Sramana: You have been immersed in the healthcare IT space since 1996. Could you give me an overview of the major trends and evolutions you have witnessed in that industry? What is your analysis of the progression of the industry leading up to this point?
Ido Schoenberg: It has been a fascinating journey to say the least and I think my journey has mimicked the progression of the industry. It has been very clear to me since medical school that the healthcare system is incredibly broken. There is a tremendous amount of inefficiency. When I started out in this space medical offices worked off of pen and paper. Documentation was really the first focus area for a lot of these companies. At iMDSoft we focused on intensive care units where it was very clear that every patient had a large flow sheet with millions of potential data points. There was simple no way for the staff to interpret all of the data points correctly and analyze the trends in real time.
The initial focus was on accurate data collection and implementation. Parallel to our work at iMDSoft there were a lot of people focusing on EMR. The challenge comes once you have the data. In our case it was apparent to us in the ICU space that alarms are either false positive or false negative. When the heart rate drops beyond limits there are alerts. Those are simple things.
Patients are much more complicated than that. We knew that our system could include all of the data points that a patient has such as pulse, temperature and blood count as opposed to a flow chart. We were one of the first to create an event manager. It was a much more sophisticated system capable of incorporating many parameters into alerts. We took a lot of data points and created algorithms that raise a flag when more sophisticated things happen.
Once we knew what was wrong with patients and could generate alerts we then started to focus on taking the correct action with those alerts. We could start alerting the correct people based on the type of alert. For example, the onset of sepsis could trigger the pager of the infection specialist so they could treat the patient. We then created a system that would allow those people to access the clinical situation from where they were as opposed to the bedside.
Remote treatment was much more scalable. When a large medical center left patients with a smaller amount of supervision during the night we would be able to reach out and take care of those patients during that timeframe. We were able to obtain significant results. We saw a reduction in morbidity using this simple process.
The industry moved from simple data documentation and collection to alert management and rule based interaction. It has since moved into a collaborative environment that is capable of effecting outcomes.