In the Spotlight: AkkeNeel Talsma of Melius Outcomes

Colleen McBride

Interview with AkkeNeel Talsma- Melius Outcomes

Colleen McBride

You help a lot of people in the healthcare community—how would you explain your company’s mission to someone without a background in that sphere (such as myself)?

The vision of Melius Outcomes is to make the system better by creating quality care. The name Melius comes from the word ameliorate: to make things better. We do this by using clinical data from health records and linking it with the references, protocols, guidelines, and implementation strategies to fix a problem. Nurse managers might spend 40 hours per month gathering data instead of fixing things, which wastes a huge amount of time. This also wastes money—about 35-40 thousand dollars a month on wasted time, and this number only increases in a bigger hospital with multiple units. Now we have a business analyst and IT person doing similar things,however, many of those resources are not dedicated to nursing quality and/or may have left the organization

Melius then takes this data, creates actionable reporting, and shares it with clinicians, so they can address the issue. It’s very frustrating for clinicians to wait for internal reporting, as that may take 6-9 months to receive the data and still need to develop the reports. This is a problem because they aren’t acting on current data, and it’s hard to improve problems when you don’t have current reports and evidence at your fingertips. Melius brings this data together, makes it easy to understand, and pairs it with evidence so problem-solving becomes that much easier. I like to explain it with this analogy: there’s a tsunami of data, but a desert of information. Melius addresses the desert.

We focus on the efficiency and quality of care in the operating room. We work directly with operating room  clinicians, nurses, surgeons, and anesthesiologists—this is an important department, and if it’s not running well, the patients and rest of the hospital struggles. Our other areas of focus are the emergency room and maternal care units to improve outcomes. As a clinician, you like your work to have a positive outcome, Melius Outcomes helps clinicians, nurses and leadership accomplish that.  

What is the most rewarding part about working within healthcare? What is the most frustrating part?

The most rewarding aspect is that Melius can have a huge impact on patient and family outcomes through the improved use of clinical resources. Giving clinicians the data to improve the likelihood of good outcomes has huge impacts, which is very rewarding. For a lot of people working in the industry, efficiency can be the difference that keeps them from walking out of the job from burnout or stress, which happens a lot. That's our goal and it’s at the heart of our work.

The most challenging aspect is working within large healthcare organizations. It can take a long time to make connections and meet the right people to get the yes to go forward with our work. This can involve a lot of steps. Melius is a SaaS company—which stands for Software as a Service. Clinical data comes into our service, which we then display with best practices. A lot of people spend a lot of time working with Excel(™) trying to use the data for reporting. I don’t want to say we take all of it, but we take a good chunk of it. It’s likely that your veterinarian knows more about your pet than the average doctor knows about their patient. Additionally, many hospitals need to be accredited, and you can only do this if you’re involved with a project like Melius that generates outcomes.

What drew you to this type of work?

I worked as a nurse, and I’ve been in the healthcare industry as the person with the yellow pad looking for small details like patient records. I know first-hand how time-consuming and frustrating that can be. At the end when I was done reporting all the data, I was too tired and fed up to do anything practical with it, which felt like a huge waste. That’s what drew me to the technology to use data better. 

We have a team of medical directors, a senior IT person, and some media and junior people who all work together to make this project work. The IT people develop the software and lean on the clinical folks to guide them through the process as content experts. With that team, we create a strategy of which hospitals we think would be a good opportunity for us.

How do you improve the efficiency of administrative function in hospitals without sacrificing patient-doctor relationships or the personability of care?

When clinicians spend less time searching for data, this improves workflow and allows them to discover problems they didn’t even know about, which only improves the quality of care for the patient. The software we built can sit within the hospital’s site, so it can be presented and accessed in a manner the staff is comfortable with. Rather than something being on five different servers within four different folders, there’s a simple policy such as cleaning your hands with iodine that can be found in one place so everyone is on the same page.

Staff satisfaction is important; if people are too frustrated then they’ll walk out the door. If a nurse costs 70 thousand dollars, it will take at least that amount to recruit someone in their place when they walk out. If we have people feeling more satisfied and at-ease because we’ve created a more streamlined work environment, that’s a win that the patient will experience too.

How has your job changed during COVID, and is Melius working on any projects within the COVID sphere (vaccinations, intensive care units, etc.)?

Unfortunately with the pandemic, we have less human resources. This makes Melius even more important, because the nurse that was spending 40 hours organizing data before either doesn't have that time or just isn’t there anymore. Hospitals are legally required to have certain kinds of data, which puts them between a rock and a hard place especially during this stressful time. Like I said, we focus on efficiency in the operating room first. For example, an inefficient system causes surgeries to be cancelled last-minute, which can be very expensive for the hospital. We can also decrease the amount of time it takes to get one patient out and another in. 

With the pandemic, we have an application that is more out-patient based, which monitors whether each patient has been exposed or vaccinated. That way, when they come into the clinic you can input this and determine the risk of transmission or infection. You’d know if someone had been travelling or recently exposed, so you might choose to push that patient’s surgery that otherwise would’ve been postponed at the last minute due to a COVID exposure.

Melius was always an online company, so that didn’t change when the pandemic began. However, it became more difficult to meet with clients because the hospitals were so overwhelmed. It was common for them to push something six months down the line. Sometimes contacts were furloughed because of the focus on the pandemic, and our work slowed down a lot. Fortunately, a lot of opportunities are coming back now, because hospitals still need to focus on quality. A lot of meetings are still online, but I hope we’re back to in-person events too. There are certain benefits to increased online access, such as being able to attend cross-country conferences that I would have otherwise had to miss. The pandemic has caused a lot of pain and suffering, and I keep thinking there must be a silver lining: we can and should use technology better to improve the healthcare system.