Aspire for More with Erin

He is Changing Healthcare for our Residents Virtually

October 19, 2023 Erin Thompson
Aspire for More with Erin
He is Changing Healthcare for our Residents Virtually
Show Notes Transcript

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I have a very esteemed guest today on the aspire for more with Aaron podcast. And let me just read to you his bio. Dr. Cosmo. A seasoned professional in healthcare and emergency response management holds a PhD in health science and an associate degree in fire science. Throughout his career, he has demonstrated an unwavering commitment to public health and safety with extensive experience in the medical field doctor cosmos excels in leading and training, emergency response teams. His expertise spans industrial safety, environmental health, and safety. And emergency response command, including dispatch operations, resource allocation, and emergency preparedness training. One of Dr. Cosmos pivotal moments occurred during his work in emergency departments. He recognized a significant gap in care for residents of assisted living and skilled nursing facilities. Leading him to a mission of improving the quality and cost-effectiveness of resident care. His research culminated in a groundbreaking pilot program that integrates cutting edge technology and real time diagnostics coupled with access to skilled medical providers, specializing in emergency medicine and advanced virtual healthcare. This innovation has significantly enhanced the speed and quality of resident care. Dr. Cosmo's most recent achievement is the remarkable reduction of unnecessary transport by 96% and the complete elimination of 30 day readmissions through his pilot program. As president of senior virtual health, he now oversees the nationwide expansion of the advanced virtual health care program. His illustrious career includes training personnel for the center for domestic preparedness. And responding to chemical, biological, radiological, nuclear, and explosive events. Running him a bronze level training award. Dr. Cosmo also holds two us patents highlighting his innovative con contributions to the field. He possesses instructor certifications in weapons of mass destruction. General terrorism, hospital, emergency response, team operations. For CBR, N E radiological emergency response, operations, and point of dispensing operations from the CDP and the department of energy. While originally from Massachusetts, Dr. Cosmin and his two teenage sons have proudly called North Carolina home for 15 years. His journey and unwavering dedication are a source of inspiration in healthcare and emergency response. Exemplifying the transformative impact of visionary leadership. And community will be. Enjoy this podcast. He's literally changing healthcare. As we know it.

Erin:

Hi, I have a wonderful guest with me today. His name is Dr. John Kazma and we met on LinkedIn and he has an amazing product that is going to change the lives of residents and associates inside senior living communities. And so welcome Dr. John. Thank you for being here today.

Dr. John:

No, thanks. I'm glad to be here. Thank you for having me and help get

Erin:

the word out. Yes, when we spoke, I felt such hope for the future of our residents inside long term care communities, and maybe even 1 day assisted living communities that they don't have to go out as much to get the care. before I, talk about things that maybe I shouldn't talk to us about senior virtual health. And all the benefits, how it got started. Take it away.

Dr. John:

Sure. Yeah. senior virtual health is a company I'm the president of, founded by Mr. Robert Dudley and we officially launched, January ended January of this year. prior to that, we ran a pilot program with the system that I patented. it came about several years ago, took about three, almost four years really of research and development and some testing. And, a lot of people. Sitting down with me much smarter than I am really just going over. how do we get to the bigger picture of what I was looking for? And really what we were wanting to do is bridge the gap in senior health care because there's been a huge gap in senior health for a long time. I used to work in an E. R. very rural E. R. and when Covid hit, obviously, a lot of things came to light. But 1 of the things that really you Caught my attention was how seniors in senior living facilities, skilled nursing facilities, ILFs, ALFs, really were being sent out to the emergency department for things that could be treated and taken care of at the facility where they were comfortable, if they had the right tools and had the right people to contact them. and a good friend of mine was a DON at a local facility. and I called her 1 day and we started having this conversation and I will tell you from somebody who works in an E. R. most E. R. providers, most E. R. employees absolutely clueless at the hurdles that staff members have to go through in these facilities. And so when her and I were talking, she started explaining to me about the issues of. not always having a primary care provider in the building or trying to get a hold of a PCP and how hard that can be, especially nights, weekends, holidays, or they do get a call back. And it's an on call doctor who simply tells them, listen, I don't know anything about the resident send them out and then them just not having the tools. To really do the diagnostics needed to take care of somebody there. And it really blew me away. And my 1st instinct was, this has to be just a regular local issue. And when I tell you, I made phone calls and I spoke to DONs and executive directors all over the country. That is not an exaggeration. And obviously, I heard a lot of issues in senior health and I've been very fortunate. I was able to go up to the Hill and speak several times last year, on that topic. But it amazed me in almost every single conversation. Those 2 things kept coming up and I realized that we need to do something. We cannot just let this gap continue to get wider and wider and senior health care. Came up with a plan, contacted some friends of mine, Dr. Renee DeRussell, who is amazing leader in point of care ultrasound and, a few other folks and really sat down and said, here's my picture. I want to create a plan. I want to create a system that we can put to skilled nursing facilities that allows us to do everything we can do in the ER, but do it there at bedside. And that's what we came up with. So we came up with what we call an advanced virtual healthcare system. It's not a telemedicine system. I'm not a proponent for telemedicine. I don't think you can definitively take care of a patient on a phone call. I think you have to be able to do 12 lead EKGs and do ultrasound imaging and. Get lab work and do all those things that you would do in an ER to really treat somebody. So we've put together a system where virtually 24 hours a day, 7 days a week. The system is in the facility, a staff member can click on the desktop icon, connect with one of our ER providers. We'll do a complete triage, just as if they were going into the emergency department. And then we'll do a complete ER assessment. And we have the capabilities. Not only to see that resident and the staff member, but to have that staff member assist us and do a 12 lead, which we can see in real time, do ultrasound imaging of, lungs, cardiac, musculoskeletal nerves, ophthalmic, vascular. abdominal kidney spleen bladder. So really everything you can do in the ER, we can now do at the facility and see that virtual in real time. So there's no delay in patient care increases the quality of health care for the patients, increasing the quality of life for the patients. and honestly, it allows those skilled nurses who have these professional nursing skills. Now to have the tools to use their skills that they went to school for. and we're really seeing an empowerment in the nursing and the staff there as well. So it's been great for the residents. It's been great for the facilities. It's allowed them to cut down on their unscheduled transports. Nationally, we're at 98. 6 percent reduction for unscheduled transports out of the facilities. And to date, we've completely eliminated 30 day readmissions. we're very excited at the growth that we're seeing. okay.

Erin:

That is a lot. You would think even just all the benefits that you just stated at the end of that. you would think like every community needs this. Absolutely. Let's just go back. Let's just go back to, you don't have to send your resident out to the emergency room. if you're an executive director or a long term care administrator, or a director of nursing how. Difficult it is to watch a resident suffer and then have to send them to the E. R. where they're just going to sit there and wait for hours anyways. And sometimes, depending on the residents cognitive situation, how difficult that E. R. stay is, we can dive into lots of stories about that. I'm sure you have them. And so what you're saying is that now there's a device, something that can be inside of a long term care setting, senior living, long term care setting, that can do most of the ER scanning in the community.

Dr. John:

