Vidyo
Vidyo

Cool Vendors in Healthcare Providers, 2015

This year's Cool Vendors for healthcare providers showcases vendors that offer solutions to some of healthcare's biggest challenges. We spotlight vendors tackling revenue cycle, clinical surveillance, clinical analytics, nursing and patient engagement with real-time and cloud-based solutions.

Key Findings
  • Globally, healthcare is facing extreme transformation. Strategies to lower cost, increase quality and keep populations healthy dominate agendas and drive IT investments.
  • It is an era marked by the rapid introduction of new applications and technologies addressing the persistent challenges facing providers, such as optimizing the revenue cycle, managing unprecedented volumes of data, and connecting patients and providers across an expanded continuum of care.
  • The market is increasingly being driven by consumer/patient expectations, which can be seen by an uptick in vendors entering this hot, yet blurry, space. We highlight a few in this report.
  • Cool Vendors remind CIOs and the market that there is ample opportunity and a healthy need for solutions beyond those provided by the megasuite vendors.
Recommendations

CIOs, CMIOs and IT leaders:

  • Look at solutions like QPID to improve patient outcomes and increase clinical satisfaction.
  • Partner with CFOs, revenue cycle VPs, and health information management (HIM) professionals to look at tools like Recondo to improve the entire efficiency and effectiveness of the revenue cycle.
  • Pay attention to products like Sphere3 when developing the patient-facing IT strategy – it focuses on nursing engagement as a critical cog in the delivery of effective and efficient patient care and patient satisfaction; as well as Telesofia, which reflects a growing market of vendors providing patient educational content to where it is needed in a timely manner.
  • Look to VigiLanz as a good example of how an innovative and practical solution to often-urgent and serious medical, healthcare and public health needs will require a very different management paradigm around the electronic instantiation of policies and actions.
Analysis

This research does not constitute an exhaustive list of vendors in any given technology area, but rather is designed to highlight interesting, new and innovative vendors, products and services. Gartner disclaims all warranties, express or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

What You Need to Know

Healthcare provider organizations continue to be challenged by the disruption new financial realities have created – increased consumerism and the changing role of the patient; the intensity of competition; and the unprecedented need to be efficient, effective and streamlined across a fluid and dynamic enterprise. The industry is no longer "preparing for" but is in the throes of operating under value-based care models and population health management principles.

This year our Cool Vendors represent vendors that present unique solutions in specific niches under the broad realm of transformation and change. Our vendors cover nursing engagement, clinical surveillance, customized patient videos, revenue cycle optimization and data overload.

QPID Health

Boston, Massachusetts

Analysis by Zafar Chaudry, M.D.

Why Cool: QPID Health ("Queriable Patient Inference Dossier") was launched as a commercial company in late 2012. QPID was spun out of Massachusetts General Hospital and was developed by Massachusetts General Hospital, Partners HealthCare, and Harvard Medical School almost 10 years ago. QPID is a set of Web-based applications (which support both mobile and desktop devices) that are designed to help clinicians and administrators make decisions and take action to improve quality and protect revenue based on up-to-date patient information gathered from multiple data sources. QPID integrates with any electronic health record (EHR), health information exchange (HIE) or data repository, and displays context-sensitive patient data according to a user-expandable, curated library of thousands of clinical concept queries from anywhere in the medical record. QPID software uses a scalable cloud-based architecture (it can also be self-hosted) and leverages concept-based natural language processing (NLP) to extract insights from data stored in EHR systems and other clinical repositories. These insights, reflecting complex clinical logic and guidelines, and delivered at scale, are designed to open up near-real-time clinical surveillance capabilities. Unlike data warehouses, QPID does not require complex database input or mapping to integrate with an existing system, and is designed to deliver a faster and more complete patient story than simple keyword search or strict medical ontology-based systems.

