The Insiders Scoop: Medical Informatics and Physician-Entrepreneurship

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Name:

Gerasimos Petratos, MD, MS

Medical Interests: 

  • Medical Informatics, Clinical Decision Support, Clinical Documentation Improvement, Physician-Entrepreneur

Education: 

  • Cornell University (BS)
  • Howard University College of Medicine (MD)
  • Masters in Medical Informatics at the University of Utah with Healthcare Administration certificate (MS)
  • National Library of Medicine Fellowship in Medical Informatics

Current Position: 

  • CEO and Founder, Hiteks Solutions Inc.
  • Formerly Global Head of Healthcare Data Analytics at Genentech
  • Formerly Adjunct Professor at Northwestern University Masters in Medical Informatics Program 

Medical Informatics:

  • Medical informatics is an interdisciplinary field of medicine, information science, and computer science, and involves the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of data in decision-making and evidence-based medicine.
  • Medical informatics directly impacts the physician-patient relationship by applying systematic approaches to effectively collect, store and analyze high volumes of data that would otherwise be stashed away in paper-based charts. Medical Informatics has potential to improve the quality of care delivered to each patient by increasing accessibility to information at both the individual patient-level for a given encounter, and across populations, which can influence research and medical knowledge. 

About Dr. Petratos: 

Gerasimos, at 28, was an early entrant as a physician trained in Medical Informatics when he joined the BioPharma industry in 2003, first for Schering Plough and then Roche and then Genentech (after the Swiss-based Roche merged with San Francisco-based Genentech in 2009). Gerry immersed himself in Pharmaceutical Medicine after  his biomedical informatics training when after medical school at Howard University he entered a NIH Fellowship at the National Library of Medicine and a Master’s Program in Biomedical Informatics at the University of Utah Health Sciences Center. 

At the University of Utah, Intermountain Health Care, and the Department of Veterans Affairs he conducted public health research in adverse drug event computerized monitoring for hospitalized patients.  His interests blended the business side with the science of health care, and Gerry realized that his potential was to pioneer new innovative business models and analytics technology to help practicing clinicians make better decisions regarding their health.  In 2011, Gerasimos launched Hiteks Solutions and ran a largely virtual company based in New York.  In 2013 he was joined by co-founders Peris Brodsky and Dr. Marty Coyne, both of whom connected with Gerasimos (Gerry) while he was teaching virtually at Northwestern University’s Masters in Medical Informatics Program in the School for Continuing Studies.

Gerry was born in Washington Heights in Upper Manhattan and raised in Queens and Long Island, New York.  He graduated with Distinction from Cornell University in 1996 with a B.S. in Biology. Upon graduation, he got experience in front-line public service with his experience at the American Indian Law Alliance.  He experienced grassroots support for indigenous populations in the New York area and internationally with the acceptance of the organization as a Non-Governmental Organization to the United Nations. Gerry decided to formalize his health care interests by obtaining a Doctorate in Medicine from Howard University College of Medicine in Washington DC, where he engaged in cancer clinical research and received the Lasalle Lefall Fellowship in Surgery where he conducted clinical research in Pyriform Sinus Carcinoma.

 

1 | As a physician-entrepreneur and the CEO of Hiteks Solutions, what is the long-term impact that you are working to impart upon the medical field?

The fundamental problem at hand is that clinicians require timely and accurate advice to improve patient care and practice management.  Advice in documentation improvement and decision support to improve claims, reduce medical errors, reduce variations in care, increase evidence-based decision-making and increase compliance with guidelines medications are among the key areas on which Hiteks is focused.  The advent of the Electronic Health Record has made decision support possible due to the common workflows and digitization of clinical data available for processing.  However, the avalanche of clinical data produced every day for innumerable medical conditions is stashed away in difficult-to-consume structure, often going untapped. This information, if assessed to the fullest degree and made available for analytics, can be utilized to improve patient care through the clinical information breakthroughs and timely delivery of targeted, patient-specific advice to practicing clinicians.  As a result, the most optimal care can be provided to every patient based on the patient’s own history, comorbidities, laboratory measurements, radiology and pathology findings. 

