Hyr Medical — a Cleveland startup that connects health care providers to places to practice — has partnered with Axuall, a digital verification company, also in Cleveland, to pilot portable digital credentials across portions of Hyr's network of more than 650 physicians, according to a news release.
The partnership will leverage Axuall's national network of primary-source credential issuers to enable physicians to present fully compliant credential sets to places where they apply to practice via the Hyr platform. Hyr Medical's online network directly connects qualified physicians and health care systems for freelance ("locum tenens"), telehealth and permanent jobs.
Regulations require health care employers and health plans to credential practitioners upon hire and periodically after that. The process, which can be a significant operating expense and take anywhere from three to six months to complete, is repeated for each additional care setting where a physician works, leaving qualified physicians waiting to start work, patients waiting for care and health care systems losing money, according to the release.
"Together, the Hyr and Axuall technologies will play complementary roles in reducing unnecessary costs and time to place qualified physicians into much-needed positions," Charlie Lougheed, Axuall's CEO, said in a prepared statement. "We expect to learn a great deal during this pilot as we observe how this technology reshapes workflows and improves efficiencies."
Supported credential types include, according to the release: medical education, training, licensing, board certification, work history, competency evaluations, sanctions and adverse events.
Axuall's network leverages patent-pending blockchain technology to enable physicians to acquire digital versions of their credentials from authorized issuers, including medical schools, residency programs, license bureaus and medical boards, according to the release. They can then share those credentials securely with health care systems and medical groups.
"As the U.S. health care system grapples with the challenges of meeting the growing demand for care coupled with the disparity in physician density between metro and rural locations, health care employers are looking for new ways to attract, engage and deploy practitioners," Hyr Medical CEO Manoj Jhaveri said in a prepared statement. "We expect new models like on-demand freelancing, telehealth and faster placement to play a significant role in addressing these challenges. Technologies like Axuall and Hyr will enable these advancements."
As part of the pilot, the companies will study the experience of the practitioners acquiring, managing and sharing their digital credentials with employers. Collected data will help them better understand how technologies "improve workflow, reduce redundancy and create empowering experiences for physicians," according to the release. Axuall has recently started separate pilots with two health systems, details of which will be announced "shortly," according to the release.
Inspiration arrives in unexpected ways.
Thirteen years ago, Jonathan Klinger came home from work to find his wife, Julianne, in the living room of their home in Cambridge, England. She was holding a CD player and had big earmuff-sized headphones strapped to her pregnant belly.
More than a decade later, the couple's baby-tech startup has gone through loads of research, engineering, testing, relocation and risk-taking. After several prototypes, securing a patent and winning the Northeast Ohio Chapter of the Innovation Fund of America prize (a "Shark Tank"-like competition) in the form of a $100,000 interest-free loan, Mbrio Pregnancy Earbud Adapters hit the market in June 2019, and they're getting noticed.
The adapters, which transform regular earbuds into pregnancy headphones, garnered an Instagram shout-out from supermodel Ashley Graham to her almost 10 million followers, blurbs in People and Us Weekly magazines, online coverage on lifestyle sites including PopSugar, and a rating of 4.9 out of 5 stars on Amazon.
Having an idea, designing the product, manufacturing it and establishing a company around it are daunting tasks. Jonathan and Julianne Klinger merged their experience — his in engineering, hers in marketing — to create earbud adapters that clip to a pregnant mom's waistband. They're made of safe, quality materials in an ergonomic shape. Decibel level and frequency testing was performed by a nationally registered lab.
"I'd heard about playing music to my unborn baby from my mom and sister," Julianne said. "It wasn't a new concept, and after my midwife suggested it, I decided to give it a try. I thought I could go to the store and pick something up. All I found were bulky speakers that required adhesives or straps and splitters or adapters. That got us thinking that there must be a better way."
Jonathan, raised in England, is an engineer with a graduate business degree from France. Julianne, raised in the Midwest, has an undergraduate degree in anthropology and an MBA from the University of Chicago Graduate School of Business, where the two met through a mutual friend.
Together, the couple moved often, following their jobs. Jonathan worked in marketing and product innovation for large corporations, while Julianne worked in advertising and marketing for a large Fortune 100 company.
