Improving Population Health by Empowering Patients
Episode 557

Kistein Monkhouse, Founder and CEO at Patient Orator

Improving Population Health by Empowering Patients

Today’s Outcomes Rocket guest is Kistein Monkhouse, founder and CEO at Patient Orator, a digital health startup empowering chronically ill underserved patients with effective communication tools and health care resources. You’ll hear Kistein talk about how her company raises awareness of poor health outcomes and leveraging technology to tell patient stories more effectively to their doctors  She also shares her insights on the topic of social determinants of health, better access and quality care for the underserved population, and more. Listen to my interview with Kistein here.

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Improving Population Health by Empowering Patients

Episode 557

Kistein Monkhouse

Kistein Monkhouse, MPH is the CEO & founder of Patient Orator, a digital health platform focused on using storytelling to improve patient experience and population health. She is a former healthcare frontline staff who saw an urgent need to build bridges across communities in healthcare. Her work is at the intersection of public and private health using stories to bring awareness to the importance of improving the health of people and communities with a focus on catalyzing storytelling to address social determinants of health.

She is an award-winning documentary director of the film Humanizing Health Care, a narrative-driven emotionally paced documentary about healthcare experiences in the United States. She sits on the advisory board of We The Patients NY, an initiative by the Community Service Society of NY and NYS HIMSS Patient Advocacy Committee.

Kistein completed her Bachelors’s degree at Queens College and her Master’s degree at LIU Brooklyn.

 

Improving Population Health by Empowering Patients with Kistein Monkhouse, Founder and CEO at Patient Orator transcript powered by Sonix—easily convert your audio to text with Sonix.

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Intro:
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Saul Marquez:
Welcome back to the Outcomes Rocket. Saul Marquez is here, and today I have the privilege of hosting Kistein Monkhouse. She is the CEO and founder of Patient Orator, a digital health startup empowering chronically ill, underserved patients with effective communication tools and health care resources. She’s a former health care frontline worker who saw an urgent need to build bridges across communities and health care. Her work is at the intersection of public and private health, using stories to bring awareness to the importance of improving the health of all people, particularly underserved communities, with a focus on catalyzing storytelling to address social determinants of health. Kistein is a 2019 CMA Studios Fiscal Sponsorship Award recipient for her short film, Humanizing Health Care, a narrative driven, emotionally paced documentary about health care experiences in the United States. The film explores deeply rooted systemic issues across the health care ecosystem and the barriers to present the people at each touchpoint and care delivery. It’s such a privilege to have Kistein with us today, and it’s gonna be a great discussion about social determinants of health, increasing access and improving outcomes. So Kistein, in such a privilege to have you here with us today.

Kistein Monkhouse:
I’m very honored for this opportunity. Thank you so much for having me.

Saul Marquez:
Absolutely. So before we dive into the awesome work you guys do at Patient Order, I’d love to hear a little bit more about you, Kisteine, and what inspires your work in health care.

Kistein Monkhouse:
Sure. So my love for health care was initiated many years ago. I began working in private home health care, providing care to the elderly. And it was then that my passion for health care was part. Soon after, I became a certified nursing assistant, blended my very first position in a long term care setting. And this experience was very eye opening where I saw that the care that was being provided lacked empathy, that administrators were prioritizing cost savings over the safety and well-being of patients. And so as soon as I could get out of that setting, I did. And I really started looking at it at what were the driving factors, poor, poor patient experience. And what I came up with at the time was that the lack of resources for frontline healthcare workers specifically compromised empathy within the front liners. And this added to what we know to be the dilemma within the modern health care delivery system. On the flip side of that, after I parted ways with working in long term care, I began working at my local emergency room where I saw that patients were complaining that they were not being treated in a humanized the way that they had to wait very long hours to be seen. And I saw that there were a number of barriers that presented in those said and specifically in the emergency room where population density played a role. There were language barriers. There were cultural diversity issues, resources or a lack there of. And these are some of the complexities that impacted poor patient experiences. And it seemed to me, as someone who was on the back end, that administrators didn’t care about the complaints of patients. And I came up with that based on their inaction to improve services in prior to founding patient. NARRATOR I began working as a service coordinator, also known as a care coordinator, facilitating care for patients living with mental illness and or substance abuse issues and in working with these underserved patient population. I felt an urgency to raise awareness to poor health outcomes and bridge disparity gaps using technology.

Saul Marquez:
I really appreciate that and say you were on the front line and you saw the difficulty of providing care, but also the difficulties faced by patients receiving care. And he said I had to do something about this.

Kistein Monkhouse:
Absolutely I did.

Saul Marquez:
And so patient order your helping patients and also providers tell stories and by telling those stories, achieve the vision of better access and quality care, regardless of age, gender, race, zip code, income or education level.

