Digital and mobile startups are fueling health care innovation in Dallas

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“Driven by extreme demands on the crumbling U.S. health care system, care must now be delivered outside the four walls of the hospital,” says Vivify CEO Eric Rock.

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By HANAH CHO

Staff Writer

hcho@dallasnews.com

Published: 15 June 2013 04:44 PM

Updated: 16 June 2013 05:12 PM

Entrepreneurs across the country are transforming the health care industry through technology.

Digital and health information tech startups are growing as doctors, hospitals and administrators look for ways to provide better care and reduce costs under federal mandates.

Consumers, too, are embracing mobile tools to be healthy.

Dallas is no exception.

“D-FW has a tremendous amount of health information technology activity, far more than we give ourselves credit for,” said Dr. Hubert Zajicek, co-founder of Health Wildcatters, a new seed accelerator for digital health startups in Dallas.

“An extremely competitive health care delivery market in the most rapidly growing top five American metro areas, combined with our strengths in technology and telecom, provides fertile grounds to grow and support the newest crop of innovative health care startups in Dallas,” he said.

To get a picture of the activity, we talked with executives from three health care startups in D-FW:

Vivify Health, a Plano company that developed a cloud-based platform for remote patient monitoring.

Axxess Technology Solutions, a Dallas company that uses cloud-based software to perform administrative functions for home health care agencies.

DealWell, a Dallas firm that has a website where people can shop for the best deals in health care services.

Vivify Health

For the last several years, Vivify has been developing its platform for remote patient monitoring and testing it with several hospitals and other partners, such as Texas Health Resources and AT&T Inc.

In May, the company announced it raised funds from venture firms Ascension Health Ventures and Heritage Group, whose partners include hundreds of hospitals. The startup, founded as Intuitive Health in 2009, also rebranded itself.

Regulatory filings put the investment at $3.4 million, but founder and CEO Eric Rock said the amount is much larger, though he declined to provide an exact number.

With the funds, Vivify plans to jump-start the marketing of its platform to users, such as hospitals, home health care agencies and physician practices. It also plans to offer a direct-to-consumer product soon.

Rock described Vivify’s software as a tool that seeks to reduce hospital readmissions, improve care and reduce costs — challenges facing the health care industry amid reforms.

“Driven by extreme demands on the crumbling U.S. health care system, care must now be delivered outside the four walls of the hospital,” Rock said.

Vivify’s software, Rock said, is less costly and easier to use for both patients and providers because it uses common consumer devices, such as mobile tablets and computers. The platform also provides video conferencing, educational health videos and customized care plans.

Here’s how it works: Using a tablet, for instance, patients log onto the Vivify platform from their home. Depending on the plan customized by a physician or provider, patients typically answer a daily health survey, keeping track of their weight, blood pressure and other vital signs. Vivify’s platform can be integrated with other devices like a scale or a blood glucose meter.

On the other end, doctors can monitor the patient’s progress remotely.

Preliminary results from a pilot involving AT&T and Texas Health Resources using Vivify’s platform have shown positive patient feedback and reduced readmissions for chronic heart patients, according to the Texas Health Research & Education Institute.

St. Vincent Health, Indiana’s largest health system, is getting ready to launch a large-scale program to monitor patients using Vivify’s software in July, said Dr. Alan D. Snell, St. Vincent’s chief medical informatics officer.

On any given day, health care providers expect to monitor 500 patients who have complex chronic diseases, as well as those discharged with specific diagnoses such as heart failure, heart attack and pneumonia, Snell said.

St. Vincent chose Vivify as its software vendor because of “the flexibility of their platform and software, their analytic capabilities and their progressive view of where remote care management should be going,” Snell said.

Vivify is Rock’s third startup and second in health care.

Two previous ventures had successful exits. His first, ProHost, a table management system for restaurants, was sold to OpenTable. MedHost, focused on emergency room information systems, was also acquired.

Axxess

In six years, Axxess Technology Solutions has grown into an $8 million business.

Dallas-based Axxess provides cloud-based software that serves as the clinical, operational and administrative backbone for home health care agencies.

The home care market represents about $68 billion a year in U.S. health spending, according to McKinsey & Co. The consulting firm said in a study that technology can be the main driver for expanding the market.

