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Stanford Report, May 10, 2000

Stanford launches start-up to improve information access for physicians  


Stanford has been sending scholars out the door for more than 100 years. But on May 9th, the University's newest graduate was sporting not a PhD or an MBA, but a new set of letters -- dot com. Based on a highly successful internal service known as SHINE, e-SKOLAR will allow clinicians across the country to perform the integrated searches of multiple medical reference sources that have been popular with Stanford physicians for years. Participating physicians will also have the opportunity to earn continuing medical education credits through their use of the system.

"e-SKOLAR has provided us with a great opportunity to respond to the needs of physicians worldwide," said Eugene Bauer, MD, vice president of Stanford University Medical Center and dean of the School of Medicine. "We believe the service will significantly raise the bar of medical practice by bringing rapid knowledge to the point of care."

"e-SKOLAR's knowledge service provider model gives us the chance to realize the true potential of the Web -- to link knowledge users and knowledge creators in a mediated system that extends the University from a training resource to a sustaining resource," said Paul Lippe, CEO of e-SKOLAR. "Addressing important challenges, such as improving medical care, by leveraging the Web, can do good while creating a very good business."

The launch of e-SKOLAR, Stanford University's first Internet spin-off, represents an extension of the University's core mission -- to promote knowledge and enhance learning. The School of Medicine will be actively supporting e-SKOLAR with a combination of technology transfer, ongoing content collaboration and oversight.

e-SKOLAR's fast, cross-referenced searches of textbooks, medical journals, drug databases and clinical guidelines, coupled with the opportunity for physicians to learn and earn CME credit online will form the basis of a unique Internet-based service known as Stanford SKOLAR, M.D.

"Stanford SKOLAR, M.D. represents a new category of integrated knowledge environment for medical professionals," said Phyllis Gardner, MD, senior associate dean for education and student affairs at the School of Medicine. "It combines the immediacy and reach of the Web with the depth and commitment to quality of an academic medical center."

Stanford SKOLAR, M.D. evolved out of the Stanford Health Information Network for Education, or SHINE. Over the last four years, SHINE was developed by Ken Melmon, MD, associate dean for postgraduate medical education, in collaboration with an interdisciplinary team of faculty members and students from the schools of computer science and medicine.

SKOLAR, M.D. has become an essential resource for Stanford physicians seeking to stay abreast of the exponentially increasing amount of medical information available in textbooks, journal articles, drug databases and updated clinical guidelines. By entering an unstructured query, a clinician can pull up disease or symptom information ranging from basic definitions to drug dosage schedules for patients with complicating factors such as pregnancy or a secondary illness. Stanford physicians currently use the service to supplement their clinical decision-making.

"We have found that Stanford clinicians are actually using the system in the presence of their patients, indicating a very high degree of confidence in the information and how it is presented," Melmon said. "We have also found that clinicians who leave Stanford continue to request access to the service. Once physicians have experienced having this level of information at their fingertips, they are unwilling to accept less."

With the formation of e-SKOLAR, the service will no longer be restricted to the Stanford community. Any physician or medical group can subscribe to Stanford SKOLAR, M.D. for an annual fee of $240 per user. e-SKOLAR's first distribution partner will be Agilent Technologies, Inc. (a subsidiary of Hewlett-Packard), which will incorporate SKOLAR in a new generation of Internet-enabled medical product devices.

The widespread demand for real-time access to clinically relevant information was confirmed by a recent survey by the consulting firm McKinsey & Co. In the study, 74 percent of physicians surveyed described Stanford SKOLAR, M.D. as "very useful" and more than 50 percent indicated they would use the service at least once a day.

A March 2000 report by the Institute of Medicine highlighted the need for access to accurate, timely information at the point of care to improve both the safety and quality of health care in America. The report emphasized the important role to be played by electronic databases with integrated interfaces in knowledge acquisition.

Not only does e-SKOLAR give physicians the information they need when they need it -- allowing them to make informed decisions and better serve their patients -- e-SKOLAR's unique structure also allows them to learn while using the system. This integrated approach mirrors Stanford's commitment to improving medical care and promoting education.

"By providing point-of-practice responses to physicians' information needs, Stanford SKOLAR, M.D. reintegrates doing and learning, and validates that lifelong learning and professional practice are integrally related," said Gardner.

e-SKOLAR was formally launched yesterday during the 2000 e-Health Summit, which took place on the Stanford campus, May 8th and 9th. Titled "Health in the Digital Age," the summit served as a forum for the discussion of the impact of digital information and Internet-based technology on health care in the 21st century.

The School of Medicine chose to launch e-SKOLAR as a company because it recognized that for the system to achieve its full potential benefit to users in the health care system overall, it would need to grow rapidly, requiring the flexibility and speed of a new business structure. While the type of support the University is providing to e-SKOLAR is a first, the University has taken an equity interest in other companies developed from technology created at Stanford.

e-SKOLAR currently boasts a 17-member team. Among them is Lippe, who joined e-SKOLAR as CEO from a post of senior vice president of business and market development at Synopsys; Ken Melmon, MD, who will serve as chief medical officer; Jonny Goldman, vice president of research and development; Rose Vasquez, MD, MBA, vice president of medical affairs; and Sue Sweeney, vice president of sales & marketing. SR