Jay Colfer is CEO of Fivos Health of West Lebanon, NH.
Tell me about yourself and the company.
I’ve been in healthcare for 30-plus years. I joined Fivos Health last October as their CEO.
Fivos was previously known as Medstreaming or M2S, two companies that provide three things in the marketplace — a software solution for ultrasound specialties, a technology platforms for societies and registries, and data analytics for device manufacturers. The common thread is vascular medicine. Each business line solves for specific problems, but collectively they lead to driving towards quality in that specific area of vascular medicine. We have over 1,000 clients clients in the specialty providers of office-based labs and hospital and health systems, combined with medical societies, registries, and device manufacturers.
We relaunched the rebrand of our company to Fivos recently as part of the “one company” initiative that we developed to help unify our clients and our employees and make it simpler for them to work with us. People ask what Fivos means and how we came up with it. The short answer is that it’s easier to come up with a name than finding an available URL. We wanted to make it a short. We didn’t want it to be something that began with an “M” because people would deviate back to the old M2S or Medstreaming. Fivos is an alternate name for the ancient Greek deity Apollo, which is the god of light, truth, medicine, and healing. It stuck with us because remind us what our focus is. Even though our roots are in vascular, we are focused on medicine and our commitment to create insights around healthcare and around quality, particularly in the vascular space and in some of the other modalities that we serve today.
How are registries populated and used?
A registry is typically formed by a society. We got our start partnering with the Society for Vascular Surgery. They formed a Vascular Quality Initiative that has 14 registries. A registry in this case might be for carotid artery stents, with a clinical site, a hospital site, contributing data around that clinical procedure and as well as follow-up information to that care.
Today, we have more than 800 healthcare organizations contributing to various registries on clinical procedures in the vascular space. It becomes a repository of data for clinicians to be able to figure out, how are we doing from a quality perspective? Are there things that we can do from a clinical outcomes perspective?
How do registries get information from provider EHRs?
There’s some complexity to that because there are multiple parts. An example is our work with device manufacturers. Because of our partnership with Society of Vascular Surgery, or SVS, we have the ability through their patient safety office to take that data from a quality perspective, anonymize it, and provide it to device manufacturers. They are looking to use quality clinical data for pre- and post-approval studies or device trials. We provide that data to them. A number of them use that specific data as they are working with the FDA for their regular regulatory and compliance issues.
Who pays for that movement of data?
Device manufacturers, via their patient safety office. The PSO is purchasing that anonymized data for their specific devices. That revenue is split between the technology company, Fivos, and the society, SVS.
Before registries, was the only available option for these kinds of projects the commissioning of new studies?
It was. The VQI was started probably 15 years ago and has evolved over time. It started in the Northeast. Our chief medical officer, Jack Cronenwett, MD, who was out of Dartmouth, was one of the founders. They started as a regional group that grew over time and expanded geographically to the point where they had to make that a formal organization with SVS. This vascular registry it is the largest one in North America.
What is involved in transforming hospital EHR into registry form?
One of the biggest issues is extracting data from the client’s EHR. A lot of our data sits in unstructured notes. For years, a lot of companies focused on on natural language processing and AI to try to figure out how to bring that back. We are working with our partner SVS with the major HIS vendors, leveraging our relationships where they are committing to building structured report templates as part of their base system that would provide an easy way for us to be able to extract information. Over the last 20 years, while there have been advancements in machine language and AI, part of the work is still extraordinarily manual. We are working with the major vendors to create that structured note to automate that data abstraction and that information can flow into the registries.
You must also need to avoid impeding the workflow of clinicians or adding extra work for them.
Correct. It takes time working with the vendors to say, how do you come up with a clinically appropriate templates that will capture the relevant information and not impede their normal practice? That’s a challenge.
What led to the decision to change Medstreaming’s business by acquiring a registry company and combining those business into something new?
As I mentioned, there are three parts to our business lines. Our workflow solutions started in vascular as a platform for being able to help reduce reporting times for providers. Our system helps build patient reports in an ultrasound modality that is complete with images and anatomical sketches and allows the documentation to happen as the exam is occurring. That then feeds into the EMR or EHR, depending on what the environment is, and allows for better and faster reporting times. As a patient, the frustrating part is having to wait on results when you’ve had that type of an ultrasound. That model for workflow solutions allows us to help quickly get reports back faster.
Where that ties in is that our workflow solutions have expanded from vascular to cardiovascular to women’s health, and we’re now looking at building for all general imaging modalities. From an ultrasound perspective, we create a baseline for a lot of clinical data in a structured environment that can then be fed into registries.
In our vascular world, we have 14 registries. We have expanded into neurovascular registries. We are having conversations with orthopedic societies that are starting registries.
We are looking to bring this under one brand to expand our general imaging modalities to be able to provide our technical platform for societies. Then, combine that with the whole data piece, with data abstraction as to being able to pull data from our workflow solutions into the registry, or directly from the EMR or EHR into the registry.
Those are the three growth areas as we take Fivos forward.
Where do you see the company going?
Fivos has been around for 15 years, which probably surprises a lot of folks. We want to become agnostic as it relates to ultrasound platforms. There was an international organization that was looking to replace their ultrasound system. They told the five major ultrasound device companies, “All of your products are great, but if you don’t have the piece that Fivos provides, don’t participate in the tender or the RFP process.” We are building our brand with those organizations so that our solution can be the front end to getting information into the registries.
Then on the back end with the registries, to be able to look at that data from a quality perspective and say, what improvements can we make? Not only from a device manufacturer perspective, but also from a clinical perspective inside of research. Whether that’s vascular, cardiovascular, or neuro, we can analyze the data that contains that information.
We think there’s an ability to even enhance that for healthcare organizations that say, how do we marry up our clinical data with charge, cost, and pharma information and make that available back to our clients? They have a lot that data already inside their organizations, but how do we bring that together for them? We are going to be focused on that.