Correct yeah, so we can do all the 12 lead. We can do the ultrasound imaging. we can do at bedside within 48 seconds to opponents within 3 minutes. so all those things that normally you would send somebody out to do. We can now do at the bedside in the facility, utilizing the nursing staff that's in those facilities. and the great part about it is it's a constant connection. So they're seeing our doctors. Our doctors are seeing them. some of the nurses, when we go out, we deliver this device, 1 of the things I hear from a lot of these nurses is my God, I haven't done a 12 lead since nursing school. That's okay. as long as they can connect with us, we can see them. We can talk to them. We can walk them through everything else they need to do. we can say, hey, you just need to put that electrode a little bit lower or a little bit over to the right. Same with the ultrasound. a lot of these. Nurses have never held a point of care ultrasound unit, but the fact that we can see them and they can see us and we can communicate back and forth, we can direct them on how to hold the probe and they need to fan it a little bit left or right and we can get those perfect images. And it's worked incredibly well. now we have some nurses in some of the facilities that went through the pilot with us. So they've been doing it for a year and a half, two years now, call us up and they'll be like, Hey, I'm with such and such resident and they've got some fluid in the lower lobes and they'll take that probe and put it right there and show us the perfect ultrasound image. so to see these nurses and their skill level really increase and the pride that they're taking, and their ability to treat residents now is fantastic. It's 1 of the greatest things I love about what we do.

Erin:

so you could take me a non clinical person, just a, just an administrator. Yeah. And I could go, I could be with the resident in a room and this machine, this device, you could watch me and teach me how to do these things.

Dr. John:

Absolutely. In a matter of minutes, in a matter of minutes, and you would give us perfect ultrasound pictures of what we need to see. And that's the beauty of it. especially when you start talking about behavior health residents who are fighting dementia or fighting Alzheimer's, I spent 6 years in the ER, love the ER. ER staff are fantastic people. They work extremely hard, but it's not a place for someone who is, like I said, fighting Alzheimer's or dementia to be if they don't need to be because you have one nurse. Who has a 4 or 5 room assignment, right? And you have your behavioral health patient in room 1, but then you have sepsis workup in room 2 or an M. I. going on in 3 or a stroke in room 4 and like any medical facility, hospitals are understaffed just as skilled nursing facilities are. So it's not that these nurses don't want to spend time with that resident. They just can't right there. They're just too busy. and I, our health care system has been broken for a long time, not just senior health, but. Healthcare in general and our ERs are over overrun. There's so many people using them as primary care providers because of cost of health care now, right? it's just not a place for a senior resident to be if they don't need to. so we're really proud of the fact that we're able to reduce 98 percent of those transports and keep those people at the facilities where they can be treated where they're comfortable, where they know the staff, where the staff knows them. and we even have the ability to bring family members in. So if there's a family member who's a power of attorney or just deeply involved in medical care, of their resident. We can send them a link either to their phone or email or both, and they can click on that and they can drop right into that virtual visit. They can see the entire assessment, talk to the doctor, ask the questions, get those questions answered, understand the treatment plan moving forward, and just really give them a sense of knowledge on what's going on with their loved one. I

Erin:

mean, let's just think about this for a minute. So you're telling me, I know this sounds This is not a commercial, I promise, but I am an executive director in a past life of a 64 apartment memory care community. Okay. So you can imagine all the things that I have seen for a total of 10 years when I had to send residents from that memory care to the, it was always. Always is a strong word, but it was traumatic on probably many different levels. if I had a resident that literally could just needed something that this. Machine could do, we could get that done in house. Their family member could be there. They would get the results. They would be able to talk to the doctor and we would be able to get a prescription. Absolutely. Without even going to the ER.

Dr. John:

Without ever having to leave the facility. Yes, ma'am.

Erin:

to me, every member care needs to have 1 of these. every member care needs to have 1 of these. Absolutely. Absolutely. yeah. Now, that just brings up like a lot of questions and how this could benefit. I am not strong in the background of long term care and the Medicare payment. So how does that and I know that this so how does this solve? Because you talked about those stats. Does it solve the problem for the long term care for the skilled nursing communities to not have that going keep going back to and from the hospital, which costs them money.

