Lead Horse Technologies’ Medloom Decision Support System: Bolts Onto Electronic Health Record Systems To Provide Alerts Of Potentially Dangerous Medication Situations Automatically
The folks at Start-ups.co had the opportunity to interview Dr. Ramie Leibnitz, Ph.D., Co-Founder and President of the Kansas-based startup Lead Horse Technologies. Ramie shared about what her startup is all about and details of the company’s flagship decision support systems product, Medloom.
“Lead Horse Technologies” is the Personalized Medicine Company that lowers healthcare costs for everyone by giving you better drug safety information than you can get anywhere else.
“Medloom” Decision Support system. In a pure SaaS model, “Medloom” is offered as a cloud-based app that bolts onto any electronic medical information system to make it better at lowering costs related to patient safety.
Below is the full interview that Start-ups.co conducted with Dr. ‘Leibnitz’ regarding her company “Lead Horse Technologies” and their groundbreaking decision support systems product, Medloom.
What is it exactly that you do and what your start-up is all about?
Adverse drug events cost ~$400 billion/yr in the U.S., and many are considered unpreventable. Lead Horse Technologies helps identify patients at risk with the IT solution Medloom®. Medloom bolts onto electronic health record systems to provide alerts of potentially dangerous medication situations—automatically!
Doctors receive alerts at the point-of-care when prescribing life-saving (or harming?) drugs to patients, and people with medical issues will soon be able to use the “Medloom for ME” iPhone app. Medloom can uniquely saves lives while reducing costs, lawsuits, and hospital readmissions.
Enough is enough. Stop worrying about the ads from law firms asking if “you or a loved one have suffered from using the medication XXX…” Medications should help, not harm, and Medloom helps increase patient safety.
When was your startup founded? And what stage is your startup currently at?
Lead Horse Technologies launched April 2006. We’ve spent 5 years in R&D developing Medloom’s artificial intelligence algorithm, testing in a clinical study, getting involved in peer-reviewed publications, collaborating with a national drug safety surveillance team out of S. Carolina, and receiving FDA’s nod of approval for work on task orders.
The professional Medloom IT tool is a market ready product. We’re seeking sponsorship to develop the patient-facing tool called “Medloom for ME” (see our recent crowdfunding endeavor on www.MedloomforME.com).
What is your startup’s business model and how does it work?
Medloom is provided as a subscription service to hospital systems, health insurance companies, big Pharma, pharmacy chains, and other healthcare organizations/companies that have an interest in accessing pharmacovigilance data for point-of-care impact, or who seek a registry for drugs and diseases that is passively populated in near real time by being integrated into electronic health information systems. (Please note: Medloom is HIPAA compliant because no patient identity is captured.)
Integration of Medloom is at-cost, then the annual license fee can be prepaid or set up on a monthly payment plan. The iPhone app will also be available on a subscription basis. The on-going fees enable Medloom to incorporate data from drug safety reporting agencies and provide up-to-date assessments of patient risk.
How did your team meet? And who in your team does what?
Co-founders John M. Armstrong, Ph.D., and Ramie Leibnitz, Ph.D. met at UT Southwestern Medical Center at Dallas while completing their Ph.D. degrees in immunology.
Dr. Armstrong is Lead Horse’s C.E.O. and Chairman. His strength lies in bioinformactics. In a previous position, he was the lead author on a bioinformatics proposal that received $29 million in funding through the NIH.
For that proposal, he named the principal investigator, Dr. Richard Scheuermann, who is now on Lead Horse’s science advisory board and who currently acts as director of informatics at the J. Craig Venter Institute. Dr. Leibnitz was a member of the prestigious Basel Institute for Immunology. She is president of Lead Horse and specializes in medical communications.
Tage Tracy, author of well-known business finance books, acts as the Company’s CFO. Kevin Biersack, VP of Product Development, met Dr. Armstrong while working for Northrup Grumman as a project manager.
Mr. Biersack and Dr. Armstrong collaborated on the NIH project mentioned above.
