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March 31, 2014 Issue

The Most Powerful Name In Corporate News and Information


Electronic Patient Information for EMR and Healthcare Information Systems

Jon Elwell

About Inofile
Inofile technology creates vital links to simplify healthcare. Its groundbreaking software solves one of the most complex and overlooked problems facing healthcare, transforming unstructured medical information into a common, standards-based format. Inofile connects the healthcare continuum with simple, cost-effective technology designed to integrate into any patient care setting.

“Our understanding of and discipline to applying standards to our technology is another core strength. When we identify unstructured content and determine how it can become part of the patient record, we are very disciplined in using US and international healthcare standards.” - Jon Elwell

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Interview conducted by: Lynn Fosse, Senior Editor, CEOCFO Magazine, Published – March 31, 2014


CEOCFO: Mr. Elwell, what attracted you to Inofile?

Mr. Elwell: I first became aware of Inofile when I was the VP of Healthcare at Ricoh Corporation. As we built technology into our devices we found Inofile solutions to be very compelling, especially within the healthcare segment and the different customers we served. After I made a decision to leave Ricoh about a year and a half ago, they asked me to become an adviser. As of January 1st, they asked me to be the CEO. This journey started when I experienced Inofile technology firsthand at Ricoh and started to learn more about their team.


CEOCFO: What is the Inofile technology?

Mr. Elwell: In layman's terms, the easiest way to think about it is to remember your last visit to a doctor’s office or hospital. You fill out a registration form. A specialist faxes over notes from your visit. Perhaps an image of an injury is taken. All of this is unstructured content and none of it integrates easily into an electronic medical record, if at all. Inofile brings structure to all of this unstructured content.


When you think of all of these paper-based medical documents, including prescriptions, transfer of care, allergy information or lab results, these are only growing in volume every day. Each document is critical for optimal patient care but it is very difficult to take action from this format and even more difficult to collaborate and share.


Ultimately our goal is to transform the paper-based or unstructured pieces of patient information into an electronic format that is easily integrated into existing EMR or healthcare information systems. This delivers more value to the provider and empowers them to provide better care to their patients.


CEOCFO: What do you understand about the process to provide this service where perhaps others cannot?

Mr. Elwell: First, we understand where unstructured content is being produced and for what purpose. We stay focused in that space instead of getting lost in the sexier places of healthcare, with more complicated and IT-intensive solutions. Secondly, our understanding of and discipline to applying standards to our technology is another core strength. When we identify unstructured content and determine how it can become part of the patient record, we are very disciplined in using US and international healthcare standards.


An example of this is our participation in a healthcare technology event in Chicago earlier this year called the Connectathon. We were certified on almost 80 international standards by healthcare IT experts and seen as one of the teams most knowledgeable and driven to achieve these standards.


Lastly, we take a very user-based approach and look at the real situation. Technology can do so many things that it can become very complex and time-intensive if you aren’t focused on your customer’s needs. We call this the consumption gap. There is so much going on in healthcare IT systems, with so many features that no one is able to consume all of them, creating a gap between the intended outcome of the investment and the realized outcome the organization actually receives.


In most instances across healthcare, the real situation is that IT departments are struggling to maintain the technology. That’s why we create “lightweight” technology that is easy to install, intuitive, affordable and requires little to no IT involvement. The average person who works with our technology does not need hours and hours of training.


Those are the things that separate us. We believe that much of what happens in healthcare today is very resource-heavy and expensive. It is important to serve our end users correctly so they don’t feel any additional stress.


CEOCFO: Would you explain the different markets that you serve?

Mr. Elwell: We have three technologies and three primary markets. We have a product we refer to as ChartMD. It is focused on the ambulatory space, such as your doctor's office. ChartMD structures the unstructured content in these settings by taking paper-based and other medical information and integrating it into a patient record.


Then we have a product called Messenger which focuses on the acute care space, or the hospital space. Messenger connects the devices used at all points of patient care in a hospital – from scanning equipment to medical devices to digital cameras – and transforms previously unstructured information into part of the medical record.


