For 30 years, hospitals, insurers and other healthcare providers have sought ways to track patient outcomes to better determine which medical procedures are most effective and which physicians need to show improvement or be weeded out.
Until now, that ability has largely eluded them. But now, Beverly Grove-based OutcomeMD Inc. is one of a small group of health tech startups aiming to deliver that holy grail of healthcare metrics. OutcomeMD has developed a software platform that interacts with patients and tracks their symptoms before and after they undergo medical procedures.
In the two years since officially launching the platform, OutcomeMD has been tracking patient symptoms and outcomes for health insurers, hospitals, surgery centers, individual doctor practices and organizations such as the Veterans Affairs Greater Los Angeles Health Care System.
At the center of OutcomeMD’s platform is an ongoing series of assessment questionnaires sent to patients via a mobile phone app, tracking their symptoms before medical procedures or treatments are performed and symptoms and recovery progress for months following the treatment. The patient responses to those questionnaires are then tabulated to present a picture of how well each patient is recovering. When patient recoveries are not up to par, the physician is alerted.
“The key to delivering value-based healthcare is generating outcome data,” said Justin Saliman, OutcomeMD’s chief executive. “But the most detailed outcome data is locked up in the patient’s brain. That data has to be tapped to quantifiably measure pre-treatment condition and compare in the same way to post-treatment outcome.”
The immediate goal, Saliman said, is to improve the performance of physicians, surgeons and other medical providers. They can sign up through subscription plans for OutcomeMD’s software tool. When their patients enter intense symptoms or below-average outcomes into the program, the medical providers are immediately alerted, giving them the chance to intervene to improve the outcomes.
But insurers and larger health provider organizations – especially hospitals – are also keenly interested in this information. They have strong financial incentives to keep tabs on doctors and surgeons with a track record of below-average outcomes that require hospital readmissions or other costly procedures.
“You are seeing more and more healthcare payors requiring the use of patient-reported outcomes,” said Jason Cole, president and chief science officer for P3 Research Consulting Inc., a Torrance-based healthcare consultancy. “Physician practices that may sense this change coming are wise to get out in front of this now. For one thing, it gives them time to improve outcomes before the payor-outcome-reporting mandates kick in.”
This is exactly what Saliman intended when he founded OutcomeMD six years ago. Saliman, an orthopedic surgeon, said he was working at a healthcare consulting firm that mined data from billing records to try to gauge patient outcomes. He said he quickly realized that billing records gave a very spotty and incomplete picture of patient outcomes; the more complete picture was through analysis of patient-reported symptoms and progress.
Saliman reached out to physicians that he knew – many from Beverly Grove-based Cedars-Sinai Medical Center – to raise $100,000 to start creating his own patient-reported outcome program that could be used as part of physicians’ treatment programs.
Overcoming doctor reluctance
But a key obstacle was physician reluctance.
“Doctors fear that if they use patient-reported outcomes, they will be punished for having bad outcomes, so they tend to avoid using patient-reported outcomes altogether,” Saliman said. “Rather, the aim should be to make doctors who have bad outcomes do everything in their power to improve outcomes.”
To achieve this, Saliman and his growing team worked to develop a platform system where doctors can compete on the basis of favorable outcomes.
“The favorable outcome should be the currency: A doctor can say, ‘If I get a good patient outcome, I can market that outcome and therefore, I’m going to try harder in the future to get more good outcomes,’” he said.
That ability to market good patient outcomes is what drew Andy Ball to OutcomeMD’s software program. Ball is longtime chief executive of Precision Ambulatory Surgery Center near Cedars-Sinai in Beverly Hills. In 2017, that center merged with three other Beverly Hills surgery centers to form Beverly Hills ASC Venture; Ball also became chief executive of the merged entity. Cedars-Sinai has since acquired a stake in Beverly Hills ASC Venture.
Ball said that as an independent surgery center, Precision was at a disadvantage compared to hospitals when it came to receiving medical treatment reimbursements from health insurers.
“When we go to payors like Blue Shield or Aetna, we have to show we’re a quality program,” Ball said. “To do that, we need to demonstrate using long-term data that we are achieving good outcomes.”
Ball said that through his affiliation with Cedars, he became aware of OutcomeMD and in January 2020, became one of the first surgery center executives to sign on.
Ball quickly put OutcomeMD’s new patient reported outcome system as he went to get recognition for his spinal surgery center from the Joint Commission on Accreditation of Healthcare Organizations, or JCAHO. Up until that point, JCAHO rarely gave accreditations for independent surgery centers.
This past November, Ball said Precision Ambulatory Surgery Center received a “Center for Excellence” designation from JCAHO; he credited the patient-reported outcomes platform from OutcomeMD with helping to secure that designation.
“This is a tremendous boost to physician and patient confidence,” Ball said. “And I expect it will only help in the next round of negotiations we have with payors.”
But Saliman said trends of bad outcomes are hardly ignored. Rather, decisions on how to deal with doctors and surgeons with histories of bad patient outcomes are left to that other group of OutcomeMD customers: insurers and other health care payors, as well as hospitals that can use the records to withdraw treating physician status for those with repeated bad outcomes.
This is in addition to giving doctors and surgeons the chance to improve individual patient outcomes that appear headed in the wrong direction.
“We prefer the bad outcomes to be dealt with quietly, behind the scenes,” Saliman said.
Looking ahead, in the short run, Saliman said the company is trying to get on as many electronic medical records systems as possible, either directly or through their marketplaces (similar to Apple Store). This could help bolster OutcomeMD’s market position as more companies enter the patient-reported outcome sphere.
“Right now, most of the companies that are in this space are focused more on patient-reported outcomes for pharmaceutical companies conducting drug trials,” consultant Cole said. “But as more health plans require tracking of patient outcomes, more companies will pivot to the commercial side of physician practices.”
Further down the road, Saliman hopes to use all the outcome data his company is collecting to begin measuring medical procedures on a more widespread basis.
“Our data can be aggregated to determine which medical procedures and treatments perform the best and which ones should be discarded,” he said.