Dr. John:

Yeah, absolutely. it's a huge cost savings for the communities, right? Because, a lot of times, especially in the E. R. world, a resident will come in and for very minor things. And again, E. R. providers, maybe not being completely aware of. The issues and, the roadblocks that these facilities have to go through to get a doctor to call them back or to get orders. so a lot of times when they come into the ER, the initial thought of that of some of those providers is listen, I'm just going to go ahead and admit this resident because if I send them out. They're going to come back to my ER within 24 hours, and I'm going to get dinged for a 30 day readmission, right? Which I think the average cost of 30 day readmissions over the last couple of years has been a little bit over$10,000 per visit. So incredibly expensive. So now that resident gets admitted and now that facility has just lost day rates for 3 days, and they have a bed that they can't fill. They have a bed that's not creating them any revenue. And then when it comes time for that resident to return to that facility, right? If they don't meet medical necessity, then that facility now has the cost of transport from that resident from the hospital back to the facility. Which is an additional, I don't know,$800,$1,200 spending over here in the country For basic EMS unit or if they have their own van, the cost and maintenance of the driver in the van, maintenance and mileage and things along that lines. and then, when you start looking at increased 30 day readmissions increased unscheduled transports, now that starts affecting your matrix care scores and, your scores with CMS, your quality care scores, and higher those rates are. now there's a possibility of CMS fines coming back into effect, where if those numbers are low, then at the end of the year, there are those bonuses for that CMS gives out for those facilities that are doing a good job on that. so not to mention the time it takes to do an intake again, when that resident comes back. So there's. All of these things that figure into the cost that goes to those communities. And let's face it, communities are struggling today. right now, we're looking at this huge staffing mandate that, that they're talking about, which is just going to really destroy, a lot of skilled nursing facilities and cause a lot to close if those goes through. there's so many angles that these facilities are getting hit at. So to be able to give them something that they can use in their facility. And decrease those costs, increase the quality of care, increase the quality of life for the residents, increase the morale of the staff, right? We really feel this is a perfect time for this to come out because they really need some help. and there's just not a whole lot of people looking to help them right now. so we're glad that we were able to come up with this and we're glad it's working so well.

Erin:

Yeah, I always try to put things in, a win win quadrant, very Stephen Covey like, and I feel, is there any other quadrant that this device wouldn't fit in, we know that it will eliminate, potentially eliminates a strong word, maybe, but it will lessen ER visits for, Cognitively impaired residents, which to me is a win for everybody. So that's in a win win category. so Medicare will insurance will cover this for the resident. Does the incur costs?

Dr. John:

No, there's no cost to the residents at all. so there's just 1 flat fee that goes to the facility and that's just based depending on bed size. which is minimal. And then any visit that we do, we bill CMS for. so there's no additional cost to the patient. There's no additional cost to the patient family. There's no additional cost to the facilities. and when you take in the fact that we can do 12 lead EKGs and ultrasound imaging, that's a huge win because up until now, if there was, even if the primary care provider was in the building, but wanted to get a 12 lead or, an ultrasound image, they had to call a third party company. So that was several hours before they came out or CMPs even, several hours for them to come out. And then that was an additional cost. For that third party company to come out that the facility had to bear. So this is all inclusive. So if they need a 12 lead, they no longer have to do that. They don't have to pay that fee anymore. They don't have to wait that time anymore. They just jump on the machine and they do the 12 week same with ultrasound imaging. we work with a fantastic lab, total labs, that has partnered with us. Where, even when we start talking about infectious disease, right? So residents who maybe you're dealing with the, but a non symptomatic, generally, we take that, a facility would have to take that sample, send it out in your week, 72 hours for a CNS growth report to come. now we have a way that we do a DNA molecular breakdown. in 24 hours. We get a complete molecular DNA structure, not only of bacterial, but viral and fungal infection. So we know everything that's growing there and the exact antibiotic we need to use to fight that. So now you have a non symptomatic patient. We can easily wait 24 hours, right? We get a report back. We know exactly what we're dealing with. Put them on the precise antibiotic that they need. So antibiotic stewardship scores now start going up. so there's just so many wins on this, that we're just so excited to finally be able to launch this, and really start growing nationwide with this. we truly believe this will be the standard of care for seniors within the next 2 years. It needs to be.

