The Problem: Medical errors are the 3rd leading cause of death in the United States.
THE SOLUTION: I-PASS
In a July 2016 primer on handoffs and signouts, the Agency for Healthcare Research and Quality “AHRQ”, an agency within the U.S. Department of Health and Human Services, stated that: “The I-PASS signout format is now widely used in graduate medical education and is considered the gold standard for effective signout communication between physicians.”
As a result of the academic studies, it has been demonstrated that the successful use of I-PASS by medical professionals benefits all involved parties. Most importantly, the safety and health of the patient is improved. Additionally, medical professionals, hospitals and medical insurers benefit from avoidance of the social, psychological, and financial burdens of making errors that harm patients, as well as by enhanced reputations. The reduction of medical errors eliminates costs from the healthcare systems through both the elimination of events caused by the errors, and also through the reduction in associated malpractice claims that may derive from such a medical error.
I-PASS PATIENT SAFETY INSTITUTE: SCALING I-PASS FOR BROAD ADOPTION
I-PASS Patient Safety Institute has standardized the process for I-PASS adoption and sustainment. Our certified mentors guide hospitals every step of the way in the key project phases of assessment of the baseline state, planning for implementation, training providers, and ensuring long term ongoing continuous improvement and sustainment of I-PASS.
We have an exclusive license, from Boston Children's Hospital, to use the I-PASS trademark for communications related to patient handoffs.
HOW WE MAKE MONEY
We sell term-based licenses to hospitals to use our software as a service offerings and the associated data fees. We anticipate that the majority of our revenue will be derived from those software offerings, and that we will be able to manage our costs for software offerings in order to have gross margins in line with other high-performing SaaS companies. Our professional mentor services are provided to hospitals for a fee as well, often in connection with our licensed software, and at times as a standalone fee charged to hospitals. When sold standalone, those professional services are generally in the context of an initial evaluation study to help hospitals assess their current capabilities as relates to handoff communications, and therefore build a value proposition for a broader implementation of our product and service offerings.
SIGNIFICANT MARKETS FOR OUR SOFTWARE AND SERVICE OFFERINGS
Our initial market, based on our existing products and services, are targeted to the communication between medical professionals used in hospital inpatient settings. We are initially focused on the U.S. market, but our products have applicability across the globe. Within the U.S. market, the majority of the opportunity for our sales is to community hospitals, of which there are 5,564 based on a 2016 survey by the American Hospital Association. We estimate our U.S. market opportunity with our existing products and services to be over $500 million per year. I-PASS as used in this hospital inpatient setting is applicable to markets outside of the U.S., and we believe that those markets outside of the U.S. are equal to or greater than the U.S. market opportunity.
Our existing products and services are targeted to the communications between medical professionals in hospital inpatient settings. I-PASS also has applications to handoff communications that are outside of those that take place solely between medical professionals. The I-PASS Study Group is currently studying Patient & Family I-PASS that will target improving the handoff process between medical professionals and the patient / family of the patient. Additionally, I-PASS has applicability in an ambulatory setting. We believe that the markets for “Patient & Family I-PASS” & “Ambulatory I-PASS” are larger than the market for I-PASS in an inpatient setting.
REDUCING COSTS IN THE MEDICAL SYSTEM
In a May 2017 presentation at the Pediatric Academic Societies (PAS) Meeting, researchers presented data from a random sampling of 23,000 malpractice claims from 2001 to 2011. In these findings, it was noted that 52.0% of malpractice claims involved a communication error. 41.4% of those cases involved a handoff of care. The researchers noted that it was possible that a standard handoff process and tool may have averted 83.6% of those claims involving a handoff of care. Accordingly, the adoption and use of a tool such as I-PASS is estimated to potentially reduce 18% of total U.S. malpractice claims, which would save $12.7 billion from the U.S. healthcare system.
Our Journey So Far
Initial Single Site Study Begins
I-PASS is born at Boston Children's Hospital.
