This article first appeared in Xconomy
By Angela Shah
Austin—Iris Plans is using telemedicine for an often overlooked part of health care: advanced care planning.
Iris recently announced a partnership with the University of Utah Health Plans, and is now providing technology-enabled advanced care planning for about 50,000 members. Iris has created an online office where doctors, nurses, or social workers can advise patients and their families about forming a plan for end-of-life care.
“Towards the end of life, many patients get care that they wouldn’t want if they really understood what it entails,” says Steve Wardle, Iris Plans’ CEO and co-founder. “This [Iris’ solution] puts patients in the driver’s seat and empowers them to be more active in their decision-making.”
“Telehealth has an advantage over a health clinic: Families who are spread across the country can join in the call,” Wardle says. “It’s important to have the next of kin who will be walking through the illness with you.”
Advanced care planning, or palliative care, has been growing over the last decade. But the number of healthcare professionals with that expertise in traditional healthcare settings is not keeping up with the need, Wardle says.
That’s where Iris Plans and its network of contract and employee healthcare providers come in, he says. Using telemedicine, these professionals can walk through a patient’s wishes alongside their families. Do they want to pursue treatment at all costs? Do they want to maintain quality of life in order to travel the world and visit family and friends? The answers to these questions can help inform treatment as a disease progresses.
“A path of least resistance in the current system is to do everything,” Wardle says. “But we know that doctors wouldn’t choose this for their own treatment. They would choose a much less aggressive path.”
Key for the success of a company like Iris Plans is a decision by the Center for Medicare and Medicaid Services last month to reimburse for advanced care planning services. Wardle would not say what
fee the University of Utah Health Plan is paying Iris for providing such services to its plan members.
Companies like Iris could be a way for health plans to add this benefit for their members, in the hope that such discussions could help prevent unnecessary and costly care. A lack of planing contributes to some $210 billion in unneeded care each year, Wardle says.
Wardle says there are about 10 million people in the U.S. that have serious chronic illnesses who “are in urgent need of advanced care planning and don’t have access.”
As the population ages, that number will only increase.
Right now, those patients and their families are often driven to seek out additional care in the heat of the moment when confronted with acute life-or-death situations. Wardle says with upfront information about their loved ones’ preferences, that care may not be requested.
End-of-life care is a growing focal point for healthcare startups. Another example is Boston-based startup Cake. Its app helps people designate a healthcare proxy and buy life insurance, as well as create an online handbook or posthumous preferences for loved ones, doctors, and lawyers to carry out.
Iris Plans, founded last year, has raised $1 million from a variety of institutional and angel investors including Better Ventures in Oakland, CA, Wardle says.
Iris co-founder Stephen Bekanich began the company after watching his grandparents suffer through chronic illness, according to an Austin Inno story earlier this year. Bekanich, formerly an ICU doctor, switched fields to palliative care and became the medical director of palliative care services for the University of Utah Hospitals and Clinics in 2005. He came to Austin to lead the palliative care program for the Seton Healthcare Family in 2012.
Wardle says that typically there has been an aversion by physicians to emphasize such care early on in a diagnosis. “It feels like you’re eliminating hope,” he says. “And it’s not something that physicians learn in medical school.”