CHICAGO – Oncology informatics startup Vidence has publicly emerged as an independent company after spending its formative years as the data analytics division of Cancer Center Treatment Centers of America Global (CTCA). The Boca Raton, Florida-based company officially took its own identity in March and publicly launched last month.
Cofounder, President, and CEO Percy Van Crocker said that the independence will allow the company to partner with hospitals that might otherwise see CTCA as a competitor.
Vidence makes a cloud-based platform called Scimon that helps pharmaceutical companies and cancer care providers manage and organize multi-omic data for research. "It exists to consume data from multiple sources within a health system or other data contributors into a highly secure repository where the data can be organized," Crocker explained.
Data can come from electronic medical records (structured and unstructured), imaging systems, laboratory information management systems, (including those at molecular labs), and administrative networks including claims data from payors. Scimon then organizes and refines the records into a form that is usable for its clients.
Vidence also has collected patient-reported outcomes data. According to Robert Hauser, cofounder and chief business development and analytics officer at Vidence, the company's clinical partners provide patients with a questionnaire, either on paper, on an iPad in the clinic, or online at home, to ascertain any side effects of cancer therapies and how individuals view their outcomes. The dataset now includes 275,000 records on nearly 60,000 patients.
Those patient-reported outcomes are integrated into EMRs at participating institutions, Hauser said.
All told, Scimon provides longitudinal views of more than 100,000 patients, based on information from electronic medical records, genomic test results, billing claims, and patient surveys. The dataset is intended to indicate time, in the form of diagnosis to survival; "depth of moments," namely clinical and genomic outcomes; and breadth of story, which incorporates social determinants of health, according to Crocker.
Crocker, a veteran of management consulting and data analytics in healthcare, joined Vidence in March after serving for nearly seven years as president of Healthagen, the analytics division of health insurer Aetna that now is part of CVS Health.
While at Healthagen, Crocker noticed a "blind spot" in the data. "Obviously, Healthagen had access to Aetna's tens of millions of overall lives, millions of analyzable lives, but dominated by claims information, which is relatively structured and relatively standardized," he said. Real-world clinical data was missing, so the company struggled to create full pictures of patients and cohorts, particularly in cancer.
"Cancer was always problematic because there's so much richness and detail in the unstructured data [from patient records]," Crocker said. "Until I was presented with an opportunity [at Vidence] to do something much closer to the source of a lot of that critical information, which is within the health systems themselves, it was a frustration."
Vidence will exclusively focus on cancer for the foreseeable future. "Our mission is to be the premier oncology information company, providing primarily … pharmaceutical companies and those similarly situated with critical insights that allow them to enhance their ability to create cures, to refine them, to find a new opportunities for them, and to evolve the way they explore and analyze and even conduct clinical research," Crocker explained.
"It is a well-seasoned team of not only technologists that have built platforms in the oncology space before, but also a well-seasoned team in health economics and outcomes research, real-world evidence, data analytics in oncology specifically, and pairing all of that together in an organization that grew within CTCA," Hauser said.
While Crocker is thrilled to have access to real-world clinical evidence, he said that type of data cannot be viewed in isolation.
"You can't just understand the way that the electronic data works, as it were. You have to also understand how it works in concert with relationships, with patients, and with consented situations," he said. "Genomics is one of the enabling opportunities here for innovation," Crocker said.
For the purpose of creating longitudinal records and measuring outcomes, Crocker said that there really is no substitute for an ongoing relationship between a patient and a health system.
"It's not all the data, but it is huge critical mass, and if you're going to be successful in growing this kind of model, you need to start where the critical masses exist," he said.
Vidence sees pharma as its primary customer base, though that could also include diagnostics and medical device companies, according to Crocker. He also sees a potential market with government agencies that run clinical trials and conduct surveillance.
The company has announced just one partnership, with Bristol-Myers Squibb, which has been using Scimon for a real-world study of tumor types and is in the middle of a study of immuno-oncology treatments for melanoma and renal-cell carcinoma in research.
Annette Powers, BMS VP in charge of health economics and outcomes research and strategic payor marketing for the US, said that the pharma giant is adding clinical and genomics data to try to gain a better understanding of disease burdens, treatment patterns in the real world, and outcomes.
