E49: Dr. Ross Sommers on Bringing NICU-Level Care Into the Home

What motivated you to start this venture you call First Health?

Yeah, so first day health care is really a passion.

I love what I do as a neonatologist, but I saw this huge gap in trying to get former premature infants home from a NICU.

You know, the NICU is probably the only field in health care where patients are regularly going from an ICU to home the next day without any transitionary models of care.

And I saw that parents were really struggling and weren't ready to take this, you know, two pound baby, not even at their due date, often going with hospital level services, such as oxygen, home as a caregiver of their child medical complexity.

And I felt like we were often misleading them when we said that they're ready to go home.

But from the other standpoint, I can't keep them forever.

And I saw, you know, this, explosion of digital health tools for adults with chronic conditions.

But I didn't see anything being built for the specific needs of the pediatric population.

And I saw it as a personal mission as well as an opportunity because a day in the hospital in the NICU could be very costly and a lot of it could be preventable with better and more timely and technology and oversight of care in the home for these parents.

Maybe, so it's not everyone that listens to this is a neonatologist.

Maybe take us through a story or two of what the challenge is for a parent, as you just pointed out, and maybe the challenge for the neonatologists themselves.

Yeah.

So one of the biggest challenges is that we're saving infants of younger gestational age.

It seems like we're constantly pushing the limit.

You know, when I was in training my predecessors said was like you know 27 weeks then it was 25 weeks now it's like 23 weeks and there are you know some babies not all very small babies being saved and they have more and more complications that take longer and longer to recover from so a lot of these morbidities of prematurity such as still requiring a little bit of oxygen or needing the help from a feeding tube because they're not able to eat all their feeds from a bottle These morbidities that they have of prematurity take a very long time to recover from.

Sometimes they may not recover even fully, but the problem is that we're having more and more very, very premature infants who have more and more severe morbidities that take longer and longer to recover from.

And the NICU wasn't intended to be a place for them to rehabilitate and know, get over these morbidities.

But it has become that facility because we have no other place to send them.

So that's what I've been trying to do is that noticing that we're already sort of halfway there sending these parents home with hospital level tools like oxygen, that there's this opportunity because while babies do go home from the NICU on oxygen, it's very you know, not standard between hospitals.

Overall, we're sending about 50% of our ex-small babies who are still requiring oxygen home with oxygen, but it may vary from 7% to 95% between hospitals.

So there's no standard of care when trying to get a former premature infant home and sending them home with these hospital level tools.

And that's the dilemma I, you know, I and my colleagues face is that we are sending them home to the unknown with these tools.

So my theory is that hospitals will be more towards those 90% numbers if they knew that there was a service like First Aid Healthcare that was able to help oversee the vital signs and the weaning off of these therapies that they're still dependent on and not just sort of sending them home with a graduation cap and a good luck and a lot of unknowns, which is currently what we're doing right now.

Actually, you touched on graduation cap.