Kistein Monkhouse:
Exactly. So when I look at social determinants of health and really what that is, is where people work, live and play. And then we look at the fact that 80 to 90 percent of social determinants of health is linked to behavioral socioeconomic factors and environmental factors. I believe in 2017, according to the report, there’s been over a 3.5 Trillion dollars on spending, and that number is looking to increase at around 5.7 Trillion dollars. And we look at issues related to social determinants of health and poor health outcomes. Racial disparities specifically led by African-American and communities of color and not be in the lead in healthcare setting. There are all issues that attribute to poor health outcomes and so that the fact that we develop this really to look at what are the main drivers of poor health outcomes to a multitude of facets, not just at bridging those those disparity gaps.

Saul Marquez:
I think it’s awesome, you know. I mean, a big part of what you guys do then is help patients and caregivers share their story. And they do so via video, right? Well, it’s a little bit about how that works. I’d love to better understand that. And because I’ve seen your YouTube channel, Right. ton of videos there.

Kistein Monkhouse:
Sure. Sure. So after I began working with underserved patients, I felt an urgent need to raise awareness of poor health outcomes. And that’s where I began telling stories through video. I began documenting stories of underserved communities and patients that have been chronically ill. That helped amplify the voices to bring awareness to poor patient experience, to bring awareness to health care disparities. And in doing that work, I became ill and I found myself on the receiving end of what was the very thing that I was advocating for again. And in that moment, I realized that it was not enough to just raise awareness and to document these issues that we really need to start working on the tech piece of how we’re going to solve for these issues. Right. So it’s easy to put out a video with a patient describing the problem, but it’s much more effective if we’re also providing that patient with the tools so they can navigate their storytelling. They can access the resources they need and they can also improve their health literacy. And if you look at what the data says, these are all the relevant issues to why we have high healthcare spending in the United States. So we’ve developed an app within within the last few months. And what that app does specifically is it helps patients with their storytelling so that when they are encountering clinicians or anyone from their care team that they’re able to effectively tell their stories, their clinical centers, articulate their clinical symptoms in a way that the clinician was quickly understand. Because what happens in clinical encounters is that physicians, clinicians, they’re all limited with the time they have to spend with patients. They’re limited with the with the other burdens that they have, such as documentation. And there’s just so many different issues and silos at play in this encounter that we really thought that the best way to improve health outcomes is to look at how we can empower a patient’s voice and help educate them and help them with the resources that they need. Does that make sense?

Saul Marquez:
It makes a lot of sense. Yeah, and I and I appreciate that. You know, it’s you guys are helping them translate their diagnoses and clinical story in a way that the system language will process correctly.

Kistein Monkhouse:
That’s correct. That’s very correct. That’s very cool. You know, and I think it’s a big gap and an opportunity for all these amazing people that are having a hard time communicating. And let’s face it, folks, it doesn’t matter if you have money or not. You more than likely have a hard time communicating your story to your doctor. I mean, let’s face it, it’s it’s hard and it shouldn’t be. And so tell us a little bit about how this storytelling has helped improve outcomes or maybe made a business better, potentially even a provider business better overall to help the health care system.

Kistein Monkhouse:
So we’re very targeted on underserved communities and we’re very early stage before we began actually building this tool. We did a survey and much to what you just said. We found that 97 percent of people this is across socioeconomic status have difficulties communicating their clinical sentence to their clinical team. And so we knew immediately that that was a problem. And after we had shown the participants of what we were building, about 70 percent of them stated that they would use this tool. And so that’s the way in which we then proceeded to build our tool. And the way in which it helps health care settings, for example, is when you look at a hospital, they have their internal screening and they’re responsible in some cases to connect patients to community resources. And then there’s the external factor, and that entails engaging with community organizations or partnering with them or investing in those organizations. And we’re really that bridging the gap between the patients, the community resources and the clinicians. So we’re saying, hey, we have this tool that the patient can then narrate their story, securely store it so that when they are encountering the clinician, they’re able to say to those clinicians, these are the issues that we’re facing in a timely manner, in an effective manner. Does this answer answered a question.

Saul Marquez:
Absolutely. Absolutely. And so now they’re able to do this effective. I’d love to hear about maybe a story or two that, you know, things have worked out.

