ERinfo for Rare Diseases

There are more than 150 million emergency department visits and over 35 million medical 911 calls per year in the US. Patients suffering from Rare Diseases (RD) may arrive at the emergency department with many life-threatening symptoms . Diagnostic delay experienced by patients with rare diseases is common and often caused by unawareness of rare diseases among physicians. Rare diseases are not actually rare, as they collectively affect around 25–30 million people in the United States (US) alone and more than 300 million people worldwide.

While there are medical ID products in the marketplace today to help identify RD patients during emergencies, they are rarely used.  Less than 3% of the patients that need medical IDs use them.  Furthermore, all existing medical ID technologies require that the patient be compliant and either carry a device or have their medical ID present time of the emergency.
Access to a preferred medical facility can help ensure equitable continuity of care in managing rare diseases, including adequate diagnostics and priority management strategies for emergencies.

Hospital charges for all rare diseases in the U.S. totaled $768 billion in 2016. For individuals, the direct health care cost can reach millions of dollars per year for certain rare diseases, with cost drivers including hospitalizations, emergency room visits, medications, and caregiver support.  Earlier intervention improve overall patient outcomes and reduce costs.

ERinfo's patented cloud-based platform provides anywhere, anytime patient identification, life-saving medical information, and access to emergency contacts.  It can be used by medical first responders and emergency departments to identify unconscious, non-communicative and low-medical literacy persons during medical emergencies, mass casualty and natural disaster events.  ERinfo provides real-time access to a patient's identification, their pre-existing medical conditions including rare disease information, medications, allergies, primary care provider, primary care facility, important documents, and emergency contacts.

Subscribers enroll online and provide ERinfo with their picture and as much medical information as they want.  Just as with conventional analogue medical IDs, all information provided by subscribers is opt-in.
During an emergency, medical first responders use their mobile device (cell phone, tablet, or laptop) to take a picture of the patient.  Using artificial intelligence driven facial recognition, a match is looked for in ERinfo’s member database.  If found, a patient’s vital information is returned to the provider in real time.   ERinfo also has the capability of dialing or sending text notifications to a patient’s emergency contacts.

ERinfo is FirstNet Certified®. FirstNet® is America's public safety communications platform designed with and for public safety and first responders. Built with AT&T, in public-private partnership with the First Responder Network Authority, FirstNet® is bringing public safety a much-needed technology upgrade to help them connect to the critical information they need – every day and in every emergency.

After thorough inspection by FirstNet, ERinfo demonstrated:

- It is directly relevant to first responders
- Its code and binary are highly secure with a high degree of data protection
- It has a history of being at least four 9’s available (99.99%)
- It is resilient and scalable in cases of failure and peak demand

ERinfo also has multiple layers of security and abuse prevention built in. For example, every time a match is returned by ERinfo, the patient, the medical first responder, and the medical first responder's organization are notified.  ERinfo monitors use on a provider-by-provider basis and has safeguards to prevent consumer app abuse as well.

To reach medically vulnerable communities and underserved populations (MVCUPs) such as elderly or low-income patients with rare diseases, ERinfo allows medical first responders to enroll those patients at no-cost to the patient. 

ERinfo serves medically vulnerable communities and underserved populations (MVCUPs) and the population at large as it acts as a medical information proxy when a patient cannot articulate their information accurately, or on their own.  The need for real time access to important medical information during emergencies is universal. There are specific groups of people that stand to benefit from ERinfo during medical emergencies.  These include:

• ~25-30M people that the NIH estimates suffer from one of 7,000 rare diseases,
• ~29M people with Diabetes (Type 1 & Type 2)
• ~15M people with food, drug, or animal allergies
• ~5M people suffering from Alzheimer's
• ~3M people living with Epilepsy

Cost and patient compliance issues have created restrictions preventing wider adoption of medical IDs amongst underserved populations.  ERinfo encourages Medical first responders to subscribe their regularly contacted patients (high-utilizers) at no cost.  Finally, there is medical ID technology that can be delivered to underserved populations cost effectively on a broad scale, reducing a source of medical inequity.  ERinfo can have dramatic impact on these persons’ lives during emergencies.  These populations include:

• ~87M people on Medicaid
• 30M+ uninsured (disproportionately Black and Hispanic)
• 1.4M At-risk veterans
• Refugees
• No ID population

ERinfo has a very experienced team that has years of expertise in all the critical areas needed to drive the success of the business: medicine, technology, finance, and product commercialization.

One co-founder is an experienced physician and EMT, having worked in dozens of emergency rooms across the country. Another co-founder is an experienced CTO with over 25 years of software development experience.  One of our key team members is a firefighter/EMT who also has a Masters in Public Health, and our Board of Advisors consists of some of the most prominent paramedicine researchers in the field.

We work with the world renown Gordon Center at the University of Miami's Miller School of Medicine to help further our understanding of our critical stakeholders so that we continue to build a product that will return the most value to them. 

