Listening to doctors and patients talk

When Zaccary Newsham-Quinn, 4, visits his pediatrician in Levittown, the doctor, Nathan Zankman, asks if he would be willing to have their conversation recorded for use in medical research.

Zaccary's mother, Danielle, agrees, and signs a consent form, and the doctor turns on a small digital recorder that captures every word between the physician and patient behind the examining-room door.

Later, Zankman sends the recording via computer, along with others he made that day, to a Fort Washington start-up technology company, Verilogue Inc.

Verilogue has software that analyzes the real-time patient-physician interactions, compiles a verbatim transcript, and puts the recording and transcript in a database that Verilogue clients in the health-care industry will use to learn what doctors and patients actually say to each other about diseases and medicines.

These exchanges are kept confidential and anonymous, with the names, ages and any identifying information, even a location and city, removed to meet strict federal privacy standards, in a law known as HIPAA, governing personal health information.

Capturing real physician-patient interactions is new to pharmaceutical market research. The idea came from Verilogue's two young founders, Jeff Kozloff and Jamison Barnett, both 31, who had worked in pharmaceutical market research, and who saw a need to go beyond traditional recall methods, such as focus groups and interviews based on memory after the fact.

"The idea is, by increasing access to information where it's truly happening, at the point of practice, you are increasing knowledge, and will be able to come up with better support and communication materials for physicians and patients because they shared their experience," said Kozloff, Verilogue's president and chief executive officer.

Verilogue has been up and running since late 2006, and has nine large pharmaceutical clients and a network of participating physicians nationwide.

The company maintains a database of thousands of patient-physician conversations, which are scrubbed of names and other identifying information.

Doctors record their interactions with patients during two days each month, and are paid what Verilogue said is a nominal fee for their time.

Last year, Verilogue had revenue of between $1 million and $5 million. In December, the firm was named "technology start-up company of the year" by the Wayne-based Eastern Technology Council.

Verilogue recently raised its first venture capital, $4 million, from Edison Venture Fund in Lawrenceville, N.J.

"This is unique. No one is doing it in quite this way yet," said Carolyn Choh Fleming, a professor of pharmaceutical marketing at St. Joseph's University. "That doesn't mean there won't be fast followers, when something is a good idea and profitable. But being the first to market with the idea is a big plus."

Zankman, a pediatrician for 44 years in Levittown, said he received a fax in October from Verilogue about the technology and thought it sounded "interesting, fascinating, really."

"I do it a couple days a month. I choose the days," the physician said. In the three months since he began recording patient visits, Zankman said he has concentrated on four medical conditions, chosen by Verilogue. They are fairly common pediatric ailments: allergic rhinitis, asthma, persistent asthma in a child less than 4 years, and attention-deficit hyperactivity disorder.

Because the patients are children, their parents must give consent, and Zankman said so far he has not been turned down.

When Zankman asked Danielle Newsham, 29, if she would be willing for Zaccary's office appointment to be audio-recorded and used for research by companies, she quickly said yes.

"We're here quite frequently. I look at it as helping medical research," said Newsham, a single mom who lives in West Bristol and owns a daycare center.

Zaccary has persistent asthma and several other medical issues, she said. "I'm a firm believer in science and technology. If companies could learn something from conversations about my son's condition, maybe it could help someone else."

Verilogue's technology allows pharmaceutical and biotech firms to hear first-hand from customers, get a glimpse of the patient's state of mind, progression of disease, and what is said about the company's medications - or a competitor's drug.

"It's marketing 101," said Kozloff, a graduate of the Wharton School. "Listen to your customers, in their natural environment, without any outside influences."

Verilogue says a growing number of health-care companies are buying the information, including major pharmaceutical firms. "We don't share specific names," Kozloff said. "You could throw a dart and probably guess who they are."

To attract physicians, the company sent e-mails and faxes, targeting specialty doctors, such as oncologists and psychiatrists who are paid for their time. The company said the fee is similar to stipends paid to medical investigators in other clinical research.

John Martinson, founder and managing partner of Edison Venture Fund and a Verilogue board member, said the company has about a dozen clients and several hundred physicians participating across the country.

"We've not seen anything at all like this," he said. "They use fairly straightforward recording technology, but very sophisticated analysis of that."

Barnett, Verilogue's vice president, said the real patient-physician conversations are often "eye opening" in what they are not about. They sometimes don't discuss the patient's condition at all, but rather talk about family, or about sleeping habits. Sometimes a product, or a medicine, isn't even mentioned.

Verilogue's customers pay for access to the information on the Web.

The company said its eventual goal is to make the data available to the broader health-care industry - and to the physicians and patients who participate.

"We are not the next Google, but we are revolutionizing our own segment in the industry," Kozloff said. "The physician-patient conversation behind closed doors is the epicenter. The long-term value of what we are doing has tremendous upside potential for everyone in the health-care continuum."