Audacious Inquiry celebrated its 15th birthday this past month. This moment offered an opportunity to reflect on where we have been, those who have helped shape us, and the impact we strive to make moving forward.  It also offered a chance to consider all that has changed, but importantly, those things that have remained the same.

Our earliest work in connected care was in support of a vision laid out by a dynamic entrepreneur named John Erickson.  John is the founder of Erickson Retirement Communities, and among the many innovations in senior living which he pursued, he wanted a more connected care experience for his residents.

In the mid 2000’s, John and his technology leader at Erickson, David Horrocks (now the CEO of CRISP), placed trust in the young and ambitious team at Ai (all 4 of us!) to find and help implement solutions to electronically move clinical records between Erickson’s PCP offices and a local hospital.  It was a successful project that motivated John, David, and the Ai team to push harder for broader solutions beyond those that impacted residents living within an Erickson community.

As John and leaders from Maryland’s health systems convened and agreed to advance the cause of securely sharing clinical information, Ai was in the fortunate position to lead the planning activities that ultimately evolved into CRISP.  We owe a great deal to John’s vision and David’s faith in us.

The Ai team at the signing of House Bill 706 which established key elements of Maryland HIE regulatory landscape and set the stage for CRISP’s emergence as the statewide HIE.

In those earliest days of our HIE experience, we leaned heavily on the experience of others.  In fact, after Googling “Health Information Exchange” in early 2007, I quickly scheduled learning visits with some of the top search results; Micky Tripathi at the Massachusetts eHealth Collaborative and Greg Farnum (now a leader at Ai) at Vermont Information Technology Leaders (coincidentally, Greg introduced us to his technology partner, Bill Howard, who is now also a leader at Ai).

We learned much from our colleagues around the country and relied on those lessons as we helped execute Maryland’s HIE efforts through CRISP; an organization we are still proud to serve.

In our early days we were fortunate to be called on by Claudia Williams (now CEO of Manifest MedEx) from the Office of the National Coordinator (ONC) to provide guidance to the HIE program through targeted monthly issue briefs.  This was the beginning of a long and on-going partnership with ONC that has allowed us to understand connected care and policy making through the federal lens.

Our lessons from on the ground HIE work also paved the way to support other health information exchange organizations, state governments, and health systems who were defining their own interoperability roadmaps.

In 2012, we became deeply familiar with a fundamental care coordination gap; primary care doctors rarely were notified when one of their patients had an ED visit or were hospitalized.  At that time, in partnership with CRISP, we developed the first version of the Encounter Notification Service® (ENS®), an event-driven care coordination system that provides real-time updates to participating organizations. The service has since proven to reduce readmissions, improve care outcomes, and lower costs.

In 2015 we celebrated the milestone of ENS distributing 10 million alerts per month. Today ENS distributes over 33 million alerts per month.

In the following years, we have evolved ENS into a broader platform and developed numerous other software solutions now deployed extensively throughout the country.

Ai has surely evolved in the above ways and many more; it has been an exhilarating journey so far.  But the most compelling aspect of Ai is all that has remained the same.  Ai has always treated our customers as partners; thinking about their interest before our own.  More often than not, our partners have done the same in return, creating a powerful dynamic.  While we give all we have to our partners, we have also been intentional about learning from each and every one of them.

Perhaps most important of all, we have remained a family of colleagues that cares deeply for one another.  Our team lives out a daily commitment to our work with a keen understanding of its impact.  We share a bond of a common pursuit to use our collective experience and will to be change agents for good.  In a very simple way, I am thankful each day to be around my colleagues and to work on solving hard problems together.

Our value system at Ai defines us; not because of a mantra we recite, but because our teammates live our values out each day and because our colleagues joined Ai since they shared similar values.  We value commitment, hard work, a diversity of our people and therefore our ideas, we value curiosity.  But perhaps the most defining aspect of our value system is a basic question we ask when confronted with a difficult issue that may not appear to have an obvious answer; what is the right thing to do?  It may seem like an overly simplistic or non-specific question, but it offers remarkable clarity and a gravitational pull back to those most central values at Ai.

We have created something truly special and unique at Ai.  I am grateful for having been part of it so far and eager for our continued journey ahead!


Scott Afzal HeadshotScott Afzal
President | Audacious Inquiry