Our team is experienced, hard-working, dedicated, and not only has a history of working together, but have now worked together at Lead Horse Technologies for years.
What, exactly, makes you different from existing options, what will make your product and/or service stand out in the marketplace? In other words what’s unique about you and what’s new about what you make?
Medloom represents a groundbreaking innovation in the prevention of adverse drug events. Current drug-drug interaction systems, medical reference systems, or even clinical decision support systems offered within electronic medical record systems only provide information that is known and published.
However, it takes over seven years for the most serious warnings to be included in a medication’s package insert. Medloom shines a light into that seven years of darkness by accessing adverse drug reporting databases and assimilating data about real world use of medications into statistically significant correlations that can be provided when a person is taking (or is about to take) medication that puts them at significant risk for a bad health outcome.
What is your growth like? And what milestones has your startup achieved so far?
This C-type Corp currently has 8 employees and contractors, has completed research and development for its go-to-market product Medloom, has multiple customers in its pipeline, and projects growth to more than 280 employees globally in 5 years.
Morrison and Foerster serves as the Company’s general counsel in the U.S. and abroad and advises the company on intellectual property and other matters.
A very recent milestone includes acceptance of the Company’s first (of three) patents.
Lead Horse Technologies plans to exit in five years through acquisition by one of its strategic customers after penetrating less than 5% of the health IT market and reaching annual revenues of approximately $100MM, earnings of $24 million, and EBITDA margins of 42%. Exit valuation comparables show companies like Lead Horse exiting for 3-4x revenues and > 10x earnings.
Who are your competitors? And what is your start-up’s competitive advantage over them?
Our competitors include other clinical decision support systems and medical reference systems that provide drug-drug interaction information. Often, potential customers believe their current safety alert systems adequately protect against medication side effects. However, these systems allow almost 4,000 people to die each week due to adverse drug events. Our biggest competitor is acceptance of this horrific death rate.
Medloom provides a way to prevent what has always been considered the UNpreventable by allowing patients and doctors a way to assess the real world of drug use and be alerted when their situation matches a situation that has proven to be dangerous.
What obstacles did you face and how did you overcome them?
The technical challenge to provide pharmacovigilance data to the point-of-care was overcome by hiring a talented artificial intelligence development team out of N. Ireland called SophiaSearch.
They have developed A.I. technology similar to that used by Google or Amazon, and they helped us apply it to the field of medicine.
The financial challenge that almost all start-up companies face was overcome by an extraordinarily dedicated and evangelistic management team who raised $4.5 million and who have developed a market-ready product that will change the way patient safety is protected.
What are the key things about your field that outsiders don’t understand?
Everyone expects that healthcare professionals are aware of problems associated with medications and that their doctors will not prescribe medications that are dangerous for them.
However, doctors cannot know everything about all your drugs, particularly those prescribed by specialists, and new information is being discovered every day. Providing that information so it can positively influence clinical decision-making is a priority for Lead Horse Technologies.
We respect that the practice of medicine is an ‘art’, but we also recognize that healthcare professionals can use a little extra help knowing when the medications they are prescribing could put their patient at risk for a serious health outcome.
Why are you going to succeed?
Lead Horse Technologies will succeed because of our Executive Team members who over the last six years have demonstrated incredible perseverance, diligence, adaptability, insight, enthusiasm, self-sacrifice, hard-work, and patience.
The innovations encapsulated by the Medloom product define “disruptive technology,” and Medloom is anticipated to become a new standard of care for patient safety.
If your startup succeeds, what additional areas might you be able to expand into?
The Medloom architecture works similarly to a real loom by weaving in numerous ‘skeins’ of data.
Medloom is infinitely expandable, and we plan to include additional sources of data such as biomarker data as well as fold in information from genomics and proteomics.
Other fields we can launch the Medloom platform include animal health. An on-going endeavor is to develop Medloom applications for mobile platforms.
Why did you choose this idea and concept?
