Startup Insider: 6 questions with Evidence Care CXO Deb Miller, COO Jim Jamieson on clinical decision support

Brian Fengler, MD, was working as an emergency room physician when a patient came in with a pulmonary embolism. She was pregnant, and he wasn't sure if the usual treatment would affect her unborn baby.

He also did not know where to find the information he needed quickly enough to make an informed, evidence-based decision at the point of care.

"Brian went about creating this tool that works the way ER doctors work," explains Deb Miller, chief experience officer for EvidenceCare. Dr. Fengler's tool provided physicians with clinical decision support for conditions that are the most common, complex and costly. This tool eventually became the basis for EvidenceCare, a company founded by Dr. Fengler.

EvidenceCare is a clinical decision support tool that equips physicians with the knowledge they need to make evidence-based decisions when caring for patients. It helps physicians look up expert-designed protocols on a number of diseases and conditions so they can be confident a specific treatment will not harm their patients in any way. It also features a patient engagement tool so physicians can provide patients with additional, customized information about their care.

"One thing about the platform from the technology side is we build it to be basically EHR daunting, for it to be framed into the workflow of a provider at any EHR," Jim Jamieson, EvidenceCare's COO, says.

Because no such comprehensive platform existed before EvidenceCare, the solution is drastically improving physicians' workflows, according to Ms. Miller.

"We're filling a very important gap and we're doing it in a really great and effective way," she says. "This isn't a pipedream; it's a real product."

Ms. Miller and Mr. Jamieson recently spoke with Becker's Hospital Review about how EvidenceCare is improving physicians' lives.

Note: Responses have been lightly edited for length and clarity.

Question: Where is EvidenceCare now and where would it like to be in 2018?

Deb Miller: We're in the midst of a Series A round of funding, some of which has been from friends and family, and the rest from a small angel investment group out of Nashville, Tenn. But 80 percent of our investors are physicians, hospital executives or revenue cycle leaders, because they see what we can do and the gap we are filling, and they get it and want to be a part of it.

Jim Jamieson: One of the challenges I see with CMOs and chief medical information officers is they see the work of clinical decision support has been patronized, but when you get into the weeds of it, it is no where near what the doctors and nurses actually want. When they see our product, they love it and they want to embed it in the EHR, but they have to go through IT, which might be short-staffed. So, one of our goals is to embed the solution into the Cerners and Epics of the world. We're really focused on execution — building the product, getting the data, garnering feedback, launching the new version of the product and fundraising.

Q: How do you develop the information within your system?

DM: We go to the foremost expert in the field. Sometimes that expert is a single physician — like in the case of Peter DeBlieux, MD, for sepsis — but sometimes it is an association. For example, we are working with the American College of Gastroenterologists, and we are producing their protocols. They've gone out and curated those protocols with experts in the field. And, we're aligning with associations and experts in the field who are doing education on a regular basis. 

Q: What is unique about the EvidenceCare tool?

DM: What's great about our tool is it counts as education. Physicians earn Continuing Medical Education credits for the time spent in our system — that's with our premium version. We work with various associations to accredit the CME. What is also unique is we offer a free version of our tool as well that has all of the content, and it has the patient engagement piece — the clinical documentation customized for the patient — for all providers to use. That was Brian's primary mission: 'How do I make the experience better for my colleagues and our patients and the community?'

Q: Does EvidenceCare integrate with hospitals' EHRs?

DM: Every step is documented and it's all captured within the system so at the end of the encounter, all of that documentation — including the citation, all the resources and graphs — are captured and can be pasted back into any EHR. It offers full clinical documentation, which reduces risk for the hospital because the entire encounter, all the decisions made and clinical support used, like the calculators to assess risk, are all captured and documented. It really helps with the time spent because only about 12 percent of a doctor's time is spent face-to-face with patients and the rest is either in research, in looking up things or with their head down in the EHR. No physician went to school saying, 'I want to spend most of my time in a computer.'

Q: Which EHRs or health systems currently use EvidenceCare?

DM: We're in the process of implementing our first two enterprise versions — one is in conjunction with MedStar Health out of Columbia, Md. — and we are working with them to create protocols for urgent care. We're also in the process of integrating with Cerner because the two hospitals we are working with are Cerner innovation centers. And, we've signed an agreement with athenahealth, and we are working to find a pilot — one of their clinics — to start that process.

Q: What has been your biggest challenge so far?

DM: Building awareness around the tool, because nothing like this has been available before, so doctors don't think about it. Making it part of their every day is what we are working on right now. It's more of an opportunity as opposed to a challenge. Our other opportunity right now is to drive value and keep it top-of-mind so physicians understand it is available to them, and it is just a click away. Obviously, when fully integrated with an EHR, that streamlines the adoption right there.

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