Business as Usual: Liftoff PGH Femprenuer with Dr. Tiffany Kelley

Transcription: 

So good afternoon, everyone. It is Wednesday in December. I like to say that because I never really remember what day today is, because it really is a blur. Jonathan makes fun of me. And I just want to welcome all of you to business as usual, but it's different today. Today is our partnership with liftoff PGH, we're going to talk about that we love the partnership with them. We love the people who live who work on this initiative, and we love the topics at hand. So I'm pretty thrilled about that. I'll talk about that in one moment. I want to first of all introduce to everyone if you haven't met him before. It's Jonathan kersting. He's vice president of all things media and marketing, Adria, I run the Pittsburgh tech Council and an organization called 40. By 80. We love our partnership with the Jewish health care foundation. And today is an example of that partnership. We also deeply appreciate Huntington bank for their support, ongoing support of all of our work. So a little bit about the Jewish health care foundation. And then I'm going to bring on Megan Butler, they are an organization that actually has three distinct operating arms, the Pittsburgh Regional Health Initiative, and the health careers futures and the women's health activist movement. They offer unique brand of activist philanthropy, which really focuses on advancing healthcare innovation, advocacy, collaboration, education in the interest of better overall population health for all of us. It's a big vision, it's a mighty vision. And they do a lot of work that many people just aren't familiar enough with. And that's why we're pretty thrilled about always partnering with them on the topics at hand. I mentioned earlier about 40 by 80. That's the longitude and latitude of Pittsburgh. And that is a wholly owned, subsidiary, which is nonprofit of the Pittsburgh tech Council. And we focus on entrepreneurship, and workforce development in this region. So we have muted your microphones. We've done that on purpose. And we've enabled the chat so that you can have an opportunity to ask questions of our illustrious guests that I'm going to let Megan introduce. So Megan Butler is from the team. And she is going to tell us more about her the program of liftoff. And she's going to introduce our special guest, who's joining us today from Boston, Dr. Tiffany Kelly. She's the founder and CEO of Nightingale apps. And she's going to tell us a little bit about that the history about her. So Megan, thank you so much for joining us today really appreciate your time and partnership. And it would just be awesome to hear a little bit more about liftoff. Sure.

Thank you, Audrey. My name is Megan Butler, and I'm an innovation associate with the Jewish health care foundation. And I am a part of the liftoff PGH team. So I believe we have some folks on the call today who came from lift off PGH. But for those of you who aren't familiar, lift off is a two week virtual summit that is currently happening with a goal to help prepare the Pittsburgh region for the future of healthcare innovation. So we still have programming going on for about the next week. On Tuesday, the 15th and Wednesday, the 16th. We have full day conference programming going on. So if you haven't joined us for any of the programming yet, we'd love to have you join us for either of those days, registration is still open. And we're really thrilled to be partnering with the Pittsburgh Technology Council and business as usual today on today's session. So with that, I'd like to introduce our speaker for today, Dr. Tiffany Kelly. Tiffany is the DeLuca foundation visiting professor for innovation and new knowledge in Nursing at the University of Connecticut. And she is also the founder and CEO of Nightingale apps. So we're really excited to hear a little bit more from Tiffany today.

That's great. Thank you so much, Megan, thank you to you and your team on doing this work. It's really important conversation. So Dr. Tiffany Kelly, thank you so much for being with us today. I'm glad that you're safe and sound in Boston. But let's talk a little bit about you. So let's talk about your career. Your career includes being in the frontlines of health care and working as a nurse. So can you tell us a little bit about that and then your pivot in from direct care to being an entrepreneur?