Erin:

Oh, yeah. So you can get you can literally get a culture back from a UA in 24 hours.

Dr. John:

DNA molecular structure. So not only bacterial, but viral and fungal as well. So we know everything that's going on in there,

Erin:

which would eliminate wrong antibiotics given to somebody. Absolutely. And if we can take it back to memory care, boy, that would help boy. That would help. wow. what brought this? I know, obviously, Your history and in the E. R. and seeing how things weren't working. But how did this come to fruition?

Dr. John:

Okay, so full disclosure. Here we go. in the E. R. one day, and this is when Covid just started ramping up. So we were getting hit pretty hard. and our hospital had an 8 bed ICU, which was full and we probably had 9 or 10 ICU holds in the ER. So now that 19 bed ER is now down to 9, right? We're the only hospital in a 35 40 minute radius. So lots of EMS coming in still have a full lobby. and we get this resident from a facility where my friend happened to be the D. O. N. And, we're all human. I was having a very frustrating day. So out of frustration, I picked up the phone. And I called her, which was my first mistake.

Erin:

Hey, all you senior living people. Look when he's doing the director of ER is calling a community to complain. Okay. Yes, please go ahead.

Dr. John:

So it wasn't calling to complain. I was just, we were good friends. We've known each other 20 plus years. And I was like, what are you doing sending this lady to me? And that's where she really shut me down. and read me the riot act and really started filling me in on the issues that go on in senior health care. and again, I was clueless up to that point. So when she told me that I was blown away and I was just like, wow, I can't believe that as a society and where we are today. That we have created such a huge gap, for such an important demographic of our society, right? because seniors are incredibly important. the knowledge they have, the stories they can tell, the guidance they can give, and it just seems like that their health care has been put on the back burner for, and not just seniors, like veterans. rural communities, right? all these different areas. I know hospitals have been shutting down all over the country. We had several shut down in our state over the last few years. So there's so many benefits and so many different avenues that this system can work in. so that really was the start of it. And I was like, we got to change this. We have to do something. And, I come from. a background of medical care for gas and oil. so we used to work for a very large company that was medical director for gas and oil companies. And, there were clinics on the rigs. And if someone got hurt, they would go down to that clinic and the paramedic would call and turn on a camera. And, those doctors would give guidance to keep Those employees from having to be medevaced for things that will be taken care of on the rigs, right? Because that's 86, 000 or so just to start a helicopter up. and I just thought, there's got to be a way we can take today's technology and put it into a facility and be able to do use those virtual connections that we have today. And the technology that we have today, and treat people virtually because we have skilled nurses in these facilities. They just need the tools to utilize their skills. and, up until now, no one's ever given them that. we're super excited about what we're doing. And we're seeing, even through our pilot program, we're starting to see the relationships between the hospitals and the facility start to get better because now these hospitals are realizing that these facilities have ER type capabilities. so now the referrals go up because now they're they feel much safer sending a resident to a facility that has this type of capability because that reduces the risk of 30 day readmission to the hospital as well. so it really has just so many things that have just been a huge benefit on this program much more than what we thought when I first started to put this together. We are. We're just very excited about it. And like I said, there's been some great people involved much smarter than I am. I'm putting this whole thing together. but it's been just a great collaboration of people who are just out to make a difference and do the right thing. So

Erin:

it sounds. It's so exciting because it's changed and because the lives of the people that we serve will be improved greatly. And yes, the relationships between the ERs and I will just say memory cares because memory cognitive impairment allows so much interpretation.'cause you know when you have, and just in my own experience, when you give, you have people in between when they leave the community and when they go to the er, you have the ambulance drivers there that may forget to give the paperwork that forgot they had the paperwork, or don't communicate the things the way that the community wanted to communicate the things. There's so many facets. That can hinder or even help the resident and then the relationship, even for referrals can certainly improve like you're saying from the ER to the communities because now they understand there were so many things that ER never understood about a memory care number one, we're not skilled. So there are so many things that we can't do, but now this particular device allows people, in communities facilities to do amazing things to keep a resident safe just 24 hours for that UA would change lives. Dramatically. I have seen, just in my own experience, knowing that would be available, somebody had a U T I and pushed another resident down. That resident who was pushed down had a fracture, right? His life was changed and we had to wait three days to, to get a culture or send them to the E. R. to get it for themselves, so there's so many facets that something like this, the opportunity of something like this changes. And I think It's an obviously from a financial standpoint that will make a lot of people happy. Absolutely. You've got the financial people and then you have the people's people. And, how can you say I know you said it earlier, say it again, how much money. what is that stat that you said? How much money is this saving communities just from the readmit standpoint?

Dr. John:

from a CMS perspective, and talking with some people over at CMS and if we did nationally, what we did during our trial program, just in the reduction of 30 day readmissions, that's over like a 3 billion savings, for a CMS 30 day readmit. Reimbursement, right? and again, to date, we've completely eliminated 30 day readmissions, right? So we're extremely proud of that. some people, in the unscheduled transports, there are certain things that have to go to the E. R. right there that we're not going to be able to handle on virtual health. and, we'd be foolish to think we're going to be able to handle every single situation. Virtual health care. Some people need to be in a hospital. and when that happens, our providers will call over to the ER doctors and let them know what we've done and send over the EKG or the ultrasounds imaging or the labs or whatever we've done already just to help them and have that doctor to doctor conversation. So when that resident gets there, hopefully their wait time is diminished a little bit and they can get admitted much quicker and get to where they need to be and get more comfortable. so it's just, yeah, we're just really proud of I'm really proud of the team that helped put all this together and the work that they've done. And, when we first started this, I'll be honest with you. We had doctors and nurses that I used to work with in the hospital that we're working free of charge, and they were working 12 hour shifts free of charge to get this up and running. which, kudos to them, right? if that's not dedication to health, I don't know what it is. so it's just been a great team that we've had to get this launched and that are really put a lot of love and care into this. and it shows. So we're looking forward to the future for sure. And really getting this out and getting into more communities and help more residents.

Erin:

Yeah, when we think about I never can say this word right in a rural area. Yes, we are. Yes. And you had a small regional ER and covid happens, or if we have anything to that effect, if it's a bad flu season, the people who need the ER can't get the ER. I think what we saw during covid is what the future potentially looks like. If we're not careful, just on an everyday perspective, right? Not even with covid. if you have. millions and millions of I don't know the stats right of people who are 85 years old, you know, that something's going to happen to them. And if even 1 percent of them hit the ER on a day, the ER is not capable. They're not going to be able to withstand that. And so what this does. Is it helps relieve the pressure from a elderly standpoint? You

Dr. John:

bet. you look at ERs all across the country, right? In your 4, 6, 8 hour wait times. and you look at all the talk and statistics about the physician shortages that We're going to be facing in the 2030s, right? 120 plus thousand physicians. We're going to be short in our country. and, as you mentioned, rural communities where hospitals are shutting down and people maybe 1, 2, 3 hours away from a hospital. And a lot of those folks won't go. Until they're really sick. so to be able to take this type of technology and put that in those places where, they can go to a nurse who may be. Have a small office in the corner and connect with a doctor who can do this full virtual exam, and we can do oscultation of lungs and abdominal sounds and e n T exams. we can do all that. And we see all this in real time. So it's literally as if the doctors are right there in the room with these residents. and we piloted this throughout Illinois and Ohio and we worked with one facility that literally their closest e m s unit was a volunteer service that was an hour and 15 minutes away. when you get into two areas like that, this type of system is just absolutely invaluable to the health and safety of those residents. and, one of the things we like to do on an intake. is we like to, get a family member on the phone with us and review the past medical history for the last 5 or 10 years. Because a lot of times these residents aren't, the best at recalling their medical history. we like to get the family involved and do that past medical history and get a baseline EKG, labs, ultrasound imaging so that if we see this resident in a couple of weeks or a month or 2 months, we have something to compare that to. But when we do that initial intake and we do that visit, we get all this information. And, we have a pharmacist that kind of reviews medication and doesn't med reconciliations for us and we really get a full picture of. what's the risk limit of this resident becoming a 30 day readmit? And if it's a high risk, then we'll see them weekly. We'll just do a weekly visit. Just make sure nothing's changing. Or if it's a moderate risk, we'll do it biweekly. And if there's a low risk, we just see him as needed. But, that's how we've been able to really catch things at very early stages. Because now these facilities have all those tools. For us to do that complete diagnostic test. especially CHF patients or things along that lines, we can start seeing those changes very early on, are instrumental when it comes to sepsis. Because we can catch that now very early. We can do this in 48 seconds rather than having to wait 3 or 4 hours for a stat blood lab to come back. And by that time, you've missed the window when we're talking about sepsis. there's so many benefits of Just increasing the quality of care. And even when there are primary care providers in the building, like I said, they still, if they don't have EKG machines or ultrasound machines there. if they need those type of tests, they have to send somebody out a call in a 3rd party company. And now they're able to do that at bedside within minutes. it's really almost taking those skilled nursing facilities and building them up to be in an in house emergency department. if you would, with those doctors right there.

Erin:

So the medical director could use the equipment to absolutely. You bet. I have to be on it. Y'all would have to be

Dr. John:

yeah, they have to connect with us. And a lot of times, the providers that are in those facilities or nurse practitioners, so they can't read a 12 lead anyway. So they're going to need that doctor to read it. so our doctors will be on there and we do that reading for him. But the fact that it's real time, it's instantaneous. We're seeing it as it happens saves hours. And, a lot of times minutes can make a difference. Never mind hours. So the fact that it's just right there and available to them. we've really just. People are loving it. Facilities are loving it. Staffs are loving it. so we're just really excited to, to see how this has been just welcomed into the communities and the benefits that it's given people. And even the residents are enjoying it now, they'll click on to the cart and start talking to the doctor and, hear them talking to their family. daughters or brother or sisters or whatever, and be like, oh, talking to the doctor on the TV. So they get a kick out of it as well. We're just seeing a big morale boost all around. And it's so

Erin:

easy that an administrator can do it.

Dr. John:

Absolutely. Absolutely. As long as you, as long as you can just hit that 1 desktop icon and connect with us. Our staff can walk you through everything else you need to do because we can connect up to 10 cameras on the system. we can get 10 different views. And so if there's skin rashes, or even wounds that we need to get a deep look into to make sure it's nice and clean to see if we can steri strip it versus sending them out and having it sutured or things along that lines, rashes, irritations, all that we can get up close and get really good quality imaging video of

Erin:

what's going on. Okay, so you can look if they fall and nothing's fractured that we know of. No pain. There's a bad skin tear. You can look at that. Absolutely. And tell us whether or not it needs to go out for stitches.

Dr. John:

So these are cameras can connect to the scrubs of the nurses. and then we have ones that they can hold and bring right down and consume in and get nice close up looks at what's going on and magnification of those areas. So it's pretty amazing.

Erin:

if you did that, and then you said, the doctor said, or the, whoever was looking at it said, yes, they do need to go out for stitches would Medicare pay for both visits. Then at that point, yeah,

Dr. John:

it's 2 different visits, right? So it's just like you have your in house visit and you're in person visits and then you have your telehealth visits and your visits. but the fact that we can keep 98 percent of those visits from going to the ER is a huge cost savings for CMS. the average video conference. Visit is what 240, 250 compared to an ER visit at 2, 500 or 3, 500. it's, you don't have to be a mathematician to see the savings there, right? it's huge cost savings for CMS.

Erin:

That's amazing to me how far technology has come. That is amazing to me.

