Say you were diagnosed with prostate cancer and had to choose between chemotherapy or surgery. Though your doctor inundated you with information during your office visit, you can hardly remember anything and have many more questions.
That’s where a virtual physician could come in handy, according to the folks behind Santa Monica health care data firm Doctor Evidence, which is working with USC’s Center for Body Computing to bring on-call, artificially intelligent docs to the palm of your hand in a smartphone app.
A patient could pull up the program’s lifelike physician avatar, enter personal details and get plain English explanations about how other people in the exact situation fared choosing chemo or surgery.
This new app will be powered by Doctor Evidence’s extensive database of peer-reviewed clinical trial statistics on disease and treatment outcomes, normally reserved for its large clients such as Kaiser Permanente’s Care Management Institute and IBM’s brainy Watson platform.
Though its technology might be forward-thinking, Doctor Evidence’s collaboration with USC, as well as the other apps it’s developing with Boston Consulting Group’s digital ventures division, mark the decade-old firm’s return to its original mission: helping patients directly.
As Fitbits and other app-enabled sensors eat up increasing real estate on consumers’ wrists and phones, digital has become an acceptable way to monitor one’s health care, said Doctor Evidence Chief Executive Bob Battista.
“That’s what started to really get people socialized to a new way of getting data,” he said. “That’s what we’re really riding on the back of now.”
That socialization has also cracked open the lid of a lucrative digital health market. In a recent report, Goldman Sachs predicted that the commercial U.S. market for Internet-connected devices informing clinical decision-making will see revenue of more than $32 billion in the next decade.
Though in an environment where many consumers have to fork over big bucks under high-deductible health plans, the major factor determining whether patients actually use such an app could be how much money they’d save.
“The greatest sensitivity people have is less about evidence and more around price,” said Dr. Harry Greenspun, Washington, D.C.-based director of Deloitte’s Center for Health Solutions. “Just having the data doesn’t necessarily change behavior, unless there’s an incentive to do so.”
Data driven
Battista co-founded Doctor Evidence in 2004 with the firm’s chief medical officer, Dr. Todd Feinman, who saw the need for gathering medical evidence data while serving as the medical director of a large physician group at Queen of the Valley Hospital in West Covina.
Feinman’s job was to make sure his doctors were ordering the right treatments for patients. As is common, he relied on guidelines established by medical societies and analysts that renewed clinical data.
But he saw his physicians making inconsistent treatment recommendations and felt they could benefit from seeing evidence firsthand. However, when Feinman tried organizing that information himself, he realized it was far too time-consuming a process.
Enter Battista, who had a background working for educational health care companies and had recently left a job as executive vice president of Bethesda, Md., specialty pharmacy TheraCom, where he oversaw technology development.
The duo started out doing custom projects for individual patients, but Battista and a team of developers soon created a digital platform to make the process more efficient. With some human help, the technology can easily find studies buried in reams of research and then synthesize the data to make it more digestible.
Battista likened the process to converting “medical Shakespeare” into something Homer Simpson could understand.
Around 2008, the firm realized it could have a bigger impact and scale more efficiently if it served bigger corporate clients such as drug developers, medical societies and large-scale health providers.
Doctor Evidence’s multiyear subscriptions typically start in the hundreds of thousands of dollars a year and can go all the way up to eight figures, Battista said.
The firm has swelled to a staff of 150, including biostatisticians and computer scientists that occupy an airy office overlooking Santa Monica’s Third Street Promenade in the heart of Silicon Beach.
Palm of hand
Now that Doctor Evidence has built out its infrastructure by serving these larger clients, it’s economically feasible for the firm to also serve individual patients once again.
“Our content assets are so big, we’ve hit an inflection point, a critical mass, and our library is big enough we can circle back to the individual business model,” Battista said.
That financial stability also gave Battista and Feinman the flexibility to work with their friend, Dr. Leslie Saxon, head of USC’s Center for Body Computing, who approached them last year about developing the virtual app.
The mobile program is meant to be part of a larger virtual care clinic – think holographic physicians and body sensors – that Saxon and corporate partners such as Doctor Evidence are developing.
“It follows you when you’re outside of the traditional health care system and helps you manage every aspect of your care,” Saxon said of the clinic.
She added that the app is meant to be part of holistic solution providing the best on-demand medical information specific to a patient’s needs, emphasizing that it could help digitally leverage the world’s limited number of experts. Saxon said she expects working prototypes of the app and the clinic’s other virtual tools to start launching over the next one to two years.
Feinman and Battista also see their project as part of a long-overdue consumerization of health care.
“Consumers are currently using evidence outside of health care, whether it’s Carfax, Amazon.com or Trip Advisor,” Feinman said. “It’s very bizarre to me that that same type of evidence is not available in health care. And that’s what we’re trying to accomplish.”