Sure, happy to. I am a nurse of 20 years as of last June and couldn't wait to become a nurse. I went to Georgetown University School of Nursing and my first nursing job was at Children's National Medical Center. Very quickly, I saw that there were challenges that healthcare professionals and nurses are faced with On a daily basis, at the time, I thought it was just where I was working. So I ended up becoming a travel nurse and working in San Diego at Rady Children's Hospital for six months, and then Boston Children's Hospital as a travel nurse for about two years. I share that with you because at that point, I had three experiences at large academic well known medical centers, and was still running into system failures. And the sense that the things that I was trying to do for my patients were constantly fraught with roadblocks or barriers that I had to work through. So I transitioned away from the bedside to really understand what's going on at a system level within healthcare, when I went to pursue my master's degree in nursing administration and MBA. And doing that, I also had a career change into informatics and working on the electronic health record project at Boston Children's Hospital that introduced me not only to informatics, health IT, but also to the systems at play. And in working through that project every day, we talked about making decisions on higher quality, safer care. And everyone was on board with that. And we strived for that. Six months after our implementation. And now I'm going back almost 14 years now. I started to notice that nurses were struggling with knowing their patient, they were also not necessarily I wasn't seeing what I thought I would see from this implementation. And I didn't really know why it was happening. And at the time, I couldn't really get answers to my questions. So that led me to pursue a PhD at Duke University to really understand how his health IT quality and safety working together. And if you think about the timing of that, I started in 2008, before the high tech Act came out, and but well before most of the nation was on electronic health records. So my dissertation focused on what does it mean to know the patient from a nurses perspective, but also what's happening as we transition from paper based records into electronic records. Now, I say that today, and most organizations have already made that shift. But I felt it was important to capture what's going on, and the day to day experiences of nurses. So I conducted interviews and observations and document reviews, I spent over 400 hours with nurses watching how they managed health data and information it was that was the focus. And as they transitioned to their electronic charting system, it became abundantly clear that temporary data sources, so paper towels, scrap pieces of paper, tape on one pants, writing on one's hands, all sorts of other mechanisms to store temporarily pertinent patient information were became essential, it became that much harder to utilize the tools because before it was a piece of paper that's flexible, goes into your, you know, into the room with you, when you're working with a workstation on wheels or some larger system, it becomes that much harder. And there's lots of other things with that. So the pivot, you know, I tell you guys, it's been a long journey. The pivot came when one day I started to notice that nurses were pulling their smartphones out of their pockets and using them to for the time for the calculator for the flashlight at night to look at ID bands and IV sites and not turn the lights on. And as a nurse, I thought, well, this is working. This is working for you whether or not you're supposed to be using these tools or not, if you found a vantage point. And then I started to look at the scrap pieces of paper that nurses were using to get shift report and use throughout the day. And I thought well, our research showed most of the information already lives in the chart, the challenge is getting it out. And so those two areas together really married for me and opportunity of thinking, well, I could do this, I could develop an application that could work for nurses to be able to alleviate some of these issues of safety, efficiency, timeliness, and patient centeredness. And the pivot was leaving my PhD getting my PhD and really do I commercialize work to commercialize or take an academic trajectory. And I felt strongly and I still believe it was the right choice to work towards commercialization of the application. So that's a little bit towards the pivot. I'll stop there in case there's a follow up question. journey.

It's so interesting, because you know, if any, any of our listeners who have joined us today have spent time inside of hospitals caring for someone that you know, that's in any kind of situation that's been in the hospital for more than two nights, you can see the you know, this this amount of information and the amount of requirements that is actually pushed and accelerated on nurses and more so than ever before. And I've always been absolutely fascinated by how they keep it all together, no matter what the ratios are, whether they're in intensive care, whether they're in the neonatal unit, whether it's just being on a regular floor, and how they access information. And I've watched that whole nurses on wheels and moving back and forth and still having what we call countermeasures to try to solve the problems and access access what they need. I were I, every day I worry about the nurses today that are dealing with the, you know, the the onslaught of COVID and COVID-19. What have you in terms of your world just to get sort of the COVID thing out of the way? What have you? Have you heard from nurses in terms of being on the front lines right now? In terms of COVID? And, and the actual problems that you're trying to solve as well? Is it gotten worse? Is it gotten? are we losing nurses? Are we, you know, I try to have like a whole slew of questions there.

