Physicians Ancillary Systems CEO Carl Tyler spoke with MetroHartford Alliance Content Manager Nan Price about his cutting-edge healthcare services company.

NAN PRICE: There’s an interesting backstory about how you came up with the business concept.

CARL TYLER: Back in 2007, I started losing my balance a dozen times a day. I visited my doctor, Dr. Ralph LaGuardia, who was afraid I might have some neurological problems, so he ordered an ambulatory EEG with video. The video component with the brainwaves tells the doctor if there’s a physical manifestation related to a neurological disorder.

I did some research to find out what the test involved. I couldn’t find a hospital or neurologist in Connecticut that could deliver it. I finally found a technologist who was registered in the service and a company willing to lend the machine. It was a horrible experience. Fortunately, my test results were negative. When I reviewed the explanation of benefits from my insurance company, I couldn’t believe how much they had spent! I thought: For that kind of money, there must be a better way bring value to providers.

I knew there was a barrier to the service, a shortage of technologists, and a shortage of equipment. And, I knew there was a niche market. The idea of creating a company that could deliver this service on demand for neurologists and hospitals just made sense.

I talked with Dr. LaGuardia, who agreed to be the medical director. We met weekly for six months and he came up with a service and a company. We launched Physicians Ancillary Services in January 2008.

NAN: What background do you have to start this type of business? Do you have any startup or entrepreneurial experience?

CARL: Almost none. I had started several other businesses but not in the medical field. That’s why I knew I had to bring in an actual physician. Dr. LaGuardia specializes in internal medicine, bariatrics, and geriatrics. He’s been in private practice in Connecticut for more than 25 years.

NAN: Let’s talk innovation.

CARL: In terms of innovation, we were the first company to provide fully monitored, hospital-grade sleep studies remotely from a patient’s home. It was a completely innovative approach. The patients we were monitoring were in their own beds, going to sleep at their own bedtimes. We leveraged technology so a registered technologist could monitor patients through the night, disconnect the monitoring device in the morning, and deliver the data to ear, nose, and throat doctors that day, versus waiting for a sleep lab’s results. In effect, we were able to do better for the patient with a higher clinical value and a lower cost and leverage technology along the way.

NAN: How your business evolved?

CARL TYLER: We grew our outsourced sleep apnea monitoring service for neurologists for more than 10 years, became a national provider, and sold the business to a leading EEG company in California in 2019.

Essentially, the business has evolved by leaving “Services” and sleep apnea studies for neurologists and, in mid-2019, morphing into Physicians Ancillary Systems, applying the same business model and providing outsourced enhanced Holter monitoring for doctors treating patients with cardiac issues.

The reason is, I saw changes and opportunities coming in technology that could enable us to provide better service monitoring patients from home full time. I was about a year ahead of the industry. That’s exactly where they’re going in 2020.

NAN: What makes your Holter monitoring system unique?

CARL: The concept of Holter monitoring is not new; what is new is recording for 72 hours versus the typical 24-hour monitoring. This way, the device captures more data and provides a better service for the patient and the physician. It also benefits the insurance industry by not charging more than what’s necessary to get the diagnostic results needed. We were the first company that filed for a patent on this type of monitoring device.

Our full-vector monitoring device is small and light, making it easy for the patient. It’s different than using a typical patch, which is very convenient for the patient, but it only captures one vector of the heart. Because it’s full vector, our device captures data from all five vectors of the heart. We like to say, “The more you see, the more you know.”

Is it ever preferable to make any decision—in this case, a critical diagnosis—based upon minimal information? Wouldn’t the likelihood of a better outcome be realized by inclusion of all pertinent information in the decision-making process?

Our system delivers more information to physicians more quickly than they are likely to do in-house.

NAN: So, your clientele is physicians, not patients?

CARL: Right. It’s physicians and practices. The advantage is, they don’t have to purchase any equipment or sign any contracts. The fee to PAS covers data collection, report preparation, free consumables, and free replacement of damaged or lost equipment.

We’ve created a way to better serve patients and physicians with higher clinical value at a lower cost, while leveraging technology along the way. We’ve taken what we learned from our neurology-focused experience and applied it to our new cardiac-focused service to deliver the most beneficial services for everyone. All the advances we’ve made are in line with our mission to deliver the best diagnostic value to physicians for their patients.

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