"We kept thinking that playing music for our baby shouldn't be a different experience than playing music for ourselves. It should be seamless and use things we already had," Julianne said.
Three months after their first child was born, Jonathan's work took them to New York. Design began with a trip to Walgreens and CVS, where they bought everyday products, including things with plastic clips, gel shoe inserts and other items that would attenuate sound.
As an engineer, Jonathan had two questions. "One was: How do you make the sound safe for the baby? And the second is: How do you hold it to the mom's belly without harnesses or sticky stuff? The first sketch was literally drawn on the back of an envelope.
"We made several iterations," he added, "and by the time we got close to the final prototype, we searched to see if anyone had done anything like it. No one in the world had, so we applied for and received a patent. No one can legally copy it."
After having another child and moving to Cleveland a few years ago, the Klingers were nearing the home stretch. They discovered Sears think [box], a public-access innovation center at the Case Western Reserve University School of Engineering.
"They have a phenomenal 3D printer that we could use for free," Jonathan said. "Unlike many 3D printers that only produce items in hard plastic, this printer allows you to model the squishiness of the piece."
"We gave prototypes to local pregnant moms to try," added Julianne, who named the company Mbrio. They also commissioned Suzy.com, a market research company, to carry out an online survey of 500 pregnant moms across the U.S. to confirm attitudes about the benefits of prenatal music and interest in their product.
The couple also discovered the JumpStart Inc. nonprofit accelerator, which provided mentoring, networking and ongoing support before, during and after the grant application through Glide (Great Lakes Innovation and Development Enterprise) for the Innovation Fund of America prize and the product's launch.
The final product, which looks as sleek as anything hanging on the wall of an Apple Store, meets the standards put out by the CDC and the National Institution for Occupational Safety and Health (NIOSH). It's made of medical-grade silicone and a plastic clip that are joined without screws or glue but using split, flanged pegs. When it came to finding a manufacturer, Jonathan says that many turned the product down due to the complicated design.
"It was our choice to be this concerned about product safety. I've been through this with other products," said Jonathan, who left his full-time job two years ago. Through his contacts, he chose a high-quality, tier-one manufacturer in Asia to make the two components.
The next step, he added, became equally important.
"The organization that assembles the product and the packaging is a nonprofit based in Norwalk called CLI Supports," he said. "It provides paid employment to adults with developmental disabilities. They assemble the silicone to the clip and package the finished product. We also have the graphics done locally and use Ohio suppliers. Many are women-owned businesses."
"We could use suppliers from around the world," Julianne said. "We could have the graphic design done elsewhere, anyone could do our fulfillment, but we feel the community has given us so much, we love Cleveland and we want to give back."
She manages engagement with influencers and moms through Instagram. "That was a big part of this for us," she said. "Who we are in terms of bringing this product to light is also about who we are as parents. We left our lives in large corporations to do this a certain way. It might have taken us a little longer, it might cost us more, but there is integrity in it and that's the only way we wanted to do it. We came into it launching a product for pregnant women, but the richness has been the lives of these women we've gotten to know and remain in touch with. That's been the jewel of the whole thing."
As for additional items from Mbrio, Julianne said, "We're thinking of the next product as we consider the community and their needs."
Mbrio Pregnancy Earbud Adapters fit earbuds by Apple, including wireless AirPods, Samsung and Google Pixel. They're available in white or aqua, sell for $30 and can be purchased at mbriotech.com and on Amazon. For additional reviews and images see mbriotech on Instagram.
Whiskey makers tout the centuries-old craft of making their liquor: aging it in barrels for many years yields deep, smooth flavors. Patience is the key ingredient. Some distillers are out of it.
A new generation of whiskey makers is looking to quickly and cheaply capitalize on bourbon’s booming popularity by maturing it for just a few months, weeks or even seconds.
Healthcare staffing has long been a big business — and a major spend category for hospitals and healthcare systems.
But are the established staffing models meeting the needs and expectations of healthcare delivery organizations and contingent healthcare professionals? And are there alternatives?
