Health Startups That Could Make My Job Easier

Opinion

It’s remarkable how just six months of 80-hour weeks has changed me. Before I started my first year of residency last July, I was optimistic and excited about all sorts of healthcare startups. But now I can’t remember the last time I did my laundry and I’m just hoping to make it home from the hospital in time to take a shower. So if you have a startup that will increase hospital revenue or help a patient shop for doctors—I’m sorry to say it—I just don’t care.

All I want for Christmas is a healthcare app that will get me home in time to slurp down a microwaved burrito before passing out on the sofa.

So I went on the hunt for health IT startups that will make my life as a doctor easier. On a recent trip to the San Francisco Bay Area, I met with founders of four companies that could do that. (And they might actually improve quality of patient care while they’re at it.)

AgileMD

I was really excited to hear about this former Rock Health and Y Combinator company from its co-founder/CEO, Borna Safabakhsh. AgileMD has built a program that can be integrated into any major EMR (including Epic) and provides decision support for over 300 conditions.

What distinguishes AgileMD from Epocrates, UpToDate, or the other resources that collectively serve as my external brain is that it goes beyond making recommendations to actually populate notes and facilitate order entry. For example, if I have a patient with shortness of breath, it will help me identify whether a CT scan of the chest is indicated and will make it easy for me to order the study within the EMR. Then it will automatically create documentation.

“Take the generic clinical guidance of UpToDate, take the institutional guidance from your own department, and tie that with orders and everything that’s built into your EMR,” Safabakhsh says. “You click once, twice, and you’ve placed all those orders and generated the documentation to bring back into your note.”

Of course, anytime I hear about a technology that will help me enter my orders and write my note, I am interested. What makes AgileMD particularly appealing is that it could also improve quality of medical care. With each hospital AgileMD adds to its client list, it builds a stronger library of protocols that it can then share with all its clients, thereby disbursing best practices throughout the health system.

Medisas

Dr. Gautam Sivakumar was a surgical fellow before jumping ship to found this former YC company. Sivakumar combined his deep experience in medicine with a background in programming to build a mobile-ready, elegant application that aims to facilitate the everyday workflow of hospital teams.

Unlike the numerous EMRs that I have used, which are mainly focused on legal documentation and billing, Medisas was designed to improve the quality and efficiency of care doctors provide. “If you analyze why care is not safe and why it is not efficient, it always comes down to the same three things: lack of access to information, poor communication, and lack of standardization,” says Sivakumar. “We help to improve these three things.”

Team members collaborate on rounds using a shared task list to keep track of to-dos. They can view and update a handoff template that allows key patient data to be communicated completely but concisely between teams, reducing the risk of key facts being lost in the game of “telephone” that hospital teams play at shift change. And when a patient is ready to leave the hospital, a discharge tool ensures important steps are taken to make discharges safer.

What I like most about Medisas is that it was built from the perspective of a physician. The interface seems to anticipate my needs, making my work faster, easier, and more enjoyable. And because the largest engineering group at Medisas is its integration team, the software plays nice with Epic, Cerner, and most other major EMRs.

Stroll Health

Jordan Epstein and Matt Maurer co-founded this company in 2013 to improve transparency of pricing in healthcare, starting with radiology. Stroll’s software has miraculously navigated the labyrinthine world of insurance pricing and can spit out an estimate, usually within 20 percent accuracy, of the out-of-pocket price to a patient for almost any radiology study. A physician or an assistant can comparison shop with the patient, find the lowest cost imaging center in their area, and then electronically order the study within the app. Stroll currently has a pilot with 27 practices in the San Francisco Bay Area. Almost all patients in these practices have access to the service, regardless of their insurance.

I love this idea for two reasons. One, it streamlines an order entry process that is often cumbersome for doctor’s offices, improving efficiency and adherence. “We’ve gotten it down to a one or two minute process that involves a seamless workflow—a couple clicks through the app,” Epstein tells me.

The bigger reason that I am excited about Stroll is because I hate not knowing the cost of a study I am going to order. Today, when my patients ask me how much a study will cost, I try to change the subject. With Stroll, I can give a good estimate, which makes my patients happy and—just as importantly—boosts my ego.

In their ongoing pilot, patients have saved about 50 percent on average on radiology studies ordered through the app.

Augmedix

This former Rock Health company’s goal is to eliminate the burden of documentation that weighs down clinicians’ lives. The approach is simple: Wearable technology like Google Glass connects a doctor to a trained scribe in a remote location. While the doctor sees a patient, the scribe is documenting the interaction and preparing prescriptions. By the time the visit is over, the note is ready for the doctor to review. According to co-founder Pelu Tran, “98 percent of our notes are submitted into the EHR without needing any change.”

Any clinician will immediately understand the value of a service that could erase the hours spent each day documenting patient encounters.

Augmedix is more committed to improving physicians’ satisfaction than any other company I’ve encountered. “The measures that we use to determine our success are things like number of early retirements averted, number of marriages saved, number of relationships with children rescued,” Tran told me. “We give you back time.”

(A marriage? I have one of those! A life? I want one of those!)

Augmedix offers a way to make outpatient clinicians happier and more productive. As someone planning to go into primary care, this gets me excited to go into work.

Despite my whining, residency so far has been an amazing experience. With technologies like these, my career as a doctor will be even more sustainable and rewarding than it already is.

Alex Harding is a resident physician in the primary care track of Internal Medicine at Massachusetts General Hospital. He has no financial interests to disclose. Follow @alexharding7

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