VisionTree: Helping Eradicate Paper

San Diego-based VisionTree is inarguably a leader in web-based patient-centered health record management, communication and data collection systems. They have VisionTree Optimal Care™ or VTOC, VisionTree MOC Online™ and VisionTree Clinical Trials™ for web-based data collection, speeding workflow, and improving communication, documentation and quality of care.


And they have a patent application for a Patient Health Management Portal, from 8/2007 (courtesy www.freepatentsonline.com):

A secure online patient health management portal for patient and payer/provider communication, documentation and improved workflow efficiency. A payer/provider portal provides patient and file management, patient tasking and reminders, calendaring, creation and management of medical condition templates, aggregate report generation and electronic informed consent. A patient portal provides personal health management, task management and reminders, comprehensive access to and management of health records and documentation, calendaring, online payer/provider and institution communication, prescription and finance management and discussion forums.

Since 2002, VisionTree has implemented solutions at 70 sites across some 200,000 patients. The firm is laser-focused on eliminating the paper process of patient’s completing information and saving steps to input their data directly into a secure, electronic and easily accessible format.

VTOC is a user-friendly system for both patient and staff involvement in electronic documentation, which completes the workflow where traditional electronic medical records end.

VisionTree indicates that results have included:

1. 90%+ of patients want to keep using it for long term care with their physician
2. 80%+ patient compliance
3. 85%+ rated very user-friendly
4. Average age of patient user is 61
5. 20% improved efficiency – through reminder/messaging system

SUMMARY: VisionTree is a company-to-watch, especially with EMR gaining new life thanks to the planned Obama administration spend over the next 2-3 years.

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MedApps: Wireless Health

Scottsdale, AZ-based MedApps is focused on making healthcare available anywhere, for anyone, through innovative wireless health monitoring solutions.

MedApps has developed a system that integrates cost-effective, easy-to-use, wireless health monitoring devices with a broad set of online health management tools. The MedApps System is aimed at the burgeoning wireless medical monitoring market. The company's theme is: "Healthcare Anywhere".

One of their offerings is HealthPAL:

HealthPAL automatically collects data from compatible, off-the-shelf, medical monitors using a smart cable or wirelessly via Bluetooth. The data is then transmitted using embedded M2M cellular chip (GSM and CDMA) technology to be received by HealthCOM, MedApps' full-featured, web-based portal for health care providers.

About the size of a cell-phone, the HealthPAL is ultra-portable for maximum mobility and its low cost enables remote monitoring to be available to large patient populations. It is considered to be the ultimate in simplicty. While it has buttons for special features and set-up, during daily operation the reading and data transmissions are COMPLETELY automated. The patient does not push any buttons, navigate any screen commands or touch the HealthPAL in any fashion.

HealthPAL is currently approved for use in conjunction with glucose meters. As additional approvals are received, MedApps looks forward to expanding its capabilities to include the recording and transmitting of data from weight scales, blood pressure monitors, INR monitors, ECG, Pulse Ox, CPAP, spirometers and O2 concentrators.

The HealthPAL has audio capability and can "speak" readings and alerts to the user. HealthPAL also has multi-lingual capability and can be programmmed to address patients in their own language.

We don't see any patents or patent applications yet for MedApps, Inc. at www.freepatentsonline.com, but they claim to have filed for 31.

SUMMARY: In the next three years we'll see the rise of what we call the "Homespital," and wireless medical devices and the back-end ecosystem facing doctors and patients into which they tether in real-time will become very prominent, very rapidly.

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NaviMedix

Cambridge, MA-based NaviMedix (founded in 1998) is a leader-- perhaps THE leader-- in real-time healthcare communications, with 700,000 Healthcare Professionals on board.

Their NaviNet is America’s largest real-time healthcare communications network, giving physician offices and hospitals a single point of access to conduct patient-centric financial, clinical and administrative interactions with national and regional health plans and other sponsoring healthcare companies.

NaviNet now facilitates nearly 400 unique, sponsor-branded information exchanges, allowing providers to access real-time patient information such as eligibility, benefits and claim status, as well as advanced clinical information, including patient care alerts and personal health records from the health plans and other companies with which they do business.

The firm addresses the 25% of all healthcare costs that are administrative; it's a ripe area for real RoI.

The 200-employee firm has this patent (courtesy www.freepatentsonline.com): System for Dynamic Information Exchange from January, 2008:

The communication bridge enables trading partner customers to mass customize their interactions with their affiliated trading partners by controlling workflow and data presentation. A method and system allows the integration of standard and proprietary content, such as data and “look-and-feel” elements, from trading partners to be presented via a standard interface for the purpose of conducting mass customized interactions (transactions, communications). There is a high degree of variability in screen and workflow presentation. A particular Application Programming Interface (API) facilitates the dynamic exchange of information between disparate trading partners and end users.



