They built IT themselves

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What’s up with computerized physician
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Vol. 10/No. 3 • March 2006
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BY JAY GREENE
Chris Kryder, M.D., first identified the
disconnect between clinical medicine and
financial management during medical
school. So when it was time to pick his
internal medicine residency program in
1981, Kryder chose a program that would
also allow him to enter a business school
to bridge the gap between the disciplines.
Kryder parlayed those backgrounds 20
years later when in 2001 he founded
D2Hawkeye, a Boston-based clinical and
financial data-mining company.
D2Hawkeye develops software used to
analyze patient information, identify sick
individuals and evaluate disease-management programs.
Randall Oates, M.D., noticed how little
in the way of medical instructions patients
retained during examinations when he
was a family-medicine resident in 1982.
Concerned, Oates wrote a rudimentary
software program that he and other physiContinued on p. 2
Frustrated with healthcare
inefficiencies, these
docs have launched
their own IT companies
They built IT
themselves
Chris Kryder, M.D., founded a clinical
and financial data-mining firm.
Ira Wyman
COV E R STO RY
COV E R STO RY
the company’s premier program,
aggregates data from the member
cians could use to develop takelevel up, creating a medical
home information sheets for
record for every enrolled individpatients. Oates parlayed that softual that includes a complete hisware-writing talent 12 years later
tory of all medical and pharmainto a low-cost electronic medical
ceutical claims.
record and the founding in
Managers use
1994 of DOCS Inc., which
D2HawkeyeExplorer to
is now called SOAPware,
identify patients who
Fayetteville, Ark.
need more intensive
Kepa Zubeldia, M.D.,
care management by
realized how important
analyzing collected data
computers could be for
through more than 800
medical administration in
quality and risk measures.
1979, when he was run“We want to enable
ning a clinical pathology
physicians to make betlaboratory in Spain, his
ter decisions for their
home country. Zubeldia
Zubeldia: Docs
later refined his ideas on
can adopt IT that patients,” says Kryder.
“Our guiding principle is
applying information techcan lower costs.
that if managers can get
nology to medical administransparent financial information
trative uses while he was studying
in an organized and easy-to-read
biomedical engineering at the
way, they are in a much stronger
University of Oklahoma in 1982.
position to medically manage
Zubeldia parlayed those experiences 18 years later when forming their patients.”
D2HawkeyeExplorer provides
Claredi, a Salt Lake City-based
company that provides software to cost and clinical data on individual
patients that show, for example,
monitor and manage clinical,
financial and administrative health- average dollar costs for specific
diseases or admissions. “One of
care transactions.
the root problems in managing
Kryder, Oates and Zubeldia are
patient care is that doctors don’t
using their medical training inside
the business world to create infor- know what things cost, and
mation technology solutions aimed patients don’t know what things
cost,” Kryder says.
at helping physicians manage
Kryder, who earned an MBA from
patient care.
the Sloan School at the
“I want to be part of a radical
Massachusetts Institute of
solution that proves higher quality
Technology in 1984, says the puractually does cost less,” says
pose of placing average costs
Kryder, D2Hawkeye’s chief execualongside clinical information is
tive officer. D2HawkeyeExplorer,
Continued from p. 1
Modern Physician | March 2006 • 2
to submit without the group numthat “You can’t manage the case
ber. I am always vouching for
without knowing the cost.”
administrative simplification,”
Creating a system where medical
Zubeldia says.
and financial activities are joined
Oates is another one of a growat the hip “provides a much better
ing number of physicians dedicated
view of individual diseases and
to simplifying clinical management
costs,” he adds.
systems. Described by Medical
Zubeldia also wished to develop
a program that could help doctors
Economics as one of the most
better manage their practices.
popular low-cost EMRs for small
Through Faciledi, Claredi’s premier groups, SOAPware has sold more
program, providers, payers and
than 8,000 systems, primarily to
clearinghouses can accurately ana- groups with five or less physicians,
lyze, validate, route and report
Oates says.
healthcare transactions,
“My goal is to help
he says.
transform healthcare and
“Big payers have clearly
bring physicians into the
dominated the EDI (elecmodern world,” says
tronic data interchange)
Oates, SOAPware’s presindustry,” says Zubeldia,
ident. “Most small pracClaredi’s president and
tices are nearing obsochief technology officer.
lescence, and physicians
“Payers have been reducare really burning out. By
ing administrative transre-engineering their pracaction costs, but they
tice they can achieve betare shifting costs to
Oates: “My goal is ter results because the
providers. Physicians can to help transform current reimbursement
adopt technology that
system is not going to
healthcare.”
can lower those costs.”
support them.”
Zubeldia understands the needs
Oates says SOAPware can help
of payers to lower costs and the
doctors reduce their charting time
desire of physicians to be paid.
from an average of about 40% of
“Sometimes those requirements
their office time to 20%. “Doctors
conflict with each other,” he says.
can spend more time seeing
For example, payers want patient
patients, making more money, or
identifications and group health
they can have more free time,” he
numbers on transactions so they
says. “Patients also benefit by havcan easily match eligibility files.
ing medical recommendations all
“I saw that patients don’t always written down, and with a punch of
come in for a visit with the ID
a button, a doctor can send a precards. In meetings with payers, I
scription to the pharmacy.”
insisted that providers be allowed
Continued on p. 3
COV E R STO RY
Data Interchange.
A practicing physician, Oates
The three IT entrepreneurs
believe their medical training helps says he spends 25% of his time
seeing patients. “I couldn’t do
them explain and sell their prodwhat I do if I didn’t see patients.
ucts to managers and physicians.
You lose perspective,” says Oates,
“Typically we need to convince
who recently opened a
both the CMO (chief
new clinic, DOCSmedical officer) and
“
T
y
p
i
c
a
l
l
y
w
e
Clinic and Institute in
the CFO (chief financial officer) of the
need to convince Fayetteville. “I have to
be practicing. I see
value of the system,”
both the CMO
myself as a bridge
says Kryder, who is a
clinical instructor at
(chief medical between practicing
doctors and the IT
Harvard Medical
officer) and the world.”
School and an MIT lecWith SOAPware now
turer. “We have many
CFO (chief
in its fifth version,
good people who are
financial officer) Oates says he develgood at selling, but I
am one of only a few
of the value of the ops specifications for
the design team. “I
who can speak both
s
y
s
t
e
m
.
”
tell (the programlanguages simultaneously,” Kryder says.
—Chris Kryder mers), ‘This is the
Zubeldia often goes
D2Hawkeye CEO way it needs to operate,’ ” he says.
into the field on demon“What’s wrong with IT
strations and to help
is there is a disconnect (between)
implement systems.
design and engineering and real
“I hear feedback directly from
world practice. I see myself as a
the users, and my medical backchange agent to help the medicalground helps tremendously,”
industrial complex transition to a
Zubeldia says. “Feedback helps
more working model.”
me to improve the product’s funcKryder agrees. “If we can make
tionality. It is always an eye-openthe whole system simpler to make
ing experience to see the amount
of pain that electronic transactions medical and financial managers
work better together, we can make
inflict on providers.”
patient care better,” Kryder says. ■
Zubeldia also effects policy
changes at the national level as
past president of the Association
Jay Greene is a former Modern
For Electronic Health Care
Healthcare reporter and now a
Transactions and co-chairman of
freelance healthcare writer based
the Security Policy Advisory Group in Thompson, Conn. Contact
of the Workgroup for Electronic
Greene at [email protected].
Modern Physician | March 2006 • 3
Continued from p. 2
The path to providing
quality health care
is clear
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To learn more about how the Accreditation Association for Ambulatory Health Care can put your organization
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