With the goal of democratizing lab results, Elaborate raises $10M

Steven Loeb · January 27, 2023 · Short URL: https://vator.tv/n/560b

The company embeds itself into EMRs and uses patient data to create an actionable report

I got lab work done recently, and while my results were posted onto my patient portal in a few days, but I had no idea that what they meant, even after Googling them. Everything looked fairly normal but it wasn't until I spoke to my doctor a couple of weeks later that I actually was able to find out what I was supposed to do next. What I got from them was basically useless. 

This kind of experience is pretty common, and it's bad for the patients, who look at their results and might panic because they don't know what they mean, and bad for the doctors who have to take time out of their day to field phone calls and messages from those patients, even though they may not have reason to worry.

This is what Nicole Bocskocksy saw throughout her career while working at companies like Oscar and Parsley Health, and it's what led her to found Elaborate, a tool to physicians that can take those results and not only contextualize them for the patient, but even advise them on next steps. 

"I was figuring out the way to most efficiently make the operation run, which most often times was making the doctors most efficient. So much of my time and energy was spent thinking about where they were spending outside efforts to do work that wasn't actually generating value for either the patient or their doctor," she told VatorNews in an interview.

"Lab results are the number one problem that I have seen over and over and over and over again, for the eight or nine years that I've been doing this. That hasn't been solved, in part because there's like a pretty significant communication issue and many companies have tried to do this as a side hustle of their business. However, I came to conclude that someone needed to help build a solution for this."

Now that solution is ready to scale, as the company announced a $10 million seed funding round led by Tusk Venture Partners, with participation from Founder Collective, Company Ventures, Bling Ventures, and Arkitekt Ventures, as well as Elliot Cohen, Sara Wajnberg, Scott Belsky, and Sean and Peter Glass.

Along with the funding, Jordan Nof, Managing Partner and co-founder at Tusk Venture Partners, will join the company's Board of Directors.

Launched in 2021, Elaborate partners with doctors, connecting its systems to their EMR, which allows it to suck in all the data about the patients that they're managing. That includes their previous lab results, their demographics, their clinical diagnoses, and then Elaborate uses that information, along with its clinical based guidelines, to customize an interpretation for the patient when a new lab result comes in. 

The idea is to put results into context, so that patients have a better understanding of what they actually mean. For example, an abnormal pap smear can be a scary result for a woman, but there are many of different reasons that could be abnormal, and so the company provides that upfront explanation, giving them an immediate sense of reassurance.

The company also makes sure that the results are delivered in a way that patients can understand; to that end, it hired a clinical team who contribute to writing the content in a way that is both clinically sound but also curated.

"It's almost like what TurboTax did for taxes, but we're doing it for lab results, with the important caveat that we still have the doctor in the flow. We're not diagnosing, we're not communicating a treatment plan to the patient, we're simply letting them know, 'here's what the results mean,' so they're not Googling," Bocskocksy explained.

These reports are generated by AI and machine learning algorithms, but the company always leave open the opportunity for the practitioner to update, edit out, add a note, or communicate with the patient, and each practice is able decide if they want to look the reports over before they are sent out to the patients.

While some of the practices working with Elaborate do take advantage of this, some of its clients, some, especially the larger ones, are less likely to due to the recent 21st Century Cures Act, which mandates that the electronic release of all medical records to patients, including test results, without delay.

"We've codified standard clinical guidelines leveraging gold-standard sources like UpToDate and PubMed.  Then, with each practice, we customize their communication preferences to ensure we're always communicating at the direction of the practitioner," Bocskocksy said.

While the company doesn't share the number of practices that are currently using its software, she did share that it is covering just under half a million patient lives, and that it has integrations live with over 65 EMRs

On the patient side, the company is showing a 2x improvement on access rates; the EMRs, on average, will be see between 30% to 40% of patients logging, but with Elaborate it's 90% to 92%. In addition, 67% of the users on its platform will take the action the first time that Elaborate recommends that they take it, whether that be to schedule a follow up with their doctor, that they don't need to reach out to their doctor, or that their doctor wants them to take them some next step.

