Virtual Care & Services

DayToDay: Where It All Began

Prem Sharma
March 30, 2021

How (and Why) Was DayToDay Born?

DayToDay began when its founder, Prem Sharma, was studying at MIT and gained more exposure to healthcare through courses and one-on-one interactions with patients. He found a serious gap in one specific stage of the healthcare process - aftercare. Specifically, the patients he spoke with who had been in acute care situations - ones in which the patient undergoes surgery or another major procedure - stated that they were told very little about rules and instructions for post-op care. When asked, less than 10% of people he spoke to felt they knew what to do day-to-day after returning home from the hospital. In fact, the majority said they didn’t even know what they were supposed to do a mere two hours after leaving the hospital.  

This was the tipping point for Prem as he realized the severity of the situation. How could patients expect to make a full recovery when they were never briefed on how to take care of themselves after their operation - arguably the most important time in achieving a full recovery?

Prem got to work, spending the summer of 2018 building the foundations of DayToDay and joining the MIT incubator later that year, marking the official start of DayToDay.

The Importance of Post-Op Care

When a patient undergoes a complex treatment, they typically follow this series of steps:

  1. Undergo procedure
  2. Manage post-discharge care
  3. Revisit the hospital for a follow-up checkup
  4. Maintain ongoing care and support

There are currently plenty of resources and high levels of support given to patients while they are in the hospital, but once they leave the hospital, they’re on their own. For acute patients, this is especially problematic given the sensitive nature of their health post-op. Many could die within 24 hours of their operation without the proper care, and unfortunately, some have.

However, many other issues occur when patients are not given proper care after their procedures. For example, the risk of infection is very high for patients if their wounds are not properly taken care of. This could lead to extra hospital visits, serious complications, and extended recovery times. Another example is if a patient is diabetic, managing their sugar levels with hyper-accuracy is essential to their wound healing and infection prevention.

While these two examples are more external, internal factors can also greatly impact a patient’s recovery. Stress, for example, triggers the brain to release cortisol and other chemicals that help manage stress but are bad for our health. If a patient goes into a procedure feeling stressed, the increased cortisol combines with anesthesia and remains in patients’ brains for a longer period.

There are a few things that can lead to increased stress levels in relation to patients’ confidence. After a procedure, patients may be unable to take care of themselves the way they would have before the procedure, leading to decreased confidence. They may also avoid calling doctors or visiting the hospital to ask smaller questions, and this constant uncertainty can eventually lead to lower confidence levels in their own perceived knowledge. This decrease in confidence is closely associated with patient stress levels, which leads to a slower recovery.

Problem: Lack of Affordable and Effective Aftercare

There is a concept in user experience where you always want to test your prototype on someone completely unfamiliar with your product. There are blind spots that you can fall into when testing it on yourself because many things that have become common knowledge to you may be confusing to the average person. This is one factor that contributes to the lack of post-op care. Many things that may seem obvious to doctors and nurses are things that the average person may not know.

Additionally, when you are familiar with a topic, it’s easier to remember things related to it. For those completely unfamiliar with medicine, hearing verbal instructions on post-op care once is synonymous with not hearing them at all. Statistics show that 80% of the information told to the patient before they leave the hospital is forgotten, and of the remaining 20%, only about half is remembered accurately. Part of what contributes to this statistic is that a lot of important information is given to patients right after surgery while they are still under the effects of drugs and/or anesthetics, which makes it even easier for them to forget. Another contributing factor is that family members are not briefed on how to care for the patient, so once the patient gets home, they have to rely on their knowledge. This issue could be improved or even avoided if patients were given written instructions, but this rarely happens.

Another factor that contributes to this information gap is the lack of hospital resources. Hospitals are constantly pressured to lower their costs, and they are often running on limited resources. Prioritizing in-patient care comes first, and the bulk of hospital resources - including doctors’ and nurses’ time - goes towards that.

Solution: DayToDay

In crafting a solution to this problem, Prem visualized a situation where a queen falls ill. He asked himself the question: “When a queen falls ill, what does her care team look like?” He concluded that she would likely have a nurse, a psychologist, a pharmacist, a nutritionist, a physiotherapist, and overall, a very comprehensive care team.

This empathetic and holistic care that the queen would receive is what Prem believes everyone should receive. However, he realized that the cost of delivering all of this care can add up to more than 1000 pounds per month. The queen would be able to receive this care because of the financial resources she has, but how would people without these resources be able to receive the same level of care?

This was one of the biggest obstacles for DayToDay to overcome. In creating DayToDay, Prem wanted to make sure that he was capturing all of the essential functions that people involved in a patient’s journey perform, but deliver it in a financially sustainable way. At the end of his research and observation, he came up with three main functions: support, education, and risk management. To correspond with each of these three functions, Prem came up with a 3 C’s model: coaching, content, and context.

