Apixio aims to bring Google-like search capabilities to a vast and fast-growing trove of health information
SAN MATEO, CA — Healthcare is swimming in data. Objectively, that's a good thing, of course. But a sea of information is useless – and can sometimes be harmful – without a way to navigate it, to get the right data at the right time.
Think of the Internet: a boundless and ever-expanding universe of knowledge, some of it essential and some of it trivial, but where would the Web be without search engines?
Apixio is a two-year-old startup whose mission is to offer "instant access to relevant clinical information, anywhere."
With a management team and board that includes a telecom pioneer, two experts in PACS and image management systems, a physics PhD who previously put his proprietary algorithms to work at a successful hedge fund and a former CTO at Yahoo!, the firm is bringing its diverse experience to bear on technologies targeted at harnessing the "explosive growth in the volume of clinical data."
Apixio CEO Shawn Dastmalchi says the company's "deep expertise in health IT, Internet media, search and telecom" is the right mix to get the industry where it needs to go in four areas – care coordination, knowledge extraction and decision support, population health management and patient engagement – which he calls "key components of what meaningful use is about." Toward those aims, "there needs to be a platform that can clinically integrate information and get it from one application to another."
Apixio's technology can be deployed both within and beyond the hospital or physician practice walls. Its Embedded Search can be deployed in EHR, HIE, PHR, PACS, home-monitoring or medical device applications, offering the ability to search for clinical data within them. Its Community Search can scan multiple sources of electronic health records and health information exchanges for relevant patient information.
The centerpiece of those capabilities is Apixio's MINE (Medical Information Navigation Engine) technology, which allows providers to enter text queries – just as they would on Google – and, thanks to natural language processing (NLP) technology that infers the search's intent, retrieve medically relevant results – both structured data and unstructured data.
"We bring the data in from multiple sources, we normalize, we semantically map, we de-duplicate and then we index all the data – whether it's structured or ad hoc," says Dastmalchi.
That "knowledge base inside the system, developed using NLP and machine learning that knows how medical terms relate to each other," is crucial to returning useful results says Apixio’s Chief Scientist Bob Rogers.
So if a doc searches an EHR for, say, "diabetes," results will pop up for a patient's hemoglobin A1c lab and glucose tests. "Those don't contain any lexical or keyword relations to 'diabetes,' but those are what you want to see," says Rogers.
But Apixio has aims beyond simple search. "Look at Google," says Dastmalchi. "In the second or third year of their business, all you knew of them was search." Nowadays, while search is a core component of its business, to call Google merely a search engine is to understate the case – it's an "Internet media leader."
Apixio, he says, wants to change the way the "entire [healthcare] industry has been thinking about information" – effecting a "paradigm shift" in what it calls the “clinical media world."
Jenny Field joined the company as director of product marketing this summer. Prior to that, she was director of ambulatory medical informatics at Salinas Valley Memorial Healthcare System. Her experience helping providers across different specialties implement EHRs has helped her appreciate the utility of a technology like this, she says.
Previously, when trying to map a way for the family practice doc to compare notes with the cardiologist, and for the cardiologist to talk to the hospital, "what I thought I was looking for was an HIE," says Field.
But so often, information exchange required "another heavy tool on top of the heavy tools that already existed – I couldn't imaging asking a provider to learn a new system to log into," she says. "We needed an embedded system to truly bridge the gap between different information systems."
With Apixio pre-loaded onto the existing technology the physician has "spent so long to learn already," the onus is taken off the doc. "Everyone knows how to search."
So far, Apixio is in use at five medium-sized healthcare organizations and 40 or so smaller, more specialized entities.
It's "done heavy integration so far with NextGen," says Dastmalchi, and has successfully integrated Community Search with Allscripts' Sunrise Clinical Manager and Enterprise EHR. Doing so, he says, "turns an EMR, out of the box, into an HIE. By putting the search bar into that EMR, you've enabled it to search across the community."
He likens the capability to "the difference between using the phone book and using Google." Indeed, just as Google helps citizens and consumers "make smarter decisions, so does Apixio want to do for physicians, says Dastmalchi.
"We want medical information to be liquid, and transactable at high speeds," he says. "We've built a system that can respond to queries at high speeds and get the data where it needs to go."