Kistein Monkhouse:
Sure. So, for example, with my personal story, I have lived with chronic pain for three years. And what I didn’t realize was that physicians, clinicians were not taking me seriously until I was in a in crisis. And it had to the seven clinicians in order for me to be diagnosed, in order for me to receive pain medication, to manage my sense. What I didn’t know was that there were driving factors behind that related to social determinants of health. Again, going back to the fact that black patients, for example, are 34 percent less likely to receive opioids for acute pain than white patients. In addition to that, Hispanic patients are 13 percent less likely to receive opioids in comparison to their white counterparts. And this is a study that was done by the American Journal of Emergency Medicine. And what I didn’t know is that my skin color and my gender directly impact the way I was being perceived. And so I began examining the way in which I shared my story and the way in which I was selling communicated particularly in my clinical symptoms to my provider. And really came to a point where I realized that based on the person, physicians or hierarchy in the organization, I was communicating completely different. And so I put a system in place with which I would then formulate and record every time I had a system exactly what happened. And then in my encounter, we would be able to tell that effectively to the clinicians. And that made a huge difference in terms of how I was treated and the way I was, I believe, perceived in those encounters. So in a way, is.

Saul Marquez:
Good for you.

Kistein Monkhouse:
Yeah. Thank you. In a way that will be done is created an app that flipped the switch under communication breakdown. And we’re very intentional about providing this tool specifically to underserved patients and the care team in terms of connecting them to those resources.

Saul Marquez:
Wow, that’s so great. You know, and kudos to you, Right.. You went through it yourself and you’re like, you know what? I don’t have to deal with this. And this could be a lot better for me and could be better for others. Yeah, this is a practice and it resonates with me. I mean, I anytime I prepare for a meeting Kistein, I do a debrief and I write out what I expect to achieve after that meeting. And then I. So I write up my outcome and then I write out what the plan will be. It doesn’t always work exactly the way that I write it out. But at least with a clear direction, you can achieve your objectives. And why is it that we go into a medical appointment without clarity? I’ll be honest. I’ve never done this for myself. When I go in to see my doctor, you know, and this is a great opportunity for me to start doing that. This is a great opportunity for our listeners to start doing that. And specifically for those underserved populations, an opportunity to start doing it with the help of your app. So how did people get a hold of this app? And, you know, what’s the process? How much does it cost?

Kistein Monkhouse:
Sure. So there currently in private beta, but not available to the general public. But one way in which provider systems can or anyone to reach out to would potentially bring in this app to their patient population is simply by email and info@patientorator.com. And we can start talking about ways in which we can help bring the app to any given patient population. So very intentional. Again, like I said about bringing this to underserved communities, because these are the voices that are not being heard. And these are the voices that needs to be empowered.

Saul Marquez:
Love it. So great. And so as we look to bridge the gap in communication, we also bridge the gap in care and access. And so this is an incredible platform that you guys are building on. What would you say makes you most excited about the work that you’ve been doing?

Kistein Monkhouse:
I think because of the fact that I’ve been on on the end where I was someone who was not being believed, I understand the needs of what we’re solving for and also in working with patient groups and working with underserved communities that are over and repeatedly not being provided the most optimal care that they can possibly receive. I know the impact that this app for me and because I know that this app is impactful in terms of bridging these gaps. And in recent events where we’re seeing the issues around racial disparities being brought to the forefront, it makes me very hopeful that change is on the horizon. And I think now is the time for systems and health care leaders to start looking at innovators like myself who have lived experiences either working in. These populations are experiencing these same points ourselves to partner and to collaborate with. Because there are groups of people who are just being ignored by the system.

Saul Marquez:
Now, it’s a great call to action there and certainly an opportunity for health care executives to listen and be able to offer, you know, patients when they come in an opportunity to use this tool. Right.. So maybe you’re working with patient order to best help their populations that they’re serving. Exactly. Well, they have folks if you want to learn more about how patient orator is helping bridge that communication gap, go to their Web site and learn more about how you really you could work together with them. We’ll leave that Web site on the show notes, but it’s refresh me on that website again, its patientorator.com, right..

Kistein Monkhouse:
That’s correct.

Saul Marquez:
So patientorator.com. But you’ll also find links to our entire discussion with Keystone. Go to outcomes, rocket health and the search bar. Type in patient order and do your part to help these patients tell their story and increase access and quality care. I really appreciate you and all the work that you’re doing, Kistein, to make access better and really excited to stay in touch with you.

Kistein Monkhouse:
Thank you so very much for having me. Before we close, I really have to say that every voice matter that we need to continue to empower folks, especially disadvantaged folks, and to help improve health outcomes for everyone.

Saul Marquez:
I love it. Yeah, I couldn’t agree with you more, Kistein, and the work that you’re doing is going to help us get there faster. So really appreciate what you and your team are up to and want to give you big kudos.

Kistein Monkhouse:
Thank you. Thanks for having me.

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Things You’ll Learn

  • The lack of resources for frontline healthcare workers specifically compromised empathy with the frontliners
  • There are many issues that attribute to poor health outcomes and technology can bridge some disparity gaps
  • One of the best ways to improve health outcomes is to look at how we can empower a patient’s voice and help educate them and help them with the resources they need.

 

References
https://www.patientorator.com/