Part 1: William Kirsh, DO, MPH, Chief Medical Information Officer
Agilum puts objective, real-world data to work to help hospitals, life science companies and payers administer better patient-centered and cost-effective care. As a healthcare business intelligence company, Agilum distinguishes itself by offering clients financial and pharmacy analytics that include control group comparisons detailing how disease and data move through populations. Clients can use Agilum’s information in meaningful ways to analyze populations, identify risks and develop interventions from a public health perspective.
We begin our interview series highlighting Agilum’s team and their passion for helping clients with William D. Kirsh, DO, MPH, whose background in IT innovation, family practice, geriatrics, hospice and palliative medicine informs his work as the company’s Chief Medical Information Officer.
In terms of your career path, how did you end up in IT? Was that intentional, or was it an accident?
I should say it’s an accident in some ways. I started off interested in public health and epidemiology and had done a residency in preventive medicine residency at Hopkins (where I got my MPH). Early in my career, I was interested in international health. I did work in multiple countries—Africa, India—and was interested in the whole concept of population-based health. It was really through that interest that my career developed.
We started Agilum because we felt that we could apply data to solving the problems we saw in healthcare. Offering acute care hospital data, both inpatient and outpatient, that you could analyze and look at the population to determine best practices and outcomes was an early direction we chose to go. We provide analytic power and the ability to use a census population as a comparison through the software and the applications.
Was there a point in your career where you started to get interested in healthcare IT and what technology could do?
It’s not the IT portion for me; it’s the epidemiology portion. It’s how disease and data move through populations and how to understand that better from a public health perspective—how to look at populations, how to identify a risk, how to develop intervention on a population basis and how to aggregate data so that it has meaning.
What do you think Agilum is doing differently than other healthcare analytics companies? What is it that makes using Agilum stand out for you?
Well, I think that the added value is that we’re using a comparison population or an index to be able to compare. One use of the data is to compare utilization cost, outcomes and quality measured against a population or index so that there is some reference point. That really is rarely done in medicine on real-world data. And to the extent that it’s done specifically for the hospital as a comparison against other similar hospitals, it’s even more limited in what you have available in the marketplace today.
Certainly, there are opportunities to compare hospitals against other hospitals, but not with the breadth or flexibility for the target hospital to compare itself in terms of outcomes of care, specifically of formulary management, found under the pharmacy therapeutics application.
Is there something that you think hospital leaders might not know or don’t often think about in terms of analytics, something they don’t know they can accomplish? What should they be thinking about?
It was very traditional that hospitals were providers, that they were just like physicians and other facilities—they were providers of care. But because of the amalgamation of hospitals into larger groups of hospitals under a similar organization, they have taken on risks as if they were an insurance plan, and now you see many hospitals acting like insurance plans. Hospitals are no longer just receivers of payments, but in fact, are managing the premium to meet the requirements of the population they serve.
It’s a much different environment and very complicated because you have so many moving parts. One of the most important parts is pharmaceutical services, simply because it’s the fastest growing and most expensive area in medicine right now. In fact, over the next year or two, I believe the amount of money spent in a hospital for pharmaceutical services will exceed the inpatient component by percent. It’s a huge expenditure and one that needs controls based in science, not in anecdotal information. If you have the aggregation of real-world data, then you can apply that to real-world information to make decisions. But you need the tools to be able to do so. And that’s what we’re putting together at Agilum, the ability to have those tools specifically for those institutions that need to manage risks.
That’s really the premise, but Agilum is more than that. For instance, we have formulary data not only for hospitals but also for any kind of risk holder—insurance plans, ACOs—anyone who holds risk and needs to manage that risk. And, the same information, although structured slightly differently, could have a major impact on public health issues such as the coronavirus. Being able to look at the population, identify which protocols should be used across the United States and then aggregate that information to compare it again in the index is pretty valuable. We are currently doing this for COVID-19; you can find that data here.