This Startup That Improves Patient Care Moved to NYC to Improve Their Chances of Success

Clinigence provides real-time, clinically-based reports about care gaps which help healthcare providers improve outcomes to proactively address the shift to value-based models and the growing demand for quality patient care.

They’re part of the New York Digital Health Accelerator, a five-month program run by the New York eHealth Collaborative and the Partnership Fund for New York City for growth-stage digital health companies developing cutting edge technology products for healthcare providers and patients ..

Clinigence founder, CEO and successful serial entrepreneur Jacob Margolintalks about his solution, and why he (and his team) came to New York to participate in the program.

Tell us about the decision to apply for the Digital Health Accelerator.

We applied for the NYDHA when it was first announced in 2012. At the time, we were just launching our clinical data analytics software and the accelerator concept seemed timely. We were chosen among the top 20, but ultimately didn’t make the final cut of eight companies. This experience, however, gave us deeper exposure to the program. We really liked the vision of bringing together the innovators, the customers and the funding sources—all within a very focused market of digital health for healthcare providers. We also felt that this was a great learning experience for our team.

When the second class was announced in the spring of 2014 our biggest concern was that we might be too “mature” for an accelerator. By that stage, our solution had been installed in more than 300 practices. We reached out to the organizers and to some of the graduates and they assured us that our stage of development might actually be better suited for the program. We therefore decide to apply again.

Tell us about your product.

Our clinical intelligence tools help providers transition from the traditional payment model where they were compensated solely based on the volume of patients they saw to the emerging model where they are paid based on their patient care quality and ability to control costs. Clinigence does this by allowing providers to easily capture data they have in their medical charts in real-time and combine them with data from other providers, as well as claims data from health insurers, to get a comprehensive picture of their patients’ health statuses and outcomes. Our software is cloud-based, or software-as-a-service (SaaS), so it can be rapidly installed and operated without expert IT resources

We’re now in over 400 practices of all sizes and accessed by 2,000 physicians of all specialties who treat more than 4 million patients. We are also utilized by seven accountable care organizations (ACOs), which is a new risk-based payment, managed care model that is increasing in popularity with Medicare and commercial insurers. We work with some of the earliest adopters of the ACO model, but we also work with many medical practices that are in very early stages of their accountable care journey. With ACOs, our approach is collaborative to ensure that providers have all the data and IT tools they need to succeed under these new payment models. Our solutions allow them to keep better track of their patients and become more proactive when patients’ health statuses are headed in the wrong direction—the foundation of better population health. We also automate the time-consuming reporting process that payers require in these ACO programs, improving performance and optimizing care processes.

For those who are just starting in clinical data analysis, we have pre-packaged solutions that help them maximize benefits today without “biting more than they can chew.” The product is tiered in such a way that they can dig deeper and derive more benefits whenever they are ready.

How is it different?

Compared to more traditional clinical analytics solutions that use medical claims as their primary data, we leverage the providers’ electronic health records as our primary source. This offers three distinct benefits:

  1. Our reports are real-time, unlike older claims data, and thus empower clinicians to become proactive rather than reactive.
  2. We measure clinical outcomes, which are critical, but simply unavailable in claims. For example, claims tell you that a diabetic patient’s blood sugar levels were tested, but they don’t tell you the result. Those missing outcome data severely limit the usefulness of claims-based reports in managing patients with chronic illnesses. Claims data alone also doesn’t help provider identify clinical interventions to prevent high-risk and high-cost complications. We pull all available data in to give clinicians the opportunity to intervene before it’s too late.
  3. Clinicians generally don’t trust claims-based reports. We gain their trust and boost their decision-making confidence by providing complete transparency to the data that they themselves collected in their systems.

In the emerging market of electronic health record (EHR) system-based analytics, we offer two unique advantages:

  1. We integrate data from virtually any source, including different providers’ EHR information, at a fraction of the time and cost of other technologies. The differentiator is that our software uses algorithms to translate data collected from disparate providers to make sure the analysis is accurate and all relevant patients are included. In a simplified example, if one physician records high blood pressure as “hypertension” while another records it as “HTN,” our software detects those differences and ensures that both patients are included in the desired analysis of high blood pressure patients.
  2. We enable clinicians to define their own metrics as they practice, like Lego pieces that they can use to build anything. The beauty of our solution is that they don’t need an engineer. For example, one of our ACO clients is using this capability to design new treatment regimens to better manage Chronic Obstructive Pulmonary Disorder patients—a major cost driver in the population. The clinicians are building the regimen and the measurement tool at the same time, which is truly revolutionary.

What market are you attacking and how big is it?

We target the healthcare provider market with primary focus on ACOs and organizations in transition, to value-based payment models. There are currently between 600 to 700 ACOs—all created within the last four years and the number is growing rapidly. We especially see growth in terms of commercial health insurers engaging with providers in risk-sharing arrangements.

What is the business model?

Our clinical business intelligence tools are cloud-based, also called software-as-a-service (SaaS). Medical practices pay subscription fees, based on their size (number of physicians or patients). For ACOs that purchase our complete solution, including combined cost and quality management applications, we also offer risk/gain-sharing arrangements.

You have a great team with extensive backgrounds in healthcare IT. How did you all come together?

Our core team had worked together in previous health IT startups, so when we started Clinigence, we already knew that we could work well together. Beyond the core team, we have established a hiring process that focuses on culture and team fit before looking at skills.

What are the milestones that you plan to achieve within six months?

We are preparing for our first institutional funding round to accelerate our sales and marketing activities. So far, we have built the business with private funding and are close to financial break-even.

If you could be put in touch with one investor in the New York community who would it be and why?

We are specifically interested in strategic funding sources. This means either the venture arms of industry players or a venture capital fund that is active in the healthcare services or health IT space. Fortunately, the NY Digital Health Accelerator has these types of investors among their network. This is another clear benefit of the program.

What is your take on the current healthcare scene in New York today?

As mentioned above, we really like the ecosystem created by the NY Digital Health Accelerator. NY physicians, like physicians everywhere, demand ample, documented evidence to prove the efficacy of a medication, procedure or technology. This makes health IT innovation all the more difficult, because technology advances so quickly.

At the same time, there is unprecedented need for innovation in our healthcare system. Programs as noted above are putting NY at the forefront of healthcare innovation and pulling innovators (like us) from outside NY into the city to demonstrate the proven efficacy of different types of health IT solutions.

Where’s your favorite happy hour in New York?

As a new transplant to NYC, I prefer to keep my options open and try a new place every time… I’m honestly not a big beer drinker, but what amazes me about NYC is the variety of restaurants of any type imaginable—all within one block. As an ex-Israeli living in Atlanta for 15 years, I had to learn to live without hummus and falafel on a regular basis… In NYC I can feel at home again.