Mobile healthcare doesn’t necessarily need another smartphone glucose monitor, mobile pedometer or cellular-heart-meter-communicator that updates a patient’s EHR on an hourly basis. The market is awash in mobile point solutions and nearing saturation.
Instead, what we need now are mobile applications and services that can take mHealth to the next level.
Let’s look at three such start-ups – Aptible, Cureatr and Q-reviews – to see how their HIPAA-compliant, cloud-based services may do just that.
Aptible
Target market: Large providers, payers and academic institutions that have in-house development teams and innovation centers and mobile app developers.
Offering: Compliance-as-a-service. To paraphrase an old Greyhound bus advertisement about "leaving the driving to us," the client brings the application and leaves the regulatory infrastructure to Aptible. The company provides risk analysis, development of compliant policies and procedures, training, operations, incident and breach response, auditing trails and continuous monitoring. Aptible is also expecting to launch a pilot audit program for regulated entities and business associates in the next couple of months. In addition, it provides both technical and legal assistance.
Benefit: Aptible monitors compliance status in real-time in the Aptible cloud. Most compliance management tools work via point-in-time. The client must do the paperwork and documentation, which can be out of date before the ink dries, says co-founder Charles Ballew. The current state of healthcare IT is still at least five years behind where it should be. Software developers don't have access to the same tools and options at the same cost as everyone else. Aptible gives engineers the flexibility to compose their applications correctly from components part (i.e., their "stack"), making choices that are best for the entire service. Data stores and back-ends don't offer that kind of flexibility.
Ballew argues that larger providers are still trying to jerry-rig older applications to fit modern requirements. Aptible benefits modern mobile web developers by allowing them to access their tools unburdened by the legacy software found in most healthcare IT shops. By lowering costs and lowering barriers to working in healthcare, Aptible helps make challenging ideas easier to implement in health tech, which just may make the company one of those startups that takes mobile healthcare to the next level. Platforms-as-a-Service in healthcare offers the promise of innovation within digital health and healthcare in general. When more developers have lower barriers to entry because much of their security and privacy compliance work is automated, we may see a shift in the rate of viable businesses coming out of the digital health sector.
Price: About $2,000 per month, with no up-front costs.
Co-founders: Frank Macreery was the engineering lead for Web-based companies Give Real, XGraph and Artsy. Chas Ballew practiced law in the Office of the Army General Counsel in Washington, D.C.
Current funding: Bootstrapped in October 2013. Seed stage funding with customers in private beta.
Cureatr
Target market: CMIOs, CIOs, nursing information officers and VPs of safety.
Offering: Offering HIPAA-compliant tools for secure messaging and notifications for specific clinical workflows such as results of lab work, imaging, admissions and discharge. It also coordinates alerts when a significant actionable event has occurred in order to launch a response team. The system syncs with standard health system directories, scheduling software and existing text-pagers.
Benefit: Coordinating inter- and intra-organizational communications in high-risk environments using mobile tools enables healthcare teams to access best practices at the point of care. The company provides a communications link between doctors and nurses around workflows, medical management and treatment management. In today’s environment no one is sitting at a workstation to view the latest lab reports, says co-founder Joseph Mayer. By reducing coordination errors, which often lead to readmissions, it can also help cut costs.
Curater’s claim to uniqueness in the market comes from a vision around a single solution that combines notifications, messaging and expertise in clinical workflow. The cloud service allows users to communicate with other providing entities to coordinate meaningful use requirements and also offers a system to track clinical interventions as they happen at the point of care. While there are many companies offering secure texting and management, no company appears to offer a mobile solution that covers as much ground as Cureatr. The company takes point of care to the next level by creating a single platform for communications and workflow coordination in order to reduce errors, improve clinical outcomes and reduce costs.
Price: Cureatr charges an annual fee based on the size of the enterprise, with full and partial enterprise-wide solutions offered.
Co-founders: Joseph Mayer, MD, is on leave from residency at The Mount Sinai Medical Center. He founded Unwired in 2006. Alex Khomenko was formerly the director of engineering at 23andMe, a personal genetics company, and a principal team architect at PayPal.
Current funding: The pilot was launched in January 2012. Investors include New York Digital Health Accelerator. The company has raised Series A financing with Cardinal Partners and Milestone Venture Partners, and has so far raised $5.7 million.
Q-reviews RateMyHospital
Target market: Hospitals, outpatient clinics, nursing homes and ambulatory surgery centers. The targeted users are those patients discharged from any one of those facilities.
Offering: Real-time patient feedback on behalf of the hospital via a web-based dashboard to which a hospital administrator has access. Once discharged, a text message consisting of a brief, 10-question patient satisfaction survey pops up on the patient’s smartphone. No native application on the phone is required. When a patient is discharged, the IT department accepts a securely encrypted data feed that triggers an alert and a one-way feed from the hospital to the Q-reviews cloud service is sent.
RateMyHospital gives the caregiving institution the ability to search results by age, gender, name of provider and health insurance provider, among other attributes. It also offers analytics by aggregating the quality of care rating from patients. RateMyHospital gives payers an effective way to survey their members about the care that they receive from providers and provider organizations in that payer's network. Eventually the results will also be available to consumers, giving them more visibility into the quality of each payer's network of providers.
Benefit: RateMyHospital claims an 80 percent response rate within 24 hours of delivering the survey to a smartphone, results that offer caregivers a far more accurate window into the patient experience. Q-reviews brings healthcare to the next level by giving voice to both the patient and/or the family caregivers. Patients have an opportunity to voice their feedback in real time to implement changes. This is a rarity in healthcare, although this level of feedback has been mainstream in other industries, such as the travel sector, for some time.
Cost: The company's subscription-based model is based on the size of the institution and the number of discharges.
Founders: Edward Shin, MD, is a physician-entrepreneur with more than 12 years of experience building and scaling healthcare businesses. He was formerly director of content development at Healthology, now a part of iVillage and NBC Universal. Leonard Achan, Jr, RN, MA, ANP, is currently chief communications officer of the Mount Sinai Hospital and The Icahn School of Medicine at Mount Sinai in NYC. Mark Gerson is the co-founder and chairman of the Gerson Lehrman Group.
Current funding: Officially incorporated in October 2012, with its first customer in July 2013. Completed angel round of funding in August 2013.
Ephraim Schwartz is a freelance writer based in Burlington, Vt. Schwartz is a recognized mobile expert and columnist, having spent 15 years as Editor-at-Large for InfoWorld, half of those cvoering the mobile space. Prior to that he was Editor-in-Chief of Laptop Magazine.
