Why Alcidion's Tech Works and What it Means

It's been a while since I've chatted properly here and provided my views, mainly since I've been travelling without good or reliable internet.

A great benefit of this travel has been the amount of reading I have been able to get done in transit (I barely get the time to read for leisure). At the moment I'm reading SuperFreakanomics, a part of the Freakanomics series (I highly recommend it) - where economics-style thinking is applied to interesting issues. It's no joke, either, the authors are a New York Times columnist and a University of Chicago economics lecturer.

Anyways enough of the promotions - in a chapter titled "Why should suicide bombers buy life insurance?", a section caught my eye which I thought I'd share (to provide some context, the inefficiencies of emergency departments globally are being analysed, focusing on the impacts of the 9/11 Pentagon crash on Washington area hospitals)

Here are some abridged extracts (Mods: this is less than 10% of the book and is abridged so afaik constitutes fair use) (hopefully they make sense by themselves):

Please hang in there if these clippings initially don't make sense, it all will by the end (I hope - very hard to avoid copying the couple of pages this is printed on)
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"Craig Feied was the chief architect of a federally funded pilot program called ER One, which was meant to drag the emergency room into the modern era."

"don't even get Feied started on all the hospital patients who die from a cause OTHER than what brought them to the hospital: wrong diagnoses; medication errors; technical complications and bacterial infections"

"The state of current medical practices is so bad right now that there's not very much worth protecting about eh old ways of doing things," Feied says. " Nobody in medicine wants to admit this but it's the truth"

"Feied arrived at Washington Hospital Center (WHC) in 1995, recruited by his longtime colleague Mark Smith to help fix its emergency department. (Smith was also a true believer in technology. He had a master's degree in Computer Science from Stanford)"

"despite ranking well in other areas, WHC's ER constantly ranked last in the DC area. It was slow, crowded and disorganised and even the hospital's own medical director called the ER 'a pretty undesirable place'."

"They found one commodity was always in short supply: information ... We often knew what information we needed, and even knew where it was, but it just wasn't available in time. The critical piece of data might have been two hours or weeks away. You can't do that when you have forty patients and half of them are going to die"

"The problem agitated Feied so badly that he turned himself into he world's first emergency-medicine informaticist. He believed that the best way to improve clinical care in the ER was to improve the flow of information"

"Smith and Feied discovered more than three hundred data sources in the hospital that didn't talk to one another, including a mainframe system, handwritten notes, images, lab results"


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To cut a long story short, the two developed a system called Azyxxi which was a computer system that collected all the data and was flexible, encyclopedic and fast.

I'm going to butt in here a bit but it really struck me how similar Azyxxi sounded to Alcidion's platform Miya (even just Miya ED), even the fact that one of the creators had a masters in CS from Stanford (Malcolm Pradhan, Alcidion's CEO has a PhD in Medical Informatics from Stanford University).

Azyxxi was built a while back which has a huge benefit for us... we can see the results of it. Here's the interesting stuff - with a fun twist.

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"Within a few years, the WHC emergency went from worst to first in the Washington region. Even though Azyxxi quadrupled the amount of information that was being seen, doctors were spending 25% less time on 'information management," and more than twice as much time directly treating patients."

"The old ER wait time averaged 8 hours, now, 60% of patients were in and out in less that 2 hours."

"Patient outcomes were better and doctors were happier (and less error-prone). Annual patient volume doubles, with only a 30% increase in staffing. Efficiencies abounded, and this was good for the hospital's bottom line"


Me butting in again: implementing a system like that offered by Alcidion is a win-win. Hospitals save money and patients get better care. The data doesn't lie! Now we have the best bit


"As Azyxxi's benefits became clear, many other hospitals came calling. So did, eventually, Microsoft, which bought it, Craig Feied and all. Microsoft renamed it Amalga and, within the first year, installed the system in 14 major hospitals including Johns Hopkins, New York-Presbytarian and the Mayo Clinic [some of the US's top hospitals, funnily enough where ResApp is running many of its trials]. Although it was developed in an ER, more than 90% of its use is currently in other hospital departments"

"As of this writing [2009], Amalga covers roughly10 million patients at 350 care sights; for those of you keeping score at home, that's more than 150TB of data"

"It would have been enought if Amalga merely improved patient outcomes and made doctors more efficient. But a massive accumulation of data creates other opportunities. It lets doctors seek out markets for diseases in patients who haven't been diagnosed. It makes billing more efficient. It makes the dream of electronic medical records a straightforward reality. And, because it collects data in real time from all over the country, the system can serve as a Distant Early Warning Line for disease outbreaks for even bio-terrorism"

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So yeah hopefully that reads well (it's middle of the night here). Alcidion's Miya platform is like Amalga on steroids (features AI to make suggestions to doctors as well as being interoperatable with other systems and very flexible). We know Microsoft bought Amalga - can't find for how much - (and just sold it to GE) so the big fish are playing in this field.

On top of that Alcidion has the government links to expedite rollout (it is mentioned that the health department and doctors initially weren't very receptive). This is almost a perfect situation to be in!