Q&A with Joshua Liu of SeamlessMD: Empowering patients in self-care


AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the patient education space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

Toronto-based SeamlessMD created its digital patient education and engagement platform to simplify the care continuum and improve outcomes with guided care journeys and user-friendly interfaces. Accessible on smartphones, tablets, or desktop computers, SeamlessMD shepherds patients through the care process with reminders, tailored educational content, and progress tracking. Since its founding in 2012, SeamlessMD has emerged as a leading digital care platform, and in 2022, Canada’s Coordinated Accessible National (CAN) Health Networked recognized it as Company of the Year for its work in supporting patients through surgery during the pandemic and improving how health systems across North America deliver health care at scale.

Cofounder and CEO Joshua Liu, M.D., is a physician turned entrepreneur who found his calling in digital health during his training at the University of Toronto, where he co-led a research project on preventing adverse outcomes, such as readmissions. The experience inspired him to co-found SeamlessMD in 2012 and devote his career to healthcare innovation. In addition to leading SeamlessMD, Dr. Liu has served as Chair of the Canadian Medical Association’s Joule Innovation Council and has been honored as the Digital Health Executive of the Year by Digital Health Canada. A frequent industry speaker, Dr. Liu can also be heard on the weekly podcast The Digital Patient, where he discusses digital health trends with a variety of industry guests.

Q: Can you tell us about your company and the challenges you are solving within the patient education space?

A: SeamlessMD provides a digital care journey platform for hospitals and health systems to engage, monitor, and stay connected with patients throughout the care continuum. More than 35 clinical studies and evaluations have shown SeamlessMD to improve the patient experience while reducing length of stay, ED visits, and readmissions.

Large health systems like UAB, Intermountain, Atrium, University Hospitals, MultiCare, Baystate and others rely on SeamlessMD to elevate the patient experience, improve outcomes, and lower costs. Patients access digital care plans on their smartphones, tablets, or computers and are guided via reminders, evidence-based education, and progress tracking. Providers receive alerts, monitor patients, and access analytics to deliver better care. SeamlessMD is directly integrated with leading EHRs solutions such as Epic, Oracle Cerner, and MEDITECH.

Q: How does your company differentiate from other patient education solution vendors?

A: We utilize cutting-edge interactive technology to improve patient self-care through simple, action-oriented, tailored, and accessible education. Our customizable care plan templates are designed and developed in-house by our dedicated Patient Education team, which includes professionals with clinical experience like pharmacists, dietitians, and so on. We use our proprietary methodology to translate evidence-based guidelines and medical literature for different episodes of care into patient-friendly interactive journeys that meet best practices for health literacy, health behavior change, adult education, and online accessibility. All content is screen reader-friendly, written at a sixth-grade reading level, and includes step-by-step illustrations with a colorblind-friendly palette. Everything we release is also WCAG 2.0 Level AA-compliant. 

Additionally, SeamlessMD leads the market on the three critical dimensions to reduce risk and maximize adoption for health systems. 

  • Scalability. SeamlessMD is an app-based platform that enables health systems to engage patients via the patient’s smartphone, tablet, or desktop computer to send surgery or condition-specific reminders, deliver pre- and post-care evidence-based education, and monitor symptoms. Patients can self-monitor with automated workflows (e.g., receive automated guidance on how to manage constipation post-surgery) and providers can get alerts and view dashboards to monitor patient progress remotely (e.g., pain, vital signs, or incision photos). We offer an extensive library of out-of-the-box care plans across several service lines, so clinical teams can rapidly implement our solution and digital leaders can centralize on a single system-wide platform.

  • Clinical evidence. We have the largest body of clinical evidence across the most clinical specialties in the patient education space, with more than 35 studies and evaluations that show how our solution improves outcomes and reduces costs. This high degree of clinical validation assures executives and clinicians alike that they can successfully scale SeamlessMD across all departments and obtain buy-in from clinicians who only want to leverage clinically proven solutions. 

  • Turnkey EHR integrations. We are the only digital care journey platform in the industry that offers validated turnkey integrations with the top three EHRs–Epic, Cerner, and MEDITECH. These features mean that digital leaders can deliver an integrated user experience within just weeks.

Q: What are some of the biggest changes your company has seen around how health systems are approaching precision medicine since 2020?

A: The biggest change we’ve seen: Health systems adopting patient-driven care management solutions that extend care beyond the hospital setting and into patient homes with timely and personalized evidence-based education. Instead of creating their own content, time-starved clinical leaders are adopting solutions that let them assign pre-built, evidence-based education with automated patient education sessions. These solutions save time and eliminate costly printed booklets that most patients ultimately lose or misplace, and clinicians can ensure that their patients receive the right educational materials, reminders, and daily tasks at the right time.

When patients can access this type of evidence-based material on their smart devices and computers, they’re better equipped to adhere to care team guidance and stay on track with their care pathways. That translates into better patient preparedness, fewer phone calls and cancellations, shorter length of stay, and fewer ED visits and readmissions.

