It’s always interesting to see new companies pop up on the HCI 100 list, but it’s even more fun to speculate about which companies will make the list two or three years from now. Healthcare Informatics interviewed the CEOs of five promising companies to keep an eye on.

PatientSafe
Companies that offer the most elegant, streamlined solutions involving mobile devices and care coordination are bound to be in high demand in the coming years. One to keep an eye on is San Diego-based PatientSafe Solutions, which has built a mobile care “orchestration” system around a ruggedized Apple iPod.

The company, which started a decade ago as Intellidot, and focused on handheld bar-coding systems, changed its name in 2009 to PatientSafe, and with a $30 million infusion from investors re-launched in January 2011 with the new focus. (The company was named one of the Wall Street Journal’s Top 50 Venture-Backed Companies in 2011.)

President and CEO Joseph Condurso joined the company in 2011 after more than 25 years in health IT, including stints at Motorola Inc. and CareFusion Corp. “What attracted me to PatientSafe was the disruptive opportunity to create a mobile healthcare IT platform that truly is patient-centered,” he says. “It can put the technology in the hands of clinicians and provide real-time clinical decision support.” He was also intrigued by the possibility to leverage Apple’s elegant consumer user experience in the clinical IT space.


Joseph Condurso

The company’s PatientTouch system and electronic mobile medical appliance (eMMA) can work with any core EHR system and send data bi-directionally. The iPod solution is engineered and ruggedized for hospital use and features a scanner to read barcodes for patient association and verification. Communications are via a hospital’s secure wireless network.

“We think we are working on a brand new category called mobile care orchestration,” Corduso says, that includes workflow, clinical decision support, care coordination, and communication. “We can help create a social network inside the firewall, so nurses aren’t hunting for data. The whole care team sees all the information surrounding a particular patient concurrently.”

Among other things, PatientTouch allows users to access real-time information, view and manage a care plan, handle patient assignments and manage alerts and notifications.

The 100-employee company has 70 healthcare facilities lined up as customers, 63 of which are up and running now. It sells directly to hospital organizations, targeting chief nursing executives and quality and patient safety officials. As meaningful use and accountable care models emerge, PatientSafe will continue to fine-tune its technology that supports caregiver communication and real-time access to clinical data, Corduso says.

“The next step is to follow the patient outside the walls of the hospital and in transitions of care for things like, ‘medication management,’ he says. The patient has to be at the center of care.”

Humedica
Healthcare organizations of all stripes are moving beyond business intelligence based on claims data. They are starting to access and mine the clinical data necessary for performance improvement. One company that may have found the sweet spot of clinical informatics platform innovation is Humedica. Founded in 2008, the Boston-based company has grown to 80 employees and expects to reach 125 by the end of the year.

Humedica’s software-as-a-service analytics platform assembles, standardizes, and analyzes EHR data as well as operational and financial data. “We felt the time was right for the disruption needed to get the clinical data that organizations need,” says Michael Weintraub, Humedica’s president and CEO. “The plumbing and piping of EHRs is now getting into place. But their DNA is transactional, not analytics. Accountable care organizations, population health organizations and multispecialty groups all have to get their arms around their manufacturing processes and take a longitudinal view, and it has to be data-driven.”

Some of Humedica’s growth is based on its partnership with Anceta, a subsidiary of the American Medical Group Association that facilitates shared learning around Humedica’s comparative data. Multispecialty groups are looking across disease and therapeutic areas to understand their data and get better together, Weintraub says. “We now have two dozen organizations involved. Anceta is the trusted intermediary and we are the informatics platform.”

So as large medical groups join Anceta, they automatically begin using Humedica tools. For instance, 150-physician Holston Medical Group in Kingsport, Tenn., recently announced it would work with Anceta and Humedica’s MinedShare clinical intelligence solution.

Another milestone in 2011 was a partnership formed with Allscripts, which is now both an investor in the company and a sales channel, Weintraub says. “They have a large footprint and saw the opportunity to be a horizontal solution provider in the clinical informatics space,” he adds.

Humedica now works with provider organizations in 30 states that are responsible for more than 20 million patients, Weintraub says, adding: “We are investing in scaling up to take the company to the next level.”

Practice Fusion
When web-based electronic health record vendor Practice Fusion launched in 2006, the company expected to charge physician offices around $300 per month. “We had the idea of being the Salesforce.com of healthcare,” notes Ryan Howard, the company’s CEO and chairman. But Howard’s team soon switched gears when potential customers balked at paying even that much.

Practice Fusion changed to a free service that is supported by advertising and hasn’t looked back since. “Because we were small we had the agility to change quickly based on physician feedback,” Howard says.

