Dear Real World (Data) – (Part 1),

The last 15 years have seen a dramatic shift in the healthcare data ecosystem. These shifts have been at the regulatory and policy level (e.g., HITECH Act , 21st Century Cures Act ), at the technology infrastructure level (the rise of cloud infrastructure, federated compute infrastructure, etc.), the security and privacy infrastructure (i.e., cryptographic technologies, de-identification and patient tokenization, statistical de-identification and safe harbor techniques, synthetic data, etc.). There has also been significant investment in the platform layer both institutionally (e.g., Mayo , Novartis ) and in venture-backed companies that have increased access and significantly enriched quality content and connectedness of health care data. Additionally, multiple companies have begun to expand on the potential applications of artificial intelligence and predictive analytics layers to these platforms to drive insights and actions.

Given the progress to date, it is natural to ask, what could be next?

Positives/Opportunities

• Access: Data is more available than ever before and grows in scale, complexity, depth, and quality every day
• Infrastructure: The infrastructure to enable secure access, link, and analyze this data largely exists and becomes less risky and more standardized every day
• Opportunity: The sheer scale and power of the current data ecosystem is ripe for AI/ML approaches and we are just beginning to uncover the potential of the predictive layer in healthcare data (medical, claims, genomics, etc.)

Negatives/Uncertainties

• Uncertainty: There is an exploding number of data sources and products, with significant uncertainty on attributes, strengths and weaknesses of each that leaves consumers of data uncertain about the underlying value and appropriateness of use.
• Evidence Gap: While the use of data to aid research objectives is accelerating, it is unclear whether these use cases are finding their way back to the practice of medicine and patient care in an efficient way. As great as 70% of care decisions lack sufficient personalized evidence, and the complexity of this is rising as the output of more diverse sets of -omics data enter daily care.
• Inconsistency: While secure access to data has improved, the ongoing speed of analysis, overall cost, lack of transparency, and methodological inconsistencies has led to a labor-heavy, lengthy and sometimes methodologically inconsistent process to generate evidence from this rapidly increasing data layer
• Not Actionable: As the platform layer has grown, a wave of insights and alerts are now being made available, but this wave faces a channel and attention challenge. How do you drive action and behavior change as predictions to improve evidence-based medicine, and outcomes for patients?

Reflections on 15 years in the Healthcare Data Business

Having lived through this last period of innovation in our industry, it has been a pleasure to be part of a community so focused on building productive businesses to advance the industry’s common goals. However, we have reached a critical inflection point. The model must shift.? To derive the full benefit of the past 15 years of clinical data & infrastructure investments, we must complete the loop back to where it all begins: with the patient. They need care powered by personalized evidence, generated in a manner transparent and trustworthy enough for doctors to use. Enabling this scale will help us meet our business goals, open up new market opportunities, and achieve the potential impact we have all been chasing. In other words– evidence-based medicine is our logical next step. It will build a better health system that learns as its wheels turn. We at Atropos Health believe we can be the ally to help our partners and peers begin to access this new wave of market opportunity and benefit from an acceleration in the rise of transactional personalized evidence.

Today we Announce:

Launch of the Atropos Evidence Network. This is a federated network of healthcare institutions, data companies, research institutions, and more.? Members of the Network can pose observational research questions on Atropos Portal as a single phrase or full protocol., Within 48 hours, they receive a novel observational research study in the form of a Prognsotogram report. Speed stems from automation, not rushed work. Prognostograms are produced via transparent methods that have been peer-reviewed and refined over the past decade. They feature all the tables, figures, and statistics needed for publication in leading medical journals - like High Dimensional Propensity Score Matching. Clinicians review each one and are available after delivery for informatics consultations. Now with Atropos Evidence Network, this data-driven clinical Q&A capability extends to more of healthcare, across more data.?

Launch of Atropos’ Data Scoring Solutions. Across a network approach, the question arises– which data set is the most appropriate to use for the question I have? Now, we have an answer. Over the last year, Atropos has developed data-scoring solutions called the Real World Data ScoreTM (RWDS) and Real World Fitness Score (RWFSTM).

