Improving Hospital Rounds with Dr. Michael Pitt, Co-Founder and CEO, Q-rounds

Frank Jaskulke  01:21

Good morning, good afternoon and good evening to everyone out there in Medical Alley. Thank you for joining us on another episode of the Medical Alley Podcast. I'm your host, Frank Jaskulke. And today, we have a pretty interesting conversation, one of the newer emerging, fast growing companies in the ecosystem that is solving a pretty significant problem that, if you've ever been in a hospital, had a child in a hospital, you probably understand and appreciate and will really appreciate what Q-rounds is doing to address it. So today I'm joined by Dr. Mike Pitt, who's the co founder of Q-rounds. He's gonna tell us a little bit about what they're working on, what they're up to, where they're going. Dr. Pitt, thank you so much for being on the podcast today.

 Dr. Mike Pitt  02:05

Thanks for having me. I feel like I need to say longtime listener, first time participant.

 Frank Jaskulke  02:10

Indeed, I appreciate it. Well, maybe where we can start, for the the listeners who aren't as familiar with your work or with Q-rounds, can even the quick background on you, what you've been up to what you're doing, and then introduce Q-rounds. 

 Dr. Mike Pitt  02:23

Sure. So my name is Mike Pitt. I'm a pediatric hospitalist. That means I'm a doctor that takes care of kids that are sick enough to be in the hospital. So I don't have a clinic. I work at the University of Minnesota as a professor of pediatrics there. And when I see patients in the hospital, I know the pain points of me as a doctor and an administrator. But I also have been on the other side of that bed too, with loved ones or a patient myself and really have learned those pain points. And I'm excited to solve a problem that really hits all of those stakeholders.

 Frank Jaskulke  02:50

Yeah. All right. So yeah, let's talk about that. What is that pain point? Maybe start from the patient side first, this pain point that Q-rounds addresses? 

 Dr. Mike Pitt  02:59

Yeah, I think anybody who's ever either been a patient in the hospital or had a loved one in the hospital knows that that most important conversation that happens every day is when the doctors come in the room. They say, this is what we think's going on. Here's what our plan is for the day, this is when you get to go home. That conversation is called rounds. So doctors make rounds. That originates from the time in the hospital when doctors lived there made their residence there, that's why they're called residents, and physically walked around and around around seeing every patient. So that moment of rounds is what you're waiting for as a patient. And it's what you're waiting for when your loved one's in the hospital. Not knowing the answer to the question of when will the doctor be here is a major pain point. It's the number one question nurses are asked by families and patients. And so you end up sitting there hoping, maybe held hostage for seven hours waiting for that moment, for that conversation. Families don't know if you can get a cup of coffee or go to the bathroom. Or if you were like me, and your loved one was across the country, you were waiting, hoping they would remember to call you or somebody would call and you start every meeting with I'm going to get a call between 7am and 2, and I'm going to have to drop what I'm doing because my dad's in the hospital. That's the pain point that we're solving with Q-rounds for family is predictable time transparency, knowing when the doctor will be there with the ability to join remotely if you can't be there in person. 

 Frank Jaskulke  04:15

Oh, wow. And yeah, I've definitely experienced that. And it's real, like you're just waiting and waiting and waiting and it feels like you're just, you're in a vortex, you can't do anything about it. So what about on the other side then for the doctors and nurses, the other staff that are around. I imagine they're waiting as well?