QPID uses data extraction specifications that are written to take advantage of the latest extraction, transformation and loading (ETL) tools, and it can take advantage of existing Web services and interfaces. EHRs provide patient data that can be continually updated and easily shared. But it's often difficult to piece together what's relevant to the immediate issue from the mass of information in the health record. Critical insights that can impact care decisions, quality measures or population health management might be buried in any of hundreds of notes related to visits or inconsistently stored in a variety of data fields in the EHR. Many EHRs today are like the Internet before Google. However, QPID's application portfolio is designed to have the capability to provide:

  • Expedited ability to fulfill quality metrics, registries and reports at scale, leveraging structured and unstructured EHR data
  • Rapid review of patient history in medicine, emergency medicine, cardiology and radiology
  • Highlighting of safety issues for procedure planning in endoscopy, radiology and anesthesia
  • Guidance for the appropriate use of high-volume, high-cost cardiac, vascular and orthopedic procedures
  • Identifying patients for clinical trial research and population health management
  • Tools to expedite appropriate coding and increase claim edit volume by automating search of the patient record for medical necessity indications
  • Tools to increase referrals to palliative care or care management based on demographic, clinical and other factors

QPID's "coolness" arises from having a simple approach that provides the power of Google-type searches to find information in a high volume of data, and the convenience of CliffsNotes to present findings in an easily digested fashion, all of which is cloud-hosted.

Challenges: QPID should be prepared to clearly demonstrate how the price/performance characteristics of its application can deliver measurable benefits to healthcare delivery organizations via pilots and published case studies. There is a risk that EHR vendors may fight to freeze it out of the market. QPID certainly has had a massive amount of clinical input into its product, but commercializing the tool will be a different challenge.

Who Should Care: HDO CIOs, chief medical information officers (CMIOs), chief quality officers (CQOs), CFOs, and senior clinical executives who are responsible for patient care and quality improvement to reduce the economic impact of healthcare, and to truly achieve patient-centered care, should be looking at QPID as a solution to protect revenue via surveillance and reporting, improve patient outcomes and increase clinical satisfaction.

Recondo Technology

Greenwood Village, Colorado

Analysis by Vi Shaffer

Why Cool: Founded in 2007, Recondo Technology is a cloud-based healthcare revenue cycle service that does some pretty cool real-time data trolling for improving the effectiveness and efficiency of the whole revenue cycle process. It also operates as an electronic data interchange (EDI) transactions clearinghouse (eligibility, claims, and so on). Of particular note is its ReconBot technology (U.S. patent awarded in January 2015), that mines payer portals for payer/provider transactions. These portals hold much more information than is conveyed in standard transactions (for example, EDI 271 eligibility, coverage/benefit transaction set). The "bots" can, for instance, determine how much patients have already paid toward an annual insurance deductible, which better clarifies what the patient's total financial obligation for this provider's bill will be for more-effective provider collections, patient financial counseling, and improved patient satisfaction with the administrative/financial aspects of health services. Central to the intellectual property behind the patent is the ReconBots' ability to transform mined payer data into workflow triggers that guide staff through the claims process to adjudication, focusing only on exceptions that require human intervention.

Recondo Technology's CEO, Jay Deady, and Chief Growth Officer, Ralph Keiser, are longtime healthcare industry veterans. They can leverage their personal industry contacts and acumen about finding value in filling gaps in current revenue cycle processes and systems, as well as how to sell into this market. Their early relationship is with Community Health Systems, which they are seeking to turn into a news showcase this year.

Challenges: Recondo's biggest challenge is intruding into an established marketplace of entrenched players. The revenue cycle management field is cluttered with healthcare megasuiters, bolt-on and clearinghouse vendors (such as Passport Health, which holds a large position in eligibility transactions), revenue management portfolio "assemblers" like MedAssets and Craneware, and those that combine IT systems with business process outsourcing models. The relative market positions and leading players in each of these arenas periodically shift; Recondo's top competitor at the front end of the revenue cycle is Passport Health.

Who Should Care: Healthcare provider CIOs, CFOs, revenue cycle VPs, HIM professionals (who bear the brunt of rejected and denied claims work) will be interested in the enhanced information and workflow triggers that Recondo can provide timely to patient scheduling, eligibility and other revenue cycle steps.

