We were pleased to rub shoulders with our colleagues and customers at last week’s AMIA (American Medical Informatics Association) annual meeting. Of note were posters presented by two teams, one led by Gaurav Singal and the other by Shann-Chirag Gandhi. The teams presented case studies of QPID at work to support clinicians with patient information extracted from medical records.
In QPIDMed: A Search-Driven Automated Chart Biopsy Dashboard, Dr. Gaurav Singal and his research partners at the Massachusetts General Hospital (MGH) described the QPID EHR and Medicine Portal applications. The problem with the modern-day EHR, simply put, is that critical information is hard to find. As the poster aptly summarizes:
Critical information is frequently buried beneath volumes of data, frequently leading to errors in patient management.
The authors provide several clinical scenarios in which simply storing data in an EHR has failed, including “a patient who presented with a fracture bleeding profusely because of chronic anticoagulation – with notes documenting warfarin should have been stopped years ago.” The problem is not only the volume of data, we believe, but that notes such as this one are found in unstructured fields that are laborious to comb through without a smart NLP-based search engine such as QPID.
Queries can be developed within QPID that can identify clinical concepts, not just keywords. QPID queries showed on average over 90% sensitivity and 99% specificity, according to the authors, exceeding performance of simple keyword searches.
The Medicine Portal (or what the authors’ cleverly call an automated “chart biopsy” dashboard) was deployed to the MGH Department of Medicine in September 2012. Usage is heaviest at patient admission, but extends into a “long tail” of many days into hospitalization.
The authors plan to study nuances of usage to guide development of additional “contextually aware” dashboards such as those optimized for rounds, floors, the ICU and so forth. Further, they plan to study impact on clinical outcomes and test ordering.
Detailed knowledge of a patient’s past medical history can be crucial for optimal study interpretation. Manual electronic record searching is time-consuming and can lead to potentially lower-quality, less-efficient interpretations.
The authors used QPID to extract information pertinent to the interpretation of liver, prostate, and rectal MRIs and display that information in an organized graphical interface which included interpretation guidelines.
Patient historical data that is pertinent to the radiologist can be “distilled and converted” to fast, accurate search queries using QPID. For example, in this case, queries designed for magnetic resonance (MR) imaging studies encompassed relevant imaging studies, laboratory/pathology results, medication and allergy lists; admission, progress, operative/procedural and discharge notes; as well as other unstructured/structured data.
For the study, nine MR search algorithms related to liver, prostate and rectum exams were run on a test sample of 20 patient records. High levels of Positive Predictive Value (0.86 +/- 0.02) and Negative Predictive Value (0.91 +/- 0.01 were reported.
We are looking forward to follow-up research from our esteemed customers.
Two recent studies caught our eye. Both tell us that half of physicians are still dissatisfied with their EHR systems. Those who are unhappy cite a negative impact on their productivity.
IDC Insights reports that “inappropriate form factors and user interfaces” contribute to the productivity drain. Similarly, in an AMA-commissioned RAND study, researchers found that “poor usability” is a common source of dissatisfaction.
To translate: Physicians are frustrated because they spend less time with patients and more time related to updating and reviewing records in systems that are not designed to make things easier for them.
QPID alleviates this pain. The QPID platform was designed to deliver patient summaries directly to the point of care for rapid assimilation of the key facts that impact decisions. Instead of searching through multiple EHR screens in the hopes of finding all the information to piece together the patient story, QPID delivers an “at a glance” view of the pertinent labs, drugs, symptoms and common causes. For example:
The QPID Medicine Portal automatically displays answers to some 300 questions an expert clinician wants answered about a newly admitted patient. The screen is organized for rapid review by body system, lab results and common workups.
For emergency department staff in a hurry, the ED Portal instantly delivers vital information on allergies, conditions, medications and more that can drive life-saving decisions. And QPID finds this even in unstructured notes written in medical “street language.”
Provider organizations take note: 60% of costs in healthcare are labor, so solving the problem of productivity is more than just about making physicians and other clinicians happy. It’s a bottom line decision.
Mike and his colleague Mitch Harris conceived, designed and developed the QPID software as a direct result of Mike’s experience on the front lines. Like many clinicians, Mike wanted to make the best decisions for patients when analyzing an image, but he found that it was taking far too long to dig out what he needed from the patient’s electronic health record. He thought that it had to be possible to automatically extract the relevant information from the EHR, but after investigating found that no one had figured out how to do it yet. Thus QPID was born.