Patient identification and efficient emergency care is extremely important to the individual members of our team. For example, our CFO, whose son suffers from a rare disease, is extremely close to the problem we are trying to solve. We leveraged these multidisciplinary experiences to develop and iterate ERinfo to be the best emergency care value-add platform in the medical ID marketplace.

Recently, ERinfo was used in an academic study involving paramedics. The results of this study are extremely promising. Fire department chiefs are requesting the immediate deployment of ERinfo into their departments.  Over the next 3 months we hope to deploy ERinfo to more than 1500 firefighter/paramedics, with the possibility of deploying ERinfo to more than 5000 south Florida medical first responders by year end.  As part of this deployment, we expect the firefighter/paramedics to not only enroll themselves and their families, but also to enroll at least 5 high-utilizing, underserved patients within the first month of using ERinfo.

This rapid growth will challenge us financially.  ERinfo will use 100% of any prize money to support these programs which specifically targets firefighter paramedics and their MVCUPs in south Florida.

Medical IDs have been available on a broad basis for over 60 years.  Without exception, all the existing products require on-going involvement of the patient.  Until now, not only do patients need to enroll themselves, but they must carry or be near the medical ID, whether it’s a piece of jewelry, ID card, or cellphone-based app. With ERinfo, there is nothing to wear or carry, no phone or jewelry needed, no equipment or installation, and ERinfo works anywhere, anytime.  ERinfo also makes it easy to enroll an entire family.

ERinfo is disruptive as in an emergency, paramedics and other medical first responders can gain real-time access to patients’ critical medical information without any involvement from the patient.

We believe that ERinfo is not only disruptive to the medical ID marketplace but will be catalytic amongst medical first responders by enabling even broader positive impacts that will affect the patient emergency care journey. For example, with the information ERinfo provides, medical first responders are equipped to make better field assessments, transportation decisions and reduce errors from unknown contraindications.

We endeavor to serve medically vulnerable communities and underserved populations (MVCUPs), including RD patients. To accomplish this over the next year, we are currently partnering with fire departments, emergency medical service (EMS) providers, and university graduate programs to conduct grassroots initiatives that penetrate MVCUPs in South Florida. Our goal for the next five years is to ultimately expand our scope. To accomplish this, we will continue to work with our partners at fire departments, EMS, health insurance companies, and university graduate programs around the country. 

Our most important success indicator is growth, and we intend to use aggregate statistical feedback from our member database to track our progress. Specifically, we will track enrollments per month per community, utilization by participating emergency medical service providers, percentage of successful matches, and member demographics. Growth is the most critical indicator here because as we scale, network effects from using our platform will scale as well. 

To solve the issues that people with rare diseases experience with during emergencies, our inputs are: the ERinfo application as well as fire department, EMS provider, university, and insurance partners to support members in the database. 

The processes required for a solution include: inputting people with rare diseases into the database, training EMS providers, distribution of educational and marketing material, and monitoring the results of all processes. 

The outputs should be: a larger proportion of successful matches, an overrepresentation of medically vulnerable communities and underserved populations (MVCUPs) in the database, greater penetration in communities, a reduction in contraindicated interventions and medical errors for successful matches, and reduced costs. 

The overall impact would be: a reduction in the disproportionate negative outcomes experienced by MVCUPs and better overall patient care during emergencies and in pre-hospital settings. 

ERinfo’s core patent is for “a system and method for a participant to securely store select preexisting medical and other information which is then available in real time to emergency workers using a (mobile) software application that uses facial recognition to match a presenting image of a casualty with a master image of the participant to provide their identity. Once identified, pre-existing medical and demographic information may be transmitted to emergency responders to better care for the casualty in an emergency situation.”

To build a globally scalable solution, we implemented our system using cloud technologies commercially available from Amazon Web Services (AWS).  We fully exploit the latest of those offerings and have built ERinfo using infrastructure-as-code and run as a serverless application.  ERinfo leverages AWS’s Rekognition machine learning facial recognition engine.  Rekognition is widely used in public safety applications and AWS publishes best practices for its use.  Further, all AWS services used by ERinfo are HIPAA compliant. 

ERinfoPRO, the iOS, Android, and browser based clients used by emergency medical services professionals, are built using a hybrid framework, allowing us to present nearly identical user experiences regardless of the device being used in the field. The consumer interface, ERinfo, used to enroll and maintain consumer information is browser based, and operates across all popular browser types and both desktop and mobile devices.

We approach diversity, equity and inclusion from every angle at ERinfo.  From a corporate standpoint, ERinfo is committed to promoting an equitable and inclusive working environment.  We lead by example. At the very top of our organization, our co-founder is a female engineer and doctor who understands the advantages of working with a diverse team. 

Additionally, the most senior members of the ERinfo team are made up from a diverse group of individuals from marginalized communities – African American, Indian, Hispanic, and veterans. Together, we make ERinfo’ s value proposition stronger.  

From a consumer perspective, ERinfo also has an extremely critical social mission. Aside from its capacity to serve as the most innovative medical alert for millions of patients living with chronic conditions, our team is committed to assisting populations who need help navigating the complex mess that is our healthcare system.

