Houston’s Decisio Crunches Patient Data for Better Care
Doctors and nurses in Houston’s Memorial Hermann Hospital scramble among hospital beds, making split-second decisions on treatment based on experience and a half-dozen blinking screens flashing different vital signs.
“There are a lot of data sets—plus, blood on the floor,” says Bryan Haardt, chief executive officer of the Houston-based medtech startup Decisio Healthcare.
It’s a distracting environment, to say the least, and Haardt says Decisio can bring some order to that chaos. Its software takes the data in those stand-alone monitors present in a typical ER and puts them into a dashboard on a computer or tablet screen, flagging items that need attention. “Today’s thermostats have more intelligence than most medical monitors,” he says. “This electronic triage allows caregivers to work more efficiently and give better care.”
He and co-founder Gray Hancock formed the company in April, after the software had been in a beta test at Hermann’s trauma care department for seven months. The men say they could have no better trial site than Hermann, one of the nation’s busiest trauma centers, which treats more than 6,000 patients each year.
Satisfied with the trial run, Decisio recently signed a licensing agreement with the University of Texas Health Science Center, which owns the intellectual property, to bring the software to market. UT developed the software in-house, using about $2 million in grant funding and a staff of as many as five software engineers for more than a year.
A Decisio screen looks like this: On the left side, there is a column that details all the procedures a patient has undergone, each with a time stamp. In the middle is a display with relevant vital signs and preliminary test results, along with a countdown clock that starts at admission. On the far right, recommendations based on existing patient-care protocols and real-time analysis of clinical data are given—say, call blood bank or consult neurosurgery. Data is highlighted in red, yellow, or green to indicate urgency.
“We’re not telling the doctor what to do,” Haardt says. He stresses that the software helps caregivers better assimilate patient information in an emergency care setting based on their existing protocols. “If the doctor had time to look up the information in this way on their own, they would, but they don’t have that time,” Haardt says.
With the beta test in the ER ongoing, Decisio is expanding it into the Hermann’s intensive care unit, where 40 screens are being installed. For the ICU, Decisio is tweaking the software so that it emphasizes health data that’s more important for monitoring in an acute-care environment versus those needed in trauma care.
Haardt and Hancock describe the difference this way: In trauma, the data the software churns out helps clinicians save lives; in the ICU, where patients are often stable, the software can save money. To illustrate this, they point to research that showed a savings of $19 million just by implementing protocols aimed at reducing the occurrence of sepsis in patients at Houston Methodist Hospital from 2009 to 2013. “That was on paper,” Hancock says. “Electronically, I can take those protocols and do better than that.”
Decisio will analyze rates of sepsis in Hermann’s ICU following the installation of monitors there. In the meantime, the founders are speaking to Austin-based Seton Medical Center about conducting a similar pilot there. The 1,700-bed hospital is owned by Ascension Healthcare, one of the nation’s largest hospital groups.
As it implements these programs, Decisio has raised $1.35 million in a $2.2 million Series A round from high-net worth individuals in Texas to make software tweaks and for marketing.
It is also seeking FDA approval for the software as a class 2 medical device, which is how 43 percent of such devices are classified. (Powered wheelchairs and some pregnancy test kits are classified as class two.) The founders hope to secure this by summer. If it gets the approval, Decisio pans to sell the software at rates from $500 to $1,000 a bed, working in partnership with existing electronic medical records companies who have contracts with hospital chains.
The inspiration for what would become Decisio came a decade ago, when John Holcomb, director of the Center for Translational Injury Research and vice chair of the department of surgery at UT’s Health Science Center in Houston, was in charge of the hospital’s Life Flight program.
“As a trauma surgeon, I was frustrated with having to make decisions on a single point of data—do I cut the guy’s chest open based on a single data point?” he explains. “In my animal labs, I have beautiful continuous data. I realized I had better data on my rats than I did on my people.”
He wanted a patient dashboard, similar to the unit status reports he used during his decades serving in the military—most recently as Commander of the U.S. Army Institute of Surgical Research—that provided a real-time update coded in red, yellow, and green to show urgency. Then Holcomb met Hari Radhakrishnan, a surgical resident at Hermann’s trauma department who happened to be a computer programmer before attending medical school, and they began to collaborate.
Radhakrishnan says the software improves communication between providers. “On any given trauma patient, multiple consulting services—trauma surgeons, emergency department staff, orthopedics, neurosurgery—can all see the dashboard and know what has happened,” he says. “Physicians do not need to spend valuable time bringing their colleagues up to speed.”
Hancock was introduced to Holcomb last year through his wife, an epidemiologist at UT. Hancock then brought in Haardt, who had also been involved in health IT startups in Houston. Hancock had been the director of operations at DNAtrix, while Haardt had founded two local medtech companies and, most recently, was COO of Prognosis Health Information Systems.
Provisions in the American Recovery and Reinvestment Act in February 2009 that provided incentives to hospitals to digitize patient care records helped pave the way for startups like Decisio, Hancock says. “Penetration of electronic records has jumped in four years,” he says. “That’s step one. We are doing things with the data that are useful, things you couldn’t do in a paper-based world.”