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Up-and-Comers 2018: Collective Medical Technologies and Healthfinch

June 5, 2018
by David Raths
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Another two of this year’s six up-and-coming health IT vendors, as selected by Healthcare Informatics

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.)

Chris Klomp

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.”

Jonathan Baran

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.”

 


2018 Seattle Health IT Summit

Renowned leaders in U.S. and North American healthcare gather throughout the year to present important information and share insights at the Healthcare Informatics Health IT Summits.

October 22 - 23, 2018 | Seattle


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ASCO Picks IBM Watson Exec to Lead CancerLinQ

August 10, 2018
by David Raths
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Big data platform collects and analyzes data from cancer patients at practices nationwide

The American Society of Clinical Oncology (ASCO) has named a former IBM Watson executive as the new CEO of its CancerLinQ big data platform.

Cory Wiegert was most recently vice president of product management for IBM Watson Health. Prior to joining IBM, Wiegert held positions with Sterling Commerce, Siebel Systems Inc., Centura Software and Safety-Kleen.

Kevin Fitzpatrick stepped down as the nonprofit CancerLinQ’s CEO in April 2018. Richard Schilsky, M.D., who was serving as interim CEO of CancerLinQ, will continue his role as ASCO's chief medical officer.

CancerLinQ collects and analyzes data from cancer patients at practices nationwide, drawing from electronic health records, to inform and improve the quality of cancer care. Its database contains more than a million cancer patient records. The effort has two major components:

• The CancerLinQ quality improvement and data-sharing platform for oncology practices,

• CancerLinQ Discovery, which provides access to high-quality, de-identified datasets derived from the patient data to academic researchers, non-profit organizations, government agencies, industry, and others in the oncology community.

CancerLinQ LLC also has established a number of collaborations with government and nonprofit entities -- including American Society of Radiation Oncology, Food and Drug Administration, and the National Cancer Institute -- as well as industry through its collaborators AstraZeneca, Tempus, and Concerto HealthAI.

In a statement, ASCO CEO and CancerLinQ LLC Board of Governors Chair Clifford A. Hudis, M.D., said Wiegert’s arrival “comes at a pivotal time, as we are quickly building on and improving CancerLinQ's core quality improvement platform for oncologists and data analytics services for the broader cancer community."

As CEO, Wiegert will be tasked with developing new solutions to help oncology practices improve the day-to-day care they provide their patients and continuing to serve CancerLinQ collaborators.

 

 

 

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A ‘Google’ for Clinical Notes Draws Interest

August 8, 2018
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Developed at the University of Michigan, EMERSE allows users to search the EHR’s unstructured clinical notes
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Those of us who cover healthcare informatics often hear clinicians and researchers talk about the problems involved in doing analytics or research on unstructured data in clinical notes. That was why I was intrigued when I saw that informatics teams at the University of North Carolina School of Medicine are implementing a tool called EMERSE (Electronic Medical Record Search Engine), which allows users to search free-text clinical notes from the electronic health record (EHR). They describe it as being like "Google" for clinical notes. 

But then I noticed that the tool was actually created quite a while ago, in 2005, at the University of Michigan, and has been in use there ever since. So I reached out to its developer, David Hanauer, M.D., a clinical associate professor of pediatrics and communicable diseases at the University of Michigan Medical School. He also serves as assistant director for clinical informatics in UM’s Comprehensive Cancer Center’s Informatics Core as well as associate chief medical information officer at the UM Medical Center.

Hanauer told me that the developers of EMERSE at Michigan have a grant from the National Cancer Institute to further develop the tool and help disseminate it, with a focus on cancer centers around the country. “We are about one year into the grant,” he said. “We have spent the last year cleaning up the infrastructure to make it even easier for people to adopt. We have been working hard on technical documentation. When we started it, we had almost no documentation; now we have substantial and detailed documentation about how to implement and run it.”  

The five sites implementing EMERSE as part of the grant are the University of North Carolina, University of Kentucky, University of Cincinnati, Case Western Reserve University and Columbia University.

I asked Hanauer if health systems continue to struggle with unstructured data in clinical notes. “They all absolutely struggle with it,” he said. “They have mostly been ignoring it, to tell you the truth. That is why we believe and hope EMERSE will fit well into this environment of people needing different tools.”

I also asked him to describe some of the use cases. Most generically, anybody who needs to look through the chart and doesn’t know exactly where to look can get benefit from it, he said. He described three categories of users: research, clinical care and operations. “For example, in research you could use it for cohort identification. You want to find patients who meet your needs when it comes to a research study. This is important in part because ICD codes, the go-to way people often try to identify a cohort, are often inaccurate and non-specific.”

According to the EMERSE web site, for studies in which eligibility determination is complex and may rely on data only captured within the free text portion of documents, EMERSE can be a rapid way to check for mentions of inclusion/exclusion criteria.

In another example, EMERSE also can be used to help find details about a patient rapidly, even during a clinical visit. “For example, if a patient mentions that a certain medication helped their migraine three years ago but can’t remember the name, just search the chart for 'migraine' and find that note within seconds,” the web site notes. Cancer registrars can use EMERSE for data abstraction tasks, including difficult-to-find information such as genetic and biomarker testing.

