Tech company connects patients with docs for second opinions

Access to top-tier specialists, second opinions and timely appointments. That's what the savviest and most connected patients get when they're faced with a serious medical condition.

Technology company Grand Rounds has developed tools it says provide that same level of service to everyone else.

The company's technology platform helps connect patients who want a second opinion on a diagnosis or treatment plan with physicians who are experts in their conditions. These physicians, who may be located up the block or thousands of miles away, agree to review those patients' medical records and offer feedback on how they should proceed.

Grand Rounds was founded in 2011 as ConsultingMD. Co-founder Owen Tripp previously helped create Reputation.com, a software company that helps businesses manage their online reputations.

His partner in Grand Rounds, Dr. Lawrence Hofmann, is chief of interventional radiology at Stanford (Calif.) Hospital.

“We got together to develop a technology platform that can get insider access,” said Tripp, who is also the company's CEO.

Grand Rounds' primary customers are employers that want tools to help guide their workers in their sponsored health plans to high-quality, cost-effective care.

The company also sells a software program called ExpertLink, which allows hospitals to perform remote consults under their own brand with their own experts.

Studies from as far back as the 1980s have found that second opinions can be cost effective in preventing unnecessary treatment. Grand Rounds is one of the newest players in this space, which also includes the companies Best Doctors and PinnacleCare.

Tripp said Grand Rounds' proprietary quality algorithm for finding experts sets the company apart from its peers. That algorithm scores physicians based on their training, institution, publication history and other undisclosed factors.

“Grand Rounds is incredibly selective,” Tripp said. “We've picked off the top 0.1% of experts to play with the other experts. From Grand Rounds, you've got the A-Team.”

The company also helps patients track down and compile their medical records, a daunting task when records can run hundreds of pages long.

Few studies have been conducted on how often second opinions diverge from an initial treatment plan. A 2014 literature review, published in Mayo Clinic Proceedings, found that second opinions contradicted an initial diagnosis or treatment in 10% to 62% of cases, depending on the study.

At Grand Rounds, Tripp estimated that its experts disagree with the original diagnosis or treatment plan in 66% of cases.

Grand Rounds doesn't disclose revenue. The San Francisco-based company has raised $100 million in capital from backers, including Venrock and Greylock Partners.

In 2014, the company partnered with price transparency company Castlight Health, which allowed consumers to access Grand Rounds directly through Castlight's platform.

Physicians who work with Grand Rounds are paid, or can direct their pay to charity. But highly specialized physicians also are attracted to the service as a way to find patients with specific conditions that interest them, Tripp said. “This takes them back to the go-go days of their residency,” he said. “That's why we call ourselves Grand Rounds. It's a little bit of a wink and a nod to the doctors.”

Hospitals, too, see value in extending their brand and reach.

The Hospital for Special Surgery (HSS) in New York has been working with Grand Rounds for more than a year. The partnership is part of an overall focus on making care more convenient for patients, including through new digital health tools.

About 15 surgeons across its service lines have piloted the technology and the hospital is now more broadly expanding the program. “Their platform really fits in with our brand,” said Justin Oppenheimer, vice president at HSS. “In today's world of healthcare, it's forever important to bring care as close as possible to the patient.”

Dr. Michael Cross, a hip and knee surgeon at HSS, has seen more than 20 patients through Grand Rounds since he began working with the company several months ago. Patients might be seeking a second opinion on having a knee replacement or may be facing a complicated revision after a previous surgery.

“People want to come to HSS, but don't want to fly out to New York,” Cross said. He estimated that he disagrees with the original treatment plan in more than a third of cases. About a quarter of patients ultimately transfer their care to HSS, he said. “It's a smaller number, but it's still a real number.”