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Product Review
Vol. 1, Issue 1, 2020April 28, 2020 EDT

Product Review: StreamMD

Benjamin Schwartz,
patient engagementtechnologydigital healthvalue based care
Copyright Logoccby-nc-nd-4.0 • https://doi.org/10.60118/001c.12655
J Orthopaedic Experience & Innovation
Schwartz, Benjamin. 2020. “Product Review: StreamMD.” Journal of Orthopaedic Experience & Innovation 1 (1). https:/​/​doi.org/​10.60118/​001c.12655.
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  • Figure 1 StreaMD sign up notecard
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  • Figure 2 - Example of StreaMD text messages
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  • Figure 3 - StreaMD Surgeon Dashboard
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Abstract

In an era of performance-based care and increased focus on use of technology for patient engagement, digital solutions must be easy to implement, elegantly solve a healthcare “pain point,” and demonstrate improved value.

This manuscript is a review of StreaMD, a text message-based platform for guiding patients through the perioperative process. Based on 5 months of usage by a single surgeon, the product features, pros and cons, and implementation are discussed and a recommendation is given regarding the utility of the platform.

StreaMD Product Review

What Is It?

StreaMD is an artificial intelligence and natural language-based platform that seeks to “improve surgical care and patient adherence.” The service sends text messages to peri-operative patients before and after surgery to help guide them through the process with the goal of maintaining patient engagement, reducing office phone calls, ER visits, and use of narcotic pain medication. By engaging patients, the platform hopes to support value-based approaches to care by minimizing complications and increasing patient compliance and satisfaction. As Orthopedics shifts to pay-for-performance models, StreaMD hopes to partner with surgeons to reduce the cost of care.

The company was founded by Kevin Campbell, MD (an Orthopedic Surgeon) and Christy Dimond (Head of Business development). Support was received through MATTER Health, a Chicago-based healthcare technology incubator.

How Does It Work?

The company provides a template of text message content to be sent out at defined time intervals (e.g. 2 weeks preop, day of surgery, post-op day 10). Each surgeon can customize the content to fit his or her own protocols and the content of the messages can be easily changed by accessing an online Google Document. Each surgeon is assigned a unique, local phone number for the service. Patients text the word “JOIN” to the number and are prompted to enter their type of surgery and surgical date. Onboarding of patients can occur at any step in the process. The company provides pre-printed notecards that tell patients how to sign up for the service.

Figure 1 StreaMD sign up notecard

Patients are sent daily reminders, tips, and links to short exercise videos beginning 2 weeks before surgery and extending to 6 weeks after surgery. Messaging is one way and does not require live monitoring or direct input from the surgeon once the initial set up process is complete. However, there is limited ability for patients to text keywords like “ICE” to get some basic information and answers to questions. If the platform is unable to process what the patient has texted, a message is sent to call the office. Patients can stop receiving texts at any point by texting the word “STOP.”

Figure 2 - Example of StreaMD text messages

At the end of 6 weeks, patients are asked to rate their overall surgical experience on a scale of 1 to 5. Patients that select 4 or 5 are then invited to leave a review on a website of the surgeon’s choice. The company provides a login where each surgeon can track the statistics of their practice including number of patients signed up, number of phone calls and ER visits avoided, number of texts sent, and other such information.

Figure 3 - StreaMD Surgeon Dashboard

My Experience

I began StreaMD for my hip and knee replacement patients 5 months ago. The setup process was straightforward, taking about 45 minutes. I was easily able to edit the templated documents to fit my particular practice. The platform is truly “set it and forget it” as it requires very little input after the initial setup. However, making changes and tweaking the content of the messages is as simple as editing a Google document. I began onboarding patients at their preoperative visit and also began including the phone number and instructions to sign up as part of the PAT packet sent out by my surgical scheduler.

Response from patients has been overwhelmingly positive. Many patients comment that the daily texts were incredibly timely, answering questions as they arose. Several patients have jokingly asked if we placed video cameras in their house – the information and timing are that spot on. Anecdotally, the office has reported fewer phone calls from my patients.

While the platform is straightforward and easily customizable, there are a few minor drawbacks. Some patients may find the messages unnecessary or too frequent (one patient claimed I send more texts than a teenager). As the information is pre-scripted, it may not fit each patient’s exact scenario which can lead to minor confusion and additional phone calls. Finally, some patients don’t have cellphones or aren’t comfortable with texting. While onboarding is as simple as sending a text, a few patients ran in to technical problems requiring a phone call and some troubleshooting for the office staff.

StreaMD doesn’t publish pricing information on its website, but I found the service to be reasonably priced. Options exist for individual or whole practice pricing. While I used the platform for my total joint practice, the messages can be tailored to any specialty or sub-specialty. As of this writing, the service is paid on a month-to-month basis and can be cancelled at any time without penalty.

Conclusion

In an era of value-based care where patients will increasingly expect technology-enabled engagement with their doctor, a solution like StreaMD makes sense. Because it is based on text messaging and does not require downloading an app, onboarding of patients is straightforward. As a one-way system, StreaMD does not require constant monitoring by the surgeon or office staff. My patients have found the service timely, instructive, and helpful with minimal complaints. The value proposition for surgeons in reducing phone calls and reducing ER visits while improving patient satisfaction is high. After using the service for several months now, I can confidently recommend StreaMD as a product to enhance your medical practice.

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