Health IT Success Story – VisualDx

7-1-2013 6-49-03 AM

I love learning about companies that are succeeding in health IT without getting much press. They aren’t raising huge rounds of funding and aren’t in accelerators, but have created and sold compelling solutions.The concepts and products resonate with me.

One such company is Logical Images, with VisualDx as its flagship product. VisualDx is a clinical decision support tool and was #1 in its KLAS category in 2011 and 2012. Originally built by a dermatologist and targeted at dermatologic conditions, it has since expanded its coverage and will eventually cover all areas of medicine.

I’ve known VisualDx for years as my wife contributed content five or six years ago. It sounded interesting, but I didn’t really get the power of it. I loved that it was image driven because I could actually identify and compare rashes. I really didn’t spend much time on it. My wife has been a long-time user and loves the apps, which she uses on her iPhone.

Last December at the mHealth Summit I wanted to speak to the people at the Direct Dermatology booth. I’m a big fan of virtual care and especially telederm since my wife is creating telederm services for her practice. At the Direct Derm booth, I met and spoke with Noah Craft, MD, PhD. We mostly covered Logical Images and VisualDx. Logical Images is a content partner for Direct Derm.

VisualDx is licensed by 1,600 hospitals and clinics, including the entire VA, 61 medical schools, and six states. It average 5,000 mobile downloads per month, with about 2.5 times more installs on Apple devices than Android. I’m betting mobile provider communication companies like Doximity have similar numbers. It’s something that should weigh into mobile platform decisions of vendors building tools meant to be used by providers.

In terms of clinical reach, VisualDx offers support for over 1,500 diagnoses with plans to expand to all of medicine over the next year or so. If I was one of the other decision support vendors, I would pay attention to what VisualDx is doing and hows it’s growing. It’s easier to use than UpToDate.

In addition to decision support for providers, VisualDx also provides patient education that can be reviewed face to face or e-mailed to patients so they have a record at home. This is valuable since most patients aren’t going to remember all of what is said. The ability to share educational material with family and caregivers is powerful.

At HIMSS13 in New Orleans, I met with the Logical Images CEO Art Papier, MD. We had a great talk about why he created VisualDx. The conversation included a lot about Larry Weed, MD, who Dr. Papier met as a medical student. Dr. Weed’s famous Grand Rounds video at Emory from 1971 has its own page on the VisualDx site. In following up with Dr. Craft and Dr. Papier, it appears that much of what Dr. Weed has been advocating for over the last 40 years or so have shaped the building of VisualDx.

VisualDx has grown as a standalone tool (though it has an HL7 feature to be integrated into an EMR) much like Epocrates. It’s interesting to explore what has made it compelling enough for notoriously hard-to-sell-to physicians. It has support from Wolters Kluwer. For proof of its success beyond the adoption numbers, check out the user stories.

VisualDx is image driven. Even complex cases are representative visually. This allows for pattern recognition and immediate affinity, making it easier for users to filter and find information. I’ve only used it for skin conditions, but image comparisons are easy to do even if you don’t know derm-speak.

The second and more interesting differentiator is that all of the information within VisualDx is structured. It is not a typical text-based search like Google or Isabel that crawls through documents and sources to find the best matching text.

Just as Dr. Weed preached about back in 1971 at Emory and more recently in his book Medicine in Denial, VisualDx has created structured, problem-based knowledge. The information is matched and linked to create what Craft and Papier consider the true VisualDx IP — the structured knowledge database behind VisualDx. Structured data linked to diagnoses or problems takes the burden off providers to hold too much information in their heads. It also makes scaling large sets of clinical data easier.

To be clear, Dr. Weed is not endorsing VisualDx or Craft and Papier, but the company has taken his lessons to heart in building what it thinks is the future of medical knowledge transfer. Providers I talk to, despite not having a clue who Weed is or why a structured approach to data is a challenge and opportunity in healthcare, like VisualDx.

It’s compelling to think about the power of a structured knowledge engine in healthcare, even if that data is independent of the EMR. And it’s really interesting that this truly powerful part of VisualDx is not what people see or like because it’s behind the scenes. It allows VisualDx to scale to all conditions in medicine without having to worry about crawling more and more blobs of text.


Travis Good is an MD/MBA involved with health IT startups. More about me.

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