Axxess CEO Niyi “John” Olajide saw the underserved technology market in the sector when he started his business as a one-person consultant a decade ago.

At that time, he was a telecommunications engineering student at University of Texas at Dallas. While visiting an aunt who was an administrator at a home care agency, Olajide noticed the computers were not set up under one network.

After inquiring about the issue, he was hired as an IT consultant. That job led to others, and Axxess was officially created in 2007.

After realizing that Olajide was solving similar problems for his clients, Axxess decided to develop Web-based software that would help home care agencies automate their business. The product launched in 2011.

“We saw a need for that and set out for the home health care software market and haven’t looked back since,” Olajide said.

Administrators and health care providers can schedule patient visits, bill insurance providers and document patient care plans using Axxess’ software. Since it is cloud-based, nurses can update patient files or access medication guides on any mobile device during a home visit.

For MedPro Health Providers, a home care agency outside of Chicago, using Axxess’ software has reduced time on paperwork, cut the hassle of billing and made patient care coordination among the various providers easier, said chief executive Riz Villasenor.

“As we work with hospitals and other institutions, the ability to share information swiftly and the right information is also a big plus when you’re working in an environment like health care,” Villasenor said.

Today the startup has 800 customers in almost 40 states, serving about 150,000 patients.

Olajide bootstrapped the business and has not taken any outside investment. The startup has been profitable since 2011.

Now the firm, which has 53 employees, faces a different challenge.

“We’re always looking for talented people, and we can’t find them fast enough to maintain our pace of growth and innovation,” he said.

DealWell

The Internet has changed the way we shop for most everything.

One exception has been health care. Now, an increasing number of startups are trying to create marketplaces where consumers can shop around for the best deals for medical services.

Dallas-based DealWell is one such company.

The website officially launched in August to offer services in nine categories in the Dallas-Fort Worth region. They are chiropractic services, cosmetic surgery, dental, eye exams/Lasik, hormone therapy, massage, medical imaging, medical/day spa, and weight loss and management.

“We’re bringing price transparency and comparison shopping,” said Geoffrey Fischer, DealWell’s chief executive, whose experience includes working at Microsoft’s MSN division. “We’re making the market more efficient and helping customers get good deals.”

The startup is backed by Plano-based Preferred Medical Holdings, a provider of MRI services in the region.

Every offer on the site is at least 20 percent off retail and as much as 85 percent in some cases. DealWell vets providers that sign up, checking their credentials.

Consumers can buy a deal or bid for a better one. Think of DealWell as being like Priceline for health and wellness services.

And unlike popular deal sites, offers do not expire and consumers can choose from a variety of providers for a single service, Fischer said.

Fischer declined to provide revenue but noted that sales have been increasing 25 percent monthly. Several thousand customers have bought a deal on the site.

DealWell takes a cut of each sale. Fischer declined to give an exact figure but noted that it was far less than the 50 percent split that deal sites like Groupon reportedly take.

DealWell providers also pay a small monthly fee to participate.

William A. Moore, clinical director of Dallas-based Advanced Skin Fitness and Advanced Men’s Clinic, has been using DealWell since last fall.

Moore said the clinics have seen a “great return” from DealWell. In several cases, DealWell customers have bought additional services.

“They’re not deal hopping,” he said. “They seem to be a more loyal clientele.”

Follow Hanah Cho on Twitter at @hanahcho.

By the numbers: Digital health care

73: Percent of doctors who believe health information technology will improve the quality of health care in the long term

43: Percent of physicians who use mobile health technology for clinical purposes

35: Percent of U.S. hospitals that have converted to electronic health records

44 million: Number of mobile health care and health apps downloaded in 2012

$1.4 billion: Amount of venture funding raised for digital health startups in 2012

SOURCES: Deloitte; U.S. Department of Health and Human Services; Juniper; Rock Health

http://www.dallasnews.com/business/health-care/20130615-digital-and-mobile-startups-are-fueling-health-care-innovation-in-dallas.ece

Intermountain CTO: Patient experience ripe for transformation

By: Jonah Comstock | Jun 4, 2013

Intermountain Healthcare, a Utah-based hospital system with 22 hospitals and 185 clinics, has worked extensively with digital health companies — most recentlyupgrading their pilot with wristworn vital signs monitor company Sotera Wirelessinto a full partnership last month, and teaming up with MModal in February to develop a speech-enabled computerized physician order entry system.

