Cover: Colorado’s health innovation ecosystem
Forward-thinking individuals coming together to improve health care
by Jeffrey Nathanson, CEO, Prime Health
Editor’s note: The practice of medicine is changing. Forward-thinking Colorado companies are using innovation to drive down costs, improve quality, and improve the care experience for both patients and practices. These leaders have created an ecosystem of Colorado entrepreneurs and investors to accelerate and foster good ideas that will flex the health care system and influence positive change. In many examples throughout this issue, improving health care starts with an individual, takes root through partnerships, and spreads through strategic action and collaboration.
The Colorado Medical Society and American Medical Association are playing our part, too, working on behalf of and in collaboration with physicians to lead change and move health care forward in the exam room, boardroom and the public policy realm. Share your feedback at email@example.com.
The U.S. health care system is broken. We have higher costs and worse outcomes than most of the world’s industrialized nations. In 2016, health care spending exceeded $3.5 trillion, accounting for 17.8 percent of our GDP and surpassing $10,000 per person. Though cost increases slowed under the Affordable Care Act (ACA), coming in at 5.8 percent in 2016 and down from the pre-recession rate of 8 percent, health care spending is still growing at an unsustainable pace. If allowed to continue, the consequences for our country could be grave.
In 2012, the Institute of Medicine at the National Academy of Sciences recommended the adoption of new efficiency measures and information technology, claiming that a combination of the two could reduce health care spending by up to a third. As a means of assessing the new ideas, processes and technologies that promised to reduce spending, many looked to the Triple Aim, a concept that stated innovations should increase patient satisfaction, improve outcomes and cut costs. It became a rally cry for innovators, and the first ray of hope for those who feared spending might never be brought under control.
Yet health care as an industry has traditionally been slow to adopt innovation, with some experts estimating a 17-year lag before new technologies make it to clinical practice. Adding to this delay, one of the first large-scale attempts to transform health care through digital technology, the electronic health record (EHR), was a famous disappointment. Instead of improving the delivery of care – as it was intended to do – the EHR significantly increased the administrative burden on physicians, while significantly decreasing their levels of professional satisfaction. With the EHR, physicians frequently found themselves trapped behind computer screens, clicking and typing away, instead of interacting with patients.
Needless to say, the early failings of the EHR left providers of all kinds wary of innovation, precisely at a time when we could least afford it.
To offset the widespread physician burnout caused by clunky EHRs, innovators amended the Triple Aim. Alongside reduced costs, improved outcomes and patient satisfaction, they added provider satisfaction. This represented a seminal moment in health innovation. New ideas, processes, and technologies would, from this point forward, be designed to fit into the provider workflow in a seamless manner. Those that did not would be deemed failures.
But seamless innovation required insight into the provider’s experience, a refined sense of both the clinical setting and day-to-day operations within it, which was something innovators often lacked. Suddenly, the prospect of launching the next great health care company and disrupting the industry overnight became a distant prospect, and health-tech innovators of all kinds experienced a dawning realization. To reimagine our industry, they would have to work alongside the members of the existing health care system, closely collaborating with the executives, administrators and clinicians whose jobs they hoped to transform.
Across the country – and, perhaps, even the world – the profound shift in health innovation brought about by the newly codified Quadruple Aim accelerated the development of regional communities of physicians, investors, technologists, academics and policymakers who were already working together to reimagine health care. Known as health innovation ecosystems, these communities of innovators frequently collaborated to ensure that new ideas, technologies and processes were properly researched, funded and vetted. More often than not, they focused on entrepreneur-driven innovations, since entrepreneurs, more than anyone else, seemed to be the professionals most qualified to bring innovations to market.
Colorado’s health innovation ecosystem
In Colorado, our regional health innovation ecosystem has a name: Prime Health. It began in 2012 as a meet-up, a monthly gathering of health innovators from around Colorado, held in co-working spaces and tech incubators in Denver, Boulder and Fort Collins. Founded by Denver South Economic Development, it quickly attracted major sponsors like Kaiser Permanente, Aetna, iTriage, and Ernst and Young. When it became a standalone nonprofit in 2015, it received funding from Rose Community Foundation and the Colorado Health Foundation.
Prime Health grew quickly for two reasons. The first was the people. Our members include more than 2,500 health care administrators, physicians, entrepreneurs, investors, technologists, policymakers and academics. These are highly educated, highly intelligent, highly experienced professionals who are intent on improving the delivery of care through innovation. To ignore them would be a mistake, and the major organizations that have partnered with us recognize this.
The second reason for Prime Health’s rapid launch was the structure of our ecosystem. To further encourage collaborations between the members of our community, Prime Health regularly convenes them at monthly meet-ups in cities along the Front Range. To ensure that new products and services meet the Quadruple Aim, each year we enlist dozens of health care experts to vet startups in a three-month-long process known as Prime Health Qualify. The half-dozen or so companies identified by this process as ready for adoption within the health care system are then given the chance to pitch their intentions at the Prime Health Challenge, a major public event where payers and providers are able to select the innovations they would like to pilot.
