Liu's hard worked earned him a spot at the Medical College of Virginia in Richmond, and later an internship and residency at Barnes-Jewish Hospital at Washington University Medical Center in St. Louis. In 2000, during the last year of his residency, Liu made a purchase that ultimately would change the course of his career: He bought a Palm Pilot.
“I was one of the first ones to buy it. I'm kind of geeky, techy guy,” Liu says. “It seemed like a great thing to use just for my own residency.”
At a time when most of his peers were documenting their work on 3-by-5-inch note cards, Liu started to use his Palm Pilot to track patient visits and services performed for billing purposes. One day, Liu found one of his colleague's lab jackets with an old stack of those note cards in the pocket. The doctor had forgotten to submit the charges, and as a result, the hospital lost about $150,000 of revenue. At that moment, Liu knew he had to create a technological solution to help his colleagues to more efficiently track and bill their work. He recalls talking to his family about his idea and his fear that he had no business experience. His parents encouraged him to pursue his goal.
“When I think back on my life and all the pivotal moments, that was one of them—having that discussion with my parents,” Liu says.
Armed with the engineering and computer programming skills he thought he'd never use, Liu set out to create a handheld and desktop software solution that his fellow physicians could use to automate charge capture and the billing process. After his residency, Liu was tapped for a job as the director of the hospitalist group at Emory Eastside Medical Center, Snellville, Ga., and also became the director of medical informatics at Emory Hospital Medical Group. He recruited Dr. Mohan Gounder, Dr. Geoffrey Marx and Dr. Jason Stein, all colleagues of his at Emory, to work with him on the fledgling software product.
“In beginning, I used to write code until 4 or 5 in the morning,” Liu says. “We basically boot-strapped the company, working during off-hours and putting in money from our own salaries.”
In 1999, Liu and his colleagues officially formed Ingenious Med, providing their newly created charge capture and billing software to only a few dozen physicians. Liu says he knew he was taking a risk by deviating from the traditional career path of a physician. But he had taken a similar risk seven years before when he decided to pursue medicine in the first place—and he says he knew this was something he simply had to do.
“We did it because we really believed in the product and the company,” Liu says. “We knew it was something special. It was one of those no-brainers—you just do it.”
There were plenty of 100-hour workweeks, few vacations and a lot of “sweat equity.” But Liu says the buzz about his easy-to-use product spread quickly among hospital physicians.
“There was a huge market (of hospital physicians) that was growing really fast and they were starving for this sort of solution,” Liu says. “I had this market that was in tune with what I was creating and needed it immediately, so I built a user base very quickly.”
Today, Ingenious Med has about 9,000 users in more than 800 healthcare facilities across the U.S.