• The Real World Data Score is a general dataset evaluation. It looks at dataset size, completeness, and patient timelines within. This tells a data provider how they might refine their assets and gives potential users a quick quality reading. Each dataset in Atropos Evidence Network is assigned one Real World Data Score which can change per dataset refresh.
• The Real World Fitness Score, on the other hand, changes based on each question submitted. The score is a fit-for-purpose assessment of the appropriateness of a data source to the question at hand. Designed as an attribute score, Real World Fitness Score is based on a proprietary algorithm that accounts for how well question criteria are represented within the dataset. For users, this gives clarity on how well data sources truly answer the questions they have posed. It also helps them compare and contrast results run on more than one data source.?

Atropos Evidence Network Members Receive Access to:

• Atropos Evidence Platform. Where observational insights exchange takes place. Here clinicians, researchers, and data proprietors convene to transact insights from a broad array of clinical data sources.?
• Green Button Informatics Consult Service. Our core solution for data-driven clinical Q&A. Go from question to Prognostogram in 48 hours, with extremely low effort. Relevant clinical insights become available on-demand for the manifold needs in medicine. Personalized evidence at the point of care, care protocol optimization, refinement of clinical guidelines for diverse populations, observational research acceleration, workflow augmentation in healthcare and research settings, and more.?
• Atropos Evidence Library. A vast and growing content hub of studies generated with Atropos. Among the thousands of past Prognostograms are many that have identified clinical quality, and cost improvement opportunities in healthcare. Experience the ROI of evidence in action on the first day of installation. Insights Across Datasets: Unlock insights from hundreds of millions of de-identified patient-level records, from thousands of healthcare institutions, and dozens of data aggregators and enrichment platforms.
• Control and Security. Evidence Network members are not asked to sell or move healthcare data from its current environment. The Atropos Evidence Network leverages a secure federated model for data analysis and insights exchange. Further, members control when and for whom their data is utilized.
• Monetization Opportunities. Access the TAM of real-world evidence in healthcare. Network members who enable insights on their data are compensated for each use. This unlocks greater transactional volume and untapped demand. Atropos Data Scoring solutions ensure utilization by matching insight seekers to the right source data. When a certain data source yields the best answer to a question, we let requestors know.?
• Reduce Transactional Friction and Feasibility Hurdles. Bypass long deliberations about data value and protocol feasibility. Atropos provides rapid answers to these questions across multiple datasets scored for suitability.? Our Real World Fitness Score indicates whether a certain dataset is the best to answer a study question and others like it. This arms both investigators and data proprietors with justification for transactions. Confidential Data Assessment on installation where summaries of scores on Atropos Evidence Library studies will be provided to summarize data strengths and weaknesses and suggest areas of optimization and improvement (Data Linkage, NLP, Curation, etc.)

Benefits for Health Systems, AMCs, and Community Providers

• Use Data Assets to Drive Clinical ROI. The opportunity exists here not just to think about collected patient medical records as critical to business operations but to actually drive clinical ROI back to patient care.?
• Build on Existing Platforms and Security, and Maintain Control of Data Assets. Following a decade of investment in cloud-based security and data infrastructure, Atropos Evidence Network members can maintain control of data in their own environment. No data leaves, and interface with the Atropos Evidence Platform occurs on your institution's own secure infrastructure. This federated model builds on existing investments and is designed for institutions to maintain control of how and when their data is leveraged.
• Improve Physician Experience, Upskill Caregivers, and Drive Optimized Reimbursement. Physician users of the Green Button Informatics consult service receive the benefit of personalized evidence for care in as little as a few hours, with a user experience that mimics emailing a colleague or peer. As a result, physicians can easily incorporate the use of Real-world Data into their day-to-day practice. This leads to improved clinical decision-making and a reduction in specialty and out-of-network referrals. All of this is in the form of a peer-to-peer e-consult that physicians love and return to again and again. The service also enables reimbursement or the ordering physician to maximize the value of the time spent engaging in personalized evidence generation.
• Enhance Research Infrastructure and Drive Sponsored Research Opportunities. The Atropos evidence platform allows researchers to turn abstracts, publications, and research proposals around in days and weeks as opposed to months. This can enhance the speed of publication, enhance translational research, and raise the profile of physician researchers. It also can offset staffing needs and infrastructure costs normally required to interface with institutional data assets. This speed of engagement can also generate additional opportunities for clinical and observational research opportunities with life science companies for the institution.
• Justify Investments in Data Infrastructure and Enrichment. Leveraging the Atropos Evidence Library and the Real World Data ScoreTM (RWDS) institutions can receive a confidential third-party evaluation of their data assets. This can offer opportunities to improve the quality and utility of data assets by demonstrating the best-fit use of the current data as well as opportunities for enhancement through things like data linkage, curation, NLP, and other methods. This mechanism inherently also can measure the potential benefit of such investments by identifying the quantity of benefit for making these investments.