RD populations are one of many who face barriers that are preventing them from receiving equitable care.  Many factors contribute to worse health outcomes, leading to more hospitalizations, greater use of emergency care, overall poorer health status, and higher mortality rates.  

At ERinfo, we are proud to have created a platform that closes the gap; RD patients don’t have to worry because once they are in the system, their information is easily accessible anywhere by EMS providers.   Additionally, they don’t have to worry about affording, wearing, or losing expensive medical alert jewelry.  Early patient identification and proper triage of RD patients makes all the difference. 

ERinfo’s business model is an annual subscription model with the ultimate benefit of reducing medical expenses and improving medical outcomes. ERinfo has two primary customer groups:   

1. Consumers through partnership with their health insurers, colleges and universities, pharmacies and other affiliate groups.   
2. Emergency medical professionals  

The main revenue source for ERinfo will be annual subscription fees paid by health insurers, colleges and universities, and pharmacies on behalf of their members/students/customers.  The benefit of ERinfo providing a platform is that ERinfo allows people to prepare for and be helped/advocated for during medical emergencies - especially when they cannot speak for themselves. All of these stakeholders simultaneously benefit from ERinfo because it drives individual engagement with their programs, improves health outcomes of their clients, and reduces costs. Overall, this revenue stream is highly scalable; the typical insurance company covers millions of members so revenue of only a few dollars per member per year can generate tens of millions of dollars of annual recurring revenue for ERinfo.   

The secondary source of revenue is driven by annual fees from first responder agencies from value-added services.  Basic access to ERinfo is provided at no cost to emergency medical professionals and they are encouraged to enroll frequent users of emergency care and underserved populations, free of charge, which helps their workflow in the field.  

The revenue opportunity comes from the value-added services requested by the first responder community after they had exposure to ERinfo. One example is that we have been asked by first responders that patient information available from ERinfo be automatically transferred into their EMS charting system.  With integration, using ERinfo will become the first step upon arriving on scene for a medical emergency. This saves first responders’ time, eliminates input errors, and can improve billing practices.  This value-added service would be billed to public service agencies via a user or annual department fee for public safety organizations.   

Lastly, once at scale, the data ERinfo may provide additional revenue streams for market research, clinical trial recruiting, and other potential commercial uses for large data sets. 

ERinfo's initial funding has been provided by founders and several other strategic investors including ANTLER, a global early-stage VC comprised of experienced entrepreneurs, retail investors, and company builders that enable and invest in the world’s most exceptional people.  In the next round of funding, ERinfo will primarily reach larger fund investors and grants/research opportunities.  

Our Series 'A' round is targeted at investors represented by family offices and Series 'A' funding firms.  Additionally, we are targeting grant/research opportunities from RD organizations like the Cystic Fibrosis Foundation to help solve problems within their ecosystem.  For example, the information provided by ERinfo can help increase the likelihood that patients will receive the appropriate continuity of care from providers who are experienced as opposed to a standard ER physician.  

As ERinfo scales, revenue from subscription sales will be the primary source of revenue.  However, ERinfo is truly a global opportunity that can be expanded to countries like Canada, Britain, the EU, and Scandinavia. Additional financing will be needed for global expansion. 

We plan to achieve initial financial sustainability in the near-term from its Series A funding; longer-term financial sustainability will be achieved from the revenue generated by its services.  Our team is currently demonstrating its viability and business model by concentrating its efforts in the South Florida market.   We have embarked on a multi-faceted approach: 

ERinfo has partnered with the fire-rescue departments of Coral Gables, Hialeah, Miami, and Monroe County to start using ERinfo in the field.  This represents over 1000 fire-rescue personnel and 70 trucks.  Through a cooperative effort, the fire-rescue personnel are enrolling high utilizers of emergency services, their personal friends and family into ERinfo.   

We are working closely with the University of Miami Medical School and Gordon Center for academic credibility.  These efforts are focused on research to show the useability of ERinfo in emergency settings as well as retrospective research of emergency department data to determine ROI from prehospital identification and access to patient’s critical medical information.  

Our team is working with various organizations to perform community outreach to enroll people from the underserved populations into ERinfo.  This includes booths at community fairs, health fairs, and other community support organizations.  This will take place throughout the summer.    

We are leveraging relationships with the University of Miami to offer enrollment to all students of the University.  The fire-rescue department of Coral Gables views this as a key initiative as the University is a key part of the community that regularly utilizes its services and would benefit from student enrollment (especially those with pre-existing conditions) in ERinfo. 

Our team is leveraging contacts in the government to follow-up on the recently published study by the VA that demonstrated veterans who needed emergency care and were rushed by ambulance to a VA hospital versus a non-VA hospital in the community had lower mortality rates. Their survival rates were at least 20% better at the one-month mark for those taken to a VA hospital – and this includes vets with RDs.  Based on this study, we are proposing a pilot program with the Miami VA to enroll all its veterans in ERinfo to help facilitate transport to a VA hospital in emergencies. 

At the same time, we have started serious conversations with health insurers and other organizations to facilitate the sales process of providing ERinfo to their customers.