As Mike notes in the abstract for his presentation:
Electronic health record data, whether in discretized (structured field) or unstructured forms presents a potentially overwhelming amount of information for a Radiologist to consume at the time of clinical encounter. This applies for both in- and out-patient settings, and spans a broad range of sub-specialty and acuity scenarios. Consuming and understanding this data in an efficient way is essential for efficient, high quality care delivery, especially since most Radiologists have little prior familiarity with their patients.
ohn Osborne, writing in Forbes online, highlights QPID as a “promising start-up software development firm” that is applying technology to advance healthcare delivery. Although there are dozens of technology firms trying to solve problems in our healthcare system, writes Osborne, QPID is notable in that it impacts outcomes and efficiency by delivering vital data quickly that would otherwise be hidden in medical records.
QPID HEALTH’S MISSION IS TO ENHANCE THE PHYSICIAN USER EXPERIENCE BY DIGESTING AND RETRIEVING THE MASS OF PATIENT HEALTH DATA AND PRESENTING IT IN AN ACCESSIBLE DASHBOARD FORMAT. THE INHERENT VALUE OF THIS IS EVIDENT IN COUNTLESS SCENARIOS.
The promise of access to a patient’s medical record from anywhere is still to be realized and digitizing records has created issues along the way. When faced with a mass of digital information in electronic health records (EHRs) and other digital systems, physicians can find it “just as daunting to access as if it remained written on a piece of paper attached to clipboard or a manila folder,” writes Osborne.
To solve this problem, QPID makes relevant patient information immediately available to physicians in a dashboard view,without the need to search the electronic records manually. This greatly improves clinicians’ experience and productivity, and enhances patient outcomes by bringing critical information to the point of care. Osborne shares several scenarios where QPID plays a major role in saving lives and avoiding unnecessary adverse events. For example:
IF A PATIENT IS ADMITTED TO THE HOSPITAL FOR A SURGICAL PROCEDURE, THE ADMITTING FORM WILL INCLUDE A QUESTION AS TO CURRENT MEDICATIONS. SUPPOSE THAT THE PATIENT HAS A HISTORY OF TAKING THE ANTI-COAGULANT DRUG WARFARIN SODIUM, SOLD UNDER THE TRADE NAME COUMADIN. THIS IS IMPORTANT FOR THE SURGEON TO KNOW, SO THAT PRECAUTIONS MAY BE TAKEN TO AVOID HAVING THE PATIENT BLEED TO DEATH ON THE OPERATING TABLE. GRANTED, THIS INFORMATION SHOULD BE NOTED ON THE HOSPITAL INTAKE FORM, OR IT MAY BE INCLUDED IN THE PATIENT’S EHR HISTORY AND ALREADY BE PART OF THE HOSPITAL’S DIGITAL DATABASE. BUT SUPPOSE THE PATIENT IS UNCONSCIOUS ON ARRIVAL? OR SUPPOSE THEY DO NOT RECALL WHEN THEY WERE LAST ON THE DRUG? OR SUPPOSE THE NURSE IS INTERRUPTED AND DOES NOT TRANSCRIBE THE PATIENT INFORMATION ACCURATELY? THINGS HAPPEN. IN SUCH CASES, A LIFE MAY BE SAVED IF THE OPERATING OR ATTENDING PHYSICIAN SEES A REFERENCE TO COUMADIN PROMINENTLY NOTED (ALONG WITH OTHER PERTINENT MEDICAL HISTORY) ON A DASHBOARD DISPLAY PRESENTED ON THEIR IPAD AS THEY ARE RUSHING TO REVIEW THE PATIENT PROFILE IN THE LAST MINUTES PRIOR TO SURGERY.
Thank you to all the friends and supporters of QPID who attended our Open House this Monday evening. After a long and emotionally draining week here in Boston, it was our pleasure to host some of the city’s brightest tech and health care minds for a night of conversation, cocktails and camaraderie. We are grateful that the evening was possible – only after the heroic and timely actions of Boston’s emergency personnel, police department and health care systems – along with the FBI – to make our city safe again.
Health care played a pivotal role in the events that unfolded at the Boston Marathon last week. Many in the general public jumped into action on scene, to save the injured. Physicians and other clinicians worked through the night performing multiple surgeries. Politics and opinions don’t come into play at these times – just quality care for the wounded and for the patients. It was but one example of how important the health care industry is, and that we need to work together to keep it available, affordable and efficient to everyone. Some victims of last week’s bombing will need help – their medical bills will be more than they can afford, and some were uninsured altogether. To help those in financial need as a result of the Boston Marathon bombing, please visit The One Fund Boston – a fund created by Massachusetts Governor Deval Patrick and Boston Mayor Menino to raise money to help those families most affected by the tragic events that unfolded during Monday’s Boston Marathon.