I founded Hiteks Solutions in 2011 to provide software tools to solve this problem. Early-on we created a platform that could process thousands of medical records per minute and take the unstructured information and automatically structure it into a clinical database.  The Hiteks platform evolved through advanced analytical techniques to identify the patients and diagnosis areas which could benefit most. The manual techniques which have been available were no longer acceptable because they were too time consuming, caused errors and limited to a small number of records being analyzed.

An average institution sees 25,000 patients a year and it is cost-prohibitive for hospital systems to manually comb through every clinical document and data point they have on file to search for quality and claims opportunities. I’ve been interested in imparting a systematic understanding as to how software and systems technology can be used to derive the exact meaningful information that is necessary to advance medical care. During this process I’ve realized that not only can informatics approaches be used to extract relevant information, but also send suggestions in the form of advice and queries to clinicians to respond in real-time to opportunities to improve the content of the medical record or the correction of diagnoses and optimization of medications.

 

2 | What is the mission of Hiteks Solutions? 

As a physician-owned and operated company, we have a unique perspective on how software and systems can be leveraged to provide cutting edge decision support to doctors. Patient records, for the most part, are written in an unstructured fashion. By using Natural Language Processing, we’re able to analyze tremendous volumes of information stored in patient health records, and ultimately, we’re able to give diagnostic, preventative, and treatment advice to clinicians.  That said, the mission of Hiteks Solutions is to engage healthcare providers with timely patient-specific information at the point of care, which ultimately improves the quality of care delivered to patients, treatment compliance, and the reimbursement process. 

We apply hundreds of algorithms to patient records to provide actionable, accurate advice to clinicians. By providing complete and timely information to physicians, they can make the most optimal decision at the point of care over 99% of the time – ensuring that the quality of care delivered is of the highest quality available for the exact patient in consideration – and we’re proud to have hundreds of hospitals and medical practices, as well as tens of thousands of clinicians as our user community. 

 

3 | When you were building Hiteks Solutions, what did your schedule look like? 

My team had a lot of phases where we were working nonstop on weekends without taking any time off. When we were part of the 2013 Blueprint Health Accelerator Program in NYC (a program that brings investors to meet entrepreneurial needs for new technologies), we were pressured to get our product finalized and gather new clients. We were working nonstop to make that happen, with constant client demos, product development meetings, investor meetings, etc. We were literally sleeping at the office – I was travelling to meet clients, but besides that, we were working 14 hours a day, every day. I wouldn’t want to repeat this again because it was very draining and, having done it for so long, it was also dangerous for our health. After a few years – next month is actually going to be the 10 year anniversary of the founding of Hiteks Solutions – we were able to adopt a much more humane schedule and started taking weekends and holidays off, as well as some time in the summer. 

 

4 | When did you first realize that you wanted to go to medical school and why? 

Growing up, I used to spend my summers in Greece where my parents owned a hotel, and I’d spend the school year in Queens, NY. It was in Greece where I witnessed a heart attack for the first time and, ultimately, the death of one of my parents’ clients. That moment was particularly memorable because I came to recognize that through medicine, I could potentially be empowered to intervene in such a situation and save someone in true need. This realization aligned well with my interest in biology, and soon after, I made the decision to pursue a career in medicine.

 

5 | How did you determine the path you wanted to pursue following medical school? 