 Dr. Mike Pitt  04:35

Well, right. So as a doctor, you know, we know a scientific best practice is to round with the nurse and the family present. It's called multidisciplinary. Not just the doctor, the doctor and the nurse and others. Family centered rounding. Medical errors go down when that happens. 38% reduction in medical errors when the nurse is at the bedside for rounds. Yet the practicality of that as I walk in a room, I go to that room for rounds. I look at a whiteboard and I tried to decipher the handwriting of the nurse, I find their phone number, I say I'm rounding in this room, they are in the middle of doing a procedure and can't be there. And ultimately, they are expected to drop what they're doing and show up when the doctor's there. That's not possible. And so the reality is as low as 20% of the time, there's even the nurse joining the doctor for rounds. And so by giving that time transparency to the nurses too, we're having nurses tell us for the first time ever, they're eating lunch again because they can see when the doctor is going to be there. So it solves that pain point for me as a doctor finding the nurse, for the nurse being expected to drop what they're doing. But also as a doctor, if the family is not there, as a pediatrician, I don't get to walk in and see a seven month old, notice the family's not there and then say, okay, tell Mom and Dad what we talked about, right, I have to find them, I have to call them later, track them down. With Q-rounds, they're getting that real time update so they're present. We've had three to four fold increase in family presence at rounds since we've been live. And now those conversations I was having to do later in the day are all happening. So the thing I'm the most proud of is that every stakeholder thinks it's for them. You know, this makes our family, families are like, Well, why hasn't this existed before? I have time transparency with DoorDash, with the mail, with FedEx, with my hair cut, with the Olive Garden table being ready, yet it's abandoned when it matters the most. Nurses are instantly having value add in that they're shown that we respect their opinion, because we're inviting them to rounds, they're part of the conversation. And then doctors, we've been live for 11 months, not had a single day that the doctors didn't use it. That's really powerful technology story that this was valuable enough to them that they were willing to press the button every day and get that value. So that's been really exciting. 

 Frank Jaskulke  06:42

So maybe let's describe the product little bit more because what I'm hearing is you're you're giving the stakeholders the information they need to know when the staff, when the doc, the nurse or whoever, when they need to be there, when they'll show up. Can you describe a little bit more detail further? What is the product to sell?

 Dr. Mike Pitt  06:58

Yeah, so Q-rounds is a software. The only person that has to download anything is the rounding doctor. So on their app or on the desktop computer they're rounding with in the hospital, they access Q-rounds, it pulls securely from the electronic health record their patients that they're going to see that day. So that's a list that already exists in the EHR. They drag and drop the patients into the order they want to see them. Q-rounds can suggest seeing the sickest patient first or patients that are being discharged. Those are hospital priorities that you discharge and turnover beds faster. But when they hit share, they drag and drop — it takes them on average 41 seconds to drag and drop the order — when they hit share, three things happen. A text goes to the nurse or a call to the nurses, any nurse that has a patient on that queue gets a call says, Dr. Pitt shared his rounding queue. You have two patients on the list. Your first is at 8:45. The next call you get is when you're next to be seen. So they have that ability to plan based on knowing that time. Two is it gets pushed to the electronic health record. So anybody that will look in there can see, this is social workers, discharge pharmacist, dieticians, they can see real time updates of when that package will arrive, the doctor will be there. And then that game changer is the family gets a text. If you've ever been at a hotel and you get a text that says your room's ready, family gets a text that says the queue has been shared for rounds today, your fourth to be seen your estimated time is 9:30. They click without downloading an app and they see a real time countdown. I'm fourth to be seen. I'm second to be seen. I'm next to be seen. On that visual dashboard, if they can't be there in person, they can with one click RSVP to join by a call. And so now as the doctor when I'm ready to round, and I'm going from room to room, if I reach every time I hit next, the nurse is notified. They're waiting for me. The nurse is arriving on average six seconds before the doctor as opposed to missing an entire row. The family gets that notification. And if they've RSVP'd when I walk in the phone, that button lights up on my phone that says start call. And with one click the dad's pulled on the line, the interpreter's there if necessary, all that multidisciplinary teams brought in for that most important discussion.  Oh, wow. I mean, just as you describe it, it's immediately apparent how that would be such a better experience for the patient and for the family members, but also for the care providers and for the health system that's trying to manage this huge flow of information and patients and stuff that's just moving around. You've been a physician, you are a physician, you were on the side of it. What prompted you then to make the leap to go start a company go through this fun of entrepreneurship?  Yeah, fun of the three letter word fun. The starting of a company. Yes, I you know, I'm a researcher. I'm a scientist first. And so this started as seeing a problem and feeling it myself. My dad and my father in law were hospitalized and I spent every day with that same pain point. You know, knowing that I was getting a call by the doctor as a courtesy because of my doctor title. Leveraging the privilege of being a doctor was why they were calling me not because they called every family and that upset me. Of course I took advantage of that when it was my own loved ones, yet I wanted everyone to have that. You can't have equitable health outcomes without a seat at the table for rounds. So sitting in a Great Clips saying, if I can get a text that I'm three haircuts away and know that they're valuing my time enough to let me know, I can run and grab a Starbucks before my haircut time starts, why aren't we doing that in healthcare? And so I started as a research question, you know, could we build this? Could this work? It wasn't really, it was not the entrepreneurial spirit that started this. It was kind of relentless curiosity, like, could we build something that would — and I met with John Sartori, he's a PhD at the University and one of the co founders, and said, you know, could you build me the Great Clips app for healthcare? And we got a $5,000 grant, kind of leveraging research to build out some wireframes and talk to people about it. And that led to subsequent grants and more grants and bringing in another co-founder, Chelsea Klevesahl, who really had that design and business experience and running from there. 