We’re proud to have been born out of a city that is not only a mecca of great health care, but one of amazing people.
In case you didn’t see the news, today we announced our first round of funding. While this is certainly a typical step for an innovative startup, I believe we’ve got a unique story for a few reasons:
the quality and track record of our investors is first rate, with the perfect blend of tech and health care excellence
we raised more financing than expected, immediately expanding our capabilities for commercial growth
while we accepted an additional investor beyond our original plans, we had to turn away others
All of this adds up to great excitement for what we’re doing here at QPID. We believe the interest and support from such quality investors – Matrix Partners, Partners Innovation Fund, Massachusetts General Physicians Organization (MGPO) and Cardinal Partners – is a significant nod to the power of what QPID is providing to the health care industry. In step with Electronic Health Record (EHR) providers, we’re poised to make digital health management a pleasant reality.
EHR vendors have made great strides in digitizing health data. But the reality is that the switch for clinicians hasn’t been as smooth as it could be – the industry is still struggling with the marriage of data workflow and human workflow. Data is great when it’s useful – but so far, EHRs have been little more than digital repositories – actually impeding clinical workflow and in some cases, patient safety, while clinicians struggle to access and use the data within.
As a result, workflow, efficiencies, job and patient satisfaction have suffered. QPID integrates with EHRs to accelerate the data – making it easily accessible, understandable and useable within different departments – from ED to oncology to radiology, gastroenterology to cardiology, and even billing. We help assimilate both old and new knowledge, and enable clinicians to apply that knowledge to their patients, recall each patient’s individual health status and history, and communicate quickly and accurately.
Clinical studies suggest that for ideal results, one should take the objectivity of data and marry it with the reasoning capabilities of a human. QPID does just that for the health care industry – making data easily retrievable, readable and understood by both clinician and patient. Perhaps that’s why investors have already invested $4 million – nearly twice what we projected. With it, we’re disrupting health care and making the dream of digital health a reality. Stay tuned, or if you’re an institution or clinician interested in more, download ourproduct overview, and let’s get a demo scheduled.
With all the buzz around Marissa Mayer’s decision to kill telecommuting, it’s an interesting time to think about the effect office space has on culture. Throughout the years of my career in building world class teams at startups (or reinvigorating them at more established companies), I have always been a big believer in the importance of a connected culture – one where team members are not only physically able to come together (perhaps not every day but certainly a few days per week), but one where their votes count in almost every aspect of the business. I don’t hire people, we hire people. And I believe having an office space conducive to working together and collaborating is key to making sure our QPIDians perform at their maximum potential.
That’s why I’m excited to announce that we’ve just moved to a new space that will allow us to collaborate better than ever as we grow QPID this year. You can now find us at One Financial Center in Boston – the hub of activity and collaboration for our talented team, as well as many other companies such as Mintz, Levin, Cohn, Ferris, Glovsky, and Popeo, Gemvara and a host of other law firms, CPA firms, tech and financial services companies. In addition to being the seventh-tallest building in Boston, it is home to amenities (Starbucks, anyone?) that welcome our employees to work, and is touted as “the most accessible building in Boston.” After all, we’re right next to South Station and Boston’s newest great neighborhood, The Seaport Area. Making the office an enjoyable place to be – and to get to – is the first start in keeping team members engaged and happy. I am excited for what’s ahead for our team, and invite you to stop by and visit us – or stay tuned for details on our upcoming Open House. You can also view some of our candid photos from the move – and keep up with our other “moves” – on Facebook, Twitter or Linkedin.
Our new headquarters: One Financial Center, 8th Floor Boston, MA 02111 Tel: 617.292-7743 (617.292-QPID)
I’m really excited to announce that we officially launched QPID to the world today. After four amazing years of R&D at the #1 hospital in the nation, QPID is now officially its own venture-backed company and commercially available to academic medical centers, community hospitals and group practices outside of the Partners HealthCare network. The reception has been great, and the QPID team is pumped up to make EHRs – and the data they house – useful and exciting for healthcare workers around the nation.
One might even say, in the spirit of Valentine’s Day, that we’re spreading the love. We’re igniting new passion for EHR systems by giving them a voice that will help with clinical decisions and make doctors, physicians, PAs, nurses and even billing staff more productive. When workflow (and attitudes) improve, the positive effects spread throughout the institution: from the front desk to the Emergency Department; Billing Department to the patients.
Because while these clinicians are enamored with the idea of electronic records, they haven’t yet experienced the best relationship they can have with them. QPID is changing all of that. We’re not only giving a “voice” to the data within those EHRs, but we’re making the date more useful, relevant and insightful – improving productivity, workflow and ultimately, patient safety.