"What's in a clinical trial and how the treatment has been dictated in a clinical trial is very different than what's happening in the real world," Powers said.
This is a longitudinal study of multiple tumor types, following patients from diagnosis through early stages of therapy, then looking at how therapies change after administering large-panel genome tests, and eventually tracking outcomes, according to Vidence's Hauser. The researchers will be evaluating metrics including adverse events, overall survival, and progression-free survival.
Hauser said that the study should wrap up in the early fall, perhaps before the end of the third quarter. "We'll then begin the analytics and start delivering results in the beginning half of next year," he said.
Powers, who joined BMS in March, said that Vidence offered a unique dataset that goes beyond claims data to offer "real-world" information from EMRs such as tumor type and lab results, and also draws from a diverse population.
"When we're buying claims data, we're at the mercy of the insurance organization or the data that they have," Powers said. If a patient switches insurers, BMS cannot get a longitudinal view of that individual without EMR data.
Powers said that she had no qualms working with an under-the-radar startup like Vidence because of that company's ties to CTCA and because she has known Hauser for years.
Powers said that BMS is interested in continuing to use the Scimon technology beyond the current study. "This type of collaboration is definitely here to stay, not just for BMS, but for any other pharmaceutical organization," she said.
Vidence also is continuing to approach health systems to become part of the company's consortium of data contributors, according to Crocker. He said that Vidence tries to add value for both parties in a data transaction.
"Vidence would get organized information, the deidentified version of which could be analyzable and useful in our pharma-facing activities. The health system gets organized data with multiple applications," he said.
Scimon now also can incorporate elements of precision medicine and clinical trial management for healthcare providers as well as for the core pharma customer base, Crocker said. In this context, Crocker defines precision medicine as applying technology to weed through complex genomic and clinical reports to produce actionable therapeutic plans.
"That's the simplest approach," he said. "Over time, you can clinically contextualize that, not just with the data that the individual provider is providing, but also data that has been analyzed [from] multiple providers."
The more advanced approach will allow for researchers and clinicians alike to match new patients with cohorts to look for similarities and differences to individuals with a given condition, according to Crocker.
For that to work, information has to flow from the interested clinician as well as from other clinical and molecular data repositories so the technology can make inferences based on as large of a relevant dataset as possible. "That is, over time, what Scimon is designed to do," Crocker said.
"Precision medicine is really important in terms of a nearer-term application for us, but it certainly will not remain the only thing that providers use to get value out of the system," Crocker said.
Like so many data aggregators, Vidence relies on natural-language processing to pull out unstructured data.
"Converting increasingly large amounts of information into a structured form is a constant manufacturing exercise for us that renders value pretty quickly. I don't know how you can do it competitively without leveraging NLP to an extent," Crocker said.
Crocker noted that Vidence backs up its technology with human abstractors. "Cancer data is simply too nuanced, too specialized, and changing too frequently to be reliably [and completely] structured or automated. You have to have abstractors ready at all times," he said.
The company acquired oncology-specific NLP capabilities early in its existence. "The real value is in refining the engines in oncology specifically with real documents and real use," Crocker said.
Vidence also provides dashboard services to the pharma industry. "Think of that as dynamic environments that give access to aggregated, deidentified insights to a pharma client," Crocker explained. "They get a dynamic, visualized environment that lets them see the landscape of a certain condition."
"For instance, what's the landscape for prostate cancer over the course of a few years and how is that changing into the future? Can you give me an environment where I have the ability to drill down geographically or as to demographic characteristics or comorbidities?" Crocker explained.
Vidence has close to two dozen employees now, and has largely relied on contractors for much of its technology development. That is changing this year as the company looks to bring more of the development in house, potentially by forging permanent relationships with some of the contractors.
Vidence has not publicly announced any funding, though its early work was supported by CTCA. Without going into specifics, Crocker said that the company is considering other funding sources going forward, though Vidence may decide to grow organically.
"I think we're as focused on the buildouts of successful commercial relationships as we are on fundraising," Crocker said.