On the doctor's side, it's saving them an average of 28 to 29 minutes per day, which comes out to a few hours a week, simply by giving patients their results faster with a clearer summary so they don't feel to call their doctor asking what to do next.

Going forward, the company plans to increase the number of patients on the platform by 4x to 5x this year, and that growth will come from the company spending its new capital on signing new enterprise clients. So far, Elaborate's customers have been independent clinical practices, which can be anywhere from 10 to 50 doctors, and it has a few 100 doctor practices, but now it plans to go up market to the larger hospital systems. 

"While we serve mainly independent practices and small enterprise customers today, we see the solution working just as well for the health systems as the problem is pervasive across healthcare, whether you are in a 10 doctor practice or a 5000 doctor system," Bocskocksy said.

"What we would love to see is up deepening our Epic integration, so that the product is more deeply embedded within the workflow of the physician. Obviously, we're doing some hiring for that, both on the sales and engineering product side."

In addition, the company will also continue to invest in its research abilities: in the past, Elaborate has done studies, both on those who users and those who are not, asking them to go through prototype testing, to get their feedback.

"That iterative testing approach is quite important to have as an early stage business, where there is still opportunity for us to innovate and iterate quite substantially, based on what those users most need. At the end of the day, some of that comes down to how people are actually using the products but we we both have a responsive product approach, where customers tell us they need xy&z but I also have deeply invested in this proactive product iteration development arm, where we just have an ongoing team of evergreen research findings that are helping us with product strategy," Bocskocksy said.

There are a number of cultural trends in the healthtech space that Elaborate is piggybacking on, including the concept of data aggregation, which has become more consumer friendly in the last decade, but which has not yet made its way to healthcare. 

"This concept of serving up data that tells you more and more about yourself has become something that consumers expect out of their product experiences. At the same time, that has interestingly not really happened with healthcare. If it does exist, it tends to be very transactional to the type of care you've received: you can go to your Oscar Help Portal and see how many visits you've had in a year, how many tests have you done in a year, but that doesn't actually help you understand your health," said Bocskocksy.

"When I think about the opportunity for Elaborate, it's about creating a way for you to most measurably understand, 'Am I okay? Is my health okay? What should I be focused on? Am I focused on the right things?' And there's lots of secondary measurements of that question, whether it be the Apple Health app or my Fitbit, but this gold standard of health data, which was the lab results, has not been tracked."

The other trend that helps Elaborate is the fact that recent regulation has improved the willingness from clinicians to actually send this data to patients. While, historically, clinicians have held this information back because of all of the communication problems, the recent 21st Century Cures Act, which went into effect last year, mandates that the electronic release of all medical records to patients, including test results, without delay. 

"Now all these systems have a meaningful mandate to start releasing the data, but they're very reticent to do so without some solution that helps to alleviate patient panic components, because it creates more confusion and work for their doctors. So, that's where this type of solution is now. Startups are always time and place, and this is a time and place opportunity." 

Ultimately, though, the goal at Elaborate is to take 80 to 85% of the transactional routine work that physicians are doing so that they can have a higher value conversation with their patients because they've been able to do their own research on the side and then come prepared for the conversation.

In order to do that, the company needs to build up credibility with clinicians and the clinical community, being a partner to them and creating opportunities for them to augment the individual doctor, said Bocskocksy.

"We've invested deeply, even at an early stage business, in publishing some of our results, in creating more opportunity for us to have a conversation with the broader clinical community, but I'd love to see us also grow in a way that's validated by others outside, so that we can avoid some of the paths that have happened with larger businesses, when don’t seek the council of the experts that have been doing the work for years and years and years and years and know way more than them," she explained.

"I'll be the first to admit that we don't know everything and we're excited to partner with the community to learn more about where we can better help our users."

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