Lastly, we have a product that we released at the HIMSS (Healthcare Information and Management Society) Annual Conference & Exhibition called Kno2. Compared to ChartMD and Messenger, which are really structuring engines focused on specific healthcare segments, Kno2 brings the same capability but allows you to exchange that information among different providers and organizations. You may have heard of health information exchange as a term or direct exchange which is a subset of health information exchange. Kno2 technology provides this functionality across the healthcare community, enabling the multiple points of patient care to connect with one another.


Kno2 is positioned for what we call the post-acute space. Say your father-in-law gets into a ski accident. When you watch all the touch-points that he goes through to restore his health, this is called the continuum of care, from the emergency room on the ski slope to the hospital in Sacramento to a nursing home in Walnut Creek, California, to rehab and therapy – all are part of his patient experience and getting him back to health. This process involves many hand-offs, and every one of those hand-offs is very important. His patient information needs to be maintained and communicated effectively at each point.


Most of these post-acute markets don’t receive the same funding or technology that traditional doctor offices or hospitals do. Because of that, they risk becoming the weakest link in the continuum of care. When there is a weak link in healthcare, then the whole thing falls apart. In the case of your father-in-law or anyone for that matter, you don’t want any weak links in their care.


When you combine how critical the post-acute space is with how often it is overlooked, it becomes pretty obvious that Kno2 fills an unmet need. It provides any organization with the ability to communicate between all of its care partners simply, easily and affordably. This goes back to our lightweight approach, enabling all providers to participate regardless of technology infrastructure or budget – whether they are still paper-based or have an EMR in place.


Those are the three products and markets that we serve inside the healthcare industry. They are all centered around the same context, which is that we need to take this unstructured information sitting outside your patient electronic record and integrate it quickly, safely and inexpensively while using industry standards to ultimately improve patient care.


CEOCFO: How do you reach the end customer?

Mr. Elwell: We work primarily through partners. One of the central premises inside the organization is that those that create the problem can solve the problem.


You asked me earlier how I got to know Inofile. When I was the Vice President of Healthcare at Ricoh, we sold multi-function devices that produce paper. That’s usually a copy machine that costs somewhere between $5,000 and $15,000 and produces paper in an environment that is incentivized to eliminate paper.


This scenario is what brought me to Inofile. I could reverse engineer my technology and take paper out of the environment instead of producing more unstructured information. This functionality makes the device manufacturers more relevant across the healthcare industry.


That is why it makes sense on both sides to distribute through the Konica-Minoltas and the Kodaks and the Fujitsus of the world, because we can empower those that create the problem to fix the problem. If we can replace their value as document producers with new technology that maintains their relevance in healthcare, then it is a great situation for everyone.


CEOCFO: Does the end user know that Inofile is providing some of these services? Do they care? Should they care?

Mr. Elwell: In my advisory role, I quickly identified how phenomenal the company was at building products, and I truly mean this. Even from the outside, the company is seen as an incredible innovator with awesome products. As such, we could rightfully demand the attention of these distribution channels, but we struggled on sell-through. We could sell-to by getting a partner excited, but how do we get to that end user?


I started to use this very simple diagram of a teeter-totter. We have an issue with the distribution of our weight on that teeter-totter. We are innovators, we know how to garner attention of the channel, but historically we have not been really good at sell-through. Unlike traditional companies focused on sales and marketing efforts designed to grow business, we were focused on building great products. As a result, our end user community is unaware of what Inofile does.


Recently we’ve created a different trajectory to start creating awareness. This includes what we’re doing with press releases, to bringing Mike Dane in to lead our Marketing, to the way we reach the market directly and provide messaging on behalf of our partners and the tools they need to educate the end users.


We need to keep doing this through different channels to move our company from a well-kept secret to a well-known entity in the healthcare space. A key priority is transitioning us from a sell-to model to a sell-through model.


CEOCFO: What is the competitive landscape?