Benefits for Data Aggregators, Platform Companies, and Firms Focused on Data Enrichment

• New Market Opportunity Access. Large data purchases are a critical part of the Real-world data ecosystem. However, these transactions miss the opportunity to enable individual researchers and clinicians to be able to answer questions rapidly. Participation in the Atropos Evidence Network allows data organizations to access this largely untapped user base, and simply transactional access to this opportunity. Leveraging the speed of the Green Button informatics consult service, researchers and clinicians can quickly realize value from normally hard-to-access data assets while still maintaining control of the underlying assets.?
• Value Differentiation, Pricing Power, and Rapid Feasibility. Leveraging the Atropos Evidence platform and the Real World Fitness Score (RWFSTM) Data holders can show off the discrete value of their data set and platform in terms of their ability to be the best answer to critical clinical questions. This circumvents the need for circuitous feasibility requests in the sales process and can be used to highlight the strengths of data assets as well as the differentiation of platform enrichment. This benefit can directly drive greater transactional volume as well as pricing power for key assets.
• Security, Control, and Transparency. Through the Atropos Evidence Platform's cloud-based federated deployment model data holders maintain control of data assets and can easily meet data security and identity management requirements, reducing risk and maintaining control of key assets.

Benefits for Clinicians and Researchers

• It Starts with a Hypothesis: Clinicians and researchers are the drivers of evidence generation. With access to the Atropos Evidence Platform and access to the Atropos Evidence Network users can quickly receive study results for key clinical and research questions. The Atropos Evidence Network allows for network access to dozens of datasets, and over 100M deidentified patients. Allowing them to engage the right dataset for the right question
• Takes the Guesswork Out of Data Selection and Bias. With the Atropos Data Fitness Solutions clinicians and researchers receive transparent insight into the appropriate match of Question-to-Dataset. Ensuring that the right dataset is used for each question and biases are clearly identified.
• Query Multiple Datasets at Once, and When Relevant Combine Results in a Meta-analysis. Through the Atropos Evidence Network users can select o answer questions using multiple datasets simultaneously. Both to examine the concordance of findings, and determine if findings translate across different populations or settings of care, but also to determine which dataset has the best Real World Fitness Score (RWFSTM) giving the highest confidence of use. Lastly, results from multiple datasets can be combined by leveraging meta-analysis techniques to produce a more highly powered answer across the network.
• Speed and Rapid Iteration. As always when leveraging the Atropos Evidence Platform, questions are returned, even across multiple datasets, in about a day. This enables clinicians and researchers to cut study timelines, incorporate findings into the pace of medicine, and lower the infrastructure costs associated with data analysis.
• Transparency and Consistency. A core of the Atropos Evidence Platform is the transparency of methods. Ensuring that our techniques are easily understandable and based on top-tier publications ensures that findings can be easily interpreted and trusted. Building confidence and consistency in the evidence-generation process.

More to come from Atropos Health, and excited to continue the journey with our community toward driving robust evidence to clinical care to improve patient outcomes.

To learn more reach out to us Here

Brigham Hyde Ph.D.

CEO

Atropos Health