Bobby Grajewski is president of Edison Nation Medical, a healthcare product and medical device incubator and online community for people that are passionate about healthcare innovation. Prior to joining Edison Nation Medical, Grajewski, a serial entrepreneur, co-founded two online companies (Heritage Handcrafted and eCollector) and spent five years in venture capital and private equity both in the middle market (J.H. Whitney Capital Partners & Kamylon Capital) and at larger LBO firms (Permira Advisers) investing in companies across numerous industries.
Grajewski holds a MBA from The Wharton School at the University of Pennsylvania, a MPA from Harvard Kennedy School, and a BA from Harvard University.
Here he discusses Edison Nation Medical, its importance, who it serves and how it came to be.
What is ENM? How did it begin and who are your partners? Please provide a little about the history, present and future goals.
Edison Nation Medical is a medical device incubator and online community for people passionate about making a difference in healthcare. We provide a clear pathway for anyone—physicians, nurses, technicians, entrepreneurs, university tech transfer officers, small companies, and even patients and caregivers—to submit their medical product innovations for in-depth review and potential commercialization. Our business model is based on trust—trust between a person with a great healthcare invention and a company that gives a thorough and expert read to determine the value of the innovation. If an innovation has value, we find it, unlock it and get it to market in order to improve care, lower cost and increase access for the patient.
Edison Nation Medical was founded in 2012 as part of a collaboration between the prolific consumer product developer Edison Nation, and Carolinas HealthCare System, one of the nation’s leading public healthcare systems. Both valued innovation in healthcare, and desired to create a model whereby open innovation in healthcare could exist, outside the traditional pathways, that would foster new ideas to improve care and increase efficiencies in the healthcare ecosystem.
In a change of pace, and in the spirit of patient engagement, the following graphic from Primacy speaks to the importance, and the need to engage patients online to educate them and bring them to a practice’s door.
According to Primacy, an award-winning agency known for creating digital experiences with impact: “Investing money in your hospital’s website can drive traffic online and to your door.”
Primacy analyzed the traffic and paid search activity of five hospitals during 2012 to see if any patterns emerged. It turns out some did. Take a look at the infographic below to see which clicks matter the most.
Dr. Mary Jo Gorman established Advanced ICU in 2005 as a solution to the growing ICU crisis across the country — ICU care accounts for a large portion (40 percent) of hospital costs. With only 1.5 ICU physicians per hospital, there is already a shortage in care; which will continue to magnify as Baby Boomers age (those 65+ use the ICU 3 times more than those under 65).
Advanced ICU aims to deliver a solution to this critical issue by working alongside hospital staff to provide 24/7, remote patient monitoring in ICUs across the U.S. The company manages more tele-ICU programs than any other organization in the country, and combines physician-led teams with telemedicine technology to improve the operational, clinical and financial performance of ICUs. For example, after an average of one year of services, Advanced ICU clients see a 40 percent decrease in mortality, and patients spend 25 percent less time in the ICU.
You started out as a medical doctor in the field. What drove you to leave your practice and start your own business? How has your perspective changed since launching the company?
As I practiced in the hospital ? both as an intensivist in the ICU and as a hospitalist — I saw firsthand the importance of having a well-staffed and well-run ICU. In addition, I have been responsible for recruiting physicians and experienced the recruiting challenges that ICUs face. I was aware of some of the technology solutions that were being developed and saw how we could combine our knowledgeable medical team with technology to bring our special expertise to hospitals in need. Now, as I look back, I realize that through the Advanced ICU Care team, I have been able to help more people than I ever could have in private practice. Every week at our staff meetings we highlight a clinical success story, and every month when I look at our clinical outcomes, I know that my training is having a positive impact and helping improve ICU patient care. Since Advanced ICU Care was founded, we have cared for nearly 100,000 patients.
The market for electronic health and health records (EHRs) is set to experience rapid growth over the coming years, with EMR peer group value estimated to climb from approximately $10.6 billion in 2012 to $17 billion by 2017, at a Compound Annual Growth Rate (CAGR) of 9.8 percent, according to research and consulting firm GlobalData.
The company’s new report estimates that McKesson had the largest healthcare information technology software and services revenue in 2012, with $3,300 million, placing it as the EHR market leader. McKesson is followed by Cerner and Allscripts, which achieved revenues of $2,666 million and $1,477 million, respectively.
