Market Profile: Health IT Leaders, and Silicon Valley, Have Their Eyes on Cleveland

Cleveland, Ohio has long been recognized for its leading medical centers, as it has more than 60 medical centers, including three major health systems—Cleveland Clinic, University Hospitals and MetroHealth System—and hospitals such as the Louis Stokes VA Medical Center and St. Vincent Charity Medical Center. Within the broader Northeast Ohio region, there also are Western Reserve Hospital and Health System, based in Cuyahoga Falls, Ohio, Akron-based Summa Health System, and several hospitals within the Cincinnati-based Mercy Health system, as well as a number of educational institutions involved in cutting edge medical research, namely Case Western Reserve and Cleveland State University.

Northeast Ohio also is home to a number of very successful health IT startups—Explorys, originally spun off from the Cleveland Clinic, was acquired by IBM Watson in 2015, and Cleveland-based CoverMyMeds, which started in 2008, was acquired by McKesson last January. That all adds up to a tremendous amount of healthcare and health IT-related innovation and advancement in one region of the country, and in a city that’s not even the largest city in Ohio (Columbus has that ranking).

And while the three biggest health systems in Cleveland have long been focused on medical innovation—the Cleveland Clinic launched its commercialization arm, Cleveland Clinic Innovations back in 2000—there are many indications that Cleveland is fast becoming a hotbed of healthcare innovation, and a city to watch in the health IT space.

Speaking of the Cleveland health IT market, local health IT consultant Frank Myeroff says, “I think we’re bleeding edge.” Myeroff, who is president and co-founder of Solon, Ohio-based Direct Consulting Associates, an IT consulting and staffing firm, cites growing focus and investment in the development of new healthcare technologies from both within local health systems as well as from the Cleveland business community, such as the opening of the Global Center for Health Innovation in 2014.

With the Cleveland Clinic and large health systems like UH, the market naturally attracts health technology startups and entrepreneurs, Myeroff says. “If I’m a new tech startup, I want the Cleveland Clinic to be my beta site because of the name recognition. For the health systems, they test new technology systems, and some succeed and some don’t, but it’s a competitive advantage, because if you win, you’re the first one to have that technology.”

An Increasingly Consolidated, Advanced Market

It’s no surprise that cutting-edge research and innovation within Cleveland are receiving an exceptional level of support at the Cleveland Clinic, the 10-hospital integrated health system on the leading edge in terms of clinical quality improvement, clinical integration, and IT innovation.

Cleveland also is a very consolidated healthcare market, notes Deanna Moore, vice president, corporate communications at The Center for Health Affairs, a hospital association for Northeast Ohio hospitals. “We’re a marketplace that has 46 community hospitals, across a nine-county region, and over the course of the last couple of decades, most have affiliated with UH or Cleveland Clinic,” she says.

According to many Cleveland healthcare executive leaders, in many ways consolidation has actually helped to advance the forward evolution of health IT in the region. “There has been a lot of market consolidation in this area; between Cleveland Clinic, MetroHealth and University Hospitals, and if draw a little bit broader and get down to Akron, there are only a small handful of integrated healthcare delivery networks. And why I think that’s important, when you think about health IT, is that when you have large integrated delivery networks the natural thing for them is to buy large EHRs (electronic health record systems) and there’s a lot in IT to make that process work well. Because it’s a mature market, the implementation, adoption and use of EHRs, and health IT more generally, is probably a little bit further along than in markets that are more fragmented, from a healthcare standpoint,” says David Kaelber, M.D., Ph.D., the chief medical informatics officer (CMIO) at MetroHealth System.

Myeroff notes that the ongoing trend of business affiliations between patient care organizations in the area results in the larger, more advanced health systems sharing technology solutions with smaller and medium-sized hospitals. “That technology is being pushed down, and many of the larger health systems also provide EHR implementations and hosting services to the organizations they have business affiliations with,” he says.

Dr. Kaelber also notes that the majority of the health systems in the Cleveland and Akron area, are “Epic shops,” meaning they partner with Verona, Wis.-based Epic for their EHR systems. “I think because there is such a large Epic EHR presence here, it really allows us to leverage the technology and also sort of the collective experience a lot of us have with the EHR, specifically the Epic EHR, to do more things,” he says.

And while the health systems and hospitals in the Cleveland area are highly competitive from a business standpoint, there is collaboration around technology initiatives, many local healthcare leaders say. “At a health IT and informatics level, we do collaborate,” Kaelber says.

“We’re fortunate that there are good healthcare IT leadership in the region, and that has helped to keep us at the forefront,” Ed Marx, Cleveland Clinic CIO, says. In fact, many seasoned health IT leaders have returned to Cleveland—Marx had served as CIO at University Hospitals earlier in his career and Robert Eardley was recently named CIO at University Hospitals, where he had previously served as associate CIO seven years ago.

“There are some good, strong healthcare IT leaders in the region, and there have been for many years. We’ve all worked together for a number of years, have learned together and have gone off to different areas, now three or four of us are coming back and bringing back some things that we’ve learned in other markets. It’s been very collegial,” Marx says.