Ryan Howard

In order to be attractive to advertisers, Practice Fusion had to have a strong user base, so it battled a chicken and egg problem the first few years. But with more than $40 million in venture funding and other investments, it has grown to 150,000 users today. “Price point is the most obvious way we are disruptive,” Howard says. One of his greatest challenges, he says, is just managing the San Francisco-based company’s growth. It now has 150 employees and is adding eight to 10 per month.

“My job is to maintain the culture,” Howard says. “We love our users and they love us. Look at our Facebook page and look at Allscripts’ Facebook page, and I think you’ll see quite a contrast.”

Howard notes that the timing of the federal government’s EHR incentive program has helped immensely. “I think we came out at exactly the perfect time because it takes three or four years to build out the product,” he says, “and meaningful use comes along and is basically a $20 billion marketing campaign. It is a massive catalyst for our business.”


Montage Healthcare Solutions
Clinicians often make good entrepreneurs because they can clearly see a product niche that needs filling. That’s the case with Montage Healthcare Solutions, which was founded by a group of radiologists and imaging informatics experts. Their radiology search engine grew out of their own daily work in the Department of Radiology in the Hospital of the University of Pennsylvania (HUP) in Philadelphia. Montage enables radiologists and researchers to search their own radiology information system and EHRs for specific diagnoses.

“We had a lot of data but had trouble getting access to that data,” explains William Boonn, M.D., Montage’s president. They could ask a database analyst to help them craft something, but that might take a week and then the radiologists would have to go through iterations to refine those searches. “With today’s technology, we expect to find that information instantly just like searching with Google,” Boonn says. “So we saw opportunities for hospitals to search their imaging systems to help with clinical data support, for performance measurement and efficiency and for research at academic medical centers.”

Montage’s founders had previously developed a product called Yottalook, a widely popular and free medical imaging search engine. The commercial product, Montage, combines Yottalook’s external search capabilities with an enhanced capability to query both radiology and pathology information systems.

As Woojin Kim, M.D., another Montage executive and associate director of imaging informatics at HUP, told Healthcare Informatics in a January 2012 interview, a lot of hospitals are building their own data warehouses or buying one so that they can federate their databases and mine them. “This is a nice application that can sit on top of such a system,” he adds, “where its easy-to-use interface allows for powerful searching capability across multiple different databases.”


Woojin Kim, M.D.


Launched in 2009, Montage now has a dozen hospital customers and expects to announce several more soon. Its users include radiologists, administrators, non-radiology physicians, and research coordinators.

One milestone that may boost sales is a reseller agreement with speech recognition reporting vendor Nuance Communications Inc. “They are a large company with a big reach, something like 1,500 customers,” Boonn adds. “We are excited to be integrating with their flagship product. It gives the ability for radiologists doing dictation to access Montage. It’s easier in some way to approach their installed customer base than to approach new customers.”

There are currently lots of technological and policy disruptions in radiology, Boonn says. There is an enhanced focus industry-wide on quality, efficiency, and performance measurement. “The tools we provide can help practices through these rocky waters,” he says. “If you can’t measure, you can’t improve. Without these tools, people trying to measure find it takes too long and they are flying by the seat of their pants rather than really looking closely at their data to identify the issues they can address. This helps them quantify and focus.”


DiagnosisOne
People tell Mansoor Khan that his company’s timing was good. His response is “No, the world is finally catching up with us.”

Khan, CEO and co-founder of clinical decision support vendor DiagnosisOne, is riding a wave of growth. The Lowell, Mass.-based company expects to almost double its headcount from 40 to the mid-70s by the end of this year and to double that number next year. It has 200,000 physicians using its decision support and analytics tools. Its smartConsult module integrates with electronic health records to deliver real-time, patient-specific alerts at the point of care.

“Our company grew out of an effort by our chief medical officer and others to write a textbook about diagnostic algorithms,” Khan explains. “They created this huge collection of evidence-based knowledge. Having a software background, I saw that this needed to be in electronic format, so we took that baseline work and expanded it.”


Mansoor Khan

What makes its platform unique, he says, is the container around that knowledge. “We made two key early decisions: First, we based it on HL7 Version 3 object model, which is where the industry is heading, so we have a head start there,” he says. “Second, we keep the knowledge in one centralized database but have a highly distributed model and work with many EHR platforms.”

DiagnosisOne offers a menu set, and providers can choose which tools they want to use, ranging from notifications about care gaps to order sets and public health reporting. Each physician gets the alerts and analytics they want. “As risk is shifting to providers, they need this information to boost efficiency and to support the decision-making process,” Khan says.

DiagnosisOne may not grow to be a household name, in part because it doesn’t sell directly to the end-users; its products are embedded directly in EHR vendor software. In 2011 it signed a deal with Allscripts, but also has arrangements with vendors such as Aprima and Greenway.

Meaningful use Stage 2 presents clinicians with a series of issues, Khan says, ranging from CPOE to clinical decision support rules to a variety of quality measure reports. “These are all knowledge management challenges that we can help clinicians address.”