Sphere3

Kansas City, Kansas

Analysis by Vi Shaffer

Why Cool: "Engagement" is the hot buzzword that's everywhere in healthcare right now. This company is cool because it focuses on a critical aspect of patient engagement that is often neglected – nursing engagement and its tight connection to patient safety, satisfaction and quality. Another emerging example of the real-time healthcare system, Sphere3's solution, Aperum, offers real-time monitoring and data analysis linking nursing actions and patient engagement. The company uses mobile devices to collect real-time data from a growing number of sources (such as medical devices, nurse calls and patient satisfaction measures) in order to correlate patient data and nurse activities. It offers insights into actual, specific patient need requests and caregiver capacity. Sphere3 dissects this cascade of data associated with requests and responses, time frames, escalations, and adverse events in ways that are meaningful to nurses and nursing management.

Aperum provides a mobile dashboard to drive data to the caregiver, and has three areas of concentration: caregiver workload management, deconstruction of data with root-cause analysis, and a Patient Experience Record. Workload management is linked to the workload associated with various alarms, and notifies architectural alarms and alerts, and provides insights into the variable acuity being generated by a patient. It is focused on driving data to the hands of the caregivers to make a decision at the point of care. For instance, it shows how close an indicator is to a goal, and the dashboard allows users to further drill into greater detail with some very simple interactions – which is where the whole industry has to get to on alarm data. Deconstruction of critical events, such as falls and deterioration, drives awareness on what the specific patient experienced at the time of the incident and supports nursing in the description of what was occurring on the unit.

The Patient Experience Record is designed to complement the EHR, capture patient perception and enable a balanced understanding between the qualitative information the patient is providing (feeling) and the more quantitative perspective of the EHR.

The company recently announced record growth in 2014 and a 60% increase in subscriptions, albeit on a small base.

Challenges: This is a small company, and its biggest challenges are getting an audience with the right leaders, further proving its unique value, and overcoming resistance to adding niche players to the market when so much of HDOs' work lately has been consolidating on fewer vendors. Sphere3 complements/competes with numerous larger nursing-focused vendors or nurse call systems, staff scheduling/acuity systems, real-time health system applications and emerging patient throughput and capacity management systems, and, of course, EHRs. It has a unique value niche, but it's tough to be in the game when all those other ideas and entrenched vendors are elbowing to dominate investment priorities. Thus, partnerships with other vendors would seem to offer an attractive path to more, faster deals.

Who Should Care: COOs, chief nursing officers, VPs of quality, patient experience leaders, chief nursing information officers (CNIOs) and chief medical information officers (CMIOs) should pay attention because nursing is the critical cog in the delivery of effective and efficient patient care and patient satisfaction. CIOs should care because this is a good example of how to collaborate and not neglect the big nursing workforce when so much of their and CMIOs' recent attention has been focused on physician EHR adoption, the advent of patient-centered medical homes, and change management challenges.

Telesofia Medical

Tel Aviv, Israel

Analysis by Barry Runyon

Why Cool: Telesofia's stated value proposition is to help healthcare providers explain complex medical information to their patients using automatically generated, personalized videos that can be viewed on any Internet-connected device. Videos are personalized for each patient based on their individual healthcare information and particular demographics.

Medical instructions and content can be confusing, and recent surveys indicate that a large percentage of patients, for various reasons, do not understand them.1 Discharge instructions can be hard to follow and many patients have learning deficits that are barriers to understanding. Informed consent forms can be similarly daunting.2 This comes at a significant cost to the healthcare industry annually – related to poor treatment adherence, readmissions, treatment and procedure cancellations, and litigation based on inadequate informed consent.

Telesofia's platform allows healthcare providers, payers and pharmacists to automatically generate personalized educational videos for patients, with 30-day follow-up, that clarify medical information and increase patient understanding and compliance. The videos are tailored to the patient and are easy to understand, optimized using industry health literacy guidelines and sent to patients via text or email or embedded in patient portals. They can be branded for the healthcare provider and integrated into existing workflows and platforms through Telesofia's application-programming interfaces.

