HIStalk Interviews Terry Edwards, CEO, PerfectServe

Terry Edwards is founder, president, and CEO of PerfectServe of Knoxville, TN.

Tell me about yourself and the company.

I started PerfectServe in the late 1990s after spending a few years in a technology company called Voice-Tel, which was one of the early pioneers in interactive voice messaging. At that company, I saw the need to improve communications in healthcare and later started PerfectServe. The company started in managing communications in the physician’s office, extending later into managing nurse-to-physician communication in the hospital and acute care environment while still doing the physician work. We evolved that over the last several years into one of the most comprehensive communication platforms in the industry.

How will the mid-January acquisition of Telmediq, the top-rated secure communications vendor, change your business?

PerfectServe was acquired by the Los Angeles private equity firm K1 Investment Management in the middle of last year. That was part of the plan to get our early venture investors out. They had been invested in PerfectServe for a long time and stood behind the company. We were able to give them a successful exit.

With that, we were also able to clean up PerfectServe’s balance sheet and to gain the backing we needed to execute on a broader strategy. As you and I have talked about in the past, the industry in which we operate is that outside the realm of the EMR, the technologies are fragmented. We started to see this just in the fragmentation of communications alone. But in addition, other technologies that are adjacent to communications could be part of a more comprehensive platform.

We surveyed the landscape and saw the opportunity to consolidate some of the stronger players within our category. Telmediq was at the top of that list. It had capabilities that we did not have, such as in the contact center and call center space as well as in nursing mobility. We thought those would be valuable to our customers. While there’s overlap in what both companies do, Telmediq was doing some things better than PerfectServe, and PerfectServe was doing some things better than Telmediq. By bringing these two together, we believe we’ve created the leading communications platform in the marketplace.

How important is it for a CEO to work with investors who can help take the company to the next level or help it clarify its acquisition and positioning strategies?

K1 is a growth investor. There are different kinds of private equity firms and different business models. Some will find slower growth opportunities with companies that might be growing five or 10 percent a year, then put two of them together and then take out costs and try to drive synergy.

K1 is a growth company where they are looking to invest. They are about building leaders in the category. As they evaluated PerfectServe, one of the opportunities was that PerfectServe could be the cornerstone of a much larger and broader care team collaboration product offering strategy. That led to the opportunity to acquire Telmediq.

We just announced two other acquisitions. Lightning Bolt Solutions, which is in the physician scheduling space, and CareWire in the patient communications space. Our broader strategy is to build the care team collaboration platform of the future. We will do this through both acquisition — and integration of the acquisitions — as well as organic development. That takes capital to do well, which is why we have K1 at the table with us.

Was the death of pagers greatly exaggerated?

[laughs] They are dying a slow death, but there’s a long tail.

Consumers seem to be using phones more often for texting more than for making phone calls or sending email, and now they are using speech recognition to drive that messaging. How is that  impacting healthcare communication?

I’ve been amazed to watch the adoption of texting as a mode of communication. When we started PerfectServe, everything was voice driven. In fact, the first version of the PerfectServe platform was purely an interactive voice response platform. All the communications were voice driven and interacting with the keypad.

We first entered the acute space in 2005. Due to the nature of the platform, 100 percent of the communications we were processing were over the phone, either as a live call or sending a page or text message. The text messages could be as an alphanumeric page or SMS and they were all system generated.

We later introduced our web interface and then our mobile interface. With mobile came texting. We started to see texting rise.

About 18 months ago, we introduced a new user object so that nurses could authenticate in the same way as our physicians. With that, we were able to facilitate bidirectional communication. A nurse can send a text to a doctor via the secure platform, then the doctor can reply. In our newest hospital environments, 90-plus percent of all the communication that’s running through the platform is text, and it is secure text, which has been fascinating to see. It’s convenient and that’s the benefit.

What is being done to make communications part of the overall workflow?

Gartner has classified us in the category of clinical communication and collaboration, or CC&C. They gave it that name to help communicate to hospital buyers that communication is more than just secure texting. Secure texting is a component of a broader communication strategy.

But as we’re looking at this — and I think it’s consistent with how Gartner is looking at this – the clinical communication platform is a core component or pillar of a broader care team collaboration platform. It needs to encompass the communication modalities of secure texting, paging, SMS messaging, email notifications, and voice calling, whether it’s a cellular, voice over IP, or landline. You have to have this omni-channel communications component.

The key to PerfectServe since Day One has been our workflow capabilities. We are automating a communication workflow to make sure that we can connect the initiator – a nurse or a doctor or some other caregiver — to the person they need to reach, who can then take action at that moment in time. Workflow is a component of this.

As you think about workflow, there’s not only the algorithms around routing, but also call schedules. PerfectServe as well as Telmediq built call schedules into our platforms, but they were limited to the schedules specific to a communication workflow. Medical groups, for example, have scheduling needs that are broader than that, that go across the whole workforce. That is where Lightning Bolt comes into play.

These adjacent technologies move beyond communications to staff scheduling, referral management, rounding, and integration into other technologies like alarms, alert systems, nurse call, and interactive patient care. Our vision is to build the most comprehensive care team collaboration platform, either by building or acquiring technologies that make sense to be a part of it, and then integrating with those that are adjacent but outside the domain, such as nurse call.

How have the communications needs of health systems changed as they acquire hospitals and practices?

I don’t think they are changing, but the expansion is enabling them to put in stronger governance structures to drive higher levels of standardization. One of our clients, Advocate Health Care in Chicago, has been a model in terms of saying, these are the parameters upon which we’re going to communicate with you. We’re going to have these minimum standards around fail-safe notification processes and escalation and things like that. This starts to move the organization away from letting doctors do it however they want, which might be might be efficient for them but not for nurses or colleagues who need to reach them.

What do you as a CEO do during the HIMSS conference?

[laughs] It’s usually a pretty packed schedule. I will spend a little bit of time in our booth, and that’s unstructured. But for the most part, I’ve got meetings scheduled, a mix of customer meetings, new prospect meetings, analyst meetings, and sometimes meetings with folks in the financial community. It’s usually a pretty intense time, one of those events that I look forward to, but that I also hope to never attend again.

Do you have any final thoughts?

I’m excited about where PerfectServe is. Not just for me personally or our company, but for our customers. I’ve been in this space for a long time and I’ve seen a lot of things. There’s this bigger vision that I started to see about three or four years ago and it is here now. PerfectServe and our customers have the opportunity to deliver even greater value than I envisioned. I’m excited about that and excited about the future.