Dr. John:

It has come a long way, we just have to embrace it and use it. and that's, that's the big thing about it. So it's

Erin:

definitely yeah, the win that I see from an administrator who's not long term care. I will throw in the fact that there's obviously a cost savings for a long term care community that I'm not necessarily an expert of, but from a staff morale from empowerment from. Adding value and changing the life of somebody who's in a very vulnerable situation. you can take control. You can literally affect change very quickly now. just from the perspective of somebody who wants to help somebody, which is what we all want to do inside health care. to me, that's the most ultimate win win situation. That we have here,

Dr. John:

and we're even, we're even seeing census in these facilities going up because as word gets out, they're getting not only they're getting more referrals from the hospitals, but now. People who are coming in residents coming in for the 1st time, who are looking for places to go, when they're comparing facilities, and there's a facility that has this amazing capability of doing all this ER type medicine at the facility, and you don't have to send residents out anymore. Compared to a facility that doesn't have that who's sending a high number of residents out every month, right? where are they going to want to go? And so we're seeing a huge increase in census and beds being full. and it's just, yeah, it's just been a great experience, working with these communities. So we're very happy, very excited at the

Erin:

results of this. You have caught the attention of everybody's ears when you said that you're going to increase census.

Dr. John:

we'll take the added bonus to this sentence increase.

Erin:

We're going to change the lives of your residents and we're going to increase your census. Yeah, let's talk about that. It's saving money. I know, right? I know. I am super impressed by it. I just, not even having seen it, but having multiple conversations with you about it. I believe every memory care probably needs this, as well as every long term care community, skilled nursing who has to meet those Medicare, Medicaid, financial regulations that, I think that you have really started to change, which you should be very proud of. You have affected change.

Dr. John:

we got a great team. and our, one of our slogans is just go change the world. and that's really what we're out to do. And again, it's not, it's great. I get to be the front guy, It's like the, the front man of the band, but there's a whole lot of people who put a whole lot of time and energy and effort into this, and this would have never been possible without them all. it really has been a great team effort from some great people who really, are just in it to win it for healthcare, and for seniors. it's a team effort for sure.

Erin:

Absolutely. And it all was born out of a moment of frustration, really a moment of frustration and how something that I think is very important where we have these moments where we get angry, where we get frustrated, where we think all these things and those moments. If we allow them to can start something that is a powerful movement, powerful change like this is and can be for an entire industry. And yes, the long term care skilled nursing world needs this kind of positive energy right now, for sure.

Dr. John:

Agree. Agree. yeah. So we're, we're ready. We're ready to do this and we're ready to change lives of people all over the country and hopefully the world after that.

Erin:

so again, the company's name is Senior Virtual Health and you are Dr. John Kosmeh and I'll have your information. in the show notes and, you can give them how they can get in touch with you here if they want to write your name and information down now. yeah,

Dr. John:

they can, they can send me an email at J Cosmo. It's J. K. O. S. as in Sam M. E. H. At seniorvirtualhealth. com, and either myself or one of our team will get back to them and, we'll come out and, we more than willing to come out and do a full free demo at the facility. We will bring the card out and, do a complete demo of how it works and everything it can do. teams can get a full look at it and make a decision for themselves whether or not they think it's as valuable as we think it is, and as valuable it seems to be proven to be. So sounds

Erin:

valuable to me. So thank you for your time today and thank you for making the effort to look at something and really change people's lives. That's powerful stuff. It

Dr. John:

just, we're excited about it. Thanks so much for having me on here. I really

Erin:

appreciate it. You're welcome. And as always, to my listeners, aspire for more for you.

Can you believe where technology has brought us to, to where we can have such amazing responsibilities and capabilities inside of a community. That actually helps the entire surrounding cities and counties. It's amazing. Dr. John cosmos is. A fascinating person to talk to and you can just feel and see, and almost touch the passion that he has in regards to this product. And I am excited to follow the journey. And see. Where it leads our industry. I hope you enjoyed this episode. And thank you for your time today