8. Do patients like MayaRED?

In clinical trials, patients report very high degrees of satisfaction, ease of use, and a sense of “caring” and understanding. Most importantly, when asked “Who would you like to receive discharge instructions from?” twice as many patients prefer the conversational agent than a doctor or nurse, often reporting, “It was just like a nurse, actually better, because sometimes a nurse just gives you the paper and says ‘Here you go.’ [Maya] explains everything.”    

 

9. What happens when the patient goes home? 

MayaRED provides the patient the option to download the MayaMD App where the patient can receive post-discharge reminders about appointments and medicines at times convenient to the patient, a functionality shown to reduce readmission., The portal allows the patient and providers (and others with permission) access to the care plan. 

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Selected chronic care patients also have access to the MayaMD Remote Patient Monitoring (RPM) system that can monitor a patient’ vital signs. The RPM service provides reminders to take their readings of clinical measures using automated transmitting devices (e.g., blood pressure monitor, pulse oximeter, scale, glucometer). The MayaMD Provider Portal displays the clinical measures, shows trends graphically, and notifies about any abnormal readings using individualized guidelines from the ordering provider. These tele-monitoring activities are also highly efficacious in lowering readmission rates.

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10. Is MayaRED integrated into the Hospital EMR?

MayaRED can be used as a stand-alone system or integrated into the EMR. If used as a stand-alone product, the provider responsible for the discharge enters data into the MayaMD web portal (for details see the document (see Instructions for the Discharging Provider Using MayaRED). It might make sense to do this early in a hospital implementation as the system is being customized to hospital specifications. When all parties agree on expanding production it makes sense to integrate with the EMR, as integration can save a few precious minutes of data entry time. The MayaMD team has experience integrating products into all the major EMRs.

 

11. What reading level is MayaRED?

MayaRED is understandable to patients at all levels of health literacy. The multiple channels of communication (e.g., AHCP is shown on the screen held by the patient, with conversational explanations provided by Maya, and close captioned display of the words spoken) all reinforce the key messages. A great deal of thought and testing was put into ensuring patients can understand all parts of the discharge plan. 

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12. Does MayaRED speak languages other than English?

Delivering discharge information in a patient’s preferred language greatly improves quality of care and reduces post-discharge adverse events. It also saves an enormous amount of staff time as it alleviates the time needed to identify an interpreter and deliver information via asynchronous interpretation. Maya’s advanced technology now makes delivering discharge in most languages technically straightforward, however, as a start-up company we have not yet had the opportunity to implement this functionality. It is a high priority in the near future. We hope to identify a partner interested in having MayaRED speak Spanish, (and later other languages).  

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13. Can the Family Caregiver be involved in discharge planning? 

If available, with patient permission, the family caregiver can be present when MayaRED teaches the AHCP to the patient.  After the teaching session, the AHCP can be viewed by the home family caregiver giving them access to the medicines, appointments, 30 day calendar and all other aspects of the plan. Family caregiver involvement in discharge planning is a evidence-based activity shown to reduce rehospitalization.  

 

14. Is MayaRED designed specifically for certain diagnoses?   

MayaRED is designed for all diagnoses. MayaRED is based on evidence shown to reduce readmission and improve patient satisfaction regardless of discharge diagnosis. MayaRED focuses on improving understanding of medicines, appointments (and other areas) and motivates them to appropriately follow-up after discharge. (See the MayaRED document How Does MayaRED Teach the ReEngineered Discharge?).   

 

15. Does MayaRED address high-risk diagnoses?

Yes. MayaRED specifically addresses the diagnoses defined in the CMS Hospital Readmission Reduction Program that impact readmission penalties. These diagnoses include heart failure, pneumonia, acute MI, COPD, coronary artery bypass surgery, and elective hip and knee replacement. Additional diagnoses requested by a hospital system can be added. For example, we are now adding the top 10 behavioral health diagnoses (e.g. alcohol use disorder, depression, anxiety, etc.) and the top 10 social determinants of health (e.g., illiteracy, unstable housing, limited English proficiency, etc.). 

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16. Can you give an example of how you have adapted MayaRED to a specific diagnosis?

MayaRED is now adapted for patients with heart failure,, based on American Heart Association guidelines. System specifications for patents being discharged with a heart failure diagnosis include: 

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• Identification of patients eligible for the STRONG HF protocol and connecting them to “up-titration” visits at 1, 2, 3, and 6 weeks;

• Using a “3 zone self-check” figure, and “crisis management plan” to explain what to do if a problem arises;

• Describing cardiac rehab and prompting referral;

• Discussing the “DASH” diet and connecting to further education on the MayaMD patient portal;

• Offering standing orders for self-administered furosemide weight-based protocol;

• Education about smoking cessation, alcohol reduction, diabetes education, sodium reduction and non-pharmaceutical hypertension control.