Spend Matters spoke with Manoj Jhaveri, the co-founder and CEO of Cleveland-based Hyr Medical, which aims to leverage lean processes and technology (including blockchain) to provide a lower friction, higher velocity alternative to traditional locum tenens staffing.
Spend Matters: So, in a nutshell, what is Hyr Medical? And why did you start the business?
Manoj Jhaveri: Hyr Medical offers a transparent, online staffing platform that enables physicians and hospitals to directly connect for freelance work. We also provide upfront transparency into rates and practice locations, and we are automating portions of the credentialing process, using blockchain.
Hyr Medical got started after I got to know my first co-founder, Dr. Faris El-Khider, in 2017. Faris had firsthand experience working as a freelance (“locum”) physician and explained that the experience was extremely painful, slow, paper-based and frankly stuck in the 1980s. There was also a lack of transparency. For example, key information like hourly rate and hospital name was not provided upfront, and staffing agencies sought to increase their 40-60% markup on the physician’s rate. We knew that this was a big, hairy, audacious problem (with a massive market size) worth solving, and so Hyr Medical was born! Hyr now includes three additional co-founders (CFO, COO, CSO), four key advisers, five doctors who are regional VP’s and four employees.
What exactly does Hyr Medical do? What are the target markets on the demand and supply sides?
Hyr Medical has developed a two-sided online marketplace that enables locum/freelance physicians — as well as certain advanced practice practitioners (APPs) — and hospital systems, standalone hospitals, urgent care clinics, private practices and medical groups to automatically match and connect with each other for freelance work. Today, most of our current jobs are in the Midwest and Southeast/South USA, and we are starting to expand more now into the East Coast and West Coast. We currently serve a range of different healthcare organizations that include Cleveland Clinic, Miami Jewish Health, Northstar Anesthesia, Rogers Behavioral Health and others.
It was always clear to us solving the staffing problem had to go beyond just enabling matches. It also had to solve the very painful credentialing issue, which is what we are doing. We have deployed Phase 1 of our credentialing solution, in which we utilize some automation and access to key data sources such as CAQH and NPDB. Our current solution is three times faster than the typical staffing agency timelines, which can exceed three months. But we are not stopping there. Our goal is to achieve an almost instantaneous credentialing time by applying lean processes with technology and APIs, and by leveraging blockchain.
Yes, something I found unique about Hyr Medical was what the company was doing with blockchain and credentialing. I know you are working with Axuall. Can you sum up what the relationship with Axuall and where that fits in your overall business model?
Solving the physician credentialing problem is inextricably linked to solving the overall healthcare staffing problem. Our strategic partnership with Axuall is critical to our business success. Axuall is rapidly building a blockchain-based, credentialing commerce network that includes holders, verifiers and subscribers.
That will significantly reduce the waste and redundancy in the current credentials supply chain, including medical professional credentialing. Why verify something like where a physician went to medical school over and over again; instead verify it once and protect it using blockchain technology. We are already engaged in Axuall pilots.
On the demand side, where you are working with healthcare systems, etc., what functions/roles are you finding the business development discussions are happening with? Procurement, HR, COO, line management?
We generally engage with the following roles in the organization for our early informational meetings and software demo: the CEO, Chief Medical Officer, CSO, COO, Chief Innovation Officer, CFO, Director of Physician Recruiting or the Director of the Medical Staff Office. The smaller the organization, the less time is generally spent with the C-Suite, as their time is more limited. Also, with large systems and groups, the CLO and Chief Procurement Officer (CPO) are generally involved, and we usually have to register as a preferred vendor.
What’s your view of the competition? I know there are other healthcare platform players out there, like Nomad Health. Apart from where you are going with blockchain credentialing, what are Hyr Medical’s other differentiators?
Our view is that the market for online healthcare staffing platforms is not a “winner take all” market. We believe that in the Physician/APP space, three to five platforms will ultimately dominate, and we will be one of them. Freelance staffing is a $15 billion market today and will more than double by 2025. Incumbent staffing firms will still remain, but more share will be gained by online platforms like Hyr Medical over time. Direct competitors like Nomad are actually a good thing for Hyr because they will raise the general awareness and adoption of using online platforms for staffing. This is still very new to medical practices today, but an increasing number are getting the advantages and benefits. The market for platforms like ours is definitely expanding.