While Dr. Armstrong worked as a medical science liaison for a large pharmaceutical company, a little boy we’ll call “Billy Jones” suffered an adverse drug reaction.
Billy had several chronic medical conditions, and the doctor at the emergency room did not know which medication was causing the damage to Billy’s liver, which was causing liver failure.
The doctor swapped out one medication for what was believed to be a safer medication, but this was the wrong clinical decision and within days Billy was on the liver transplant list.
Drs. Armstrong and Leibnitz knew that the information to make a safer clinical decision WAS available, but not in a timely manner.
Between Dr. Armstrong’s bioinformatics expertise and Dr. Leibnitz’s medical communications experience, they envisioned the Medloom clinical decision support system.
Within 6 months, they had a working prototype that solved the Billy Jones crisis in under 20 seconds. We at Lead Horse hope that other children like Billy Jones will not suffer needlessly.
What have you learned so far from launching your idea?
Early on it became evident that providing a software tool that requires busy healthcare professionals like doctors or pharmacists to input data was not going to work.
We adapted from a human user-interface data portal to an embedded web-app, as invisible to the user as “Intel Inside”.
The increased use of electronic health information systems has set the stage well for our tool to act as an ‘add-on’ that provides information to enhance patient safety.
Six months from now, what’s going to be your biggest problem?
Our biggest challenge will be to manage growth of the company. We have prepared for rapid growth by contracting with a company specializing in rapid integrations of software based on the InterSystem’s platform, such as ours.
We based Medloom on InterSystem’s Caché because of its use in 60% of this nation’s health IT solutions, and because Caché runs Oracle data five-times faster than Oracle itself.
We have all but signed with a large hospital group purchasing organization that will act as our initial sale force, although we will need to provide sales personnel to close with the hospitals who are interested in licensing the Medloom product.
What’s the benefit for the customer/user?
There are a number of benefits for the healthcare professional who makes use of Medloom, but ultimately, the benefit will be experienced by the patients whose lives are saved by the Medloom technology.
Patient safety can be metricked by reduced hospital re-admissions or lawsuits or by monetizing the savings associated with replacement medications that doctors prescribe after they receive an alert from Medloom, but we anticipate the greatest benefit will be to reduce the nearly 4,000 lives currently lost each week due to adverse drug events.
How did customers/users find out about you?
The Lead Horse management team includes a VP of Strategic Alliances and Business Development who, along with our C.E.O. and President, attend healthcare conferences and coordinate marketing endeavors to engage potential customers.
We have developed marketing materials with the help of the experts at Feinstein Kean Health, a company focused on promoting personalized medicine endeavors, and we also benefit from the outreach activities of our global technology partner, InterSystems Corporation.
Who are your current customers/users? Who are your target customers/users?
Our sales pipelines consists of two prominent large hospitals systems, a top-10 pharmacy benefit management company, a large chain pharmacy, and a medical malpractice insurance company.
Our target customers are anyone who buys, sells, or uses electronic health information systems such as electronic medical record systems, personal health record systems, claims databases, pharmacy management software systems, etc.
Where do new customers/users come from and what makes new customers/users try you?
New customers learn about Medloom’s patient-safety capabilities through outreach activities described in Question 16, and they are willing to try us to derive cost saving and increased patient safety records.
Moreover, as Medloom gets out to the market, we anticipate becoming accredited for providing Meaningful Use critiera, which will attract customers looking for healthcare reimbursement funds from the federal government.
What do your customers/users say about your product and/or service?
Dr. Dennis Tribble, the Chairman of Pharmacy Informatics at ASHP, commented about Lead Horse Technologies in his blog entitled:
“At last…somebody gets it!!!”
Dr. Charlie Bennett of the drug safety surveillance group at University of S. Carolina report:
“Lead Horse Technologies helped to identify 5 of the 43 potentially fatal and previously unreported side effects associated with blockbuster drugs detected by SONAR in recent years, which led not only to saved lives but enormous cost savings. Without the powerful Medloom technology developed by Lead Horse Technologies, including its unique, artificial intelligence-driven ability to identify patients at risk for death or hospitalization, we would be more than a decade behind in discovering these adverse events.”
