As more evidence demonstrates that timely care coordination improves outcomes and reduces costs, visionary vendors and clinicians are finding a fertile field for technology that provides real-time or near-real time communication capabilities.
"If you look at existing electronic health records, the biggest problem we have is they are actually silos of data," says Gregg Malkary, managing director of healthcare IT analyst firm Spyglass Consulting. "The communication tools are inferior. What if I could have much more context-sensitive patient information that's actually communicated in the message?"
Such technologies are indeed emerging and gaining traction quickly.
"With everything going on at a macro level in healthcare and healthcare reform, the wind is in our sails right now," adds Joseph Mayer, M.D., co-founder and CEO of New York-based care coordination platform vendor Cureatr. "So much in building a company like this is timing."
Though Cureatr, which Mayer and his partners founded in 2011, might still be considered a startup, Mayer began studying the effects of efficient communication technologies – or the lack thereof – while still in medical school and during his internship. Bearing out Malkary's observation, it was during the latter period when Mayer discovered complex enterprise EHR systems didn't eliminate workflow and information bottlenecks.
"There was no easy way to get in touch with my patient's primary care physician or referring physician, no easy way to get in touch with family members, and no easy way to find out what meds they were on," he recalls. "The basic stuff was not doable. So, based on that and my research interests, I started digging into events notification research, which is basically what we do today."
Mayer calls Cureatr's bread-and-butter platform, which is hosted on Amazon Web Services, "UPS tracking for your patients." It helps health systems and their partners receive real-time admit-discharge-transfer notifications and set up messaging capabilities between providers and insurers to coordinate care.
Mayer says the company is on a rapid growth curve, from about 10 large enterprise customers in 2014 to "dozens" presently. In addition, funding heavyweights such as Cardinal Partners, the New York State-run New York Ventures Fund, and Cerner Capital have funded Cureatr to the tune of $20 million.
"We have a very simple product you can describe in one sentence," he said. "People understand what it does. It's tied to a very clear clinical value, a financial ROI, and it's making the jobs of providers on the front line easier – they know when their patients are getting care."
Other vendors are getting in the game. Boston-based American Well, founded in 2006 as a provider-to-patient telehealth service, introduced its provider-to-provider Telemed Tablet in February 2015 in response to demand from customer organizations for an efficient video consulting technology.
"A lot of clients were trying to solve a supply side issue for their system," Katie Ruigh, American Well's vice president of product management, says. "If you look at how specialists will utilize telehealth, it is highly unlikely that you will have a staff of cardiologists sitting by a computer waiting for a request to come in for a consult."
The Telemed Tablet platform allows a physician to send out a one-to-many request for a specialist video consultation request across whatever provider network the contracting organization has defined. Specialists throughout the organization who have registered earlier in the day as being available can then reply to the request and perform the remote consult using whatever device they are using – smartphone, tablet or computer. Though the company also features a provider-to-provider capability that does not use the Telemed Tablet, Ruigh says the tablet was designed to be the fastest way to get in touch with a provider in the system – "they can literally tap one button and the system will use our brokerage engine to bring in that provider."
Integration between the platform and an organization's EHR is flexible, Ruigh says, and the company has already established integration with some platforms, including Surescripts, to enable the participating clinicians to access a patient's medication history.
American Well has also attracted well-established investors. The firm closed an $80 million round in December 2014.
Other startups to watch:
*ACT.md: The Boston-based firm was co-founded by informatics gurus Isaac Kohane, M.D., Ken Mandl, M.D., and CEO Ted Quinn. The company provides a team-based care platform including web software and professional coordination services.
*Doximity: The San Francisco company offers a nationwide collaboration network for physicians. It features multi-platform support for secure communications, research dissemination, and a "Rolodex" of physicians nationwide.
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