Healthcare and technology are two of the fastest changing industries out there. Florida-based startup OrthoSensor, Inc. straddles both of them. The company is working to develop and commercialize sensor assisted intelligent orthopaedic devices and data services that provide real-time, actionable information to surgeons and measure outcomes for providers. When VP of Information Management Thomas Packert joined the company two years, he was charged with building an application to manage the data around these devices, either from the ground up, or by choosing a cloud platform. Keep reading the latest in the “IT Visionaries” series to learn about his development journey.

1. How does OrthoSensor’s technology work?

The VERASENSE Knee System is a proprietary, single use tibial insert trial embedded with advanced sensor, accelerometer, RF, and microelectronic technologies to wirelessly transmit important procedural information during total knee arthoplasty (TKA). The sensor is placed in the patient’s knee joint and wirelessly sends data on joint loading and implant positioning to a computer positioned outside the sterile field. Similar to the computerized balancing of the tires on a car, VERASENSE provides data that the surgeon can use during surgery to ensure the knee replacement is properly balanced. Balanced knees have been shown to result is less pain, improved range of motion and recovery time, and a better overall knee replacement experience for the patient. OrthoSensor also has hip and spine alignment technology in development.

2. Tell us about the app you built on the Salesforce1 Platform to track the VERSENSE Knee System data.

The app is called VERASENSE iQ. It collects pre-operative, intra-operative and post-operative data and integrates seamlessly with most hospitals' electronic health record (EHR) systems. VERASENSE iQ also tracks what is referred to as “patient reported outcomes” from post-surgery surveys conducted by surgeons. What we’ve really created is a data and analytics component to track, document, and analyze the patient’s pre-operative condition and planned treatment protocol. This includes everything that was done during the procedure and what the outcome was three to five years after surgery. If you look at the Affordable Care Act, a major aspect of reducing costs is to collect data about more effective and efficient ways to achieve better outcomes for patients. VERASENSE iQ helps prove the value and effectiveness of our VERASENSE Sensor.

3. What was the development timeline for the application?

The speed of deployment was incredibly fast. We built and deployed the VERASENSE iQ app in three months. At first, I thought the Salesforce1 Platform was too good to be true and there had to be something wrong with it. Being an open source proponent, I looked and looked, and I just couldn’t find any open source project nearly as robust as the Force.com platform. It handles all the hardware, all the firewalls, all the redundancy, and the disaster recovery planning. That’s probably a million dollars in salary of full-time employees alone that I don’t have to hire. Especially as a startup, I can just dig right in and put all that precious early capital toward developers.

4. Why is this out of the box infrastructure so valuable for startups like yours?

Why should healthcare startups have to build role-based access control just to get started? Plus all the blocking and tackling; plus putting servers in the co-location site and having to put up firewalls. And then all the work of what we call “the magic rule of three”: You have to have three of everything because if you take one down for maintenance, you still have redundancy. If you only have two, and you take something down for maintenance, you have no redundancy at that point. So you have to have three firewalls, three admins, three database servers, three of everything, and that gets very expensive. The Force.com platform gives healthcare startups prebuilt high tech security and controls, the audit trails, everything we need for building modern healthcare IT systems that can pass the ever increasing security compliance regulations.

5. What does this mean when it comes to scalability?

Most startups invest in a minimum viable product running on minimal hardware. If you are fantastically successful, then all of the sudden have to go and buy a bigger database much sooner than you thought. You have to add more load balancers. You have to have more back up, more bandwidth, and if you’re doing that physically, that’s a lot of planning you have to do to upgrade your infrastructure. So there’s a lot of overhead to providing rollouts. And then depending on the framework you pick, you have to upgrade that as well. With the Salesforce1 Platform, that's not our problem. Salesforce is handling the infrastructure and the updates. We don’t have to worry about it. We just need to keep our admin certifications up to date for the new releases.

6. How has this impacted your role?

I finally sleep well at night. Now I only focus on the things that add value, which are features and development, not firewalls, bandwidth, redundancy, disaster recovery planning, and so on. Who wouldn’t want to eliminate all that overhead? With the Force.com platform, you don’t have to spend money on those technical resources. Now I have a lot more time to focus on business issues because I don’t have to worry about keeping the lights on. As my dad used to say: “A lot of IT is really just the mastery of clutter.”

7. Why do you describe yourself as a “recovering server hugger”?

I call myself that because I don’t want to hang servers in racks anymore. Sure, I am still fascinated by data centers and their design, but if an entity is still hanging their own physical servers in 2014 and expecting to be a healthcare innovator, you're way behind the eight ball. I just want to build apps. IT should stand for “interesting things.” If you’re getting bogged down in the clutter of minutia, that’s no fun. You eventually just reach the point where you can’t make any forward progress because your boat is growing larger and larger barnacles on the hull everyday. With the Salesforce1 Platform, we have a very efficient system. With one admin we can manage all the deployed instances and with the click of a button we can push updates out.



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