Synapse

The Bay Area is teeming with startups, many of which have a UCSF connection. Each month, the Synapse will sit down with one such startup to hear about what they're working on and how they got there.

A nurse's day can be a whirlwind. It is challenging to keep track of all that needs to be done for each patient and when it must be done. But now, there's an app for that.

The app, NurseMind, is produced by the startup Nurse Tech, and uses a proprietary algorithm to dynamically track a nurse's myriad tasks.

“The app knows what you need to get done on your shift. If you are running late, it turns red,” said Dan Keller, founder of Nurse Tech. “The needs of your patients are changing all the time. New patients are coming, others are getting discharged or handed off to other people, and everything changes.”

Keller, who is a registered nurse and has a master's in medical informatics from UCSF, has been working on NurseMind for four years. He believes that his experience as a nurse has enabled him to make an app better than its competitors.

“I think my algorithm is better,” he said. “The process it uses to construct the checklist and how it knows what your to-do items are is more nurse-centric than other software products.”

Keller stated that most competing products are extensions of electronic medical records and are centered around the orders provided by a physician. “Yet much of what nurses do is not orders-driven.  They get surprisingly little support for their complex workflows.  We’re changing that.”

NurseMind is particularly good for the many nursing tasks that are important but not urgent, Keller said.  “You are okay as long as you get it done. But the problem is often you forget to do something. Nurses are juggling so much information. For example, after a surgical procedure you need to get the patient out of bed and ambulatory as soon as possible. So every hour you have to remember to come back and walk them around.” 

Keller said that the challenge in building the app was to have an algorithm that keeps up with a changing work schedule without slowing the nurse down.

Another important but not urgent task cited by Keller is moving bedbound patients to prevent bedsores. Bedsores are not only painful and dangerous to the patient but expensive, typically costing $20,000 to treat.  Hospitals are not reimbursed for this treatment because bedsores are considered the result of poor nursing care.

The app is available through iTunes. It is free for the first month, after which there is a four dollar monthly fee. Since it was released in February 2013, the app has been downloaded more than 10,000 times. The app has received a couple of hundred payments, most for a single month's fee.

Currently, NurseMind does not have enough subscriptions to support a viable business. Keller is pursuing a partnership with a major publishing house that would sell the app with textbooks and clinical materials to nursing schools. Nursing students have been among the most enthusiastic users of the app, according to Keller. He is also considering licensing his algorithm.

Approximately $100,000 has been invested in Nurse Tech, mostly from outside sources.

NurseMind has been tested at three hospitals so far with mixed results, said Keller.  Nurses mostly like it but management has yet to grasp its value.

UCSF, a world leader in health care, has an opportunity to position itself as a pioneer in nursing time management, with several groups considering piloting NurseMind, noted Keller.  This would get it in the hands of nurses more quickly. “If they pilot this, it will give good evidence of utility and prove its appeal to potential customers.” 

Keller previously ran another successful technology-driven business. Thirty years ago, he founded a technology training company, Dan Keller Technical Services. It started by providing trainings for Unix, then moved on to HTML, Perl, and XML, each for an increasingly short period of time.

“Each technology’s lifetime decreased by half with each cycle. I had Fortune 500 clients and worked like a dog,” said Keller. “But by 2000 I was burned out at 46 years old.”

He laughed and said, “So I retired. But then I got bored. Be careful what you wish for!”

“Timing is everything in business,” Keller said when reflecting on the success of his first business.  Perhaps the time is right for NurseMind.