Telesofia functionality and content is delivered via a cloud-based SaaS platform. Its service also includes an extensive medication library product that offers healthcare providers fully branded, personalized videos that explain prescriptions through a service called myRx TV. Telesofia also offers a consumer version of this service, a YouTube for medications if you will, with an ad-supported business model and "freemium" licensing.

Challenges: Telesofia considers itself a "patient engagement" platform. The categorization in and of itself presents a challenge – as there is considerable provider confusion about what patient engagement actually is. At present, Telesofia does not have any direct competition – other vendors that could provide personalized video-based health information on the fly. Competition will come from traditional educational content vendors such as Krames and Emmi Solutions as they adjust to the market. While Krames and others customize their content to the patient condition, they do not autogenerate it and push it to consumer mobile devices as Telesofia does. Telesofia could also face pressure from secure texting and clinical communications and collaboration vendors, looking to leverage their technology platforms and reinvent themselves and transition into new markets. Telesofia views health information content providers as potential distribution channels, rather than competition, because of their lack of patient personalization. On the technology side, dynamic video companies such as Wibbitz, SundaySky and Eyeview could verticalize their offerings, but it is unlikely given the complexity and cost.

Who Should Care: There are obvious benefits and efficiencies of a service that provides the patient with personalized medical information that is meaningful and easy to consume. Telesofia should be of interest to HDO CIOs, CMIOs, house counsels, and compliance and chief experience officers – those responsible for compliance, patient safety, patient experience and engagement – or anyone else within the HDO who has responsibility for providing patient educational content to where it is needed in a timely manner. Telesofia services can be used to enhance the informed consent and discharge processes and provide content for interactive patient care systems, patient portals, and pharmacy and telemedicine systems.

VigiLanz

Minneapolis, MN

Analysis by Vi Shaffer

Why Cool: VigiLanz is a timely example of the expanding array of companies proposing real-time enterprise data surveillance and "clinical intelligence resource" solutions for healthcare providers. Its main areas of focus include real-time infection control, antimicrobial stewardship, adverse drug events, quality surveillance analytics, predictive modeling and other clinical intelligence. Though founded back in 2001, with early growth as a useful tool for adverse drug event prevention, the value and visibility of its approach is much more intriguing now, and we assess VigiLanz as "newly cool," partly because of how it can leverage any EHR data, and partly because of the urgent nature of the surveillance, data integration and action alerting and analytics it can perform. The vendor's Dynamic Monitoring Suite is a SaaS offering that focuses on real-time surveillance and assembly of a wide variety of data sources. The solution includes an advanced rule engine for rapid, exception-based alerting and dissemination of "what to do" information to various actors within the healthcare process. The suite provides both "baked" modules/content for certain common uses and use of the platform as a toolkit that clients can build to meet their own urgent or unique scenarios. The ability to normalize and use a wide variety of data sources (including nonclinical data for a particular scenario that would not be part of the EHR) is one thing that distinguishes VigiLanz's model from the EHR architecture. VigiLanz also enables fast development of responses, exception-based and temporally rendered alerts and metadata, and so on, to get information back out to any defined community (including beyond clinicians and beyond HDO staff alone). Ongoing managed clinical services augment frontline clinical teams for speed and customization of rules, and so on, thus positioning the company to provide monitoring services for a region, state or country with a mature-enough infrastructure.