According to GlobalData, this rapid EHR market growth is because of incentives offered under the American Relief and Recovery Act of 2009, which delivers opportunities for providers to transform unstructured, paper-based data into electronic digitized information that can be shared across the entire care industry.
In 2013, healthcare industry stakeholders, including associations, EHR vendors, practitioners and providers, raised significant concerns relating to the implementation timing of meaningful use Stage 2 and 3 criteria, including problems with interoperability, usability and regulatory failure to assess “value added” by implementation of meaningful use criteria to date. On December 6, 2013, federal officials announced that Centers for Medicare and Medicaid Services (“CMS”) were proposing a new timeline for the implementation of meaningful use stage criteria for the Medicare and Medicaid Electronic Health Record (“EHR”) incentive programs. The Office of the National Coordinator for Health Information Technology (“ONC”) further proposed a more regular approach for the update of ONC’s certification regulations.
Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers had completed at least two years in Stage 2. The goal of the proposed changes is twofold; to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2, as well as evaluate data from Stage 1 and Stage 2 compliance, to date, to create and form policy decisions for Stage 3.
CMS expects to release proposed rulemaking for Stage 3 in the fall of 2014, which may further define this proposed new timeline. Stage 3 final rules would follow in the first half of 2015.
Despite CMS’s positive response to stakeholders concerns relating to the timeline for implementation of Stage 2 and Stage 3 meaningful use criteria, significant reservations continue to be enunciated, on a monthly basis, by providers at both Health information technology (“HIT”) policy committee and work group meetings. Providers continue to urge rule makers to institute consensus standards that could be adopted broadly across the healthcare industry to ensure both usability and interoperability.
In early 2013, former national coordinate Farzad Mostashar chastised electronic health record vendors for improper behavior in the marketing and sales of systems that continued to frustrate interoperability goals. This frustration with EHR vendors continues to be enunciated in HIT policy committee and work group meetings as recently as January of 2014.
Dr. David Lischner started Valant Medical Solutions in 2005, a web-based EHR and practice management solution designed specifically for the mental healthcare practitioner. Because he went to school to practice medicine and not administer paperwork, he set about creating a tool that would not only afford him more time free from his practice, but also provide a secure record keeping solution that is integrated with a clinical support tool – allowing him to be a better doctor to his patients. Simply put, he and the team have developed a SaaS tool that intuitively enforces measurement based care.
Despite expert literature highlighting the potential importance of evidence-based-care in psychiatric practice, most doctors simply do not employ these measures. As we know, those physicians who don’t start showing off their patient outcomes to insurers are going to be weeded out by both the federal EHR incentive program and the Affordable Care Act. Valant provides this market, along with the early adopter forward thinkers with both useable solutions to age old problems and readied answers to future concerns — of which there are many within this industry, and this specialty particularly.
The following are his thoughts about EHRs, building a software business and why he chose to start Valant Medical Solutions.
As a practicing psychiatrist with a successful group practice, why did you venture into the EHR space and develop your own software?
I loved seeing patients. I loved being in private practice. But I wanted to have an impact on a larger scale. And, I also discovered that I loved starting and growing businesses.
I didn’t like the solutions that were out there to help me manage my practice. They were either focused on primary care and other specialties or too narrowly on just one type of mental health care provider or practice. I also saw that web-based software was beginning to transform business processes in other industries and thought that this must be possible in healthcare, and specifically in behavioral health care. Finally, and this was a more distant motivation, I wanted tools that made it easier or even fun to practice in an evidence based fashion.
An enterprise-wide data warehouse and a cross-functional team approach to analyze care delivery and protocols has enabled Texas Children’s Hospital in Houston to improve care and achieve millions of dollars in savings at the same time.
Implementing electronic health records was only a starting point for the process, says Myra Davis, senior vice president and CIO for the Houston-based facility. Analyzing the data from the EHR system and other information systems in the hospital with diverse team members using visualization applications has enabled significant improvements in clinical processes, she said.
The use of the data warehouse and improved analytical processes has strong support from clinicians and research specialists, who lauded the approach’s ability to conduct research.
“It’s great to be in a meeting to slice and dice the data,” said Terri Brown, research specialist and assistant director of data support at Texas Children’s Hospital. “When it used to take three months to get a report, now within 30 minutes you have such a great understanding of the data. It takes away the false leads. It tells you what the source of truth is for how we have changed care delivery. It has been revolutionary.”