 Frank Jaskulke  11:04

Oh, very cool.

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 Frank Jaskulke  11:50

And I appreciate that that it was, you were starting with this real tangible problem. And you just wanted to figure it out. And you took the path where it took ya, and here we are today. There's another aspect of this, I think for a number of our listeners will be very interesting to them, which is it seems like this would also have a lot of benefit then for the hospital, for the health system and a boost in efficiency and productivity. That's good for the business side of it, which helps to pay the bills. What's the value prop then for the health systems that are using this? 

 Dr. Mike Pitt  12:24

Well yeah, and I'll answer that by saying that my entree into being the entrepreneur here took me a while to learn that I had to care about the hospital bottom line. So like this was it started from this sense of like, well, this is something every person has felt. Why aren't we just doing this? How can we make the right thing the easy thing to do? And it took me a little bit to recognize, well, somebody has to pay for this. And what does that look like? And the beauty of Q-rounds is it solves problems that they care about. So by turning beds over faster, getting everybody in the room at that same time to have the discussion and identify barriers to discharge, that speeds up discharge. And so that's something hospitals care about. Things that we didn't even realize. So yes, we know they care about safety. So having — knowing that by bringing the nurse to the bedside, we reduce medical errors, and we can automate that. That's a direct correlation to revenue. But also looking at revenue generating things for hospitals. For example, being able to bring a consultant in remotely through Q-rounds that's then able to bill for virtual consults and generate new income for a hospital. So there's been lots of things in that space. And I think that yes, we're navigating the long sales cycle that is healthcare. It hasn't been hard to get people to see the value, though. 

 Frank Jaskulke  13:38

Yeah. And you know, I hear this from a lot of companies that the long sales cycle of healthcare which right is true, but it also seems like when you bring something that truly addresses the needs of that end stakeholder, of the customer, but also addresses the patients and the employees, that like, I don't know, triple helix or something really seems to click and not that it's easy, but it does move. And if I remember right, you know, you all had started with kind of the first pilot or the first customer being our friends at M Health Fairview. How's it been engaging in that process? The long sales cycles, engaging with large provider systems and navigating being a small startup engaging with a very large, complex organization? I think the other entrepreneurs that are listening might appreciate some of that experience. 

