[Corrected 12/10/09, 1:05 am to show Anvita does not store or manage EMRs.] Ahmed F. Ghouri was frustrated. Too often, the anesthesiologist had seen seemingly preventable prescribing errors that threatened the lives of patients. So nine years ago, with angel backing from doctors who shared his same frustrations, Ghouri co-founded Anvita Health, a San Diego company that analyzes clinical data and electronic medical records (EMRs) to provide health care providers the information they need to avoid mistakes.
Today, the market for electronic health records is poised for growth. As part of its economic stimulus package, the Obama administration will spend billions of dollars to hasten the digitization of medical records in physician’s offices. Doctors who buy and use electronic health records technology can qualify for more than $40,000 in incentive payments over a period of years.
One impetus for the program is the mounting evidence that medication errors carry a tremendous cost. In 2006, the Institute of Medicine (IOM) said medication errors injure 1.5 million patients a year, and the extra costs of treating mistakes made in hospitals total $3.5 billion annually. The IOM called for technological solutions to prescribing, administering and monitoring drugs.
“The problem is not a single bad doctor or bad hospital, but primitive systems of quality control,” says Ghouri, who is also Anvita’s chief medical officer. For example, he recalled one case in which a patient experienced gastric bleeding after erroneously receiving aspirin. That triggered a sad chain of events: emergency surgery, a blood transfusion and later, a liver transplant because the transfused blood was infected with hepitatis C virus. “All this could have been avoided if the patient had not been given aspirin in the first place,” Ghouri said.
Anvita, which has about 40 employees, believes its software can reduce human error and fill the sort of information gaps that can lead to near-calamitous outcomes. Besides analyzing electronic medical records, the software is continually reloaded with the latest medical research and drug information to provide up-to-date advisories on drug interactions and medical tests and procedures. Customers include Beth Israel Deaconess Medical Center, a teaching hospital for Harvard Medical School, and Google Health, an online consumer service that stores personal health information that individuals can share with their physicians.
Ghouri says Anvita’s software does more than track prescription drug information, and the case of Beth Israel Deaconess Medical Center provides an example: Working with the hospital’s physicians, Anvita developed a software package that would help them choose the most appropriate imaging procedure (x-ray, CAT scan, MRI, etc…) for any given patient. The software provided guidance regarding radiation doses, and identified which patients were likely to experience adverse reactions to contrast dye agents. Anvita says its software, which was integrated into the hospital’s electronic medical record system, decreased inappropriate imaging and reduced costs, in part because physicians had the information they needed to help them select the correct test for individual patients at the outset.
Ghouri says the greatest challenge for Anvita was not so much integrating the information but writing an algorithm that could process the data and provide a patient-specific response in real time. “No one is going to wait three minutes for an answer. The computer must have an answer in less than a second for it to be practical and usable by the doctor, nurse, or pharmacist. It took many years, and we had to rewrite our engine four times, to meet this performance,” he said.
Anvita started marketing its product in 2008, but lately, with the stimulus money as an incentive, the field is heating up. CEO Rich Noffsinger says the company is pursuing an “Intel Inside” strategy in which it markets its software to customers for use within existing electronic data management systems. Licensing fees are charged on a per patient (physicians) per member (insurers) or per bed (hospitals) basis.
The company has more than doubled the size of its workforce in the last two years, as it has added sales reps, computer programmers, medical informaticists and software installers. On a quarterly basis, Anvita either breaks even or comes close to doing so, Noffsinger says. He declines to say how much money the company has raised since inception or to predict when Anvita might become profitable. “It’s a matter of how fast we want to grow,” he says. “A matter of trying to balance our opportunities and the proper level of growth.”
Noffsinger says that for the next 18 months, the company will focus on insurers and prescription benefits managers that can use analytical software to control costs and also understand how they can provide better care to members. As the stimulus funds become available, Noffsinger says Anvita will focus on physicians and hospitals.
“The solution exists. The issue is distribution,” said Ghouri, drawing an analogy to autos. “The air bag has been invented. Now we have to get them in cars.”