If you’ve ever had a CT scan, X-ray or MRI, you were likely given a CD to tote around in case you wanted a second opinion. That’s because there isn’t a universal network or database for medical image files, even in an industry that demands standardization.
Hamid Tabatabaie and Amy Vreeland founded a company that aspires to solve this problem, which has existed ever since the first X-ray was digitized. Their company, LifeImage, lets patients, physicians and institutions search, share and access medical imaging records across different networks. LifeImage, which works with storage giant EMC (NYSE:EMC) for its cloud-based platform aims in part to reduce orders for redundant images, which Tabatabaie says adds an additional $15 billion to the U.S.’s annual healthcare bill.
The company sells itself based on an ease of use that is uncommon in healthcare IT. A tagline on the company’s website says, “His wipeout made it to Facebook before his X-rays made it to the surgeon,” referring to a young skateboarder having video of his injurious crash posted on social networking site, which is also cloud-based, before his doctors saw his X-rays. LifeImage’s software includes other attributes such a virtual drop box to make managing EMR content not unlike managing one’s email.
Vreeland, a senior vice president at LifeImage, is a former VP at Amicas (NSDQ:AMCS), a healthcare IT company. Tabatabaie, the company’s president and CEO, is something of a serial entrepreneur. He was involved in the early stages of four healthcare IT companies in the last two-and-a-half decades. Together, they started up Newton, Mass.-based LifeImage in 2008.
MassDevice spoke with Tabatabaie about LifeImage’s EMR product.
MassDevice: How is LifeImage’s EMR offering an improvement over what’s currently available?
Hamid Tabatabaie: We’re the only EMR that looks like an email inbox, but it’s specifically made for capturing imaging exams information about medical imaging exams and allows the user to save, view, access from anywhere, give access to anyone to any particular exam in that inbox or to a number of different exams in that inbox, and also lets you upload your own. As a patient you can appreciate that [it would be great if] you can have all of your imaging information in one place and whenever possible you can share it with a new doctor for second opinion purposes or having access to your medical history and so forth.
MassDevice: So LifeImage grants the patient more control over their medical records?
HT: Absolutely, and specifically, the medical records that are centered around imaging exams. Imaging is a very important component of healthcare now. It’s the second most expensive component of the healthcare budget, second only after pharmaceuticals. That’s because images are literally worth a thousand words. They enable doctors to see what’s inside of you, abnormalities, many issues early, they can decide how to treat you, how to navigate through your body for surgical or implantable devices. So images are used by more and more physicians that we call image intensivists, whether they’re cardiologists, neurologists, gastroenterologists, surgeons; they all use images to decide on the treatment of their patients.
It’s the only part of the medical record today that is governed by standards, to ensure that images are in the same format from one facility to another.
Images in particular, out of all the components of the electronic medical record, are the only part that has a standard format. So you can open .WRT files, I can open .WRT documents, but your vital signs, your prescription history, your discharge summaries, your visit notes, depending on what facility it’s in, it’s an entirely different format, so the only way that they can exchange them today is to hand over documents, pieces of papers, files of paper, depending on how much you want to take from one place to another. Images, on the other hand, are all in the same format. Today they hand you a CD. What we’re replacing is the inefficiencies of the CD, while taking advantage of the standards. Now that the entire country is getting mobilized to have an electronic exchange of a patient’s record, images can be in the forefront because they already enjoy a universal standard.
Imagine if he wanted to get a second opinion from another doctor. Isn’t it funny that he has that image on his computer screen, but he cannot electronically transmit that to anybody? The only way to do it is to burn a CD from his computer and physically either carry or deliver to wherever it is he wants to get a second opinion from. LifeImage changes that. We let him pick what’s on his computer, upload to an account in the cloud just like you upload video to YouTube, and from there you can invite other people — just like you’d invite your cousins to look at holiday pictures — to come take a look at your imaging exams. So he can get a second opinion using LifeImage in seconds, versus today when it all depends on where he’s going and how fast he can get there.
