Dave Chase, who founded Microsoft’s health platform business, helped create electronic medical records software to give patients a place to manage their health information.
They are also responding to an evolving model of health care, which will ultimately be focused more on outcomes than on services, and to the
Medicare and Medicaid Electronic Health Records Incentive Program, which, in an effort to improve the coordination of care, gives providers financial incentives to adopt electronic health records and report how they use them. “We are about to see a fundamental transformation in the way care is delivered and the way patients are engaged with that care,” said Frank Moss, head of the New Media Medicine Group at the M.I.T. Media Lab. Here is a sampling of the innovative companies pushing that transformation:
Airstrip Technologies, San Antonio
THE BIG IDEA In 2005 Stephen Moore, software engineer, asked Dr. Cameron Powell, an obstetrician, to describe an ideal mobile app, one that would make his job easier and improve the quality of care. Dr. Powell suggested an app that would let him see on his smartphone — even when he was not at the hospital — the fetal heartbeat and mother’s contractions in high-risk deliveries. That idea prompted the partnership between Mr. Moore and Dr. Powell that became
AirStrip Technologies. Its first product, the AirStrip OB, was introduced in 2008.
HOW IT WORKS AirStrip’s technology connects a hospital’s various bedside devices — an E.K.G. machine, a ventilator, a fetal heart monitor, for example — to its server and then transmits the data to a smartphone or tablet. It can also transmit data from monitors in an ambulance to the emergency room, so the staff is ready to treat patients as soon as they arrive, said Alan W. Portela, the company’s chief executive. Airstrip’s three products, for obstetrics, cardiology and patient monitoring, have been cleared by the federal Food and Drug Administration.
HOW IT WILL MAKE MONEY Organizations are charged an annual fee that varies with the products used and the volume of data. In November the company signed a three-year, $4.3 million contract with Catholic Healthcare West (now Dignity Health) to use Airstrip OB. In February, Airstrip received an investment of an undisclosed amount from the Qualcomm Life Fund.
Avado, Bellevue, Wash.
THE BIG IDEA Dave Chase, who founded Microsoft’s health platform business, helped create Avado to give patients a place to manage their health information. “It’s like a
mint.com for health care,” said Mr. Chase, who founded the company along with Bassam Saliba, a software developer, in February 2011.
HOW IT WORKS A doctor subscribes to
Avado and gets a suite of tools that enable the easy creation of a Web site where patients can fill out intake forms, schedule appointments, ask for weekly medication reminders and track symptoms for chronic conditions. Patients and doctors decide together which metrics they will track — blood sugar, blood pressure or frequency of asthma attacks, for example — and that information is shared. Avado, Mr. Chase said, “considers the patient a partner in the process.”
HOW IT WILL MAKE MONEY The founders put in half a million dollars. Avado operates on a subscription model — $100 per month per clinician, although there is a free version that includes the Web site and secure e-mail.
ClickCare, Vestal, N.Y.
THE BIG IDEA A nurse practitioner who had worked with Dr. Cheryl Kerr, a pediatrician in Binghamton, N.Y., got a job in a low-income school in upstate New York and was confronted with a rash she had never seen before. This was in 1995, so the nurse used an early version of e-mail to transmit a photo of the rash to Dr. Kerr, who helped her make a diagnosis. It was an early example of telemedicine, and it gave Dr. Kerr and her husband, Dr. Lawrence Kerr, a plastic and reconstructive surgeon, the idea for
ClickCare, which they founded in 2006.
HOW IT WORKS Doctors and nurses post a photo of and information about a patient’s problem on ClickCare’s secure Web site. Then a link is sent to a consulting physician who logs in, looks at the data and photos and responds. “This increases a doctor’s ability to collaborate with other physicians quickly, even if they are in very different places,” said Lawrence Kerr.
HOW IT WILL MAKE MONEY The Kerrs initially financed the business and received federal grants for their work in 2003 and 2005. They charge $99 a month per user for the service. Sales have doubled in each of the last two years.
ZocDoc, New York City
THE BIG IDEA In 2007, while Cyrus Massoumi was landing on a flight to New York, his eardrum ruptured. He did not have a primary care doctor to refer him to a specialist and when he tried to find one on his insurance company’s Web site, he found mostly inaccurate information. “It took me four hours over the course of four days to find a doctor with an open appointment,” he recalled. Later that year, he and two friends started
ZocDoc, a site that allows users to find a doctor, spot open appointments and book them.
HOW IT WORKS On ZocDoc’s site, consumers can see a doctor’s qualifications, read patient reviews, check the insurance plans the doctor accepts and look at photos of the offices. “We know about last-minute cancellations immediately,” said Mr. Massoumi, now the chief executive. “You can usually get in to see a doctor within 24 hours.”
HOW IT WILL MAKE MONEY Mr. Massoumi and his partners initially financed the company. In 2008, they won a $100,000 prize in the Forbes Boost Your Business competition, then raised $5 million in a Series A investment round. In 2010, they raised $15 million in a Series B round, and Series C closed last summer, having raised $75 million. Doctors pay $250 a month to be listed on the site, which is now available in 16 cities; more than 1.2 million people used ZocDoc in March.
Telcare, Bethesda, Md.
THE BIG IDEA When he was chairman of the health care committee of the President’s Information Technology Advisory Committee from 2003 to 2006, Jonathan C. Javitt led the development of the policy to adopt electronic health records. What was missing from those discussions, he says, was a direct connection between patients and their health information.
HOW IT WORKS Telcare’s first product is an F.D.A.-approved glucose meter that transmits each reading to the cloud, where it can be read by a group of people preselected by the patient. Feedback is sent back to the patient’s meter from a diabetes educator, for example, or a pharmacist, nurse or parent. “What we are doing today, essentially, is enabling the mother of a diabetic child to know what’s happening when her son is at school,” said Dr. Javitt. “We can put an app on mom’s
iPhone and send an S.M.S. for every reading her child takes. Achieving this type of feedback may be critical, because even a 10 percent improvement in glucose control reduces the likelihood of diabetes complications — blindness, amputation, stroke and heart attack — by 40 percent.”
HOW IT WILL MAKE MONEY Telcare raised $7 million in a combination of debt and equity. The company began shipping the product in February. Revenue comes from sales of meters, which cost $150, and test strips, which have a list price of $72 for 50 strips. Cellular connectivity, back-end server service and smartphone apps are all included in the meter price.