This week, MobiHealthNews caught up with Fred Holston, Intermountain’s chief technology officer since 2008, to discuss the Sotera deal and its other digital health initiatives. Holston also oversees Intermountain’s Healthcare Transformation Lab.

Intermountain discovered Sotera when it was in its early stages and started working with them right away.

“What we went searching for were a couple of things,” he said. “There’s a section of data we were missing, the more continuous vital monitoring in healthcare. What happens when you’re not in an ICU, you’re not in the ER, you’re just in the general part of the hospital? … And then things happen and you don’t have enough information maybe to understand why. We also have nurses running around with all these devices, and every few hours they check all these vitals and write them on the piece of paper in their hand, and then go back and sit down at the nursing station and spend an hour filling out nursing documentation with that information. And we believe there are better ways to do that.”

But Sotera also has another benefit, beyond the clinical advantages. Holston believes one of the biggest areas where hospitals can fall down is not focusing holistically on patient experience.

“Being in a good mental state is also a feeder into good healing,” he said. “And when people sit and think about how much they hurt all the time and then you ask them their pain scale — ‘It’s a 10! All I do is think about how much I hurt all the time.’ Versus having their mind engaged and not thinking about that. And Sotera’s part of that, part of the role of Sotera is to get all the wires on their body so they’re free to move about or go to the bathroom or walk the halls or go sit in a chair, and not be so tied down. Because that is also a healing piece.”

As another part of keeping patients engaged, Holston sees a lot of potential in consumer-facing apps and data-collecting devices. (Intermountain inked a deal with Kony last year to build some patient-facing apps.) But Holston listed a number of problems that need to be overcome before apps and consumer devices can be effective parts of the healthcare system.

“You’ve got all these cool applications and people are throwing data in a lot of cool places, but who sees it, what does it mean?” he asked. “I think that’s something we have to figure out. As people who deliver healthcare, who understand healthcare, who have the protocols for healthcare, understand what the data is or have the means to understand what the data is. How do we bridge that gap between all these apps that are out there that are part of healthy living that are going to non-health providers, consume it, trust it, evaluate it, understand how to distill that so your physician or any physician can understand that?”

The responsibility for solving these problems is spread between several interest groups, Holston said.

“The people who are collecting that data need to find strategic relationships with real healthcare providers who can make sense of that data, but I think it’s also incumbent on the health systems to see how do we trust and consume it,” he said. “Today I would dare say that the funding models, the reuimbursement models don’t really lend themselves to that either. As health systems we’re going to have to figure out what to do with that and how do we do our part.”

Although Intermountain is an innovative establishment, Holston warns against innovation for innovation’s sake. For instance, although Intermountain is working with MModal on speech CPOE, that’s a carefully chosen and targeted mobile use case. In other cases, he’s not convinced mobile is a benefit.

“Everybody loves the new bright shiny device and they’re getting smaller and lighter and everyone’s going ‘Why wouldn’t I carry it?’” he said. “Well, be a nurse. Carry tapes, an IV bag, scissors, the water someone wanted, half a dozen other things, and then try and carry a tablet or a small phone around and try punching around on it. It doesn’t necessarily make sense in all situations.”

What healthcare really needs, he said, is not just innovation, but transformation.

“If you look at Merriam Webster, one of the definitions of innovation is a novelty. Transformation is defined as real change. I agree that innovations will be needed, but we need to look at the transformations of healthcare. And for me as a technology geek, sometimes, absolutely new technologies will be those innovations that are part of tranformation. But that isn’t always the case. And we can’t start by saying how do we make this device fit? It’s ‘What is it we need to accomplish?’  What change could we drive most? I hope what my lab is doing is trying to listen to the people who provided the care, whether that’s a doctor, a nurse, or our clinical program, and say ‘What transforms healthcare? What could really make change?’”

http://mobihealthnews.com/22780/intermountain-cto-patient-experience-ripe-for-transformation/