Under senior executive leadership, a number of local hospitals and health systems also have banded together to tackle serious community health issues, particularly the opioid epidemic. Ohio has been one of the states hit hardest by the opioid crisis, with 86 percent of overdose deaths in 2016 involving an opioid. According to the Centers for Disease Control and Prevention (CDC), Ohio’s drug overdose deaths rose 39 percent between mid-2016 and mid-2017, triple the U.S. average, and the third-largest increase in the country.

Last year, local hospitals and health systems, including MetroHealth, UH and Cleveland Clinic, and in coordination with The Center for Health Affairs, formed the Northeast Ohio Hospital Opioid Consortium to formally address the issue. Among the initiatives the Consortium will pursue are sharing data and best practices, finding new and better ways to manage pain without using the prescription painkillers that lead to addiction in the first place, and applying for grants together as one entity.

Ohio leaders are also trying to lead the way in the nation’s fight to address the growing opioid problem by leveraging technology. In December, Ohio Third Frontier, a technology-based economic development initiative, awarded a handful of grants, totaling $8 million, to entrepreneurs who proposed creative ideas for tech solutions in the battle against drug abuse and addiction. One concept that was awarded a grant proposed an opioid risk assessment screening app to help medical professionals identify patients with risk factors for opioid abuse. In the final phase of the Ohio Opioid Technology Challenge, winning solutions will receive funding to cultivate the solution into a product.

Nurturing Health IT Innovation and Startups

The major health systems in the Cleveland area all individually focus on developing healthcare technology innovation—University Hospitals last year launched UH Ventures, for example, to support innovation and commercialization of discoveries. However, the health systems also work with community partners. All three major health systems are tenant partners of the Global Center for Health Innovation, located in downtown Cleveland. The Center is an event space and showroom for the latest in medical product development, education and technology and partners with 45 healthcare, health IT and medical innovation brands. The space also houses the HIMSS Innovation Center and the HIMSS Cybersecurity Hub, initiatives of the Chicago-based Healthcare Information and Management Systems Society.

John Paganini, president and owner of Cleveland-based health IT consulting firm Paguar Informatics, previously managed the operations and logistics of the HIMSS Innovation Center in his prior position as senior manager of interoperability initiatives at HIMSS North America. Beyond hosting events and meetings, the Global Center for Health Innovation supports ongoing vendor collaboration on health IT issues such as cybersecurity and interoperability.

MetroHealth’s Dr. Kaelber says the Innovation Center has proven to be a catalyst for innovation. “We were already being entrepreneurial and trying to push the ball forward with health IT, and I think having that as an additional catalyst here has helped us to do more things, both collectively and individually,” he says.

It was recently announced that BioEnterprise, a company that promotes and nurtures healthcare companies and bioscience technologies, will now oversee marketing, promotion and tenants at the Center with the aim of growing the area’s biomedical sector. In addition, back in October, Silicon Valley innovation company Plug and Play announced a three-year partnership with Cleveland Clinic and JumpStart Inc. to bring a new biotech and digital health innovation accelerator to downtown Cleveland.

Starting this spring, the "Plug and Play Cleveland HealthTech Accelerator," which will be located in about 10,000 square feet of space in the Global Center for Health Innovation, will operate two cohort programs annually, inviting a group of at least 10 companies every six months. The Clinic will collaborate with up to six of the companies every year to pilot their health care innovations.

“It’s going to be a new generation of the global center, and that’s all going to be happening this year,” Paganini says. “This HealthTech Accelerator is really going to move forward the healthcare innovation in this region.”

And, out of the Global Center, several initiatives have evolved with the intent of driving medical technology development, including the Cleveland Medical Hackathon, which encourages doctors, nurses, IT professionals and public health workers to propose technology solutions to a number of healthcare challenges. In April, the Global Center will host the second annual Medical Capital Innovation Competition, in which teams representing new medical device and technology products pitch their inventions, says Paganini.

The Global Center for Health Innovation, which is publicly financed, is one example of how city and county government leaders are supporting the growth of healthcare technology and biomedical sectors to boost the area's economic development.

The greater Cleveland area has a booming biotechnology and biomedical industry that now includes more than 700 companies. Business and public leaders now have their eyes set on building up a health-tech and high-tech business corridor on the east side of Cleveland. The Health-Tech Corridor (HTC), founded in 2010, is a public-nonprofit collaboration between BioEnterprise, The Cleveland Foundation, the City of Cleveland and MidTown Cleveland that has worked to rebrand the 3-mile stretch between downtown and University Circle.

According to the website, HTC leaders recognized that the 3-mile area offers companies “close proximity to four world-class healthcare institutions including the Cleveland Clinic and University Hospitals, six business incubators, four academic centers, and more than 170 high-tech and health-tech companies engaged in the business of innovation.”

Paganini says of the Northeast Ohio market, “To me, that is the power of this region, in that there are organizations that might typically compete with each other, yet are all working together to move the industry forward, to move the region forward, and move healthcare forward, and ultimately, the patient benefits.”