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"For the last 30+ years, the company has sat down with physician experts to ask, say, ‘if you’re seeing a patient with bacterial pneumonia, what would you expect to see? What would you ask, what historical facts would you like to know?'"
This week in the C-Suite Q&A, Healthcare Analytics News spoke with Jay Anders, MD, a former internist who is now Chief Medical Officer with Medicomp Systems. Medicomp works to make the curation of electronic health records simpler for physicians through their software, and is also the primary data source for the Department of Defense.
A former physician with experience in tech, Anders approaches the industry with a detailed perspective and an inspiring confidence. This is the first of two parts of our conversation.
Let’s start off with a general introduction to yourself and the company, if we could.
I’m an internist by training, and I practiced in a very large, multi-specialty group practice for the first 20 years of my professional life. I got into the administrative part of that, which sort of led me into electronic healthcare because we in our clinic decided to install an EMR back in 2001, and that’s when EMRs were very, very green. I have a computer science background, a minor in it, so it was kind of an interesting fit, and I was President of that group for the last 7 years of my practice lifetime.
I got an offer to go to a software company named Integrate and became their Chief Medical Officer, that company was purchased by another company called Med3000, became their Chief Medical Officer, and then that was purchased by McKesson, and I became their Chief Medical Officer of Business Performance Services. Two and half years ago, almost three, it came time I was ready to make a change, and I became Chief Medical Officer of Medicomp Systems.
If you could sum up your mission over there in just a few sentences, what would it be?
Medicomp’s main mission is to facilitate physicians in the use of electronic healthcare and electronic healthcare data. We are a middleware company, and we have a documentation tool called Quippe which helps physicians intuitively build notes without using a whole host of templates, as well as a product called Clinical Lens, which takes data from any source and stripes it and enters it by clinical entity. Say you’ve got a health record of a 55 year old man who has diabetes, and you want to see everything in that health record pertinent to diabetes: we can take all that data in and give you a “diabetes view” of that patient’s data, or any condition, or screen for any condition. So it’s a clinical engine that sits under everything we do and allows us to create very usable documentation tools as well as take data to make it very usable at the point of care.
Can you tell us a little bit about those underlying mechanics?
We have about 400,000 clinical concepts that are mapped to about 10.7 million mappings, all interconnected together. What that means is having given any condition, we have all the connections for the history, the physical exam, diagnostic assistance was well as temps and therapies for any clinical condition on-demand. It’s not a static system, it’s a sinking system with algorithms underneath that allow us to connect all those dots in any fashion we want to connect.
It’s a curated system. For the last 30+ years, the company has sat down with physician experts to ask, say, ‘if you’re seeing a patient with bacterial pneumonia, what would you expect to see? What would you ask, what historical facts would you like to know, what physical exams would you do? What are the specific treatments?’ And over those last 30+ years, we have curated that content, and there’s an algorithm that sits underneath our Quippe clinical engine that derives that. It’s a proprietary algorithm, so it really isn’t a machine learning type of thing, but it’s curated content using medical knowledge and experience.
Does the system cull from others naturally, or is there inputting involved?
We are system agnostic, and the way it’s designed it can sit on top of or inside any existing EMR regardless of their structure. We pull information out of the existing systems, allow our clinical filtering to occur, allow clinical documentation and quality measures to occur, and then it’s fed back into the existing system.
We have about 120,000 users, we’re in a lot of EMRs. Epic is one, Athena uses our materials, Pulse, Meridian. We’re in that middleware section of an EMR where they want documentation terminology, clinical filtering, whatever that happens to be.
Also, we’re the primary data source for the Department of Defense.
And how did that come about?
Well they were looking for a documentation tool to put inside their existing system and came and looked at us, it had to be 10 years ago, and said they really like our system and they wanted it. They asked if we wanted to work with them, we said ‘sure’ and they put it in and we enhanced it to meet their needs.
Is that relationship going to remain with DoD’s move to Cerner?
That’s kind of yet to be determined, they have about 10+ years of clinical data that’s in Quippe format, with terms, so we haven’t yet determined how they want to move ahead with that. Cerner has looked at us in the past, but it’s the Department of Defense and the government so it’s really hard to determine which direction they’re going to go. And it’s not all Cerner’s decision, nor is it all the Department of Defense’s decision, there’s a lot of moving parts. They’ve just started the implementation of Cerner, so that’s yet to be determined going forward.
And who knows if that will be quick…
That’ll be pretty interesting going forward. Is there anything that you’ve achieved that felt like a coup?
One of our biggest coups was that children’s hospital, because the other company had our nomenclature within their system but didn’t do anything with it, and the organization went to them and said they wanted to do this and the other company did a lot of maneuvering to keep us from being installed there: ‘We’ll provide this, don’t worry about it.’ The hospital didn’t believe them, but they went on down the road with that promise, that someday they would have it. That was a real coup, that was one of the places we went into that was physician-run, and the physicians saw the value, they installed it and they’re happy with it, productivity went up and costs went down.
So that takes us into costs, and what the technology can do to those, care to dive in?
We’ve seen almost across-the-board productivity increases when physicians start using our program and nomenclature in the way we provide it. We’ve developed this year, and we’ve just started to roll out, all of the MACRA measures that physicians and physician organizations have to be compliant with, we now have 230-some-plus ambulatory measures built within the physicians’ workflow. They can really just practice medicine and the quality measure takes care of itself, as opposed to the other approach where it’s a separate system and they’ve got to fill out all kinds of new forms and new things to comply with quality measures. We’ve incorporated that within the workflow. That’s a tremendous increase in productivity and physician satisfaction.
It’s the fact that when the system is being used the way we’ve designed it, these measures just fall out of it, it’s not as if you have to do anything else. We’re mapped to our standard nomenclature, so whatever that reporting service needs to report to CMS, it’s already in our system and it’s automatic for the doctor. That’s our mantra: we want to make things as easy as possible for the physician and assist them in the practice of medicine.