VigiLanz's story has become more compelling when you combine EHR data access with the many infectious disease outbreaks that have touched healthcare providers and scared citizenries. Its marketing can legitimately and with dignity capitalize time and again on headlines such as the Ebola virus, Middle East Respiratory Syndrome (MERS) and the recent unexpected measles outbreak in California. The company was able to rapidly configure its VigiLanz Dynamic Infection Control Monitor for all clinical users to query data based on admission diagnosis and radiology keywords to enhance MERS surveillance. With Ebola, which does not have a rapid confirming test, the company enabled clinician review of patient's travel history plus a multitude of other symptoms to attempt to ascertain the need for closer scrutiny and add real-time alerts to take protective measures, for hospital infection prevention teams, and report cases to public health departments sooner. It quickly configured real-time alerts with clients for Enterovirus D68. In February 2015, the vendor alerted hospitals on how to prepare for the latest "superbug," on endoscopes for which the company had pushed out real-time rules several months ago. VigiLanz perfectly illustrates the advent of Gartner's real-time health system (RTHS) situational awareness paradigm, and also how new platforms in an emerging health information technology category Gartner calls real-time Enterprise Intelligence Resources (EIR) built with innovative interoperable abstract data architectures and knowledge players are staking a complementary claim to the EHR and its megasuite vendors.

Challenges: As with most innovative healthcare vendors, VigiLanz confronts both the busyness and backlog of information and technology imperatives and limited budgets of most HDOs. It also encounters the market-freezing tactics of megasuite vendors and their loyal clients (especially CIOs), who just want to align their IT plan with core vendors' roadmaps and see everything else as messy distractions. VigiLanz's delivery of a single-service platform and suite with many uses gives it a leg up over single-point solution offerings, and can make them more palatable to CIOs ("At least I don't have to add 12 different new niche vendors, just one."). The year 2015 has to be a year of further validation and promotion of the solution's distinctive criticality and value for the medical and quality audience. VigiLanz also will need to do some targeted messaging to CIOs and CMIOs to show that knowledge/action solutions are an increasingly necessary complement to the core.

Who Should Care: Chief medical officers, VPs of quality, healthcare provider CMIOs, infectious disease physicians and government ministry/public health officials (including the emerging role of public health CMIO) will be interested in VigiLanz. It is a good example of how a new innovative and practical solution to often-urgent and serious medical, healthcare and public health needs will require a very different management paradigm around the electronic instantiation of policies and actions. For CIOs, this is a good example of how the notion of "enterprise architecture" must be redefined to include knowledge services in the post-EHR digital health era.

Where Are They Now?
Phytel

Dallas, Texas

Analysis by Laura Craft and Vi Shaffer

Profiled in "Cool Vendors in Healthcare Providers, 2013"

Since our initial profile of Phytel two years ago, the company has propelled itself forward in the population health management space, steadily increasing its client base by focusing on large-scale, sophisticated enterprises that need to complement existing data warehouse and analytic environments with tools to cohort, engage and manage patients.

Why Cool Then: We identified Phytel as cool because it was a provider-led population health management firm before provider-led population health was cool. Phytel began offering compliance/quality measurement programs to providers in 2007, and quickly added disease management expertise by appointing its then-chairman, Steve Schelhammer, to be CEO. At a time when most care management and population health programs were being operated by payers, Phytel focused its sales efforts on two groups: integrated delivery networks/health systems, and large multispecialty group practices that were embracing patient-centered medical homes and taking on shared-risk contracts.

Where Are They Now: Phytel has successfully moved from the midsize physician group market to large health systems over the past three years. With a national footprint, its client base includes more than 150 customers, seven of the largest eight for-profit health systems, and a patient registry of more than 40 million patients. Phytel has effectively distinguished itself, targeting clinical leadership that understand the importance of providing a set of tools to the primary care channel to manage under patient-centered medical home (PCMH) models. Its proven ability to scale (cost-effectively) has made it an attractive solution for large provider networks. The platform uses a variety of capabilities to communicate with patients (audio, text and so on) and the recent additional of the Patient Engage module has rounded out the platform to include care management, planning and documentation functionality. Phytel has been endorsed by and has reselling partnerships with Premier and VHA.

Who Should Care: CIOs, CMIOs, CEOs and senior clinical executives of large-scale enterprise who need to augment existing analytic capabilities with a population health management platform that will support patient-centered care, quality improvements and efficiency.

Vidyo

Hackensack, New Jersey

Analysis by Barry Runyon, Zafar Chaudry, M.D.