SUMMARY: eHealth, especially on the supply-side, is moving rapidly towards real-time connectivity at every touchpoint, including the patient-doctor interface, and the money savings with the right implementations are eye-popping.

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MedFusion

Raleigh, NC-based MedFusion is at the intersection of physicians' offices and the web, offering Improved Efficiency via their communications solutions, such that patients fill out standard and custom forms, request appointments and prescription refills, and even communicate with practice staff online.

They sell their solutions via the lens of RoI, with a clever tool on their website that allows docs to "game" their practice.

From their website:

Medfusion offers patient-provider communication solutions nationally to enable healthcare providers offer superior service to their patients while improving office efficiency and generating revenue. Medfusion’s powerful web-based solutions virtually transforms physician/patient communications using applications for pre-registration, appointment requests and reminders, outbound messaging, lab results delivery, prescription renewals, online bill payment, virtual office visits, and unique web sites. Medfusion is the preferred portal and website provider for the Medical Group Management Association (MGMA) and the American Academy of Family Physicians (AAFP).

MedFusion stands to benefit as an increasing percentage of appointments move from not just online booking, but online fulfillment (virtual visit to the doctor).

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DestinationRx

LA-based DestinationRx wants you to create a free account and manage your scrips with them, mostly as a way for you to save money.

Here are the top searches on their site, to give you a sense of their consumer audience--

• Lipitor
• Tri-Sprintec
• Synthroid
• Metformin hcl
• Prevacid
• Zocor
• Crestor
• Flomax
• Accupril
• Topicort.

From their website:

Since 1999, DestinationRx has evolved from a pioneer in prescription drug price comparison into the recognized industry leader. The company built and owns the most comprehensive drug therapy and price comparison database available, which we combine with proprietary technology to equip individual consumers and organizations with educational, strategic, and transaction-support tools to navigate the ever-changing healthcare marketplace. We work with government agencies, such as Centers for Medicare and Medicaid Services, and some of the nation's largest commercial health plans and non-profit groups.


DestinationRx aggregates a meds-centric audience:

• 1.4 million marketable "DRx Medicine Cabinets" for advertiser messaging
• 400 million+ medicine cabinet sessions in the last 36 months
• 10 million "actions" taken on over 80+ sites in the DRx network (their partners)
  
• "DRx Medicine Cabinet" Growth of 337% over the last 12 months
• 65% of all Medicare enrollees (23 million+) use DRx technology
• 300,000 unique visits a month (note current Quantcast data pictured above).
  

Here are their stated ad rates, far in excess of current CPMs in eHealth, but then pharmas can afford the richest cost per impression.

SUMMARY: In the shaking-out eHealth environment of today, the onus is on most properties to be one or the other of these, not both: A Direct-to-Consumer destination site, or a Partner Property that white-labels its solution for others, or at least allows co-branding.

We think DRx's "My Medicine Cabinet" is well-executed, and given the modest audience aggregated to date directly, partnering likely is the best bet.

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EmpowHer Launches

Phoenix, AZ-based EmpowHer.com has launched.

It offers women a comprehensive multimedia library, access to leading medical experts and advocates, and a devoted community where women can ask, share and connect with one another in a safe and supportive environment.

The launch follows a beta period, during which EmpowHer reached over 200,000 women around the world.

From their website:

EmpowHer was created based on one woman's experience with our sometimes challenging healthcare system. Michelle King Robson, EmpowHer's Founder, suffered from serious health issues. In spite of considerable resources and access to care, Michelle cycled through several different doctors who prescribed multiple treatments and medications. After nearly a year, she found herself suffering in silence – confused, isolated and still sick. Michelle ultimately became her own advocate and started on the road to wellness. She went on to become a renowned medical advocate helping women across the country. Now Michelle has helped assemble a team of leading medical, technology and media experts at EmpowHer – all focused on expanding her vision and improving women's health one woman at a time.

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RealAge, Real Audience

San Diego-based RealAge is a Hearst Digital Media property, and has a huge and growing audience:

RealAge is consumer-health media company and provider of personalized health information and management tools. These tools aim to motivate health-conscious people to look, feel, and actually be many years younger— to Live Life to the Youngest®.

RealAge levers the writings of Michael Roizen, the chief wellness officer at the well-regarded Cleveland Clinic.

RealAge has a powerful direct response mechanism-- a measurement standard for healthcare. The RealAge Test provides medically-based metrics that compare biological versus calendar age, based upon answers to the test.

RealAge experts developed the metric by reviewing 25,000 medical studies, which revealed 125 different factors that can influence rate of aging.

