Only in the fresh-faced world of health care technology start-ups could a 31-year-old CEO claim to be "a little old" compared to his peers, as Anmol Madan, the founder of Ginger.io, sheepishly confesses over the phone. He has some company in the 28-year-old behind RxApps, John Moore III. Each heads a firm that is finding a foothold in the changing world of health care technology.
"Technology is being forced on care organizations," Moore says, citing the Health Information Technology for Economic and Clinical Health Act of 2009, a precursor to Obamacare. The HITECH Act for the first time requires hospitals to use electronic medical records. "Now that hospitals and doctors are being forced to use these fairly basic software tools, there's pressure to adopt more tools," Moore says.
The Affordable Care Act also shifted the incentives system for health care providers in a way that encourages the development of new technological tools, making funding available for challenge grants to test new care-delivery models. "With so many people now being insured, there is a much grander focus on population health," Moore writes in an email. "This means a big focus on new analytics tools."
Moore's Boston-based RxApps is a mobile platform designed to facilitate better communication between doctors and patients. If a patient is diagnosed with depression, for example, Moore says the doctor will use RxApps to check in and see how the treatment plan is working. The patient will receive a series of texted questions tailored to the individual and the issues he or she struggles with: Did she take her medication? How many hours of sleep did he get?
The benefits of these reminders work both ways. Moore, whose background is in molecular biology and genetics research, was inspired to create RxApps after watching friends and family go through treatment for which "doctors weren't getting all of the information to make fully informed treatment decisions," he says. The free-to-use product recently went live, which means the firm can collect more data on how doctors and patients communicate. That will not only help them improve results for users, but will also help the company attract investors, for whom cold, hard data is king.
RxApps trains potential clients to ask questions that won't put them at risk of breaching the HIPAA privacy rules they are all subject to. The user manual includes instructions on customizing text messages according to those rules: "How is your mood?" rather than, "How is your depression?"
Meanwhile, Anmol Madan's company, Ginger.io, looks for patterns in phone usage that could help answer that question. The Boston-based firm is named after the root, with its famed medicinal powers—a kind of international symbol for the kind of preventative care that Madan would like his company to represent. (".io," was simply cheaper than ".com.")
The start-up harnesses data from patients' phones to help providers predict how they'll behave during treatment. Using this information, Madan says, hospitals and doctors can gain insight into how people, particularly with mood disorders or attention deficit disorder, are feeling and what kind of medical assistance they might need.
Patients with depression tend to isolate themselves, which could appear in a diminished amount of output and interaction on their phones. The software would recognize such a change in data patterns and relay this information to concerned parties, which could, if patients opt-in, include family and friends. "We call it the 'check engine light,' which goes off when something's wrong," Madan says.
The idea for the company came out of Madan's Ph.D. work at the MIT Media Lab; he wrote his thesis "on modeling human behavior using mobile sensors." In the two years since it was founded, the company has grown to 18 Boston- and San Francisco-based employees, most of them scientists or engineers rather than medical school grads. Madan says Ginger.io currently works with 12 hospitals.
Keeping people's most intimate information secure is a key issue health care tech CEOs like Madan and Moore will face going forward. "The whole behavioral side of health—people are really touchy about that. People don't want other people to know that they have bipolar [disorder] or anxiety, because society stigmatizes those conditions," says Moore. "We've made sure to encrypt everything very well."
"Those are all things that … most engineers guard on a day-to-day basis," says Madan. "The bigger thing is what is your philosophy on that data and who [ultimately] owns that data." And that's a debate just getting started.