We think we have a number of other differentiators other than what we are doing with credentialing. We are hyper-focused on physicians and APPs, not on other healthcare professions, such as nursing. We go beyond rate management and focus on getting high quality doctors at high velocity to reduce/eliminate revenue leakage and improve patient throughput. We also think, and hear from our users, that our platform user experience is best in class. Finally, another differentiator will be our quality scorecards, which enable physicians to earn and display “badges” and will also enable physicians to opt in and display ratings and comments from facilities where they have worked.
We’re nearing the end of 2019, what does the future of Hyr Medical look like going forward through 2020?
Based on the traction we’re getting now and what we have planned for 2020, we’re very optimistic. We will be launching our iOS and Android mobile apps which will enable push notifications and alerts, in Q1 2020. In addition, we’ll also be launching our Physician Quality Scorecard. Finally, our integration w/ Axaull will become deeper, and we will complete Phase 2 of our credentialing transformation roadmap by the end of 2020.
What if eating locally sourced food wasn't just a trend or a bonus, but a way of life? That's the vision for Farm Fare, a Cleveland startup that created a custom software to help small farms compete with large, industrialized competitors by sharing resources and providing logistics to help keep costs down. The platform creates networks of farms and food hubs to improve distribution, data and efficiency, helping local products stay in your area.
“At Farm Fare, we help small- and medium-sized family farms, usually between 15 and 50 acres, gain access to markets like hospitals, public schools and universities,” said co-founder and CEO Cullen Naumoff. “We help regional food hubs collaborate and provide farms with data that tells them exactly what to plant based on what those institutions want to purchase. In America, four percent of farms own 70 percent of the market, and there’s something wrong with that picture. We think the future is collaborative with small farms efficiently feeding their own communities.”
Farm Fare isn’t just about tasty food or market efficiencies – the startup also takes its environmental role seriously. Naumoff said the company is focused on the sustainable and environmentally friendly aspects of local food, which makes their mission more than just a business plan.
“The United Nations recently predicted that, globally, there are only 60 harvests left, which means we only have 60 more years to produce enough food to feed the world’s population in my lifetime,” said Naumoff. “We know that big, industrial agriculture won’t work. We’re facing this global urgency, and we can use the knowledge we have to better support our own communities. We can’t just help farms get bigger and bigger. Instead, we want to support the very communities that give us our fresh food. We have a better, more equitable future in mind.”
Farm Fare was founded by Naumoff, Laura Adiletta and Daniel Conway, who each brought a different perspective to the enterprise. Naumoff had worked at food hubs and had an agricultural background, Adiletta had been a chef and food critic, and Conway co-owns Great Lakes Brewing Company. By the time the trio was sharing their idea with farms and organizations, they were receiving overwhelmingly positive feedback. The response prompted Naumoff and Adiletta to quit their day jobs and go all-in on Farm Fare’s mission.
“At the food hub, I realized there had to be a better way to connect family farms to distributors and the end customer,” said Naumoff. “We knew that a new supply chain model could support the local food economy, and we knew technology could get us there. Institutions really want to purchase locally, but they’re very price- and volume-sensitive. So, we needed a way to achieve greater efficiency, and that’s exactly what our tool does.”
For Farm Fare, the future includes expanding beyond northeast Ohio to food hubs in New York and the east coast before eventually stretching across the country. The startup is well on its way toward that growth, and has forged connections with a combination of local entrepreneurial resources like JumpStart, Great Lakes Innovation and Development Enterprise, and BrainTree, and good relationships with local food organizations and distributors. Thanks in part to an award from the Innovation Fund Northeast Ohio, they have plans to continue to scale their concept.
“Those folks have been tremendously supportive of us and believe in us, and it makes all the difference when you’re trying to get something like Farm Fare off the ground,” said Naumoff. “When you’re exploring the entrepreneurial environment, it’s like opening one door and seeing 10,000 more possibilities. These resources have been such a help in navigating which doors to open. I think you have an edge when you say, ‘I’m from Cleveland. Let me tell you about what’s happening in Ohio.’ We’re not just another Silicon Valley or New York startup.”