Hanauer said at Michigan, clinicians have a way to access EMERSE from their Epic EHR. “If you have a patient’s record open, you can click a button, it will log you into EMERSE and bring that patient’s context over, and you can start searching in just of a few seconds.”

In 2005, the platform was written to work with a homegrown EHR. When UM transitioned to Epic in 2012, Hanauer and team used that as an opportunity to make it more powerful. “When we went live with Epic, it became clear there were some architectural limitations that were probably going to limit the future power of the software,” he recalled. “We leveraged the design and concepts and rewrote it from scratch. But even though we were going to work with Epic, we designed it specifically so it would not be tied to any particular EHR.”

Because it deals with patient records, security and audit logs have to be taken very seriously. Every time you log into EMERSE, you come to an attestation page. “You have to declare why you are using it for this session,” Hanauer explained. “We have tried to make it as simple as possible. Almost every institution that does research now has an electronic IRB system, so we have a way you can pull a user’s IRB-approved study into the EMERSE database, and a list appears of that user’s studies only. The user can click on it, record that use, and move forward.” There also are quick buttons for common administrative use cases.

I asked Hanauer if other academic medical centers had developed similar search tools. He said some have created local tools. “The main difference with EMERSE is that it is proven it can work elsewhere. (It was used at the VA in Ann Arbor, Mich., on the VistA system.) “We have a long track record of use and have been working on the infrastructure to disseminate it,” he said. “We are giving it away at no cost, but it is almost like running a software company, where you have to have a web site, user documentation, and system administrator documentation. To me, it doesn’t make a lot of sense for others to reinvent the wheel when this is something we have invested millions of dollars in at this point.”

He stressed that although the grant project is focused on five cancer centers, they are giving the software away at no cost, and are glad to help anybody interested in getting it up and running. “One of the key challenges is that the users can’t control whether it gets deployed or not,” he said. “Our biggest challenges is not the users, who are contacting us and asking us for it, but getting this through local IT leadership, and that is a big hurdle.”

Why would CIOs be opposed to deploying this tool? “I think their plates are full and a lot of times people are looking for vendor solutions,” he surmised.  “I also think that often people don’t understand what the issues are. Some people think they will just get some off-the-shelf NLP software. But I can assure you that that software will not be able to do the kinds of things that EMERSE can do. That is partly because a lot of medical documents are not in natural language. Medical documents are anything but. They are a mess.”

 

 

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Anthem Expands $500M Deal with IBM with Focus on IT Automation, AI

July 26, 2018
by Heather Landi
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Health insurer Anthem has expanded its services agreement with technology leader IBM with a focus on using artificial intelligence (AI) and automation to improve operational efficiency and modernize technology platforms.

With this collaboration, Armonk, New York-based IBM and Indianapolis-based Anthem, one of the largest U.S. health insurance coampnies, will work together to help drive Anthem’s digital transformation and deliver an enhanced digital experience for its nearly 40 million consumers, Anthem said in a press release.

In 2015, Anthem entered into a five-year, $500-million-dollar strategic technology services partnership with IBM in which the technology giant provided operational services for Anthem’s mainframe and data center server and storage infrastructure. As part of that agreement, Anthem has been able to leverage IBM Cloud solutions to increase the ease, availability and speed of adding infrastructure to support new business requirements, the company said.

Under the expanded agreement, IBM will provide Anthem with enterprise services for its mainframe and data center server and storage infrastructure management. In addition, IBM will work with Anthem towards creating an AI environment which will allow for an automated infrastructure providing 24/7 digital capabilities. This will bring greater value and access to Anthem's consumers, care providers, and employees, Anthem said.

IBM and Anthem will also continue to work together on IT automation. Since 2015, the two companies’ have implemented over 130 bots, automating over 70 percent of the monthly high volume repetitive tasks. This includes bots that can identify when a server is reaching capacity to shift workloads to other less utilized servers ensuring that work is not impacted. This capability has improved systems availability as well as freed up resources to work on higher-value projects, Anthem said in a press release.
 
“We are seeing a dynamic change in the healthcare industry, requiring us to be more agile and responsive, utilizing advanced technology like AI to drive better quality and outcomes for consumers,” Tim Skeen, senior vice president and chief information officer, Anthem, Inc., said in a statement. “Our continued strategic partnership with IBM will help establish a stronger foundation for Anthem to respond to the changing demands in the market, deliver greater quality of services for consumers and help accelerate Anthem’s focus on leading the transformation of healthcare to create a more accessible, more affordable, more accountable healthcare system for all Americans.”

“The collaboration between IBM Services and Anthem has already laid the groundwork to improve healthcare processes and quality,” said Martin Jetter, senior vice president, IBM Global Technology Services. “Our latest agreement will accelerate Anthem’s growth strategy and continued leadership as one of the largest healthcare insurance companies and provide a solid path to bringing new efficiencies in driving digital transformation.”
 

 

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