In medical school, I made an effort to experience as many specialties as I could, including those that are heavier in patient care as well as those that aren’t. While I enjoyed taking care of patients, I came to recognize that I was more interested in being intellectually challenged and conducting the research-heavy, data-oriented work that has the potential to evolve the field at a systemic level. My intellectual interests were better met in the non-patient care rotations – I was forced to be more critical of information, understanding how to generate data and to translate that data into something functional. I spent some time doing a few informal rotations with my uncle, who happened to be a famous dermatologist in New York City. However, I quickly recognized that dermatology wasn’t for me. I didn’t feel like I could apply my scientific knowledge and I felt that my work should be catered to ameliorating suffering to a greater degree. I narrowed my interest down to a clinical specialty like ENT – this was largely influenced by my 6 months of research in pyriform sinus carcinoma. Soon after, however, I did my rotations in Medical Informatics and Biostatistics and I fell in love with the nature of the work – doing chart reviews, I was abstracting data relevant to designing new treatment protocols, and by applying rigorous statistical methods to the data, I was able to differentiate the efficacy of different treatment protocols in their quality of care delivered. My interest in systems-based care was solidified, and I ended up pursuing a Masters in Medical Informatics where I delved into research on Adverse Drug Event Prevention and Patient Safety at Intermountain Healthcare. There, I became familiar with drug development and drug commercialization, setting me up to join the Pharmaceutical Industry in the years after to continue improving the quality of care delivered to patients at macro-systemic levels. 

 

6 | How did you go about realizing the vision that drove you to start Hiteks Solutions? 

After pursuing my Masters at the University of Utah, I joined the Pharmaceutical Industry and stayed for 9 years. There, I was designing ways to assess the effectiveness of medicines for oncology and neurological patients, directing the flood of clinical data needed to discover, approve, and promote new drugs, and managing a team supporting the development of Phase 2-4 drugs. I quickly rose in the ranks, but around 2010, I came to recognize a market gap with respect to clinical tools that conduct data analyses of medical records. Immediately I realized that this niche held an opportunity for me: I had been looking to change careers and depart from the Pharmaceutical Industry, and through this, I’d be able to go back into patient care at a closer level, while still serving on the systems side. 

Because I knew the software side and data analyses processes required to gather meaningful information from medical records productively, I launched Hiteks Solutions to fill the gap between patient care and software. After having spent so much time in the Pharmaceutical industry, I had developed a strong network and was able to show healthcare leaders how to better organize oncology care at a northern NJ academic medical center. From there, I started helping out in other specialties and got involved in their general informatics needs. Soon after, I worked with a California community hospital system and a number of other clients in the coming years. This move was timely made because of the digitalization of medical records that was taking place across the medical establishment. If I tried to do this in 2000 or 2005, the efforts would have been fruitless. People weren’t interested in doing analytics on paper then. This was also my first time doing something entrepreneurial.  

 

7 | What has been one of your most fulfilling professional experiences?

My most fulfilling experience has been working with practicing doctors and helping them understand the value of good data and how the effective delivery of information can aid them in their decision-making. The idea of technology joining the treatment process often vexes many physicians, but by illustrating how seamlessly our platform integrated into the medical workflow, we are able to demonstrate the utility of our systems, and deliver an immediate and sustained impact on the lives and health of our patients. 

When I started a relationship with a northern NJ hospital system to evaluate the documentation practices of their providers, I saw tremendous variation which was negatively impacting both their reimbursement and quality of care.  But instead of trying to stress that clinicians should document in the same way to reduce variation, my team and I knew that it would be too much of a challenge for the clinicians to adopt that type of software.  So we built our system to be smart enough to extract and apply in algorithms the important clinical concepts such as Ejection Fraction and Stages of Cancer from the note-based section of the charts.  In this way, we accommodated a wide variety of differences in practice patterns and helped the Electronic Health Records system to become more usable, which allowed us to grow our user-base especially amongst Epic users.

 

8 | What advice would you give to students interested in becoming Physician-Entrepreneurs?

It’s difficult to do both clinical care and pursue entrepreneurial efforts simultaneously. That said, you can serve in both areas on a spectrum. You have to decide how much you want to get involved in each and what role you want to play. You can participate in both but if you want to lead a company or engage in a successful effort where you are going to be rewarded with your time and you’re willing to leave patient care, I would recommend doing some patient care and then moving into the entrepreneurial world rather than trying to combine things too much. 

 

9 | Are there any disciplines/skills/habits that you believe students should pick up? 

Although most medical specialties are now data-driven and quantitative in terms of the gathering of clinical evidence I think it is important to get familiar with non-patient-care fields as well.  Although there may be limited patient interaction, the science dictates more quantitative understanding of medicine. Non-patient-care fields include radiology, biostatistics, epidemiology, and medical informatics. 