I think all of the above, I think that there are

and it's,

yes, there are nurses that are leaving the profession. There are new challenges, there are the existing challenges that are being placed. But one of the things that I've noticed is that and I've always known this, we're problem solvers at heart, taking the resources that are available and figuring out how do we make this work, and making those workarounds to solve whatever the challenges are at bay. For example, I was on a call earlier today talking about the no visitor policies within COVID. And a big part of nursing care is not just caring for the patient, but also the families and finding ways to leverage technology such as iPads or other tools to FaceTime or zoom with family members, it's, it's not ideal. But at least we have an upper option. If we were in this situation, you know, 10 years ago, it would be much harder to be able to accommodate such, you know, a moment that folks want to hold on to so I've seen ingenuity, across the board from nurses as well as recognition, something as simple as the masks behind their ears start to rub and small little pressures. So people have created add ons to the mask. So it's not behind their ears, but it's on these little buttons behind there, behind their ears to protect them. So I think nurses are faced with a lot of challenges today, they always have been, which was one of my reasons for trying to solve this problem. Because I think, at the core, we're there to take care of patients and having to decide between nursing the patient or nursing the computer is is a challenge. I've seen the struggle. And I think now we've got not just those fundamentals, but also how do I strive to make an experience for patients and their families that's as positive as possible. Nurses printing out pictures of themselves and putting them on their on their gowns, so that people can recognize a face, not just, you know, someone behind all of the personal protective equipment. So I think it's a little bit of everything. But I do see that we're recognizing as a profession that we're capable of changing and making change in the light of what's available to us.

So it had to be quite a pivot for you from being on the front line. And working directly with patients to really saying, Okay, now I want to work on something systemic. Mm hmm. Right, do you miss being on the front line.

Um,

I could see how it looks like a big change and pivot. I think the steps have been gradual for me. And working at the on the electronic health record project at Boston Children's Hospital. What that did for me, was I got to work with people I would have never, I would have never met otherwise, and working on my patient care unit. And it helped me understand interdependencies of everyone's role, as well as some of the challenges that are faced and where people fit in the puzzle. So I really actually enjoy systems level work because I think that we can't give the best possible care if we don't have the systems in place to be able to support that. I am a nurse, but I depend on the resources and the infrastructure of the organization in which I work and the processes and culture in order for me to give the best care so For me, I've enjoyed it. I enjoy looking at data and information problems and thinking about how do we solve this for, for what's happening at the moment in time, and, and helping other nurses and healthcare professionals do the same.

That's awesome. That's awesome. Thank you. So let's talk about your company. Let's let's just jump in and start talking about Nightingale apps focuses on, you know, all the things that you just talked about accuracy, efficiency, and patient information. So just so tell us about it, give us give us your sales pitch. And tell us where you are in the journey. Yeah.

So as I mentioned, I happened to notice that the temporary data sources were a core, the lifeline of the nurse. And that is something that I was told in interviews. And looking at those scrap pieces of paper that I would use myself, I started to think about what is the core functions of this tool? Why is this helping you? And how are you using it? And I spent a lot of time analyzing what's the core elements that are in here? How are you using it? When would you be seeking information? And how do you need to use that information? And I think, know, my patient is the name of the app, because essentially, as I mentioned, nurses will say everything you need to know about my patient is on that sheet of paper. So it's it's not just replicating the piece of paper in an electronic form, but rather systematically delivering the same information to nurses, regardless of their experience level. And to get a little academic to tie it in. Research shows that to deliver individualized quality care, nurses need to know their patients, but no, my patient or knowing the patient has been discussed as an expert level nursing practice. My argument is, but everybody, every patient deserves to be known by the nurse. So we can't create this barrier, whether you're a first year nurse or a 20 year nurse. So how do we give you the same information that you need across caregivers, you're rewriting something over and over again, there's risk for error? omission, not intentionally. But how do we create that mechanism so that you've got a tool, a systematic tool that gives you what you need to be successful? Not only getting shift report, but getting stopped in the hallway and being asked questions of, you know, does Johnny have any allergies? Or, you know, have my test results come back yet, these inefficiencies that are sort of existing today have an opportunity to be reduced and allow more time and energy for patient care. So this the applications a bi directional interface system available on a mobile device, because nurses need something that can fit in their pocket, designed to give them the information that they need based on core elements of what would be asked over the course of a shift.