The test bears a patent, System and method for developing and selecting a customized wellness plan, dated 7/31/2001 [courtesy www.freepatentsonline.com]:

The System and Method for Developing a Customized Wellness Plan of the present invention provides a means of measuring a user's wellness by determining a user's physiological age. The disclosed system and method also provides a means by which a user can learn about personalized wellness options, where the wellness options have been chosen for the user based upon wellness factors input by the user, additional constraints input by the user and the most recently available information relating to the health sciences. The user can select one or more of the disclosed options, and determine the potential effect implementing the options could have on the user's physiological age over the short or long term. In this fashion, the user can continue selecting various groups of alternatives until he or she has determined the group of options that the user would like to implement as a wellness plan. The user can then obtain further information regarding the chosen wellness plan from the system and method of the present invention. The disclosed system and method also provides a means whereby a user can monitor their progress toward improving wellness, wherein this progress can be positive or negative.

The site is ad-monetized, the details are here. In an eHealth space that is stalled in terms of ad rates, if not declining, RealAge is a real bright spot.

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Epocrates

San Mateo, CA-based Epocrates has great momentum. Back in April of 2008 this clinical data provider filed for an estimated $75 million initial public offering, but it appears to have been pulled or stalled. The firm's investors include Sprout Group, Interwest Partners, Three Arch Partners, Draper Fisher Jurvetson, Bay City Capital and Goldman Sachs.

Founded in 1998, the 200-employee firm develops clinical information and decision support tools that enable healthcare professionals to find answers more quickly and confidently at the point of care.

More than 600,000 healthcare professionals, including one in four U.S. physicians, use Epocrates’ mobile and web-based products to help them reduce medical errors, improve patient care and increase productivity.


Epocrates' new version of their Essentials suite was developed exclusively for the iPhone platform. It takes advantage of the iPhone's touch-screen interface, and introduces new disease content, features and functionality to the platform. The Essentials premium software solution includes:

* Drug prescribing and safety information for more than 3,300 drugs, including pill pictures
* Peer-reviewed disease content and evidence-based differential diagnosis developed in conjunction with the BMJ Group, publisher of the British Medical Journal
* Infectious disease treatment guide with empiric and specific treatment recommendations
* Hundreds of diagnostic and laboratory tests for interpretation and diagnostic support
* 600+ alternative (herbal) medications with drug interactions
* MedMath medical calculators including commonly-used pregnancy wheel and unit conversions.

Epocrates offerings are about convenient access to the critical information doctors need all on one device right at the point of care. The firm's suite features cross-linking between the drug, disease and diagnostic content and can be used to support a patient’s consultation from diagnosis to treatment.

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Doctors On Demand

We like Jacksonville, FL-based Doctors On Demand from Delta Health.

They aim to provide personalized health care initially face-to-face to be followed by the convenience of telemedicine.

The model requires every patient to see their Delta Health Network Physician for an initial, face-to-face visit. Then every patient is assigned a Personal Assurance Agent. The "PAA" calls to introduce himself/herself, gives his/her direct phone number and email address, and spends a few minutes getting to know the patient.

Then, the doctor will deliver follow-up visits via telephone for the next year assuming the patient's condition doesn't change.

This is in the wheelhouse of our prediction: A significant percentage of doctor visits will move to virtual (phone, email, IM, even video) over the next three years.

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Home Medical Monitoring

Providers of personal health technologies such as health monitoring devices and personal health records (PHR) are projected to generate more than $460 million in revenue by 2013 by targeting the disease management (DM) industry, according to a new Parks Associates’ report.

Players like Intel are already in the game, in their case with the Health Guide pictured above.

The report, Disease Management Industry and High-Tech Adoption, cites changes in the healthcare landscape combined with the new Democratic administration’s stimulus package and reform initiatives as catalysts for accelerated technology spending over the next several years.

From the Intel website:

The Intel Health Guide is meant to be a powerful care management tool for healthcare professionals who manage patients with long-term (chronic) conditions.

The Intel Health Guide promotes greater patient engagement and more efficient care management by enabling communications between patients and healthcare professionals and providing clinicians with access to the most current, actionable data. This comprehensive personal health system combines an in-home patient device—the Intel Health Guide PHS6000—as well as an online interface—the Intel Health Care Management Suite—allowing clinicians to monitor patients and remotely manage care.

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1life

San Francisco-based called 1Life has raised $8 million led by Benchmark Capital, which was joined by existing shareholder Pinnacle Ventures.

1life fits the trend we see towards virtual visits, and lists these value-prop points--

• Same-day appointments
• Longer, more personalized visits that start on time
• Team of trusted physicians and providers
• Email access to all clinicians
• Online health tools.

The firm's CEO Thomas Lee was Chief Medical Officer, VP Product Design and Editor-in-Chief at Epocrates. Lee founded 1Life in 2005 and ran it while he was still with Epocrates for about 3 years.

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