Caradigm takes end-to-end enterprise approach to population health

The past five years have been a whirlwind journey for population health vendor Caradigm. The Bellevue, Wash.-based startup was created in 2012 as a joint venture between General Electric and Microsoft. During the ensuing years, the company has grown its customer base to more than 1,500 hospitals globally while managing data for more than 175 million patients.

However, in April 2016, Microsoft quietly sold its 50 percent stake in Caradigm and in the process the vendor became a wholly owned affiliate of GE Healthcare. That same month, Neal Singh, who previously served as chief technology officer, replaced Caradigm founder Michael Simpson as CEO.

Singh came to Caradigm from ERP and CRM software vendor Microsoft Dynamics, where he spent more than a decade as general manager leading a global team overseeing business strategy, product management and engineering. He brings more than 20 years of software leadership to his new role as CEO of Caradigm.

Health Data Management sat down with Singh last week at the HIMSS17 conference in Orlando to discuss Caradigm’s strategy as well as healthcare’s near-term challenges and opportunities as the industry moves to value-based care.

How did Microsoft’s departure from Caradigm come about?

GE acquired all the shares from Microsoft. That was the plan that we have had since the formation of the joint venture. We’re now a wholly owned GE affiliate. We still have a deep technology partnership with Microsoft, but in terms of investors, it’s 100 percent owned by GE.

Is it fair to say Caradigm’s focus is still on analytics and population health?

Absolutely. From Day 1, we’re been a population health company, and that continues to be our strategy and focus. We’re focused specifically on the enterprise space on large clinically integrated networks and accountable care organizations to help them transition towards the value-based care model. Last year was the first HIMSS conference where everyone plastered population health on their booths and signage. However, five years ago, when we came to the HIMSS conference, we were probably the only company that had population health as our goal. We consistently get called out by analyst firms such as Black Book, Chilmark Research and IDC as a population health leader.

What are you doing to help your customers move from fee-for-service to value-based care?

We’ve taken an end-to-end enterprise approach to population health, which is one of the things that serve to differentiate our solution in the marketplace, instead of offering specific point analytics solutions that meet a particular need. It gives our customers the ability to have one vendor meet their requirements.

A lot of healthcare organizations have taken on multiple products through acquisitions and bundled them together. But when it comes to deploying them, the cost of ownership is high, workflows don’t work well, and their data models are not synching up. So the entire process is not driving more value to customers.

What we do is bring in all the data across their enterprise systems, typically multiple EHRs and source systems, and then the data goes into a single healthcare data model that serves all customer applications, including risk stratification and care coordination. We’ve got more than 400 source systems that we work with. There isn’t a single EHR, lab, clinical or claim system we don’t work with. We’re pulling in information at the discrete message level in real time.

Here at HIMSS17 in Orlando, Caradigm announced a risk stratification solution integrated with care management workflows. Can you tell me about that?

A lot of the risk stratification systems are built on claims data, which come in once a month. Our risk stratification solution is based on real-time clinical data aggregated from multiple EHRs in real time, creating segmented patient lists using clinical indicators. That identifies patients who meet defined criteria, and they’re automatically enrolled into programs within Caradigm’s Care Management—an enterprise care coordination workflow application—so that care teams can engage patients more quickly to drive better health outcomes.

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As a provider, you have to figure out how to stratify populations so you can focus on the high-cost patients—you can’t continue to spend the way you’re spending today. You have to move towards value-based care. As populations continue to age, the demand on the healthcare system is only going to increase. You can’t continue to be episodic in the disease treatment space, which only increases costs. When we do the risk stratification, we look at multiple comorbidities as risk factors plus the social determinants. Social is something that we are early in the journey in terms of leveraging. Actuaries have been doing this for a long time in other industries. Why wouldn’t we do it in healthcare?

How important is cloud computing for your business model?

It’s absolutely our business. We made the transition to the cloud when we started the company five years ago. That was a pretty bold move from a technology and business perspective. In the early days, we had resistance from customers. But now, it’s part of our product as a hosted SaaS subscription model.

Who are some of your competitors?

Of course, there are the traditional EHR vendors who are moving into the space. The difference is that all EHRs are designed to be encounter-based, and we are built around the lifecycle of the patient.

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