And Dr. Michael Montgomery states;
“Rules-based software will only predict what is known and deliver warning after warning without the proper context to act appropriately in the patients at greatest risk. This leads to warning fatigue. A better system would be specific and accurate as to the predicted event (stroke, heart attack, re-hospitalization, etc.), and the specific group of patients affected; Medloom AI Technology is that system.”
How are you going to scale?
We built Medloom on InterSystem’s Caché because of its inherent ability to scale. It’s the world’s fastest database and currently the basis of the biggest electronic medical record systems in the world, including EPIC’s electronic medical record system and the VA’s VistA system.
In addition, Lead Horse Technologies uses the nations’ premier server farm, Rackspace, with their famous ‘fanatical’ support to minimize downtime and maximize dependability.
What’s the biggest missing feature? The one thing customers/users keep asking for?
As we go out to market with Medloom, potential customers ask, “Who else is using Medloom?” At this point, we are looking for the early adopter who is willing to upset status quo and save the lives lost to adverse drug events that are currently accepted as collateral damage in our nation’s quest to provide healthcare.
Are you going to internationalize? And if yes how are you planning to expand your start-up’s operations accordingly?
We have been working with the economic development commission in Halle, Germany and have been gifted three villas on a site within their technology park when Lead Horse is ready to expand to Europe. Halle, Germany provides an ideal location for access to both East and West European markets.
A significant factor in our expansion to Europe is that medications are often approved for use in Europe two years before approval in the United States, so there can be millions of real world adverse event use cases available for analysis in Medloomprior to a drug ever being launch in the U.S., making U.S. drug launches safer when Medloom is in use.
We are also in pilot studies with pharmacy organization in Australia.
All of our business develop efforts are supported by our business development/technology partner InterSystems. They assist our international expansion by providing ‘boots on the ground’ in 32 countries globally.
How big do you think you can get? Why? And how you are planning to achieve your goals?
Last year we hired Lauren Flanagan as a strategic advisor to the Company. Ms Flanagan is the CEO of SCIO Corp, the Managing Director of the Wisconsin-based angel group, ‘Phenomenelles’, and a BusinessWeek Top 25 Tech investor. She is helping us build our product Medloom into what we all expect to be a billion dollar brand, and the Company into a global player in the health IT industry.
Are you looking to hire a new workforce? And if yes, what job vacancies do you currently offer and where can potential applicants contact you?
Until we become a revenue-generating company later this fall, we are not currently filling any job vacancies. Currently, Lead Horse Technologies hires contractor developers from a consulting company specializing in development on the InterSystem’s platform.
We will be internalizing operations as we expand to bring our technological core competency in-house. We will also be seeking to expand our management team, including a CTO and CMO, and will bolster our sales and marketing team as we move forward.
Are you looking for partnership opportunities or funding from Venture Capitals (VC) or other funding sources? Or your business is self-sustainable? And if the first option applies where can potential partners / investors contact you at?
We would be very interested in strategic partnerships and can be contacted for discussion at our headquarters in Junction City, Kansas. Please contact Ramie Leibnitz, Ph.D., President, at 785-238-5666 or via email at [email protected]. We expect Lead Horse Technologies to be self-sustaining by the end of 2012/early 2012.
What advice do you have for fresh entrepreneurs?
Fresh entrepreneurs should be ready to fundraise more than expected, live with ambiguity but be self-confident of success, afford good legal and financial support, and be adaptive to market needs.
Finally, do you have any other comments that you would like to add?
The Medloom’s artificial intelligence algorithm gets smarter the more it’s used, so our ability to provide predictive analytics is honed as Lead Horse Technologies grows.
We are geared for success. Last week our first patent was accepted in Australia (and soon, we hope, in many of the other countries around the globe where we have filed for protection), and the five-year process is nearing completion for our other two patents.
Lead Horse Technologies plans to be “Leading the Way” towards better patient safety!
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