 Dr. Mike Pitt  14:30

Yeah, you know, we had a head start because I was an employee in the system as a doctor and I think that voice mattered when I was sharing a solution. The same as if I said, Hey, I have a drug that I think will solve X, Y o Z. Help me study this in our system. They're gonna jump on it. And so the fact that you're right, everybody could wrap their mind around this this problem pretty easily. They knew that I had experience in kind of seeing projects through, so trusted me to give me a lane to build this in. That was the space, it was a long process. And if you've certainly read a newspaper, the marriage is is in trouble right with Fairview, with M Health Fairview. Yet this was something that was easy for them to partner on, the university and Fairview to say, well, we all care about that. And it was a good reminder for me to continue to have a hope as a citizen in the state, as an employee in the system, that things are going to work out there is that when something mattered, they moved in the right direction. So so that was a big part of our story was having the landscape and the blessing to do the integration with the electronic health record and a testing laboratory. And I think that gave us some credibility now that we're moving, we're going into Texas Children's May 15 for our first pilot there, really being able to have the blessing of a big institution was a huge part of our success

 Frank Jaskulke  15:46

Right on, and good luck on that. That's a great organization. And it'll be fun to see you'll be about as north as you can get and then about a south as you can get within the network, then you start to hit east and west and then you've covered it. The other thing I always like to ask about is then the people side of it, right? So being a clinician, you're interacting with people all the time. We hear about bedside manner, all of that. What's it been like making the switch to being CEO and leading a team in this environment? What's that experience been like for you?

 Dr. Mike Pitt  16:18

Yeah, I think the the memoir title would be the reluctant CEO or the accidental CEO, meaning it was, it took me a while to realize no, this is me, this is not something I'm building for somebody else to run with, you know, and leaning on my own skill set and growth mindset and ability to know that I don't know everything. And that's so much of what makes a good doctor. I used to think medicine was very — before I was in it, you know — it was black and white. If you had pneumonia, you're gonna put an X ray up, and it's gonna say the word pneumonia. It's a right answer. It is so gray. And so the more comfortable you can be with ambiguity and with saying, I don't know the answer to this, but I can help find it. You know, medical knowledge is doubling every 72 days. So you can't know everything. So I think that posture of knowing I didn't know everything, knowing I could lean on people that knew the things I didn't and build the team for that has made it a really successful partnership thus far. And I really have come to embrace that role as CEO, as opposed to apologizing for it.

 Frank Jaskulke  17:17

Yeah. Well, that's really heartening to hear. I talk to a lot of doctors who they're interested in innovation and entrepreneurship, but they fear that they're, they know, the clinical side, but they don't know the business side. And I think what I heard you say is that a lot of the experiences and the knowledge you've gained practicing medicine actually can be quite applicable. And I hear you, especially on the dealing with the ambiguity in the gray. If you knew where this was going to end up, it'd be a heck of a lot easier. But you might not know where it's gonna end up tomorrow, let alone a few years down the road.

 Dr. Mike Pitt  17:50

Yeah, absolutely. I'd say to fellow clinicians, you know how to learn. And that's all this takes is kind of recognizing, I don't know what they mean when they say safe note. I even used to bristle at the word entrepreneur as something I just saw on the bottom of the title card in the Bachelor, you know, that people were saying their job was, so I didn't identify with that. And I've come to realize you can have multiple identities and rest in those and, you know, a moment of vulnerability here, you know, when I was swimming with my daughter about two years ago on vacation, as I was navigating the tension of this duality of like, I'm an academic, no, I'm a doctor, no, I'm an entrepreneur, this is a business and had filled the void of free time in my life with with Q-rounds. My daughter said, you know, what's the best decision you've made in the last 10 years? She was 10 at the time. And I said —

Frank Jaskulke  18:36

That's a good question!