 

10 | What is medical informatics, and what do you believe to be the most exciting frontier or new things on the horizon in the field? 

Medical Informatics is growing very fast because of the overwhelming amounts of data and processing power available – and also because of software techniques that can essentially marry clinical data with biological data. The field of medicine has potential for improved health outcomes and new capabilities. People talk about interfacing the human mind and the human body with technology – that is certainly possible. Also, empowering patients with more data than even the doctors have and giving them access to shared records and insight from cases could be very powerful. This raises the level of medical knowledge amongst the layperson, which in general is very good for healthcare because it can help improve individuals’ health and it challenges the medical community to help explain the data and guide patients even more. Some people are scared that if you give patients too much information, patients will stop visiting doctors. However, it is really the opposite – the more information you give patients, the more they are going to use healthcare to make the most sense of what they’re experiencing in terms of signs and symptoms. The degree of preventative care would increase and you’d get earlier diagnoses of more chronic conditions that could be treated successfully.

 

11 | What drew you to Medical Informatics, and how has it influenced your work in the medical field? 

Medical informatics and understanding the history of the field from the 1960s to today has largely influenced my work. I was drawn to this because I was interested in being intellectually challenged, doing research, and using big data to improve healthcare at a systems level. I’ve also taught for the Medical Informatics Masters Program at Northwestern University between 2010 – 2015. I was invited to do this because I had specific insight in clinical decision support and it happened to be a great experience for me since I was able to meet our CTO and our CMO from that program. I recruited them into the company after they finished my class.

 

12 | How much sleep do you get every night? 

I make a deliberate effort to be well rested, and I prefer to sleep early and wake up early, averaging around 7-8 hours a night if possible. I’ve also minimized my caffeine and alcohol intake because I find that caffeine and alcohol negatively affect my sleep quality. 

 

13 | What was the biggest challenge you’ve had to overcome? How did you overcome the obstacle and what lessons did you take away?

My biggest challenge arose when I worked in the pharmaceutical industry: there were unethical incentives permeating each level of the company, and the ethical standard of my colleagues did not live up to mine. I asked myself, irrespective of my professional obligations, whether making a statement about what was going on could help the medical community and patients. The answer to this question was yes – it would make a big difference because the more information prescribers and patients had about what was going on with these drugs, the more they could utilize that information to make the best decisions for themselves. Both patients and practicing providers benefit from information transparency. I then decided that I would disclose the misconduct that was going on to both management of the company and to outside groups. I became a whistleblower and pursued my case with a group of lawyers who argued as to the harms done to providers and patients from the suppression of data in Oncology.

One of my mentors who continued to work at this company revealed to me that they reflected on my statement and developed an organizational boundary – a wall – between the scientists who were doing safety surveillance/product development and the salespeople/commercialization team. Previously, when the drug safety and epidemiology group received questions from doctors about the role of the drugs in health complications, the scientists would first check the impact that their answer would have on sales.  It was dangerous to have  the safety scientists and epidemiologists as recipients of sales revenue data since their decisions would be unduly influenced.  Although some of the physicians working in Pharma were sensitive to this, others who were Masters or PhD level epidemiologists didn’t seem to be bothered that their behavior and decisions was unethical and put patients in harm’s way. 

 

14 | What are some of the most influential books you’ve read? 

  • Kitchen Confidential, by Anthony Bourdain
  • Art and Argyrol: The Life and Career of Dr. Albert C. Barnes, by William Schack
  • A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution, by Jennifer Doudna and Samuel Sternberg
  • Father Dancing, by Nick Papandreou
  • Islands in the Stream, by Ernest Hemingway

 

15 | What is one thing you wish you had learned sooner? 

Everything that is worthwhile takes time. You can’t expect things to happen overnight. Embrace this because it helps you appreciate the things you’re involved to a greater degree, equipping you with a deeper understanding of each area you put your time and attention towards. 

 

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