NEW YORK (GenomeWeb) – With a string of deals, including its most recent with healthcare software developer Allscripts, NantHealth is aiming to make precision oncology a reality in the near future.
Earlier this week, Allscripts said that it had invested $200 million in NantHealth for a 10 percent stake. For NantHealth, the Allscripts deal provides the firm a chance to show Wall Street that it can link diverse technologies and data sources to bring precision medicine to a large swath of the US population.
"They have a large global and national foot print in the ambulatory space," NantHealth Founder Patrick Soon-Shiong said of Allscripts. "I have firm belief healthcare is going to be local. The capacity to integrate complex genomic data into an ambulatory space was very exciting," he told GenomeWeb.
NantHealth is already working with Allscripts and its clients to create a framework for personalized oncology, he said. "We will have integrated phenotypic data and genomic data and tie it to outcome data. Until you have that, you really have nothing."
Soon-Shiong's vision is to acquire the necessary technologies and partners to make precision oncology available in this decade, not the next. To do that, NantHealth needs to be able to generate and store multi-omics data, find mutations and discrepancies, combine the omics data with phenotypic data, analyze the combined data, securely deliver that data to doctors in a clinical setting and highlight the relevant information, help doctors use that information to guide treatment, and monitor outcomes.
Not even the most forward-thinking, resource-rich healthcare institutions have been able to come up with solutions to each of those challenges. Even at Massachusetts General Hospital, a project to combine phenotypic data with genomic data and present it to clinicians in an actionable format was only launched in January.
NantHealth is braiding a rope out of different threads of technological and scientific advancement that it says can address all those problems. It plans to use that rope to drag healthcare delivery into the age of genomics and cloud computing, but at the moment it looks more like collection of loose ends than a taut, finished product. NantHealth is hoping that with Allscripts, it has found a partner that will enable it to show that all its technologies can work in concert.
In the last year, NantHealth has slowly started to demonstrate the technologies it has acquired or developed, striking deals to show them off individually.
Just last month, it announced partnerships with UK Healthcare Trust and Genomics England to analyze tumor genomes. In December 2014, it announced a deal with Blackberry to launch a cancer genome browser this year. One aspect of its integrative efforts will be to put the cancer genome browser inside an Allscripts window.
"You can browse to the single base pair," Soon-Shiong explained. "You can hyperlink to the mutation and the mutation hyperlinks to the drug," which in turn has a hyperlink to clinical trials, he said.
NantHealth also has an alliance with Blue Shield of California dating back to 2012 to use Eviti, the firm's cancer treatment protocol recommendation tool.
Those technologies are nothing new, but the ultimate goal is to put them all together in one framework that could potentially be used for any patient. And only in the last year has the firm made deals that could allow it to show off that unified framework.
In August 2014, NantHealth signed a deal with Providence Health, one of the largest non-profit health systems in the US, to extract data from Providence's Epic EMR platform and combine it with whole-genome sequencing services offered by NantOmics, another company under the umbrella of Soon-Shiong's NantWorks.
Now, Soon-Shiong and Allscripts have invested in each other to strengthen an alliance announced in March, which will deeply integrate NantHealth's technologies with Allscripts EMR software. Among the technologies listed as part of the collaboration: NantTransporter, NantContraster, Paradigm, DeviceConx, Hbox, Eviti, cOS, and NantCancer Genome Browser.
"We believe [NantHealth] has a game changer and capabilities no one else in the marketplace else has," Assaf Halevy, Allscripts' senior vice president for strategy, population health, and analytics, told GenomeWeb. "When combined with our installed base in the cancer center space and broadly at the national level, we believe this combination is driving a game changer and will position us way ahead of the competition."
Halevy said that new products developed as part of the collaboration will be made available to new and existing customers and that there would be a cost associated with those products.
As the healthcare landscape moves to an accountable care organization (ACO) model, the ability to track outcomes — something NantHealth says it offers — could be an attractive feature for an enterprise healthcare platform. "In the context of ACOs, when you have cancer survivors you want to monitor them over time to see that things are not coming back, and if they do, then link [recurrence to a previous disease condition] or challenge whether there was a link to previous disease condition," Halevy said.
Soon-Shiong has also taken a financial stake in Allscripts. According to a document filed by Allscripts with the US Securities and Exchange Commission, Nant Capital, an investment vehicle of Soon-Shiong's, acquired about $100 million of Allscripts stock in a private placement. Shiong said the investment was "a vote of confidence" in the EMR maker. "I wanted Wall Street to understand we're completely committed to this," he said.
In the SEC document, Allscripts disclosed that it used proceeds from the Nant Capital private placement as part of its $200 million investment in NantHealth. Soon-Shiong wouldn't disclose how much of NantHealth he owned, but said it is a majority stake in the firm.
If Allscripts is able to successfully integrate with NantHealth, it could be a stepping stone to greater adoption of the NantHealth framework, though Halevy said there were limitations in the commercial agreement that restrict both Allscripts and NantHealth from working with each other's competitors.
"The ability to deeply integrate with Allscripts gives them a leg up, which is fine with me," Soon-Shiong said, but added that prior to the Allscripts deal, which began in earnest following the JP Morgan Healthcare Conference in January, NantHealth was in talks with other major EMR vendors including Epic and Cerner.
As he sees it, EMR systems are a data input to a bigger picture of precision oncology. That input is enabled by NantHealth's clinical operating system (cOS), a service oriented architecture-based middleware software that is EMR platform-agnostic. "The advantage Allscripts will have is we will deeply integrate with their systems and deeply integrate with dbMotion," Allscripts' own middleware, to extract data from multiple sources, Soon-Shiong said.
But as the deal with Providence Health, which has an Epic EMR, shows, Soon-Shiong thinks NantHealth can be successful with any healthcare system in the country.
"Never mind the country, we need to expand to the globe," he said.
An IPO, which Soon-Shiong told The Los Angeles Times this week the firm would pursue, would help NantHealth do that. So would a detailed and complete demonstration that NantHealth's technologies can succeed in the monumental challenge of connecting siloed healthcare data and presenting informative analyses of that data to doctors in real time.
In its partnership with Allscripts, NantHealth believes it is taking a step towards both those goals.