32 Site SHM Mentored Implementatation Study Begins
I-PASS Patient Safety Institute Founded
Friends and Family Preferred Stock Round
I-PASS Study Group Wins Eisenberg Award
Patient & Family I-PASS Published Results
Letter From Our Founder
Dear potential I-PASS investors and supporters,
For decades, the healthcare community has known that medical errors are a major problem in our hospitals. Far too many patients die or are harmed as a consequence of care they receive, despite the best intentions of their doctors and nurses. Miscommunications are a leading cause of these harms, particularly during “handoffs” at change of shift or when a patient changes locations in the hospital. At an average sized U.S. hospital, there are approximately 1.6 million handoffs every year. We developed I-PASS, a multi-faceted handoff improvement program, to fix this problem.
Over the past nearly 10 years, I have had the honor of working with the five physician co-founders of the I-PASS Patient Safety Institute, as well as over 150 physicians, nurses, family advocates, and others to carry out a series of studies to look at what happened when we put I-PASS into practice. Since we started I-PASS in 2009, the program has been extensively refined, tested and adapted, and well-integrated into doctors’ and nurses’ workflow patterns.
With the support of over $7 million in federal and foundation grants, we found in our first major study that implementing I-PASS led to a 30% reduction across 9 hospitals in injuries due to medical errors, and in subsequent studies found similar benefits in a diverse group of 35 adult and pediatric hospitals across the country. I-PASS leads to improvements in handoffs for physicians and nurses. It works across specialties, in academic and community hospitals alike. Additional research into this topic has found that an estimated 80 percent of the most serious medical errors in hospitals can be linked to communication failures, particularly during patient handoffs.
My interest in handoffs began early in my career, during my medical residency and fellowship. I trained in the late 1990s, just as the healthcare community began to recognize the scope of the patient safety problem in our hospitals. I became interested initially in studying the effects of sleep deprivation on patient safety and performance, as I had personally struggled with the effects of a lack of sleep on my ability to provide appropriate care to my patients as a trainee. I learned very quickly that I was not alone in this struggle. I led studies documenting the effects of doctors’ sleep deprivation on patient safety, and advocated for policies to begin to move the profession towards safer work hours. Although we still have a long way to go on this front, we have begun to take some small steps forward. However, as I worked to eliminate the 24-hour and longer shifts that doctors have traditionally worked, it became apparent that a reduction of each work shift would translate to more shift changes and more handoffs. To support those shift changes, we needed to reduce the risk inherent in handoffs, and I-PASS was born.
It is extremely gratifying to see I-PASS beginning to spread, but we are truly just at the beginning. While we have managed to introduce the program in over 50 hospitals, there are over 6,000 hospitals in the U.S. alone. Even in the 50 hospitals where we have gotten I-PASS started, the program is for the most part being used in only a couple of units or departments. Grants and an academic approach to the problem were crucial for getting started, but in order to scale the program so that it has a real impact on the safety of the healthcare system, we need to work differently.
The I-PASS Patient Safety Institute was created to meet this tremendous need. The Institute has now been in existence for just over one year, and in that time we have developed a series of product offerings that are allowing us to take the key elements of I-PASS – an interactive handoff training program, modification of oral and written handoff processes in hospitals, and tracking, reinforcement, and iterative improvement of those processes over time – and scale them for hospital-wide application. We have been working intensively with several hospitals to test the initial commercial release of our products and have been tuning our related professional service offerings that leverage the nearly 10 years of research that we have put into I-PASS. The feedback that the I-PASS Patient Safety Institute has received on the applicability and usability of our products has been extremely positive, and we believe that our product and service offerings will be able to help large numbers of hospitals achieve their goal of improving patient safety, while having the added benefit of driving down costs that are associated with medical errors (including the costs of care associated with medical errors and medical malpractice claims).
In closing, I want to thank you for spending your valuable time to understand more about I-PASS and the I-PASS Patient Safety Institute. We hope that you share our passion for patient safety. Should you elect to invest in us through this crowdfunding offering, you will be joining our friends and family, who invested in us at the same per share price that we are offering to you. We would be honored to have you become a part of the I-PASS family.
Thank you for considering joining us,
Christopher P. Landrigan, MD, MPH
Principal Investigator, I-PASS Study Group
Co-Founder and Board Member, I-PASS Patient Safety Institute