Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…
Dan Cane is co-founder and CEO of Modernizing Medicine.
Tell me about yourself and the company.
Modernizing Medicine was created after a chance meeting between me and co-founder and Chief Medical Officer Michael Sherling,MD a practicing dermatologist in Palm Beach County, Florida. I was retired in South Florida after selling a company I previously co-founded – Blackboard – and my wife encouraged me to get some medical check-ups, including with a dermatologist. I was referred to a super smart, Harvard-trained physician for this routine skin exam, but that meeting turned out to be anything but routine. I noticed that this well-trained physician with an MBA was still using pen and paper to record the details of my medical visit. Since my curiosity as a software entrepreneur was peaked, I asked him why he wasn’t using an EHR system. He stated that there weren’t any systems made specifically for dermatologists that knew their workflow, and all the others on the market slowed him down. We decided to combine his medical knowledge with my software and entrepreneurial experience to transform how healthcare information is created, consumed, and utilized in order to increase efficiency and improve outcomes. Our flagship product, Electronic Medical Assistant, is a cloud-based, specialty-specific EHR system that’s available as a native iPad application, plus from almost any Web-enabled Mac or PC. EMA also automatically adapts to each physician’s unique style of practice.
The software for our first specialty – dermatology – is now used by about 30 percent of dermatologists in the U.S. We’ve since expanded into ophthalmology, orthopedics, otolaryngology, gastroenterology, rheumatology, urology, and plastic surgery markets. One characteristic that makes EMA so unique is that we have 18 practicing specialty physicians code their medical knowledge into the software, and this model has been so successful that there are now over 5,000 physicians in the U.S. who use EMA.
Another real differentiator is that EMA collects structured data, which helps physicians in so many ways. They only have to enter the patient data once and it can be used for multiple purposes – from running quality reports to printing patient education materials.
We’re also one of the first healthcare companies to join the IBM Watson Ecosystem. We’ve developed an app called schEMA that utilizes Watson’s cognitive computing power to provide physicians with evidenced-based clinical decision support at the point of care. In seconds, schEMA can retrieve peer-reviewed, published journal articles from JAMA Dermatology and the British Journal of Dermatology, rather than physicians having to spend hours researching after the patient has left the office.
Finally, at the end of 2014 we purchased a company that expands our service offerings to include specialty-specific billing, inventory management, and group purchasing services. We’re starting out these services in the dermatology field, and plan to include them for our other verticals in the future.
How do you feel the latest vendor criteria for Meaningful Use will impact vendors’ abilities to keep up with the federal program?
I believe the program is well intentioned, but raising the bar too high prevents rather than encourages innovation. Focusing on interoperability is critical for the overall success of HIT and standards are the only path to data liquidity.
At this point, do you think that Meaningful Use is hindering rather than helping providers improve outcomes and increase efficiencies?
Parts of Meaningful Use are pushing providers forward. As I look at the overall adoption of EHR systems since the program’s inception, there can be little doubt that the program has very successfully encouraged providers to abandon paper and go digital. It’s on the EHR vendors to find ways to improve outcomes and increase efficiencies – both of which are literally in our mission.
How many of your customers completely opted out of MU? How many attested for Stage 1 and/or Stage 2, but then dropped out?
We will see where the final numbers end up, but Modernizing Medicine is only five years old, and we’ve only had a certified product for the last two years. The fact that we are in the top 30 vendors for overall number of attestations is pretty impressive. I’m not sure of the exact number, but I believe it’s over 1,700 providers.
What do you see as the key to truly moving interoperability forward? What will this look like for physician practices?
The key to interoperability is a well-defined and easy to implement standard. We need to keep the simple, simple, but allow for more complex data exchanges using extensible metadata. Almost every major industry has achieved interoperability. Perfect is the enemy of good. Let’s get something good that works out first, and then we can let the academics spend the next decade determining the 100 different (possibly better, but does it really matter?) ways to exchange vitals. To a physician practice it should look easy. The industry and EHR vendors have issues to tackle around security, permissions, and overall portability of data, but once those are ironed out, the data should go where the patient wants it to go.
How do you feel point-of-care clinical decision-making technologies benefit physician practices, especially specialties?
Our country trains some of the best doctors in the entire world. The best thing we can do is present our physicians with access to information in the correct context so that they can make the best decisions around patient care. Technology and data should not aim to replace a physician. Instead, we should harness the coming wave of data analytics and cognitive computing to enable an entirely new generation of physicians with the ability to practice evidenced-based medicine.
How did the company’s partnership with IBM Watson first start?
Modernizing Medicine applied to be a founding member of the IBM Watson Ecosystem as soon as the opportunity presented itself over a year ago. Watching Watson’s abilities on display during the Jeopardy event in 2013 showed the power of cognitive computing in the context of a nuanced trivia game. We know that the same engine would change healthcare by using peer-reviewed source data to answer a provider’s questions, in seconds, at the point of care.
What does the future hold for MM’s schema app, given IBM’s recent funding?
IBM investment adds rocket fuel to the schEMA fire. We are now able to purchase additional content to train into the application and hire additional resources to train the engine. Most people don’t realize that Watson is not like a search engine – it must be trained up through thousands of questions and answers before it will confidently and accurately be used in a clinical setting.
What are your clients’ biggest challenges right now, given that they are faced with Meaningful Use, ICD-10, shifting reimbursement models, etc.?
Our client’s biggest challenges are simply understanding the massive set of changes going on in healthcare. We spend a great deal of time educating the market, and we spend a great deal of money automating and building intelligence into our products. The result is a system for ICD-10 unlike anything in the market – where the codes are almost entirely automated without crosswalks or GEMS. Our level of intelligence for PQRS lets our users see, in real-time, what their outcomes are for every patient across dozens of eligible measurements. While most physicians settled for reporting on three measurements last year, hundreds of our users reported on the full nine. Physicians need to understand the difference between a vendor that says, “They are ready” for Meaningful Use, ICD-10, PQRS, etc. and a vendor that can alleviate the burden through automation and intelligence. The most important thing we need physicians to focus on is patient care – they should leave the rest to their vendor to figure out for them.
How do you see these being overcome?
Elegantly designed and implemented technology, of course! You can’t have engineers designing systems – you need physicians who understand the medical domain and the technical domain in order to build solutions that really work. The level of automation EMA can achieve helps our practices focus on patient care rather than the burdens of regulatory compliance.
Do you have any final thoughts?
It’s an incredibly exciting time in HIT in general. The right technology can improve the productivity of practices. The right data at the right time can improve patient outcomes. We are at the beginning of a renaissance age in healthcare IT.