Q: What does an ideal client look like? How are health systems best organized for success in advancing their patient education capabilities?

A: Our ideal client is a health system with a digital health strategy that focuses on:

  • Digital patient education across episodes of care
  • Removing barriers and addressing the evolving needs of patients who want self-care options that allow them to recover at home
  • Digitally augmenting Enhanced Recovery After Surgery (ERAS) or Enhanced Recovery Programs (ERP)
  • Building competitive advantage

Successful adoption of SeamlessMD depends on stakeholder buy-in from clinical champions. We often see health systems start with at least one or two department chiefs across orthopedics, cardiac, maternity care, and oncology who are fully on board with digital patient education and what our solution provides. These early champions are crucial to ensure clinical buy-in for a patient engagement solution and digitally optimized patient education.

Q: What measurable outcomes have you seen from your clients?

A: Our clients who have prioritized delivering digital patient education have achieved:

  • 45-72% reduction in readmissions
  • 1-2 day reduction in length of stay
  • 41%-68% fewer ED visits
  • 59%-65% fewer phone calls
  • 89% reduction in 30-day mortality
  • Up to $8,100 cost savings per patient

SeamlessMD clients who truly leverage the solution’s capabilities also achieve high patient adoption and activation–both patients and caregivers find the platform easy to ease and appreciate always feeling connected to their care teams.

In one recent study, UAB Medicine’s gynecology team found that 84 percent of patients preferred digital patient education over printed materials. When SeamlessMD partnered with UAB in 2018 to augment their existing ERP pathway for gynecology/oncology, the results included faster recovery times, with average length of stay reduced by 19 percent. Thirty-day readmissions also dropped by 50 percent.

With this initiative, UAB produced astonishing results across multiple service lines, including cardiac, thoracic, and colorectal. Some of the notable metrics:

  • 94.7% patient adoption rate
  • Length of stay reduced up to 2 days
  • Readmissions reduced by up to 50%
  • Cost savings of more than $8,100 per patient

MultiCare launched its digital care journey strategy in June 2021 and deployed across multiple service lines, including hip and knee replacement surgery, spine surgery, bariatric surgery, maternity care, gynecology, colorectal surgery and endoscopy. Clinical outcomes improved within the first six months, such as a 25 percent decrease in length of stay and 37 percent reduction in readmissions for hip and knee replacement patients–while average contribution margin increased by 19.9 percent.

After Baystate Health launched its digital care journey strategy for cardiac surgery, 30-day readmissions dropped by 72 percent, length of stay decreased by about a day, and discharge to skilled nursing facilities dropped by 60 percent. But according to Baystate’s Director of Digital, the biggest impact has been on the consumer experience–he told us about bumping into a veteran patient who raved about Baystate’s digital care journey experience and how it had supported his recovery after cardiac surgery.

In 2020, University Hospitals launched their digital care journey strategy to guide, monitor and elevate patient care beyond the four walls of the hospital and achieved the following outcomes:

  • Reduced readmissions by 49%
  • Decreased ED Visits by 68%
  • Reduced phone calls by 59%
  • Reduced discharge to skilled nursing facilities by 52%
Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of patient education?

A: We continue to innovate across a variety of dimensions based on the priorities of our health system partners. First, we continue to expand our evidence-based digital care plan library to align with the evolving consumer and value-based care landscape. Secondly, we continue to invest in our industry-leading EHR integrations, making more robust and comprehensive integration workflows available, such as more streamlined integrations with EHR-based dashboards and analytics.

Q: What are the biggest opportunities health systems should be thinking about this coming year when it comes to patient education?

A: In 2023, more health systems will realize that delivering digital patient education is a natural part of the evolution from reactive to proactive care that extends beyond the hospital setting to empower patients and improve outcomes. As health systems continue to battle staff burnout, they should consider embracing technology that delivers evidence-based patient education throughout the care journey. An effective digital strategy that reaches all patient care journeys can reduce unnecessary phone calls while still providing a mechanism to escalate serious issues to providers.

Q: How do you see patient education evolving in the next two to five years and beyond?

A: App-based patient education solutions, more commonly known as digital care journeys, have proliferated in recent times to meet the needs of digitally savvy consumers. These solutions can easily be scaled across surgery, oncology, maternity care, and other service lines. Patients can engage with personalized digital care journeys on their own mobile devices or computers to receive condition-specific reminders, pre- and post-care evidence-based education, and report symptoms to their care teams. Patients can self-monitor with automated workflows (for example, automated guidance on how to manage constipation after surgery) while providers can get alerts and access dashboards to remotely monitor patient progress.

Long-term, we will see scalable, clinically relevant and consumer-empowering remote monitoring delivered at scale across all journeys in a health system–driving better patient experience, improved clinical outcomes, and lower costs on a much larger scale.

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