As competition in the prison-health field increased, COO Ted Willich expanded MDI's business to include a web-based health data warehouse and analytics service. [Photo-illustration: Ryan Ketterman]

The evolution of Ponte Vedra Beach-based MDI Holdings mirrors the fast-changing complexities of the nation's healthcare system. Founded in 1992 in California as a provider of billing services for physicians by Ted Willich, his father Richard Willich, and a group of investors, MDI was struggling within three years of its creation. Then, a jail captain in Colorado confided to one of the investors that he was having difficulty providing healthcare services for his inmates beyond those supplied by the jail's in-house physician.

Ultimately, Willich and his father, who serve as COO and CEO, respectively, built a provider network tailored to the needs of both inmates and outside healthcare providers. MDI's timing couldn't have been better. Around the same time, the Federal Bureau of Prisons adopted a similar approach to inmate healthcare, and for five years, MDI had very little competition and accumulated a wealth of contracts. "We were just knocking it out of the park," says Willich.

In 2003, the firm moved to north Florida to take advantage of the area's workforce and the proximity of prominent healthcare players like Blue Cross Blue Shield of Florida, Aetna, Humana, Baptist, Shands and Mayo Clinic.

But as competitors crowded into the prison-health field, Willich, 45, realized MDI needed a new line of business. Drawing on its expertise in customizing networks for prisons, the firm in 2008 began building provider networks for self-insured entities like hospitals. Hospitals typically use their own physicians as providers, but not every hospital has staff physicians in specialty areas like pediatrics or obstetrics, for example. MDI fills in the gaps by contracting with outside pediatricians and obstetricians — and managing co-payments and deductibles so the outside providers don't get stuck with a lot of bad debt.

The next year, MDI shifted further, positioning itself on the cutting-edge of the healthcare evolution. Capitalizing on the IT platform it created to handle its corrections work, MDI rolled out a web-based health data warehouse and analytics service called Viewpoint that helps employers reduce costs, manage risks and anticipate their healthcare needs.

The number-crunching system works by extracting data from disparate sources for individual employees, ranging from health insurance claims to prescription databases, employer eligibility files, lab test results and health risk assessments. Then, the information is translated into a consistent format and loaded into MDI's proprietary database. The client data — which customers access through a secure web connection — is housed at MDI's headquarters, which is built to withstand a Category 5 hurricane and equipped with generators that can provide energy for up to 10 continuous days. Once assembled, that data can be used for everything from monitoring disease and managing care to benchmarking and predictive modeling.

One component of the analytics program is a graphic tool called E.A.R.L., which allows users to display a specific patient's medical history (including diagnoses, claims and pharmacy information) in an animated presentation featuring a rotating human body and a timeline that runs across the screen. Different colors identify the severity of affected organs, bones and other body parts, allowing users to hone in visually on high-risk situations.

Case managers can use the Viewpoint analytics to monitor high-risk, high-cost patients with chronic diseases such as diabetes. A search engine flags those who fail to get their insulin prescriptions refilled or don't make prescribed doctor visits, and case managers can intervene to get the patients back on track before they become ill and require costly hospitalization.

Client data is stored in MDI's headquarters, which was made to withstand a Category 5 hurricane. [Photo: MDI]

Companies also can use the algorithms in MDI's software to analyze demographic information and claims data in order to forecast trends and flag high-risk situations. Employers end up with a better gauge of their employees' potential demand for healthcare services so that they can either budget for it or negotiate appropriate contracts with their insurers.

While MDI's prison-health segment continues to thrive, the company's new business lines are growing fast. MDI is the primary data analytics provider for Wells Fargo Insurance Services and competes directly with the largest nationally recognized analytics company in the nation, Boston-based Verisk Analytics. Other customers include First Coast Advantage, the Medicaid managed care program run by UF Shands, the Community Health Network of Central Florida and Parrish Medical Center. Evangelical Community Hospital in Lewisburg, Pa., recently hired MDI to set up its customer provider network and implement a healthcare analytics system.

The growth has boosted MDI's revenue to around $100 million in 2009 and its workforce to 170.

MDI is also finding applications for its products among healthcare providers who've adopted the "medical home" approach to healthcare delivery. The medical home is a team-based model of care in which one provider or organization — the patient's primary care doctor, for example — oversees and coordinates all physicians involved in a patient's care and ensures that the patient follows treatment regimens. "We did it with UF Shands and also an accountable care organization in South Carolina — we built a medical home for all the patients into our analytics. Then you can measure outcomes of the patients that are with that particular home," says Willich. "You can't manage what you don't measure."

Willich envisions even more possibilities for healthcare analytics, as analytical tools are integrated with electronic health records and language processing technologies, which enable computers to "read" medical records and apply what they have read to completing a task — for example, applying appropriate medical billing codes to records after reading them.

The combination of tools, he says, will enable "a wider proliferation of customized treatment simulations moving from not only emergency, oncology or other specialized care to a wider array of disciplines. It will be best-treatment practices for the specific individual and not just for a specific disease."