Posted: November 01, 2013

Medicine in the information age

IT industry steps up to curb health care inefficiencies

Eric Peterson

Doctors represent a different problem. “Doctors are so mobile,” he adds. “They’re on three floors. Connecting the physical world to the virtual world is a big challenge.”

Gobron cites To Err is Human, a book published by the Institute of Medicine, that estimates 80,000 annual deaths due to errors, often related to bad handwriting. “It’s the equivalent of a jumbo jet crashing every day,” says Gobron. “We help prevent that.”

The ACA mandates adoption of electronic health records (EHRs) via fines and financial incentives. Though roughly half of paper records have been digitized to date, doctors’ adoption-rate has lagged, says Gobron, and data is often not shared between facilities.

“Clinical health care is so complex,” says Gobron. “There are only so many things you can put in a drop-down box. We cannot hardcode workflow.

“The entire health care system benefits from EHRs, except the doctors who have to spend less time in front of patients and more time in front of computers. That’s where companies like Aventura can step in.”

Aventura’s “awareness computing” platform helps with EHR implementation as well as improved security and mobility for iPad-loving practitioners.

“Hospitals are getting pinched,” says Gobron. Since nurses are typically a hospital’s top expenditure, Aventura’s ability to improve nursing efficiency is one answer.

But clinical productivity gains can only go so far, he adds. “Outcomes are better and costs are lower when … we get people to take care of their own selves.”

In other parts of the world, this is understood.

“In Japan, a physician is paid by your lifetime health care costs,” says Gobron. “They talk to you about your holistic well-being.”

In the U.S., adds Gobron, “We’re headed over the health care equivalent of the fiscal cliff. With an aging population, we have to get better. That’s where technology comes in.”

TriZetto is the big dog on the local health care IT block with about 900 of 3,800 employees worldwide at its Greenwood Village headquarters, newly opened in April 2013. It’s also the biggest such dog in the world.

“We are by far the largest health insurance IT company,” says Dan Spirek, chief strategy and marketing officer. About 180 million patients use their turnkey solutions for payers and providers. “We pay more claims than anybody,” says Spirek.

From this lofty perspective, Spirek says the industry is a different animal than most. “Health care is the only industry where you can consume services and leave without paying for them,” he says. “It’s dine and dash at a restaurant.”

Spirek argues such a system is inherently fiscally unstable, especially if you take into account the dominance of faxes and notepads. “It’s analogous to what banking looked like 30, 40 years ago,” he says. “The people in health care want to do it their way and that’s an impediment across the board.”

He adds that technology has the potential “to reduce the cost of care but also improve the quality.” He touts the new health care exchanges stemming from the ACA as allowing patients “to act like adults and choose their own health care rather than their employers.”

The Startups

With all the activity in health care IT, the mile-high city has emerged as a hotbed for like-minded startups.

Presm

Denver-based Presm is “a next-generation patient portal,” says co-founder Kevin Fredrick. “We integrate with existing clinical software – medical records, scheduling systems – and serve as connective tissue between people who need information.”

Fredrick says the three-employee Presm is gunning for federal certification before launching in “the near future” to benefit from the coming boom in spending thanks to ACA incentives to modernize health care IT.

“The irony to me is parts of health care are very sophisticated when it comes to technology – imaging systems, for example – but when it comes to basic uses of technology, health care is way behind. The fax is still the most popular communication method for a lot of doctors. Companies like Presm are trying to change that.”

CirrusMD

Denver-based CirrusMD is bringing health communication into the 21st century with HIPAA-compliant text and video-chat technology. The model calls for doctors to resell it to patients for $40 a month and it can be a huge time-saver for both patient and provider.

“It pays for itself,” says CEO Andrew Altorfer. “It captures a substantial amount of margin back into the system and also gives the doctor an incentive.”

Technology has the potential to cure medical inefficiency and misguided allocation of resources, he adds. “One of the biggest costs boils down to inefficiencies, whether it’s paper inefficiencies or handwritten notes. Who wants faxes at this point in time? Statistics show doctors spend roughly half of their time with administrative tasks and they are an expensive commodity. Their highest and best use is getting in front of patients and that’s what they want to do.”

Altorfer says the fee-for-service model is broken. “The patient has to go in for a visit for the doctor to get compensated,” he explains. “That adds inefficiency to the system.” Fee for access offers a streamlined alternative.

MedPassage

CMO Mike Biselli describes the Denver-based startup as an online marketplace for medical devices that cuts out the middleman. “There’s no reason we can’t create a direct connection between buyer and seller,” he says.

Biselli says MedPassage is seeking a $750,000 bridge round and working with several pilot customers. “This is a huge beast we’re dealing with,” he says.

“On a broad level, we’re starting to see health care listen to the voices of the startup community,” adds Biselli. “We didn’t see that a few years ago.”

ONLINE:

HealthGrades: healthgrades.com

WellTok: welltok.com; cafewell.com

iTriage: itriagehealth.com

Aventura: aventurahq.com

TriZetto: trizetto.com

CirrusMD: cirrusmd.com

MedPassage: medpassage.com

Presm: presm.com

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Denver-based writer Eric Peterson is the author of Frommer's Colorado, Frommer's Montana & Wyoming, Frommer's Yellowstone & Grand Teton National Parks and the Ramble series of guidebooks, featuring first-person travelogues covering everything from atomic landmarks in New Mexico to celebrity gone wrong in Hollywood. Peterson has also recently written about backpacking in Yosemite, cross-country skiing in Yellowstone and downhill skiing in Colorado for such publications as Denver's Westword and The New York Daily News. He can be reached at Eptcb126@msn.com

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