HIStalk Interviews Adam Turinas, CEO, Practice Unite

Adam Turinas is CEO of Practice Unite of Newark, NJ.

Tell me about yourself and the company.

Three of us started the company. I have a background in digital communications, building various digital user experiences for a couple of decades. My partner Stu Hochron is a 30-year practicing physician. The third leg of the stool is Ed Guy, who’s a PhD in computer science and who has developed mobile applications and voice over IP and things like that for as long as these things have been in existence. That’s the three of us who created Practice Unite.

This is our fourth year in the market. We started as a specialized consulting organization focused on helping healthcare organizations improve communications because we think that it’s, if not the biggest, certainly one of the biggest problems in healthcare. Within a few months, we thought, wait a second, mobile applications can clearly help solve a lot of these problems. That inspired the idea for Practice Unite. That was about three years ago.

We’ve evolved Practice Unite to be a mobile enablement platform for healthcare. What that means is that we have a system for delivering configured mobile applications that help clinicians communicate more effectively, help improve the way that healthcare systems engage with the patient, and also help address communication workflows and things like the management of high-risk patients. Even solving some of the issues in home care.

We’re casting across all of the different domains in healthcare because there are some common communication problems. We’re able to do that because we have a system that allows us to create highly configured applications pretty much on the fly.

Who are your competitors and how do their products compare?

The core competitors are in the secure texting space — TigerText, Cortext, companies like that. Our differentiation is the ability to deliver a much more customized and configured solution. We can deliver a customized solution which includes an integrated on-call system with the ability to escalate integration with the EMR so that lab results and consults are delivered into different containers within the application. Then it gives the hospital system the ability to do things like target different types of content for different users.

For example, we can do things like deliver KPIs to an individual physician. If you think about secure texting as being the fundamental commodity — the foundation of this new generation of communications products — we’ve taken it to another level by using that as a foundation for creating different communications solutions.

The other element is that we bring in other modes of communication. We include voice communications, whether that’s simply using the phone’s dialer in a way that makes it easy for physicians to call each other or integrating voice over IP. We have our own client for that. We’re now rolling out secure video communications as well.

When you look across the market right now, the primary buyers for mobile communications solutions are the CIOs, the IT teams for the various healthcare organizations. They default to secure text, so there’s lots of RFPs out there for secure texting solutions. But as they get into it, they immediately see that there’s a lot more that we could be doing with this mobile application. If we’re going to go to the trouble of deploying a secure text solution, let’s address a range of use cases. It might be about improving different workflows. It might be about making it easier to find a physician on call. It might be escalation or delivering clinical data. The market has evolved from being a point solution for secure texting to becoming platforms for delivering all kinds of different solutions.

When we entered the market, there were a number of secure texting vendors who were out there doing very well with it. We thought, we’ve got to go a step beyond that. When we built Practice Unite, we built it with a view of, this is where the market is going to be in two years. We’re finding that that’s the case.

What are examples of clients using photos and video?

I’ll give you a simple text and voice example. One of the things that we’re doing is integrating hospital systems and phone systems into the solution. You have a nurse web-based desktop because nurses tend to want to put the application on their own devices, a whole other BYOD thing. The desktop is configured so that when they send a message out to a physician, it automatically puts their extension in. The nurse might send a message to Dr. Smith, “Please call me about patient Jenny Jones. I need to update you on her condition.” The doctor receives that text message and can click the message and automatically be routed through to that nurse. One of our hospitals actually went from doing 150 overhead pages a day down to three because the nurses don’t have to page anybody any more. That’s a simple use case.

There’s a video on our website — it’s a wonderful story. The very busy ENT surgeon at one of our customers is also chief medical officer. At the end of the day, a small child presents with an upper airway obstruction. He has the child admitted, runs some tests, and tells the hospital that he’ll come back in the morning and most likely operate, but he’s not really sure because he isn’t really sure what is going on with the child. By the time he gets home, he gets a critical lab result that shows that the child’s white count is highly elevated. He gets a radiology impression, which confirms that the child has a mass that is probably an abscess. He opens up the app, opens up the on-call system, finds the resident on call, texts and says, “Send me a screenshot of the the MRI.” The resident takes a screenshot of it, texts it to him, and he responds back saying, “Put the child in for the OR and I’ll operate in the morning.” He came in the next morning, operated, and the child was back in his bed by 7:30 and was discharged later that day.

What he said to us was, putting aside the economics of it, the child spends probably less than 24 hours in the hospital when he’d likely be spending 36 or 48 hours in the hospital. Putting that aside, it’s better for the patient. The parents of the child know what’s going on because he’s able to give them accurate information quickly. The surgeon’s life is a lot better because he knows what’s going on. A simple combination of different communications modes working together very quickly is what’s compressing the time.

We’re getting into some very interesting telemedicine pilots. I can’t go into the details, but we’re in conversation with a group that’s taking care of some very high-risk patients with a serious infectious disease. What they want is for the care manager to have the ability to do a secure video communication with the patient on a daily basis. You can do that with Skype, but because they’re doing it through a mobile app, you can then add other features into the mobile app.

For example, the patient can provide updates on their condition or they can send a text message to the care manager between the calls, because they’re probably only going to do a video call once a week. Between those calls, they can send a daily update on the condition. They can send a text message that says, “I’m really not feeling well today.” That way the care manager gets ongoing feedback from the patient on the condition and then once a week can do a video call with them.

What’s the future of secure messaging over the next five years?

Secure texting is becoming a basic fundamental part of everything. The notion of a standalone secure texting application will pretty much be obsolete within a couple of years. I can’t see a reason why people would just buy a secure texting application on its own. Secure texting will become an ingredient for a different solution.

Where I think the market is going for us and where I think we’re evolving to is the ability to be in the middle of mobile-enabling all of these different workflows and all of these different interactions between clinicians and each other and clinicians and their patients.