Dr. Ryan Van Wert is Addressing a Critical Unmet Need in End of Life Care

Note: This interview has been condensed and edited for clarity.

EOL: Ryan, talk to us about the origin and function of Vynca. What does it look like behind the scenes in these healthcare settings, when it comes to dealing with end of life issues?

Dr. Ryan Van Wert: During medical school and residency, I found palliative care and hospice care exceptionally important and fulfilling, but I ended up going down the pathway of critical care. It came full circle for me when I saw the consequences of how we deal with end of life issues in this country.

During post-doc, I had finished off my clinical training at Stanford and gotten involved in a program called BioDesign, which is a health technology focused on value-driven innovation. The program itself has been around for more than 20 years, and millions of patients have been treated through technologies developed in that post-doc. The real crux of it is to identify very pressing and unmet needs in healthcare, then go through a structured process that allows you to develop solutions. It's heavily based on the tenants of user-centered design and design thinking, but customized and configured to the healthcare context.

Our initial insight was, 'Wow, this person had an advanced care planning conversation, they've dialogued and documented it, but no one showed up with that form.'

We were spending a lot of time in the ICUs and seeing individuals, time and again, coming through the doors of our emergency room, often ending up on ventilators when they had existing serious illnesses, advanced cancers, and dementia. Our initial insight was, 'Wow, this person had an advanced care planning conversation, they've dialogued and documented it, but no one showed up with that form, and it wasn't available.' It was either in a safe deposit box or we would hear stories of forms lost on route in an ambulance. There was certainly a gap, but we recognized that the bigger problem was many people were not having these dialogues at all, with their clinicians or with their families.

So we wondered, 'How do we as a community ensure individuals have the chance to make their voices heard? How do we make sure that their values and goals are clarified, particularly when faced with a serious illness?' And ultimately, we wanted to figure out: 'How to make those actionable?'

It started with a very narrow insight around document availability. As we took a wider look, we saw that healthcare organizations really struggle with making sure advanced care planning is done correctly for specific populations who need it, so organizations ultimately struggle to provide goal concordant care. That's where we saw an opportunity: support through a technology-first approach, helping healthcare organizations make sure they're providing goal concordant care for individuals in their communities.

We make sure that the right individuals are having the right conversations, at the right time.

EOL: How specifically does Vynca address this need?

Dr. Van Wert: We provide consulting services around clinical workflow redesign; support with trained facilitators to have these dialogues; and offer analytics to make sure the provider network is identified and mapped out, from an adoption, to utilization perspective. We make sure that the right individuals are having the right conversations at the right time.

EOL: This sounds incredible. What does adoption rate look like so far?

Dr. Van Wert: We crossed an important milestone earlier this year, managing more than a million documents in Vynca's secure cloud for advanced care planning. That represents about 850,000 unique patients and is something we're really, really proud of.

EOL: As you should be! Lastly Ryan, we'd love to hear about the outcomes you're seeing.

Dr. Van Wert: We show very significant outcomes in terms of driving goal concordant care. We see dramatic reductions in hospital deaths, increase in hospice utilization, and reductions in emergency visits and hospitalizations in the last thirty days of life. As we look at the landscape going forward, we see opportunities to continue to build out our offerings for healthcare organizations to support these goals. Increasingly, organizations are participating in value-based arrangements, and this is a real driver of success in those systems.

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