So it's amazing because the their mobile technology is really like an extension of themselves. Yes. Right. I mean, for me, it's just they're just tethered. Yeah. So they're working inside these systems already. And I think what you're saying is they're still inefficiencies that exist as they're tethered to those they're What did you call it the mobile? They're their little note. On Wheels. Yeah, the station. Right? So there's still things that are missing? Yes. And so those of us who've spent time in hospitals over the last couple of years, but I have just because of caring for other people, I've actually always thought that that has all the information that they need. And you're saying no, they do a lot of countermeasures to make sure that they can grasp the information that they need to be more effective. And Nightingale apps actually allows that to be even more efficient and effective, if I understand you correctly. Yes,

and I'll elaborate a little bit further on two points. The electronic health record is absolutely a data repository. But just think about your own searching for information or one piece of thing, something that you need over the course of the day, it may all be there. But if you can't get it out in a quick and efficient way, then it no longer becomes as accessible or valuable to you. Right. I think peace is the personal characteristics of the patient. So and as a nurse and in health care, I believe people deserve to be treated as individuals, not diagnoses and that we all have unique qualities that help us build these relationships. Those personal care characteristics currently don't live any spot that's easily accessible within an electronic health record based on the research that I've done. And I'll give you an example. Well, there's many, usually I took care of children, there's different ways in which children take their medications, whether it's mixed in cherry syrup, or dad gives these meds and mom gives these meds. One day, I was going into a patient room with a nurse and she had sailing syringes that were wrapped up in the sterile packaging. And there was about a dozen she pulled out of her pockets. And she looked at me and said, normally, I'd take these out of the wrapping, because it would save me time in the room. But I know that the parent wants these in the packaging, because she's worried about an infection for her child. And that for me, I said, Well, how do you know that she said, hopefully somebody tells you and report otherwise, it's nowhere in the chart. And so the downstream of something like that becomes a lack of trust. And then, you know, this breakdown of relationships. And for us to truly know, our patients, there needs to be a way to summarize that information. So there's, there's those are a couple ways to think about it.

Right? So that's the nuances of Yeah, the relationships. Yeah, that's a great example. So where are you in the journey of this? Can we actually, is there a link to your apps? Is there anything that we can take a peek at? Where are you in terms of app development,

we are app, we have our beta version developed. And we're working at this current moment in time to secure clients that we can pilot test the application with. I've been watching the infrastructure development over the last few years, based off of moving from a focus on electronic health records now to interoperability and data exchange. And so the timing is right for us to explore bringing this into facilities and and starting to test it out for effectiveness and even refine it even more.

So there's a question, Jonathan, from LA Gordon, that I think is transcends everyone that's working and trying to get customers that maybe you can help us with Tiffany? Absolutely. First, Ellie, thank

you for joining us today. And she wants to know, what was your process to get your app into the hospitals? How did you get the funding access to the hospital system? And how did you manage scaling? If you're not there yet?

