When you hear about companies developing their technology for eight years, it’s usually a medical device or biotech business gradually raising funds to take them through each phase of development, peppered with meetings with the FDA, until the regulator greenlights the drug or device. But for Ruben Amarasingham, founder and CEO of Pieces Tech, his path took a different direction. His research and development of clinical decision support at Parkland Health and Hospital System led to the formation of a health IT nonprofit that launched a predictive analytics startup this week.
“When I started this work, the end outcome was not necessarily this day,” Amarasingham said. Trained in bioinformatics, he said in a phone interview that he was interested in using clinical data to predict real-time clinical events and trigger alerts for care teams to intervene. He received permission to test this at Parkland Health and Hospital System, a safety net hospital in Dallas.
“It started as a research effort. The first step was understanding whether we could predict events at all, and the second step was can we predict events in real time? And how can we insert this into clinical practice and integrate the data with electronic medical records.”
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It led to the creation of nonprofit Parkland Center for Clinical Innovation in 2012, marking a shift from a department within the hospital to a separate entity. Its research has been supported by $45 million in grants to advance model building and testing variations in real world settings around different aspects of Amarasingham’s work. PCCI still does clinical studies and testing of how these technologies can be used in inpatient and outpatient settings.
“How do you construct clinical workflows and understand when something is not working? How do you avoid creating stress rather than removing stress? That is something we thought a lot about and invested a lot of resources into.”
Given that he embarked on this research 10 years ago and has since built a team of clinicians and research scientists, I asked him to share some observations of what has changed about how hospitals view companies like his.
“Most health systems recognize that there is a lot of hyperbole regarding what software can do…The sheer amount of data tech and knowledge that doctors and health systems and nurses have to deal with is mind-boggling,” he said. “To the extent that we can simplify that, that is where we can improve outcomes and reduce cost.”
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He added that he sees an increased willingness among some electronic medical record providers to collaborate with startups.
Although the clinical component of its PIECES software is critical, Amarasingham said it also developed a case management system, Pieces Iris, as a way to connect community service providers such as homeless shelters, job placement organizations, senior service organizations, food banks, and housing services. These are the kind of social service agencies that provide wrap around services to hospitals, Amarasingham said. It’s also talking with behavioral health and substance abuse organizations.
“A lot of these community organizations either have no client management system or no client record system or it is a legacy system.” He noted that in Dallas alone, there are 9,000 community service organizations.
It charges them $200 per month as a Software as a Service fee to manage client needs. That seems like a big chunk of change for groups serving the poor, but Amarasingham disagreed. In some cases health systems will step in and cover these costs, he said.
Baylor plans to go live with its PIECES software soon and it is already being used by Washington Health System in Fremont, California and at Texas Health Resources.
Photo: Flickr user jurvetson