There are major healthcare regulatory mandates going in effect, at the federal and the state level, which will significantly impact property and casualty (P&C) insurance medical bills payers. The Administrative Simplification provisions of the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II), state mandates for property and casualty eBilling and more regulatory initiatives are forcing payers to understand these regulation’s requirements and be prepared to implement new processes and technologies in order to be compliant. Federal healthcare administrative simplification offers payers an opportunity to prepare for compliance while meeting cost containment and operational efficiency objectives, empowering property and casualty payers to prepare for an all-electronic American healthcare future.
The concepts of eBilling and ePayment for medical bills are gaining traction throughout the healthcare arena, along with the adjacent P&C insurance industry. Medical providers and P&C payers are increasingly taking advantage of the benefits associated with electronic billing and payments, which include substantially lower transaction costs, increased efficiency for call centers, adjusters and finance departments.
Non-legislative organizations are collaborating and recommending changes that could accelerate the impact on the P&C industry.
Other non-legislative organizations are collaborating and recommending changes that could accelerate the impact on the P&C industry. For instance, the Workgroup for Electronic Data Interchange (WEDI), the International Association of Industrial Accident Boards and Commissions (IAIABC), the American Medical Association (AMA), and the Accredited Standards Committee of the American National Standards Institute (ASCX12) are all working to ensure standards to facilitate eBill exchange and adoption. The National Committee on Vital and Health Statistics (NCVHS), a public advisory body to the Secretary of Health and Human Services (HHS), periodically holds meetings to review health statistics and trends. And while the NCVHS does not set policy, they do provide analysis, insight and recommendations to HHS, with eBilling as a topic of likely review in the future. These organizations have collectively laid a path for how to participate in this new environment.
Guest post by George Bailey, senior advisor, health IT/security, Purdue Healthcare Advisors.
The recent large-scale data security breaches experienced by major retailers Target Corp. and Neiman Marcus provide opportunities for learning across industries. These data breaches are painful for the companies, shareholders and, certainly, for the consumers victimized by subsequent fraudulent transactions on their financial accounts.
But once the dust settles, will these 110 million consumers suffer long-term damage to their privacy and financial security? I would argue no. Surprised? I say this because most of the attributes compromised in the Target and Neiman Marcus data breaches are short-lived items. By “short-lived,” I mean bits of information that can be changed or replaced by the consumer.
For instance, charge card numbers can be changed and accounts closed; debit card PINs can (and should) be changed; lost funds can be reimbursed; and credit scores reinstated. Now I don’t want to imply that this cleanup is easy, quick or inexpensive to do. It’s not. But looking three to five years into the future, these data breaches—just as the T.J. Maxx breach in 2007—will have little-to-no lasting effect on those compromised.
For the healthcare industry, a data breach is a quite different. A patient’s social security number (contained many times within healthcare records), medical history, psychiatric notes and sexual preference are not considered attributes that are “short-lived.” While a social security number can be changed, it’s a difficult and time-consuming process. The other data contained in a healthcare record is very sensitive, private, and cannot be re-written, as it is there to guide physicians in providing optimum care. Once sensitive electronic patient health information (ePHI) is lost, stolen or leaked to the Internet, it can spread faster than the best Facebook gossip and be cached, indexed and copied to a seemingly endless number of devices.
According to HIMSS, going beyond implementation of the electronic health record, healthcare providers increasingly look to innovation to reduce costs, improve patient care and increase patient safety. To learn more about how hospitals and health systems plan for, resource, and execute on their innovation agendas, HIMSS and AVIA launched the 2013 Healthcare Provider Innovation Survey. (Infographic below)
HIMSS and AVIA collaborated to produce the 2013 Healthcare Provider Innovation Survey, which was conducted by email from Aug. 20 to Sept. 30, 2013, with select U.S. hospitals, academic medical centers, children’s and ambulatory care centers to understand the current state of innovation within provider organizations. By analyzing the data collected from the 92 participants, HIMSS and AVIA determined the top barriers to innovation. The data is not necessarily meant to be representative of the market, but rather, facilitate dialogue about what the market is doing to determine the top barriers to innovation and other findings as reported in the results.
Eric Langshur, AVIA CEO, said: “The future of healthcare will be greatly influenced by providers’ ability to harness the latest technologies to positively impact their patients – and their bottom line.”