Coaching

Psychologists, nutritionists, therapists, and more are responsible for optimizing the health and recovery of patients. DayToDay decided to provide each patient with a coach who stays with them from the beginning of their care journey to the end. The coach is constantly in touch with their patients, and they are very active and involved in the process, from personalizing the patient’s care plan to being present in the face of complications or problems to helping manage post-op care.

Content

Another area that doctors are responsible for is educating patients. To replicate this education piece, DayToDay looked into the types of healthcare content currently available to patients. What they found is that healthcare content is largely outdated, presented in a hard-to-digest way, and not personalized toward specific patient needs and questions. For a patient who is already experiencing stress from their illness or who is not educated at a high level, having information that they can easily read and digest is extremely important. DayToDay recognized this need and created consumer-friendly, bite-sized pieces of content in the forms of daily tasks, interactive media, courses of mental and physical skill-building, and more. They write all of their content at a 6th-grade reading level to further ensure that the information is useful to everyone, regardless of their level of education.

Context

After a patient has an operation, their doctor will ask them questions about the progress of their health to gauge whether it is necessary for them to return to the hospital. Technology is what ties all of this together and enables DayToDay to provide patients with this high level of care. DayToDay has built out an automated process in which the patient’s care team can perform health checks on patients every day through the DayToDay platform. Patients can upload photos of their wounds and provide detailed updates on their health daily, which helps identify problems and prevent them from escalating into bigger issues. This automation that DayToDay has implemented ensures that data is not lost and that follow-ups can happen frequently.

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The DayToDay App gives patients all the information they need regarding their post-op care, as well as an entire recovery team to help assist in their recovery.

Core Features of the DayToDay App:

Below are some of the core features of the DayToDay app:

  1. Wound management: Patients can send photos of their wounds to doctors who will monitor them and make sure they’re healing properly
  2. Daily check-in: This ensures that patients are healing properly and that a doctor can step in promptly before an issue escalates.
  3. Healing Checkpoints: The healing process gets broken up into smaller checkpoints so that patients can see constant progress in their recovery.
  4. Live Chat: While coaches will regularly reach out to patients to guide them through their care process, patients can also reach experts through a live chat if they have additional issues or questions
  5. Meal Recommendations: The app provides patients with meal recommendations and delicious recipes so that the patient can maintain a healthy diet during post-op care.
  6. Physical Rehabilitation: DayToDay supports patients in their rehabilitation, such as physiotherapy or cardiac rehab, with tools and care plans when applicable.
  7. Appointment Preparation: Failing to prepare for an appointment or procedure could lead to complications during the procedure, inaccurate results during the appointment, or a variety of other problems. The DayToDay app gives detailed tips on how to prepare for an appointment or procedure.
  8. Digestible Material: All content is written at a 6th-grade reading level so that information is easy to understand for patients.
  9. Family Member Access: Family members can make their account and access the patient’s platform (with permission from the patient) so that they can also stay up-to-date on how to help out and keep the patient accountable during the recovery process.

The DayToDay app brings together parties who were previously disconnected - doctors, patients, and their families - to work together in helping the patient heal. It turns an individual recovery journey into a group effort and provides added layers of support for patients.

How Does DayToDay Benefit Doctors and Hospitals?

Innovation in any industry is never easy, but in healthcare, it’s especially hard. The healthcare industry tends to be slower to adapt to new technologies and disruptive companies, like DayToDay. DayToDay requires a big mental shift for more traditional doctors and hospitals because ultimately, DayToDay creates a paradigm shift in how doctors and hospitals have been operating.

Because healthcare is not black and white, healthcare experts may have differing opinions on the best way to care for their patients. It can be difficult for doctors to release control over their patients, and it is important to build trust between them and others (nutritionists, psychologists, etc.) who are caring for their patients.

To achieve this trust, DayToDay makes an extra effort to explain everything in detail to doctors and to create clear boundaries for which areas doctors will always have the final say in. DayToDay also walks doctors through potential scenarios and helps them visualize how everything works together. Doctors initially respond with cynicism and questions, but after they understand the system and potential benefits better, they often are excited to jump on board.

Because DayToDay brings about a more transparent and hands-on patient process, both doctors and patients become more aligned on treatment plans. This takes away the possibility of, for example, patients going in for chemo treatments that they aren’t ready for, patients going home and getting infections or taking the wrong medicine, or other scenarios that would lead to patients having to go back to the hospital unnecessarily. At the end of the day, having this clear and open line of communication ends up saving hospitals both money and time.

Ready to try DayToDay out for yourself? Ask your doctor or hospital to use DayToDay - today!



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