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CloudMedx (YC W15) Helps Doctors Spot Patients Who Will Need Expensive Treatment (techcrunch.com)
30 points by tashfeens on Feb 18, 2015 | hide | past | favorite | 19 comments


tashfeens, I'm always skeptical about healthcare startups. A few questions: How accurate are your predictions, and how do you assess accuracy? (Do you have any prospective studies?) How is this better than the nanny reminders in current EMRs such as Epic? How does your platform deal with missing data when a chunk of a patient's visits are not transmitted to your platform?

Does the software parse free text, depend on someone taking the time to curate a list of "problems" or "diagnoses", or just look at lab values? What is the explanation given by the software when it makes a recommendation, other than deference to a statistical model?

Why would I, a physician, want to spend time or money on this rather than depend on my own sensibilities and training? (I am not going to watch the demo video on your website because I will not agree to an NDA.)


I'm not tashfeens, but given that you have a CS degree and an MD, I'd be curious as to what makes you skeptical about healthcare startups. Or, conversely, what should a healthcare startup do to earn the respect of you and your colleagues?


Overall, make a case to truly be worth the time and effort.

Anything that second guesses my clinical judgment, and/or requires extra paperwork to do so, had better be able to show its justification in an intelligent manner. There is a lot involved in evaluating a patient that is not encoded in machine-readable form, so some percentage of things software reports is going to be wrong or pointless. (Trivial example: The K is 3.4. Is the patient hypokalemic?) The time spent ignoring nuisance notices may render the whole thing useless, even if there is useful information somewhere.

Have practicing physicians intimately involved in the UI design process, so the resulting product is usable to physicians and actually saves time. Billing software in disguise such as Epic has a terrible user experience and could be so much better.

There's more, but I have to head to work...


This is great to hear. We're in a similar position, working on a startup for mental health providers. We spent a solid three months focused on user experience above all else and involving clinicians, case managers, and other end-users in the design process. It's a shame that more startups don't seek this from the get-go, especially those wanting to seek some kind of clinical validity.


Thank you! That's helpful. If you'd ever like to talk further feel free to email me (email on my profile).


I can probably echo some similar thoughts that we heard when we talked with providers. I'm not tashfeens nor do I work for his company, but I run Varsa Health, a data analytics company for behavioral health providers. We "earned" the respect of clinicians to a certain degree by spending a lot of time (months) learning about their workflow before we started even writing code. My co-founder used to work on similar work in a research setting, so user experience was particularly important to us. I noticed you were working on Healthcare.gov - that's a massive undertaking and kudos to you for having the civic duty to help clean up the mess that it was. Would love to chat further about some of our lessons learned and share our experiences.

https://varsahealth.com/


The fact that it's not Epic is a huge plus in my book.

Eef: I've seen the horror that is Epic's 1980's terminal SQL nightmare backend. Lipstick on a dead, rotting windows-only pig running on citrix.


Fun fact: MUMPS predates C as a programming language. Sad that a company like that continues to do as well as it does, but then again it sells to admins, not doctors.


Spot expensive patients so they can be denied and reap more profit.


Thanks for your comment. The platform helps identify the high risk patients so that physicians can spend more time and effort on providing better care and coordination to improve their outcomes. A majority of heatlhcare utilization is being consumed by high risk patients due to redundancies, gaps in care, lack of data sharing. We are addressing those concerns by using insightful and actionable analytics. So that the financial burden is not felt by the patients :).


No problem.


From one healthcare entrepreneur to another, congrats. It's difficult to clear that hurdle, especially with the two-sided approach of doctors and patients. What's been your biggest challenge with patient adherence / engagement?


We got patients engaged through an app delivery method that integrates a few key features of messages and engagement. Would be happy to connect with you and discuss more :)..


Would love to hear some of your thoughts, especially since engagement tends to be an issue we've seen with patient-facing apps after a period of a few months. We're exploring what levels of engagement tend to work best with patients, especially as the length between provider visits increases. I'll be sending you an email and would love to discuss more / share some of our insights.


I'm one of the co-founders of CloudMedx. I wanted to thank all the people who commented. Its certainly very encouraging.

The premise of the company is to help organizations identify the high risk patients so that their physicians can spend more time and effort on providing better care and coordination. We are addressing this by using insightful and actionable data. The physicians and organizations that are using our system are making efforts to make costs more manageable for patients.

Our algorithms help predict readmission rates, comorbidity, and financial outcomes using evidence backed data and statistics from renowned institutions. In the end, we are not looking to remove physicians from the equation, nor are we replacing EMRs. Rather we are augmenting both with our actionable insights. When healthcare organizations are managing an entire population health, it provides opportunities for errors or sometimes even gaps in care. This is where we are looking to improve the process for physician organizations and hospital groups.

I hope these comments were useful. And I would love to talk to you individually. Please write to me and we can further discuss this in detail and talk about opportunities in this space.

Best, Tashfeen CEO CloudMedx


Congrats! As an healthcare entrepreneur I appreciate the hurdles and challenges of this space. I run AsthmaMD [1]

Our app and hardware is distributed in every 15000 CVS and Walgreens in US.

I'd be happy to meet and discuss any opportunities for partnership.

1: http://www.AsthmaMD.org


This is very interesting. As a med student with a programming and CS background, these efforts are particularly appealing to me. It seems that (polling healthcare workers, mainly docs) technology (EMR) is more of a hindrance than a benefit, which to me has always seemed like poor design, gamblers fallacy + overwhelming costs associated with changing software in a large hospital. I don't see how this can change unless there are standard protocols that allow for flexible data entry and analysis. The problem I see with this new system is that it doesn't (at the surface) appear to offer anything new, whereas asthamMD is creating objective data and a unique pipeline between healthcare teams and patient. It seems like we are just waiting for some software revolution that actually saves doctor time and improves patient outcomes - rather than generate data for administrators and bureaucrats at the cost of inefficiency.


Great work Salim. Please email me and we can certainly discuss mutual opportunities.


That's one ugly EKG in the logo...




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