Each step in the career of Ashwini Zenooz is less comfortable than the last. She started as a radiologist, moved to toil over government medical records, and then took a leading health care role at the cloud technology company Salesforce. Now she is joining a California startup called Commure, hoping to agitate for the change that has eluded her.
“We have been working fast and furious for the past few years to try to solve some of the pain points” in health care, Zenooz said at the STAT Health Tech Summit, where she announced her new role. “We’re seeing such great innovation, but no one is connecting all the dots and thinking about the experience of the end user.”
That is the raison d’être of Commure, the company she’ll help lead as president and chief medical officer to build a new, standardized framework for compiling and sharing health data to better serve patients.
The San Francisco company was conceived and launched in early 2020 by the venture capital firm General Catalyst, which needed a data platform to serve a growing portfolio of digital health companies such as the health insurer Oscar and Livongo, a digital provider of chronic disease care acquired by Teladoc.
Forced to build their own technology ecosystems, these companies threatened to add to the disjointed jumble of electronic health record (EHR) products used by hospitals and other bricks-and-mortar providers.
“The bottom line is you need a fundamentally new infrastructure that sits next to the EHR, which was built for different purposes — running billing and compliance,” said Hemant Taneja, a managing partner at General Catalyst who founded Commure. “We started by working with health systems that were sort of living this pain.”
He met Zenooz for a casual cup of coffee last year and came away convinced that she was the right medical leader for the company. “She’s one of the rare people who’s been in the belly of the beast on both sides” of health care, Taneja said, referring to her work to modernize health records within the U.S. Department of Veterans Affairs and build novel products at Salesforce. “What was clear to me was that we were very like-minded.”
Zenooz said her desire to change health care technology was driven by personal experience. A decade ago she left her job as a radiologist to care for her mother, who had ovarian cancer.
Even as a health care professional, she found herself unable to navigate the system. At 2 a.m. one morning, her mother’s tongue turned black from a medication she was taking. Zenooz wanted to send a picture to her provider or do a quick video call to make sure it didn’t require urgent attention.
“They said, ‘No, you have to bring her in,’” Zenooz recalled. “I just remember carrying this 79-pound woman into the emergency room and thinking: This should not happen.”
The health care system, she said, was perfectly capable of serving patients with technology, but was simply not motivated to do so. It was content to rely on fax machines and CDs to transfer patient records, and to force patients to search for the best care in the dark.
“The limitation is not the technology,” she said. “It’s the incentives, the reimbursements, the regulations. We need to focus on people.”
How Commure will bring about that change is a work in progress. Starting several years before its official launch, a team of engineers, now numbering around 150, began building a software platform based on the standard known as FHIR to help providers build applications to serve their patients.
The goal is to help customers create products in a common technology language, so that information and insights can be harnessed across different tools to establish seamless service for patients. Zenooz said the company has been working with clinical leaders from its beginning and intends to serve both digital health clients and traditional health care entities.
“We’re working on an open platform,” she said. “We want to work toward connecting all the dots and I see the opportunity here to make this happen.”