronic obstructive pulmonary disease, pneumonia, diabetes management, skin infections, and others, these are all patients that traditionally would have to go to the emergency department and wait hours to gain treatment access, which is fairly straightforward and simple, as long as it's being done properly, and the patients are being monitored effectively. I believe the latest survey showed statistics that about 20% of hospitalized patients could be safely managed at home. That’s the population that Estella Health is targeting.

So, what would you say are the big trends really accelerating the adoption of mobile healthcare today?

It’s no secret that healthcare is not typically a fast mover when it comes to adapting to change. We’ve already touched on overcrowded EDs and physician resource shortages driving demand for new care delivery models. In response to that we are seeing, hospitals and health systems like Mass General Brigham, Beth Israel Deaconess Medical Center, and Boston Medical Center, are really advocating for mobile health because managing patients safely in the out-of-hospital setting would also serve to decrease congestion within their hospitals.

And then there are the providers who have been championing for mobile healthcare for some time now. If you talk to a primary care physician, these folks have been at the forefront of home health and mobile health for many years because up until recently they have served as the non-hospital entity that treats patients outside of the four walls of the building via primary care and they simply don’t have the bandwidth anymore and are limited by what they can do. If you talk to them, they all say, well, we've been doing this for years and so now to have the expanded capabilities to be able to manage that patient from home with a higher level of diagnostic capabilities, this is a win for us. For example, do you know that our paramedics are carrying a whole case of technology into the home, including a portable lab machine that can analyze the patient’s blood and generate your results in five minutes in your living room? Astounding! This drives better clinical decision making by our partner physicians and allows for more timely management of the patient. In many cases, primary care providers see the value in managing their patients outside the hospital, and with mobile healthcare, and the capabilities that we offer through Estella Health, know that their patients can be managed safely and, in many cases, earlier from home.

And would you say patients have traditionally been pretty receptive to being cared for at home versus in a hospital setting?

If there is one positive thing to come out of COVID I would say that post-pandemic patients are a lot more flexible about how, when, and where they are being treated as long as they know that the quality of care received, and outcomes will not change. Obviously, there is also the huge plus of being able to receive care in their homes versus a often times confusing hospital environment. Overall, I would say the sell has not been that hard . Patients ultimately want the diagnosis, the treatment, and they want the convenience. And that is something that mobile health offers today.

So, you are the COO of Estella Health which launched its mobile health services offering in Massachusetts late last year. Business is rapidly growing and with that, I can estimate that building up a mobile health team to meet this demand will be important. What kind of experience are you looking for when it comes to bringing on new resources?

Much like our patients need to be conditioned to understand that mobile health is the same care just provided in a different setting, so do our paramedics. We just say it is a different type of medicine. They are accustomed to treating car accidents, shootings, and stabbings, heart attacks and strokes. With mobile health, their diagnostics skills still have to be spot on but in a different way. In the mobile health world, it’s really dispatch, response, arrival, assessment, consultation with medical specialists, be it physicians, nurse practitioners, PA’s, which is case dependent and then in home treatment, managing the patients at home and making sure that you can safely do that.

 Adjusting to that shift in care delivery definitely takes time and training and I would say it is certainly a position that is better suited for experienced providers that have a number of years under their belt. At Estella, we are committed to making sure each and every mobile health professional on our team has the appropriate levels of training, education, and certification.

You joined the team quite recently. What about the Estella Health opportunity did you find particularly attractive and worth making a career move?

I think it’s important to preface that I am not a person who switches jobs often or for every shiny prospect that comes my way, in fact I am quite the opposite. At this point in my career, I’ve been working in the mobile health space almost exclusively for years on the health system side, helping to build meaningful programs in different parts of the country, including Arizona, Texas, and Massachusetts. I also worked for a large mobile health program before this where I served in an executive leadership position helping that program to nearly double in size in a year.

When the Estella Health opportunity came my way, I was intrigued with the chance to build our offering from the ground up, to define what the gold standard of mobile healthcare delivery looked like in New England. But perhaps the most significant thing that made me seriously consider the role was the vision of Estella Health CEO Alexandre Theoharidis. I found that he has a very keen sense of where the clinical need is and how we can rapidly deploy to address that need. He also has pretty much gone all-in on mobile integrated health, so he recognizes that this is an effort  that is going to require  an investment of time, people, and dollars  and he is willing to commit these resources as he really  sees mobile healthcare as the future of our healthcare industry, as do I. It was this shared passion coupled with our alignment of values and ethics that definitely made the move a no-brainer.

What’s next for Estella Health?

Mobile healthcare is proving that it can improve the overall care of a patient in a safe environment,  produce extremely high patient satisfaction results, while also decreasing  the overall burden on the healthcare system at reduced costs. As the clinical value of the model continues to be fully realized we expect that demand for the services will  grow exponentially. Right now, we are relatively new, so we are laser focused on providing a superior level of in-home care for the communities we are already contracted to serve while making sure that we have the properly trained team in place to service their growing needs. In the coming year we will be scaling our geographic reach, expanding our team of paramedics, evaluating new technology innovations to incorporate into our model and exploring new clinical delivery capabilities that we can offer in the future which can be accomplished organically or through future partnerships.

If you are a paramedic or EMT  looking to learn more about Estella Health and the rewarding career opportunities available in mobile healthcare reach out today!