MassDevice: If LifeImage is as convenient at YouTube, do you have a business model that is as simple as YouTube’s?
HT: We certainly do. We start out dealing with doctors in hospitals because we had learned from 27 years of healthcare IT experience that it is a fallacy that consumers will, by volume, be attracted to medical information just because you can make it convenient for them. Consumers, when they behave as patients, will go along with what their doctor says, so we start at the physician side making it convenient for the physician to be able to exchange imaging information, just like with YouTube, among themselves and similarly let them exchange the information with their patients, but as an iterative process, as an incremental adoption of ideas. Others are coming out onto the market, like Microsoft HealthVault and Google Health, advertising personal health record accounts in the cloud, but they’re not having any success: Nobody that you know has a Microsoft HealthVault account.
We want to make sure that repeat exams are eliminated. Today the country spends $15 billion to $20 billion per year on repeat exams. Simply because when a patient goes from Doctor A to Doctor B and doesn’t have his or her images with them, the doctor needs to re-examine and re-image them. With our network, that problem goes away, because you can easily provide access to the appropriate people at the right time, therefore avoiding the excessive costs of repeat examinations.
MassDevice: Where did the germ of the idea for LifeImage come from?
HT: I was CEO of a local company called Amicas and our business was to create digital images for radiologists so they could more conveniently read the exams and have a better throughput. That was a very successful company; it had over 1,000 installs. It was recently sold for $260 million or $270 million, but the problem is it didn’t go far enough to connect the different silos of information, so inside of Hospital One and Hospital Two, thing are automated, but you couldn’t translate that success into exchanging information from Hospital One to Hospital Two, so we decided to fill that void and that’s where LifeImage came from.
MassDevice: You seem to be an entrepreneur at heart, with a string of successful companies under your belt. Do you think you’ll stay with LifeImage for a while, or do you have more ideas up your sleeve?
HT: My sleeves are getting old. This is going to be the biggest and most appropriate company for me to stay with for a long time. I just like building things. When it gets to a point that the building becomes mundane, I need to move on. LifeImage has a very long, useful life ahead of it, because images are just the beginning. We want to go all the way to fully enabled medical records to be shared, and there’s so many different facets of it. There is the physicians’ way of accessing a set of tools, there’s the patients’ set of access, there’s the researchers, there’s the payers, so this is a company that has many different tentacles yet to be developed. I don’t expect it to become boring anytime soon.
MassDevice: With regard to the cloud, are you planning to make the information that you store in the cloud accessible to researchers in any way, perhaps by anonymizing some of the data you’ve built up over time?
HT: That is a very good question and it has a very tough answer. The confidentiality and security nature of our business is first and foremost to us. To the extent that patients will decide to opt in for anonymized information to be shared with others for purposes of research and so forth, sure, but we’re not building it for that purpose. We don’t need to do that to be helpful for the research community. Instead of selling anonymized data, we can describe aggregate behaviors. When our network is up and running at a significant scale, we can simply tell people that in the Northeast United States or Greater Boston area, 40 percent of breast exams show that women between the ages 35 and 40 are best served having a breast MRI after mammography because we see the images and reports to indicate that.
So we no doubt do data mining, no doubt we take advantage of the scale of the amount of data available to us, but I’m not trying to sell anonymized data in one capacity or another. Rather, we would take advantage of the real goal of better information to be analyzed and that doesn’t hurt anybody, it doesn’t offend anybody’s confidentiality and yet it’s a very powerful tool.
MassDevice: Do you plan to keep the company private?
HT: We are an investor-based company, so we will do whatever is in the best interest of our shareholders, but we’re not in any hurry to go public. Going public has its own perks, but regulatory and oversight issues that go along with being a public entity. In my experience, a company that is growing by leaps and bounds in the first several years of its life shouldn’t limit itself in any way, including excessive oversight and regulatory issues. No doubt going public is one way of translating success, but there’s no hard-and-fast rule and no hard-and-fast plan. We just have one plan in mind and that’s do the right thing for our customers dominate the market as much as we can.