Cleveland, OH - The American Medical Informatics Association held its third annual competition to identify the best new solutions in healthcare that use information and informatics to improve patient care. The contest is run in partnership with MedStartr, a crowdfunding marketplace for healthcare company development, that seeks entrepreneurial organizations to invest in and accelerate. Start-ups from all over the country were asked to submit a project idea and were vetted by the MedStatr community that includes healthcare experts and iRxReminder was selected as a finalist.
Five teams took the stage on Sunday morning, November 18, at the AMIA annual conference in Washington DC to compete for $25,000 in grants and entry into the MedStartr Acceleration Program. Each team was given 6-minutes to present a complete overview of their company, the problem to be solved, explain their unique solution, and present the business case.
“I was stunned and thrilled when they announced our name,” said Anthony Sterns, CEO of iRxReminder who made the winning pitch. “The other teams are also doing great things with large data sets and have relationships with major clinical organizations.” However, the judges determined that iRxReminder has the strongest business case and that the other competing companies still left them guessing as to how their ideas could scale and grow.”
We worked closely with our lead mentor Cathy Lippert from the Burton D. Morgan Mentorship program, Russ Donda our mentor from the GLIDE Innovation Fund, and Jim Weisman, our mentor at BioEnterprise to build a strong business case to help mental health agencies support their patients and staff with our proprietary technology.
Mental health service agencies have a serious problem with over 25% of their client-patient population routinely in crisis. iRxReminder provides a smartphone app and a wirelessly connected smart pill dispenser to patients. When patients take their medication the confirmation of dispense is shared with their healthcare team. What makes iRxReminder unique is that the dispenser works with a dosing window. If the patient takes the medication on time on their own, in the first half of the dosing window, they get no alert. Only when they forget do they get an alert. As they get better at taking the medication on-time, they get fewer more meaningful alerts driving high adherence.
“We are training people to take their medications on-time without help,” said Dr. Sterns. “People want to feel in control, and with our method, they are not nagged by an alarmed box telling them what to do.”
The contest began with companies joining a special AMIA MedStartr Crowd Challenge and teams competed to be a finalist by how much the crowd and judges like, follow, try, partner, pilot, mentor, and invest in the ideas and companies. iRxReminder was actually the first alternate but was elevated to compete when another company could not make the trip to Washington. The other finalists included: IANN, Inference Analytics Neural Network of Chicago, IL, who came in second, Stocastic E-Triage of Baltimore, MD, who came in third. IrisOB Health, Inc. of Scarsdale NY, who won the People’s Choice award. MedAux of New York, NY, also competed.
Andrew Park, the Managing Director of Warburg Pincus
Charles Safran, Professor of Medicine at Harvard Medical School,
Craig Feied, MD former Chief Strategy Officer at Microsoft Health Solutions Group and Professor of Emergency Medicine in the Georgetown University School of Medicine.
Michael Kaufman Managing Partner of Knowledge Based Transaction Partners.
Steve Tolle, a Partner HLM Venture Partners
About iRx Reminder, LLC. iRxReminder is a Cleveland, Ohio-based medication management platform service provider focused on empowering patients and healthcare professionals to manage medication adherence. Our platform ensures that patients achieve high medication adherence, communicate timely with their care team, and improve healthcare outcomes. The iRxCapture app, available in the Apple App Store and Google Play store, is a customizable, bidirectional tool that empowers patients with a unique behavioral approach to compliant self-managed medication taking. The technology also provides effortless remote clinical monitoring that triggers timely and critical interventions by agency staff. The data from monitoring and intervention activities also provides reimbursable activities that help agencies increase their revenue up to 40-percent for their patients using the technology. The company has projects completed or in progress with such institutions as Harvard University, The University of Michigan Cancer Center, George Mason University, Case Western Reserve University, Kent State University, University of Wisconsin School of Medicine, and Summa Health System. The company plans to evolve with FDA clearance of the iLidRx, their wireless smart pill dispenser that verifies medication dispensing as a 510(k) Class II medical device. It is a complete patient-centered medication management and education system that addresses accountable care and population-health-management goals. For more information, go to www.irxreminder.com or contact Larry Tusick, Vice President of Business Development.