Okay. Well, there? Those are some good questions. Well, as I mentioned, we're not quite in the hospitals yet. But hopefully soon. In terms of funding, I've been self funding this journey myself to date. And that's its own discussion around entrepreneurship and startup to scale. We've been well, I've been taking it from, you know, day one, looking at what,

how do we maximize the use of the dollars that are available and applying for non equity dilution funding sources? There's lots of other opportunities as well, if you're thinking about your own ideas, and how do I secure funding from small grant programs, there's a lot more today than there were seven years ago. As well as accelerator programs, there's several different accelerator programs, tech stars masschallenge, dream it, many others that I haven't mentioned, that are good places to try to scale your idea. In terms of access to hospitals, I think it's a matter of, you know, calling upon relationships that you've had, or know or looking for people that are also looking to bring change is a big just creating a solutions one piece, but then finding a way to diffuse the solution becomes another and finding the right partnership with someone who's looking for either your solution to address their needs, or also someone that fits within, you know, their strategic plan. There's a lot of variables that are involved. And I think this is an area where I see opportunity in terms of healthcare innovation, how do we bridge the startup to scale

gap a little bit more?

Let's see, did I answer most of the questions here? We haven't yet gotten to scale. So I will be happy to answer that we get to that point.

Great. So I want to pack into questions here before we, you know, get sort of the end of our conversation. So I'm working education specifically, as you mentioned in the health innovation at the University of Connecticut, you know, how do we get more students and support students who are interested in working in health, innovation? And then the second piece of that is what advice do you have for women Who are actually working in healthcare? And you know, many, there are many women that are working in nursing and healthcare related to get interested in entrepreneurship, as well. So there's two pieces to that.

So from the first question, how do we get more students interested? The approach that I think about every day is, there are problems all around us, right? If we think about healthcare, there's problems everywhere. And we all have the ability to uncover them, we all know, the things that we don't like that don't feel right, that we fixate on and get frustrated by that's usually a good clue that there's something there that needs to be solved. But how to get students interested in Well, I spend a lot of time we've built in curriculum across all degree programs, so that students are exposed to what is innovation and AI, at the very beginning us bringing positive change to healthcare as a starting place. So often people think it's just about technology. And it can be a whole lot more, it could be a whole new process or service. So bringing new students in, I think, is giving them the the mindset and having them think about when you encounter a problem, it's not just about identifying it, how could you bring your expertise and skills in to solve for it? What is it that you know, better than anybody else that's going to help the millions of other people that are affected by this challenge? and with that comes, I don't know if it's permission or confidence are both? Right, I think people get a little nervous. I'm not this, or I'm not that I haven't gotten this yet, or haven't gotten that yet. And if you look through history, it's it's not necessarily based off of a list of items on your resume. It's about how well you know the problem, and what, how resourceful Have you been to try to solve for it? So I think I'm grateful at the University of Connecticut, that we have such an ecosystem, and focus on innovation. And that's essential, you know, as you were talking about some of the barriers that people encounter that's essential to be successful, but really encouraging people to think about how could we do things differently? And these last nine months have been perfect for that. To make sure I address your second question

about women working in healthcare, and encouraging entrepreneurship.

You know, I get asked the question, sometimes of what is it like to be a female entrepreneur, and I've never really focused on the fact that I'm a female, I've focused on what I know, and the expertise that I have, and the interests that I have, and I happen to be a female. And so I share, because I think that's important for for anyone to think about. It's my decisions, I don't think are being made based off of my gender, they're being made off of the science, the opportunities and the challenges at hand. So for other women that are thinking about, I've got this idea for something, but I don't know if I can do it, or I don't see many other women doing this, that maybe it's You're the one to take the next step, maybe you're the one to break down the next barrier. And that's the way I always look at things now. Because you have to if you've got that knowledge and expertise, take the chance and entrepreneurship sometimes get stuck on the money side of things and about trying to make money. And