In a few short years, Prime Health has qualified dozens of new products and services. We’ve helped more than 30 entrepreneurs secure pilots with major health care organizations. Those startups that have participated in the challenge have collectively gone on to raise more than $34 million. And we’re just getting started.
Joining the movement
Innovation can be messy, especially when it’s driven by entrepreneurs. Yet we’ve found that the messiness of company formation, expansion and even collapse all serve to enhance the dynamism, robustness and maturity of our ecosystem. Startups grow, attracting employees. Employees leave, joining other companies or founding startups of their own. Just in the past few years, Colorado-based digital health companies like Trizetto, Healthgrades and iTriage have inspired the development of a number of health-tech startups, including DispatchHealth, ListenMD and MDValuate. Importantly, although our ecosystem is constantly changing, the ideas, processes and technologies being developed within it are consistently becoming more sophisticated, more refined and more targeted.
Prime Health wants to grow Colorado’s health innovation ecosystem. Fortunately, we have several advantages working in our favor. Colorado has a booming startup community. It has the nation’s second most educated population and its top labor supply. Forbes recently named it the best place to do business in the country, and Business Insider called it the fastest growing state economy. All of these factors work together to ensure that a steady stream of talented innovators flows into our ecosystem – innovators who are willing to develop technology after technology, build startup after startup, and commercialize innovation after innovation in their quest to improve the affordability, efficiency and accessibility of the U.S. health care system.
But the most important asset we have is our community. Our ecosystem is the powerhouse of innovation that it is today because of the participation of health care organizations like Kaiser Permanente, Aetna and CU Anschutz; innovation economy institutions like Catalyst HTI, Innosphere and Innovation Pavilion; health-tech startups like RxAssurance, Prima-Temp and Radish Systems; and, most importantly, individuals like you. If you’re not currently a member, please come to our monthly meet-ups. Join our online collaborative platform, Prime Health Collaborate. Attend our quarterly summits and annual challenges. Together, we’ll make sure that health innovations reduce costs, improve outcomes, and increase satisfaction for patients and providers alike.
Three Prime Health portfolio companies
Examples of innovators, in their own words
Prima-Temp | www.prima-temp.com
Prima-Temp has revolutionized wireless, continuous temperature sensing. Our devices and software precisely and continuously measure core body temperature. Our first product, OvuRing, passively and continuously tracks a woman’s core body temperature, detecting the subtle changes that occur before ovulation, then sends an alert to her phone when she’s most fertile.
Radish Systems | www.RadishSystems.com
Radish Systems improves how health care organizations communicate with phone callers by adding visual information – care plans, photos, directories, test results – to voice/text calls. ChoiceView®, the award winning, HIPAA-compliant, multi-channel platform bridges telephone and Internet worlds to support many voice and data use cases. As is often said, “One picture is worth a thousand words.” Radish’s patented mobile enterprise software platform allows health care firms (providers, payers, etc.) to seamlessly exchange visuals during voice/text calls.
Health care firms struggle to cost-effectively communicate to improve their callers’ care and health. Callers increasingly use mobile phones and the Internet; more than 85 percent of adults in the United States already own smart devices. Health-related calls often involve complex information with potential consequences for misunderstandings or non-compliance. Callers are upset with long waits and frustrated by automated systems. Callers are aging, sometimes hard of hearing, and using many different languages. If callers don’t understand or receive clear answers to critical questions, the results could be problematic.
Undesirable results include lack of adherence to medications, hospital readmissions, more office and ER visits, or worse. ChoiceView allows health care firms to talk/chat with callers (patients, caregivers, other HC providers) using any phone while instantly sharing visual content via smartphones or browsers (PCs, Macs, tablets). ChoiceView delivers improved population health, improved patient experience/care, and reduced per-capita costs.
RxAssurance | www.rxassurance.com
Our platform, which addresses the American Opioid Epidemic and other chronic disease states, just launched last fall and is receiving great traction. OpiSafe represents a single prescriber dashboard with four verified data streams for opioid prescribers (ePROs, PDMP, EHR, & Lab results) – a huge innovation for a sector of health care that is in crisis. Our lab program allows laboratories to upload lab results into our OpiSafe platform, thus providing medical professionals access to all relevant opiate-prescribing patient data in one place. OpiSafe is a very sophisticated, value-add delivery portal for the labs that they pay for on a per-report basis.
Our sales pipeline includes several large pain clinics, large health care organizations, several strategic specialty lab partners that are using OpiSafe as their provider portal, insurance companies and PhRMA companies that are considering using our platform to complement their product offerings.
Posted in: Colorado Medicine | Cover Story | Practice Evolution | Practice Redesign | Health Information Technology