he was in Curry’s office, confirming his diagnosis and talking about surgery options. A month later, he was back at work, cancer free.
Martell believes that without the help of Grand Rounds, he could not have been connected with such an accomplished surgeon so quickly. “ It’s not something you really want to wait around on,” he says.
Though the service aims to help patients, when Tripp and Hofmann first started thinking about it they focused on doctors’ needs. Hoffman is an expert in blood clots—specifically those that develop in veins in the leg. He was frequently asked to review cases from patients around the world, but without having all of the necessary information—medical history, test results, etc.—he couldn’t do it. “He’s got a gift a lot of people in every state could benefit from,” Tripp says. “How could we create a marketplace that would allow the Dr. Hofmanns of the world to treat patients safely without having them to fly for treatment at Stanford?”
Grand Rounds addresses of the problem by collecting all of the information doctors need to treat a patient. Staff members make the calls and collect the records, then Grand Rounds uses software it has created to digitize all the records and allow doctors to review patient cases.
Recently, Sumit Shah, a staff physician at Grand Rounds and a member of the UCSF faculty, consulted on the case of a 40 year-old man in New Jersey who came in to a hospital with flu-like symptoms, and ended up with kidney failure and severe swelling. “The hospital did very appropriate and extensive testing for things like hepatitis, autoimmune diseases, cancer, and blood clots, but they couldn’t find anything,” Shah says.
When the patient went into intensive care, the family reached out to Grand Rounds for help. Within 24 hours, Shah was able to interview the family, obtain medical records and test results, and consult with the patient’s treating physicians. After a family member mentioned a kayaking trip in Florida, Shah thought the patient might have a bacterial disease called leptospirosis. Shah and the treating physicians agreed to put him on antibiotics, and a week later, the patient was discharged from the hospital. ”At the end of the day, medicine is an extremely collaborative field,” he says. “Physicians are typically very happy to receive help.”
They’re also happy to give it, according to Ray Dorsey, a neurologist at the University of Rochester who reviews cases for Grand Rounds. “This is just another means of using tech to increase access to care,” he says.
One of the more complicated parts of building out Grand Rounds’ business was finding the expert physicians that could most help patients, Tripp says. Though the team could easily suggest experts in big cities like San Francisco or Boston, “that doesn’t work for people in Topeka or Anchorage,” Tripp says.
So the company built a 13-factor algorithm to help create a list of the best of the best, evaluating both qualitative and quantitative data. Physician training—medical school, fellowship, internship, physicians doctors studied under and the time period in which you studied—is very important, according to Tripp. But so are observed factors, like the number of procedures preformed and treatment outcomes.
Though Grand Rounds pays the physicians who give patients second opinions, Tripp says some don’t do it for the money. “They either do it for fees, or they do it because they like being part of the club,” he says. “Expert physicians are very pedigree driven.” Plus, specialists don’t always get to see a ton of particular types of cases in the area in which they live. Opening themselves up to a national audience allows them to treat a much larger group, giving them better practice treating specific diseases.
All in all, says Tripp, “I think it’s part of larger healthcare conversation in terms of extending resources and improving access and quality of care. Harnessing the technology we have here can dramatically improve the healthcare landscape.”