I

that wasn't at all what got me interested in this. It was I don't like seeing nurses struggle. And I don't like that this is what's happening. So how can I solve this problem? So entrepreneurship really is about making an impact, a positive impact and solving a problem for the people that are being facing it. You know, they're desperately looking for someone to help them. Maybe it's you. And so I think that for other women that are interested and maybe a little bit intimidated or not sure they're going to be able to, or worried about making a mistake. I mean, I tell my students, you're going to make mistakes, they're going to be failures, like if you can accept that. And you could just keep going and making that mindset change. So, so often in nursing, we try to remove error, right? We have to for taking care of patients, we have to make sure we don't make a mistake. But when you're creating something new for society, it's going to have some messy parts to it. So your mindset needs to be a little bit different. I would say go for it. I grew up in a household where I was told I could do whatever I set my mind to and I think you know, if that's helpful to somebody else, you know, keep that in mind as you're trying to solve whatever it is that we desperately need, that will help us take care.

You made a great example there when you talked about so you're in a precision role. I mean, the Nurse has a lot of precision. And yet when we talk about entrepreneurship, it is messy, and you fail and you fail and you fail and you stand up and you, you know, you fail again. So I really appreciate you sharing that it does take, you know, a significant mindset to understand that that that messiness is inherent to the process.

Yeah, it's like a roller coaster ride at times to where you're having a great day. And then the next day, it's not so great. You have to figure out, Okay, this is part of it, how do I calibrate my expectations? The roller coaster just feels like the small kiddie ride. It's not the one from six flags. And that takes time. But I think knowing that others struggle as well, I think it's such an isolating experience. And there's some oftentimes things you can't share, don't want to share. And being able to say, there's going to be failures, you you have to know when you can't really make a lot of failures. But there's a lot of room for testing at the beginning. And working to get it right. It's like deploying a new IT system, right? You can't you can't do can't just send it to production without testing it first. And because your users will find the flaws that you should have caught during testing. So anyway, yeah, it's

enjoyable. It's great. First of all, it was a delight to have you with us today. Really appreciate your candor, and really appreciate actually your leadership and taking your career to the level that you've taken it both academically and professionally. The nursing industry has been under so much pressure for so long. And the discipline is has gotten really highlighted, I think through COVID. You know, for better or for worse. Yeah. And, you know, I think even as we get into the darkest days of the winter in the US, and here in Pittsburgh, you know, we definitely are seeing an acceleration of COVID. I worry about nurses, I worry about, you know, the safety, the protocols and the stress and all that they see. Yeah. And then that they bear witness to. And I think you know, there is there is something that all of us as a community and society need to support and be cognizant of. So I'm always fascinated when people go from the front lining to get into systems. But I think you made it clear that you do this for your love of nursing as well. So appreciate that. And I think that if people want to know more about your work, where should they go? Is there a link? Is there any place to go out to him,

you can find me on LinkedIn and connect there and then send me a message. If you want to set up a time to chat. I've got my email address as well as it's willing to share. Tiffany Kelly at night and Gil apps comm you can reach me there. And yeah, to your point, I think we're seeing I believe nurses should be in all areas where decisions are made around health care. And so it's a team effort. So thank you for your words on on nursing and what you're seeing as well.

Yes, thank you so much. Thank you, Megan Butler, thank you for being with us. Thank you for liftoff pvh. And for the work that you're doing to make sure that all of these issues get get highlighted, as well as opportunities for innovation and collaboration. So, Jonathan, what do we have in store for tomorrow? Well,

tomorrow really excited we have Dr. imesh adelia, who's the senior scholar at Johns Hopkins Center for Health Security, talking about what's going to happen with the rollout of the new vaccine once that gets underway kind of manager expectations and give us some insight as to what we can expect moving forward should be a great business as usual.

Wow. That's awesome. Maybe Dr. Kelly, you might want to join us for that one. Yeah, that

looks great.

Yeah, that's great. Thank you again to the folks in the team at Megan Butler and the team for liftoff PGA and for the Jewish health care foundation for their belief in our partnership. Really appreciate that. And we will see all of you tomorrow. Please stay safe. Signing off for now. Thanks again.

Transcribed by https://otter.ai