Health IT

Former Archimedes staffers develop a risk management tool of their own for the ACO era

With Rock Health’s Demo Day less than a week away, the digital health startups in the accelerator’s current class are probably heads-down this week, polishing their pitches. There are several promising companies from this class that we’ve already highlighted: product report card app LabDoor, smart toothbrush maker Beam Technologies, fitness teletraining company Wello and medication […]

With Rock Health’s Demo Day less than a week away, the digital health startups in the accelerator’s current class are probably heads-down this week, polishing their pitches.

There are several promising companies from this class that we’ve already highlighted: product report card app LabDoor, smart toothbrush maker Beam Technologies, fitness teletraining company Wello and medication interaction app Mango Health.

But since we won’t be able to attend this Demo Day, there’s one more I wanted to point out before the big day. It’s focused on the all-important theme of efficiency in healthcare, both at the clinical and administrative levels.

Clinicast offers what co-founder and CEO Jack Challis called a FICO score for patients. It’s a data analytics tool that helps case managers match patients with the most appropriate care, based on their risk profile.

Challis is a physicist by training but after finishing his degree landed a job at Archimedes, the Kaiser Permanente spinoff that uses mathematical models to help in decision-making. “It was a very good place to learn about how to use data,” he said. “I got the bug to learn something new. How can you help providers that are taking on more risk?”

Under accountable care organizations, providers are becoming more financially at-risk for patient costs, he reasoned. So before, providers could get away with not using risk management tools, but things are changing.

In 2011, he and colleague Krates Ng officially formed CliniCast and developed an offering that’s designed to help case managers identify patients who are most at risk for costly health events or hospitalizations, and who are most likely to benefit from specific interventions. The product, ARTO, integrates structured data from labs, pharmacies and claims, and unstructured data from discharge summaries and physician reports.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

“It’s about helping case managers be smarter about who they reach out to and be more effective in helping patients manage their disease,” Challis said.

It’s still a very early-stage operation. Discussions for the company’s first pilot are underway now, he said, and the next big milestone is to get that pilot running. “We need to show that this tool is going to identify high-risk patient who use a lot of resources and have adverse outcomes, and match them to interventions that are going to reduce that risk,” he said.

Eventually, there’s the possibility of giving providers even more tools to build care plans around patients based on their risk profile.

CliniCast counts Verisk Health, OptumInsight, TIBCO and Health Care Dataworks among its competitors, but cites its differentiators as the broader data sources and more powerful risk models. It’s working in a data analytics market that’s expected to grow at a rate of nearly 24 percent each of the next five years.