Monday, August 25, 2014

Fibers of Change - Andrey Ostrovsky, MD Part 2

Andrey Ostrovsky is a pediatric physician, CEO and co-founder of Care atHand, and social entrepreneur.  While there is a place, he believes, for healing one patient at a time, he wants to affect entire populations, starting locally, then regionally, across the globe.  Read Part 1

Dr. Ostrovosky set out on an unusual thread right out of high school.  While his “not so tactical grandparents” were happy that he decided to go through medical school.  The seams zigzagged well outside the pattern.  

“What did you do after high school?”
“I went to Boston University for undergraduate.  I took six month off to move to Geneva and work for the World Health Organization as a data analyst.  That was my first large scale, high-level work experience.  There, I started to get a better understanding of health systems and just systems thinking in general.
“During my time at the World Health Organization, I helped organize a conference.  The memorable from that conference was a nonprofit called the Health Systems Action Network.  Throughout the end of undergrad and into medical school, I had been an advocate for involving trainees into global health to help strengthen health systems.”  The program came about from meetings in 2005.  “I was invited by the board to run that organization.  I ran that organization while I was in medical school.  My pathway of early acceptance into medical school allowed me to do that.”

In his third year of medical school, he went to work with the Doris Duke Foundation.  He moved to San Fransico, California to work on a technology project for the health department in finding correlation between brain volume using MRI and neurodevelopmental outcomes in neonates with congenital heart defects.

Yet, another break, he spent six months of his senior year working for U.S. Senator Ben Cardin of Maryland.

It was during the stretch of time he spent in San Francisco to the time he spent in the U.S. Capitol that Care atHand began to take shape.  The idea came about when Doctor Ostrovsky’s friend, Jeffrey Levy, came to understand the challenges of caring for aging parents. It wasn’t until April 2011, that Andrey’s friend contacted him.
            “I knew he had ideas and frustrations regarding care for his parents.  He reached out to me as a physician and someone who had done some technology stuff in the past.  He quit his very lucrative job in Silicon Valley.  He asked me over.  I flew to San Francisco for a full day of brainstorming and meetings.   That was the beginning of Care atHand.
            “The name came from simplicity. We had a vision of something lightweight, something mobile.  We focused on a mobile, low-skilled workforce.  A mobile device would be carried in these caregivers’ hands, helping them to collect and communicate important information on patients they encountered in the community.”
            “How has that changed over the years?”    

“Initially, we wanted to automate workflow within home care. Typical home Personal Care Assistance services - we wanted to help with the activities of daily living.  We thought there was a big opportunity in this community to introduce mobile into that workflow and workforce.  We had a very innovative scheduling system.  We had very simple design, easy to deploy.  It was easy to use by a workforce that may be technology illiterate.  We saved a little money for our customers in homecare   but we did not have the impact we imagined. 
"We did this for about a year, year and a half and decided to take a step back.  We looked at where our passion was, where our strengths were.  When we looked at the intersection of the two, we realized that we were definitely on the mark with the workforce.  We are on the mark with the non-clinical folks.  Especially those that were unaccounted for, the gray workforce that’s not official.  It doesn’t have a MEDICARE reimbursement code behind it, a family care giver, a community health giver.  So we knew a lot about that workforce .  We are experts in that workforce and we are already experts in care coordination and transitions.  We are experts in big data, at least from the financing side of it.  So, what don’t we fit all this expertise together and focus in on digitizing care coordination.  We wanted to make care coordination a smarter process and in doing so, always emphasizing - how do we leverage the benefit of the community health worker and at the same time a clinician like a nurse?  That is the germ that led us to where our software application is now. “ 

Monday, August 4, 2014

Fibers of Change - Andrey Ostrovsky, MD

The Fiber of Andrey Ostrovsky, MD Part 1
by Al Hardy

“When we left Ukraine, I thought I was on a field trip.”  Dr. Andrey Ostrovsky chuckled.  This was the type of chuckle that only retrospection can bring.  The type that emphasizes a few things: first, it’s really not all that funny;  second, sometimes, life was pretty tough; third, there is still only a partial understanding of how we made it through.