Mr. Elwell: The space is crowded. Any time there is $30 billion coming from the federal government, you aren’t operating in a traditional market. The supply and demand curve is a little messed up when you have $30 billion to buy technology.


Instead we complement the electronic medical records space by focusing on the content that doesn’t make it into the EMR and the care providers who may not have the incentives or budgets to afford an EMR. We think of the person who is sitting there managing patient records is saying, “excuse me, but, stacks of paper and faxes are coming and digital photos and patients are coming in” with paper under their arms. This is real, and at the end of the day, I have to take that information and get it to a point where my physician can view it so I can provide good care to my patient.


As far as people trying to do what we do, there are all kinds of parts and pieces of technology that do things that we do, oftentimes not in the markets that we are focused on.


One of the things that I was articulating to you on the new product, Kno2, was focused to the underserved market. This $30 billion funding, if you are familiar with what is happening in the healthcare space, the High Tech Act, the Affordable Care Reinvestment Act, all of that $30 billion is rushing to the market but there are all those micro-verticals such as home care, long term care, nursing home, therapies, etc. which are not benefiting from these funds or investment. We said, “Why don't we step down and serve them?” and serve them correctly.


Much of our position, even if there are folks that come close, relies on being accessible and affordable. We are cloud-based, subscription-based, and very inexpensive. Kno2 is our solution to this under-served market, which will be below $100 a month, that is very disruptive in a market used to significant technology investments.


CEOCFO: What is the key to being user-friendly? How do you ensure a positive customer experience?

Mr. Elwell: The majority of our success comes from engaging with the end users throughout the development process. For instance, we are releasing expanded functionality in our Messenger product in the hospital space. We will not go live into the market until we get our use cases and our pilots done. We do not rush to revenue.


Similarly with our Kno2 product, we’ve done a number of engagements with end users where we made assumptions up front. We thought we could build work-flow rules into the product just to make it easier, knowing that we could route incoming medical information a certain way to a specific role or group. By engaging with end users, we found that our high-level rule might not be repeatable, but if we enabled users to build a rule simply it would be incredibly powerful. We said, “OK, great! Love to do that!” Much of it comes with us being diligent in our customer feedback; it is just a core value.


This is really what we are about, paying attention to the problems that we’re solving and who we are solving them for. We could build layers and layers of technology on top of what we do as a core functionality, but it would overwhelm the end user.


Think of Microsoft Word. How many features of Microsoft Word do you use? If they put the next 20 features in, who cares? I have not used those last 80 you gave me. If you gave me bold or underline, I am kind of good. Spell check, for me anyway, is pretty important. The next 20 do not matter. That is really the view that we take. It is built from the end user feedback that we are very diligent about gathering and speaks to our core value of serving them best.


CEOCFO: What can you tell us about the short term and the long term goals of Inofile?

Mr. Elwell: One of our primary goals is end user awareness of our solutions and how they can help them by giving market-specific insights into what we do. We solve problems in a unique way. If you don’t know that we solve those problems, they will just go to what I already know.


Hopefully you will see our awareness approach in our redesigned website, our press releases, the way that we engage our partners, and the way that we are starting to communicate to the market directly. This continues to be a high priority.


Another priority is staffing. We are a high-growth company, so continuing to bring in the right people to our organization both from a talent and cultural fit is critically important to us. The scaling of businesses is always painful unless you have the right people to lead and contribute, so one of my goals is always acquire the right talent.


The last one is the continuing expansion of our distribution channels. As we create end user awareness and people start to understand who we are, it is important we continue to expand our reach. From a technology standpoint, we are sitting on a great technology stack. We do not need to invent the fourth product. You will soon see a press release on this – we were awarded a really important patent on our Kno2 product recently, so we are diligent on protecting our IP. But on our product road map, short of continuing to enhance the capabilities of the three products we have, we are not going to launch a fourth one anytime soon. That is really it. We are looking to expand the channels and make sure that our end users are aware and making sure that we bring the right people.


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