Meet Akute Health, the EHR for Asynchronous Medicine
After battling cancer, software developer Sharud Agarwal decided to build a better electronic health record, one that powers “membership medicine” and treats patients and doctors as the true end users.
For too long we’ve seen patient health records dominated by the needs of insurance claims. We’re proud to be investing in a Health Transformer who is changing that equation as part of the Access to Care Moonshot and StartUp Health’s 2021/Q2 investment vintage. Learn about how Sharud Agarwal is creating a healthcare infrastructure built on trusted doctor-patient relationships, one that powers new business models in healthcare delivery.
Challenge
Over the last couple of decades, we’ve seen the infrastructure of patient data undergo a sea change. First, we upgraded patient records from paper to digital. Then we used those systems to triple down on the ability to gather data, creating a body of data so “big” a whole industry had to emerge just to manage it.
Today, doctors have access to everything — prescription data, lab data, patient history. But rarely is that information delivered to the doctor in a way that is clear and actionable. Instead, over the years, electronic health records (EHR) evolved based on economic drivers. Because of the hospital’s bottom-line need to bill fully and accurately for services, big EHRs like Epic and Cerner became more and more like billing platforms, and less like a platform for doctors and patients to understand and share critical information.
In fact, according to Sharud Agarwal, the CEO and Founder of Akute Health, EHRs don’t treat the doctor and patient as end-users at all. That designation belongs to the hospital and the insurance company.
Case in point. When a patient suffering from a chronic disease wants to know their current health metrics, they might be handed a stack of print-outs containing ALL of their numbers, even if only one number matters. Want to know how that number is trending over time — which is 10 times more useful than a single data point — good luck. You’ll have to do that math manually.
But these two examples barely scratch the surface of how today’s EHRs fail to treat patients and providers as end-users. There’s the lack of API integration, forcing people to move between platforms like Zendesk, Slack, and the EHR. There’s the lack of mobile interfaces, making it nearly impossible to communicate on the fly. And there’s the inability to capture and bill for asynchronous healthcare.
Of course, for anyone in healthcare today, this will sound like preaching to the choir. These are legacy problems. The more interesting topic is, who’s willing and able to build a better EHR?
Origin Story
In 2014, Sharud Agarwal was just another student graduating from the University of Texas with a degree in computer engineering. But less than a year later, his world and identity would shift. Rather than launch into a successful software development career (he scored a job at Qualcomm right out of school), he found out he had cancer and would need to manage his health full time if he wanted to survive.
But for the ever-curious Agarwal, this turned out to be less of a detour, and more the next phase of his education.
“You learn way more about healthcare than you want to when you’re diagnosed with cancer,” he says with a disarming laugh. “At the time I didn’t understand how insurance worked or anything.”
Over the course of his patient journey, he saw dozens of doctors, reviewed medical charts, and monitored his own health trends. What he discovered was that the tech infrastructure behind his patient data was a broken mess. For instance, he noted that his health record was designed around the idea of billing for distinct “encounters”.
“If I email my doctor, is that an encounter?” says Agarwal. “That would suck for me if I got billed for that.” Typically, they don’t, he discovered, but that means that doctors end up operating outside of the chart, using text and email that never gets integrated into the patient record.
His second lesson was that the data infrastructure behind his care was, as he puts it, “terrible.” He’d carry a giant binder with his records around with him as he saw doctor after doctor. This was both frustrating and unhelpful. To solve this problem — and to fill his time lying in hospital beds — he built an iOS app to track his own medical records.
These lessons, that frustration, might have remained just that if it hadn’t been for a phone call he received. Agarwal’s department chair from UT, who he’d interacted with just a few times, called him up out of the blue and asked him how he was doing. Agarwal was moved, and they struck up a relationship. Later, when it looked like Agarwal was going to beat his diagnosis, the professor posed a question: What’s next? They talked about the problems he’d witnessed in patient data, the app he’d built, and his passion for putting patients at the center of the data conversation.
“Through his questions, he pushed me to realize that I was actually onto something.”
With the need so tangible, and the patient record app serving as a beta project, Sharud Agarwal founded Akute Health in 2018. His professor at UT helped connect him to the university medical center where he was able to dive even deeper into health data infrastructure and learn what was broken and what wasn’t. Then it was off to the races.
Under the Hood
For anyone in the corporate world today, Akute Health will look pleasantly familiar. You see, Agarwal grew up with SAAS platforms like Slack, Calendly, and Twilio. He couldn’t imagine why doctors, patients, and developers would accept less than what these platforms (some of which are free) offered to the world. So he baked all of that functionality into one patient data platform, under a HIPAA-compliant umbrella.
Akute Health follows the SAAS model of being cloud-based — unlike most EHRs today — so it’s accessible on any device. Patients can schedule appointments like they’re using Calendly and have it integrate with their Google Calendar. Physicians can prescribe medications, order labs, or send a fax. There’s a built-in task manager that helps users assign tasks and track progress. Every feature works as well on mobile as on a desktop, which, according to Agarwal, is a surprising differentiator.
“I’m absolutely shocked that other EMRs don’t work on your phone,” says Agarwal. “I can’t believe I still have to point this out as a feature in 2021. But it is.” Some competitors offer app or web access for mobile, but the functionality is often limited to “read only.”
Beyond the basic functionality, which early testers have described as gloriously user-friendly, Akute bakes in one important element that has shaped its business model. Every interaction between provider and patient is given equal value in the chart. Whether it’s a text, an email, a video check-up, or an in-person visit, it’s seamlessly integrated into one provider-patient relationship.
What that means is that Akute Health isn’t built for healthcare facilities that want to stick to the legacy way of tracking “patient encounters.” Akute is enabling a new care paradigm where patients are cared for, and billed, more holistically. We’re seeing this more and more with Direct Primary Care (DPC) clinics, which bill members monthly rather than by encounter. That said, as Akute gains momentum in these innovative markets, legacy players are taking note. The tide is shifting towards true asynchronous care, and when it does, there will need to be a software infrastructure to support it.
Why We’re Proud to Invest
Agarwal’s vision is a big one. He’s disrupting an electronic health record market that includes the likes of Epic, Cerner, and McKesson. But it’s even bigger than that. With Akute Health, Agarwal is sparking and supporting a movement of alternative care models. He wants to power a kind of healthcare that isn’t built around insurance claims but is structured around a trusted doctor-patient relationship. In this, Agarwal is in good company. He follows a trend in the market of tech-enabled asynchronous clinics like OneMedical, Forward, and Cityblock Health. That’s an awesome health moonshot vision that we can get behind.
There’s a lot more here to be excited about. Akute is leveraging a full-stack software approach that we’ve seen succeed in other markets. It’s prioritizing trust and transparency over insurance claims. It supports continuous monitoring and true preventive health.
Akute Health is an enabling technology. It lowers the barrier to entry for an entrepreneur that wants to create a new way of caring for patients. Whether they’re creating the next virtual-first clinic or a clinic dedicated to a rare disease, Akute Health makes the EHR process simple and comprehensive.
Finally, we’re bullish on Akute Health because it’s not just trying to improve on today’s broken EHRs. Sharud Agarwal is young enough and personally motivated enough to take on the seemingly impossible task of disrupting how healthcare gets delivered, using patient records as the entry point. The company is poised to be a critical piece of a “membership medicine” movement that could improve the health of millions, opening up access to care while lowering overall costs. We can’t wait to see what they do next.
Connect with the team at Akute Health via email.
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