 Dr. Mike Pitt  18:38

I said, you know, moving us to Minnesota, like it wasn't even on our radar. We knew of Minnesota through the Golden Girls. And now we're like, oh, my gosh, this is the best kept secret in the country. And the weather is the bouncer to the best club in town. It scares people away and  So I then had to explain to my daughter what a bouncer was, but yes, yeah. So you know, that was my best decision was our family moving here. And she said, What was the worst decision? And my instant answer was inventing Q-rounds. This was two years ago. It just came out of my mouth in the pool. And I have thought of that so much, like, gosh, that bothers me that that was my first sentence. I know this is a problem being solved. But it's been really hard. It's navigating this complex ecosystem. It's raising money. It's doing all these things that weren't what I wanted to be when I grew up. But it was my answer, you know, and there was a season when I would be walking in the house and I'd sigh and my wife would say, 'I that a Q-round sigh?' You know, like, and it was. And it's been in the last several months of seeing the impact on patients since we've been live, families saying how this has allowed them to drive their, you know, they've been in the hospital for six months in the NICU and they've been able to drive their siblings to school for the first time because of Q-rounds because they don't fear missing the doctor, and nurses telling us they feel valued and are taking breaks again because they know this and doctors saying they feel more connected to patients because of the technology as opposed to what usually happens is pulling them away. That I think back in that would be what I'm the most if you asked me a question today, what am I most proud of for the last 10 years? It would be what I was the least proud of two years ago. So just don't judge a moment by the moment, you know, have the long game in mind and be willing to reevaluate would be my advice there.

 Frank Jaskulke  18:53

Oh that's a good way to describe it. Right on. I gotta say, this is, for me, my favorite part of this community and of all this work is that there are so many people who do that hard work to try to make this very complex thing, this very high risk thing better. There's still so much that needs to be done. But the fact that people are willing to put in that effort and do those things where it might not work, it might fail. But if it works, people's lives are that much better. I don't think you could have described it better than someone being able to drive their kid to school in the morning. Like, giving that freedom and that time back, that makes it worthwhile. Last thing I want to ask you and maybe turn it around, like, has anything turned out to be easier than you expected it was going to be? 

 Dr. Mike Pitt  21:02

Yeah, that's a good question. You know, I've always — I grew up doing magic professionally. So I did magic four nights a week, paid my way through medical school doing magic and restaurants and trade shows. And so I've always viewed medicine as a performance art. That there's an expectation of a role when you walk in the room. And even a lot of my research has looked at the words we use. We just did a study with colleagues at the State Fair where we asked people, How do you want the doctor to introduce themselves? Do you prefer? I'm Dr. Michael Pitt? I'm the pediatrician. I'm Dr. Michael, I'm the pediatrician. I'm Dr. Pitt. I'm the pediatrician. I'm Dr. Michael Pitt, I'm your pediatrician. I'm Mike Pitt. So we put all these different out and, and everybody wanted the first name, you know, which is so often not given in medicine, you know. 80% of the answers included the first name and the most preferred didn't use doctor as a title. It said, I'm Mike Pitt, I'll be your doctor — and your doctor was part of it, not the doctor. It was more preferred, your was more preferred. That tangent is to say, the nerding out on the performance that is medicine and that again, from a kid's perspective, magic and medicine are the same thing. Take this pink potion and your headache will go away or you know, there's magic in medicine from a kid's perspective. The performance art was something I'd come to embrace and research. And I think even recognizing that the entrepreneurial world involves that performance art, how do I project confidence when I'm still figuring something out? How do I show relentless curiosity, get people excited about things? So that was easier because of a lifetime of kind of embracing that, like, paying attention to how those single way we phrase something matters. That was important to me.

 Frank Jaskulke  22:44

I think that's a great place to wrap it up. So for the listeners' benefit, can you tell them, if they want to find out more about Q-rounds, where can they go? 

 Dr. Mike Pitt  22:51

Yeah, so our website is the letter Q dash rounds, Q being queue, right, waiting in line, where am I in the queue? So qrounds.com. You can email me at mike@Q-dashrounds.com. And I'd love to chat with you. 

 Frank Jaskulke  23:04

Perfect. Thank you so much. We'll make sure that's in the show notes so people can track the organization down. And, Mike, thank you for being on the podcast today. 

 Dr. Mike Pitt  23:11

Thanks for having me. 

 Frank Jaskulke  23:12

And folks, that's been another episode of the Medical Alley podcast. If you're not already a subscriber, make sure you get on to Apple, Spotify now on YouTube or anywhere else you find good podcasts. Until next time, make it a great day.