Dr. Andrey Ostrovsky, CEO and Co-Founder of Care atHand
Dr. Andrey Ostrovsky is a pediatric physician, CEO and co-founder of Care atHand, and social entrepreneur.  While there is a place, he believes, for healing one patient at a time, he wants to affect entire populations, starting locally, then regionally, across the globe.

But what is a social entrepreneur?  For that matter, why does the designation even matter?  We will not even bother to drift into the deliriously distracting debate as to the value of social entrepreneurs in capitalistic societies.  A social entrepreneur’s initiatives may be focused on people or problems that are not seen as prime for investors.  Simply put, a social entrepreneur often sees success as both:
- a resolution of a “social” issue in a way that benefits the targeted populations
- the solution will still render good returns for investors

Dr. Ostrovsky understands the criticality of patient by patient treks back to health.  He even goes to the point of helping patients understand the interactions with her/his environments.  He will get down to the dirty details to figure out what’s going on within the patient’s ecosystem.
            Dr. Ostrovsky remarked, “I am not just concerned about treating asthma in a child.  I want to know about what is setting off the asthma.  For example, are there cockroach feces in the apartment?”

The value of the work at Care at Hand as a social entrepreneurial venture may be best understood through Dr. Ostrovsky’s journey to becoming a physician.  Dr. Ostrovsky was born in Ukraine.  Just before the infamy of the Berlin Wall was transformed into market demand for pieces of collectible relics, Dr. Ostrovsky’s parents were classified as refugees and fled to the U.S.  His father, who ran a construction company, buckled down into the hard hustle life of a cab driver.  His mother left her position of running a metal refinery to being paid under the table in a pizza parlor.  Imagine this transition for his parents.  Dr. Ostrovsky was a child and had a child’s perspective.  
“When we left Ukraine, I thought I was on a field trip.  Later, we lived in Baltimore City Housing Projects. I thought it was normal hearing gunshots. I remember going to work and having to make pizza boxes in the back room.  I was awful.  I was terrible because I kept eating pizza.” 

The family lived in Baltimore City Projects for three years.  That could have been the perpetual ending of the story.  Not everyone wins the fight to find a way out.  Not everyone wins the fight back to the semblance of a previous life.  His parents did.  I am sure with great costs and great rewards.  Those of us, who have never had to escape home and permanently settle in a foreign country and call that home… we may never really be able to appreciate the depth of those losses or gains.  I certainly would not want to experience such a thing just to gain that appreciation.  But, I can surely appreciate those who do live that experience.

His parents built new careers.  His father owns and manages Network Solutions of Maryland. His mother is the Vice President of Technology at Deutsche Bank.   It is obvious that Dr. Ostrovsky did not follow in their footsteps - career wise.  I asked how that happened.

           “You don’t have much choice as an immigrant child.  You have to be a doctor, lawyer, or engineer,” he gave a quick laugh. 
            I asked, “Were you resistant to it?”
            “I had no idea.  It is only in retrospect did I come to understand the grooming that was laid out before me.” He chuckled.  My parents were very supportive and always said they would be proud of me no matter what.  I see, though, the subtle suggestions by them… and the not so subtle suggestions from the not so tactical grandparents.  They said.  You will shame us unless you become a doctor, lawyer, or engineer.  It was never anything I was forced into.
“I was very lucky at the time.  When I was about eight or nine years old, my mom and my then step-father were running one of the largest Russian restaurants in Baltimore.  It kept them very busy.  During my most formative years, I grew up raising my sister, this small child.   I coached basketball for several years.  I was good in science in high school.  I fell in love with being around kids and voilĂ , pediatrician.
“But, when I look at all the privileged kids or the kids that were able to escape that environment and compare it to all the kids that weren’t able to escape that environment, why is that?  These are the things that piss me off on a daily basis and why I do what I do.”

Part 2 Coming Soon,

Friday, August 1, 2014

Coming up on Asset Management for Healthcare: Fiber to Thread to Cloth to Garment

Coming up on Asset Management for Healthcare: The Fibers of Change, an interview with Dr Andrey Ostrovsky - What makes a change agent from fiber to thread to cloth to garment?

The Fibers of Andrey Ostrovsky, MD Part 1
Andrey Ostrovsky, MD
  • Pediatrician
  • CEO and Co-Founder of Care atHand
  • Social Entrepreneur
Blog Post will go live Monday morning, August 4, 2014 Click Here to Read Part 1