Diameter Health, MedAware and Trycycle Lead the Nation’s Healthcare Data Revolution from the Greater New Haven Hub
By Jun Chen, Samuel Kitara
Manually sorting through the mountains of disaggregated, duplicated and inconsistent patient datasets to find information necessary to inform a clinical decision has become accepted as a necessary evil in today’s healthcare system. The associated costs of this data circus and resulting provider burnout have also been accepted as normal reality — it comes with the territory.
But it doesn’t have to be this way. Enter Diameter Health, a Greater New Haven company that has so far raised the largest syndicate among its digital health peers. Armed with an $18M Series B round in 2020, led by investors such as Optum, LRV Health, and Connecticut Innovations, Diameter Health is up for the challenge.
The company has developed tools for cleaning and consolidating the complex web of electronic health data. To understand the scale of this challenge, we’ll provide a simple crash course.
Medical records are tools that doctors, nurse practitioners, physician assistants and nurses use to take notes of your appointments, medication, care pathways, etc. Electronic medical records are notes taken on the computer (these did not gain popularity until the Bush Administration in 2004). This data comes in huge volumes: in-patient health information, appointments, vitals, and lab test results in electronic health record portals such as MyChart. More information also comes from patients who use medical devices — such inhaler usage data from specialized Chronic obstructive pulmonary disease (COPD) devices. That’s not all.
Your payments, reimbursements, and claims data live within the payors’ premise. Lifestyle devices such as Fitbit, phones, and watches also document and store information such as heart rate, screen time, sleep-time/quality information, adding to the variety of data types. Did you know that there are 91 ways to document “heart failure” in healthcare? It gets more complicated if a person has multiple conditions: in Medicare, 40%+ of patients have 7+ chronic illnesses, and they have to visit 11+ care providers across 5 different settings every year. What we’ve described is just a tip of the iceberg.
Now consider the fact that these disparate data do not speak to each other. Since the late 1990s, electronic health record (eHR) systems have been developed by private companies like Epic, McKesson and Allscript using proprietary technologies to keep their solutions differentiated and competitive. Different eHRs in different states couldn’t speak to each other; even the same eHRs in different hospitals in the same state would require huge amounts of configuration to be able to share information with each other. These valuable health information bubbles live within the walls of the hospitals, clinics, and insurance companies.
If the first thoughts that come to your mind are errors, confusion…you are not alone.
$30B has been spent to adopt electronic health records in in-patient and ambulatory settings; In 2020, HHS introduced the data interoperability bill, which calls for giving patients safe, secure access to their personal health data. Investments in health data/eHR systems have accumulated $1.2B in 2019, $1.4B in 2020, and have reached $600M in Q1 2021, 140% growth compared to Q1, 2020 (data from Pitchbook).
Then comes Diameter Health, a Farmington, CT based eHR startup founded in 2013 — the inspiration for this article.
The secret sauce of Diameter Health is their ability to unify, de-duplicate, and enrich clinical datasets to help care transitions, population health, and analytics. They do this using the Fusion engine which ingests multiple sources of clinical data in the Continuity of Care Documents (“CCDs” for short, which are oftentimes 1,000+ pages long!). The engine standardizes and cleans the data into easily readable format.
Here’s a screenshot of a CCD. Imagine fact-checking this every single day!
[Diameter Health’s Fusion engine reads and corrects hard-to-notice errors in the CCD. Code 7982 is the RxNorm code for Penicillin, not Codeine! Image from Diameter Health pitchdeck]
[The wheel of 10 datasets available in a CCD, from Diameter Health pitchdeck]
With Fusion, Diameter Health can ingest data from ANY eHR systems with the need for custom configurations, custom interfaces or niche data warehouses. With such data output, Diameter Health helps hospitals and insurance payors identify patients at-risk, and provide analytics, such as a predictive readmission risk score across 5 clinical settings (Diameter Health Demo Day).
Their impact? Better health outcomes because they proactively identify patients with readmission risks and call for corresponding medications and care. $500K/patients in cost savings for a ~250-beds hospital per year.
According to Dr. Bob Kocher, an investor at Venrock, “it is surprising that information doesn’t flow like liquid across all the people that might care for a patient. In reality, hospitals are a lot more like banks or retail stores where they don’t want to share information because they’re worried that patients might actually go to another location to get their care. So while they can share the information, many of them don’t like to share the data because actually it might make it easier for you to move your care to another location.” NPR Interview
Diameter is just one of such innovators in the Greater New Haven hub — an emerging cluster of digital health, biotech and medtech innovators quietly changing healthcare as we know it.
MedAware, founded by Dr. Gidi Stein in Israel, 2012, made Stamford, CT their home in 2016. They raised a $8M Series A in 2017 from DreamIt Ventures, GE Ventures, IBM Alpha Zone Accelerator, and a few others.
They detect and eliminate prescription errors — wrong drugs to the right patients, wrong drugs to the wrong patients — by using machine learning to analyze prescription records in real time. Through using machine learning to detect the prescriptions that are statistically outliers from the prescription patterns of similar drugs to similar patients/conditions, their algorithm identified 68.2% more prescription errors than the prevalent current rule-based decision support tools, in a retrospective study of 74,000+ patients in Brigham and Women’s Hospital in 2012–2013. Given that a pharmacist fills 200+ prescriptions per day, there are 3.7b billion retail prescriptions per year, catching errors early on could lead to a $5.6M savings for a hospital per year.
Another fast growing digital health contender is TryCycle Data Systems, a clinical decision tool for substance addiction, founded in 2017 in Canada and made a home in Farmington, CT. They raised a $23,000+ seed from Connecticut Innovations and UConn Technology Inculcation Program in 2019. They use “Digital Compassion Tether”, a self-assessment-based system to patients who struggle with substance addiction. In New England, there was a 300% increase in addiction and fireman-related intervention since COVID-19 pandemic, a recipe for trouble coupled with the tight supply of mental health resources.
The self-assessment portal then evaluates the mental state and risk of individual patients immediately, allowing psychiatric clinicians to decide proactive intervention. One of the algorithms in risk-evaluation is the SAIPH (Suicide Artificial Intelligence Prediction Heuristic), invented by Dr. Kamisky at the Royal’s Institute, that examines the tone, language, and frequency of a user’s tweets, hereby identifying the stress and anxiety level, to help predict their suicide risk. With the self-reported data and SAIPH as one of the algorithms, Trycycle produces 8 relapse indicators that assess and predict the severity of cravings, triggers, and when to act on medication.
To date, 39 clinics are using Trycycle Data System, resulting in 5,000+ interventions, including with Hartford Healthcare’s Rushford Health Center, and Project Courage, a substance abuse recovery center in Old Saybrook, CT. On March12th 2021, they announced a year-long pilot with American Psychiatric Association to solve the opioid epidemic.
Companies like Trycycle Data System and MedAware add diversity and specificity within the electronic health record field. Data aggregators such as Diameter Health could clean, standardize, and aggregate the different data inputs to enhance the final health score or readmission score calculation. In this sense, perhaps partnerships among these companies can create a “win-win-win” situation for them, as well as the health systems, and patients at large.
In our next article, we will take you through some of the coolest disruptors of care delivery in the Greater New Haven hub.