Profiled in "Cool Vendors in Healthcare Providers, 2013"

Since our initial profile of Vidyo two years ago, the vendor has grown steadily, proven the validity of its value proposition, attracted marquee private and public healthcare provider clients, and successfully built upon the features and functionality of its original platform with new mobile, integration and workflow capabilities.

Why Cool Then: We originally deemed Vidyo as cool in 2013 because it changed the basic economics of videoconferencing and telepresence. Innovative HDOs required a better financial justification for telemedicine investments to improve the efficiency of clinician-to-clinician collaborations and clinician-to-patient interactions. The VidyoWorks platform allowed the use of a desktop computer, laptop, tablet or smartphone to start, join and schedule a video conference. Vidyo had combined a Web-based user interface, encryption, intelligent routing and scalable video compression to enable simplified access to low latency, high-definition, multipoint videoconferencing over existing Internet, 3G/4G, Wi-Fi and WiMAX networks. It eliminated some of the access, performance and cost barriers associated with traditional videoconferencing that more often required expensive endpoint devices, specialized facilities and support talent, multipoint control unit equipment, and dedicated quality-of-service networks provided by the major telecommunications carriers. In 2013, Vidyo's Healthcare solution included a client application, end-to-end security, and a video collaboration platform with an application programming interface and software development kit to video-enable healthcare applications, kiosks, hardware devices and smart rooms.

Where Are They Now: Vidyo has demonstrated that the price/performance characteristics of its platform and APIs compare favorably to established videoconferencing and telepresence vendors selling into the healthcare provider space. Vidyo has been able to demonstrate that it can be successfully deployed over existing networks and client devices commonly found within HDOs.

Vidyo has integrated its products with the Epic, Cerner and EMIS electronic health record systems. It is partnering with Samsung to offer an integrated telemedicine solution, to bring video collaboration to its devices – which features the industry's first QHD video conference (2560 x 1440 pixels) and integrates with Samsung's Flow cross-content sharing and Knox mobile security systems. Vidyo is working with Philips as part of its eICU offering and is currently deployed to more than 1,000 beds. Vidyo was also selected by Philips India for a more widespread implementation. Vidyo also integrates with GetWellNetwork's Interactive Patient Care solution.

Vidyo is well-positioned to satisfy growing demand for solutions in the areas of interactive patient care and engagement, telemedicine (video visits, remote patient monitoring, virtual consults, telestroke) and clinical communications, mentoring, training and collaboration. Vidyo is currently working with many of the top U.S. integrated delivery networks, including Kaiser Permanente, Mayo Clinic, Partners HealthCare, UPMC, Children's Hospital Colorado, Miami Children's Hospital and Mercy.

Vidyo has seen traction in the direct-to-patient delivery segment as well, working with providers such as American Well, whose service into the home is being resold through payers such as Anthem Blue Cross Blue Shield and UnitedHealthcare. HealthSpot leverages Vidyo's real-time, face-to-face communications technology to deliver healthcare into retail locations such as Rite Aid pharmacies.

Vidyo has continued to refine its healthcare provider messaging to better resonate with the clinical concerns of the CNO and CMIO and the cost, technology and deployment considerations of the CIO and CTO.

Who Should Care: CIOs and CMIOs who seek to enhance patient/provider communications, improve care coordination, video-enable their clinical workflows, foster more convenient care for their patients, reduce communication breakdowns across care venues and promote the use of telemedicine should look closely whenever possible at Vidyo's lightweight but robust videoconferencing platform that leverages existing networks and endpoint equipment.

Evidence

1 Engel, K.G., and others, "Patient Understanding of Emergency Department Discharge Instructions: Where Are Knowledge Deficits Greatest?" PubMed.
2 Fleisher, L., and others, "A Practical Guide to Informed Consent," Temple Health.

Source: Gartner Research Note G00275673, Laura Craft, Vi Shaffer, Barry Runyon, Zafar Chaudry, 03 April 2015