Each year, to accompany our Healthcare Informatics 100 list of the largest companies in U.S. health information technology, we profile fast-growing companies that could very well make the list in the future. Below are write-ups of the third and fourth companies that made this year’s Up-and-Comers rendition. The remaining two write-ups will be published later this week.
Collective Medical Technologies’ Collaborative Care Management Tools Meet Needs During Opioid Crisis
The history of Collective Medical Technologies has had several twists and turns, but the Salt Lake City-based company that provides collaborative care management tools has doubled in size in the last six months to over 100 employees. Its platform is used in 15 states, and that number is expected to reach 25 by the end of 2018. The company recently secured $47.5 million in Series A funding to fuel the expansion.
Collective seeks to close provider communication gaps that undermine patient care. It uses data feeds, risk analytics, notifications, and shared care guidelines to reduce emergency department (ED) utilization, inpatient readmissions and downstream care transitions, including to post-acute operators. After collecting data from all EDs visited by a patient, its solution packages that data into actionable insights, and delivers them to clinicians via real-time notifications. Collective is currently partnered with more than a dozen state hospital associations, and recently added the Florida Hospital Association to its network of partners.
The company has an intriguing startup story. Fifteen years ago, one of the founders’ mother, Patti Green, was an emergency department social worker in Boise, Idaho, and suspected that some patients were opioid seekers. She set up a rudimentary collaborative care plan for providers to use to identify and help these patients. “It is easy for us now to talk about the opioid epidemic. Nobody was really talking about it 15 years ago, but she was seeing it on the ground,” says Chris Klomp, Collective’s CEO, “and she did something about it.”
She asked her son Adam and his friend Wylie van den Akker, both computer science students at Brigham Young University, to create software to improve on the basic spreadsheet she had created, and they did so. (Klomp was also a childhood friend from Boise who studied business at BYU at the same time.)
In 2006, they tried to launch the solution as a company, but there were no customers. “No one was willing to take a chance,” Klomp recalls. “Total crickets.” So all three founders went on to other jobs. Klomp went to work for Bain & Co. But the website for the startup was still up, and in 2009 they were contacted by a hospital in Spokane, Wash., that was trying to do work in the high-utilizer space and couldn’t find any other solutions. So the three old friends from Boise resurrected the company.
“It turned out that little hospital was part of what would become Providence St. Joseph Health, the second-largest nonprofit health system in the country,” Klomp says. Eventually use of their Emergency Department Information Exchange (EDIE) solution started to spread across the state of Washington. The Washington State Health Care Authority reported that use of EDIE by hospital EDs had helped save the state $34 million in Medicaid spending and there was a 9.9 percent reduction in total Medicaid ED visits across the state. “That was big,” Klomp says. “There were compelling results around opioid utilization, in terms of visits resulting in opioid prescriptions and related deaths.”
Next, Providence drove usage across its five-state system, and Oregon adopted it. “All of a sudden, the world caught up as healthcare started paying for quality instead of just volume,” Klomp says. Growth was slow and methodical as the co-founders sought to understand clinical workflows. “We worked to get real demonstrable outcomes from a clinical and economic perspective,” he adds. “We are pretty conservative. This is a different story than raise a whole bunch of money and try to grow the business fast.”
Besides EDIE, Collective now has other software it licenses to payers and accountable care organizations, but it does not charge post-acute operators, ambulatory providers and others who don't have risk. “Our model is that we license our software to those who could see economic benefit through improving coordination of their members, which makes sense,” he says. “Others may not benefit economically, so we don’t charge them.”
Klomp says that Collective helps healthcare providers answer four basic questions:
Where are your patients right now and why?
Of all your patients, which are at risk of something bad happening?
Who should be on the care team to mitigate that risk?
How do we let those people collaborate with one another to mitigate the risk we have identified?
Looking back, Klomp sees a huge element of luck in their success story. “We work hard and try to be smart, but entrepreneurs chronically underestimate how much they get lucky or kind breaks from others,” he says. “I look back at the people willing to take a chance on a couple of unsophisticated kids from BYU who didn’t know a lot about healthcare but were trying to solve one of our mom’s problems. They gave us a chance and indulged us when we made mistakes. You look at Washington and it was just a stroke of luck.”
Each year, to accompany our Healthcare Informatics 100 list of the largest companies in U.S. health information technology, we profile fast-growing companies that could very well make the list in the future. Below, a write-up of the fourth company that made this year’s Up-and-Comers rendition. The remaining two write-ups will be published throughout this week.
Healthfinch Grows by Automating EHR Tasks
Healthfinch, a Madison, Wis.-based startup, has been laser-focused for several years on making clinicians’ lives easier with its software that automates or re-routes routine tasks in their EHR work flow. For instance, its solution helps delegate prescription refill requests to staffers so the physician has more time to spend with patients.
Healthfinch has gradually grown to more than 4,000 providers on its Charlie Practice Automation Platform, and the company now has 40 employees. It recently secured $6 million in financing led by Adams Street Partners, which brings the company’s total raised to over $17 million since it was founded in 2011.
CEO Jonathan Baran identifies two forces that have jump-started the company. Number one is that all sorts of routine tasks are piling up on physicians and staff, leading to high levels of burnout and negative consequences. “Health systems have really seen this problem and understand there has to be a better way to do this,” he says. Number two is a change in approach by the EHR vendors themselves. “When we started, it was a foreign concept to have an app store for the EHRs. None of them had one yet. But now we have seen widespread adoption of this model across all the major EHRs,” he says. “They now think about themselves as platforms and open marketplaces where people like us can build technology on top of APIs that allow us to integrate our technology into the workflow. That is a big piece. Without those two major forces—market awareness and enabling innovation by building on top of EHRs—this wouldn't be possible.”
The company got its start in 2010. Baran, a Ph.D. student in engineering at the University of Wisconsin at the time, was thinking about how to build apps to make life easier for physicians. He went to a Mayo Clinic Innovation Conference and saw Lyle Berkowitz, M.D., of Northwestern Medicine speaking. “Lyle happened to be speaking there on that very topic, coming at it from the physician perspective,” Baran recalls. “I realized this is exactly the person I need to work with. A few weeks later I drove to Chicago, met with him, and the rest is history. We started this company and have been going ever since.”
Berkowitz, interviewed in this Up-and-Comer section for his role as an executive with MDLive, is also healthfinch’s chairman. He says the idea grew out of his own experience as a physician. “If there is something routine and repeatable, I don’t want to have to do it over and over again. Computers are better at doing those activities.”
Besides refill management, healthfinch also helps physician practices with other tasks such as ordering pre-visit labs and other procedures ahead of patient visits.
Baran says that although automation of repetitive tasks is the ultimate goal, the first step in automation is delegation. “That means shifting the work from physician to staff and using technology to make that process as easy as possible. For the physicians it looks like automation because you are taking this work off their plates, and we use technology to make the process as easy as possible for the staff.”
Madison has developed a burgeoning ecosystem of health IT startups, helped by the presence of the mammoth Epic Systems and its alumni, several of whom healthfinch has hired.
The company also is starting to garner more industry recognition. It won the 2018 athenahealth Innovation Award for work in driving meaningful change in healthcare delivery and organizational outcomes. It was included in the 2017 KLAS Emerging Technologies Report and was in the first wave of vendors in the Epic App Orchard.
Baran believes the future looks bright for companies improving the utility of EHRs. “The Epics and athenas of the world have built these EHRs to capture all this data,” he says. “The next wave of healthcare IT is going to be built on top of the EHRs making life easier for the physician and the staff.”